ObjectiveTo investigate the protective effect and mechanism of action of flavonoid combination of Alpiniae Officinarum Rhizoma （A. officinarum） against Helicobacter pylori （H. pylori） gastritis in mice. MethodsAfter acclimatization for one week， 56 SPF-grade healthy C57BL/6J mice were gavaged with mixed antibiotics for three consecutive days. They were randomly divided into a normal group， model group， positive drug group （triple therapy group）， and low- and high-dose groups （100， 200 mg·kg^-1） of flavonoid combination of A. officinarum. The H. pylori gastritis mice model was established by gavage with H. pylori bacterial suspension in each group except for the normal group. After successful modeling， mice were administrated with corresponding drugs once a day for two weeks. Hematoxylin-eosin （HE） staining was used to observe the pathological changes in gastric tissue. Rapid urease test paper was used to detect the positive rate of H. pylori. Silver staining was used to observe the H. pylori adherence on the surface of gastric tissue. Immunohistochemistry was used to detect the protein expression of interleukin-8 （IL）-8 and myeloid differentiation factor （MyD88） in gastric tissue. The serum levels of IL-6， tumor necrosis factor-α （TNF-α）， IL-8， and IL-1β were detected by enzyme-linked immunosorbent assay （ELISA）. The expressions of phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） protein were detected by Western blot. ResultsCompared with those in the normal group， mice in the model group had lower gastric weight coefficients， higher pH of gastric juice， 100% H. pylori infection rate， and significantly changed gastric histopathology. The expressions of IL-8 and MyD88 proteins in the gastric tissue of mice in the model group were significantly elevated， and the serum levels of inflammatory factors IL-6， TNF-α， IL-8， and IL-1β were significantly up-regulated in mice. Compared with that in the model group， the gastric weight coefficient of mice in each treatment group of the flavonoid combinations of A. officinarum was elevated （P<0.01）， and the pH of gastric juice was reduced （P<0.01）. The infection rate of H. pylori was reduced. The expressions of IL-8 and MyD88 proteins in the gastric tissue of mice in the treatment groups were significantly reduced （P<0.01）， and the serum levels of inflammatory factors IL-6， TNF-α， IL-8， and IL-1β were significantly reduced in a dose-dependent manner （P<0.01）. The flavonoid combinations of A. officinarum down-regulated the expression of PI3K and Akt proteins in H. pylori gastritis-infected cells （P<0.01）. ConclusionThe protective effect of flavonoid combinations of A. officinarum against H. pylori gastritis is associated with the inhibition of H. pylori infection rate and regulation of PI3K/Akt signaling pathway， resulting in inhibiting the release of inflammatory factors.

Objective To observe the clinical efficacy of modified Shehuang Ointment(mainly composed of Cnidii Fructus,Phellodendri Chinensis Cortex,and Zanthoxyli Pericarpium)for the treatment of facial seborrheic dermatitis(SD).Methods Seventy-two patients with facial SD were randomly divided into observation group and control group,with 36 patients in each group.Both groups of patients were given oral use of Acrivastine Capsules and Vitamin B6 Tablets,and additionally,the observation group was given topical application of modified Shehuang Ointment and the control group was given topical application of 2%Ketoconazole cream.The course of treatment covered 4 weeks.The changes of clinical symptom scores and dermatology life quality index(DLQI)scores in the two groups were observed before and after treatment,and the clinical efficacy and safety of the two groups were also evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 88.89%(32/36),and that of the control group was 72.22%(26/36).The intergroup comparison showed that the efficacy of the observation group was significantly superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the clinical symptom scores of erythema,scales,grease,rash area,itchiness and other clinical symptoms of the patients in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the clinical symptom scores of the observation group were significantly lower than those of the control group,the differences being statistically significant(P＜0.05).(3)After treatment,the DLQI scores of patients in the two groups were significantly lower than those before treatment(P＜0.05),and the DLQI scores in the observation group were significantly lower than those in the control group after treatment,the difference being statistically significant(P＜0.05).(4)During the treatment period,no significant adverse reactions occurred in the two groups of patients,with high safety.Conclusion The conventional western medicine treatment combined with topical application of modified Shehuang Ointment exerts certain effect in the treatment of facial SD,which can effectively relieve the clinical symptoms and improve the quality of life of patients.

