This article systematically analyzes the historical evolution of the name， origin， quality evaluation， harvesting， processing and other aspects of Picrorhizae Rhizoma by referring to the medical books， prescription books， and other documents of the past dynasties， combined with relevant modern research materials， in order to provide a basis for the development and utilization of famous classical formulas containing this medicinal herb. The research results indicate that Picrorhizae Rhizoma was first recorded in New Revised Materia Medica from the Tang dynasty. Throughout history， Huhuanglian has been used as its official name， and there are also aliases such as Gehu Luze， Jiahuanglian and Hulian. The main source of past dynasties is the the rhizomes of Picrorhiza kurrooa and P. scrophulariiflora. In ancient times， Picrorhizae Rhizoma was mainly imported by foreign traders via Guangzhou and other regions， and also produced in China， mainly in Xizang. In ancient times， it was harvested and dried in early August of the lunar calendar， while in modern times， it is mostly harvested from July to September， with the best quality being those with thick and crispy rhizomes without impurities， and bitter taste. Throughout history， Picrorhizae Rhizoma was collected， washed， sliced， and dried before being used as a raw material for medicine， it has a bitter and cold taste， mainly used to treat bone steaming， hot flashes， infantile chancre fever， and dysentery. There is no significant difference in taste and efficacy between ancient and modern times. Based on the research results， it is recommended that the rhizomes of P. scrophulariiflora in the 2020 edition of Chinese Pharmacopoeia， or the rhizomes of P. kurrooa， can be used in famous classical formulas containing this medicinal herb， which can be processed according to the processing requirements marked by the original formula. For those without clear processing requirements， the dried raw products are used as medicine.

This article systematically analyzes the historical evolution of the name， origin， medicinal parts， processing and other aspects of Euphorbiae Pekinensis Radix（EPR） by referring to the herbal medicine， medical books， prescription books and other documents of the past dynasties， combined with the relevant modern research materials， so as to provide a basis for the development and utilization of famous classical formulas containing this herbal medicine. According to research， EPR was first recorded in the Shennong Bencaojing in the name of Daji， and it is the correct name of the herbal medicine in all dynasties， there are also other aliases such as Qiongju， Hongya Daji， and Xiamaxian. The dried roots of Euphorbia pekinensis from Euphorbiaceae was the mainstream of the past dynasties. Before the Ming dynasty， the above ground parts of E. pekinensis were used as Zeqi in herbal works. However， since LI Shizhen in the Ming dynasty proposed that the origin of Zeqi should be E. helioscopia， the aerial part of EPR is no longer used as medicine. Since modern times， the roots of Knoxia valerianoides has been used as EPR， and has become the mainstream of commodities， which should be corrected. Throughout history， it has been recorded that the main producing areas were Jiangsu， Anhui， Zhejiang， Shanxi and other regions， while modern botanical survey have shown that EPR is a widespread species distributed throughout the country. In ancient times， the harvesting time of EPR was mostly the twelfth lunar month， while in modern time， it is more common to harvest in autumn and winter. The main processing methods of EPR in ancient times were vinegar processing， wine processing， and stir frying， while in modern times， it is uniformly vinegar processing. In the medicinal properties and clinical aspects， the records are basically consistent throughout history， mainly characterized by bitter taste， cold and toxic nature. Its main efficacy is expelling water retention and reducing swelling. Based on the textual research， it is suggested to choose the dried roots of E. pekinensis when famous classical formulas containing EPR， processing method can be based on the original specified prescription requirements， if the processing method is not clear， it is recommended to use vinegar-processed products as medicine.

