BACKGROUND: Preclinical studies have indicated that Angong Niuhuang Pills (ANP) reduce cerebral infarct and edema volumes. This study aimed to investigate whether ANP safely reduces cerebral infarct and edema volumes in patients with moderate to severe acute ischemic stroke. METHODS: This randomized, double-blind, placebo-controlled pilot trial included patients with acute ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores ranging from 10 to 20 in 17 centers in China between April 2021 and July 2022. Patients were allocated within 36 h after onset via block randomization to receive ANP or placebo (3 g/day for 5 days). The primary outcomes were changes in cerebral infarct and edema volumes after 14 days of treatment. The primary safety outcome was severe adverse events (SAEs) for 90 days. RESULTS: There were 57 and 60 patients finally included in the ANP and placebo groups, respectively for modified intention-to-treat analysis. The median age was 66.0 years, and the median NIHSS score at baseline was 12.0. The changes in cerebral infarct volume at day 14 were 0.3 mL and 0.4 mL in the ANP and placebo groups, respectively (median difference: -7.1 mL; interquartile range [IQR]: -18.3 to 2.3 mL, P = 0.30). The changes in cerebral edema volume of the ANP and placebo groups on day 14 were 11.4 mL and 4.0 mL, respectively ( median difference: 3.0 mL, IQR: -1.3 to 9.9 mL, P = 0.15). The rates of SAE within 90 days were similar in the ANP (3/57, 5%) and placebo (7/60, 12%) groups ( P = 0.36). Changes in serum mercury and arsenic concentrations were comparable. In patients with large artery atherosclerosis, ANP reduced the cerebral infarct volume at 14 days (median difference: -12.3 mL; IQR: -27.7 to -0.3 mL, P = 0.03). CONCLUSIONS: ANP showed a similar safety profile to placebo and non-significant tendency to reduce cerebral infarct volume in patients with moderate-to-severe stroke. Further studies are warranted to assess the efficacy of ANP in reducing cerebral infarcts and improving clinical prognosis. TRAIL REGISTRATION Clinicaltrials.gov , No. NCT04475328.
Aged ; Female ; Humans ; Male ; Middle Aged ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Ischemic Stroke/drug therapy* ; Pilot Projects ; Stroke/drug therapy* ; Treatment Outcome

Eight compounds were isolated and purified from the ethyl acetate part of 70% acetone extract of Rehmannia glutinosa by various chromatographic techniques such as silica gel, MCI gel CHP-20, ODS, Toyopearl HW-40C, combined with TLC and semi-preparative HPLC. Their structures were elucidated by modern spectroscopy techniques (NMR, MS, UV, IR), and identified as neomartynoside A (1), osmanthuside B₆ (2), martynoside (3), isomartynoside (4), (E)-p-hydroxycinnamic acid (5), caffeic acid (6), ferulic acid (7), and methyl caffeate (8). Compound 1 is a new phenylethanol glycoside, which was identified as neomartynoside A. Compound 2 was isolated from Rehmannia glutinosa for the first time. In addition, compounds 2, 6 and 7 significantly increased relative glucose consumption, showing potential hypoglycemic activity.

The injury of the posterior Angle of the medial meniscus of the knee joint is very common in clinic, and the arthroscopic treatment of the knee joint has been the first choice. However, there are many difficulties in arthroscopic treatment, such as narrow space in the medial posterior corner of the knee joint, insufficient space to deal with the injured meniscus, varion and lateral rotation under 30° flexion, release of the medial collateral ligament of the knee joint, and expansion of the knee joint cavity spinner, all of which could expose and expand the medial space of knee joint. Therefore, it is necessary to master and balance the use to avoid collateral injury. It is also necessary to determine the cause of meniscus injury during arthroscopic treatment, such as degenerative injury, simple meniscus repair and forming can hardly solve the pain of patients. Anterior cross injury is easy to cause instability of the knee joint, which is closely related to the injury of the posterior angle of the medial meniscus of the knee joint. In order to achieve the maximum therapeutic effect, physiological repair should be performed at the same time. There are various types of medial meniscus posterior angle injury, among which the Ramp injury, root fracture and laminae meniscus injury are greatly affected by joint degeneration, narrow knee space or knee stability, and all influencing factors should be fully considered in treatment.
Humans ; Arthroscopy/methods* ; Tibial Meniscus Injuries/surgery* ; Knee Joint/surgery* ; Menisci, Tibial/surgery* ; Knee Injuries/surgery*

