Objective:To summarize the clinical and imaging features of 10 patients with genetically diagnosed neuronal intranuclear inclusion disease (NIID) to avoid clinical misdiagnosis and mismanagement of NIID.Methods:Ten patients with NIID, admitted to our hospital from January 2020 to March 2022, were chosen in our study. All patients were confirmed as having NIID by NOTCH2NLC gene assay. Their clinical data, gene detection results and skin pathological results were collected and anlyzed. Results:These patients aged from 57 to 84 years, including 8 females. The episodic symptoms as main symptoms were noted in 6 patients, including 3 patients with encephalopathy, 1 patient with TGA, 1 patient with stroke-like episode, and 1 patient with migraine-like symptoms. Chronic progressive symptoms as main symptoms were noted in 4 patients, including 3 patients with dementia and 1 patient with Parkinson's disease. There were characteristic linear hyper-intensities in diffusion weighted imaging (DWI) in the corticomedullary junction predominantly in the frontal lobes. White matter lesions appeared in T2 Flair might have been noted years before lesions appeared in DWI, with wider ranges. All had GGC repeated expansion in NOTCH2NLC gene in non-coding area, with mutation number>60. Skin biopsy was performed in 6 patients, showing the formation of intranuclear inclusion bodies in different cells; and ubiquitin and P62 were found positive in immunohistochemical staining. Conclusions:NIID patients have large clinical heterogeneity; most patients have episodic symptoms as main manifestations, often accompanied by chronic progressive symptoms; stroke attack and migraine are rare clinical phenotypes of NIID. The high signal at the cortical medullary junction in DWI is a characteristic imaging change.

Objective: To examine the clinical efficacy of 3 anti-reflux methods of digestive tract reconstruction after proximal gastrectomy for gastric cancer. Methods: The clinical data and follow-up data of gastric cancer patients who underwent anti-reflux reconstruction after proximal gastrectomy in 11 medical centers of China from September 2016 to August 2021 were retrospectively collected, including 273 males and 65 females, aging of (63±10) years (range: 28 to 91 years). Among them, 159 cases were performed with gastric tube anastomosis (GTA), 107 cases with double tract reconstruction (DTR), and 72 cases with double-flap technique (DFT), respectively. The duration of operation, length of postoperative hospital stay and early postoperative complications (referring to Clavien-Dindo classification) of different anti-reflux reconstruction methods were assessed. Body mass index, hemoglobin and albumin were used to reflect postoperative nutritional status. Reflux esophagitis was graded according to Los Angeles criteria based on the routinely gastroscopy within 12 months after surgery. The postoperative quality of life (QoL) was evaluated by Visick score system. The ANOVA analysis, Kruskal-Wallis rank sum test, χ² test and Fisher's exact test were used for comparison between multiple groups, and further comparison among groups were performed with LSD, Tamhane's test or Bonferroni corrected χ² test. The mixed effect model was used to compare the trends of Body mass index, hemoglobin and albumin over time among different groups. Results: The operation time of DFT was significantly longer than that of GTA and DTR ((352±63) minutes vs. (221±66) minutes, (352±63) minutes vs. (234±61) minutes, both P<0.01). The incidence of early complications with Clavien-Dindo grade Ⅱ to Ⅴ in GTA, DFT and DTR groups was 17.0% (27/159), 9.7% (7/72) and 10.3% (11/107), respectively, without significant difference among these three groups (χ²=3.51, P=0.173). Body mass index decreased more significantly in GTA than DFT group at 6 and 12 months after surgery (mean difference=1.721 kg/m², P<0.01; mean difference=2.429 kg/m², P<0.01). body mass index decreased significantly in DTR compared with DFT at 12 months after surgery (mean difference=1.319 kg/m², P=0.027). There was no significant difference in hemoglobin or albumin fluctuation between different reconstruction methods perioperative. The incidence of reflux esophagitis one year after surgery in DTR group was 12.9% (4/31), which was lower than that in DFT (45.9% (17/37), χ²=8.63, P=0.003). Follow-up of postoperative quality of life showed the incidence of Visick grade 2 to 4 in DFT group was lower than that in GTA group (10.4% (7/67) vs. 34.6% (27/78), χ²=11.70, P=0.018), while there was no significant difference between DFT and DTR group (10.4% (7/67) vs. 22.2% (8/36, P>0.05). Conclusions: Compared with GTA and DTR, DFT is more time-consuming, but there is no significant difference in early complications among three methods. DFT reconstruction is more conducive to maintain postoperative nutritional status and improve QoL, especially compared with GTA. The risk of reflux esophagitis after DTR reconstruction is lower than that of DFT.
Aged ; Albumins ; Esophagitis, Peptic/surgery* ; Female ; Gastrectomy/methods* ; Hemoglobins ; Humans ; Male ; Middle Aged ; Quality of Life ; Retrospective Studies ; Stomach Neoplasms/surgery*