In order to provide basic information for the utilization and development of famous classical formulas containing Bletillae Rhizoma， this article systematically analyzes the historical evolution of the name， origin， harvesting and processing of Bletillae Rhizoma by reviewing the ancient materia medica， prescription books， medical books and modern literature. The research results showed that Baiji（白及） was the main name， some scholars took Baiji（白芨） as its main name， and there were many other names such as Baiji（白给）， Baigen（白根）， Baiji（白苙）. The mainstream source of Bletillae Rhizoma was the tubers of Bletilla striata， and drying， large， white， solid， root-free and skin removed completely were the good quality standards. With the promotion of wild to cultivated medicinal materials， there were certain differences between their traits， and the quality evaluation indexes should be adjusted accordingly. The origin of records in the past dynasties was widely distributed， with Guizhou and Sichuan having high production and good quality in modern times. The harvesting period is mostly in spring and autumn， and harvested in autumn was better. The processing and processing technology is relatively simple， and it was used fresh or powdered in past dynasties， while it is mainly sliced for raw use in modern times. Based on the results， it is suggested that the tubers of Bletilla striata of Orchidaceae should be used in the famous classical formulas， and it should be uniformly written as Baiji（白及）. And if the original formula indicates the requirement of processing， it should be operated according to the requirement， if the requirement of processing is not indicated， it can be used in raw form as medicine.

Objective:To explore the clinical and genetic characteristics of three children with Hyperekplexia.Methods:Three children who were diagnosed with Hyperekplexia at the Third Affiliated Hospital of Zhengzhou University between June 2018 and March 2020 were selected as the study subjects. Clinical data of the three children were collected. All children were subjected to whole exome sequencing. Pathogenicity of candidate variants were verified by Sanger sequencing and bioinformatic analysis.Results:The three children were all males, and had presented exaggerated startle reflexes and generalized stiffness in response to unexpected auditory or tactile stimulation, or had frequent traumatic falls following exaggerated startle. All children had shown positive nose-tapping reflex, though EEG and cranial MRI exams were all negative. Whole exome sequencing revealed that two children had harbored homozygous variants of the GLRB gene, of which the c. 1017_c.1018insAG (p.G340Rfs*14) was unreported previously. The third child had harbored compound heterozygous variants of the GLRA1 gene, among which the c.1262T>A (p.IIe421Asn) variant showed an unreported autosomal recessive inheritance. All children had responded well to clonazepam treatment. Conclusion:Patients with Hyperekplexia have typical clinical manifestations. Early clinical identification and genetic analysis can facilitate their diagnosis.

Objective To screen the anti-Helicobacter pylori gastritis active components of the ethyl acetate extract of Alpinia officinarum Hance.Methods The"knock-out"strategy combined with high-performance liquid chromatography(HPLC)detection was developed to separate the components of the ethyl acetate extract of A.officinarum while obtaining the negative samples without the components.A human gastric epithelial cell(GES-1)model of H.pylori gastritis was established,and the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)and interleukin-1β(IL-1β)in the supernatant of the cells were determined by enzyme-linked immunosorbent assay(ELISA).Results The total flavonoid fraction,the negative fraction without total diphenylheptanoids,the negative fraction without 5-hydroxy-7-(4-hydroxy-3-methoxyphenyl)-1-phenyl-3-heptanone(DHPA),and galangin significantly reduced IL-6 levels in the supernatant of H.pylori infected GES-1 cells at a concentration of 8 μg·mL-1 with 24 h incubation.The total flavonoid fraction strongly inhibited the release of IL-6,TNF-α,IL-8,and IL-1β from H.pylori gastritis GES-1 cells at a concentration of 16 μg·mL-1.Conclusions The total flavonoid fraction is the major anti-H.pylori gastritis active component of the ethyl acetate extract of A.officinarum.The results lay the foundation for further elucidation of the material basis of A.officnarum against H.pylori gastritis.

Objective To compare image quality of 5.0T and 3.0T time of flight MR angiography(TOF-MRA)and displaying choroidal anterior arteries(AChA).Methods Data of 80 patients who underwent head 5.0T(5.0T group,n=40)and/or 3.0T TOF-MRA(3.0T group,n=42)were retrospectively analyzed,among them 2 patients underwent both 5.0T and 3.0T TOF-MRA.The subjective scoring and objective evaluation of image quality were performed,and the results were compared between groups.AChA was divided into proximal,intermediate and distal segments(A1,A2,A3 segment),the quantity of left and right AChA shown on 5.0T and 3.0T TOF-MRA were recorded,and the length and diameter of left and right AChA dispalyed on MRA were comparatively observed.Results The subjective scores of image quality of 5.0T group were higher than that of 3.0T group(5.0[4.0,5.0]vs.5.0[3.0,5.0],Z=6.417,P=0.029).The signal-to-noise ratio(91.01±5.04)and contrast-to-noise ratio(72.47±5.14)of 5.0T group were both larger than those of 3.0T group([62.11±4.16],[48.92±4.62],t=28.339,19.681,both P＜0.001).There were 80 segments of AChA-A1,80 of AChA-A2 and 60 segments of AChA-A3 displayed on 5.0T TOF-MRA,while 60 segments of AChA-A1,36 of AChA-A2 and 12 segments of AChA-A3 displayed on 3.0T TOF-MRA,respectively.In 5.0T group,the length of the left and right AChA was(24.01±7.41)mm and(22.72±9.36)mm,with diameter of(1.16±0.12)mm and(1.19±0.14)mm,respectively,whereas in 3.0T group,the relative values were(18.35±8.67)mm,(16.80±6.94)mm,(0.99±0.25)mm and(0.95±0.29)mm,respectively,all in 5.0T group were greater than in 3.0T group(t=3.242,3.183,4.595,3.846,all P＜0.001).Conclusion Compared with 3.0T TOF-MRA,5.0T TOF-MRA of AChA might provide better image quality and clearer vessel depiction,being helpful to clinical diagnosis and treatment of ACHA-related cerebral vascular diseases.

