ObjectiveTo explore the effects of angle and original moisture content on the moisture distribution， migration and contents of effective components in the drying process of sliced Salviae Miltiorrhizae Radix et Rhizoma（SMRR）. MethodsSet the slicing angles of SMRR at 30°， 45°， and 90°. Cut the fresh samples， 1/3 dehydrated samples， and 2/3 dehydrated samples， dry them in an oven at 40 ℃ and take samples at the set time points. Low-field nuclear magnetic resonance（LF-NMR） and magnetic resonance imaging（MRI） were used to analyze the changes in transverse relaxation time（T₂） of SMRR samples in 9 treatment groups at specific times， as well as the distribution and migration of water in the samples. The contents of tanshinone Ⅱ_A， tanshinone Ⅰ， cryptotanshinone， and salvianolic acid B in samples from 9 different treatment groups were determined by high performance liquid chromatography（HPLC）， and the best processing technology of SMRR was screened by combining with One-way ANOVA， Duncan multiple comparison and principal component analysis（PCA）. ResultsThe moisture content of dry basis of SMRR in each treatment group decreased with the extension of drying time. The drying rate of fresh cut group decreased slowly at first， while the drying rate of water loss group showed a trend of increasing at first and then decreasing. The internal water of SMRR could be divided into three states， including bound water， non flowing water and free water. During the drying process， the water migration law showed that the free water of fresh cut group disappeared after drying for 12 h， the content of bound water gradually decreased， and the overall fluidity deteriorated. In the water loss group， part of the free water was transformed into more cohesive and non flowing water after drying for 3 h， and the three kinds of water basically disappeared after drying for 12 h. The MRI results showed that the entire dehydration process slowly moved from the outer side to the center， and the internal water eventually dissipated. In terms of the contents of active ingredients， the order of the effect of slicing angle on the total content of active ingredients in SMRR was 30°>45°>90°. The content of tanshinones was ranked as 1/3 dehydrated group>2/3 dehydrated group>fresh cut group， and the content of salvianolic acid B was ranked as 1/3 dehydrated group>fresh cut group>2/3 dehydrated group. Combined with the results of PCA and comprehensive scoring results， the overall level of effective component content in SMRR was the highest when cut at 30° after 1/3 of water loss. ConclusionAfter comprehensive evaluation， SMRR can be sliced at 30° after 1/3 of water loss. It is not only easy to cut， but also the surface and cross-sectional colors remain basically unchanged after drying， which is similar to the color under traditional processing， and the effective ingredients are preserved the highest. This study can provide a basis for the optimization of processing technology of SMRR.

ObjectiveTo investigate the effects of rhizosphere organic acids secreted by the roots of Salvia miltiorrhiza on continuous cropping obstacles. MethodsThe mixed solution of organic acids in the rhizosphere of S. miltiorrhiza in continuous cropping and rotation cropping was added to the hairy roots subcultured for 21 days， and samples were collected on days 0， 2， 4， 6， 8， and 10. The changes of biomass， effective components， primary metabolites， secondary metabolites， antioxidant enzymes， and hormones in hairy roots of S. miltiorrhiza were observed and determined. ResultsCompared with the rotation cropping group and the blank control group， the simulation of organic acid secretion from the roots of S. miltiorrhiza had a significant inhibitory effect on the growth of hairy roots and decreased the content of effective components as well as total sugar and total protein in primary metabolites. Compared with the blank control group， the rotation cropping group and the continuous cropping group showed total sugar and total protein content decreases of 33.9% and 5.1%， respectively. On the other hand， the secretion of organic acids from S. miltiorrhiza roots significantly promoted the accumulation of total phenolic acids and total tanshinone， which showed increases of 14.6% and 1.6%， respectively， in continuous cropping group and rotation cropping group compared with the blank control group. ConclusionThe organic acid environment under continuous cropping significantly inhibited the growth of hairy roots and the accumulation of primary metabolites， while promoting the synthesis and accumulation of secondary metabolites of S. miltiorrhiza.

