Dryness is an important concept in the theory of traditional Chinese medicine， which is closely related to the transformation of the body， etiology and pathogenesis. As one of the medicinal properties of Chinese materia medica， there are various types of Chinese materia medica with dryness. Atractylodis Rhizoma（AR） is a representative medicine with warm and dry properties， which has the function of drying dampness and strengthening the spleen. Due to its strong dryness， it can cause certain adverse reactions. In clinical practice， stir-fried AR with bran is often used as medicine. The dryness of AR is closely related to its efficacy， but the underlying mechanism of the relationship between dryness and efficacy is still unclear. At present， the research on dryness Chinese materia medica has been increasing year by year， but there are still problems such as insufficient systematic research， insufficient in-depth research and lack of research on the mechanism of dryness effect， which limit the breakthrough of the theory of processing for slowing down dryness， and hinder the precise application of dryness Chinese materia medica in clinical practice. Therefore， this article comprehensively reviewed the differences in dryness characterization indicators of different Chinese materia medica by searching domestic and foreign literature， focusing on the relevant research on dryness of AR. A systematic summary and induction were made from the characterization indicators， research techniques of dryness markers， the influence of processing on dryness of AR， and the application mining of dryness of AR. The results showed that the dryness characteristics of AR mainly included the upregulation of macroscopic indicators such as water intake， urine output and whole blood viscosity， as well as energy metabolism indicators， the downregulation of water metabolism indicators， and pathological changes such as submandibular gland acinar atrophy. Based on the changes of dryness and component content of AR after processing， it is determined that the main dryness components of AR may be volatile components such as β-eudesmol and atractylon. Due to its dryness， AR is mainly used to treat diseases such as spleen deficiency， rheumatism and edema. However， the current understanding of the correlation between dryness and efficacy of AR is still insufficient， and there are still many bottlenecks in understanding and explaining its dryness. In the future， systematic evaluation and characterization should be carried out to find the common mechanism of AR exerting dryness and efficacy， providing reference for the rational clinical use.

[Objective] To investigate the functional differences and potential effects of chromatin spatial structure in patients with normal karyotype and complex karyotype multiple myeloma. [Methods] High-throughput chromosome conformational capture (Hi-C) analysis was performed on plasma cells of 1 case with 1q21 complex karyotype and 1 case with normal karyotype multiple myeloma, and the differences in three-dimensional genome structure between the two patients were analyzed, and the transcriptome characteristics of plasma cells were combined to investigate the differential features through gene functional enrichment. [Results] A/B switch occurred in 36% of the chromatin compartments in two cases, and 1 041 genes in patient with complex karyotype had B/A switch. About 3 500 topological association domains (TADs) were identified in each sample, and there was no significant difference. The number of loops identified in complex karyotype sample was 1 069, which was 1/6 of the normal sample, and there were significant differences in the number of three different types of loops, which to some extent reflected the loss of genome stability. Transcriptome analysis showed significant differences in expression profiles between the two patients, and a total of 6 150 differentially expressed genes (3 303 up-regulated genes and 2 847 down-regulated genes) were identified. [Conclusion] Compared with patient with normal karyotype, patient with 1q21 complex karyotype multiple myeloma exhibit significant changes in the spatial structure of plasma cell chromatin at different levels, which leads to changes in gene expression and activation of pathways related to cancer progression.

The theory of "supplementation/drainage for bitter-desire of the five viscera" originated from Elementary Questions （《素问》）， which is an important origin of the theory of supplementation and drainage prescription. By exploring the connotation of the theory of "supplementation/drainage for bitter-desire of the five viscera"， and adopting the archaeological method of literature research， we collected the relevant writings on the theory of "supplementation/drainage for bitter-desire of the five viscera" by the representative physicians of Yishui school， such as ZHANG Yuansu， LI Gao， WANG Haogu， LUO Tianyi， LI Zhongzi， etc.， combed through the inheritance and development of this theory， and explored the contribution of Yishui school on this. It was found that all the physicians of Yishui school， on the basis of inheriting the theory of "supplementation/drainage for bitter-desire of the five viscera"， combined with their own clinical practice to develop this theory， and promoted the application and development of this theory in clinic， such as ZHANG Yuansu's theories of cold-heat deficiency-excess in viscera and bowels， and the theory of viscera and bowels prescription， and LI Gao's theory of ascending and descending， floating and sinking， supplementing and draining in visceral qi， and other academic thoughts rooted in the theory of "supplementation/drainage for bitter-desire of the five viscera" of Elementary Questions. By clarifying the inheritance and development of this theory by physicians of Yishui school， we can deeply understand the connotation and the embedded rules of prescription of this theory， which can not only guide the clinical medication in traditional Chinese medicine， but also provide reference value to the research on the academic thoughts of the Yishui school and the theory of fsupplementation/drainage for bitter-desire of the five viscera.

