Traditional Chinese Medicine (TCM), as a treasure of the Chinese nation, plays a significant role in maintaining public health. In 2019, the Central Committee of the Communist Party of China and the State Council proposed for the first time the establishment of a TCM registration and evaluation evidence system that integrates TCM theory, "personal experience" and clinical trials (referred to as the "Three-in-One" System) to promote the inheritance and innovation of TCM. Subsequently, the National Medical Products Administration issued several guiding principles to advance the improvement and implementation of this system. Owing to the complexity of its implementation, there are still differing understandings within the TCM industry regarding the positioning of the "Three-in-One" Registration and Evaluation Evidence System, as well as the connotation and value orientation of the "personal experience." To address this, Academician WANG Qi, President of the TCM Association, China International Exchange and Promotion Association for Medical and Healthcare and TCM master, led a group of academicians, TCM masters, TCM pharmacology experts and clinical TCM experts to convene a "Seminar on Promoting the Implementation of the ′Three-in-One′ Registration and Evaluation Evidence System for Chinese Medicinals." Through extensive discussions, an expert consensus was formed, clarifying the different roles of the TCM theory, "personal experience" and clinical trials within the system. It was further emphasized that the "personal experience" is the core of this system, and its data should be derived from clinical practice scenarios. In the future, the improvement of this system will require collaborative efforts across multiple fields to promote the high-quality development of the Chinese medicinal industry.

OBJECTIVE: Anemoside B4 (AB4), the most abundant triterpenoidal saponin isolated from Pulsatilla chinensis, inhibited influenza virus FM1 or Klebsiella pneumoniae-induced pneumonia. However, the anti-SARS-CoV-2 effect of AB4 has not been unraveled. Therefore, this study aimed to determine the antiviral activity and potential mechanism of AB4 in inhibiting human coronavirus SARS-CoV-2 in vivo and in vitro. METHODS: The cytotoxicity of AB4 was evaluated using the Cell Counting Kit-8 (CCK8) assay. SARS-CoV-2 infected HEK293T, HPAEpiC, and Vero E6 cells were used for in vitro assays. The antiviral effect of AB4 in vivo was evaluated by SARS-CoV-2-infected hACE2-IRES-luc transgenic mouse model. Furthermore, label-free quantitative proteomics and bioinformatic analysis were performed to explore the potential antiviral mechanism of action of AB4. Type I IFN signaling-associated proteins were assessed using Western blotting or immumohistochemical staining. RESULTS: The data showed that AB4 reduced the propagation of SARS-CoV-2 along with the decreased Nucleocapsid protein (N), Spike protein (S), and 3C-like protease (3CLpro) in HEK293T cells. In vivo antiviral activity data revealed that AB4 inhibited viral replication and relieved pneumonia in a SARS-CoV-2 infected mouse model. We further disclosed that the antiviral activity of AB4 was associated with the enhanced interferon (IFN)-β response via the activation of retinoic acid-inducible gene I (RIG-1) like receptor (RLP) pathways. Additionally, label-free quantitative proteomic analyses discovered that 17 proteins were significantly altered by AB4 in the SARS-CoV-2 coronavirus infections cells. These proteins mainly clustered in RNA metabolism. CONCLUSION Our results indicated that AB4 inhibited SARS-CoV-2 replication through the RLR pathways and moderated the RNA metabolism, suggesting that it would be a potential lead compound for the development of anti-SARS-CoV-2 drugs.