As a Chinese saying goes， "good Chinese medicinal material makes good medicine"， the quality of Chinese herbal medicines is related to the development prospect of Chinese medicine industry in China. With the rapid development of new technologies such as traceability methods and monitoring instruments， it is imperative to integrate and innovate traditional Chinese herbal medicines with new-generation information technology in view of the quality problems existing in the current production and circulation of Chinese herbal medicines， and it is of great significance for the construction of traceability system to ensure the quality and safety of Chinese herbal medicines and to promote the industry of Chinese herbal medicines to move towards high-quality development. This paper reviews the development history of the traceability system of Chinese herbal medicines in China， takes the influencing factors of the quality of Chinese herbal medicines as the entry point， and proposes that the construction of the traceability system should satisfy the traceability requirements of the characteristics of Chinese herbal medicines and their traditional medication experience. By analyzing the influencing factors of the quality of Chinese herbal medicines， it is pointed out that focusing on the influencing factors to build a traceability system is of great significance for targeting the problematic links at a later stage and exploring the interrelationship between environmental factors and the quality of Chinese herbal medicines. Based on the previous explorations， the author summarizes the system framework， functional modules and practical applications of the traceability system of Chinese herbal medicines， and looks forward to the development of a traceability system with risk early warning function and expert decision-making function in its functional development. Finally， based on the factors affecting the quality of Chinese herbal medicines， the author puts forward several thoughts on construction of the traceability system， and makes an in-depth analysis and puts forward a solution for the current situation that a unified， standardized and universal traceability system has not yet been built， with a view to providing ideas and references for the construction of traceability system of Chinese herbal medicines.

Objective:To explore the teaching evaluation of online open course of hematology based on small private online course (SPOC) platform by means of quantitative method.Methods:The fourth-year undergraduates of clinical medicine major were selected to receive online course learning of hematology, including video viewing, rich text browsing, in-class quizzes, and seminars. The teaching contents covered the basis of hematological diseases, anemic diseases, hematological tumors, bleeding and coagulation disorders. Teaching evaluation was conducted through teaching behavior assessment, unit test, course examination and SPOC scoring. Linear regression analysis was used to analyze the correlation between the duration of the teaching video and student learning behavior. The correlation between video learning quantity and viewing time and course test scores and SPOC scores was analyzed. Kruskal-Wallis test was used to compare the differences in curriculum learning behavior (participation rate). T-test was used to compare the differences between the two results of two unit tests and to calculate the alternative-form reliability. Chi-square test was used to compare the differences in scores of different sub-specialty questions in hematology, and the differences of participation rate of different examination points of hematological tumors. Results:The teaching video viewing rate was significantly higher than the participation rate of rich text browsing and in-class quizzes ( P < 0.001; P < 0.001). There was no obvious correlation between video duration and video viewing, rich text browsing, in-class quizzes ( R = 0.168, F = 0.81, P = 0.376; R = 0.057, F = 0.07, P=0.802; R=0.124, F=0.37, P=0.546). There was a significant positive correlation between the participation rate of video viewing and rich text browsing and in-class quizzes ( R =0.890, F=76.41, P<0.001; R=0.934, F=163.67, P < 0.001). The participation rate of anemic disease unit test was significantly higher than that of hematological tumors ( χ2 = 49.08, P<0.001), bleeding and coagulation disorders ( χ2= 25.97, P< 0.001), and the second results were significantly improved ( t=-2.09, P=0.040), and the alternative-form reliability was 0.750. There was no significant difference in the participation rate of different sub-specialty courses ( χ2=5.20, P=0.074); the number of video watching was significantly positively correlated with SPOC scores ( R=0.523, F=196.22, P<0.001); the participation rate of molecular genetics and molecular biology tests of blood tumor was significantly lower than that of general clinical information questions ( P < 0.05). Conclusion:Teaching videos are the foundation of online courses. Increasing the number of video viewing and improving video viewing rate can effectively mobilize the enthusiasm of extensive learning, such as rich text browsing and in-class quizzes, and improve learning participation. It is conducive to the improvement of students' academic performance. Simple behavior factors such as video viewing time are not recommended as performance evaluation indicators. Unit test takes two times to get the highest score, which is conducive to improving professional learning level through learning behavior, without affecting the reliability of the performance evaluation. The online open course based on the SPOC platform is conducive to the balanced development of the course teaching of Hematology.

