[Medicinal Characteristics of Shao Jiu in Compendium of Materia Medica]

Modern Bai Jiu(liquor) was called Shao Jiu in ancient times.By consulting ancient books, it was found that there was a distillation and preparation process of Shao Jiu before the Ming Dynasty, but due to its high toxicity, the scope of application was limited, and there were few records of its medicinal use.However many records of its medicinal use was found in the Compendium of Materia Medica(«»).By comparing the medical books that recorded Shao Jiu in previous dynasties, it is found that the Compendium of Materia Medica comprehensively records the relevant cognition and application of the medicinal use of Shao Jiu for the first time. The book lists in detail the causes of the toxicity of Shao Jiu and the methods to avoid it, comprehensively expounds its characteristics, efficacy and indications, lists a variety of ways to use it, skillfully uses Shao Jiu to treat syphilis sores, and proposes that high-concentration Shao Jiu can be used as a solvent for medical liquor.The record of Shao Jiu in the Compendium of Materia Medica had a profound impact on the medical liquor of later generations.The use of Shao Jiu in the Qing Dynasty continued to expand, and the types of medicinal liquor were also constantly enriched. The record of Shao Jiu in the Compendium of Materia Medica can also provide a reference for the medicinal use of modern liquor.

[Analysis of clinical phenotype and gene mutation characteristics of MYH9-related disorder]

Objective: To investigate the clinical phenotype and gene mutation characteristics of MYH9-related disorder (MYH9-RD). Methods: The clinical data of 66 patients with MYH9-RD in the First Affiliated Hospital of Soochow University from January 2010 to December 2022 were retrospectively analyzed. According to the bleeding symptom, the patients were divided into bleeding and non-bleeding group, and according to the mutation sites, the patients were divided into non-muscle myosin heavy chain ⅡA head region (MD) and tail region (TD) mutation group. Statistical analysis was made to explore the clinical features in different groups such as platelet counts, bleeding, renal function, cataracts and hearing as well as MYH9 gene mutations. Results: A total of 66 MYH9-RD patients were included, with 28 males and 38 females, diagnosis age of 1-63(26±2) years. And 41% (27/66) of the patients had no family history. All patients presented with macrothrombocytopenia and normal platelet aggregation(10/10), 92% (54/59) of the patients had visible blue inclusion bodies in neutrophils, 30% (20/66) had bleeding symptoms, 45% (22/49) had proteinuria or glomerulonephropathy, 20% (8/41) had bilateral hearing impairment, and 10% (4/42) had bilateral cataracts. 18 mutation sites were identified in total, including 15 missense, 1 splicing and 2 termination mutations. Among them, p.Asp1424Asn, p.Arg1933* and p.Arg702His/Cys mutations were identified in 56% (29/52) of the patients, and p.Ser96Leu, Arg1165Cys and p.Glu1841Lys mutations were recurrent mutations, while p.Ala44Thr, p.Asp1447Ala and c.3838-2A>G mutations were novel mutations. The average platelet count of patients in bleeding group was (19±3)×109/L, which was significantly less than (36±3)×109/L in non-bleeding group (P<0.001). Compared with TD mutation group, patients of MD mutation group were presented with lower platelet count and higher risk of bleeding, as well as more severe clinical presentations including renal and hearing impairment and cataracts (all P<0.05). Conclusion: Mutations of p.Asp1424Asn, p.Arg1933* and p.Arg702His/Cys in MYH9 gene are hotspot mutations for MYH9-RD patients, Compared with TD mutation group, patients of MD mutation group were presented with lower platelet count and higher risk of bleeding, as well as more severe clinical presentations including renal and hearing impairment and cataracts.

Association between chronic disease and depression among older adults in China: the moderating role of social participation

OBJECTIVES

Depression is an increasingly serious mental health problem worldwide. Therefore, this study aimed to explore the association between chronic disease and depression and to further test the moderating role of social participation in this association.

STUDY DESIGN

This is a cross-sectional study.

METHODS

We screened 6421 subjects from the 2018 wave of the China Health and Retirement Longitudinal Study database. Social participation and depressive symptoms were assessed using the 12-item self-made scale and 10-item Center for Epidemiological Studies Depression Scale, respectively. Hierarchical regression was used to determine the main effect of chronic disease and depression and the moderating effect of social participation on the relationship between chronic disease and depression.

