OBJECTIVE To establish the fingerprints of Ardisia crenata， Sophora tonkinensis and their couplet medicines， and to determine the contents of five components in them. METHODS Using water as solvent， single lyophilized powder of A. crenata and S. tonkinensis and combined lyophilized powder of their couplet medicines were prepared by combining lyophilization technology. The fingerprints of three lyophilized powder samples were established by using high-performance liquid chromatography （HPLC）， and the contents of 5 kinds of components such as gallic acid were determined simultaneously. RESULTS There were 5， 10 and 14 common peaks in the fingerprints for single lyophilized powder of A. crenata and S. tonkinensis and combined lyophilized powder of their couplet medicines； the similarities of them with the control fingerprints were all greater than 0.90. For combined lyophilized powder of couplet medicines， peak 3 Δ 基金项目 国家重点研发计划项目（No.2018YFC1708100）；贵 州省科技计划项目（No.黔科合基础-ZK〔2022〕一般483，No.黔科合成 was identified as gallic acid， peak 4 as matrine， peak 6 as 果〔2021〕一般137）；贵州省教育厅高等学校科学研究项目（青年项目） oxymatrine， peak 8 as bergenin， and peak 14 as trifolirhizin. In single lyophilized powder of A. crenata， the average contents of gallic acid and bergenin were 0.499 3 and 4.962 6 mg/g， respectively. In single lyophilized powder of S.tonkinensis， the average contents of matrine， oxymatrine and trifolirhizin were 3.046 0， 2.336 6 and 0.278 6 mg/g， respectively. In combined lyophilized powder of couplet medicines， the average contents of gallic acid， matrine， oxymatrine， bergenin and trifolirhizin were 0.560 6， 2.548 7， 1.382 2， 5.960 7 and 0.279 1 mg/g， respectively. The transfer rates were 8.87%-513.19%. CONCLUSIONS The established fingerprint and content determination methods are stable and feasible， and can be used for the quality control of A. crenata and S. tonkinensis and their couplet medicines. The average contents of matrine and oxymatrine in combined lyophilized powder of A. crenata-S. tonkinensis couplet medicines are decreased.

ObjectiveTo evaluate the efficacy and safety of An'erning granules in the treatment of community-acquired pneumonia in children. MethodA randomized， double-blind， single-simulation， placebo-controlled trial was designed in this study. The children were randomly assigned into an observation group （An'erning granules combined with ceftriaxone sodium） and a control group （An'erning granules placebo combined with ceftriaxone sodium） according to the ratio of 2∶1. The disease cure rate was taken as the main indicator of efficacy， and the safety of An'erning granules was observed. ResultA total of 206 children （137 in the observation group and 69 in the control group） were included in this study. Before treatment， the age， sex， body height， body weight， diagnosis time of pneumonia， and symptom and sign scores had no significant differences between the two groups. After 8 days of continuous medication， the observation group［70.80%（97/137）］ had higher cure rate than the control group［56.52%（39/69）］（χ²=4.17，P<0.05） and total effective rate of chest X-ray ［97.98%（97/99）］ than the control group［86.27%（44/51）］ （χ²=12.98，P<0.01）. The observation group was superior to the control group in the alleviation of TCM syndrome under the condition of 0-3 g dose stratification on day 3 of medication （P<0.01）. The recovery time， time to complete fever abatement， time to fever abatement and expectoration alleviation， rate of conversion to severe case， and reduction in the frequency of antibiotic use showed no significant differences between the two groups. In terms of safety， 13 and 7 adverse events occurred in the observation group and control group， respectively， which were relieved or disappeared after drug withdrawal or symptomatic treatment and showed no significant difference between the two groups. ConclusionIntravenous drip of ceftriaxone sodium combined with An'erning granules is effective in the treatment of community-acquired pneumonia in children. It can accelerate the absorption of pulmonary inflammation， alleviate the clinical symptoms in a short time for young children or the children with mild symptoms， and is safe in clinical application.

