Decoction is the most commonly used dosage form in the clinical treatment of traditional Chinese medicine (TCM). During boiling, the violent movement of various active ingredients in TCM creates molecular forces such as hydrogen bonding, π-π stacking, hydrophobic interactions and electrostatic interactions, which results in the formation of self-assembled aggregates in decoction (SADs), including particles, gels, fibers, etc. It was found that SADs widely existed in decoction with biological activities superior to both effective monomers and their physical mixtures, providing a new idea to reveal the pharmacodynamic material basis of Chinese herbal medicine from the perspective of component interactions-phase structure. Recently, SADs have become a novel focus of research in TCM. This paper reviewed their relevant studies in recent years and found some issues to be concerned in the research, such as the polydispersity of decoction system, instability of active ingredient interactions during boiling, uncertainty of the aggregates self-assembly rules, and stability, purity, yield of the products. In this regard, some solutions and new ideas were presented for the integrated development and clinical application of SADs.

Objective: To evaluate the diagnostic value and application of 24 h multichannel intraluminal impedance-pH (24 h MII-pH) monitoring in children with gastroesophageal reflux disease (GERD). Methods: This is a cross-sectional study. From January 2013 to December, 2020, 417 patients who received 24 h MII-pH monitoring in Department of Gastroenterology of Children's Hospital Capital Institute of Pediatrics were included. According to results, these children were divided into the GERD and non-GERD groups. Furthermore, the 132 children with GERD who had gastroscopy were divided into the reflux esophagitis (RE) and non-erosive reflux disease (NE) groups to investigate the differences in their refluxes. Non-parametric Mann-Whitney U test or indepentent sample t test was used for comparisons between the groups. Results: Among the 417 children, 232 were males and 185 females, aged (7.3±3.9) years. The course of disease was 0.5 (0.1, 2.0) years. The main clinical symptoms included acid reflux (128 cases), vomiting (173 cases), abdominal pain (101 cases), and cough (76 cases). The 24 h MII-pH monitoring were positive in 243 children (58.3%, 243/417), which was higher than that by 24 h esophageal pH monitoring (43.6%, 182/417). The 24 h MII-pH monitoring results demonstrated significant differences in the episodes of acid reflux, weakly acidic reflux, non-acidic reflux, liquid reflux and mixed reflux between GERD and non-GERD groups (10 (4, 19) vs. 4 (1, 9) times/24 h, 14 (6, 32) vs. 7 (3, 13) times/24 h, 0 (0, 0) vs. 0 (0, 0) times/24 h, 19 (10, 34) vs. 8 (3, 14) times/24 h, and 6 (2, 12) vs. 3 (1, 5) times/24 h, Z=-6.96, -7.25, -5.62, -8.75, and -6.48, all P<0.05, respectively). Besides, the results also showed significant differences in Boix-Ochoa score, episodes of long reflux, course of long reflux, and episodes of weakly acidic reflux between the RE and NE groups (51.2 (21.4, 153.2) vs. 20.7 (12.1, 34.7), 5 (2, 10) vs. 1 (0, 4) times/24 h, 19 (7, 87) vs. 8 (3, 22) min, and 5 (2, 15) vs. 15 (6, 33) times/24 h, Z=-3.44, -3.41, -2.65, and -2.27, all P<0.05, respectively). Conclusion: 24 h MII-pH monitoring not only improves the detection rate of GERD in children, but also provides a possibility to early etiological diagnosis.
Female ; Male ; Humans ; Child ; Cross-Sectional Studies ; Electric Impedance ; Gastroesophageal Reflux/diagnosis* ; Esophageal pH Monitoring ; Hydrogen-Ion Concentration

Four salts of ticagrelor, ticagrelor-3,5-dinitrobenzoic acid, ticagrelor-pyrazinamide, ticagrelor-D-proline and ticagrelor-L-proline were prepared by solvent suspension and liquid-assisted grinding to improve the solubility of ticagrelor. The compounds were characterized by powder X-ray diffraction, Fourier transform infrared spectroscopy, differential scanning calorimetry, nuclear magnetic resonance spectroscopy, elemental analysis, and the intermolecular salt-bonding forces were analyzed. The equilibrium solubility of salts and pure drug in hydrochloride buffer pH 1.2 and phosphate buffer pH 6.8 were measured by high-performance liquid chromatography. Ticagrelor was salted with 3,5-dinitrobenzoic acid, pyrazinamide, D-proline, L-proline all in a stoichiometric ratio of 1∶1; with the exception of ticagrelor-D-proline, the solubility of the other three salts provided significantly improved solubility in hydrochloride buffer pH 1.2, and the equilibrium solubility of ticagrelor-3,5-dinitrobenzoic acid was increased by approximately 1.7 folds as compared to pure drug. Salt-forming technology is convenient and can improve the solubility of ticagrelor.

