Based on the theory of ti （character， 体） and yong （function， 用） in mental illness， ZHAO Yonghou's clinical experience in staged differentiation and treatment of schizophrenia is summarized. According to the theory， the core disease location of schizophrenia is in the brain， which is closely related to the organs， qi， and blood. It is proposed to interpret the pathogenesis of schizophrenia from the perspective of “zang-fu organs-qi and blood-brain and spirit”， that is， dysfunction of the zang-fu organs， disharmony of qi and blood， and malnourishment of the brain ti lead to dysfunction of the spirit ti and yong. In clinical practice， treatment of schizophrenia can be divided into four stages， for which the method of treating ti and yong simultaneously is suggested. In the prodromal stage， Liuwei Dihuang Decoction combined with Sini San （六味地黄汤合四逆散） with modifications is used to nourish the kidney and boost marrow， soothe the liver and rectify the spleen. For acute exacerbation with binding of phlegm and heat syndrome， Zhaoshi Yikuang Decoction （赵氏抑狂汤） with modifications is used to clear heat and dispel phlegm， awaken the brain and calm the mind. For phlegm-heat damaging yin pattern， Mengshi Guntan Pill combined with Zengye Decoction （礞石滚痰丸合增液汤） with modifications is used to clear heat and dispel phlegm， enrich yin and calm the mind. For the chronic treatment stage， Yudian Decoction （愈癫汤） with modifications is used to disperse phlegm and dissolve stasis， move qi and awaken the mind. For the rehabilitation and regulation stage， Shenan Pill （神安丸） with modifications is used to boost qi and nourish yin， and tranquilize the mind.

Objective To carry out a proficiency testing of content determination of geniposide in Gardeniae fructus,evaluate the content determination ability of index components in traditional Chinese medicine in the laboratory of inspection and detection in drug-related fields,and improve the quality control ability of content determination of related laboratories.Methods The laboratory's capability-verification activities were conducted based on the CNAS-RL02 Rules for Proficiency Testing and ISO/IEC 17043 Conformity Assessment-General Requirements for Proficiency Testing.After preparing the sample,the results of homogeneity and stability tests were analyzed according to CNAS-GL003 Guidance on Evaluating the Homogeneity and Stability of Samples Used for Proficiency Testing.After the test results were qualified,they were used as proficiency testing samples and randomly distributed to participants.The results were collected,and the robust statistical method and the Z scores were used to analyze the results of these laboratories'reports.Results 403 laboratories in this proficiency testing program reported the results,of which 367 results were acceptable,accounting for 91.07％,17(4.22％)laboratories obtained suspicious results,and 19 laboratories gave unsatisfactory results,with the dissatisfaction rate of 4.71％.Conclusion The majority of the 403 participant laboratories have the ability to determine the content of geniposide in Gardeniae fructus by HPLC and the laboratory testing ability and quality management level of the drug monitoring system are high.This proficiency testing provides a basis for understanding the technical reserve capacity and management level of China's pharmaceutical inspection and testing laboratories,and provides technical support for future government supervision.

Long-term clinical practice shows that Mongolian medicine not only has a unique effect on frequently-occurring and common diseases, but also has particularly remarkable effects on difficult diseases such as cardiovascular diseases, cancer, etc. Molecular imaging technology, which based on imaging technology, displays special molecules on the tissue, cell, and subcellular level. By reflecting the changes on molecular level in vivo, lesions can be located, quantitatively and qualitatively imaged and analyzed. Non-invasive imaging in vivo is the most significant feature of molecular imaging technology. In the research of Mongolian medicine treatment, molecular imaging technology can present the characteristics of the lesions before and after treatment in vivo and in real time, dynamically evaluate the effect of drug treatment, and provide new ideas for exploring the efficacy of Mongolian medicine and developing new drugs.

