ObjectiveTo explore the spatial distribution patterns of flavonoid glycosides in Epimedium sagittatum and the influences of environmental factors on the accumulation of these components. MethodsThe spatial statistical analysis and GeoDetector model were used to analyze the distribution patterns of epimedin A，epimedin B，epimedin C，icariin，and total flavonoid glycosides in E. sagittatum samples from 92 different production areas in 36 cities of 13 provinces/municipalities/autonomous regions of China，as well as the effects of 28 environmental factors on the accumulation of each component. ResultsThe average content of flavonoid glycosides 64 （69.56%） producing areas and 30 （83.33%） cities met the quality standard of no less than 1.50% of total flavonoid glycosides in the 2020 edition of Chinese Pharmacopoeia.Epimedin A，epimedin B，epimedin C，icariin，and their sum showed significantly high accumulation.The hot spots regions of epimedin A and epimedin B were similar with each other，mainly located in western Hunan，eastern Hubei，eastern Guizhou，and northern Guangxi.The common hot spot areas of epimedin C and total flavonoid glycosides were in western and southwestern Hunan，southern Henan，northern Anhui，eastern Guizhou，and southern Chongqing.The hot spots areas of icariin were in southern Chongqing，western Hunan，and eastern and northeastern Guizhou.The interactions between environmental factors had stronger explanatory power for the accumulation of components than single factors.The strongest single factor and interactive factor affecting the accumulation of epimedin C were precipitation of wettest quarter （q=0.16） and its interaction with temperature seasonality （q=0.35），respectively.The strongest single factor influencing both the accumulation of icariin and total flavonoid glycosides was the precipitation of coldest quarter （q equals 0.15 and 0.22，respectively）.The strongest interactions were observed between precipitation of coldest quarter and gravel content （q=0.34），as well as between precipitation of coldest quarter and aspect （q=0.35）. ConclusionThirteen cities，including Zhumadian and Nanyang in Henan，Huaihua，Shaoyang，and Zhangjiajie in Hunan，and Zunyi，Qiandongnan，and Tongren in Guizhou，were hot spots of total flavonoid glycosides in E.sagittatum.Precipitation，gravel content，temperature seasonality，and aspect significantly influence the accumulation of flavonoid glycosides in E.sagittatum.This study provides reference for the utilization and production zoning of E.sagittatum.

Objective To analyze the potential distribution and quality zoning of Gentiana farreri Balf.f.;To provide a theoretical basis for the conservation,sustainable utilization,and domestication of this Tibetan medicine resource.Methods The MaxEnt model and geographic information system software ArcGIS 10.2 were used to conduct ecological suitability zoning of Gentiana farreri Balf.f.in China through searching online specimen libraries and field investigations.SPSS25.0 software was used to construct a relationship model between indicator components and ecological factors,combined with ArcGIS software spatial analysis technology,to form a quality zoning of Gentiana farreri Balf.f.medicinal material.Results The primary environmental factors influencing the ecological suitability of Gentiana farreri Balf.f.were altitude,precipitation in May,April and December,and the mean monthly diurnal temperature range.The most suitable growth areas for Gentiana farreri Balf.f.were predominantly found at the junction of Gansu,Sichuan and Qinghai provinces,certain parts of Tibet,and selected regions of Sichuan.The southern part of Tibet and the southwestern part of Sichuan were identified as having higher comprehensive quality of Gentiana farreri Balf.f.medicinal materials.Conclusion The findings of this study can serve as a reference for the production planning and quality assessment of Gentiana farreri Balf.f.