Objective::Coronavirus disease 2019 (COVID-19) exists as a pandemic. Mortality during hospitalization is multifactorial, and there is urgent need for a risk stratification model to predict in-hospital death among COVID-19 patients. Here we aimed to construct a risk score system for early identification of COVID-19 patients at high probability of dying during in-hospital treatment.Methods::In this retrospective analysis, a total of 821 confirmed COVID-19 patients from 3 centers were assigned to developmental ( n = 411, between January 14, 2020 and February 11, 2020) and validation ( n = 410, between February 14, 2020 and March 13, 2020) groups. Based on demographic, symptomatic, and laboratory variables, a new Coronavirus estimation global (CORE-G) score for prediction of in-hospital death was established from the developmental group, and its performance was then evaluated in the validation group. Results::The CORE-G score consisted of 18 variables (5 demographics, 2 symptoms, and 11 laboratory measurements) with a sum of 69.5 points. Goodness-of-fit tests indicated that the model performed well in the developmental group ( H = 3.210, P = 0.880), and it was well validated in the validation group ( H = 6.948, P= 0.542). The areas under the receiver operating characteristic curves were 0.955 in the developmental group (sensitivity, 94.1%; specificity, 83.4%) and 0.937 in the validation group (sensitivity, 87.2%; specificity, 84.2%). The mortality rate was not significantly different between the developmental ( n = 85,20.7%) and validation ( n = 94, 22.9%, P = 0.608) groups. Conclusions::The CORE-G score provides an estimate of the risk of in-hospital death. This is the first step toward the clinical use of the CORE-G score for predicting outcome in COVID-19 patients.

Objective::Coronavirus disease 2019 (COVID-19) exists as a pandemic. Mortality during hospitalization is multifactorial, and there is urgent need for a risk stratification model to predict in-hospital death among COVID-19 patients. Here we aimed to construct a risk score system for early identification of COVID-19 patients at high probability of dying during in-hospital treatment.Methods::In this retrospective analysis, a total of 821 confirmed COVID-19 patients from 3 centers were assigned to developmental ( n = 411, between January 14, 2020 and February 11, 2020) and validation ( n = 410, between February 14, 2020 and March 13, 2020) groups. Based on demographic, symptomatic, and laboratory variables, a new Coronavirus estimation global (CORE-G) score for prediction of in-hospital death was established from the developmental group, and its performance was then evaluated in the validation group. Results::The CORE-G score consisted of 18 variables (5 demographics, 2 symptoms, and 11 laboratory measurements) with a sum of 69.5 points. Goodness-of-fit tests indicated that the model performed well in the developmental group ( H = 3.210, P = 0.880), and it was well validated in the validation group ( H = 6.948, P= 0.542). The areas under the receiver operating characteristic curves were 0.955 in the developmental group (sensitivity, 94.1%; specificity, 83.4%) and 0.937 in the validation group (sensitivity, 87.2%; specificity, 84.2%). The mortality rate was not significantly different between the developmental ( n = 85,20.7%) and validation ( n = 94, 22.9%, P = 0.608) groups. Conclusions::The CORE-G score provides an estimate of the risk of in-hospital death. This is the first step toward the clinical use of the CORE-G score for predicting outcome in COVID-19 patients.