OBJECTIVE: To compare the clinical therapeutic effect on coronavirus disease 2019 (COVID-19) with insomnia between the combined treatment of METHODS: A total of 90 patients with COVID-19 accompanied with insomnia were randomly divided into an observation group (45 cases, 3 cases dropped off) and a control group (45 cases). In the observation group, RESULTS: After treatment, the scores of every item and the total scores in PSQI were all reduced as compared with those before treatment in the two groups ( CONCLUSION The combined treatment of
Acupuncture Points ; Acupuncture Therapy ; COVID-19 ; Humans ; SARS-CoV-2 ; Sleep Initiation and Maintenance Disorders/etiology* ; Treatment Outcome

Purpose To investigate the histopathological diagnosis and follow-up of gastric mucosal biopsy. Methods A detailed histopathological observation was performed on 5 748 gastroscopic biopsies and 3 288 patients were followed up. Results In 5 748 cases of endoscopy biopsy specimens, acute gastritis was rechecked in 125 cases, of which 112 cases were cured or improved (89.6％ ), 10 cases (8.0％ ) had little change, and 3 cases (2.4％) were aggravated. There were 2430 cases of chronic atrophic gastritis, in which 1521 cases were cured/improvement (62.6％ ), 737 cases (30.3％ ) had little change, and 172 cases (7.1％ ) were aggravated. In the 71 cases of special type of gastritis, 23 cases were cured or improved, accounting for 32.3％.42 cases were not changed much, accounting for 59.2％, and 6 cases were aggravated (8.5％ ). About druginduced gastritis/stomach reexamination in 94 cases, 57 cases were cured/improved, accounting for 60.6％, 34(36.3％ ) cases did not change, and 2 cases were aggravated(3.2％ ).183 cases of gastric polyp were reviewed, 165 cases(90.2％ ) were cured / improved, 13 cases (7.1％ ) were not changed and 5 cases (2.7％ ) were aggravated. No neoplasia/ nondysplasia was found in 205 cases, 196(95.6％ ) cases was cured / improved, no change was seen in 6 cases (2.9％ ) and aggravation was seen in 3 cases(1.5％). Indefinite neoplasia/ dysplasia was reexamined in 24 cases, 2 cases (8.3％) were cured/improved, no change was seen in 13 cases (54.2％ ), and aggravation was seen in 9 cases(37.5％).156 cases of intraepithelial neoplasia were retrospectively reviewed, in which138 (88.5％ ) cases were cured or improved, 4(2.6％ ) cases showed no change, and 13(8.3％) cases were aggravated. Conclusion It is of great significance to improve the early diagnosis rate, reduce missed diagnosis rate and misdiagnosis rate of gastric cancer by establishing 11 pathological changes and accompanying lesions.

Objective To establish the quality standard of common selfheal fruit-spike granules. Mehtods Rosmarinicacid in the granules were identified by TLC. The extractives were tested by the method for determination of water-soluble extractives. The contents of rosmarinicacid were determined by HPLC. Results TLC had obvious characteristics with the spots clear and well-separated. The extraction limit was no less than 10.0%. Rosmarinicacid showed a good linear relationship at 0.062 5~2.008 0 mg/ml (r=0.999 8,n=6) with average recovery of 99.50% (RSD=1.21%,n=9). The content limitation of rosmarinicacid was discussed as 10.0 mg per pack according to the experiment data.Conclusion The method is easy-operated and accurate which has a good specificity for the quality control of common selfheal fruit-spike granules.

Objective To establish HPLC method for determination of (R,S)-epigoitrin in Banlangen granules and discuss the content limitation. Methods The samples were separated on SHIMADZU VP-ODS (150 mm×4. 6 mm, 5 μm) and the mobile phase consisted of methol-0. 02% phosphoric acid solution (7:93) at a flow rate of 1. 0 mL. min-1 . The detection wavelength was set at 245 nm and the injection volume (in automatic sampler) was 10 μL. The content limitation was assessed according to the transfer rate and statistical data of the results. Results (R,S)-epigoitrin showed a good linear relationship at concentration of 0. 058 7 – 150. 349 5 μg·mL-1(r = 0. 999 7, n = 7). The average recovery rate was 98. 72% , 98. 40% and 98. 60% , respectively; RSD was 1. 84% , 0. 50% and 1. 82% , respectively. The content limitation of (R,S)-epigoitrin was unreasonable according to the transfer rate and the statistical data of the results. Conclusion The method is easy and simple to operate, accurate and stable in results, and highly specific, thus it is applicable for the quality control of Banlangen granules. The content limitation should be determined on the basis of pharmacokinetic and pharmacodynamic data.