BACKGROUND:Some patients with cervical spondylosis have not been fully corrected sagittal position balance after cervical surgery,and this continuous sagittal position imbalance may be an important reason for the poor long-term clinical outcome of patients. OBJECTIVE:To analyze the correlation between the cervical sagittal position balance parameters and their changes and the clinical efficacy of patients in the unbalanced state after anterior cervical decompression and fusion and to explore the necessity of surgical correction of sagittal balance in order to improve the clinical effect in the later stage. METHODS:A retrospective analysis was performed on 125 patients with cervical spondylosis who underwent anterior cervical decompression and fusion in the Department of Spinal Surgery of Affiliated Hospital of Southwest Medical University from July 2019 to July 2022.Follow-up patients had good postoperative recovery(neck disability index score less than 10%one week after surgery)and had complete follow-up data.According to the axial vertical distance(C2-7 SVA)in sagittal position one week after surgery,patients were divided into type I imbalance group(C2-7 SVA loss≤5 mm,n=27),type Ⅱ imbalance group(C2-7 SVA loss>5 mm,and≤10 mm,n=19),and type Ⅲ imbalance group(C2-7 SVA loss>10 mm,n=12),and non-unbalanced group(C2-7 SVA in the normal range,n=67).The changes of visual analog scale score and neck disability index were compared among groups postoperatively and the last follow-up,as well as the changes of imaging sagittal balance parameters C2-7 cobb angle,C2-7 SVA value,neck inclination angle,T1 inclination angle,and thoracic entrance angle.The correlation between the late clinical effect and postoperative cervical sagittal disequilibrium was explored. RESULTS AND CONCLUSION:(1)There was no statistical difference in general data among the four groups(P>0.05).All patients underwent successful surgery without serious complications and postoperative wound infection.The follow-up time was more than 1 year.(2)There was no significant difference in preoperative symptom score and clinical efficacy one week after surgery(P>0.05).At the last follow-up,pain visual analog scale score,neck disability index and C2-7 SVA were lower than those before surgery but higher than those one week after surgery(P<0.05).C2-7 cobb angle was increased compared with those before operation(P<0.05).T1 inclination angle was decreased compared with those before operation(P<0.05).(3)Pearson correlation test showed that the change of neck disability index was positively correlated with the change of C2-7 SVA(P<0.05).(4)It is indicated that anterior cervical decompression and fusion is effective in the treatment of cervical spondylosis,and can effectively relieve the symptoms of patients.Patients with more severe cervical sagittal disequilibrium after surgery had worse curative effect in the later period.Continuous sagittal disequilibrium in patients with cervical spondylosis after surgery is an important cause of poor curative effect in the later stage.Clinicians should pay more attention to the correction of cervical sagittal balance before and during surgery,formulate surgical strategies and plans according to sagittal balance parameters before surgery,and correct C2-7 SVA intraoperatively to the normal range.

Objective To explore the risk factors for the prognosis of interventional treatment of multiple pelvic fractures with bleeding.Methods A total of 82 patients with multiple pelvic fractures with bleeding were selected.All patients underwent interventional treatment and were divided into a death group(n=9)and a survival group(n=73)based on their treatment prognosis.The data of the two groups were reviewed and the complications,abbreviated injury scale(AIS),Glasgow prognostic score(GPS),and injury severity score(ISS)between the two groups were compared,and multivariate logistic regression was used to explore the influencing factors of patients prognosis.Results Eighty-two patients with multiple pelvic fractures with bleeding had 9 deaths after interventional treatment,with a mortality rate of 10.98％.The univariate results showed that there were statistical differences in the mortality rate of patients with multiple pelvic fractures with bleeding after interventional treatment,as well as the time to hospital after injury,combined trauma,blood transfusion,and surgical time(P＜0.05).The total incidence of respiratory failure,shock and infection in the death group(44.44％)were higher than those in the survival group(15.07％)(P＜0.05).The AIS,ISS,and acute physiology and chronic health evaluationⅡ(APACHE Ⅱ)in the death group were higher than those in the survival group(P＜0.05);The GPS was lower than that of the survival group(P＜0.05);The multivariate logistic results showed that the time to hospital after injury,combined trauma,blood transfusion,surgical time,complications,AIS,ISS,APACHE Ⅱ and GPS were the influencing factors for the mortality rate of patients with multiple pelvic fractures with bleeding treated with intervention(P＜0.05).Conclusion The proportion of deaths in patients with multiple pelvic fractures with bleeding is often influenced by factors such as complications,time to hospital after injury,combined trauma,AIS,GPS,and ISS.However,early interventional treatment is recommended to improve the patient's treatment prognosis with minimal trauma and good results.

The biological clock(also known as the circadian rhythm)is the fundamental reliance for all organisms on Earth to adapt and survive in the Earth's rotation environment.Circadian rhythm is the most basic regulatory mechanism of life activities,and plays a key role in maintaining normal physiological and biochemical homeostasis,disease occurrence and treatment.Recent studies have shown that the biologi-cal clock plays an important role in the development of oral tissues and in the occurrence and treatment of oral diseases.Since there is cur-rently no guiding literature on the research methods of biological clock in stomatology,researchers mainly conduct research based on pub-lished references,which has led to controversy about the research methods of biological clock in stomatology,and there are many confusions about how to rationally apply the research methods of circadia rhythms.In view of this,this expert consensus summarizes the characteristics of the biological clock and analyzes the shortcomings of the current biological clock research in stomatology,and organizes relevant experts to summarize and recommend 10 principles as a reference for the rational implementation of the biological clock in stomatology research.