Objective:To observe the effect of modified Bazhentang on the nutritional status and immune function of patients with Qi and blood deficiency syndrome in neoadjuvant chemotherapy （NAC） for gastric cancer. Method:One hundred and ten patients were randomly divided into observation group and control group with 55 cases each. Both groups accepted FOLFOX6 protocol. Patients in control group took Jianpi Shengxue tablets orally， 3 tablets/time， 3 times/day. Patients in observation group received modified Bazhentang， 1 dose/day. The course of treatment was six weeks in both groups. Before and after treatment， scores were graded according to patient generated-subjective global assessment （PG-SGA）， Qi and blood deficiency syndrome， and the Revised Piper Fatigue Scale （PFS-R）. Levels of serum total protein （TB）， albumin （ALB）， prealbumin （PAB）， CD4⁺， CD8⁺， helper T lymphocyte 17 （Th17）， regulatory T cell （Treg）， immunoglobulin G （IgG）， IgM， and IgA were detected before and after therapy. Body mass index （BMI） and fat free mass index （FFMI） were measured before and after treatment. Weight loss was recorded， and the acute or subacute toxicity of anticancer drugs was evaluated. Result:The degree of malnutrition in the observation group was lower than that in the control group （Z=2.401，P<0.01）. The levels of TB， ALB and PAB in the observation group were higher than those in the control group （P<0.01）. The CD4⁺， Treg and CD4⁺/CD8⁺ levels in the observation group were higher than those in the control group （P<0.01）. The CD8⁺， Th17 and Th17/Treg levels were lower than those in the control group （P<0.01）. Besides， the levels of IgM and IgA in the observation group were higher than those in the control group （P<0.01）. The PG-SGA score and weight loss in the observation group were lower than those in the control group （P<0.01）. The BMI and FFMI data of the observation group were higher than those of the control group （P<0.05）. The scores of PFS-R and Qi-blood deficiency syndrome were lower than those of the control group （P<0.01）. The incidence of nausea and vomiting in the observation group was 45.45% （25/55）， lower than 65.45% （36/55） in the control group （χ²=4.452，P<0.05）. Conclusion:Modified Bazhentang can be used to assist gastric cancer patients with NAC， which can improve nutritional status and immune function， promote immune balance， reduce clinical symptoms and fatigue， and reduce chemotherapy toxicity and side effects， so it is worthy of clinical use.