Objective:To observe the clinical efficacy of mouse nerve growth factor (mNGF) combined with rehabilitation on children with global developmental delay(GDD).Methods:It was a prospective multicenter clinical randomized controlled trial (RCT) involving 120 children with GDD admitted to 5 hospitals in China from May 2020 to January 2022.They were randomly divided into mNGF group and conventional rehabilitation group using block randomization method.All children were managed by standardized rehabilitation after recruitment, and those in the mNGF group were additionally given mNGF injections.All subjects were surveyed using the Gesell Development Diagnosis Schedules(GDDS) at baseline, 90 days and 120 days after treatment, and their developmental quotient (DQ) was recorded.Clinical efficacy was analyzed by the paired t-test, rank sum test and Chi- squared test. Results:After 90 days of treatment and the continuous follow-up to 120 days, the increases in the DQ of gross motor (7.520±13.900 vs.0.450±11.459), fine motor (7.800±15.346 vs.1.250±11.581), adaptive behavior (7.730±13.428 vs.2.100±12.022) and personal-social behavior (6.780±11.651 vs.1.780±10.120) than baseline were significantly higher in mNGF group than those of conventional rehabilitation group (all P<0.05). Serious adverse events and important drug-related medical events were not reported. Conclusions:mNGF combined with rehabilitation effectively enhances the development levels of gross motor, fine motor, adaptive behavior and personal-social behavior, and continuously improves the condition of GDD in children with a high safety.

Objective:To automatically synthesize Al 18F-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid (NOTA)-fibroblast activation protein inhibitor (FAPI)-04, perform PET/CT imaging in vivo, and evaluate its diagnostic efficacy on tumors. Methods:Al 18F-NOTA-FAPI-04 was produced in All-in-one automatic synthesis module and its quality control was conducted by high performance liquid chromatography (HPLC) equipped with a radioactive detector. Al 18F-NOTA-FAPI-04 PET/CT imaging was performed in normal BALB/c mice ( n=3) and 4T1 breast cancer models ( n=3) to determine its biodistribution. Then Al 18F-NOTA-FAPI-04 and 18F-FDG PET/CT imaging were performed in a hepatocellular carcinoma patient (male, 51 years old). Results:The synthesis time of Al 18F-NOTA-FAPI-04 was about 35 min, and the radiochemical yield was (25.2±1.9)% (attenuation correction, n=3). The product was colorless transparent solution with pH value of 7.0-7.5, and the specific activity was (46.11±3.07) GBq/μmol (attenuation correction, n=3). The radiochemical purity was above 99.0% and was still above 98.0% at room temperature after 6 h. PET/CT imaging in mice showed that physiological uptake of Al 18F-NOTA-FAPI-04 was mainly in biliary system and bladder, and Al 18F-NOTA-FAPI-04 highly concentrated in tumor xenografts. PET/CT imaging in the patient showed that Al 18F-NOTA-FAPI-04 obtained high tumor background ratio (TBR) values of 4.1, 8.9, 5.4, 4.8, 2.2 in parasternal lymph nodes, anterior diaphragmatic lymph nodes, hilar lymph nodes, pancreaticoduodenal ligament lymph nodes, abdominal aortic lymph nodes, respectively, while TBR values were 1.0, 2.8, 5.0, 2.1, 1.1 by 18F-FDG. Conclusions:Al 18F-NOTA-FAPI-04 can be synthesized with short time, high radiochemical yield and good stability using All-in-one module. Al 18F-NOTA-FAPI-04 PET/CT imaging has high contrast and excellent diagnostic efficacy on tumors.

Objective:To investigate the biofilm-forming abilities of pathogens associated with contact lens related microbial keratitis and to compare the efficacies of different treatments in eliminating biofilms in contact lens cases (CLCs).Methods:Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Candida albicans biolm formation in polypropylene CLCs was examined by using a static biofilm formation model, which was incubated at 37 ℃ for 24 hours.According to the CLC treatment methods, the experimental groups were divided into a control group, a room temperature air-drying group, a contact lens care solution soaking group, a heat-drying group and a soaking-heating group.A pathogen colony counting-based serial dilution micro-counting method was applied to evaluate the biofilm elimination efficacies and pathogen killing rates of treatments.Results:All four tested strains formed biofilms on the inner walls of the CLC, and the biomasses of S. aureus, P. aeruginosa, E.coli and C. albicans biofilm were (10.78±2.12), (9.19±0.57), (8.03±0.30), and (7.50±0.07)lg CFU/ml, respectively.The S. aureus biofilm biomass was significantly higher than those of the other strains (P<0.05). The biofilm biomasses of all the tested strains in the heat-drying and the soaking-heating groups were significantly lower than those in the control group (all at P<0.05); and the biofilm biomasses of S. aureus and E. coli in the soaking group were significantly lower than that in the control group (all at P<0.05). The heat-drying treatment resulted in a killing rate of (51.76±16.75)% for S. aureus, (68.63±4.43)% for P. aeruginosa, (83.51±13.97)% for E. coli, and (97.13±5.19)% for C. albicans, respectively (F=31.806, P<0.001). Significant differences were observed between the killing rates for each bacterium (all at P<0.05). The E. coli and C. albicans killing rates of the soak-heating treatment were (100.00±0.00) % and (97.79±7.67)%, respectively, and were significantly higher than (81.13±14.86)% of S. aureus and (74.22±11.91)% of P. aeruginosa (all at P<0.05).Conclusions:Heating alone or combined with the use of contact lens care solution treatment can improve the pathogen killing rates and effectively eliminate the bacterial and fungal contaminations in CLCs.

