The classic formula Mulisan is the 45th of the 93 formulas in the Catalogue of Ancient Classic Formulas （second batch） of Han medicine published by the National Administration of Traditional Chinese Medicine. It consists of Ostreae Concha， Astragali Radix， Ephedrae Radix et Rhizoma， and wheat， with the effect of replenishing qi and stopping sweating. It is a common formula in the clinical treatment with traditional Chinese medicine. This study analyzes the historical evolution， composition， dosage， original plants and their processing methods， decocting method， efficacy， indications， and modern clinical application of Mulisan by tracing， comparative analysis， and bibliometric methods. The results showed that Mulisan firstly appeared in the Pulse Classic written by WANG Shuhe in the Western Jin Dynasty. The formulation idea can be traced back to the Important Prescriptions Worth a Thousand Gold for Emergency in the Tang Dynasty. The herb composition， dosage， efficacy， and indications of Mulisan were first recorded in the Treatise on Diseases， Patterns， and formulas Related to Unification of the Three Etiologies in the Southern Song dynasty. In terms of original plants and their processing methods， Ostreae Concha is the shell of Ostrea rivularis， which should be calcined before use. Astragali Radix and Ephedrae Radix et Rhizoma are the dried roots of Astragalus membranaceus var. mongholicus and Ephedra sinica， respectively， the raw material of which should be used. Wheat is the dried mature fruit of T. aestivum， which can be used without processing， while the stir-fried fruit， being thin and deflated， demonstrates better effect. The composition of Mulisan is Ostreae Concha 8.26 g， Astragali Radix 8.26 g， Ephedrae Radix et Rhizoma 8.26 g， and wheat 7.92 g. The medicinal materials should be ground into coarse powder and decocted with 450 mL water to reach a volume of 240 mL， and the decoction should be taken warm. In modern clinical practice， Mulisan has a wide range of indications， including spontaneous sweating and night sweating caused by Yang deficiency or Qi deficiency. The clinical disease spectrum treated by Mulisan involves endocrine system diseases， neurological diseases， respiratory system diseases， and cancer. This formula plays a significant role in the treatment of internal medicine diseases in traditional Chinese medicine. This study aims to provide a scientific basis for the subsequent research， development， and clinical application of Mulisan.

The classic formula Mulisan is the 45th of the 93 formulas in the Catalogue of Ancient Classic Formulas （second batch） of Han medicine published by the National Administration of Traditional Chinese Medicine. It consists of Ostreae Concha， Astragali Radix， Ephedrae Radix et Rhizoma， and wheat， with the effect of replenishing qi and stopping sweating. It is a common formula in the clinical treatment with traditional Chinese medicine. This study analyzes the historical evolution， composition， dosage， original plants and their processing methods， decocting method， efficacy， indications， and modern clinical application of Mulisan by tracing， comparative analysis， and bibliometric methods. The results showed that Mulisan firstly appeared in the Pulse Classic written by WANG Shuhe in the Western Jin Dynasty. The formulation idea can be traced back to the Important Prescriptions Worth a Thousand Gold for Emergency in the Tang Dynasty. The herb composition， dosage， efficacy， and indications of Mulisan were first recorded in the Treatise on Diseases， Patterns， and formulas Related to Unification of the Three Etiologies in the Southern Song dynasty. In terms of original plants and their processing methods， Ostreae Concha is the shell of Ostrea rivularis， which should be calcined before use. Astragali Radix and Ephedrae Radix et Rhizoma are the dried roots of Astragalus membranaceus var. mongholicus and Ephedra sinica， respectively， the raw material of which should be used. Wheat is the dried mature fruit of T. aestivum， which can be used without processing， while the stir-fried fruit， being thin and deflated， demonstrates better effect. The composition of Mulisan is Ostreae Concha 8.26 g， Astragali Radix 8.26 g， Ephedrae Radix et Rhizoma 8.26 g， and wheat 7.92 g. The medicinal materials should be ground into coarse powder and decocted with 450 mL water to reach a volume of 240 mL， and the decoction should be taken warm. In modern clinical practice， Mulisan has a wide range of indications， including spontaneous sweating and night sweating caused by Yang deficiency or Qi deficiency. The clinical disease spectrum treated by Mulisan involves endocrine system diseases， neurological diseases， respiratory system diseases， and cancer. This formula plays a significant role in the treatment of internal medicine diseases in traditional Chinese medicine. This study aims to provide a scientific basis for the subsequent research， development， and clinical application of Mulisan.

