Objective To study the impact of the SARS-CoV-2 pandemic and the first lockdown in France on voluntary changes by pregnant women in the medical monitoring of their pregnancy. Study population Adult (>18 years old) pregnant women during the first lockdown (March-May 2020), living in France, and participating in an access panel of internet users. Design and Settings A cross-sectional study was conducted in July 2020 using a web-questionnaire completed by 500 pregnant women selected by quotas sampling (age group, socio-professional category, region of residence at the time of the lockdown, and parity). Methods A robust variance Poisson regression model was used to estimate adjusted prevalence ratios (aPRs). A manual stepwise descending approach was applied to obtain the final model. Main Outcome Measures Voluntary postponement or foregoing of pregnancy monitoring. Results Almost one women of five (23.4%) reported having voluntarily postponed or foregone at least one consultation or pregnancy check-up during the lockdown. Women who were professionally inactive (aPR=1.98, CI95%[1.24-3.16]), who had experienced serious disputes or violence during the lockdown (1.47, [1.00-2.16]), who felt they received little or no support (1.71, [1.07-2.71]), and those who changed health professionals during the lockdown (1.57, [1.04-2.36]) were all more likely to have voluntarily changed their pregnancy monitoring. Higher level of worry about the pandemic was associated with a lower probability of voluntarily changing pregnancy monitoring (0.66, [0.46 -0.96]). Conclusions Our results can guide prevention and support policies for pregnant women in the current and future pandemics. Financing Santé publique France

Background: Various studies describing the clinical characteristics of patients with COVID-19 pneumonia have shown that patients with a severe disease course have a tendency to have higher C-reactive protein (CRP) levels, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR). Aims: The aim of this study was to determine whether or not there was a correlation between the CRP value, NLR, and PLR, which are simple, effective, and repeatable predictive values, and the lung involvement severity score determined from the thoracic computed tomography (CT) findings of patients with COVID-19 pneumonia. Methods: This retrospective study included 200 patients admitted to the COVID-19 clinic of Erzincan Binali Yildirim University Mengucek Gazi Training and Research Hospital between 01.10.2020 and 31.12.2020. The thoracic CT examination results and CT scores of the patients were recorded. The relationships were investigated between the thoracic CT score and the systemic inflammatory mediator levels. Results: A positive correlation was determined between the radiological scoring and NLR at a weak level (r=0.22, p=0.001), PLR at a weak level (r=0.18, p=0.012) and CRP at a moderate level (r=0.43, p<0.001).

Respiratory insufficiency can be a presenting symptom of Congenital Myasthenic Syndromes (CMS) but is rarely recognized as such. CMS result from failure of the neuromuscular transmission secondary to gene mutations affecting the neuromuscular junction structure and function. A core symptom is muscle weakness that worsens with physical exertion. We describe five children who experienced severe to life threatening episodes of respiratory insufficiency, especially during viral infections, due to respiratory muscle weakness. During infections they often also had progression of their ocular, facial, and limb muscle weakness. All children were eventually diagnosed with genetically proven CMS. In all five children, treatment with pyridostigmine, an acetylcholinesterase inhibitor, resulted in clinical improvement. CMS should be considered in every patient with unexplained recurrent respiratory insufficiency, or with a disproportionate and unusually severe course of a (viral) respiratory infection. Early diagnosis of CMS is crucial for early treatment, which may help avoiding further deterioration of the muscle strength, severe respiratory insufficiency and sudden infant death.

Aims: Currently, mannitol and hypertonic saline (HTS) are mostly used in treatment of adult with elevated intracranial pressure (ICP). However, there is no high-level evidence on the superiority of mannitol versus HTS. Therefore, a systematic review and meta-analysis was performed to compare effects of hypertonic saline and mannitol for treatment of adults with elevated ICP. Methods: We performed a search on lots of databases for eligible studies. Prospective randomized control trials comparing HTS and mannitol in adults with elevated ICP were included, and ICP monitoring should be applied. Primary outcome was change of ICP values, and secondary outcomes were changes of cerebral perfusion pressure (CPP), mean arterial pressure (MAP), heart rate, serum sodium, serum osmolarity and hematocrit (HCT). Results: A total of ten studies (384 patients, 1578 episodes) were included. A pooled result indicated HTS reduced ICP more effectively than mannitol. At 0.5 h, 1 h, and 2 h after intervention, results also showed a better efficiency of HTS than mannitol. In addition, results indicated elevation of CPP, serum sodium and serum osmolarity were all more in HTS group than in mannitol group. And there were no statistical significance in changes of MAP, HCT and HR between the two interventions. Conclusion: Our study indicated HTS had a better efficiency in reduction of elevated ICP than mannitol in earlier stage. Based on the current level of evidence of ICP control and effects in other physiological indicators, HTS could be recommended as a first-line agent for managing patients with elevated ICP.