Objective: This article summarizes and analyzes the rule of main acupoints selection in the treatment of epilepsy. Methods: The acupuncture domestic literatures about the treatment for epilepsy from CNKI, Wanfang, Vip and SinoMed Chinese databases from 1981 to 2017. To set up a database of selection points of epilepsy, we collected data of acupoints for epilepsy treatment and then did descriptive analysis and cluster analysis to the data with Excel 2007, SPSS 20.0. Results: A total of 80 acupoint prescriptions were recorded. The points of DU Meridian, BL Meridian, EX, ST Meridian and RN Meridian, were used more frequently than others.Acupoints with higher frequency of use were Dazhui, Baihui, Yaoqi, Fenglong, Xinshu. Cluster analysis divided the high frequency acupoints into 4 groups. The specific points used more were Fenglong, Xinshu and Jiuwei. Conclusions To grasp the law of acupuncture and moximoxition in the treatment of epilepsy can help to improve the clinical effect. The results can be used as reference for clinical application.

Needle-embedding therapy is characterized by shallow puncture and long retention of needle, which can reduce the pain during acupuncture and prolong the time of acupuncture effect to improve the effect, especially suitable for perioperative patients. The study shows that the clinical application of needle-embedding therapy has the effects of sedation, analgesia, reducing stress response, protecting gastrointestinal function and promoting postoperative recovery. The paper shows the advantages of traditional Chinese medicine (TCM) treatment in the field of rapid recovery during perioperative period and provides a new method for perioperative patients.

OBJECTIVE:To investigate the compatibility stability of Ulinastatin for injection with 2 commonly used solvents in the infusion pump.METHODS:After Ulinastatin for injection 500 000 U was respectively added into 0.9％ Sodium chloride injection and 5％ Glucose injection 50 mL,the appearance of the mixture at 25 ℃,37 ℃ were observed at 0,1,2,4,8,12,24 h,re spctively,pH value and the number of insoluble particles were measured.The relative percentage of ulinastatin in the mixture was determined by HPGFC.RESULTS:Under this condition,the appearance and pH value of the mixture had no significant change within 24 h;the number of particles ≥10 μm was lower than 25 particle/mL,and that ≥25 μm was lower than 3 particle/mL,which was in line with the pharmacopeia standard.The relative percentage of ulinastatin within 24 h ranged 99.45％-102.55％.CONCLUSIONS:After mixed with 0.9％ Sodium chloride injection and 5％ Glucose injection,Ulinastatin for injection keep stable within 24 h at 25 ℃,37 ℃ and can be used for continuous administration in the infusion pump.