BACKGROUND:At present,the biological functions and molecular changes of bone marrow mesenchymal stem cells in the tumor microenvironment of acute myeloid leukemia are still unclear. OBJECTIVE:To explore the changes in the biological function of bone marrow mesenchymal stem cells in acute myeloid leukemia and the role of acute myeloid leukemia conditioned medium by bioinformatics and experiment. METHODS:Differential genes were screened from GEO data sets,and enrichment analysis was performed.The protein-protein interaction network was constructed and the Hub gene was obtained.Bone marrow mesenchymal stem cells from patients with acute myeloid leukemia and healthy donors were cultured.Bone marrow mesenchymal stem cells from healthy donors were treated with acute myeloid leukemia conditioned culture solution.Each group was subjected to the adipogenic differentiation,osteogenic differentiation,staining of β-galactosidase,detection of the cell cycle,and validation of Hub genes. RESULTS AND CONCLUSION:(1)Gene expression data of bone marrow mesenchymal stem cells from acute myeloid leukemia patients and healthy donors were obtained from GSE84881,and 184 up-regulated genes and 140 down-regulated genes were screened.(2)The biological functions of enrichment mainly include cell cycle,adipocyte differentiation,cell metabolism,and MYC pathway.According to the Degree algorithm,10 up-regulated Hub genes and 10 down-regulated Hub genes were selected.(3)The cell in vitro experiment found that:compared with the control group,the surface antigen of acute myeloid leukemia mesenchymal stem cells did not change,but it showed enhanced lipid differentiation ability,weakened osteogenic differentiation ability,increased β-galactosidase positive cell number,altered cell morphology,arrested cell cycle,increased LGALS3 expression,and decreased MYC expression.Mesenchymal stem cells from healthy donors showed similar changes after being cultured in acute myeloid leukemia conditioned medium.(4)The results show that biological function of mesenchymal stem cells is altered in the acute myeloid leukemia microenvironment,which provides new insights into the interaction between mesenchymal stem cells and tumor cells.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Simmering method is one of the traditional processing methods of Chinese materia medica， which has been documented in the herbal literature and medical books of the past dynasties and has a great variety， but at present， there are not many specific varieties of Chinese materia medica involved， and there are few related researches. By reviewing the ancient and modern related information， the authors have organized and analyzed the historical evolution， processing purpose， modern representative Chinese materia medica（processing technology， quality evaluation， pharmacological research） of simmering method. After sorting out， it was found that the simmering method was widely used in ancient times， which was first seen in Huashi Zhongzangjing of the Eastern Han dynasty， and was enriched and developed through the Tang， Song， Jin， Yuan， Ming and Qing dynasties， and entered its heyday in Ming and Qing dynasties along with the economic prosperity and development of the Ming dynasty， involving as many as 159 varieties of Chinese materia medica， and gradually perfecting the processing theory of the simmering method. However， the number of varieties that still use the simmering method in modern times significantly decreased. The main purposes of using simmering method in modern Chinese materia medica are to reduce adverse reactions， moderate medicinal properties， enhance therapeutic effects， remove non-medicinal parts， and facilitate further processing， etc. This paper combed the key information of simmering methods for Chinese materia medica from ancient to modern times， which can provide a literature basis for the clinical application and modern research of simmered products of Chinese materia medica.