Nonalcoholic steatohepatitis (NASH) is a spectrum of chronic liver disease characterized by hepatic lipid metabolism disorder. Recent reports emphasized the contribution of triglyceride and diglyceride accumulation to NASH, while the other lipids associated with the NASH pathogenesis remained unexplored. The specific purpose of our study was to explore a novel pathogenesis and treatment strategy of NASH via profiling the metabolic characteristics of lipids. Herein, multi-omics techniques based on LC-Q-TOF/MS, LC-MS/MS and MS imaging were developed and used to screen the action targets related to NASH progress and treatment. A methionine and choline deficient (MCD) diet-induced mouse model of NASH was then constructed, and Schisandra lignans extract (SLE) was applied to alleviate hepatic damage by regulating the lipid metabolism-related enzymes CES2A and CYP4A14. Hepatic lipidomics indicated that MCD-diet led to aberrant accumulation of phosphatidylethanolamines (PEs), and SLE could significantly reduce the accumulation of intrahepatic PEs. Notably, exogenous PE (18:0/18:1) was proved to significantly aggravate the mitochondrial damage and hepatocyte apoptosis. Supplementing PE (18:0/18:1) also deteriorated the NASH progress by up regulating intrahepatic proinflammatory and fibrotic factors, while PE synthase inhibitor exerted a prominent hepatoprotective role. The current work provides new insights into the relationship between PE metabolism and the pathogenesis of NASH.

Objective:Hepatocellular carcinoma (HCC) is the fourth most dominant cancer in the world and the second leading cause of cancer-related deaths in the China. With the increase in the incidence of metabolic syndrome (MS) in the population, the correlation between MS and HCC has gradually been recognized. MS manifests as non-alcoholic fatty liver disease (shortly known as NAFLD) in the liver. A large number of research results has shown that the development of fatty liver is closely related to the occurrence of HCC, in which lipid metabolism plays a key regulatory role, and lipid metabolism is regulated by fatty acid binding protein (FABP). This study signifies the lipid metabolism analysis and the key FABP expression conditions in HCC.Methods:Data of patients who were first diagnosed with primary HCC between January 2016 to July 2019 were collected, and were divided into two groups according to the etiology, namely the viral and non-viral hepatitis-related HCC group. The relationship between MS-related factors and HCC was analyzed by t-test and chi square test. The expressions of FABP1, FABP4 and FABP5 were detected in cancer and adjacent tissues by immunohistochemistry, and the expressions of FABP1, FABP4 and FABP5 in HCC with fatty liver were detected by immunofluorescence. Finally, the expressional characteristics of the above-mentioned FABPs in HCC patients were analyzed with different clinicopathological features.Results:There were statistically significant differences in the rate of abnormal lipid metabolism and the number of abnormalities in MS-related factors between the viral and non-viral hepatitis-related HCC group. FABP1, FABP4, and FABP5 expression in HCC tissues were lower than the corresponding adjacent tumor tissues. Compared with simple HCC, FABP1, FABP4, FABP5 expression were increased in HCC tissues with steatosis, and the expression of FABP was closely related to the clinical characteristics of patients.Conclusion:Abnormal lipid metabolism is closely related to non-viral hepatitis-related HCC. The expression of lipid metabolism regulatory proteins FABP1, FABP4, and FABP5 are down-regulated in HCC tissues, but up-regulated in HCC with fatty liver, suggesting that the relationship between MS, especially dyslipidemia, and HCC should be paid attention to in clinical practice for early intervention. FABP1, FABP4, FABP5 may regulate HCC occurrence and development.

The incidence of metabolic syndrome gradually multiplied with the change of dietary structure of high fat-high sugar in the population,bringing it as independent risk factors for tumors.Liver is an important organ of lipid metabolism.The main manifestations of metabolic syndrome are obesity and abnormal lipid metabolism,which are closely related to hepatocellular carcinoma occurrence.MicroRNA (miRNA) is an endogenous non-coding RNA that participates in the post-transcriptional regulation of target genes by binding to the 3'-UTR of mRNA.Research studies have found that abnormal miRNA expression can influence the pathogenesis of hepatocellular carcinoma via regulating lipid metabolism-related proteins in the liver.This article reviews and discusses the characteristics and pathogenesis of lipid metabolism disorder in hepatocellular carcinoma,and the mechanism by which miRNA regulates the occurrence and development of hepatocellular carcinoma through lipid metabolism-related proteins.Furthermore,it also provides a reliable theoretical foundation for the study of the pathogenesis ofhepatocellular carcinoma.