Objective: To explore the functional connectivity between the visual brain regions and whole brain in children with autism spectrum disorder (ASD) at resting state, and to further analyze the correlation with their clinical manifestations. Methods: The functional magnetic resonance imaging (fMRI) data of 34 boys with ASD enrolled from ASD designated rehabilitation institutions and 29 healthy boys enrolled from several kindergartens in Heilongjiang were collected. Based on the resting-state functional connectivity magnetic resonance imaging (rs-fc MRI) analysis, the BA17 of the primary visual brain region and the BA18/19 of the higher visual brain region were taken as the regions of interest (ROI) to calculate the functional connectivity level between the visual brain regions and whole brain, and the differences between the two groups were compared. Multiple developmental scales were used to evaluate the behavior of ASD children, and Pearson correlation analysis was used to explore the relationship between functional connection strength and autistic behavior. Results: The ASD group had decreased positive connectivity between BA17 and the right fusiform gyrus (FFG), and was negatively correlated with social interaction of ADI-R and the total scores of CARS (r=-0.41, -0.48, P<0.05); ASD group had decreased positive connectivity between BA17 and the left FFG, there was a negative correlation with social motivation of SRS (r=-0.43, P<0.05); ASD group had decreased positive connectivity between BA17 and the left posterior cingulate gyrus (PCG). Children with ASD had decreased positive connectivity between BA18/19 and left calcarine fissure and surrounding cortex (CAL), which was positively correlated with attention conversion of AQ, total scores of CARS (r=0.43, 0.40, P<0.05), and the children with ASD had deceased positive connectivity between BA18/19 and right precuneus (PCUN). Conclusion In resting state, the functional connectivity of primary and higher visual brain regions and whole brain of ASD children is different from that in healthy children, and there is a significant correlation between abnormal level and autistic behaviors.

Objective::Coronavirus disease 2019 (COVID-19) is a global public health crisis. There are no specific antiviral agents for the treatment of SARS-CoV-2. Information regarding the effect of Abidol on in-hospital mortality is scarce. The present study aimed to evaluate the treatment effect of Abidol for patients with COVID-19 before and after propensity score matching (PSM).Methods::This retrospective cohort study analyzed 1019 patients with confirmed COVID-19 in China from December 22, 2019 to March 13, 2020. Patients were divided to Abidol (200 mg, tid, 5-7 days, n = 788, 77.3%) and No-Abidol ( n = 231, 22.7%) groups. The primary outcome was the mortality during hospitalization. Results::Among 1019 COVID-19 patients, the age was (60.4 ± 14.5) years. Abidol-treated patients, compared with No-Abidol-treated patients, had a shorter duration from onset of symptoms to admission, less frequent renal dysfunction, lower white blood cell counts (lymphocytes <0.8) and erythrocyte sending rate, lower interleukin-6, higher platelet counts and plasma IgG and oxygen saturation, and less frequent myocardial injury. The mortality during hospitalization before PSM was 17.9% in Abidol group and 34.6% in No-Abidol (hazard ratio (HR) = 2.610, 95% confident interval (CI): 1.980-3.440), all seen in severe and critical patients. After PSM, the in-hospital death was 13.6% in Abidol and 28.6% in No-Abidol group (HR= 2.728, 95% CI: 1.598-4.659).Conclusions::Abidol-treatment results in less in-hospital death for severe and critical patients with COVID-19. Further randomized study is warranted to confirm the findings from this study.

