In this research， a comprehensive examination of historical materia medica， medical literature， medical books and contemporary literature was conducted to systematically compile and verify the naming， origin， geographical variations， quality， medicinal properties and processing of Tremolitum， and combined with the physical analysis of 15 batches of samples， with a view to providing a basis for the quality evaluation. The evidences unequivocally support Yangqishi as the rectification of name， while alternative aliases include Baishi， Shisheng， Yangjushi and Yangshi. The primary source of Tremolitum has been the silicate hornblende mineral tremolite throughout recorded history， and its accompanied minerals are mainly chlorite， talc schist， anthophyllite asbestos， etc. In ancient times， the main production area of Tremolitum was situated in the "Yaoshan Mountain" region of Jinan， Shandong province. Presently， it is primarily produced in Hubei， Henan， Shanxi， Hebei and Shandong provinces. The ancient quality evaluation of Tremolitum includes "white color"， "wolf teeth"， "cloud head and rain foot"， "heron hair"， etc. While， modern materia medica mostly evaluates its quality in terms of color， luster and texture， including the characteristics of needle bundle， grayish-white， glossy and easy to be twisted and crushed. Tremolitum is slightly warm， non-toxic， and possesses a salty taste. It is associated with the kidney meridian， known for its benefits in nourishing the fire of the gate of life， warming the kidneys and strengthening the Yang. Common processing methods include fire calcination， elutriation， and processing with wine. Additionally， there is an exclusive processing method known as the "ascending Tremolitum method". Through the X-ray diffraction（XRD） analysis， the commercially available Tremolitum is mainly composed of tremolite［Ca₂Mg₅（Si₄O₁₁）₂（OH）₂］， and the accompanied minerals are calcite and quartz， etc. Its color includes white， light gray， light green and so on， and it is weight and soft texture， irregular cross-section， with obvious fibrous texture and mostly glassy luster. Among the commercially available Tremolitum， samples with high content of tremolite are characterized by high quality features， such as "white color"， "heron hair" and "ease of tearing". Also， Tremolitum is the Fe-bearing heterogeneous species of tremolite， and the two are often symbiotic. Therefore， by the herbal textual research and the comparison of the properties and composition of Tremolitum and its similar species， it has been verified that the primary source of Tremolitum is the silicate hornblende minerals tremolite and actinolite.

Objective This study aimed to identify PAX9 variants in non-syndromic tooth agenesis families of Chi-na,as well as to analyze the genotype-phenotype of non-syndromic tooth agenesis caused by PAX9 variants,which can provide a basis for the genetic diagnosis of tooth agenesis.Methods We collected the data of 44 patients with non-syn-dromic oligodontia who underwent treatment at Stomatological Hospital of Hebei Medical University between 2018 and 2023.Whole-exome sequencing was performed on the peripheral blood of the proband and its core family members,and the variants were verified by Sanger sequencing.Pathogenicity analysis and function prediction of the variants were per-formed using bioinformatics tools.The correlation between the genotype of PAX9 variant and its corresponding pheno-type was examined by reviewing 55 publications retrieved from PubMed.The studies involved 232 tooth agenesis pa-tients with PAX9 variants.Results A novel PAX9 c.447delG(p.Pro150Argfs*62)and a reported PAX9 c.406C>T(p.Gln136*)were identified in two Chinese families.Through bioinformatics analysis and three-dimensional structural mod-eling,we postulated that the frameshift variant was pathogenic.The outcome was the premature cessation of PAX9 pro-tein,which caused severe structural and functional deficiencies.Summarizing the PAX9 genotype-phenotype relationship revealed that patients carrying the PAX9 variant commonly led to loss of the second molars.Conclusion We identified the novel PAX9 c.447delG(p.Pro150Argfs*62)in a Chinese family of non-syndromic oligodontia,expanding the known variant spectrum of PAX9.The most susceptible tooth position for PAX9 variants of tooth agenesis was the second mo-lars and the deciduous molars during the deciduous dentition.

In order to help the standardized residency training of nuclear medicine residents, the standardized residency training base of nuclear medicine residents in Peking University People's Hospital, combined with forty-five nuclear medicine departments of teaching hospital, established the WeChat official account of "Standardized Residency Training of Nuclear Medicine" and submitted one teaching case per week. The appearance of the WeChat official account of "Standardized Residency Training of Nuclear Medicine" has made up for the shortcomings of insufficient teaching cases in a single training base, strengthened the training of residents' imaging diagnostic thinking, and promoted mutual learning among the bases. By writing teaching cases, instructors and residents have opened up ideas, increased knowledge, improved self-learning ability, and cultivated imaging diagnostic thinking. With the flexible and practical features of the WeChat official account, the consciousness and sustainability of residents' learning have been enhanced.

