Qing court records show that Arecae Semen was extensively applied. The royal medical records of the Qing Dynasty document nine types of Arecae Semen, with the Palace Museum preserving seven kinds, totaling twelve cultural relics. Historical documents and physical artifacts corroborate each other, providing evidence for the study of the supply channels and court processing of Arecae Semen in the Qing court. According to relevant Qing court archival records, the sources of Arecae Semen used in the imperial court were diverse, including tributes from foreign countries such as Vietnam and Gurkha, annual tributes from local governments in Guangdong, gifts from close aides, and commodities purchased by the Imperial Household Department from civilian shops. The imperial physicians of the Qing court placed great emphasis on the specifications of Arecae Semen slices and were extremely meticulous about their processing. The variety of Arecae Semen slices used in the Qing palace exceeded those recorded in the botanical texts of the era. Compared with the commonly used processing methods for Arecae Semen in the Qing Dynasty, the imperial physicians adjusted the properties and efficacy of the herbs through different processing techniques, based on the patient's condition, constitution, and other factors, in order to meet the clinical treatment needs of the court. The slicing of Arecae Semen in the Qing court required strict control of thickness, with an average thickness of 0.44 mm, which is significantly thinner than the Arecae Semen slices found in today's markets. The texture was softer, making them easier to chew and absorb. Both the Qing court Arecae Semen slices and the Muxiang Binglang Pills focused on the use of authentic medicinal materials, ensuring the quality of the medicine and enhancing the efficacy of Arecae Semen through meticulous selection and preparation.
China ; Drugs, Chinese Herbal/history* ; Humans ; Medicine, Chinese Traditional/history* ; History, 19th Century ; History, Ancient ; History, 17th Century ; History, 18th Century

Objective To evaluate the bioequivalence and safety of two pyrazinamide tablets in healthy Chinese subjects.Methods An open,randomized,single-dose,two-sequence,two-cycle,double-cross trial design was used.All 48 healthy subjects(24 in fasting and 24 in fed trial)were randomized to receive a single oral dose of a 0.5 g pyrazinamide tablet(test or reference)per cycle.The plasma concentration of the drug was determined by liquid chromatography coupled to tandem mass spectrometry method.The pharmacokinetic parameters were calculated by WinNonlin v8.2,and the bioequivalence was evaluated by SAS 9.4.Results In the fasting group,the Cmax of the test and reference preparation of pyrazinamide tablets were(13.28±2.82)and(12.88±4.49)μg·mL-1,the AUC0-t were(139.17±26.58)and(138.63±28.92)h·μg·mL-1,the AUC0-∞ were(148.96±33.65)and(148.71±36.97)h·μg·mL-1 respectively.In the fed group,the Cmax of the test and reference preparation of pyrazinamide tablets were(11.89±1.96)and(11.99±1.92)μg·mL-1,the AUC0-t were(138.22±37.21)and(141.68±25.80)h·μg·mL-1,the AUC0-∞ were(152.20±32.41)and(151.04±28.05)h·μg·mL-,respectively.The 90％confidence intervals of Cmax,AUC0-t and AUC0-∞ geometric mean ratios of the test and reference preparation were all within 80.00％to 125.00％.The incidence of adverse events was 16.70％for both the test and reference preparation in the fasting group and 8.30％for both the test and reference preparation in the fed group,all of which were mild in severity.Conclusion The test and reference preparation of pyrazinamide tablets were bioequivalent,safe and well tolerated in healthy Chinese subjects under fasting and fed conditions.

