Wuzhuyu Decoction, the classical formula recorded in the Treatise on Febrile Diseases(Shang Han Lun), has been included in the Catalogue of Ancient Classic Prescriptions(the First Batch). Consisting of Euodiae Fructus, Ginseng Radix et Rhizoma, Zingiberis Rhizoma Recens, and Jujubae Fructus, it is effective in warming the middle, tonifying deficiency, dispelling cold, and descending adverse Qi, and is widely applied clinically with remarkable efficacies. For a classical formula, the chemical composition is the material basis and an important premise for quantity value transfer. This study aimed to establish a rapid identification method of chemical components in Wuzhuyu Decoction by high-resolution mass spectrometry(HR-MS) and molecular network. AQUITY UPLC BEH C_(18) column(2.1 mm×100 mm, 1.7 μm) was used for sample separation, and acetonitrile-0.1% formic acid in water was used as mobile phases for gradient elution. Q-Exactive Orbitrap MS data were collected in positive and negative ion modes, and GNPS molecular network was plotted according to the similarity of MS/MS fragmentation modes. Cytoscape 3.6.1 was used to screen molecular clusters with similar structures. Finally, the chemical components of Wuzhuyu Decoction were rapidly identified according to the controls, as well as the information of retention time, accurate relative molecular weight of HR-MS, and MS/MS multistage fragments. A total of 105 chemical components were identified in Wuzhuyu Decoction. This study can provide data for the follow-up quality control, standard substance research, and pharmacodynamic material research on Wuzhuyu Decoction, as well as references for the rapid qualitative analysis of the chemical components of Chinese medicine.
Tandem Mass Spectrometry/methods* ; Chromatography, High Pressure Liquid/methods* ; Drugs, Chinese Herbal/chemistry* ; Quality Control

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Malignant tumors are currently seriously endangering human health and life， which has become one of the main causes of death in China. In modern Western medicine， they are mainly tackled by surgery， chemotherapy， and radiotherapy， but the death toll continues to rise year by year. At present， most of the anti-tumor chemotherapeutics used in clinical practice have toxic and side effects， affecting the anti-tumor efficacy and the conditions after treatment. Long-term medication will also induce drug resistance， making the good anti-tumor effect difficult to be achieved. With the vigorous development of traditional Chinese medicine （TCM）， it has played a crucial role in the fight against tumors. It is believed in TCM that "heat toxin" is one of the important causes of tumors. Therefore， the methods of clearing away heat and removing toxin are often emphasized in the treatment of tumors， and the resulting outcomes are satisfactory. There are many Chinese herbs and Chinese herbal compounds classified into the heat-clearing and toxin-removing type. Xihuangwan， a classic heat-clearing prescription， is composed of Calculus Bovis， Moschus， Olibanum， and Myrrh and has the effects of clearing away heat， removing toxin， eliminating edema， and dissipating mass， which is mainly used to treat carbuncle， pustule， scrofula， multiple abscess， and cancer caused by heat-toxin obstruction. In modern clinical practice， it has been employed in patients with lung cancer， breast cancer， gastric cancer， liver cancer， colorectal cancer， and other malignant tumors， especially during the advanced stage， as a routine or adjuvant treatment for alleviating their clinical symptoms and improving their quality of life. The main active components of Xihuangwan are pentacyclic triterpenoids （such as masticinic acids）， volatile oils， steroids （like porcine deoxycholic acid）， and bilirubin， which have been proved effective in anti-tumor. This paper reviewed the prescription source， pharmaceutical research， clinical anti-tumor research， and pharmacological mechanisms of Xihuangwan， which has provided reference for further expanding the anti-tumor applications of Xihuangwan and enhancing its secondary development.