Personnel training marks a key assurance for the healthy and sustainable development of healthcare sector and healthcare institutions in China, rendering it critical importance to include personnel training into performance appraisal. The authors analyzed the connotation and orientation of personnel training index assessment in the performance appraisal at tertiary public hospitals in the country, sorted out the assessment details to be optimized. On such basis, the authors recommended on optimal assessment methodology, combining the gradual improvement of medical personnel training assessment indexes and interval range assessment. These efforts aim at providing references for further improving the scientificity, standardization, homogeneity, as well as vertical and horizontal comparability and operability of personnel training index assessment.

Objective:To explore the clinical value of 18F-fluorodeoxyglucose (FDG) PET/CT in panniculitis presenting as fever of unknown origin (FUO). Methods:Patients with FUO ( n=503) who underwent 18F-FDG PET/CT examination in Peking University People′s Hospital between January 2013 and December 2019 were retrospectively analyzed, and those with final diagnosis of panniculitis were enrolled. The clinical and imaging data of patients with panniculitis were evaluated. Results:Five of the 503(0.99%) patients with FUO who underwent PET/CT imaging were diagnosed with panniculitis. Their age ranged from 41 to 76 years, and 3 of them were females. The main clinical manifestation was fever. Laboratory tests showed an increase in erythrocyte sedimentation rate and C-reactive protein. The 18F-FDG PET/CT imaging found localized FDG uptake foci in multiple adipose tissue, with maximum standardized uptake value (SUV max) ranging from 0.8 to 5.0. Those lesions located in subcutaneous adipose tissue ( n=3), mesenteric adipose tissue ( n=3) and other adipose tissue in abdominal cavity and retro peritoneum ( n=1). Diffusely increased FDG uptake of the spleen was found in 4 patients, diffusely increased FDG uptake of bone marrow was found in 3 patients, and multiple reactive hyperplasia lymph nodes was found in 2 patients. In addition, in 2 patients with the scanning field extended to the mid-thigh, high FDG uptake of the polyarticular synovium was also seen. Conclusions:Panniculitis has some characteristics on 18F-FDG PET/CT imaging. 18F-FDG PET/CT is helpful for etiological diagnosis of FUO caused by panniculitis.

Objective:To further understand the etiological distribution of fever of unknown origin (FUO) in patients underwent 18F-fluorodeoxyglucose (FDG) PET/CT imaging, and to explore the significance of 18F-FDG PET/CT in the diagnosis of different types of diseases in FUO patients. Methods:From January 2013 to August 2019, the clinical and PET/CT image data of 466 FUO patients (194 males, 272 females, age: 3-91(52.7±20.9) years) in Peking University People′s Hospital were retrospectively analyzed. The etiological distribution of FUO patients was analyzed according to the final clinical diagnosis. PET/CT imaging manifestations were analyzed for different types of diseases in FUO patients. The role of 18F-FDG PET/CT in differential diagnosis for FUO was evaluated through clinical questionnaire. Data were analyzed by using χ2 test. Results:The common disease types in FUO patients were rheumatic and immune disease (48.7%, 227/466), infection (28.5%, 133/466) and malignant tumor (11.2%, 52/466). For PET/CT imaging, 95.5% (445/466) of the patients were positive, of which 313 (70.3%, 313/445) were found to have focal lesions, and the other 132 (29.7%, 132/445) showed only nonspecific abnormal uptake. Lesions in different types of diseases were varied in the location, morphological changes as well as FDG uptake. The results of the questionnaire showed that PET/CT imaging could benefit 95.9% (447/466) of the patients in the FUO diagnosis and treatment. PET/CT reached direct etiological diagnosis of malignant tumors more frequently than other types of diseases ( χ2 values: 14.408-25.466, all P<0.001). PET/CT helped or directly reached the etiological diagnosis of rheumatologic diseases more frequently than infection and unknown cause group( χ2 values: 7.922, 9.647, both P<0.05). Conclusion:18F-FDG PET/CT imaging has high clinical value in the diagnosis of FUO etiology and can provide multilevel diagnostic information.