Objective: To investigate the resistance to rifampicin and isoniazid and the changing trends among patients with pulmonary tuberculosis in Luohu District, Shenzhen City, Guangdong Province from 2012 to 2022, so as to provide insights into improving drug-resistant pulmonary tuberculosis control and prevention strategies. Methods: Basic information, treatment classification and drug resistance data of patients with pulmonary tuberculosis and positive pathogenic detection in Luohu District from 2012 to 2022 were collected through the Tuberculosis Surveillance System of Chinese Disease Prevention and Control Information System, and resistance rates of rifampicin and isoniazid and the changing trends were analyzed. Results: A total of 2 126 patients with pulmonary tuberculosis were collected and had a median age of 34 (interquartile range, 25) years, including 1 334 males (62.75%) and 792 females (37.25%). There were 302 patients with drug-resistance in Luohu District from 2012 to 2022, with a resistance rate of 14.21%. Among them, 60 patients were monoresistant to rifampicin (2.82%), 113 patients were monoresistant to isoniazid (5.32%), and 129 patients were multidrug resistant (6.07%). The rate of rifampicin monoresistance showed a downward trend from 2012 to 2022, while the rate of multidrug resistance showed an upward trend (both P<0.05). There was no significant tendency in the rate of isoniazid monoresistance (P>0.05). The rate of multidrug resistance among patients without Shenzhen residence was higher than that among patients with Shenzhen residence; the rates of rifampicin resistance and multidrug resistance among retreated patients were higher than those among treatment-naïve patients (all P<0.05). Conclusions The rate of rifampicin monoresistance appeared a downward trend and the rate of multidrug resistance appeared an upward trend among patients with pulmonary tuberculosis in Luohu District from 2012 to 2022. Attention should be given to non-Shenzhen residence and retreated patients.

BACKGROUND:Red light therapy has the non-invasive and cost-effective characteristics,and is widely used in various acute and chronic pains in clinic.However,currently,the phototherapy equipment used in clinic is expensive and has certain site limitations,so it is necessary to explore more convenient and economical phototherapy applications. OBJECTIVE:To observe the clinical efficacy of a self-developed photon cervical vertebra massage instrument for chronic neck pain. METHODS:From November 2022 to February 2023,24 patients with chronic neck pain were recruited from the Department of Rehabilitation Medicine,Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,including 18 females and 6 males,with a mean age of(29.67±6.40)years.The body mass index was(21.39±3.52)kg/m2.Photon cervical vertebra massage instrument was used twice a day for 20 minutes each time for four weeks.The changes in visual analog scale score,pressure pain threshold,neck active activity,neck disability index,and Pittsburgh sleep quality index were observed before,after 2 and 4 weeks of treatment. RESULTS AND CONCLUSION:(1)Compared with before treatment,after four weeks of treatment,visual analog scale score,pressure pain threshold,neck disability index,and Pittsburgh sleep quality index were all improved(P<0.05),while some cervical motion(extension,left and right rotation)improved(P<0.05)after 4 weeks of treatment.(2)Bilateral visual analog scale scores,left trapezius muscle pressure pain threshold,C5C6 pressure pain threshold,and neck disability index improved after 2 weeks of treatment(P<0.05).(3)It is indicated that the application of photon cervical vertebra massage instrument can improve the pain score,muscle tenderness,sleep quality,functional level,and partial active activity of patients with chronic neck pain in a short period,and is a convenient,effective,and safe treatment method.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.

The retinal neurovascular unit (NVU) is an interdependent system comprising neurons, glial cells (macroglia and microglia), and the vascular structure, entrusted with the preservation of retinal homeostasis.It plays a key role in eye diseases such as diabetic retinopathy.Cell communication forms a pivotal conduit for interaction within the NVU, encompassing both direct communication predominantly through gap junctions and cell surface receptors, as well as indirect communication via secreted intercellular soluble factors.As resident immune cells in the retina, microglia orchestrate activities between neural and vascular tissues through intercellular communication to maintain physiological and pathological functions of the retina.This review explores the multiple impact of retinal microglia on retinal ganglion cells, the inflammatory positive feedback loop involving retinal microglia and Müller cells, the modulation of angiogenesis, capillary constriction/dilation, and the role of microglia in maintaining the blood-retinal barrier within the retina in concert with pericytes.The potential influence of microglia within the neurovascular unit is also investigated.