Objective: To evaluate the outcomes of myelodysplastic syndromes (MDS) patients who received HLA-matched sibling donor allogeneic peripheral blood stem cell transplantation (MSD-PBSCT) . Methods: The clinical data of 138 MDS patients received MSD-PBSCT from Sep. 2005 to Dec. 2017 were retrospectively analyzed, and the overall survival (OS) rate, disease-free survival (DFS) rate, relapse rate (RR) , non-relapse mortality (NRM) rate and the related risk factors were explored. Results: ①After a median follow-up of 1 050 (range 4 to 4 988) days, the 3-year OS and DFS rates were (66.6±4.1) % and (63.3±4.1) %, respectively. The 3-year cumulative incidence of RR and NRM rates were (13.9±0.1) % and (22.2±0.1) %, respectively. ②Univariate analysis showed that patients with grade Ⅲ-Ⅳ acute graft-versus-host disease (aGVHD) or hematopoietic cell transplantation comorbidity index (HCT-CI) ≥2 points or patients in very high-risk group of the Revised International Prognostic Scoring System (IPSS-R) had significantly decreased OS[ (42.9±13.2) %vs (72.9±4.2) %, χ(2)=8.620, P=0.003; (53.3±7.6) %vs (72.6±4.7) %, χ(2)=6.681, P=0.010; (53.8±6.8) %vs (76.6±6.2) %vs (73.3±7.7) %, χ(2)=6.337, P=0.042]. For MDS patients with excess blasts-2 (MDS-EB2) and acute myeloid leukemia patients derived from MDS (MDS-AML) , pre-transplant chemotherapy or hypomethylating agents (HMA) therapy could not improve the OS rate[ (60.4±7.8) %vs (59.2±9.6) %, χ(2)=0.042, P=0.838]. ③Multivariate analysis indicated that the HCT-CI was an independent risk factor for OS and DFS (P=0.012, HR=2.108, 95%CI 1.174-3.785; P=0.008, HR=2.128, 95%CI 1.219-3.712) . Conclusions: HCT-CI was better than the IPSS-R in predicting the outcomes after transplantation. The occurrence of grade Ⅲ-Ⅳ aGVHD is a poor prognostic factor for OS. For patients of MDS-EB2 and MDS-AML, immediate transplantation was recommended instead of receiving pre-transplant chemotherapy or HMA therapy.
Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes ; Retrospective Studies ; Siblings ; Transplantation Conditioning ; Transplantation, Homologous

Objective:To investigate the mechanism of Shugan Wendan decoction in treating atherosclerosis based on liver X receptor α(LXRα)/nuclear factor-κB(NF-κB) signal. Method:A New Zealand rabbit model of atherosclerosis with liver-Qi stagnation was established by using calf serum albumin immune injury, high fat feeding and bondage emotional stress method. Theses rabbits are randomly divided into 6 groups, control group,model group, atorvastatin group, Shugan Wendan decoction low, medium and high dose group(2.18,6.54,19.62 g·kg^-1·d^-1). After successful modeling, the rabbits were treated by injecting drugs with Atorvastatin and low, middle and high dose Shugan Wendan decoction to gastric.The control group and the model group were given intragastric administration of saline in the same volume. The period of gavage is 6 weeks. The pathological changes of the rabbits were detected by hematoxylin-eosin(HE) staining.Serum levels of totalcholesterol(TC), triglyceride(TG),low density extremityprotein(LDL-C), high density extremity protein(HDL-C), nitric oxide(NO), and endothelin-1(ET-1) of the rabbits were detected by enzyme method, nitrate reductase method, and enzyme-linked immunosorbent assay(ELISA), respectively.The gene expression of CRP, IL-1β, IL-6 and MMP-9 in the aorta was detected by Real-time fluorescent quantitative polymerase chain reaction(Real-time PCR) method.The protein expression of LXRα/NF-κB signaling pathway wasdetected by Western blot. Result:Compared with normal control group, in model group, the lumen of the blood vessels was significantly narrowed, atheromatous plaques were formed, and a large number of intracellular foam-like changes were seen. In atorvastatin group and Shugan Wendan decoction group, the blood vessels in high, middle, and low concentration groups were narrowed. Atherosclerotic plaques and foam-like changes were all lower than the model group.Compared with the normal control group, the TG, TC, and LDL-C levels in the model groupincreased(P<0.05), HDL decreased (P<0.05), NO decreased (P<0.05),ET-1 increased (P<0.05),the expression levels of hs-CRP, IL-1β, IL-6 and MMP-9 all increased(P<0.05), the expression of LXRα protein in the model group was decreased(P<0.05), and the protein expression of NF-κB was increased(P<0.05). Compared with model group,the levels of TG, TC and LDL-C the atorvastatin group andlow, medium, and highdose Shugan Wendan decoction group decreased,(P<0.05),NO in the atorvastatin group and the highdose Shugan Wendan decoction group increased and ET-1 decreased(P<0.05).In group comparison, the expression levels of CRP, IL-1β, IL-6 and MMP-9 in the atorvastatin group,the low, middle and high dose Shugan Wendan decoction groups all decreased(P<0.05).The expression of LXRα protein in the group was increased(P<0.05) and the protein expression of NF-κB was decreased(P<0.05). Conclusion:Shugan Wendan decoction can inhance the function of vascular endothelial cells and the stability of atherosclerotic plaque by regulating LXRα/NF-κB signaling pathway.