Objective:To investigate the protective effect and mechanism of hyperbaric oxygen (HBO) on cardiac function in model rats with myocarditis.Methods:A total of 30 specific pathogen free (SPF) male SD rats aged 4~5 weeks were randomly divided into three groups with 10 rats in each group, which were the control group, the model group, and the HBO group. The control group was only given 1 ml/kg normal saline by tail vein injection without any other treatment; the rat models of myocarditis in the model group and the HBO group were established by injecting lipopolysaccharide (LPS) via tail vein; the HBO group was additionally treated with HBO. After 6 days of treatment, echocardiography was obtained by ultrasound imaging system for small animals; and the data of left ventricular ejection fraction (EF), fraction shortening (FS), and maximum ascending and descending rate (+ dP/dt max) were collected. The levels of serum interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), brain natriuretic peptide (BNP), and catalase (CAT) were detected by enzyme-linked immunosorbent assay (ELISA) kit. After euthanasia, the myocardial tissue was taken. Some of them was stained by Hematoxylin and Eosin (HE) for morphological observation; the rest was ground for detecting the expression levels of oxidative stress related factors, including superoxide dismutase (SOD) and malondialdehyde (MDA), by ELISA. Results:The results of echocardiography showed that EF, FS, + dP/dt max, and - dP/dt max in the model group were significantly lower than those in the control group ( P<0.05); after HBO treatment, EF, FS, + dP/dt max, and -dP/dt max in the HBO group were significantly higher than those in the model group ( P<0.05). The results of ELISA showed that IL-6, IL-1 β, TNF-α, and BNP in the model group were significantly higher than those in the control group ( P<0.05); after HBO treatment, IL-6, IL-1β, TNF-α, and BNP in the HBO group were significantly lower than those in the model group ( P<0.05). Under light microscope, there was no focal infiltration of inflammatory cells in the myocardial tissue of the control group. The cardiomyocytes of the model group were arranged disorderly with more inflammatory cell infiltration. And some pink protein mucus could be seen in some blood vessels. In the HBO group, inflammatory cell infiltration was milder than that in the model group. And there were some edematous cardiomyocytes. Compared with the control group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the model group were significantly decreased, while the expression level of MDA in myocardial tissue was significantly increased ( P<0.05). After HBO treatment, compared with the model group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the HBO group were significantly increased, while the expression of MDA in myocardial tissue was significantly decreased ( P<0.05). Conclusion:HBO treatment can improve the cardiac function in model rats with myocarditis by inhibiting the inflammatory response and alleviating oxidative stress damage.

Objective::Coronavirus disease 2019 (COVID-19) is a global public health crisis. There are no specific antiviral agents for the treatment of SARS-CoV-2. Information regarding the effect of Abidol on in-hospital mortality is scarce. The present study aimed to evaluate the treatment effect of Abidol for patients with COVID-19 before and after propensity score matching (PSM).Methods::This retrospective cohort study analyzed 1019 patients with confirmed COVID-19 in China from December 22, 2019 to March 13, 2020. Patients were divided to Abidol (200 mg, tid, 5-7 days, n = 788, 77.3%) and No-Abidol ( n = 231, 22.7%) groups. The primary outcome was the mortality during hospitalization. Results::Among 1019 COVID-19 patients, the age was (60.4 ± 14.5) years. Abidol-treated patients, compared with No-Abidol-treated patients, had a shorter duration from onset of symptoms to admission, less frequent renal dysfunction, lower white blood cell counts (lymphocytes <0.8) and erythrocyte sending rate, lower interleukin-6, higher platelet counts and plasma IgG and oxygen saturation, and less frequent myocardial injury. The mortality during hospitalization before PSM was 17.9% in Abidol group and 34.6% in No-Abidol (hazard ratio (HR) = 2.610, 95% confident interval (CI): 1.980-3.440), all seen in severe and critical patients. After PSM, the in-hospital death was 13.6% in Abidol and 28.6% in No-Abidol group (HR= 2.728, 95% CI: 1.598-4.659).Conclusions::Abidol-treatment results in less in-hospital death for severe and critical patients with COVID-19. Further randomized study is warranted to confirm the findings from this study.