RESULTS

In this study, 3172 (49.40%) eligible participants were male, 4680 (72.90%) older adults were concentrated in the 65-74 years group, and 68.20% reported good health status. In addition, gender, area, education level, marital status, health status, health insurance, health service utilization, and physical activity intensity were significant factors associated with participants' depression status (P < 0.05). The results also showed that a higher number of chronic diseases were associated with a higher depression score after adjusting for confounders (single disease: β = 0.074, P < 0.001; multimorbidity: β = 0.171, P < 0.001) and that social participation played a moderating role in this association (β = -0.030, P < 0.05).

CONCLUSIONS

This study tentatively suggests that a higher number of chronic diseases are associated with rising depression scores in the older Chinese population. In addition, the moderating effect of social participation suggests that more active social engagement should be promoted in this population to alleviate the depressive mood.

[Clinical diagnosis and treatment of hereditary thrombocytopenia and purpura: a report of five cases and literature review]

Objective: To report the clinical manifestations and laboratory features of five patients with congenital thrombotic thrombocytopenic purpura (cTTP) and explore its standardized clinical diagnosis and treatment along with a review of literature. Methods: Clinical data of patients, such as age of onset, disease manifestation, personal history, family history, and misdiagnosed disease, were collected. Treatment outcomes, therapeutic effects of plasma infusion, and organ function evaluation were observed. The relationship among the clinical manifestations, treatment outcomes, and ADAMTS13 gene mutation of patients with cTTP was analyzed. Additionally, detection of ADAMTS13 activity and analysis of ADAMTS13 gene mutation were explored. Results: The age of onset of cTTP was either in childhood or adulthood except in one case, which was at the age of 1. The primary manifestations were obvious thrombocytopenia, anemia, and different degrees of nervous system involvement. Most of the patients were initially suspected of having immune thrombocytopenia. Acute cTTP was induced by pregnancy and infection in two and one case, respectively. ADAMTS13 gene mutation was detected in all cases, and there was an inherent relationship between the mutation site, clinical manifestations, and degree of organ injury. Therapeutic or prophylactic plasma transfusion was effective for treating cTTP. Conclusions: The clinical manifestations of cTTP vary among individuals, resulting in frequent misdiagnosis that delays treatment. ADAMTS13 activity detection in plasma and ADAMTS13 gene mutation analysis are important bases to diagnose cTTP. Prophylactic plasma transfusion is vital to prevent the onset of the disease.

[The textbooks in the North China Medical College]

The North China Medical College typically represented medical colleges for traditional Chinese medicine in the 1930s when many of them were set up. It was based on the principles of centring on traditional Chinese medicine, following western medicine and integrated medicine in teaching. This led to the emergence of a great number of people with a high level of traditional Chinese medicine and strong belief in it. In terms of the textbooks and handouts for western medicine, compared to similar textbooks in other medical colleges, such as the Medical College of Xie He, at that time, the textbooks in the North China Medical College covered a variety of perspectives and categories. It was found that 20 textbooks for western medicine in the North China Medical College were designed reasonably in content and were simple and applicable in teaching. More importantly, it contained some traditional Chinese medicine in different degrees, with its typical characteristics. The course design and textbook compilation provided references for the teaching in contemporary medical universities.

[Antimicrobial resistance in 33 non-O157 Shiga toxin-producing Escherichia coli isolated from human cases from 2011 to 2019]

Objective: To evaluate the antimicrobial resistance of non-O157 Shiga toxin-producing Escherichia coli (STEC) isolated from human cases. Methods: From 2011 to 2019, 33 non-O157 STEC strains recovered from diarrheal patients from 7 provinces/cities were collected, including Qinghai (1 isolate), Heilongjiang (1 isolate), Guangxi (2 isolates), Shandong (2 isolates), Guangdong (4 isolates), Henan (11 isolates), and Shanghai (12 isolates). Minimum inhibitory concentration (MIC) of 19 antimicrobials were tested by broth microdilution method; O∶H serotypes, Multi-locus sequence typing (MLST) and antimicrobial resistance genes were determined by whole genome sequencing. Results: A total of 33 non-O157 STEC strains were typed into 19 O∶H serotypes and 17 sequence types (STs), respectively. Ten strains were resistant to one or more antibiotics,of which five were multiple drug-resistant (MDR). The resistance rate of tetracycline was 30.3% (10 isolates), and azithromycin resistant strains were detected (12.12%, 4 isolates), but all strains were susceptible to carbapenems. All strains carried the bla_EC gene, and the Extended-Spectrum β-Lactamase (ESBL) genotype bla_CTX-M-15 were detected (3.0%, 1 isolates). The fosA7 gene was firstly detected in non-O157 STEC strains. Conclusion: MDR, azithromycin resistance, and multiple drug resistance genes were detected in human-derived non-O157 STECs in many regions in China, but they were all susceptible to carbapenems. Our results might guide the clinical treatment of STEC infections.