OBJECTIVE:To establish the quality standard of Banlangen dispensing granules. METHODS:Thin layer chroma-tography(TLC)was used to identify Isatis indigotica,leucine and arginine,the items according to granules preparations and the ex-traction were detected. HPLC was conducted to determine the content of (R,S)-goitrin. The Shimadzu VP-ODS C18 column was used with the mobile phase of methanol-0.05% phosphoric acid (7∶93,V/V) at the flow rate of 1.0 ml/min. The detection wave-length was set at 245 nm,and the column temperature was room temperature. The sample size was 10 μl. RESULTS:TLC showed clear spots and good resolution. Particle size,moisture,dissolubility and microbial limit test were all conformed to the specifica-tion. The extraction limit was no less than 25.0%.(R,S)-goitrin showed a good linear relationship in the range of 1.565 9-50.109 8μg/ml(r=0.999 9,n=6). The average recovery was 99.25%(RSD=2.08%,n=9);the RSDs of precision,stability and repeatabili-ty tests were no more than 1.12%. The content of(R,S)-goitrin was initially determined as 0.35 mg/g. CONCLUSIONS:The estab-lished quality standard has increased content determination,and the control programs are more comprehensive and reasonable. It can be used for the quality control of Banlangen dispensing granules.

Objective:To establish the quality standard for Isatidis folium dispensing granules. Methods:Indigo and indirubin in the granules were identified by TLC. The extract content was determined by a hot dipping method for the determination of alcohol-solu-ble extract. The content of indirubin was determined by HPLC. Results:The spots in TLC were clear and well-separated. The extrac-tion limit no less than 12. 0% was preliminarily drawn up. Indirubin showed a good linear relationship within the range of 0. 50-8. 04μg·ml-1(r=0. 999 9) with the average recovery of 99. 41%(RSD=1. 21%, n=9). The content limit no less than 50. 0 μg per pack was preliminarily drawn up for indirubin. Conclusion: The method is easy-operated and accurate with good specificity for the quality control of Isatidis folium dispensing granules.

OBJECTIVETo investigate the indications, safety and efficacy of catheter directed thrombolysis for early left lower extremity deep venous thrombosis (DVT) without vena cava filters protection.

METHODSClinical data of 54 cases of early left lower extremity DVT received catheter directed thrombolysis without vena cava filters from July 2008 to June 2010 were retrospectively analyzed. The thrombosis was entire without free floating clots and no thrombosis in vena cava detected with ultrasound scan. Twenty-five patients were male and 29 were female with the average age of 52.8 years. Fifty-one of which were iliofemoral and popliteal, the other 3 were iliofemoral. The course were ≤ 7 d in 45 cases and these were 8 to 30 d in 9 cases. Urokinase of 300 000 U was infused through catheters per 2 h twice a day. Meanwhile 4000 U of low weight heparin was administered subcutaneously per 12 h, or heparin infusion at dosage of 18 U×kg(-1)×h(-1).

RESULTSThe procedure technically succeeded in all patients. In total cases venous score decreased to 4.6 ± 2.1 post 6 to 10 d of thrombolysis from 10.8 ± 1.0 with thrombolysis rate of 58% ± 18% which was not significantly different between groups of ≤ 7 d and 8 to 30 d (t = 1.02, P = 0.34). On 14(th) day, 11 patients (20.4%) completely recovered, 35 cases (64.8%) experienced large improvement, 8 patients (14.8%) had mild improvement and nobody was failed, resulting in total efficacy of 100%. No patient developed clinical symptomatic pulmonary embolism. SpO2 did not alter markedly post thrombolysis [(91.0 ± 2.6)% vs. (90.8 ± 2.4)%, t = 2.03, P = 0.05]. No patients suffered from cerebral hemorrhage and haemoturia, and catheter induced inflammation occurred in 4 cases (7.41%). There was mild bleeding in puncture sites in 11 patients (20.4%) during the course. There were 36 patients (66.7%) had been followed up with the time of 6 to 21 months. In which 31 cases had no lower extremity edema or had mild edema after activities. Two patients developed serious edema after activities for deep venous insufficiency. Three cases combined with malignant tumor or renal failure recurred.

CONCLUSIONSFor early left extremity DVT which is entire without free floating clots and no thrombosis in vena cava, catheter directed thrombolysis without filter protection maybe administered with safety, efficiency and lower expense.

Catheterization, Peripheral ; Female ; Fibrinolytic Agents ; administration & dosage ; therapeutic use ; Follow-Up Studies ; Humans ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Pulmonary Embolism ; prevention & control ; Retrospective Studies ; Thrombolytic Therapy ; methods ; Urokinase-Type Plasminogen Activator ; administration & dosage ; therapeutic use ; Vena Cava Filters ; Venous Thrombosis ; complications ; therapy