Objective To explore the relationship between serum nerve growth factor(NGF)and neurofil-amentlight-chain(NF-L)levels with the severity and prognosis of traumatic brain injury(TBI)patients,as well as their predictive value through a prospective research.Methods A total of 132 TBI patients and 132 ordinary trauma patients were collected as the observation group and the control group,respectively.TBI pa-tients in the observation group were divided into three subgroups of mild,moderate,and severe according to Glasgow Coma Scale(GCS)scores,and they were also divided into good and poor subgroups according to Glasgow Outcome Scale(GOS)scores at 6-month follow-up.Enzyme-linked immuno sorbent assay(ELISA)was used to detect serum NGF and NF-L levels in all patients after admission.Through comparison between the observation group and the control group,the relationship between TBI and serum NGF and NF-L levels was clarified.By comparing the differences between different subgroups of the observation group,the relation-ship between serum NGF and NF-L levels and the severity and prognosis of TBI was determined.Through correlation analysis,receiver operating characteristic(ROC)curve and multivariate Logistic regression analy-sis,and the predictive value of serum NGF and NF-L levels for TBI was clarified.Results Compared with the control group,serum NGF and NF-L levels were significantly increased while GCS scores were significantly decreased in the observation group(P＜0.01).In addition,serum NGF and NF-L levels gradually increased a-mong subgroups of mild,moderate,and severe groups in the observation group(P＜0.01).The area under the curve(AUC)of serum NGF and NF-L levels for predicting mild TBI were 0.924(95％CI:0.889-0.986)and 0.991(95％CI:0.982-1.000),and the cut off values were 12.5 ng/mL and 66.5 μg/mL,respectively.AUC of serum NGF and NF-L levels for predicting moderate TBI were 0.776(95％CI:0.686-0.862)and 0.837(95％CI:0.763-0.911),respectively,and AUC for predicting severe TBI was 0.950(95％CI:0.900-0.987)and 0.988(95％CI:0.971-1.000),respectively,with cut off values of 14.5 ng/mL and 157.0 μg/mL,respec-tively.Spearman correlation analysis showed that serum NGF and NF-L levels were negatively correlated with GOS scores of TBI patients(P＜0.01).AUC for predicting the prognosis of TBI patients with serum NGF and NF-L levels were 0.858(95％CI:0.776-0.932)and 0.909(95％CI:0.824-0.978),respectively,with cut off values of 13.5 ng/mL and 71.5 μg/mL,respectively.Logistic regression analysis showed that serum NGF and NF-L levels were risk factors affecting the prognosis of TBI patients.Conclusion Serum NGF and NF-L levels are significantly elevated in TBI patients and could provide reference for early assessment of inju-ry severity in clinical practice.Furthermore,elevated serum NGF and NF-L levels are associated with poor prognosis of TBI patients and are good biological indicators for predicting prognosis.

Objective To explore the clinicopathological characteristics,prognosis and influencing factors of different pathological subtypes of gastric signet ring cell carcinoma(GSRC).Methods A retrospective analysis was performed on the clinical data of 232 patients with GSRC collected from January 2016 to December 2018 in Lanzhou University Second Hospital.According to the WHO classification criteria for GSRC,the patients were divided into pure gastric signet-ring cell carcinoma(pGSRC,n=36)and mixed gastric signet-ring cell carcinoma(mGSRC,n=196).The follow-up as of September 30,2022,the survival analysis was done using Kaplan-Meier method,the univariate and multivariate Cox regression were performed to analyze the risk factors affecting the prognosis of GSRC patients.Results The median survival time of pGSRC and mGSRC patients was 41.0(6.0-70.0)months and 24.0(2.0-74.0)months,respectively.Kaplan-Meier analysis showed that combination with diabetes,anemia,tumor diameter,nerve invasion,lymphovascular invasion,T stage,N stage,GSRC pathological subtype,CA125 and tumor diameter could affect the overall survival(OS)of patients with GSRC after radical gastrectomy(P＜0.05),but Her-2,whether adjuvant chemotherapy or not and others elements had no significant effect on OS of GSRC patients after radical gastrectomy(P＞0.05).Univariate Cox regression analysis showed that the combination with diabetes(P=0.031),anemia(P=0.028),tumor diameter＞5 cm(P=0.009),nerve invasion(P=0.002),lymphovascular invasion(P=0.002),mGSRC pathological type(P=0.039),T2-T4 stage(P=0.001),N1-N4 stage(P=0.004),pTNM stage Ⅲ(P=0.044),the number of lymph node metastasis＞30(P=0.044)and CA125 positive(P=0.009)were related to the prognosis of patients with GSRC after radical gastrectomy.Multivariate Cox regression analysis showed that mGSRC pathological type(P=0.035),T2-T4 stage(P=0.003),CA125 positive(P=0.010)were independent risk factors for poor prognosis of patients with GSRC after radical gastrectomy.Conclusion Compared with pGSRC,patients with mGSRC at diagnosis have higher pTNM stages,more aggressive,and shorter median survival time.mGSRC pathological type,T2-T4 stage,and CA125 positive were all independent factors affecting the prognosis of patients with GSRC.