Lamiophlomis Herba， one of the medicinal herbs commonly used by the Tibetan ethnic minority， has the effect of activating blood， stopping bleeding， dispelling wind， and relieving pain and is frequently used to treat trauma， traumatic bleeding， rheumatic arthralgia， and dampness and dampness-heat. By a review of ancient Tibetan medicine classics， materia medica classics， and modern literature， this paper systematically analyzed the name， nature， taste， original plant， medicinal part， harvest， processing， efficacy， and indications of Lamiophlomis Herba. The textual research showed that Lamiophlomis Herba was first recorded in the Somaratsa （《月王药诊》） in the middle of the eighth century. This medicinal herb was mainly recorded with a plain and warm nature and a sweet， bitter， and astringent taste. The herb was recorded as non-toxic in other books except the Tibetan Medicinal Plants in Gannan of Qinghai-Tibet Plateau （《青藏高原甘南藏药植物志》）. In the books of the past dynasties， the aboveground part of Lomiophlomis rotatd was used as medicine. In addition， there were also records of using the whole herbs of Ajuga ovalifolia， A. ovalifolia var. calantha， and Oreosolen wattii as the medicine. In ancient times， the herb was mainly harvested before Frost's Descent in the 8^th-9^th months of the lunar calendar， while it was mainly harvested during the flowering-fruiting stage in autumn in modern times. Due to the decreased reserve of Lamiophlomis Herba， the medicinal part evolved from whole herb or fresh leaves to the aboveground part. According to the ancient and modern records， this herb mainly has the functions of nourishing bone and marrow， eliminating dampness and dampness-heat， stopping bleeding， and relieving pain. In ancient times， it was used for treating parasitic diseases， menostaxis， spermatorrhea， diarrhea， and nourishing the body. This paper aims to provide a basis for further development and study of Lamiophlomis Herba through the textual research.

Objective:To explore the effect of clinical target volume (CTV) optimization on long-term survival and late xerostomia of patients with nasopharyngeal carcinoma (NPC).Methods:Clinical data of 763 patients with NPC treated with intensity-modulated radiotherapy (IMRT) in the Jiangsu Cancer Hospital from January 2015 to November 2018 were retrospectively analyzed. All patients were divided into the modified and conventional CTV groups. Propensity score matching (PSM) was applied to balance the distribution of baseline features. The degree of xerostomia was evaluated by Radiation Therapy Oncology Group (RTOG) / European Organisation for Research and Treatment of Cancer (EORTC) standard and Jiangsu Cancer Hospital Multi-dimensional Radiotherapy-Induced Xerostomia scale. Survival analysis was performed by Kaplan-Meier method. The difference of xerostomia between two groups was compared by rank-sum test. The dose parameters of salivary glands were compared by independent sample t-test. Prognostic factors of survival and xerostomia were assessed by univariate / multivariate regression analyses. Results:There were no significant differences in overall survival, local recurrence-free survival, distant metastasis-free survival and progression-free survival between conventional and modified CTV groups before and after PSM. There were no significant differences in the incidence of late xerostomia above grade 2 of RTOG/EORTC standard between two groups. Using multi-dimensional scale criteria, NPC patients in the modified CTV group developed less late xerostomia than those in the conventional CTV group ( P<0.05). D mean and V 26 Gy of bilateral parotid glands, D mean and V 39 Gy of bilateral submandibular glands, and D mean of sublingual glands and mouths were reduced after optimization of CTV (all P<0.001). Univariate analysis showed that clinical staging, T staging and N staging were the independent prognostic factors of overall survival. Multivariate analysis demonstrated that clinical staging was the independent prognostic factor of overall survival. The risk factor for xerostomia during night sleep was the D mean of sublingual glands. Conclusion:The optimization of CTV in IIb region in NPC treated with IMRT can better protect salivary glands and reduce the incidence of late radiation-induced xerostomia on the premise of ensuring long-term survival.