The roots of second order polynomials with real coefficients are obtained in the \mathbb{S}^{1+2} scator set. Explicit formulae are computed in terms of the polynomial coefficients. Although the scator product does not distribute over addition, the lack of distributivity is surmountable in order to find the zeros of the polynomial. The structure of the solutions and their distribution in the 1+2 dimensional scator space are illustrated and discussed.

Background: The COVID-19 pandemic affects health of pregnant women and their attitudes and behaviours related to pregnancy and birth. Aim: To explore the impact of pregnant women’s health-seeking behaviour and mode of birth preferences on pregnancy distress during the COVID-19 pandemic. Material and Method: The type of this study is cross-sectional. It was conducted with 351 pregnant women admitted to the pregnancy outpatient clinic. The data were collected using the “Pregnancy Information Form, the Pregnancy Distress Scale, and the Health Seeking Behaviour Scale”. The data were evaluated with Wilcoxon, Binary Logistic, and Linear regression analysis. STROBE checklist guide was followed in the study. Results: The study revealed that the total pregnancy distress score and risky distress levels of pregnant women during the COVID-19 pandemic were higher than before. On average, four out of every five pregnant women (81.2%) stated that they experienced difficulties (decreased social support, finding information suspicious, having to go to the hospital) during the pandemic. During the pandemic, pregnant women mostly wanted to get information about the impacts of COVID-19 on the health of pregnant (59.54%) and foetus (67.81%). Increased health-seeking behaviour in pregnant women decreased the pregnancy distress stemming from inadequate partner involvement. 11.3% of the pregnant women have changed their mode of birth preferences due to the pandemic. The risk of pregnancy distress increased 5.4 times in those who changed their mode of birth due to pandemic compared to those who preferred vaginal birth before and during the pandemic. Conclusion: There is effect of their health-seeking behaviour and mode of birth preference on distress of the pregnant women during pandemic. Health professionals should reduce the distress of the pregnant woman by ensuring the continuity of antenatal care and counseling services during the pandemic. Keywords: COVID-19 pandemic, pregnant women, distress, health-seeking behaviour, mode of birth

Richness-stability relationships (RSRs), such as richness-resistance relationship and richness-resilience relationship, are a basic, but controversial, question in ecology. RSRs vary among different communities, with the positive and negative interactions among community members considered as the potential cause of different RSRs. However, there is still no empirical data to support the relationship between these interactions and RSRs. To confirm the potential effect of community interactions on RSRs, we selected soil microbial communities from ecosystems that represented 5 different successional stages and conducted a simulated stress-recovery incubation. Our results showed that soil microbial community RSRs were controlled by the balance of positive and negative interactions. If positive and negative interaction of the microbial community network were balanced, the richness-resistance relationship was significantly positive while the richness-resilience relationship was negative. In contrast, if positive and negative interaction were unbalanced, the richness-resistance relationship was significantly negative while the richness-resilience relationship was positive.

‘Corona’ this alarming word comes from ‘Latin’ word, ‘Crown’ that protecting around the virus. In Dec, 19 first this virus was isolated from three patients having pneumonia connected to cluster of acute illness. WHO declared it as a ‘pandemic’ in Jan, 20 but later on Feb WHO general director Tedros Adhanom Ghebreyesus named the virus as nCOVID-19. First identified in Wuhan, China as a respiratory illness causing novel disease (SARS and MERS). CDC informed corona primarily causing mild to moderate upper RTI and in few cases lower RTI (pneumonia, bronchitis). Transmission going through direct contact or through air droplets of sneezing, coughing etc. The origin not cleared but recent studies reported that ACE 2, membrane exopeptidase receptor was used to enter into human cell. The primary symptoms are, fever above 104°F, shortness of breath, pneumonia, throat sore, diarrhoea etc. Available approved therapeutics are hydroxychloroquine, This current review updates about the viral transmission and mainly effect of this virus on children, pregnant women, diabetic and on cancer patients.

