Objective:To assess the efficiency and safety of combining lenvatinib with DEB-TACE for the treatment of unresectable large hepatocellular carcinoma,accompanied by PVTT,in order to provide insights into its potential as a therapeutic approach.Method:Patients with hepa-tocellular carcinoma and portal vein tumor thrombus,who were diagnosed and treated at Linyi Can-cer Hospital between June 2019 and June 2021,were chosen as the subjects of this study.Patient allocation into the experimental group(23 cases)and control group(27 cases)was based on indi-vidual preferences,ensuring a random distribution of participants.The DEB-TACE treatment was administered to the control group,while the experimental group received a combination of DEB-TACE and lenvatinib.The effectiveness of lenvatinib was assessed in the immediate post-surgery period,the patients'survival was monitored,and any associated side effects were documented.Result:3 months after treatment,the objective remission rates of the experimental group and the control group were 91.31％and 66.67％,and the disease control rates were 100％and 77.78％.The difference was statistically significant(P＜0.05).3 months after treatment,the regression rates of tumor thrombus in the experimental group and the control group were 60.87％and 29.63％,the difference was statistically significant(P＜0.05).The progression free survival time of the experi-mental group and the control group was 11 months and 8 months,the difference was statistically significant(P＜0.05);The median survival time of the experimental group and the control group was 20 months and 14 months,and the difference was statistically significant(P＜0.05).The main ad-verse reactions of the experimental group were hypertension,diarrhea,hand foot syndrome,rash,fatigue,loss of appetite,etc.,all of which were less than or equal to grade 3,and could be basically relieved after symptomatic treatment.Conclusion:The combination of DEB-TACE and lenvatinib is proven to be a safe and well-tolerated treatment for unresectable large hepatocellular carcinoma with portal vein tumor thrombus.This therapy not only effectively controls tumor progression but also prolongs survival time.

Objective China is among the 30 countries with a high burden of tuberculosis(TB)worldwide,and TB remains a public health concern.Kashgar Prefecture in the southern Xinjiang Autonomous Region is considered as one of the highest TB burden regions in China.However,molecular epidemiological studies of Kashgar are lacking. Methods A population-based retrospective study was conducted using whole-genome sequencing(WGS)to determine the characteristics of drug resistance and the transmission patterns. Results A total of 1,668 isolates collected in 2020 were classified into lineages 2(46.0%),3(27.5%),and 4(26.5%).The drug resistance rates revealed by WGS showed that the top three drugs in terms of the resistance rate were isoniazid(7.4%,124/1,668),streptomycin(6.0%,100/1,668),and rifampicin(3.3%,55/1,668).The rate of rifampicin resistance was 1.8%(23/1,290)in the new cases and 9.4%(32/340)in the previously treated cases.Known resistance mutations were detected more frequently in lineage 2 strains than in lineage 3 or 4 strains,respectively:18.6%vs.8.7 or 9%,P<0.001.The estimated proportion of recent transmissions was 25.9%(432/1,668).Multivariate logistic analyses indicated that sex,age,occupation,lineage,and drug resistance were the risk factors for recent transmission.Despite the low rate of drug resistance,drug-resistant strains had a higher risk of recent transmission than the susceptible strains(adjusted odds ratio,1.414;95%CI,1.023-1.954;P = 0.036).Among all patients with drug-resistant tuberculosis(DR-TB),78.4%(171/218)were attributed to the transmission of DR-TB strains. Conclusion Our results suggest that drug-resistant strains are more transmissible than susceptible strains and that transmission is the major driving force of the current DR-TB epidemic in Kashgar.

Objective To observe the efficacy and safety of Morinda officinalis oligosaccharides in the continuation treatment of mild and moderate depression.Methods An open,single-arm,multi-center design was adopted in our study.Adult patients with mild and moderate depression who had received acute treatment of Morinda officinalis oligosaccharides were enrolled and continue to receive Morinda officinalis oligosaccharides capsules for 24 weeks,the dose remained unchanged during continuation treatment.The remission rate,recurrence rate,recurrence time,and the change from baseline to endpoint of Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression-Severity(CGI-S)and Arizona Sexual Experience Scale(ASEX)were evaluated.The incidence of treatment-related adverse events was reported.Results The scores of HAMD-17 at baseline and after treatment were 6.60±1.87 and 5.85±4.18,scores of HAMA were 6.36±3.02 and 4.93±3.09,scores of CGI-S were 1.49±0.56 and 1.29±0.81,scores of ASEX were 15.92±4.72 and 15.57±5.26,with significant difference(P＜0.05).After continuation treatment,the remission rate was 54.59％(202 cases/370 cases),and the recurrence rate was 6.49％(24 cases/370 cases),the recurrence time was(64.67±42.47)days.The incidence of treatment-related adverse events was 15.35％(64 cases/417 cases).Conclusion Morinda officinalis oligosaccharides capsules can be effectively used for the continuation treatment of mild and moderate depression,and are well tolerated and safe.