Objective To explore the factors influencing the pregnancy rate after fallopian tube recanalization(FTR),and to construct and validate a nomogram prediction model.Methods The clinical data of a total of 322 female patients with tubal obstructive infertility,who received FTR at the Wuhan Municipal Third Hospital of China between January 2018 and December 2022,were retrospectively analyzed.According to whether the female patient had natural pregnancy or not within 12 months after FTR treatment,the female patients were divided into the pregnant group and the non-pregnant group.Logistic regression analysis was used to determine the independent factors influencing pregnancy.The female patients were randomly divided into training group and validation group at 1∶1 ratio.A nomogram model was constructed in the training group,and the predictive efficacy of the model was verified in the validation group by using receiver operating characteristic(ROC)curves,calibration curves and decision curve analysis(DCA).Results The natural pregnancy rate at one year after FTR was 45.34％(146/322).Age＞35 years,primary infertility,duration of infertility＞3 years,distal fallopian tube obstruction,and moderate to severe tubal lesion were the independent risk factors affecting the pregnancy rate after FTR(all P＜0.05).The constructed nomogram model had a good differentiation and calibration ability and it carried a high degree of clinical utility.Conclusion The nomogram model constructed in this study can effectively predict the risk of infertility within one year after FTR treatment,which is helpful for formulating the individualized therapeutic scheme for infertility female patients.

Objective To investigate the predictive value of heart rate(HR),C-reactive protein(CRP),amino-probrain natriuretic hormone(NT-proBNP),myoglobin(MYO)and other clinical indicators for left ventricular systolic dysfunction(LVSD)in the patients with acute myocardial infarction(AMI)after percuta-neous coronary intervention(PCI)under different body mass index(BMI)stratification.Methods A total of 353 patients with AMI admitted and treated in the First Hospital of Lanzhou University from January 2020 to December 2020 were selected as the study subjects.The Simpson method was adopted to detect the left ven-tricular ejection fraction(LVEF).The study subjects with LVEF＜0.05 were included in the LVSD group,while those with LVEF ≥0.5 were included in the control group.The AMI patients were divided into the lean/normal type(BMI＜24 kg/m2)and overweight/obese type(BMI≥24 kg/m2)according to BMI.The general data of the patients,laboratory indexes and myocardial enzyme indicators were collected.The different groups with different BMI stratifications conducted the comparison.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were adopted to analyze the predictive efficiency of differ-ent indicators.Results There were 153 cases of lean/normal type AMI,in which there were 54 cases in the LVSD group and 99 cases in the control group.Among 200 cases of overweight/obese type AMI,60 cases were in the LVSD group and 140 cases were in the control group.In the patients with lean/normal AMI,HR,CRP,NT-proBNP,MYO and cTnl levels in the LVSD group were higher than those in the control group,and the differences were statistically significant(P＜0.05).In the patients with overweight/obese type AMI,HR,CRP,NEUT,PLT and NT-proBNP levels in the LVSD group were higher than those in the control group,the age was lower than that in the control group,and the differences were statistically significant(P＜0.05).In the patients with the lean/normal type AMI,HR was the best factor for single index prediction effect,AUC was 0.701(95％CI:0.612-0.790).HR+MYO+CRP was the best factors combination of com-bination prediction for LVSD in the patients with lean/normal type AMI.AUC was 0.769(95％CI:0.690-0.849).In the patients with overweight/obese AMI,NT-proBNP was the best factor for the best effect of sin-gle indicator prediction,AUC was 0.706(95％CI:0.613-0.786);NT-proBNP+CRP was the best factor combination in the combination for predicting LVSD in the patients with overweight/obese type AMI,AUC was 0.761(95％CI:0.687-0.833).Conclusion In the patients with different BMI stratifications of AMI,the combination prediction has a better predictive effect than the single indicator.HR+MYO+CRP has the better pre-dictive effect for LVSD in the patients with lean/normal type AMI,while NT-proBNP-+CRP has better predictive effect for LVSD in the patients with overweight/obese type AMI.