Efficacy of intrauterine perfusion of peripheral blood mononuclear cells (PBMC) for infertile women before embryo transfer: meta-analysis

This meta-analysis was intended to evaluate the effects of intrauterine perfusion of peripheral blood mononuclear cells (PBMC) on the pregnancy outcomes including clinical pregnancy rates, embryo implantation rates, live birth rates and miscarriage rates of infertile women who were undergoing in vitro fertilisation (IVF) treatment. By searching Pubmed, Embase database, five articles meeting the inclusion criteria were included, and 1173 women were enrolled (intrauterine PBMC group: n = 514; NO-PBMC group: n = 659). For the entire IVF/ICSI population and one or two embryo transfer failure patients, there was no significant difference in endometrial thickness, embryo implantation rates, live birth rates, and miscarriage rates between the PBMC group and NO-PBMC group. Although the clinical pregnancy rates of the PBMC group were higher than that of the NO-PBMC group, the confidence interval was close to the line of unity. As for the patients with three or more implantation failures, the clinical pregnancy rates, embryo implantation rates and live birth rates were much higher in the PBMC group than that of the NO-PBMC group. In summary, current evidence suggests that intrauterine perfusion of PBMC can significantly improve pregnancy outcomes in patients who have three or more implantation failures.Impact statementWhat is already known on this subject? An increasing number of studies have shown that immune cells play an important role in embryo transfer. There is no reliable evidence to confirm the clinical efficacy of intrauterine perfusion of PBMC.What do the results of this study add? The current evidence suggests that intrauterine perfusion of PBMC can significantly improve pregnancy outcomes in patients who have three or more implantation failures.What are the implications of these findings for clinical practice and/or further research? To the best of our knowledge, this meta-analysis is the first to evaluate the effect of intrauterine perfusion of PBMC on pregnancy outcomes before embryo transfer. Our study indicated that intrauterine perfusion of PBMC significantly increased clinical pregnancy rates, embryo implantation rates, and live birth rates in patients who failed more than three implants.

[Clinical observation of desmopressin in the treatment of 15 patients with DDAVP]

Objective: To assess the significance of DDAVP use in the diagnosis and treatment of VWD. Methods: An analysis of 15 VWD cases who referred to Hematology Division of First affiliated Hospital of Soochow University and treated with DDAVP from March 2016 to August 2018 was conducted. Efficacy and treatment response of DDAVP were monitored by observations of changes in factor Ⅷ procoagulant (FⅧ∶C) and von Willebrand Factor (VWF) related indicators before and 2 h after DDAVP injection. Results: Of 15 cases with VWD, 7 males and 8 females with a median age of 23 (6-46) years, 7 of 9 type I VWD patients achieved complete response (CR) , 1 type 2A VWD case CR, 5 type 3 VWD ones no response (NR) . The VWF multimer analysis in 5 patients combined with other plasma VWF values were in accordance with the known diagnosis. Conclusions: DDAVP was effective in most type 1 patients, and ineffective in some type 2 and almost all type 3 cases. It was helpful for diagnosis and subsequent treatment planning.

[Clinical features of 20 patients with phytosterolemia causing hematologic abnormalities]