ObjectiveTo establish a method for the analysis of oligosaccharides in Atractylodes lancea rhizome based on ultra-performance liquid chromatography tandem quadrupole-time-of-flight mass spectrometry （UPLC-Q-TOF-MS） and a method for the quantification of oligosaccharides in A. lancea rhizome based on UPLC-evaporative light scattering detector （ELSD）， and to investigate the oligosaccharide characteristics of A. lancea rhizome from different habitats. MethodUPLC-Q-TOF-MS was used to identify the oligosaccharides in A. lancea rhizome with the mobile phase of 0.1% ammonia acetonitrile solution （A）-0.1% ammonia solution （B） for gradient elution （0-0.5 min， 98%A； 0.5-2.0 min， 98%-89%A； 2.0-2.5 min， 89%-86%A； 2.5-5.5 min， 86%-80%A； 5.5-6.5 min， 80%-72%A； 6.5-9.5 min， 72%-63%A； 9.5-14.0 min， 63%-50%A； 14.0-16.0 min， 50%A； 16.0-16.5 min， 50%-98%A； 16.5-20 min， 98%A）， the column temperature of 60 ℃ and the flow rate of 0.2 mL·min^-1. Electrospray ionization （ESI） was used to collect data in negative ion mode and the detection range was m/z 50-1 500. The qualitative analysis of oligosaccharides was accomplished by retention time， relative molecular weight， primary and secondary MS information of characteristic fragment ions in combination with reference substance information. UPLC-ELSD was employed to determine the contents of nine oligosaccharides in A. lancea rhizome with the mobile phase of 0.1% ammonia acetonitrile solution （A）-0.1% ammonia solution （B） for gradient elution （0-1 min， 98%-75%A； 1-7 min， 75%-70%A； 7-18 min， 70%-55%A； 18-23 min， 55%A； 23-23.5 min， 55%-98%A； 23.5-28 min， 98%A）， the drift tube temperature of ELSD was set at 50 ℃. Principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA） were used to analyze the classification and differential components between A. lancea rhizome from different habitats. ResultA total of 24 oligosaccharides， containing 11 pairs of isomers， were identified from A. lancea rhizome. Among them， compared with samples from Anhui， Chongqing， Nanjing and Shaanxi， the contents of kestose（GF2）， 1F-fructofuranosylnystose （GF4）， kestohexose （GF5）， fructo-oligosaccharide DP10 （GF9） in samples from Maoshan were statistically significant （P<0.05）， and the total mass fraction of sucrose （GF1）-GF9 reached 16.47%. The peak area ratio of fructose-fructose oligosaccharide to its isomer sucrose-fructose oligosaccharide was greater than 1 in samples from Maoshan. ConclusionThe types and contents of oligosaccharides in A. lancea rhizome vary greatly among different habitats， and the peak area ratio of fructose-fructose oligosaccharide to sucrose-fructose oligosaccharide >1 may be one of the geoherb characteristics of A. lancea rhizome， which can provide a reference for the development， utilization and quality control of this herb.

Objective:To look into the security of a second allogeneic hematopoietic stem cell transplantation (allo-HSCT) using rabbit anti-human thymocyte immunoglobulin (rATG) .Methods:Twenty-seven patients who used rATG in the first and second allo-HSCT at the Institute of Hematology, Peking University were enrolled in the study. Experienced toxicities associated with the conditioning protocol within 10 days (-5 d to +3 d) following the beginning of the rATG application, including fever, diarrhea, arrhythmia, reduced blood pressure, liver damage, seizures, and other problems.Results:The overall incidence of conditioning regimen early adverse reactions during the first transplantation and the second allo-HSCT conditioning regimen was 96.3% and 77.8% ( P=0.043) . Fever rates were 81.5% and 63.0% ( P=0.129) , diarrhea rates were 59.3% and 25.9% ( P=0.013) , liver damage rates were 22.2% and 25.9% ( P=0.75) , and the rates of other events (cardiac arrhythmia, low blood pressure, and epilepsy) were 3.7% and 18.5% ( P=0.083) . Adverse reactions that occurred during both the first and second course of rATG applications have been improved with symptomatic treatment, and no treatment interruptions occurred. Conclusion:Reusing rATG in a second transplant was risk-free and did not result in higher early toxicities.

Relapse is the main problem after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The outcome of a second allo-HSCT (HSCT2) for relapse post-HSCT has shown promising results in some previous studies. However, little is known about the efficacy of HSCT2 in patients with relapsed/refractory acute leukemia (AL) post-chemotherapy plus modified donor lymphocyte infusion (post-Chemo + m-DLI) after the first allo-HSCT (HSCT1). Therefore, we retrospectively analyzed the efficacy of HSCT2 in 28 patients with relapsed/refractory AL post-Chemo + m-DLI in our center. With a median follow-up of 918 (457-1732) days, 26 patients (92.9%) achieved complete remission, and 2 patients exhibited persistent disease. The probabilities of overall survival (OS) and disease-free survival (DFS) 1 year after HSCT2 were 25.0% and 21.4%, respectively. The cumulative incidences of nonrelapse mortality on day 100 and at 1 year post-HSCT2 were 7.1% ± 4.9% and 25.0% ± 8.4%. The cumulative incidences of relapse were 50.0% ± 9.8% and 53.5% ± 9.9% at 1 and 2 years post-HSCT2, respectively. Risk stratification prior to HSCT1 and percentage of blasts before HSCT2 were independent risk factors for OS post-HSCT2, and relapse within 6 months post-HSCT1 was an independent risk factor for DFS and relapse post-HSCT2. Our findings suggest that HSCT2 could be a salvage option for patients with relapsed AL post-Chemo + m-DLI.
Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute/therapy* ; Lymphocytes ; Recurrence ; Retrospective Studies ; Transplantation, Homologous