Objective: To investigate the feasibility of establishing a model of allograft penile transplantation in adult beagle dogs and explore the conditions for constructing a stable animal model of penis transplant. METHODS: Following the principles of similarity, repeatability, feasibility, applicability, and controllability in the construction of experimental animal models, we compared the major anatomic features of the penis of 20 adult beagle dogs with those of 10 adult men. Using microsurgical techniques, we performed cross-transplantation of the penis in the 20 (10 pairs) beagle dogs and observed the survival rate of the transplanted penises by FK506+MMF+MP immune induction. We compared the relevant indexes with those of the 10 cases of microsurgical replantation of the amputated penis. RESULTS: High similarities but no statistically significant differences were observed in penile anatomic features between the 20 beagle dogs and 10 men. All the 10 cases of cross-transplantation of the penis were successfully completed in the 20 beagle dogs, of which the transplanted glans survived with normal micturition in 12 but developed necrosis in the other 8; the success rate of one-time venous anastomosis was 95.0% (38/40) and that of one-time arterial anastomosis was 87.5% (35/40), with an average vascular anastomosis time of (71.0±9.0) minutes, a mean operation time of (133.0±10.3) minutes, and a mean blood loss of (135.8±41.4) ml. In the 10 cases of penile replantation, the success rate of one-time venous anastomosis was 100% (20/20) and that of one-time arterial anastomosis was 90.0% (18/20), with an average vascular anastomosis time of (65.0±7.9) minutes, a mean operation time of (117.4±10.0) minutes, and a mean blood loss of (85.0±10.8) ml. In the 12 cases of replantation of the amputated penis, the success rate of one-time venous anastomosis was 100% (24/24) and that of one-time arterial anastomosis was 95.8% (23/24), with an average vascular anastomosis time of (79.0±17.6) minutes, a mean operation time of (125.0±20.6) minutes, and a mean blood loss of (140.0±44.3) ml. No statistically significant differences were found in the relevant indexes among the three groups. CONCLUSIONS The anatomic structure of the corpus cavernosum penis of beagle dogs is highly similar to that of men, almost the same in cross-section anatomy. Microsurgical replantation and allograft transplantation of the penis were both successfully performed in beagle dogs, which showed similar operative indexes to those of human penile replantation. The construction of the allograft penile transplantation model in adult beagle dogs is feasible clinically, with the advantages of operability and repeatability.
Adult ; Anastomosis, Surgical ; Animals ; Arteries ; surgery ; Dogs ; Feasibility Studies ; Graft Survival ; Humans ; Male ; Microsurgery ; Models, Animal ; Necrosis ; etiology ; Operative Time ; Penis ; anatomy & histology ; pathology ; transplantation ; Postoperative Complications ; etiology ; Replantation ; Survival Rate ; Urination ; Veins ; surgery