Objective: To investigate the clinical and laboratory features of Phytosterolemia with hematological abnormalities. Methods: A retrospective study was performed on 20 patients with phytosterolemia admitted to the hematology department of the First Affiliated Hospital of Suzhou University during 2004-2017. History of patients was collected and the platelet counts, lipidomic analysis of plasma and osmotic fragility of erythrocytes were carried out. The erythrocyte and platelet morphology was examined by light microscope. Phytosterol levels in serum were measured by high performance liquid chromatography method. All of ABCG5/8 exons and intron-exon boundaries were amplified by PCR and directly sequenced to identify mutations. Results: All patients had been misdiagnosed as immune thrombocytopenia (ITP), or Evans syndrome with a mean delay of 21 years between symptom onset and accuracy diagnosis. The clinical manifestations of the patients were variable, but most of them presented with thrombocytopenia, anemia, splenomegaly from early ages, and xanthomas. Other major features were also observed, such as impaired liver functions (9 cases), premature atherosclerosis (5 cases) and/or arthritis (4 cases). Interestingly, all patients displayed an increased osmotic fragility of red cells and unique blood film features: large unequal platelets surrounded by a circle of vacuoles and various abnormal erythrocyte shapes, especially stomatocyte. Serum levels of the sitosterol and stigmasterol in the patients were remarkably elevated up to 331.05(276.00, 670.20)mg/L and 244.60(193.78,399.40)mg/L, about 10 and 24 times higher than those of normal subjects. There were 14 mutations in ABCG5/8 genes found in the patients. Among them, 2/3 of the mutations were in ABCG5 gene, including p.(E22X), p.(R446X),g.ISV7+3G>A, p.(R446X), p.(R419H), g.ISV7+3G>A, p.(G90E), p.(R389H) and g.7+2G>A), and 1/3 in ABCG8 gene involving p.(M614-K628del), p.(E25X), p.(L86P fs X185), p.(R263Q), p.(E500D fs X604) and p.(G674R) mutation. The ABCG5 p.(R446X) mutation was found in 3 separate families. Conclusions: The phenomena of thrombocytopenia/ stomatocyte/splenomegaly represents a special clinical manifestations of phytosterolemia, and distinct changes of blood cell morphology are the typical characters. Plasma plant sterols and ABCG5/ABCG8 genes should be analyzed when such hematologic abnormalities are unexplained.

[α1-antitrypsin Pittsburg mutations: report of two cases in the same family]

目的

分析2例α1抗胰蛋白酶（α1-AT）Pittsburg突变患者的临床和实验室特点。

方法

采用凝固法或发色底物法分别检测凝血时间及凝血因子活性；比浊法测定血小板聚集功能；采用毛细管电泳法测定血清蛋白；PCR扩增目的DNA片段并测序检测突变。

结果

先证者，女，34岁，多次术后出血及黄体破裂出血；女儿，10岁，无出血表现。两例患者APTT、凝血酶时间均明显延长且正常人混和血浆1∶1不能纠正，凝血因子Ⅸ、Ⅹ、Ⅺ、Ⅻ活性明显降低，蛋白C、蛋白S活性均为0，1 U/ml凝血酶诱导的血小板聚集降低，4 U/ml凝血酶诱导的血小板聚集为48%；血清α1球蛋白电泳条带异常；DNA测序结果显示两例患者的α1-AT基因（NG_008290.1）均存在g.T17132G（p.Met358Arg）杂合突变。

结论

α1-AT Pittsburg突变患者表现出明显的凝血异常，临床出血表现有较大的差异性，黄体破裂出血可能是女性患者的一个明显特征。

[The impact of resection of skull base tumor via an endoscopic endonasal approach on the visual function of vision impaired patients and the analysis of factors affecting their visual recovery]

Objective: To evaluate the visual outcomes of patients with visual impairment after resecting skull base tumor via an endoscopic endonasal approach, and to analyze the factors affecting visual recovery. Methods: One hundred and fifty-three patients with skull base tumor who suffered from preoperative visual impairment from Skull Base Surgery Center of Xuanwu Hospital were operated through an endoscopic endonasal approach. Both preoperative and postoperative visual function outcomes as well as factors that might have affected their visual recovery were analyzed retrospectively by Chi square test and Logistic regression analysis. Results: Complete resection was achieved in 85.6% of the patients using this technique. The rate of postoperative visual recovery in the female group (86.1%) was higher than that in the male group (73.9%), the benign group (90.2%) higher than the malignant group (20.0%), the group without optic atrophy (97.1%) higher than the one with (51.2%), and the acute group (96.6%) higher than the chronic group (80.0%). Significant differences were found between the abovementioned groups (χ(2) value was 5.849, 87.860, 79.757, 4.745, respectively, all P<0.05). The degree of optic atrophy and the property of tumors were significantly associated with visual improvement after treatment (Wold χ(2) value was 18.597 and 35.623, all P<0.001). Conclusions: Our results indicate that endoscopic endonasal surgery shows its ability both to resect skull base tumors and to improve visual function in the majority of patients. The timing of treatment for patients suffered from preoperative visual impairment should be selected in early stage before optic atrophy occurs.