Objective:To determine the safety of prophylactic irradiation dose CTV 60Gy optimized to CTV 50Gy for II b region in patients with stage N 0-N 1 nasopharyngeal carcinoma (NPC) and the dose advantage and clinical value for parotid gland protection, and to understand the diagnostic value of PET-CT and diffusion-weighted imaging (DWI) for suspicious positive lymph nodes in the neck (5 mm≤maximum short diameter<10 mm). Methods:Clinical data of 157 patients with primary non-metastatic NPC (N 0-N 1) admitted to our hospital from June 2015 to March 2017 were retrospectively analyzed. 104 patients underwent II b clinical target volume optimization guided by multimodal imaging system. Survival analysis was performed by Kaplan - Meier method. Univariate/multivariate regression analysis was performed to analyze the pattern of cervical lymph node recurrence. Paired t-test was used to compare the differences in target volume and parotid gland dose parameters before and after dose optimization. Results:Sixty patients underwent single-neck optimization in stage N 1, 25 patients received double-neck optimization (only those with retropharyngeal lymph node metastasis), and 19 patients underwent double-neck optimization in stage N 0. Three patients had cervical regional recurrence, all in-field. The 5-year overall survival rate was 93.3%. The lymph node recurrence-free survival rate, local recurrence-free survival rate, distant metastasis-free survival rate and disease-free survival rate were 97.1%, 91.3%, 88.5% and 80.8%, respectively. Cervical lymph node recurrence was associated with local recurrence in the nasopharynx, regardless of retropharyngeal lymph node status. Fourteen patients had suspicious positive cervical lymph nodes in II b region, with a mean maximum short diameter of 7.1 (5~9) mm on the largest cross-sectional plane, and 11 of them were positive on PET-CT, with a mean SUV max of 2.96 (2.5~3.3). There was no significant difference in GTV after optimization ( P>0.05). D mean, D max, D 50% and V 26Gy of parotid gland were significantly lower than those of conventional plan (all P<0.01). Conclusions:It is safe to optimize CTV 60Gy to CTV 50Gy in II b region in patients with N 0-N 1 NPC, and the exposure dose to normal tissues around the parotid gland and neck is significantly reduced. For small lymph nodes that do not meet the diagnostic criteria, it needs to be individualized in combination with multimodality imaging systems, such as PET-CT and DWI.

Fever is a sign of infection and inflammatory diseases in the body. Persistent high fever will lead to cell degeneration, causing multiple organ dysfunction, and seriously affecting brain nerve and tissue function. Although the fever process is common and ordinary, its pathological mechanism involves multiple signaling pathways, such as nuclear transcription factor κB signaling pathway, Toll-like receptor 4 signaling pathway. A large number of studies have shown that traditional Chinese medicine compound and its active components can reduce serum inflammatory factors (TNF-α, IL-1β and IL-6) and hypothalamic thermoregulatory mediators (PGE

Traditional Chinese medicine (TCM) is considered an important complementary therapy with beneficial effects for cancer patients. Elderly patients with non-small-cell lung cancer (NSCLC) are a complex patient group with increasing co-morbidity and shrinking physiological reserve, and may derive substantial benefit from the supportive aspects of TCM. Researchers from Shanghai Longhua Hospital found that qi and yin deficiency is a common syndrome in patients with stage III or IV lung cancer. This project was designed to study the combination of single-agent chemotherapy with TCM methods of benefiting qi and yin in elderly patients with advanced NSCLC.

OBJECTIVE: To evaluate the surgical outcomes of laparoscopic splenectomy and to investigate the learning curve of laparoscopic splenectomy. METHODS: Forty cases of laparoscopic splenectomy (performed by W.Y. between September 2008 and August 2010) in our general surgery department were reviewed, and the cases were divided equally into 4 groups (group I, II, III, IV) according the time sequence of the operations. The operating time, blood loss, conversion to open surgery, conversion to hand-assisted laparoscopic splenectomy, postoperative hospital stay, postoperative liquid diet recovery time, intra- and postoperative complications and the operative frequency were compared. RESULTS: There were no statistical differences among the groups in age and gender (P>0.05). The operating time, blood loss and postoperative hospital stay of groups III and IV were significantly less than those of groups I and II (P<0 .05). Postoperative liquid diet recovery time appear to show a gradual shortening trend from Group I to Group IV, but the differences were not at standard statistical thresholds (P>0.05). Frequency of conversion to open surgery, of conversion to hand-assisted laparoscopic splenectomy, of complications among the four groups were also not statistically different (P>0.05). The operative frequency of group I-IV increased from 1.25/month to 2.5/month. CONCLUSION The learning curve of laparoscopic splenectomy for surgeon who was experienced in open splenectomy and laparoscope cholecystectomy is approximately 20 cases, and the operative frequency is about 1.33/month.
Adult ; Aged ; Blood Loss, Surgical ; statistics & numerical data ; China ; epidemiology ; Female ; Humans ; Intraoperative Complications ; epidemiology ; Laparoscopy ; methods ; Learning Curve ; Male ; Middle Aged ; Retrospective Studies ; Splenectomy ; methods ; Young Adult