Objective:To investigate the protective effect and mechanism of hyperbaric oxygen (HBO) on cardiac function in model rats with myocarditis.Methods:A total of 30 specific pathogen free (SPF) male SD rats aged 4~5 weeks were randomly divided into three groups with 10 rats in each group, which were the control group, the model group, and the HBO group. The control group was only given 1 ml/kg normal saline by tail vein injection without any other treatment; the rat models of myocarditis in the model group and the HBO group were established by injecting lipopolysaccharide (LPS) via tail vein; the HBO group was additionally treated with HBO. After 6 days of treatment, echocardiography was obtained by ultrasound imaging system for small animals; and the data of left ventricular ejection fraction (EF), fraction shortening (FS), and maximum ascending and descending rate (+ dP/dt max) were collected. The levels of serum interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), brain natriuretic peptide (BNP), and catalase (CAT) were detected by enzyme-linked immunosorbent assay (ELISA) kit. After euthanasia, the myocardial tissue was taken. Some of them was stained by Hematoxylin and Eosin (HE) for morphological observation; the rest was ground for detecting the expression levels of oxidative stress related factors, including superoxide dismutase (SOD) and malondialdehyde (MDA), by ELISA. Results:The results of echocardiography showed that EF, FS, + dP/dt max, and - dP/dt max in the model group were significantly lower than those in the control group ( P<0.05); after HBO treatment, EF, FS, + dP/dt max, and -dP/dt max in the HBO group were significantly higher than those in the model group ( P<0.05). The results of ELISA showed that IL-6, IL-1 β, TNF-α, and BNP in the model group were significantly higher than those in the control group ( P<0.05); after HBO treatment, IL-6, IL-1β, TNF-α, and BNP in the HBO group were significantly lower than those in the model group ( P<0.05). Under light microscope, there was no focal infiltration of inflammatory cells in the myocardial tissue of the control group. The cardiomyocytes of the model group were arranged disorderly with more inflammatory cell infiltration. And some pink protein mucus could be seen in some blood vessels. In the HBO group, inflammatory cell infiltration was milder than that in the model group. And there were some edematous cardiomyocytes. Compared with the control group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the model group were significantly decreased, while the expression level of MDA in myocardial tissue was significantly increased ( P<0.05). After HBO treatment, compared with the model group, the expression levels of SOD in myocardial tissue and CAT protein in the serum of rats with myocarditis in the HBO group were significantly increased, while the expression of MDA in myocardial tissue was significantly decreased ( P<0.05). Conclusion:HBO treatment can improve the cardiac function in model rats with myocarditis by inhibiting the inflammatory response and alleviating oxidative stress damage.

Objective To investigate the distribution of age at onset and its influence on clinical characteristics in synovitis,acne,pustulosis,hyperostosis,and osteitis (SAPHO) syndrome.Methods We recruited 164 patients with SAPHO syndrome who presented to Peking Union Medical College Hospital from Jan 2004 to Mar 2015.All the patients were assessed for medical history,laboratory tests and imaging presentations.The distribution of age at onset was analyzed using Shapiro-Wilknormality test and Kolmogorov-Smimov test for mixed normal distribution.The influence of age at onset on clinical features was analyzed using Mann-Whitney U test and x2 test.Results A double-peak mixed normal distribution of age at onset of skin lesions was found in female patients with SAPHO syndrome,with means and standard deviations of (30±6) years (early-onset) and (51 ±7) years (late-onset) for each mixed normal distribution.The cut-off point was determined to be 42 years old.Nonetheless,a typical single-peak normal distribution of age at onset of skin lesions was observed in male patients.A significantly higher frequency of thoracic region pain [14/36 (38.9％) vs 6/70 (8.6％),x2=14.28,P＜0.01,spinal lesions revealed by bone scintigraphy [23/35 (65.7％) vs 23/66(34.8％),x2=8.79,P=0.003],and peripheral skeletal lesions revealed by bone scintigraphy [17/35 (48.6％) vs 17/66(25.8％),x2=5.33,P=0.021] were found in late-onset female patients compared with early-onset ones.Moreover,female patients with late onset had significantly higher hs-CRP level [(12±12) mg/L vs (9±11) mg/L;U=911.5,P=-0.042)],pain VAS (4.8±1.8 vs 4.0±2.1;U=948,P=0.036),and BASFI (3.0±2.2 vs 1.8±2.0;U=822.5,P=0.003) at baseline than those with early onset.Conclusion Female patients with SAPHO syndrome have a double-peak distribution of age at onset of skin lesions.Female patients with early and late onset of skin lesions exhibit distinct clinical characteristics.