During the storage process, Chinese medicinal materials are susceptible to insect infestation due to their own nature and external storage factors. Infestation by insects can have varying impacts on the materials. In mild cases, it affects the appearance and reduces consumer purchasing power, while in severe cases, it affects the quality, reduces medicinal value, and introduces impurities such as insect bodies, excrement, and secretions, resulting in significant contamination of the medicinal materials. This study reviewed the rele-vant factors influencing insect infestation in Chinese medicinal materials and the compositional changes that occur after infestation and summarized maintenance measures for preventing insect infestation. Additionally, it provided an overview of detection techniques applicable to identifying insect infestation during the storage of Chinese medicinal materials. During the storage process, insect infestation is the result of the combined effects of biological factors(source, species, and population density of insects), intrinsic factors(moisture, chemical composition, and metabolism), and environmental factors(temperature, relative humidity, and oxygen content). After infestation, there are significant changes in the content of constituents in the medicinal materials. By implementing strict pre-storage inspections, regular maintenance after storage, and appropriate storage and maintenance methods, the occurrence of insect infestation can be reduced, and the preservation rate of Chinese medicinal materials can be improved. The storage and maintenance of Chinese medicinal materials are critical for ensuring their quality. Through scientifically standardized storage and strict adherence to operational management standards, the risk of insect infestation can be minimized, thus guaranteeing the quality of Chinese medicinal materials.
Animals ; Drug Contamination/prevention & control* ; Insecta ; Preservation, Biological ; Temperature

ObjectiveTo investigate the value of contrast enhanced 3D STIR SPACE sequence and compare it with contrast enhanced 3D VIBE sequence in displaying the sacral nerve plexus abnormalities in pelvic endometriosis. MethodsAll the 30 patients with endometriosis and 20 healthy women received pelvic MRI examinations by contrast enhanced 3D STIR SPACE sequence and contrast enhanced 3D VIBE sequence. Then we evaluated and analyzed the image quality and diagnostic confidence of the two sequences in identifying the sacral nerve plexus abnormalities. ResultsSacral plexus nerve fibers were clearly revealed in both healthy controls and patients with endometriosis on 3D STIR SPACE sequence and 3D VIBE sequence. The consistency of diagnosis confidence by two readers using 3D-STIR-SPACE sequence was strong （Kappa=0.684，P<0.001）， using 3D-VIBE sequence was moderate（Kappa=0.130，P =0.386）. ConclusionsBoth 3D STIR SPACE sequence and 3D VIBE sequence can clearly display sacral plexus nerve fibers. 3D STIR SPACE sequence has more advantages in showing sacral plexus abnormalities in pelvic endometriosis.

Objective:According to the GB/T 15000.3-2008， to develop a fucosterol certified reference material based on the project approved by Standardization Administration. Method:Fucosterol was isolated from Laminaria japonica dried thallus via 95% ethanol extraction， vacuum concentration， repeated column chromatography separation， recrystallization in petroleum ether-ethyl acetate， and residual solvent removal. Its chemical structure was identified by elemental analysis （EA）， infrared spectrum （IR）， mass spectrometry （MS）， nuclear magnetic resonance （NMR） and X-ray diffraction （XRD）. Its homogeneity， stability， and cooperative certification conducted by 8 laboratories were carried out by high performance liquid chromatography with evaporative light scattering detector. Result:For the fucosterol reference material， the certified value of purity was 99.54% with expanded uncertainty of 0.16% in confidence interval of 95%， the stability was good within 24 months storage period at 2-4 ℃， which met the technical requirements of reference material and passed the acceptance organized by Standardization Administration. Conclusion:The national standard materials of fucosterol has been successfully developed， which can be used for the determination of this component， the evaluation of detection methods， and the detection and quality control of related products.