Objective To investigate the effect of different residence time of povidone iodine on the disinfection effect of conjunctival sac in senile cataract surgery.Methods A total of 396 senile patients who underwent cataract surgery in our hospital were selected and randomly divided into the long-residence group and the short-residence group,with 198 cases in each group.The patients of the long-residence group and the short-residence group were disinfected with a disposable filling 5%povidone iodine on conjunctival sac for 3 minutes and 30 seconds before surgery,respectively.The bacterial detection and bacterial distribution on conjunctival sac,and corneal epithelial cell damage were compared between the two groups.The subjective comfort conditions such as ocular itching,foreign body sensation,erythema,and photophobia after disinfection were recorded.Results There was no significant difference in the bacterial detection rate before and after disinfection between the two groups(P>0.05).The most frequently detected bacteria in the short-residence group was Staphylococcus epidermidis,accounting for 28.79%and 33.33%before and after disinfection,respectively.The incidences of ocular itching,foreign body sensation,erythema,and photophobia after disinfection in the short-residence group were significantly lower than those in the long-residence group(P<0.05),while the rate of corneal epithelial cell damage in the long-residence group was significantly higher than that in the short-residence group(P<0.05).Conclusion The use of disposable filling 5%povidone iodine for disinfection on conjunctival sac for 30 seconds before surgery can achieve a comparable disinfection effect to disinfection for 3 minutes,which has less effect on corneal epithelial cells,and higher ocular comfort.

Objective To investigate the effect of different residence time of povidone iodine on the disinfection effect of conjunctival sac in senile cataract surgery.Methods A total of 396 senile patients who underwent cataract surgery in our hospital were selected and randomly divided into the long-residence group and the short-residence group,with 198 cases in each group.The patients of the long-residence group and the short-residence group were disinfected with a disposable filling 5%povidone iodine on conjunctival sac for 3 minutes and 30 seconds before surgery,respectively.The bacterial detection and bacterial distribution on conjunctival sac,and corneal epithelial cell damage were compared between the two groups.The subjective comfort conditions such as ocular itching,foreign body sensation,erythema,and photophobia after disinfection were recorded.Results There was no significant difference in the bacterial detection rate before and after disinfection between the two groups(P>0.05).The most frequently detected bacteria in the short-residence group was Staphylococcus epidermidis,accounting for 28.79%and 33.33%before and after disinfection,respectively.The incidences of ocular itching,foreign body sensation,erythema,and photophobia after disinfection in the short-residence group were significantly lower than those in the long-residence group(P<0.05),while the rate of corneal epithelial cell damage in the long-residence group was significantly higher than that in the short-residence group(P<0.05).Conclusion The use of disposable filling 5%povidone iodine for disinfection on conjunctival sac for 30 seconds before surgery can achieve a comparable disinfection effect to disinfection for 3 minutes,which has less effect on corneal epithelial cells,and higher ocular comfort.

Objective:To identify the gene mutation types of 4 suspected β-thalassemia patients in Yunnan Province,and to analyze the genotypes and hematological phenotypes.Methods:Whole genome sequencing was performed on the samples of 4 suspected β-thalassemia patients from the Dai ethnic group in a thalassemia endemic area of Yunnan Province,whose hematological phenotypes were not consistent with the results of common thalassemia gene mutations.The mutations of β-globin gene clusters were confirmed by polymerase chain reaction(PCR)and Sanger DNA sequencing technology.Results:The 3.5 kb deletion in β-globin gene cluster(NC_000011.10:g.5224302-5227791 del3490bp)was detected in 4 patients'samples,of which 1 case was also detected with HbE mutation and 1 case with CD17 mutation.These 2 patients displayed moderate anemia phenotype,while the two patients with only the 3.5 kb deletion presented with other mild anemia phenotype.Conclusion:Heterozygous carriers with rare 3.5 kb deletion of the β-globin gene cluster may develop mild anemia,compound mutations of the 3.5 kb deletion with other mutations may led to intermediate thalasemia with moderate to sever anemia.In areas with a high incidence of thalassemia,suspected patients should undergo genetic testing to avoid missing or misdiagnosing rare mutations.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

The 95% ethanol extract of Poria cocos was separated and purified by ODS, MCI gel CHP20 and silica gel column chromatography combined with the semi-preparative HPLC. The chemical structures of the isolated compounds were identified by NMR, MS, IR, and calculated NMR methods. Seven compounds were isolated from Poria cocos and identified as 20S-2β,3α,15α,19,20-hydroxy-pregnane-7-ene (1), dehydroeburicoic acid monoacetate (2), eburicoic acid acetate (3), dehydroeburicoic acid (4), eburicoic acid (5), dehydropachymic acid (6), pachymic acid (7). Compound 1 is a new pregnane steroid.

Objective To construct a big data sharing platform for clinical scientific research to solve the problems of clinical research in decentralized application systems and data sharing safety.Methods A clinical research information data usage management system was developed through the formulation of management methods in line with the actual situation of the institution,normalized standard data usage processes and a data usage service team.Then a clinical scientific research big data sharing platform including the components for sharing environment construction,research application integration,data desensitization and encryption and file management was established based on the existing hospital systems,the requirements of clinical research data usage management and the habits of clinical researchers.Results The platform realized the balance between open sharing of clinical research data and data security control,which improved the efficiency of clinical researchers while reducing data security risks during data transmission and data analysis.Conclusion The clinical scientific research big data sharing platform meets the needs of clinical scientific research application and data security management,and provides references for the co-construction-sharing of medical big data resources.[Chinese Medical Equipment Journal,2024,45(4):27-31]