Objective To investigate the preventive and therapeutic effects of different doses of penehyclidine hydrochloride preoperative medication on the catheter -related bladder discomfort during general anesthesia recovery period.Methods 160 adult patients who underwent general anesthesia for elective surgery were randomly dividided into four groups.40 patients in each group received intravenous injection 30min before surgery with penehyclidine hydrochloride 0.005mg/kg (group A),0.010mg/kg (group B),0.015mg/kg (group C),or normal saline (group D).All patients were catheterized with a 12 Fr Foley's catheter and the balloon was inflated with 8mL normal saline after anesthesia induction .The bladder discomfort was assessed during recovery in the post -anesthesia care unit .The severity of bladder discomfort was graded as mild , moderate and severe .Results The incidence of moderate and severe bladder discomfort in group B and group C (group B:20.0％,5.0％;group C:12.8％,2.5％) were significant lower compared with group A and group D ( group A:38.5％,12.8％;group D:46.0％ 15.4％) (χ2 =7.834, 6.764,8.163,14.172,8.362,6.943,15.413,17.512,all P<0.05).There was no significant difference between group B and group C , group A and group D .Conclusion Hydrochloride penehyclidine preoperative administration with 0.010mg/kg or 0.015mg/kg can effectively control the incidence of catheter discomfort during general anesthesia recovery period and 0.010mg/kg is appropriate for the elderly .

Objective To explore 18F-FDG PET/CT characteristics of extramedullary relapse in patients with acute leukemia (AL).Methods Thirty AL patients with extramedullary relapse were retrospectively evaluated.The infiltrated organs or tissues and the maximum standardized uptake value (SUVmax) were recorded and compared between patients with acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML).FDG uptake pattern of bone marrow was also recorded.Results Forty-five extramedullary lesions were found in 16 ALL patients,while 29 were found in 14 AML patients.The average SUVmax was 7.38±4.46 in ALL patients and 4.87±2.66 in AML patients (t=3.022,P=0.003).Among ALL patients,lymph node and soft tissue involvement were detected each in 10,with SUVmax of 6.38 ± 3.55 and 10.12± 5.48,respectively.Among AML patients,lymph node and soft tissue involvement were detected in 6,with SUVmax of 4.82 ±1.43 and 6.60±4.58,respectively (P＞0.05).Multiple focal bone marrow uptakes of FDG were found in 5 of 5 intramedullary recurrence ALL patients and 2 of 5 intramedullary recurrence AML patients.The other 3 intramedullary recurrence AML patients showed diffuse bone marrow uptake.Conclusion There are certain imaging characteristics of 18 F-FDG PET/CT in extramedullary relapse of AL.The common relapse sites are lymph node and soft tissues in both ALL and AML.FDG uptakes of extramedullary relapse lesions in ALL are significantly higher than those of AML.Multiple focal bone marrow uptake of FDG is valuable in predicting intramedullary recurrence.

Notoginseng Radix et Rhizoma has the efficacy of dissolving stasis and hemostasis and reducing swelling and easing pain. Panax notoginseng saponins (PNS) is the main active component of Notoginseng Radix et Rhizoma, and the main components include ginsenoside Rb1, Rg1, Re, Rd and notoginsenoside R1. Injections with PNS as the medicinal material basis have become main TCM injections for the treatment of cerebral vascular diseases, with confirmed clinical efficacy. This article reviewed the research progress in pharmacological effects, clinical application and adverse reactions of PNS in treatment of cerebral vascular disease, with a purpose to provide references for further research and clinical application.

Objective To research the influence of Alismatis combined with bifendate on cytochrome P 450 in rat liver microsomes. Methods Twenty four healthy male SD rats were randomly divided into four groups:the experimental groups were given Alismatis at 140 mg·kg-1 , bifendateat 2.18 mg·kg-1 , and Alismatis plus bifendate at 140 mg+2.18 mg·kg-1 ,while the blank control group was given 0. 9% sodium chloride at 5 Ml · kg-1 . The liver microsomes were prepared upon differential centrifugation 7 days after administration.The microsomal protein concentration, cytochrome P450 content, Cytb5 content, NADPH cytochrome C reductase activity and amino pyrine N removal of methyl enzyme activity, erythromycin demethylase activity were determined by UV respectively. Results Compared with the normal control group, the combination use of Alismatis and bifendate redued the microsome content and cytochrome P450 content, while it increased the NADPH cytodrome C activity. The concentrations of cytochrome P450 were both increased by Alismatis and bifendate. Conclusion In contrast, combination ofAlismatis and bifendate reduces cytochrome P450 content which has a negative effect on phase I drug metabolism.Moreover, the combination of Alismatis and bifendate induced NADPH- cytochrome C reductase, accelerated the reduction of cytochrome P450 and inhibited cytochrome P450 isoform CYP2E1 activity.