Pharmaceutical analysis is a discipline based on chemical, physical, biological, and information technologies. At present, biotechnological analysis is a short branch in pharmaceutical analysis; however, bioanalysis is the basis and an important part of medicine. Biotechnological approaches can provide information on biological activity and even clinical efficacy and safety, which are important characteristics of drug quality. Because of their advantages in reflecting the overall biological effects or functions of drugs and providing visual and intuitive results, some biotechnological analysis methods have been gradually applied to pharmaceutical analysis from raw material to manufacturing and final product analysis, including DNA super-barcoding, DNA-based rapid detection, multiplex ligation-dependent probe amplification, hyperspectral imaging combined with artificial intelligence, 3D biologically printed organoids, omics-based artificial intelligence, microfluidic chips, organ-on-a-chip, signal transduction pathway-related reporter gene assays, and the zebrafish thrombosis model. The applications of these emerging biotechniques in pharmaceutical analysis have been discussed in this review.

Objective : To compare the clinical characteristics of ordinary and severe coronavirus disease 2019 ( COVID-19 ) cases, so as to provide basis for the diagnosis, treatment and prognosis. Methods : We recruited 77 COVID-19 cases in Wenzhou Central Hospital from January 15 to February 29, 2020, collected their general information, clinical symptoms, laboratory test and CT scan results, and compared the clinical features of ordinary and severe cases. Results: There were 50 ordinary cases and 27 severe cases. The age, prevalence of hypertension and other baseline diseases of severe cases were higher than those of ordinary cases ( P<0.05 ) . The maximum body temperature during 1-3 days of hospitalization, proportion of body temperature rising, prevalence of cough, yellow phlegm, hemoptysis, chest tightness and shortness of breath of severe cases were higher than those of ordinary cases ( all P<0.05 ) . The proportion of pulmonary consolidation, glazing and patch shadow, the number of solid changes and the cumulative number of lesions of severe cases were higher than those of ordinary cases ( all P<0.05 ) . The values of LYM during 1-10 days of hospitalization, total T-lymphocyte percentage, CD4 count and percentage, CD8 count, Hb and oxygenation index of severe cases were lower than those of ordinary cases; while the values of LDH and NLR during 1-10 days of hospitalization, N8R, AST, ferritin, CRP during 1-7 days of hospitalization and D-dimer of severe cases were higher than those of ordinary cases ( all P<0.05 ). Conclusions Severe COVID-19 cases have older age, higher prevalence of baseline diseases, fever, shortness of breath symptoms, more lung consolidation and lesions, significantly decreased lymphocyte level ( especially CD4 ) , and increased LDH, NLR, ferritin and CRP.

Objective To explore the feasibility of repairing the skin and soft tissue defect at finger palm side with the reversed free thenar mini-perforator flaps.Methods From October,2010 to October,2016,7 patients were treated with reversed free thenar mini-perforator flap to repair skin and soft tissue defects at finger palm side,including 5 males and 2 females,which the age were between of 17 and 56 (average,35 years old).Cause of injury:1 case of abrasive wear,1 case of machine twist injury,and 5 cases of heavy injury.All cases with varying degrees of phalanx and tendon exposed.The wound size was from 1.3 cm × 2.0 cm to 2.2 cm × 5.0 cm.According to the origin of the artery in the thenar area,3 kinds of reversed free thenar mini-perforator flaps were designed to repair the defective wound.In the middle of the large fish,the width less than 2.5 cm perforating flap was designed,so that the area can be directly sutured.Results All 7 flaps survived.The flap size was from 1.5 cm × 2.4 cm to 2.5 cm × 5.5 cm.All patients were followed-up from 3 months to 17 months (average,9 months).The appearance and skin texture of flaps was close to the normal finger palm side of the skin,with a clear fingerprint.Two-point discrimination was between 9 mm and 15 mm.The sensory recovery to S3 in 3 cases,S4 in 4 cases.Linear scars were left in the donor areas,with no discomfort.Conclusion This technique has the advantages of good appearance,such as good appearance and small damage to the donor area.However,the surgeon is required the super microscopic techniques.