β-glucosidases are utilized for the amalgamation of oligosaccharides and alkyl-glycosides. Oligosaccharides can be utilized as restorative specialists, indicative devices and development advancing specialist. They have significant capacities in natural frameworks including preparation, embryogenesis and cell expansion. Alkyl-glycosides are non-ionic surfactants with high biodegradability and furthermore have antimicrobial properties. Consequently, they have likely application in drug, substance, corrective, food and cleanser enterprises as these can be hydrolysed by β-glucosidase. Catalysts from the source plants or different sources might be added to food varieties and refreshments previously, during, or subsequent to preparing to improve food quality. Consequently, β-glucosidases with alluring properties might be engaged for plant reproducing programs, tissue culture and recombinant innovations to expand their overproduction in transgenic microbial or plant has and their reactant properties for flavor upgrade and security. As apparent from past segments, the wide practical ramifications and modern uses of β-glucosidases make it a promising objective for contemplates identified with its higher creation, novel protein, better strength, and so forth In spite of the fact that β-glucosidases are having colossal mechanical interest yet an appropriate modern β-glucosidase satisfying every one of the ideal properties is as yet missing and contemplates are proceeded fully expecting a novel chemical with such properties.

Background: The NIH non-myeloablative regimen has been successfully implemented for pediatric sickle cell disease (SCD) patients undergoing matched sibling donor (MSD) hematopoietic stem cell transplant (HSCT) in an effort to prevent late complications, including infertility and other endocrine sequelae. This retrospective cohort analysis evaluated the prevalence of endocrine complications in 17 pediatric SCD patients who underwent non-myeloablative MSD HSCT. Procedure: Medical records between June 2013 and June 2020 were reviewed. Data was extracted from baseline and 1,2,3, and 5-years post HSCT. Results: There were 12 females and 5 males. Follicle stimulating hormone (FSH) elevation post HSCT occurred in 42.8%; 4 females and 2 males. All females with elevated FSH had subsequent normalization of their values with time. FSH elevation in males did not resolve. Post HSCT secondary amenorrhea or oligomenorrhea was described in 4 females; however, improvement or resolution occurred in all. One female subject with normal gonadotrophin levels post HSCT had a successful pregnancy and live birth. Vitamin D deficiency (100% when measured), and obese or overweight body mass index post HSCT (41.2%) were also reported. Conclusions: A notable endocrine issue post HSCT described in this cohort is FSH elevation. The elevation was transient in females, and we identified one successful pregnancy, suggesting that non-myeloablative conditioning may convey favorable fertility outcomes compared to busulfan-based conditioning. Not all patients had baseline endocrine evaluations or consistent post HSCT endocrine testing. We recommend standardizing pre- and post HSCT endocrinology assessments for this population.

This is a prospective study on the outcome of vestibular function tests for the investigation of dizziness in patients referred to an ENT department in a district general hospital in Wales. Design, setting and participants Videonystagmography (VNG) is carried out as initial assessment of the integrity of the peripheral vestibular function in patients with balance dysfunction. The study was carried out in district general hospital and 110 patients were included in this study. Patient information were collected with the aid of questionnaire. Dizziness, a common symptom of imbalance in adults is commonly under treated and often becomes chronic; it can lead to deterioration in quality of life with substantial socioeconomic impact. It is a common problem in patients managed in primary care. Main outcome measure The aim of the study was to quantify the number of patients referred by general practitioners to ENT for investigation and what proportion were further referred for vestibular function tests. Results We wanted to establish the usefulness of VNG in the management of dizzy patients. In a large proportion of patients it was difficult to establish the true nature of dizziness. Conclusion We found that VNG is useful for exclusion of peripheral vestibular disorders and often to corroborate adequate vestibule-ocular reflex.

A document by Nicholas Kounis. Click on the document to view its contents.