OBJECTIVE: To explore the feasibility of preparing gastric floating formulations by fused de-position modeling (FDM) 3D printing technology, to evaluate the in vitro properties of the prepared FDM 3D printed gastric floating formulations, and to compare the influence of different external shapes of the formulation with their in vitro properties. METHODS: Verapamil hydrochloride and polyvinyl alcohol (PVA) were used as the model drug and the excipient, respectively. The capsule-shaped and hemisphere-shaped gastric floating formulations were then prepared by FDM 3D printing. The infill percentages were 15%, the layer heights were 0.2 mm, and the roof or floor thicknesses were 0.8 mm for both the 3D printed formulations, while the number of shells was 3 and 4 for capsule-shaped and hemisphere-shaped formulation, respectively. Scanning electron microscopy (SEM) was used to observe the morpho-logy of the surface and cross section of the formulations. Gravimetric method was adopted to measure the weights of the formulations. Texture analyzer was employed to evaluate the hardness of the formulations. High performance liquid chromatography method was used to determine the drug contents of the formulations. The in vitro floating and drug release behavior of the formulations were also characterized. RESULTS: SEM showed that the appearance of the FDM 3D printed gastric floating formulations were both intact and free from defects with the filling structure which was consistent with the design. The weight variations of the two formulations were relatively low, indicating a high reproducibility of the 3D printing fabrication. Above 800.0 N of hardness was obtained in two mutually perpendicular directions for the two formulations. The drug contents of the two formulations approached to 100%, showing no drug loss during the 3D printing process. The two formulations floated in vitro without any lag time, and the in vitro floating time of the capsule-shaped and hemisphere-shaped formulation were (3.97±0.41) h and (4.48±0.21) h, respectively. The in vitro release of the two formulations was significantly slower than that of the commercially available immediate-release tablets. CONCLUSION The capsule-shaped and hemisphere-shaped verapamil hydrochloride gastric floating formulations were prepared by FDM 3D printing technology successfully. Only the floating time was found to be influenced by the external shape of the 3D printed formulations in this study.
Drug Liberation ; Excipients ; Printing, Three-Dimensional ; Reproducibility of Results ; Tablets

Animals ; Cardiomegaly ; Constriction ; Heart ; Mice

Hydrocephalus is often treated with a cerebrospinal fluid shunt (CFS) for excessive amounts of cerebrospinal fluid in the brain. However, it is very difficult to distinguish whether the ventricular enlargement is due to hydrocephalus or other causes, such as brain atrophy after brain damage and surgery. The non-trivial evaluation of the consciousness level, along with a continuous drainage test of the lumbar cistern is thus clinically important before the decision for CFS is made. We studied 32 secondary mild hydrocephalus patients with different consciousness levels, who received T1 and diffusion tensor imaging magnetic resonance scans before and after lumbar cerebrospinal fluid drainage. We applied a novel machine-learning method to find the most discriminative features from the multi-modal neuroimages. Then, we built a regression model to regress the JFK Coma Recovery Scale-Revised (CRS-R) scores to quantify the level of consciousness. The experimental results showed that our method not only approximated the CRS-R scores but also tracked the temporal changes in individual patients. The regression model has high potential for the evaluation of consciousness in clinical practice.

Wolfberry has important unique medical values as well as edible and commerce values. In this paper,we analyze the characteristics and problems of international trade of wolfberry based on the customs data between 2008 and 2017. During periods of these ten years,the wolfberry was mainly exported with a small proportions of imports. The total export volume increased steadily,reached 82 182. 08 tons and 696. 622 million dollars respectively. Wolfberry came from 31 provinces/autonomous regions and exported to 105 countries and regions through 21 ports. Most of the total exports of wolfberry flew to markets of Asia and Europe,the Ningxia autonomous region was the major export province. Large amount of wolfberry exported through Tianjin port. Compared with the export volume,the import is almost negligible,mainly coming from North Korea,almost all through Changchun port,Jilin province to enter the domestic market. There is a situation of"import of domestic goods". To enhance the international competitiveness of wolf berry industry,we must rely on the fundamental research of wolfberry,speed up the standardization process,strengthen the scientific and technological innovation in wolfberry products,improve the added value and profit of wolfberry.
Asia ; China ; Commerce ; Europe ; Lycium

The three objectives of the Convention on Biological Diversity (CBD) are the conservation of biological diversity, the sustainable use of its components and the fair and equitable sharing of benefit sarising from the utilization of genetic resources.The Nagoya Protocol significantly advances the CBD's third objective by providing a strong basis for greater legal certainty and transparency for both providers and users of genetic resources.In June 2016, the Chinese government approved the accession to the Nagoya Protocol. The implementation of the Nagoya Protocol is bound to greatly influence the traditional Chinese medicine (TCM) as its development relies on medical biological genetic resources.Both the protection and access of medical biological genetic resources and its related traditional knowledge and the introduction, breeding, biosynthesis and the extraction and modification of effective components of medicinal organism are with the prescribed scope of the Nagoya Protocol. In this study, we simply introduce the background and main contents of the Nagoya Protocol in first. We then explore the relationship between the Nagoya Protocol and the TCM.We also analyze the positive effects on the TCM for China to be one of the parties of the Nagoya Protocol and finally make some proposals for better implementation of the Nagoya Protocol.This study has certain reference significance to the resource economy and management of TCM.
Biodiversity ; China ; Conservation of Natural Resources ; Medicine, Chinese Traditional ; standards

