Shengma Gegentang is one of the classic formulas in the Catalogue of Ancient Classic Prescriptions （Second Batch）. This study reviewed ancient and modern literature and used literature tracing and bibliometric methods to analyze the historical evolution， efficacy， indications， dosage decoctions， and modern clinical disease spectrum of Shengma Gegentang. The results indicated that the earliest record of Shengma Gegentang can be found in the Taiping Huimin Heji Jufang of the Song dynasty， but its origin can be traced back to the Shaoyao Siwu Jiejitang in the Beiji Qianjin Yaofang of the Tang dynasty. The composition dosage of Shengma Gegentang is 413 g of Cimicifugae Rhizoma， 619.5 g of Puerariae Lobatae Radix， 413 g of Paeoniae Radix Alba， and 413 g of Glycyrrhizae Radix et Rhizoma， which are ground into coarse powder. Each dose is 12.39 g， and the amount of water added is 300 mL. 100 mL of solution is decocted and taken at the right time. The four drugs in the formula play the role of relieving exterior syndrome， penetrating pathogenic factors， and detoxicating together. Its indications are widely involved in internal medicine， pediatrics， surgery， ophthalmology and otorhinolaryngology， obstetrics and gynecology， sexually transmitted diseases， and other diseases， such as measles， sores， acne， spots， surgical gangrene， red eyes， toothache， chancre， and fetal poison. The epidemic diseases treated by Shengma Gegentang are complicated， including rash， pox， macula， numbness， summer diarrhea， dysentery， sha disease， febrile symptoms， spring warmth， winter warmth， and cold pestilence. At the same time， it is a plague prevention formula. Although Shengma Gegentang has a wide range of indications， it cannot be separated from the pathogenic mechanism of evil Qi blocking the muscle surface and heat in the lungs and stomach. The modern clinical disease spectrum of Shengma Gegentang involves the ophthalmology and otorhinolaryngology system， nervous system， pediatric-related diseases and syndromes， skin system， hepatobiliary system， and digestive system. It plays a key role in the treatment of epidemic diseases such as measles， chronic hepatitis B， dysentery， and tetanus.

According to the Shennong Ben Cao Jing, Alismatis Rhizoma has tonic properties, however, that is not recorded in the Chinese Pharmacopoeia. By reviewing the relevant literature on the efficacy of Alismatis Rhizoma in ancient texts, it was found that before the Song Dynasty, the efficacy of Alismatis Rhizoma included tonic, diuresis, and heat relief. From the Song Dynasty, some medical practitioners questioned the view that Alismatis Rhizoma is a tonic, while the Ming Dynasty medical practitioners believed that the tonic function of Alismatis Rhizoma is derived from its water-relieving effect and that it is not a direct tonic, and the Qing Dynasty medical practitioners believed that the core effect of Alismatis Rhizoma is water-relieving and that tonic is an excessive praise of Alismatis Rhizoma’s effect with no practical clinical significance. By this point, the notion that Alismatis Rhizoma is a tonic has completely dropped out of mainstream traditional Chinese medicine theory. In addition, it was also found that the efficacy of Alismatis Rhizoma in stopping seminal discharge has been documented in medical texts for generations, but not in the Chinese Pharmacopoeia.

Objective To investigate the clinicopathological factors associated with pathological complete response(pCR)of axillary metastatic lymph nodes in breast cancer patients after neoadjuvant chemotherapy(NAC),and to analyze the postoperative survival.Methods A total of 116 patients with breast cancer with axillary lymph node metastasis were collected from Jiaxing Hospital of TCM,Jiaxing Maternity and Child Health Care Hospital and The First Hospital of Jiaxing.Univariate analysis was used to analyze the relationship between clinicopathological factors and the pCR of axillary lymph node metastasis in breast cancer after NAC.Binary Logistic regression was used to analyze the independent predictors of the pCR of axillary lymph node metastasis in breast cancer after NAC.Kaplan-Meier survival curve was used to analyze the disease-free survival rate and overall survival rate of patients with and non-pCR of axillary metastatic lymph nodes.Results Among 116 patients,52 cases of axillary metastatic lymph nodes achieved pCR after NAC,accounting for 44.83%.Univariate analysis showed that age,vascular invasion,pCR of primary breast tumor,the difference of Ki67 before and after NAC,NAC regimen,and the efficacy of NAC were statistically significant between breast cancer patients with pCR and those non-pCR(P<0.05).Binary Logistic regression analysis showed that age,vascular invasion and pCR of primary breast tumor were independent predictors of pCR of axillary metastatic lymph nodes(P<0.05).The 5-year disease-free survival rate(80.40%vs.54.60%)and overall survival rate(90.4%vs.70.10%)of patients with pCR and non-pCR of axillary metastatic lymph nodes were compared.Conclusion Some breast cancer patients with axillary lymph node metastasis can reach pCR in lymph nodes after NAC.Analyzing the correlation between clinical pathological factors and pCR of axillary metastatic lymph nodes after NAC,it was found that pCR of axillary metastatic lymph nodes after NAC is related to age≤50 years old,no vascular infiltration,and primary breast tumor pCR.At the same time,it was found that patients with axillary metastatic lymph node pCR had a better prognosis than those with non-pCR.