Transcription factor cyclic AMP response element-binding protein (CREB) in embryonic cortical neurons is an important modulator of Brain-derived neurotrophic factor (BDNF) induced gene expression. Meanwhile, our early researches have indicated that BDNF possesses neuroprotective role for hypoxic neurons against hypoxia. In order todisclose whether the neuroprotective role of BDNF for embryonic rat cortical neurons against hypoxia is fulfilled via nucleoprotein CREB phosphorylation, we used western blotting method to detect the expression of CREB and phosphorylated CREB in experimental groups (with BDNF) and hypoxic control group (without BDNF) with the time changes of exposure to hypoxia. Results indicated that hypoxia and BDNF both could induce phosphorylation of CREB in embryonic cortical neurons. Phosphorylation of CREB in experimental group (with BDNF) was much higher than that in hypoxic control group at the same time points (P<0.01). The expression of phosphorylated CREB reached the highest level at the first hour after being exposed to hypoxia in experimental groups, then phosphorylated CREB decreased slowly and remained at the level for much longer time in experimental groups than in control group. The total amount of CREB in embryonic cortical neurons at the first 0-3 hours after being exposed to hypoxia in experimental groups were the same as that in hypoxic control group. CREB decreased more quickly in hypoxic control group at 5-6 hours after hypoxia. This in vitro research demonstrates that BDNF plays its neuroprotective role for embryonic rat cortical neurons against hypoxia via CREB phosphorylation.
Animals ; Brain-Derived Neurotrophic Factor ; chemistry ; pharmacology ; Cell Hypoxia ; Cells, Cultured ; Cerebral Cortex ; cytology ; Cyclic AMP Response Element-Binding Protein ; chemistry ; Embryo, Mammalian ; Neurons ; cytology ; Neuroprotective Agents ; chemistry ; pharmacology ; Phosphorylation ; Rats

Mesenchymal stem cells from bone marrow of Rhesus monkey (RhBMSCs) were isolated by density gradient centrifugation, purified by adherence separation, and further identified by phenotype and karyotype analysis. Growth characteristics of RhBMSCs were investigated by observation of cell proliferation and detection of apoptosis. Density gradient centrifugation and adherence separation revealed a simple method to obtain fairly pure RhBMSCs. Fusiform was the most common form of cell under observation, and cell karyotype was normal. Phenotyping assay revealed that the RhBMSCs are highly positive (99.2%) for CD29 when compared with the low positive rates (less than 3.2%) for CD34, CD45 and HLA-DR, which indicated a successful isolation of high purity RhBMSCs and a vigorous activity of cells to proliferate. But the proliferation activity of RhBMSCs gradually decreased following the increasing of cell generations. The methods and results of isolation, expansion, identification and growth characteristics of RhBMSCs were discussed in this paper, which may be helpful to understanding the bone marrow mesenchymal stem cells of human, and may serve as the groundwork for orientated differentiation of RhBMSCs and tissue repairment on experimental animal model of rhesus monkey.
Animals ; Bone Marrow Cells ; cytology ; Cell Culture Techniques ; Cell Separation ; Cells, Cultured ; Integrin beta1 ; blood ; Macaca mulatta ; Mesenchymal Stromal Cells ; cytology ; Phenotype