Ex-situ conservation is an important means to protect biological genetic resources. Resource protection has received more and more attention with the continuous improvement of the comprehensive utilization of traditional Chinese medicine resources. In this paper, the research and compilation of the species list of ex-situ cultivated medicinal plants in 12 Chinese Academy of Sciences botanic gardens and 19 specialized medicinal botanic gardens in China were carried out. Based on the Species 2000(2017) and other classification databases, species diversity of medicinal plants ex-situ cultivated in these botanical gardens were analyzed. The study found that there were 16 351 higher plant species in our country, belonging to 276 families and 1 936 genera. Of these, 6 949 specieswere medicinal plants, accounting for 50.4% of the total medicinal plants. There were 1 280 medicinal plants were in threatened status, accounting for 19.6% of all threatened species in the Chinese Biodiversity Red List, with ex-situ cultivated proportion of 59.5%. And 3 988 medicinal plants were Chinese endemic species, accounting for 22.5% of all Chinese endemic species, with ex-situ cultivated proportion of 53.3%. This article has reference significance for the management and protection of medicinal plant resources.

Objective To observe the clinical efficacy of self-prescribed Guchong Decoction combined with Ferroids for the treatment of iron deficiency anemia (IDA)patients with unconsolidation of thoroughfare and conception vessels. Methods A total of 70 IDA patients with unconsolidation of thoroughfare and conception vessels were randomized into treatment group and control group,35 cases in each group. The control group was given oral use of Ferroids, and the treatment group was treated with self-prescribed Guchong Decoction combined with Ferroids. One month constituted a treatment course,and both groups were treated for 2 courses. Before and after treatment,we compared the parameters of blood routine test for red blood cells(RBC),hemoglobin (HGB), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), MCH concentration (MCHC),white blood cells(WBC)and platelets,as well as reticulocytes(Ret)and iron metabolism indexes including serum iron(SI),serum ferritin(SF),and total iron-binding capacity(TIBC). The adverse reaction was monitored during the treatment. After treatment,both western medicine clinical efficacy and traditional Chinese medicine (TCM)syndrome clinical efficacy of the two groups were evaluated. A 3-month follow-up was carried out after treatment to evaluate the recurrence rate. Results(1)Drop-out occurred in one case from the treatment group and in 2 cases from the control group because of short-term medication suspension.(2)After treatment for 2 months, western medicine clinical cure rate of the treatment group was 82.4％ and that of the control group was 60.6％, and TCM syndrome clinical cure rate of the treatment group was 94.1％ and that of the control group was 51.5％,the difference being significant(P < 0.05 or P < 0.01).(3)The levels of RBC,HGB,Ret, MCV, MCH, MCHC, and WBC of the two groups were obviously increased after treatment (P < 0.01), and PLT level was markedly decreased (P < 0.01)as compared with those before treatment,but the inter-group differences after treatment were insignificant (P > 0.05). (4)After treatment,iron metabolism indexes of SF and SI of the two groups were significantly increased (P < 0.01), and TIBC of the treatment group was significantly decreased (P < 0.01). The treatment group had stronger effect on increasing SF and SI and on decreasing TIBC than the control group (P < 0.05 or P < 0.01). (5)The incidence of adverse reaction and the recurrence rate in the treatment group were lower than those of the control group,the difference being significant (P< 0.01). Conclusion Guchong Decoction combined with Ferroids is effective for the treatment of IDA with unconsolidation of thoroughfare and conception vessels through relieving symptoms rapidly, reducing gastrointestinal adverse reaction,and decreasing recurrent rate.