High volume hemofiltration(HVHF) is an important development in the field of blood purification,which has a significant effect on the stability of hemodynamics,clearance of inflammatory factors and metabolic toxins in the body. HVHF also has some drawbacks in the treatment. At present,HVHF has an increasingly wide application in pediatric critical diseases,such as systemic inflammatory response syndrome, sepsis or septic shock,multiple organ dysfunction syndrome,acute kidney injury,acute poisoning,etc. It has become an important treatment in pediatric emergency medicine.

Objective To reduce the incidence rate of sepsis caused by multidrug-resistant acinetobacter baumanni and provide the basis for clinical antibiotics use.Methods It is one retrospective case-controled study.Thirty-six patients with multidrug-resistant acinetobacter baumanni infection(case group) and 42 patients with non-multidrug-resistant acinetobacter baumanni infection(control group) admitted in PICU during 2009 to 2013 were enrolled in the study.Seven high risk factors including the irrational antibiotics use,the length of hospital stay,tracheal intubation,the length of mechanical ventilation,the basic diseases (hematologic malignancies,congenital heart disease,inherited metabolic diseases),use of central venous catheters and the length of using central venous catheters were analyzed.The drug sensitivity of multidrug resistant acinetobacter baumanni was detected.Results There were significantly differences in 7 high risk factors between case group and control group,including irrational antibiotics using (29 cases vs.18 cases),the length of hospital stay ＞7 d(35 cases vs.12 cases),tracheal intubation(22 cases vs.8 cases),mechanical ventilation ＞ 7 d (19 cases vs.2 cases),basic diseases (9 cases vs.3 cases),using of central venous catheters (18 cases vs.2 cases) and central venous catheters using ＞ 7 d(9 cases vs.1 cases) ;multidrug resistant acinetobacter baumanni had high resistance against penicillins,cephalosporins,aminoglycesides,quinolones,sulfonamides (94.87％,74.36％,76.92％,65.38％ and 56.41％),but had high sensitivity to carbapenems and tetracyclines (55.56％ and 77.78 ％).Sixteen cases infected with pandrug resistant acinetobacter baumanni infection (44.44％),4 cases infected with whole drugresistant acinetobacter baumanni (11.11％).Conclusion The irrational antibiotics use,the length of hospital stay,tracheal intubation,the length of mechanical ventilation,the basic diseases,central venous catheters and the length of using central venous catheters are the high risk factors of spesis caused by multidrug resistant acinetobacter baumanni; only carbapenems and tetracyclines can keep high sensitivity rate to multidrug resistant acinetobacter baumanni among clinical antibiotics.

Objective To explore the change of serum procalcitonin (PCT)in infectious diseases and the relationship between PCT and the severity of illness in children.Methods This was a single-center prospective study of serum procalcitonin concentration in children with infectious diseases.Ninty-five children with infectious diseases (mycoplasma infection 30 cases,viral infection 30 cases,bacterial infection 35 cases),hospitalized in PICU of Shengjing Hospital from April 2011 to April 2013,were divided into three groups:non-serious group(64 cases),serious group(20 cases)and very serious group(11 cases)according to pediatric critical illness score(PCIS).Bacterial infectious patients were divided into two groups:gram positive bacterial group(20cases),gram negative bacterial group(15 cases).Twenty children of non-infectious diseases during the same period were selected as the control group.Serum PCT levels were detected by using VIDAS BRAHMS PCT detection system(rapid semi-quantitative PCT test).Laboratory detection was conducted in Department of Laboratory Medicine,Shengjing Hospital of China Medical University.Results The serum PCT levels of the control,the bacterial infection,virus infection,and mycoplasma infection group were (0.41 ± 0.34) μg/L,(2.56 ± 0.38)μg/L,(0.52 ±0.44) μg/L and(0.21 ±0.10) μg/L.The serun PCT levels higher than or equal to 0.5 μg/L were defirned as positive.There was significant difference in PCT positive rate between bacterial infection group and the control grouP(x2 =28.05,P ＜0.05).The serum PCT levels of children with infectious diseases were higher than those of non-infection group,mycoplasma infection group and virus infection group(P ＜ 0.05).Besides,the PCT value of gram negative bacillus infection group was also obvious higher than gram positive infection group.There was no significant difference among the non-infection group,mycoplasma infection group and virus infection group(P ＞ 0.05).There was significant negative correlation between the serum PCT concentration and the PCIS score in children with infectious diseases (r =-0.579 ～-0.793,P ＜ 0.05).The higher concentration of PCT in children with the infectious diseases indicated higher severity illness scores,more complications,and longer length of hospital stay.Conclusions PCT may provide an informative and sensitive molecular marker for pathogen identification (bacterial infection,pneumonia mycoplasma infection or viral infection).In the early diagnosis of infectious disease,PCT assay can help predict the severity of the disease.