[Textual criticism and discrimination on the naming of"Five-abstention Soup of Medical Professional"from the Han-tomb of the Marquis of Haihun]

A lacquer vessel with the inscription of Yi gong wu jin tang (Five-abstention Soup of Medical Profession) has been unearthed from the Han-tomb of Marquis of Haihun, in which"Five abstentions"is related to the incantations and abstention therapies prevalent in the Qin and Han Dynasties. The"Five-abstention Law"is the five rituals and methods during the process of practicing incantations and abstentions therapies including"keeping one's thinking (cun si)","holding the breath(bi qi)","twirling eyes (nian mu)","stepping after Yu's sample (yu bu)"and"incanting and blessing (zhou zhu)". The"Five-abstention Law"uses the medium"soup"to achieve the purpose of treatment."Soup"refers either to"decoction"or to"magic water". The lacquer vessel with the inscription"Five-abstention Soup of Medical professional"could be an instrument for implementing the process of practising the"Five-abstention Law", reflecting the historical facts that Liu He, the Marquis Haihun did accept the incantations and abstention therapies.

Characterization of novel microsatellite markers for Hyphantria cunea and implications for other Lepidoptera

This is the first report of microsatellite markers (simple sequence repeats, SSR) for fall webworm, Hyphantria cunea (Drury) (Lepidoptera: Arctiidae), an important quarantine pest in some European and Asian countries. Here, we developed 48 microsatellite markers for H. cunea from SSR enrichment libraries. Sequences isolated from libraries were sorted into four categories and analyzed. Our results suggest that sequences classified as Grouped should not be used for microsatellite primer design. The genetic diversity of microsatellite loci was assessed in 72 individuals from three populations. The number of alleles per locus ranged from 2 to 5 with an average of 3. The observed and expected heterozygosities of loci ranged from 0 to 0.958 and 0 to 0.773, respectively. A total of 18 out of 153 locus/population combinations deviated significantly from Hardy-Weinberg equilibrium. Moreover, significant linkage disequilibrium was detected in one pair of loci (1275 pairs in total). In the neutral test, two loci were grouped into the candidate category for positive selection and the remainder into the neutral category. In addition, a complex mutation pattern was observed for these loci, and F ST performed better than did R ST for the estimation of population differentiation in different mutation patterns. The results of the present study can be used for population genetic studies of H. cunea.

Graphitized porous carbon prepared from pyrolysis of Sterculia scaphigera and its application in lithium ion batteries

Sterculia scaphigera exhibits exceptional capability to inhale a large amount of water, which is accompanied by great volume expansion.

Support vector machine with adaptive parameters in financial time series forecasting

A novel type of learning machine called support vector machine (SVM) has been receiving increasing interest in areas ranging from its original application in pattern recognition to other applications such as regression estimation due to its remarkable generalization performance. This paper deals with the application of SVM in financial time series forecasting. The feasibility of applying SVM in financial forecasting is first examined by comparing it with the multilayer back-propagation (BP) neural network and the regularized radial basis function (RBF) neural network. The variability in performance of SVM with respect to the free parameters is investigated experimentally. Adaptive parameters are then proposed by incorporating the nonstationarity of financial time series into SVM. Five real futures contracts collated from the Chicago Mercantile Market are used as the data sets. The simulation shows that among the three methods, SVM outperforms the BP neural network in financial forecasting, and there are comparable generalization performance between SVM and the regularized RBF neural network. Furthermore, the free parameters of SVM have a great effect on the generalization performance. SVM with adaptive parameters can both achieve higher generalization performance and use fewer support vectors than the standard SVM in financial forecasting.

Parallel sequential minimal optimization for the training of support vector machines

Sequential minimal optimization (SMO) is one popular algorithm for training support vector machine (SVM), but it still requires a large amount of computation time for solving large size problems. This paper proposes one parallel implementation of SMO for training SVM. The parallel SMO is developed using message passing interface (MPI). Specifically, the parallel SMO first partitions the entire training data set into smaller subsets and then simultaneously runs multiple CPU processors to deal with each of the partitioned data sets. Experiments show that there is great speedup on the adult data set and the Mixing National Institute of Standard and Technology (MNIST) data set when many processors are used. There are also satisfactory results on the Web data set.