Objective To observe the value of 5.0T MRI for quantifying proton density fat fraction(PDFF)of liver.Methods Liver chemical shift encoded(CSE)MR scanning were prospectively performed using 5.0T,3.0T and 1.5T scanner in 30 volunteers,respectively,and CSE-PDFF were measured.Then MR spectroscopy(MRS)were performed using 5.0T and 1.5T scanner,respectively,and MRS-PDFF were also measured.The consistency of liver PDFF measured on different images was observed,and the value of 5.0T MRI for liver PDFF was analyzed.Results The overall consistencies of liver CSE-PDFF measured with 5.0T,3.0T and 1.5T MR scanner were all good(all ICC＞0.75,all P＜0.001).The consistency of liver CSE-PDFF based on 5.0T and 3.0T,1.5T MR scanner were both good(ICC=0.989,0.992,both P＜0.001).The overall consistencies of CSE-PDFF based on 5.0T MR and MRS-PDFF based on 5.0T and 1.5T MR were both good(both ICC＞0.75,both P＜0.001).CSE-PDFF had good consistency with MRS-PDFF based on same 5.0T MR scanner(ICC=0.988,P＜0.001),and CSE-PDFF based on 5.0T had good consistency with MRS-PDFF based on 1.5T MR scanner(ICC=0.978,P＜0.001).Conclusion 5.0T MRI had high value for quantifying liver PDFF.

Objective To observe the consistency of 5.0T and 1.5T MR spectroscopy(MRS)for quantitating proton density fat fraction(PDFF)of liver.Methods Lipid emulsion models with lipid content of 0,5％,10％,15％,20％,25％and 30％were prepared.1H-MRS were collected using 5.0T and 1.5T MR scanners,respectively,and PDFF were obtained with jMRUI software.Totally 23 people,including 11 cases of fatty liver and 12 healthy adults were prospectively collected,and volume of interest(VOI)in the liver were selected to acquire 1H-MRS,and PDFF were obtained with jMRUI software and corresponding workstation,respectively.The consistencies of PDFF measured with different methods were analyzed.Results PDFF of lipid emulsion models with lipid content of 0,5％,10％,15％,20％,25％and 30％measured with jMRUI software and workstations based on 5.0T and 1.5T 1H-MRS all had good consistencies and being positively correlated,so were PDFF of liver tissue measured with jMRUI software and workstations based on 5.0T and 1.5T 1H-MRS.Conclusion 5.0T and 1.5T 1H-MRS had good consistency for quantitating liver PDFF.Measuring liver PDFF with workstation in clinical practice was helpful to simplifying workflow.

Objective To compare image quality of 3.0T and 5.0T MR cholangiopancreatography(MRCP).Methods Eighteen patients with bile duct dilation(bile duct dilation group)and 7 healthy volunteers(healthy group)were prospectively enrolled.MRCP was performed with 3.0T and 5.0T scanners,respectively,and the ability for displaying details of bile duct tree,signal-to-noise ratio(SNR)and image artifacts were compared between 3.0T and 5.0T MRCP.Results In bile duct dilation group,the number of branches,total branch length and the maximum branch length of bile duct tree on 5.0T MRCP were all greater than those on 3.0T MRCP(all P＜0.05).In healthy group,the number of branches and total branch length of bile duct tree on 5.0T MRCP were both greater than those on 3.0T MRCP(both P＜0.05).In both groups,the SNR of 5.0T MRCP was greater than that of 3.0T MRCP,but the difference was not significant(both P＞0.05).No significant difference of image artifacts was found between 3.0T and 5.0T MRCP(P=0.054).Conclusion 5.0T MRCP might display better anatomical details of bile duct tree than 3.0T MRCP,with SNR and image artifacts comparable to 3.0T MRCP.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.