Objective To evaluate the clinical efficacy and safety of memantine combined with olanzapine in treating Alzheimer's disease patients with behavioral and psychological symptoms of dementia (BPSD).Methods One hundred and seventy-six cases of Alzheimer's disease with BPSD were randomly divided into treatment group (n =87) and control group (n =89).The control group received oral administration of memantine 5-20 mg qd.The treatment group was given oral administration of olanzapine 2.5-10 mg qn on the basis of control group.The treatment course was two weeks.Both groups were treated for 6 courses.Clinical efficacy,neuropsychiatric inventory scale (NPI),activities of daily living (ADL) score,and the incidence of adverse drug reactions were compared between the two groups.Results After treatment,the total efficiency of the treatment group and the control group were 90.70％ (78/86 cases)and 75.29％ (64/85 cases) respectively,and the statistically significant difference was shown between the two groups (P＜0.01).Before treatment and at week 2,4,8,12,NPI-1 in the treatment group and were(25.18 ±4.17) (23.02 ± 3.98),(20.51 ± 3.65),(17.85 ± 3.08),(16.56 ± 2.95);NPI-2 were (46.86 ± 4.65) (45.78 ± 4.62),(43.53 ± 4.24),(40.53 ± 4.31),(38.91 ± 4.27);ADL were (44.34 ± 4.59),(44.25 ± 4.53) (42.85 ±4.01),(40.30 ± 3.98),(39.21 ± 3.48).NPI-1 in the control group were(25.27 ±4.23) (24.67 ±4.12),(23.68 ± 3.98),(21.36 ± 3.57),(19.92 ± 3.24);NPI-2 were (46.56 ± 4.72) (46.31 ± 4.51),(45.82 ± 4.42),(43.21 ± 4.37),(42.74 ± 4.33);ADL were (43.62 ± 4.61),(43.36 ± 4.49) (43.08 ±4.25),(42.18 ±4.31),(41.27 ±4.29).Statistical significant differences were found in NPI-1,NPI-2 and ADL between the two groups at week 2,4,8(P ＜0.01).The adverse drug reactions in the treatment group were hypersomnia,weight gain,dry mouth and constipation;and dizziness,sleeplessness,headache,nausea in the control group.The incidence of adverse drug reactions in treatment and control groups were 8.14％ (7/86 cases) and 7.06％ (6/85 cases),without statistically significant difference (P ＞ 0.05).Conclusion Memantine combined with olanzapine achieves better efficacy than memantine alone in treating patients with Alzheimer's disease and BPSD.

OBJECTIVE: To observe the impact of energy saving light,incandescent light and circadian light on the ethology of depressive rats and explore its possible mechanism on affecting the secretion of melatonin. METHODS: Thirty rats aged 6weeks were randomly selected from 40 specific pathogen free health female SD rats after they adapted to the living environment,depressive rat models were established in the rats by bilateral ovariectomy combined with isolated living and chronic unpredictable mild stress stimulation at the age of 11-14 weeks. Then these 30 ovariectomized rats were randomly divided into 3 intervention groups,including an energy saving light group,an incandescent light group and a circadian light group,with 10 rats in each group. The rats in these 3 groups were given specific experimental light intervention for 3 weeks respectively at the age of 17 weeks. The other 10 rats were raised in conventional environment as the control group. Their body weights were measured at the age of 17,19,20 and 21 weeks. The ethology tests were carried out by sucrose preference test and the open-field test at the age of 7,14 and 20 weeks respectively. The melatonin levels in peripheral blood of 7 time points from 19: 30 to 8: 30 were measured in the rats at age of 21 weeks. One rat in each group at every time point was randomly selected for examination. RESULTS: At the age of 17 weeks before light-intervention,the body weights of rats in 4 groups showed no significant difference( P > 0. 05). After light-intervention,at the age of 17-20 weeks,the body weights of rats in 3 intervention groups were gradually increased with the increase of age( P < 0. 05).There was no significant difference between body weights of rats at the age of 21 weeks and those at the age of 20 weeks in each group( P > 0. 05). At age of 7 weeks,no significant differences were found in sucrose consumption and standing scores among these 4 groups( P > 0. 05). After the depressive models were established,at the age of 14 weeks before light-intervention,in rats of these 3 intervention groups,the sucrose consumption and standing scores were lower than those of the control group( P < 0. 05),and there was no significant difference found in the above 2 indexes among these 3intervention groups( P > 0. 05). At the age of 20 weeks after light-intervention,the sucrose consumption and standing scores were not significantly different from each other among the 4 groups( P > 0. 05). The peak levels of melatonin in the peripheral blood of rats in these 3 intervention groups were higher than that in the control group. The peak levels onsets of melatonin in peripheral blood of rats in the circadian light group and the energy saving light group were earlier or 2 hours delayed compared to that of control group,while it was similar between the incandescent light group and control group.CONCLUSION: The circadian light,the energy saving light and the incandescent light are similarly effective in improving the behaviors of depressive rats. The circadian light can delay the onset of peak level of melatonin in peripheral blood.