Zhuye Shigaotang is one of the 100 classic prescriptions published by the National Administration of Traditional Chinese Medicine. This study used the traceability method and bibliometrics method to analyze the main applicable syndromes， efficacy and meanings， modern disease spectrum， and other aspects of Zhuye Shigaotang， so as to further promote the research and development of this prescription. The results showed that Zhuye Shigaotang originated from the Treatise on Febrile Diseases， and its ingredients included Lophatheri Herba， Gypsum Fibrosum， Pinelliae Rhizoma， Ophiopogonis Radix， Ginseng Radix et Rhizoma， Glycyrrhizae Radix et Rhizoma， and Oryza sativa. The main applicable syndromes of Zhuye Shigaotang recorded in ancient books included heatstroke， cough and asthma， sores， sweat syndrome， hiccup， insomnia， malaria， headache， blood syndrome， nasosinusitis， laryngitis， etc.， involving diseases of internal medicine， surgery， gynecology， and pediatrics. Its pathogenesis was "incomplete residual heat， both Qi and Yin injuries， and stomach-Qi disharmony". The research found that Zhuye Shigaotang could also be used to treat acne， measles， and cholera， and it was especially suitable for the treatment at the later stage of epidemic diseases. Lophatheri Herba and Gypsum Fibrosum in the prescription could clear away heat and relieve vexation. Ginseng Radix et Rhizoma，Ophiopogonis Radix， Ginseng Radix et Rhizoma， and Oryza sativa could promote body fluid production and invigorate Qi. Pinelliae Rhizoma could harmonize the stomach and stop vomiting. The prescription had stable compatibility and had the effects of clearing away heat， relieving vexation， invigorating Qi， promoting body fluid production， and harmonizing the stomach. Zhuye Shigaotang was widely applied in modern clinical practices， with high application frequency in the digestive system， pediatric-related diseases， respiratory system， infectious diseases， circulatory system， and neuropsychiatric system. The specific symptoms included recurrent aphtha， hiccup， infantile pneumonia， infantile summer fever， unexplained fever， upper respiratory tract infection， epidemic hemorrhagic fever， and late measles.

Transcatheter tricuspid valve intervention is the new frontier of interventional cardiology. The LuX-Valve is a radial force-independent orthotopic tricuspid valve replacement device developed in China. The LuX-Valve Plus transcatheter tricuspid valve replacement (TTVR) system is changed from the trans-atrial to the transjugular approach, which further reduces trauma and pulmonary complications compared with the first generation LuX-Valve. The first-in-human study has been completed at Zhongshan Hospital, Fudan University and an exploratory multicentre clinical study is underway. Echocardiography plays an important role in pre-TTVR screening, intraoperative guidance and postoperative evaluation and follow-up, especially two-dimensional transoesophageal echocardiography (2D-TEE) and three-dimensional transoesophageal echocardiography (3D-TEE). However, there is a lack of appropriate intraoperative guidance and assessment protocols. In this study, we briefly described the protocols and imaging considerations for intraoperative 2D-TEE and 3D-TEE to ensure the successful implantation of TTVR.

Objective:To explore the features the gait of elderly persons with type 2 diabetes and peri-pheral neuropathy.Methods:Twenty patients no less than 60 years old with type 2 diabetes and peripheral neuropathy (DPN) formed a DPN group, while 20 counterparts with type 2 diabetes but without peripheral neuropathy composed the DM group, and another 20 healthy counterparts served as a control group. The three groups were tested using the Swedish Qualisys motion capture system and their walking speed, step length, step width, stride frequency and stride length, bipedal foot support phase time, single foot support phase time, peak plantar pressure, and regional-holding time were collected and compared.Results:The average walking speed, stride length and stepping frequency of the DPN group were all significantly lower than the other 2 groups′ averages. Their bipedal support phase was significantly longer, but their single foot support phase time was significantly shorter. And in the DPN group the average first and second peak plantar pressures and the second peak pressure time were significantly greater than the other groups′ averages.Conclusions:Elderly patients with type 2 diabetes and peripheral neuropathy have significant gait abnormalities, decreased walking stability, as well as increased plantar pressure and plantar compression time.