Background. Asthma, the most frequent allergic airway disease, is related to maternal exposure to cigarette smoke. Our previous studies demonstrated that prenatal exposure to nicotine (PNE), the major active product of smoking, impairs fetal thymopoiesis and CD4+ T cell development after birth. This study aimed to investigate whether PNE contributes to asthma susceptibility through CD4+ T cell development alterations. Methods. A PNE model was established by administering 3 mg/kg/day nicotine to maternal mice, and then an ovalbumin-induced asthma model was established in the offspring. β-Catenin and downstream pathways were further inhibited in vitro to confirm the molecular mechanisms underlying the phenotype observed during the in vivo phase. Results. PNE induced Th2 and Th17 biases at developmental checkpoints and aggravated asthma symptoms in the offspring. In fetuses, PNE up-regulated α7 nAChR, activated PI3K-AKT, promoted β-catenin level increase, and established potential Th2- and Th17-biased gene expression patterns during thymopoiesis, which persisted after birth. Similar results were also observed in 1 μM nicotine-treated thymocytes in vitro. Moreover, inhibiting PI3K-AKT by LY294002 abrogated nicotine-mediated β-catenin level increase and thymopoiesis abnormalities, and an α7 nAChR antagonist (α-btx) also reversed nicotine-induced PI3K-AKT activation. Conclusion. Our findings provide strong evidence that PNE is a risk factor for T cell deviation and postnatal asthma, and revealed that nicotine-induced β-catenin level increase induces thymopoiesis abnormalities.

Background: Several type B adverse drug reactions (ADRs), especially severe cutaneous adverse reactions (SCARs), are associated with particular human leukocyte antigen (HLA) genotypes. However, pre-stored HLA information obtained from other clinical workups has not been used to prevent ADRs. We aimed to simulate the preemptive use of pre-stored HLA information in electronic medical records to evaluate whether this information can prevent ADRs. Methods: We analyzed the incidence and the risk of ADRs for selected HLA alleles (HLA-B*57:01, HLA-B*58:01, HLA-A*31:01, HLA-B*15:02, HLA-B*15:11, HLA-B*13:01, HLA-B*59:01, and HLA-A*32:01) and seven drugs (abacavir, allopurinol, carbamazepine, oxcarbazepine, dapsone, methazolamide, and vancomycin) using pre-stored HLA information of transplant patients based on the Pharmacogenomics Knowledge Base guidelines and experts’ consensus. Results: Among 11,988 HLA-tested transplant patients, 4,092 (34.1%) had high-risk HLA alleles, 4,583 (38.2%) were prescribed risk drugs, and 580 (4.8%) experienced type B ADRs. Patients with HLA-B*58:01 had a significantly higher incidence of type B ADR and SCARs associated with allopurinol use than that of patients without HLA-B*58:01 (17.2% vs. 11.9%, odds ratio (OR) 1.53 [95% confidence interval (CI) 1.09–2.13], P = 0.001, 2.3% vs. 0.3%, OR 7.13 [95% CI 2.19–22.69], P < 0.001). Higher risks of type B ADR and SCARs were observed in patients taking carbamazepine or oxcarbazepine if they had one of HLA-A*31:01, HLA-B*15:02, or HLA-B*15:11 alleles. Vancomycin and dapsone use in HLA-A*32:01 and HLA-B*13:01 carriers, respectively, showed trends toward increased risk of type B ADRs. Conclusion: Utilization of pre-stored HLA data can prevent type B ADRs including SCARs by screening high-risk patients.

Background: Allergic rhinitis (AR) is a chronic inflammatory disease of the upper respiratory tract, which has an increasing prevalence worldwide. The aim of this study was to explore the associated immune cell infiltration and molecular mechanisms of AR based on a bioinformatics analysis. Methods: GSE43497 and GSE50223 datasets for whole blood and CD4+ T cells, respectively were downloaded from the Gene Expression Omnibus (GEO) database. Differences in AR-associated immune cell infiltration were analyzed using CIBERSORT. A gene set enrichment analysis (GSEA) was performed using clusterProfiler software. Results: There was an upregulation in the proportion of CD8+ T cells, whereas there was a significant down-regulation of neutrophils in the whole blood of allergen-treated AR patients compared to diluent-treated patients. A correlation was identified between immune cells and immune-related genes. NF-kappa B and Toll-like receptor signaling pathways were also positively regulated in AR patients following allergen treatment. CD4+ T cell genes and associated cytokines significantly differed in allergen-treated AR patients compared to healthy and diluent-treated AR patients. Conclusion: Our analysis revealed that T cell receptor signaling pathways and Th1/Th2 cell differentiation may be involved in the mechanism of AR development. This study is the first bioinformatic analysis identifying immune cell infiltration and its underlying mechanism in AR from combined microarray data and provides novel insight for further research into the molecular mechanisms of AR.