Objective:To evaluate the effects of electroacupuncture (EA) on the learning and memory function of offspring rats exposed to sevoflurane in late-pregnancy.Methods:Thirty-two SPF healthy Sprague-Dawley pregnant rats at gestational day 18, weighing 260-280 g, were assigned to 4 groups ( n=8 each) using a random number table method: control group (C group), sevoflurane group (Sev group), EA group and sham EA group (SEA group). Sev, SEA and EA groups inhaled 2.5% sevoflurane in 50% oxygen for 6 h. In EA group, Shenting, Baihui, bilateral Quchi, and bilateral Zusanli points were stimulated with an electric stimulator (disperse-dense waves, frequency 2/6 Hz, intensity 1 mA, 20 min per day for 7 consecutive days) starting on postnatal day 21, EA was performed again for 7 days after an interval of 1 day, and the EA treatment lasted for a total of 14 days. Moriss water maze test was performed at 36 days of age to detect the spatial learning and memory function. The offspring rats were sacrificed on postnatal day 42, and the hippocampal tissues were removed for calculation of the dendritic spine density of neurons (after Golgi staining) and for determination of the apoptosis rate (using flow cytometry) and the expression of the two primary forms of brain-derived neurotrophic factor (BDNF), mature (mBDNF) and pro (proBDNF), mBDNF/proBDNF ratio, tropomyosin receptor kinase B (TrkB) and p75 neurotrophin receptor (p75NTR) (by Western blot). The mBDNF/proBDNF ratio was calculated. Results:Compared with C group, the escape latency was significantly prolonged, the time of staying at the target platform quadrant was shortened, the frequency of crossing the original platform was reduced, the dendritic spine density of hippocampal neurons and mBDNF/proBDNF ratio were decreased, the expression of TrkB was down-regulated, and the expression of p75NTR was up-regulated in Sev groups ( P<0.05). Compared with the offspring rats of Sev and SEA groups, the escape latency was significantly shortened, the time of staying at the target platform quadrant was prolonged, the frequency of crossing the original platform was increased, the dendritic spine density of hippocampal neurons and mBDNF/proBDNF ratio were increased, the expression of TrkB was up-regulated, and the expression of p75NTR was down-regulated in the offspring rats of EA group ( P<0.05), and no significant change was found in the aforementioned parameters in the offspring rats of SEA group ( P>0.05). There was no significant difference in the apoptosis rate of hippocampal neurons among the offspring rats of the four groups ( P>0.05). Conclusions:EA can improve the learning and memory function of offspring rats exposed to sevoflurane in late-pregnancy, and the mechanism may be related to promoting the conversion of proBDNF to mBDNF and improving neuronal development.

Objective:To explore the application of Tongdu Tiaoshen acupuncture in patients with hemiplegia after stroke.Methods:Randomized controlled trial. A total of 70 patients who met the inclusion criteria for post-stroke hemiplegia in our hospital from January 2020 to December 2021 were divided into two groups, with 35 cases in each group, according to the random number table. The control group was given conventional treatment combined with rehabilitation exercise therapy, and the observation group was given Tongdu Tiaoshen acupuncture on the basis of the above, and both groups were treated continuously for 1 month. Compare of the two groups Fugl-Meyer Assessment (FMA), Modified Ashworth Scale (MAS), National Institutes of Health Stroke Scale (NIHSS), Activity of Daily Living (ADL) score; Brunnstrom stage method was used to assess the patient's motor ability, and Holden walking function grade was used to assess the patient's walking ability. The activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time(TT), and serum fibrinogen (FIB), D-dimer (D-D), plasminogen activator inhibitor 1 (PAI-1) levels were observed by ELISA. Adverse events were recorded and clinical efficacy was evaluated.Results:The total effective rates of the observation group and the control group were 97.14% (34/35) and 77.14% (27/35), respectively, and the difference between the two groups was statistically significant ( χ2=6.25, P=0.012). After treatment, the scores of FMA and ADL in the observation group were significantly higher than those in the control group ( t values were 9.23 and 9.54, respectively, P<0.01), the MAS and NIHSS scores were significantly lower than those in the control group ( t values were 10.23 and 11.97, respectively, P<0.01). After treatment, the distribution of patients in Brunnstrom stage Ⅴ and Ⅵand Holden functional walking stage Ⅳ and Ⅴ in the observation group was significantly higher than those in the control group ( χ2 values were 11.96 and 11.27, respectively, P<0.05). After treatment, APTT, PT and TT in the observation group were significantly longer than those in the control group ( t values were 10.37, 13.57 and 6.54, respectively, P<0.01); serum FIB, D-D and PAI-1 levels were significantly lower than those in the control group ( t values were 12.85, 11.94 and 27.39, respectively, P<0.01). No adverse reactions occurred in both groups. Conclusion:The treatment of post-stroke hemiplegia with Tongdu Tiaoshen acupuncture can improve the effect of clinical treatment and the ability of daily life, neurological function, limb function, movement and walking ability, and stabilize the clotting state.