Purpose: Treatment options are limited after the failure of first-and second-line treatments in patients with HER2+ metastatic gastric cancer (mGC). The present study aimed to explore the efficacy, safety, and prognostic factors of apatinib efficacy as a third-line therapy for patients with human epithelial growth factor receptor 2-positive (HER2+ ) mGC. Materials and Methods: A total of 59 HER2+ mGC patients who received apatinib as thirdline therapy were retrospectively enrolled in this two-center, single-arm, cohort study; the clinical response, survival data, and adverse events were retrieved. Results: The median progression-free survival (PFS) was 5.2 months (95% confidence interval [CI], 3.9–6.5), and the median overall survival (OS) was 8.2 months (95% CI, 6.6–9.8) Furthermore, forward stepwise multivariate Cox regression analysis showed that a higher Eastern Cooperative Oncology Group performance status score and multiple metastases were independently correlated with decreased PFS and OS (both P<0.05). The main adverse events were leukopenia (45.8%), hypertension (44.1%), thrombocytopenia (39.0%), handfoot syndrome (37.3%), and elevated transaminase (33.9%). Grade 3 adverse events mainly included hypertension (5.1%) and neutropenia (5.1%); grade 4 adverse events did not occur. Conclusions Apatinib is efficient and well tolerated in patients with HER2+ mGC as a thirdline treatment, suggesting that it may be a candidate of choice for these patients.

Tricuspid regurgitation (TR) interventions are under rapid development. The K-Clip? system is the first domestic transcatheter tricuspid annuloplasty system with unique clamping procedure to achieve annular reduction.Intraoperative echocardiographic monitoring procedures for transcatheter tricuspid annuloplasty have not been reported yet in China. Thus, this review aimed to propose the standard two-dimensional and three-dimensional transesophageal echocardiographic workplanes and procedures to guide and monitor the implantation of K-Clip system based on our experience in Zhongshan Hospital, Fudan University to provide a reference point for the intraoperative echocardiographic monitoring of future transcatheter tricuspid annuloplasty devices in China.

Objective : To screen the target of helicid in the intervention of depression based on network pharmacol- ogy and molecular docking，and to study the effect of helicid on the expression level of related targets in hippocam- pus，prefrontal cortex，striatum and habenular nucleus of chronic unpredictable mild stress ( CUMS) rats． Methods : The target of helicid was predicted by SwissTargetPrediction database ，and the depression related targets were screened by GeneCards、DisGeNet、TTD and DRUGBANK databases ; the metascape platform was used for gene en- richment analysis ，and the " helicid-depression-pathway " network was constructed ; Autodock Vina was used for molecular docking research ; qRT-PCR was used to detect the effect of helicid on the mRNA expression of HTR1A， ADORA1 and ADORA2A in rat tissues. Results : The 81 helicid targets and 1 640 depression targets were ob- tained，including 40 intersecting targets ; the key targets were mainly enriched in cAMP signal pathway，PI3K-Akt signal pathway，MAPK signal pathway and so on ; the results of molecular docking showed that the binding activity of helicid with most targets was good ; helicid up-regulated the expression levels of HTR1A ，ADORA1 and ADORA2A mRNA in hippocampus，prefrontal cortex ，striatum and habenular nucleus of CUMS rats． Conclusion Helicid may act on cAMP，PI3K-Akt，MAPK and other signal pathways to intervene depression through HTR1A， ADORA1 and ADORA2A.

OBJECTIVE: To assess the changes in the coagulation profiles of patients with chronic kidney disease (CKD) using thromboelastography (TEG) and identify the risk factors of hypercoagulation in CKD patients. METHODS: A total of 128 patients with CKD admitted in Hunan Provincial People's Hospital between August, 2018 and May, 2019 were recruited. The results of conventional coagulation test and TEG were compared between patients with CKD and 21 healthy control adults. The patients with CKD were divided into hypercoagulation group with a maximum amplitude (MA) > 68 mm (=66) and non-hypercoagulation group (MA≤68 mm, =62). The laboratory indicators were compared between the groups, and the factors affecting the hypercoagulable state in patients with CKD were analyzed. RESULTS: The levels of fibrinogen and D-Dimer increased significantly in patients with CKD at different stages as compared with the control subjects ( < 0.05). In the patients with CKD, the reaction time and K time decreased while MA, α-angle and coagulation index increased significantly in patients in stage 3-4 and those in stage 5 either with or without hemodialysis compared with the control group ( < 0.05). The estimated glomerular filtration rate (eGFR), percentage of patients with diabetes mellitus, history of stroke, percentage of neutrophils, neutrophil-lymphocyte ratio, red blood cell count, hemoglobin levels, platelet count, serum creatinine, serum cystatin-C, serum albumin, and lipoprotein (a) all differed significantly between hypercoagulation group and non-hypercoagulation group ( < 0.05). The eGFR, platelet count and hemoglobin levels were identified as independent factors affecting hypercoagulability in patients with CKD ( < 0.05). CONCLUSIONS s The hypercoagulable state of patients with CKD worsens gradually with the disease progression, and eGFR, platelet count and hemoglobin levels are all risk factors for the hypercoagulable state in patients with CKD.
Blood Coagulation ; Humans ; Renal Insufficiency, Chronic ; Risk Factors ; Thrombelastography ; Thrombophilia