Objective: To report our experience in the prevention and control of COVID-19 in the tramatological and microsurgical wards. Methods: A retrospective study was conducted of the COVID-19 infections in the 51 medical staff and patients from 31 December, 2019 to 14 February, 2020 at Department of Traumatology and Microsurgery, Zhongnan Hospital. The prevention and control measures were upgraded after 20 January, 2020 to address the serious epidemic situation, including preventive disinfection, terminal disinfection and personnel disinfection in wards, management of emergency patients, inpatients and patients suspected of COVID-19 infection, and training, management and psychological intervention of medical staff. The outcomes resulting from different prevention and control measures before and after 20 January, 2020 were compared. Results: From 31 December, 2019 to 20 January, 2020, there were altogether 3 cases of definite COVID-19 infection and 2 ones of suspected COVID-19 infection at the department. One doctor, one technician and one nurse were diagnosed as definite COVID-19 infection while one nurse and one patient as suspected COVID-19 infection. The 4 medical staff members infected were cured and discharged before 14 February, 2020 but unfortunately the one patient infected died. After the prevention and control measures for COVID-19 infection had been upgraded since 20 January, 2020, 12 out of the 29 emergency patients at our wards had fever (body temperature ≥37.3℃) but none COVID-19 infection. All the 47 medical staff on duty at the department got trained and none of them was infected by COVID-19 or suffered from mental disorder. Conclusion In the epidemic of COVID-19, as our prevention and control measures for COVID-19 infection were adjusted and upgraded in response to the changing epidemic situation, they eliminated nosocomial infection scientifically and effectively and ensured life safety of the medical staff and patients at the department.

OBJECTIVE: To carry out prenatal diagnosis on a fetus with abnormal findings by ultrasonography and non-invasive prenatal testing. METHODS: The fetus and both parents were subjected to chromosomal karyotyping and single nucleotide polymorphism array (SNP-array) analysis. RESULTS: The karyotypes of both parents were normal. The fetus carried a 46,N,der(X;16)(q28;q22) unbalanced translocation. SNP-array analysis confirmed that the derived chromosomal fragment of the fetus has originated from 16q. The fetus was diagnosed with 16q partial trisomy syndrome. CONCLUSION Combined chromosomal karyotyping analysis and SNP-array can detect chromosomal aberrations at submicroscopic level and enable accurate diagnosis of the fetus.

Objective: To investigate the clinical pathological features of Barrett′s esophagus in China, and to study the relationship between the number of goblet cells and the severity of Barrett′s esophageal dysplasia. Methods: From January 2008 to October 2018, in the Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, the clinical and pathological data of 453 patients who underwent gastroscopy and pathologically diagnosed with Barrett′s esophagus were retrospectively analyzed. The clinical pathological features were compared between patients with goblet cells and patients without goblet cells. Periodic acid Schiff reaction (PAS) staining was performed on pathological slides of Barrett′s esophagus with goblet cells, and the relationship between the number of goblet cells, the number of positive crypts of goblet cells and the severity of Barrett′s esophageal dysplasia was analyzed. T test and chi-square test were performed for statistical analysis. Results: Among 453 patients with Barrett′s esophagus, 251 (55.4%) were males and 202 (44.6%) were females. There were 218 Barrett′s esophagus with goblet cells, including 128 males (58.7%) and 90 females (41.3%). The average onset age was (60.6±11.9) years old, and the peak onset age was between 60 and 69 years old. The appearance under endoscopy mainly was circumferential type (58.2%, 127/218). There were 235 Barrett′s esophagus without goblet cells, 123 males (52.3%) and 112 females (47.7%). The average onset age was (56.1±14.4) years old, and the peak onset age was between 50 and 59 years old. The appearance under endoscopy was mainly circumferential type (40.0%, 94/235). The incidence of dysplasia in Barrett′s esophagus with goblet cells was higher than that without goblet cells (75.7%, 165/218 vs. 37.0%, 87/235), and the difference was statistically significant (χ²=68.501, P<0.01). PAS staining showed that goblet cells were stained purplish red. The number of goblet cells, total number of crypts, the number of positive crypts of goblet cells and the proportion of positive crypts of goblet cells of Barrett′s esophagus with mild dysplasia were all significantly higher than those of Barrett′s esophagus with moderate dysplasia (95.50±40.56 vs. 40.00±13.34, 21.00±8.31 vs. 11.83±2.92, 16.50±6.17 vs. 7.50±2.47 and 0.79±0.42 vs. 0.63±0.12, respectively), and the differences were statistically significant(t=-4.503, -3.605, -4.690 and -4.340, all P<0.01). Conclusion Barrett′s esophageal dysplasia may be related with appearance of goblet cells, and the decrease or disappearance of goblet cells may indicate the progression of Barrett′s esophagus.