ObjectiveTo study the differences in volatile oil content of bran-processed Atractylodes lancea and its standard decoction concentrate and freeze-dried powder， as well as the differences in the types and contents of chemical components in volatile oil， and to clarify the quality value transmitting. MethodTen batches of A. lancea rhizoma were collected and prepared into raw products and bran-processed products of A. lancea， standard decoction concentrate and freeze-dried powder of bran-processed A. lancea in order to extract the volatile oil， and the transfer rate of volatile oil in each sample was calculated. Quantitative analysis of the main chemical components（β-eudesmol， atractylon， atractylodin） in each volatile oil was performed by gas chromatography（GC） on the HP-5 quartz capillary column（0.32 mm×30 m， 0.25 μm） with a flame ionization detector（FID）， a split ratio of 10∶1 and a temperature program（initial temperature at 80 ℃， hold for 1 min， rise to 150 ℃ at 10 ℃·min^-1， hold for 10 min， rise to 155 ℃ at 0.5 ℃·min^-1， hold for 5 min， rise to 240 ℃ at 8.5 ℃·min^-1， hold for 8 min）. Cluster analysis and principal component analysis（PCA） were used to explore the overall differences in types and contents of chemical components between the standard decoction concentrate and freeze-dried powder. ResultThe transfer rates of volatile oil in the bran-processed products， standard decoction concentrate and freeze-dried powder were 70.51%， 1.57% and 40.90%， respectively. The average transfer rates of β-eudesmol， atractylon and atractylodin in the volatile oil of bran-processed A. lancea were 58.45%， 48.49% and 55.64%， respectively. In the standard decoction concentrate， only β-eudesmol and atractylodin were detected， and their average transfer rates were 0.22% and 0.10%， respectively. And only β-eudesmol was detected in the freeze-dried powder with the average transfer rate of 8.37%. The results of cluster analysis and PCA showed that there are obvious differences in the types and contents of chemical components between the standard decoction concentrate and freeze-dried powder. ConclusionThe quality value transmitting between bran-processed A. lancea and its standard decoction concentrate and freeze-dried powder is stable， and if the freeze-dried powder is selected as the reference material of dispensing granules， appropriate amount of volatile oil should be added back to make it consistent with the quality of the standard decoction concentrate.

Traditionally, Tripterygium hypoglaucum (Levl.) Hutch (THH) are widely used in Chinese folk to treat rheumatoid arthritis (RA). This study aimed to investigate whether the anti-RA effect of THH is related with the gut microbiota. The main components of prepared THH extract were identified by HPLC-MS. C57BL/6 mice with adjuvant-induced arthritis (AIA) were treated with THH extract by gavage for one month. THH extract significantly alleviated swollen ankle, joint cavity exudation, and articular cartilage destruction in AIA mice. The mRNA and protein levels of inflammatory mediators in muscles and plasma indicated that THH extract attenuated inflammatory responses in the joint by blocking TLR4/MyD88/MAPK signaling pathways. THH extract remarkably restored the dysbiosis of the gut microbiota in AIA mice, featuring the increases of Bifidobacterium, Akkermansia, and Lactobacillus and the decreases of Butyricimonas, Parabacteroides, and Anaeroplasma. Furthermore, the altered bacteria were closely correlated with physiological indices and drove metabolic changes of the intestinal microbiota. In addition, antibiotic-induced pseudo germ-free mice were employed to verify the role of the intestinal flora. Strikingly, THH treatment failed to ameliorate the arthritis symptoms and signaling pathways in pseudo germ-free mice, which validates the indispensable role of the intestinal flora. For the first time, we demonstrated that THH extract protects joint inflammation by manipulating the intestinal flora and regulating the TLR4/MyD88/MAPK signaling pathway. Therefore, THH extract may serve as a microbial modulator to recover RA in clincial practice.ver RA in clincial practice.
Mice ; Animals ; Gastrointestinal Microbiome ; Tripterygium ; Myeloid Differentiation Factor 88/genetics* ; Toll-Like Receptor 4/genetics* ; Mice, Inbred C57BL ; Arthritis, Experimental/drug therapy*