Objective To analyze the efficacy and adverse reactions of donepezil in the treatment of patients with a continuous disease spectrum of Alzheimer's disease(AD)with pharmacogenomics.Methods Seventy-two patients who took donepezil therapy at the time of initial molecular pa-thology diagnosis of AD continuous disease spectrum in Chinese PLA General Hospital from Jan-uary 2022 to January 2023 were recruited.Cells from the oral buccal mucosa were collected,and MassARRAY nucleic acid mass spectrometry was applied to detect the genotypes of CYP2D6,the gene encoding cytochrome P450 2D6 enzyme,and CHAT,the gene encoding acetylcholine trans-ferase.After 9 months of follow-up,drug efficacy was indirectly determined by neurological func-tion scales,caregiver evaluations,and drug prescribing behaviors,and thus,the 50 patients on donepezil alone were divide into effective group(n=28)and ineffective group(n=22).Seventy-two patients were divided into adverse reaction group(n=12)and no adverse reaction group(n=60).Multivariate logistic regression analysis was used to analyze the correlation between donepezil efficacy and pharmacogenomics.Results The frequencies of CHAT rs3793790 locus carrying G allele and rs2177370 locus carrying A allele were significantly higher in the effective group than the ineffective group(35.71％vs 9.09％,P=0.029;42.86％vs 9.09％,P=0.008).Multivariate lo-gistic regression analysis showed that donepezil was more effective in those who carrying rs3793790 G allele and/or rs2177370 A allele in the CHAT gene than those who carrying neither of the alleles(95％CI:1.20-34.47,P=0.030).There were no statistical differences in the CYP2D6 gene-adjusted activity score and whether or not carrying*10 between the patients with and without adverse reactions(P＞0.0 5).Conclusion In patients with a continuous spectrum of AD,donepezil efficacy is associated with CHAT gene polymorphisms,but there is no correlation between donepezil adverse reactions and CYP2D6 genotype.

As a chronic inflammatory disease,incidence of atherosclerosis(AS)is increasing year by year,which seriously endangers human health.Regulatory T cells are unique subset of T cells with immunosuppressive effects.In recent years,a large number of studies have shown that regulatory T cells play an important role in development of AS.This article focuses on characteris-tics of regulatory T cells and their relationship with AS,in order to provide new ideas for treatment of AS.

Acute appendicitis represents one of the most common causes of acute abdomen that may warrant emergency surgery. Necrotizing fasciitis complicated by acute appendicitis is considered a rare complication with life-threatening implications. A 65-year-old man presented with abdominal pain, where a scan, revealed a perforated appendicitis complicated by an anterior abdominal wall collection. He underwent percutaneous drainage, but subsequently developed extensive necrotizing fasciitis requiring extensive debridement and reconstruction. The rapid progression of necrotizing fasciitis calls for early recognition and prompt intervention. The key management principles employed were broad spectrum antibiotics and aggressive surgical debridement. This case demonstrated the use of vacuum-assisted closure dressing and multidisciplinary care in wound healing and coverage. To ensure early diagnosis and intervention for acute appendicitis complicated by necrotizing fasciitis, a high degree of clinical suspicion and awareness of this complication is required.