Objective:To investigate the factors affecting the quality of post-harvest Angelicae Dahuricae Radix （Baizhi） and to provide the corresponding suggestions according to these factors. Method:A series of factors affecting the quality of Baizhi were analyzed comprehensively by visiting several origins， medicinal material markets， pharmacies， supermarkets and storehouses combined with plenty of literature reports. Result:The rot of Baizhi was the most common phenomenon after harvest， and mildew， discoloration and moth could occur during the processes of processing， storage and packaging. So the quality of Baizhi should be controlled strictly through the whole process. The roots of Baizhi should be harvested on sunny days to avoid mining damage and dried as soon as possible to prevent rotting. The drying methods included both traditional lime burial and modern ways such as sulfur fumigation， saline dehydration， sun drying method， and oven drying method. However， the water content should be strictly controlled. Furthermore， the storehouses should be disinfected firstly. The temperature and humidity of the storehouses should be controlled strictly. Some suitable ways could be adopted to prevent moth and discoloration during storage， which included airtight fumigation of aluminum phosphide， cold storage， air conditioning maintenance， antagonism storage with other Chinese medicinal materials， dry ice storage at room temperature， etc. Large quantities of Baizhi were generally packaged in woven bags. Otherwise， kraft paper bags， polyvinyl chloride plastic bags， glass bottles， aluminum foil composite film bags， and other packaging materials had been adopted for the retail. However， the packaging specification should be selected according to the situation. Conclusion:The quality of Baizhi can be directly affected by harvesting， drying， processing， storage and packaging. Scientific and reasonable methods should be adopted to ensure the quality of Baizhi.

The chigger mite Leptotrombidium sialkotense is one of the 6 main vectors of scrub typhus in China. Before present study, L. sialkotense was found in some parts of Hunan province, China with a narrow geographical distribution. During field investigation 2016-2017, we found L. sialkotense in Jingha, southern Yunnan, China. Of 15 small mammal host species, L. sialkotense were collected from 6 species of the hosts. Rattus brunneusculus was a dominant host of L. sialkotense, from which 98.3% of the mites were collected. The chigger mite showed a relatively high infestation prevalence (PM=11.7%) and mean abundance (MA=0.5) in comparison with the rest 5 host species. These results reveal a certain host specificity of L. sialkotense to a rat R. brunneusculus. The mite L. sialkotense showed an aggregated distribution on the host (P<0.05). A positive correlation observed between L. sialkotense and the body length of hosts. There was a positive interspecific association between L. sialkotense and 2 other dominant vectors, L. deliense and L. scutellare.

Objective:To further improve the department information system, and to establish a multi-parameter critical care medicine database, which can provide data for the analysis and research of big data in critical care medicine, and provide references for other medical institutions to establish relevant databases.Methods:On the premise of fully understanding the needs of clinical and scientific research, based on a Critical Care Medicine Clinical Information System, the department of critical care medicine of the First Medical Center of Chinese PLA General Hospital integrated the patients' case data in hospital information system (HIS), electronic medical records (EMR), monitoring information system (Monitor), laboratory information system (LIS), and radiation information system (RIS), to establish a rudimentary critical care database. On this basis, the related data were analyzed and verified. Further, this database was gradually improved in both its content and structure by referring to Medical Information Mart for Intensive CareⅢ (MIMIC-Ⅲ) database.Results:During the operation of Critical Care Medicine Clinical Information System from September 2017 to February 2020, the database collected diagnosis and treatment data of 2 207 critically ill patients, including data before the patient entering the intensive care unit (ICU) and all data during the ICU, such as demographic data, vital signs, medical treatment, the records of intake and output, sampling time, laboratory examination results, surgical treatment, and a variety of commonly used clinical scoring and diagnosis data. The data in the database were stored in different tables according to different contents, and the tables were connected to each other through the primary key. The data could be analyzed statistically through the information system and has been applied for certain clinical studies, combining clinical practices with scientific studies.Conclusions:The critical care medicine database based on the Critical Care Medicine Clinical Information System can help medical institutions to carry out standardized treatment and clinical research of critically ill patients. With further improvement of the function, the database can be better applied to the data analysis of Chinese critical patients.

Objective: To investigate the current harvest,processing,packaging and storage of Lilii Bulbus due to the great difference in quality of commercially available products,in order to realize the factors affecting the quality after harvest and provide reference for the standardized production. Method: A series of factors affecting Lilii Bulbus quality were analyzed comprehensively on the basis of both field survey in main producing areas and medicinal material markets and literature retrieval. Result: The current situation and problems in harvest,initial processing,drying technologies,packaging,and storage were summarized. Conclusion: The harvest link of Lilii Bulbus involves growing years,harvesting time,and collecting methods. The initial processing link involves stripping,cleaning,sulfur fumigation,and many cooking and drying methods. The hot-air,vacuum-freeze,far-infrared,and microwave methods are applied in drying Lilii Bulbus. The main metamorphic phenomena are brown staining,moth biting,and decay in the packaging and storage links. Lilii Bulbus are packed mainly in bulk,and a few of them are packed in plastic bags or vacuum bags for fresh bulbus. Because the operation process is not standard,the cooking and drying methods are the key factors affecting the quality of Lilli Bulbus. It is necessary to establish a scientific and unified standard operating procedure (SOP) for controlling the whole process of Lilii Bulbus in multiple links.