Background: The significance of tumor thickness is not clear in the prognosis of basal cell carcinoma. We aimed to identify the relationship between the tumor thickness and aggressive histopathological growth pattern in BCC. Methods: We retrospectively reviewed 85 primary BCCs of 82 patients and recorded the histological subtype, ulceration, perineural invasion, and thickness of the tumor. Tumors with infiltrative, micronodular, morpheaform and basosquamous features were classified as having an aggressive growth pattern. Results: The aggressive growth pattern was determined in 21 (26.9%) tumors with a mean tumor thickness of 2.19±0.71 mm (range, 0.9-3,40). The non-aggressive growth pattern was detected in 57 (73%) tumors and the mean tumor thickness was 1.76±0.87 mm (range 0.50-4.40 mm). There was a statistically significant difference in the mean tumor thickness between the tumors with aggressive growth pattern and non-aggressive growth pattern (p=0.033). Conclusion: Tumor thickness might have positive correlation with aggressive histological pattern. Measuring and reporting tumor thickness may be a more practical way to determine the pathological risk for BCC.

As low temperature is a crucial contributing factor to the albino peculiarity of young leaves of White Leaf No.1 (WL-1), the chilling tolerance of its functional leaves should be considered simultaneously. Alteration of DNA methylation (an epigenetic regulator) due to chilling has been often observed in plants, but little is known about whether glycinebetaine (GB, a potential methyl donor) is linked to gene methylation priming responses of plants to low temperature. Herein, we provided evidence for the regulation of gene methylation by GB, which in turn affects the apparent characteristics of WL-1 functional leaves under low temperature condition. Results showed that the transpiration efficiency and chlorophyll levels of WL-1 functional leaves were significantly increased by GB application under low temperature condition. GB affected WL-1 response to low temperature by increasing the methylation level of most of the methytransferase and demethylase genes, PSⅡ structure genes, and some of the chlorophyll synthesis genes, which were further proved by multivariate analyses. Additionally, the number of methylated gene sites was increased by GB under low temperature. Present study suggests important roles of GB in enhancing photosynthesis of albino tea functional leaves under low temperature condition by regulating related gene methylation.

Emergencies in the pregnancy and postpartum are less frequent than in other groups, but not uncommon. However, the literature on the subject is scarce and controversial. The objective of this article is to present some recommendations for the management of the most common psychiatric emergencies that may occur in pregnancy or postpartum period. To this end, the present work has been driven by a panel of global experts on severe mental health illnesses, selected by Brazilian Psychiatric Association. Although many of the recommendations are empirical, it is already possible to rely on information that provides better results and safety for the patient and her infant.

Abstract Background: As the evidence has been increasing about the post-micturition dribble (PMD) symptom, widely accepted lower-urinary tract symptoms (LUTS) questionnaires fail to assess PMD alone. In this study, our primary aim is to evaluate the validity and reliability of the Turkish version of the Hallym Post Micturition Dribble Questionnaire (Turkish HPMDQ). The secondary objective is to appraise the relationship between PMD and other LUTS and the effectiveness of bulbar urethral massage in patients with PMD. Methods: The English version of HPMDQ went through a multi-stage translation process. The final draft of the Turkish HPMDQ and IPSS were queried to male patients who admitted to the urology outpatient clinic between June 2020 and September 2020. The responses of 103 patients who satisfy the inclusion criteria were analysed. 55 people suffering from PMD were offered bulbar urethral massage for one month and then re-applied with the questionnaires. Results: The kappa coefficient for the total score for the Turkish HPMDQ was 0.789. Considering the relationship between the HPMDQ and the IPSS, the HPMDQ’s total score correlated significantly with that of the total IPSS (ρ: 0.660, p < 0.001), the voiding symptoms of the LUTS (ρ: 0.621, p < 0.001), and post-void residual volume (ρ: 0.614, p < 0.001) but not with the storage symptoms of the LUTS (p=0.245). The mean value of HPMDQ-Q5, evaluating the treatment response of bulbar urethra massage, was 1.81+1.02, suggesting an effective treatment of PMD. Conclusions: The Turkish version of HPMDQ was observed as a reliable tool for evaluating patients with PMD. This study also showed that bulbar urethral massage is an effective method to relieve PMD. Keywords: Post-micturition dribble, questionnaire, Turkish validation, incontinence