Humans ; Data Warehousing ; East Asian People ; Intracranial Hemorrhages/diagnostic imaging* ; Asian People ; Cerebral Hemorrhage/diagnostic imaging*

Neurocritical care (NCC) is not only generally guided by principles of general intensive care, but also directed by specific goals and methods. This review summarizes the common pulmonary diseases and pathophysiology affecting NCC patients and the progress made in strategies of respiratory support in NCC. This review highlights the possible interactions and pathways that have been revealed between neurological injuries and respiratory diseases, including the catecholamine pathway, systemic inflammatory reactions, adrenergic hypersensitivity, and dopaminergic signaling. Pulmonary complications of neurocritical patients include pneumonia, neurological pulmonary edema, and respiratory distress. Specific aspects of respiratory management include prioritizing the protection of the brain, and the goal of respiratory management is to avoid inappropriate blood gas composition levels and intracranial hypertension. Compared with the traditional mode of protective mechanical ventilation with low tidal volume (Vt), high positive end-expiratory pressure (PEEP), and recruitment maneuvers, low PEEP might yield a potential benefit in closing and protecting the lung tissue. Multimodal neuromonitoring can ensure the safety of respiratory maneuvers in clinical and scientific practice. Future studies are required to develop guidelines for respiratory management in NCC.
Humans ; Lung ; Lung Diseases/etiology* ; Positive-Pressure Respiration/methods* ; Respiration, Artificial/adverse effects* ; Tidal Volume

Background::Pancreatic adenocarcinoma (PAAD) is an extremely lethal malignancy. Identification of the functional genes and genetic variants related to PAAD prognosis is important and challenging. Previously identified prognostic genes from several expression profile analyses were inconsistent. The regulatory genetic variants that affect PAAD prognosis were largely unknown.Methods::Firstly, a meta-analysis was performed with seven published datasets to systematically explore the candidate prognostic genes for PAAD. Next, to identify the regulatory variants for those candidate genes, expression quantitative trait loci analysis was implemented with PAAD data resources from The Cancer Genome Atlas. Then, a two-stage association study in a total of 893 PAAD patients was conducted to interrogate the regulatory variants and find the prognostic locus. Finally, a series of biochemical experiments and phenotype assays were carried out to demonstrate the biological function of variation and genes in PAAD progression process.Results::A total of 128 genes were identified associated with the PAAD prognosis in the meta-analysis. Fourteen regulatory loci in 12 of the 128 genes were discovered, among which, only rs4887783, the functional variant in the promoter of Ring Finger and WD Repeat Domain 3 ( RFWD3), presented significant association with PAAD prognosis in both stages of the population study. Dual-luciferase reporter and electrophoretic mobility shift assays demonstrated that rs4887783-G allele, which predicts the worse prognosis, enhanced the binding of transcript factor REST, thus elevating RFWD3 expression. Further phenotypic assays revealed that excess expression of RFWD3 promoted tumor cell migration without affecting their proliferation rate. RFWD3 was highly expressed in PAAD and might orchestrate the genes in the DNA repair process. Conclusions::RFWD3 and its regulatory variant are novel genetic factors for PAAD prognosis.

Objective To investigate the clinical manifestations and genetic features of children with papillorenal syndrome caused by PAX2 gene mutation.Methods Clinical manifestations,imaging changes and sequencing data were collected and analyzed from a family with papillorenal syndrome who were diagnosed in Wuhan Children's Hospital in February 2018."PAX2","papillorenal syndrome" and "renal coloboma syndrome" were used as key words to search in China National Knowledge Infrastructure,Wangfang Data Knowledge Service Platform,PubMed and Human Gene Mutation Database up to April 2018.Results A ten years old girl was admitted due to "edema and urine output decreased for one week".Lab showed BUN 25.30 mmol/L,Scr 766.5 μmol/L,Urine protein 3.6 g/24 h.Imaging examination showed bilateral vesical and ureter reflux combined with left duplex kidney and duplication of ureter.Developmental dysplasia of the left hip was also found.The father of the patient had been diagnosed with chronic kidney disease for 10 years and on hemodialysis for 6 years.Next generation sequencing revealed that both the father and daughter carried a heterozygous nonsense mutation in the exon3 c.219C ＞ G(p.Y73X) of PAX2.No Chinese literature ever was reported about papillorenal syndrome.Ninety-four articles in English were retrieved and 177 patients with papillorenal syndrome were confirmed by gene analysis with a total of 92 PAX2 variants.Ten nonsense mutations had been reported.Developmental dysplasia of the hip (DDH) never be reported before.Conclusion Papillorenal syndrome caused by PAX2 mutation can mainly manifest as abnormal development of both kidney and optic nerve,which may be accompanied by other systemic abnormalities,it is rarely reported in China.DDH may be a new phenotype of papillorenal syndrome.