OBJECTIVE：To understand the current situation and existing problems of Blumea balsamifera industry in China ， and to provide reference for its sustainable development . METHODS ：With the keywords of “B. balsamifera ”“Ai Pian ”“Ai Fen ”， etc.，through the patent platform of SooPat and Baiten ，the patent data of B. balsamifera that had been published from Jan. 1989 to Dec. 2019 were collected. The International Patent Classification （IPC）was used to sort out and count the patent information of B. balsamifera，to understand the development status of B. balsamifera industry in technology and research field ，to analyze the existing problems and to explore the development trend of B. balsamifera industry in China so as to put forward corresponding suggestions. RESULTS & CONCLUSIONS：A total of 690 patents related to B. balsamifera were collected ，mainly invention patents，of which the authorization rate was 27.39％，the effective rate was 17.97％，and the failure rate was 55.22％. Top 10 applicants with the largest number of applications had a total of 165 applications，accounting for 23.91％ of the total number of applications. Top 10 applicants were 4 enterprises，3 natural persons and 3 colleges and universities. The patents of B. balsamifera were mainly distributed in Guizhou ，Shandong，Anhui，Guangdong，Guangxi and Hainan ，accounting for 81.01％ of the total patent applications of B. balsamifera . The patent technology field of B. balsamifera had expanded from traditional Chinese medicine to daily chemical products ，health care and physiotherapy and other daily consumer good fields. From the perspective of patent intensity，the number and quality of patent applications were not coordinated ，and there were many meaningless patent applications，and the conversion rate was low. It is suggested that China should strengthen the research on B. balsamifera and its more compatible medicinal materials ，promote the innovation ，development，transformation and upgrading of B. balsamifera industry；strengthen the systematic and in-depth research on B. balsamifera，improve the quality and conversion rate of patent xiexiaoli13@126.com technology，and revitalize the development of B. balsamifera industry； expand multi-party cooperation ， strengthen the E-mail：fulai.yu@163.com research on patent core technology ，build the strategic alliance of intellectual property rights of B. balsamifera industry，and realize the high quality development of B. balsamifera industry.

Objectives To investigate the features of thyroid ultrasonographic manifestations in patients with subclinical thyroid serological anomalies during pregnancy. Methods In present study, a total of 53 women who attended the obstetrics clinic in Beijing Obstetrics and Gynecology Hospital from January 2014 to December 2015 underwent thyroid ultrasound scanning. All women included in this study were checked up for the serological levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibody (TPoAb) in the first trimester and were diagnosed as thyroid dysfunction or abnormal level of serological antibody for the first time. The χ2test was used to compare the incidences of abnormal thyroid echogenicity and increased blood flow in thyroid between groups with serological TPoAb level≥1300 IU/L and＜1300 IU/L. Results Among 53 cases, 21 were subclinical hyperthyroidism, 10 were subclinical hypothyroidism, and 22 were isolated elevated serum TPoAb cases. Among 21 subclinical hyperthyroid patients, 16 cases without elevated TPoAb were unremarkable on thyroid scanning, while 2 out of the rest 5 cases (40.0%) with increased serum TPoAb demonstrated mild thyroid diffuse abnormal echogenicity. Among 10 subclinical hypothyroid cases, 2 out of 5 cases (40.0%) without elevated TPoAb manifested mild thyroid diffuse abnormal echogenicity, while 4 of 5 cases (80.0%) with elevated TPoAb showed diffuse abnormal echogenicity of thyroid. In 22 women with isolated elevated serum TPoAb, 11(50.0%) demonstrated diffuse thyroid abnormal echogenicity. In all 32 cases with elevated serum TPoAb, the serum TPoAb level was ≥ 1300 IU/L in 9 cases and ＜ 1300 IU/L in 23 cases. The incidence of thyroid abnormal echogenicity was higher in women with serum TPoAb level≥1300 IU/L than in women with＜1300 IU/L (8/9 vs 9/23), which was statistically significant ( χ2=6.432, P=0.018); while no significant difference in the incidence of increased blood flow in both groups was identified(6/9 vs 9/23, χ2=1.970, P=0.080). Conclusion The thyroid ultrasonographic manifestations varied in patients with thyroid serologic anomalies during pregnancy, and were not closely consistent with the serological findings.

Pharmacological studies have shown that Bruceae Fructus has unique antitumous effects, which has broad market prospects. In recent years, the demand of Bruceae Fructus has increased year by year. Production and marketing thrive, and prices continue to rise. Therefore, it has become one of the Chinese medicinal herbs with antitumour effects that obtained people’s attention. This author summarized the dynamic condition of production and marketing of Bruceae Fructus during the last 10 years, and analyzed the major reasons for price changes and forecast development tendency so as to provide references for the reasonable layout of production and marketing of Bruceae Fructus.