Vasa previa or not? A special parachute type of placenta caused dispute in ultrasonography diagnosis: A case report.Hong Ling1, Wu Jiahan1.1 Department of Obstetrics and Gynecology, Ningbo Women and Children Hospital, Ningbo 315010, ChinaCorresponding AuthorWu JiahanNo. 339 Liuting Street, Haishu District, Ningbo, Zhejiang Province, China.Telephone number +86 13805840722  e-mail 3014078594@qq.comCo-authorHong LingNo. 339 Liuting Street, Haishu District, Ningbo, Zhejiang Province, China.Telephone number +86 13655742069  e-mail 409180445@qq.comshortened running title: Vasa previa or not? MRI for parachute placenta

Haemorrhage from a partially detached extrauterine placenta can be catastrophic. We describe a novel surgical technique using a Foley's catheter tourniquet, applied between the partially detached and attached portions of the placenta of an irremovable placenta to control blood loss. It may be left in situ and removed at repeat laparotomy. The catheter tourniquet has equally shown utility with a removable placenta. Applied as a temporary tourniquet around structures surrounding the implantation site, the technique enables placenta removal with minimal haemorrhage. We report use of this surgical technique with good outcomes.

Abstract Objective: This study aimed to assess factors that influence epidural labour analgesia acceptance or refusal at the maternity unit of the Tamale Teaching Hospital. Design: Prospective cross-sectional survey, Setting: This study was carried out at the maternity unit of the Tamale Teaching Hospital Population or Sampling: We recruited 540 parturients at the maternity unit of the Tamale Teaching Hospital. Methods: A structured questionnaire was administered to each recruited parturients after childbirth. Main Outcome Measures: The primary outcomes measured were awareness and factors that affected epidural labour analgesia acceptance at the delivery unit of the Tamale Teaching Hospital Results: The data showed that 525 (97.2 %) of the participants were aware of epidural labour analgesia, out of which 503 (93.1 %) refused to accept the epidural for labour analgesia. Age, educational background, cultural or religious beliefs, attitudes of midwives and the cost of the epidural labour analgesia service were observed to be some determinants of the epidural labour analgesia use at the delivery unit of the Tamale Teaching Hospital.

Coronary artery bypass surgery (CABG) in dextrocardia with situs inversus patients is comparatively rare in literature. Abnormalities in the embryonic cardiac loop and other associated congenital anomalies pose challenges in both anaesthesia and surgery. We describe, a successful elective off pump total arterial revascularization coronary artery bypass surgery with RIMA-LIMA en Y configuration with 5 distal anastomosis were performed in a 64-year-old patient with dextrocardia, situs inversus and triple vessel coronary artery disease. The peri-operative periods were uneventful. This report highlights the feasibility, benefits and relative ease of Off-pump RIMA-LIMA en Y graft in such patients

BACKGROUND AND PURPOSE Traditional Chinese medicine (TCM) is increasingly extensively applied as a complementary therapy for gastric cancer (GC); however, there is a lack of large-scale evidence-based deep learning for the guidance of clinical prescriptions. EXPERIMENTAL APPROACH We collected eligible studies of TCM treatment on GC over the past three decades from China National Knowledge Infrastructure database (CNKI), and established a library of the prescribed herbs with basic attributes. The prescription patterns were explored using association rules mining of IBM SPSS Modeler 18.1, and candidate prescriptions were subsequently explored by deep machine learning. Molecular targets of the candidate clusters were predicted by STITCH, SEA and Swiss. The affinities between bioactive compounds and protein targets of the preferred decoction were confirmed by molecular docking. Mechanisms of the preferred decoction were investigated in vitro and in vivo. KEY RESULTS We extracted 194 clinical trial-based decoctions and found that Atractylodis Mcacrocephalae Rhizoma, Poria and Astragali Radix are the core herbs for treating GC. The preferred decoction for GC is composed of Atractylodis Mcacrocephalae Rhizoma, Astragali Radix, Pinelliae Rhizoma, Citri Reticulatae Pericarpium, Herba Hedyotidis Diffusae, Crataegi Fructus, etc. The predominant bioactive compounds are quercetin, kaempferol, nobiletin, baicalein and luteolin, etc. Moreover, the preferred decoction was indicated to effectively inhibit GC cellular proliferation, invasion and metastasis via hTERT/MDM2-p53 signaling pathway in vivo and in vitro. CONCLUSION AND IMPLICATIONS TCM focusing on invigorating Spleen and tonifying vital-Qi is a promising adjuvant therapy for GC, which offers a guidance of TCM treating GC in worldwide.