Objective To explore the role of electrocardiogram (ECG) in predicting cardiac resynchronization therapy (CRT) response.Methods This study retrospectively analyzed ECG of 92 CRT patients,who received CRT therapy from 2001 to 2013 in our center and were followed up for 6 months.The patients were divided into responder group (n =64) and non-responder group (n =28).The baseline and 6-month data including QRS width,heart rhythm and axis variation were analyzed.The definition of responder is left ventricular end systolic volume (LVESV) reduction ≥ 15％ within 6 months after CRT.After CRT therapy,the ventricular activation was changed as left to right (frontal plane),posterior to anterior and axis changed in a clockwise direction.The change in more than two directions was defined as prominent axis change.Logistic analysis was performed to analyze the role of ECG in predicting CRT response.Results (1) Baseline parameter comparison between the two groups:the proportion of female and LBBB is significantly higher (P ＜ 0.01;P =0.04),while the proportion of atrial fibrillation/flutter (Af/AF) is significantly lower (P ＜ 0.01) in responder group than in non-responder group.The pre-CRT average QRS duration is much wider in responder group than in non-responder group (P =0.01).(2) Comparison of follow-up with baseline results in two groups:NYHA heart function level,6 minutes walking distance,QRS duration,LVEF,LVESV improved significantly (P ＜0.01) post-CRT in responder group.In non-responder group,the QRS duration and LVESV deteriorated significantly (P =0.02,P ＜ 0.01),while post-CRT NYHA heart function level improved significantly.In responder group,pre-CRT ECG axis of 53 patients (82.8％) pointed to left and 58 patients (90.6％) pointed to posterior;post-CRT ECG axis of 49 patients (76.6％) pointed to right and 30 patients (40.6％) pointed to anterior.In non-responder group,pre-CRT ECG axis of 25 patients (89.3％) pointed to left and 24 patients (85.7％) pointed to posterior;post-CRT ECG axis of 17 patients (60.7％) pointed to right and 12 patients (42.9％) pointed to anterior.Post-CRT,the proportion of ECG axis prominent change was significantly higher in responder than in non-responder group (62.5％ (40/64) vs.32.1％ (9/28),P =0.007).(3) Predicting value:pre-CRT QRS width ≥140 ms (OR =4.97,95 ％ CI 1.53 to 16.13,P =0.008) and post-CRT prominent axis change (OR =5.1,95 ％CI 1.67 to 15.5,P =0.004) were found to be independent predictors of CRT responders.Af/AF pre-CRT was associated with reduced CRT response (OR =0.25,95 ％ CI0.08 to 0.80,P =0.02).Conclusions ECG may play a role in predicting CRT response.QRS width and Af/AF before CRT and ECG axis change post-CRT could be used to predict CRT response.

ObjectiveTo study the effect of low molecular weight heparin sodium (LMWHS) therapy for exertional heat stroke (EHS) patients with pre-disseminated intravascular coagulation (pre-DIC).Methods A prospective randomized controlled trial (RCT) was conducted. Thirty-six patients with EHS with pre-DIC admitted to Department of Critical Care Medicine of 180th Hospital of Chinese PLA from April 2012 to November 2014 were divided into heparin sodium group (n = 20) and LMWHS group (n = 16) in accordance with the random number table. All patients received bundle treatment after being admitted to the hospital, including rapid cooling, fluid resuscitation, organ support (mechanical ventilation, hemopurification if necessary), supplement of pro-coagulation factors, etc. The patients in heparin sodium group were treated with continuous heparin sodium 12 500 U throughout 24 hours with intravenous pump for 5 days, and the patients in LMWHS group were given LMWHS 2 500 U subcutaneously, twice a day for 5 days.The incidence of DIC, incidence of bleeding and mortality of two groups were compared.The platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib) and D-dimer of each patient between pre and post treatment times were compared.Results No significant difference was found in the incidence of DIC and mortality between LMWHS group and heparin sodium group (31.2% vs. 30.0%,χ2 =0.007,P = 0.936; 6.2% vs. 5.0%,χ2 = 0.026,P = 0.871). Incidence of bleeding during treatment in LMWHS group was significantly lower than that in heparin sodium group (12.5% vs. 45.0%,χ2 = 4.425,P = 0.035). After treatment,PLT in both LMWHS group and heparin sodium group was significantly increased compared with that before treatment (×109/L: 140.5±17.5 vs. 110.5±16.5, 152.6±21.5 vs. 120.0±20.0, bothP< 0.05) and D-dimer was significantly decreased (mg/L: 0.5±0.1 vs. 3.2±1.2, 0.6±0.2 vs. 4.4±1.8, bothP< 0.05). APTT after treatment in heparin sodium group was significantly prolonged compared with that before treatment (s: 75.3±10.6 vs. 44.1±8.2,P< 0.05) while no change in APTT was found in LMWHS group (s: 38.6±5.5 vs. 42.1±8.4,P> 0.05). No significant difference was found in PT and Fib between pre and post treatment in all the patients.Conclusion When LMWHS was applied in EHS patients in pre-DIC stage, it could not only prevent DIC as efficiently as heparin sodium, but also results in lower incidence of bleeding. So LMWHS is safer.