Objective To explore the changes in expression levels of nuclear factor(NF)-κB,tumor necrosis factor(TNF)-e in the lungs of juvenile mice with acute lung injury(ALI) induced by lipopolysaccharide(LPS).And observe the repair of lung damage after intervening with exogenous mesenchymal stem cells(MSCs).Methods Thirty male juvenile C57 mice were randomly divided into the control group,the ALI group,and the ALI + MSCs group by the random number table method.Mice from each group were euthanized at 12 h and 48 h.The ALI model of juvenile mice was established by intraperitoneal injection of LPS 10 mg/kg.MSCs from mice bone marrow were isolated,cultured and amplified in vitro,and the MSCs (1 × 106/ml) 0.1 ml were given to mice via caudal vein.MSCs marker were identificated by flow cytometry.Pathomorphological changes of mice lung were observed under light microscope after Hematoxylin-Eosin staining.The protein expression changes of NF-κB,TNF-α were observed using immunohistochemistry.Resu]ts Compared with the control group,the protein expression levels of NF-κB,TNF-α were significantly higher at 12 h and 48 h in the lungs of the ALI group(P ＜ 0.05).While those in ALI + MSCs group were markedly lower at these time points than the ALI group [NF-κB:12 h:(0.181 ± 0.008) OD vs (0.203 ±0.008) OD,48 h:(0.197 ± 0.002) OD vs (0.210 ± 0.005) OD; TNF-α:12 h:(0.185 ± 0.004) OD vs (0.201 ± 0.011) OD,48 h:(0.185 ± 0.002) OD vs (0.215 ± 0.009) OD] (P ＜ 0.05).Histopathological evalution showed that typical pathological inflammation lesions in the lung were observed in ALI group,including alveolar congestion,hemorrhage,edema,infiltration of neutrophils in the airspace or vessel wall,thickness of the alveolar wall;pathological changes were relieved obviously in ALI + MSCs group.Conclusion The expression of NF-κB and TNF-α are increased in lung tissues in the juvenile mice model of ALI induced by LPS.MSCs can alleviate injury degree of ALI induced by LPS in mice,the mechanism of action may correlate with decreasing NF-κB and TNF-α content in lung tissue.

Objective To confirm existence of Sarcocystis suihominis and possible transmission cycle between human and pigs. Methods Based on the human-pig-human infection cycle of Sarcocystis suihominis, feces of naturally infected pigs were collected and over 10 000 sporocysts were received by flotation technique, which were mixed with fodder to infect a normal pig. Fresh pork meat containing mature sarcocysts was chopped into pieces and swallowed by a volunteer (the first author of this paper) with about 71 000 sporocysts. Symptoms and development of the parasites after infection were observed. Results The volunteer showed abdominal distension in about 5 hours after infection, with watery diarrhea 13 times from the 8th to 36th hour, vomiting 4 times, chilling and fever with a temperature of 38.5℃, dizziness, headache, joint and muscle ache, epigastralgia, and anorexia. Un-sporized sporocysts were found in the faces 10 days after infection and sporocysts appeared on the 12th day. The average size of sporocysts was 11.9(8.8-14.5)?m?9.2(7.5-12.5) ?m. The infected pig showed a slight anorexia, fatigue, constipation, hair loosen in 5～8 days after infection, and returned normal on the 17th day. The average size of the sarcocysts was 299.2(175-575)?m?62.3(30-102.5)?m. Size of bradyzoites was 11.5(9.5-13.5)?m?4.1(2.8-5.0)?m. The volunteer was treated with acetylspiramycin for 15 days(0.2 g/time, 4 times/d) after 46 days of infection, and fecal examination turned negative 30 days later. Conclusion There is a man-pig cycle for Sarcocystis suihominis in Guangxi.