Objective To investigate the clinical value of CT spectral imaging parameters in evaluating the liver function in patients with different types of Budd-Chiari syndrome (BCS),by comparing the normalized iodine concentration (NIC) and the slope of spectral curve in liver segment Ⅰ-Ⅷ,portal vein (PV),hepatic vein (HV),inferior vena cava (IVC) and spleen.Methods Eighty-one patients with BCS underwent spectral CT angiography.NIC,spectral decay curve and the slope of spectral curve of liver segment Ⅰ-Ⅷ in portal venous phase,PV,HV,IVC and spleen were measured and calculated.Clinical indicators of liver function including prothrombin time (PT),albumin (ALB),total bilirubin (TBIL),aspartate transaminase (AST),alanine transaminase (ALT) were recorded.Quantitative data were analyzed using One-way ANOVA.Pearson correlation analysis was used to evaluate the correlation of liver NIC and clinical liver function indexes.Results PT and TBIL were negatively correlated with liver NIC and there was a positive correlation between ALB and liver NIC (P＜0.05).The differences of NIC among the three types of BCS in liver segment Ⅱ-Ⅵ,HV,IVC and spleen were statistically significant (P＜0.05) and the difference of slopes of the spectral curves among three types of BCS in liver segment Ⅱ-V and spleen was statistically significant (P＜0.05).Conclusion Combined use of spectral CT multi-site and multi-parameter imaging may be useful in the evaluation of liver function in patients with BCS.

Objective To investigate the therapeutic effect of exosomes extracted from human adipose-derived mesenchymal stem cells(hAMSCs) on traumatic brain injury (TBI) and its possible mechanism.Methods Mesenchymal stem cells(MSCs) were isolated from healthy human adipose tissue and the exosomes were extracted by ultrafiltration.Rats were divided into four groups: sham group, PBS control group, MSCs treatment group and exosomes treatment group.24 h After TBI, the treatment group was locally injected along the lesion area, 30 μL of PBS, 2×105 MSC, 25 μg protein of exosomes respectively, the total volume was 30 μL.We performed the Modified Neurological Severity Score(mNSS) and the forelimb Foot-Fault Test in all rats before injury and at 1, 3, 7, 10, 13, 16, 21 and 30 days after TBI.The rats were sacrificed at 3 and 7 days after TBI respectively,total RNA was extracted from rat brain tissue.The expression of TNF-α and IL-1β were detected by quantitative PCR.The rats were also killed at 30 days after TBI for testing the neuronal apoptosis in lesion area by tunel-neun double imm-unofluorescence.Results Exosomes treatment significantly promotes the recovery of neurological deficits caused by TBI,and the therapeutic effect is similar to MSCs, its possible mechanism may be the inhibition of the acute inflammation and the reducing of the neurons apoptosis after TBI.Conclusions Exosomes extracted from human adipose-derived mesenchymal stem cellshas promoted neurological functionrecovery after traumatic brain injury, which will provide a new and safer TBI treatment for clinical practice.

Objective To improve the diagnostic accuracy of pediatric mesenchymal hamartoma of liver(M HL)by analyzing and summarizing the CT findings.Methods Five pediatric patients with M HL confirmed by postoperative pathology were enrolled,all patients underwent contrast-enhanced CT before operation.Results All lesions were located in the right lobe of liver.The tumor size ranged from 98 mm to 139 mm(mean size was 122 mm)in diameter.Four cases showed cystic and solid mixed masses,and one solid masses.After contrast administration,the substantial part of the mass and its septa showed enhancement while no enhancement was observed in the cystic part.No calcification was observed in the tumor.Conclusion M HL has some special CT characters.Most of M HL can be diagnosed combined with clinical practice as well as CT.