As the important external genitalia of males, penis has the functions of both urination and copulation. Battle wound, other trauma, and some diseases such as penile cancer can result in total and partial penile defect, which has great impact on the sufferers' mind and life. Therefore, the treatment of penile defect is receiving more and more importance from both the patients and doctors. The ideal treatment is expected to achieve a satisfactory appearance, unobstructed standing urination and successful copulation. Nowadays, the main clinical techniques for the treatment of penile defect include penile replantation, penile lengthening, and penile reconstruction. The progress made in transplantation immunity, tissue matching, immunosuppressive agents, and long-term surviving of animal allograft limb transplantation has prepared a firm ground for human penile allograft. The construction of penile tissues by tissue engineering techniques is still at the experimental stage. It would be a valuable research how to assimilate the constructed and autologous tissues in clinical practice so as to achieve better function and appearance of the penis.
Humans ; Male ; Penile Prosthesis ; Penis ; injuries ; surgery ; Reconstructive Surgical Procedures ; methods ; Replantation ; methods ; Surgical Flaps ; Tissue Engineering

OBJECTIVETo investigate whether there are different stromal compositions in the prostate tissue of patients with benign prostatic hyperplasia (BPH) and evaluate their significance in the course of the disease.

METHODSForty-three surgical or bioptic prostatic specimens of BPH and 5 autoptic normal prostatic specimens were stained by the Masson method to display the elements of the muscle fiber and collagen. The relationship of the changes in the prostatic stromal composition was analyzed with the degree of bladder outlet obstruction (BOO) , IPSS and medication results.

RESULTSThe mean ratio of muscle fiber to collagen in the normal prostate tissue was (3.2 +/- 0.2):1, significantly higher than that of the BPH patients (1: [4.7 +/- 3.1] ) (P < 0.01); that in the BPH patients with BOO was 1: (5.4 +/- 3.7) markedly lower than in those without BOO (1: [2.5 +/- 1.1] ) (P = 0.02); that in the BPH patients with severe prostatic symptoms was 1: (9.1 +/- 2.9), remarkably lower than in those with moderate (1: [5.3 +/- 3.4]) and mild prostatic symptoms (1: [2.8 +/- 1.7]) (P < 0.01); and that in the BPH patients with satisfactory medicinal therapeutic results was 1:(2.3 +/- 1.9), significantly higher than in those with poor therapeutic results (1: [7.6 +/- 4.3]) (P < 0.01).

CONCLUSIONThe stromal composition in the prostatic tissue of BPH patients undergoes different degrees of changes. More obvious BPH symptoms and poorer therapeutic results are associated with a bigger proportion of collagens and a smaller proportion of muscle fibers in the prostatic tissue. These changes may play an important role in the development and progression of BPH.

Aged ; Aged, 80 and over ; Case-Control Studies ; Fibrosis ; Humans ; Male ; Middle Aged ; Prostate ; pathology ; Prostatic Hyperplasia ; pathology ; Urinary Bladder Neck Obstruction ; pathology