Objective To compare the change of management time for patients with acute cerebrovascular disease before and after re-accreditation of Grade Ⅲ Class A in a general hospital.Methods Electronic medical records of 490 patients diagnosed as acute cerebrovascular disease(215 cases of cerebral infarction,275 cases of cerebral hemorrhage) managed in Zhongnan Hospital of Wuhan University from June 2015 to July 2016 were collected,including 262 patients managed before re-accreditation (group A,June 2015 to December 2015) and 228 patients admitted after re-accreditation (group B,January 2016 to July 2016).In group A,there were 109 cases of cerebral infarction and 153 cases of cerebral hemorrhage(68 caused by trauma);in group B there were 106 cases of cerebral infarction and 122 cases of cerebral hemorrhage(54 caused by trauma).The time in emergency department (ED time),time waiting for admission (admission time) and the total management time (total time) were analyzed and compared between two groups.Results The ED time in group A and group B was 44.5 (30.0,71.5) and 39.0 (20.3,69.0) min (Z =-2.103,P =0.036) respectively;the admission time was 35.0 (25.8,50.0) and 39.0 (27.3,55.8) min(Z =-2.211,P=0.027);and total time was 85.0(62.8,120.0)and 82.5(61.0,119.0) min(Z =-0.356,P =0.722) in two groups respectively.For patients of cerebral infarction in group A and B the ED time was 49.0 (33.5,81.5) and 41.0 (29.8,74.3) min(Z =-1.872,P =0.061);the admission time was 37.0(27.0,52.0) and 36.0(25.0,52.3) min(Z =-0.516,P =0.606);and total timewas97.0(69.5,131.0)and 83.5(62.0,118.3) min(Z=-1.914,P=0.056).For patients of cerebral hemorrhage in group A and B,the ED time was 42.0 (28.0,64.0) and 35.0 (17.8,65.0) min (Z=-1.426,P =0.154);the admission time was 34.0(24.5,49.0)and 41.0(31.0,61.0) min (Z=-3.353,P =0.001);and total time was 79.0(58.0,108.0) and 82.0(60.0,120.8) min (Z =-1.052,P =0.293).Conclusions After re-accreditation of Grade Ⅲ Class A Hospital the total waiting time for patients of cerebral infarction is decreased significantly in emergency department,however,for patients of cerebral hemorrhage the waiting time for admission is longer.

As people’s attention to health continues to increase, the market demand for traditional Chinese medicine (TCM) is growing steadily. The quality and safety of Chinese medicinal materials have attracted unprecedented social attention. In particular, the issue of exogenous harmful residue pollution in TCM has become a hot topic of concern for both regulatory authorities and society. The Chinese Pharmacopoeia 2025 Edition further refines the detection methods and limit standards for exogenous harmful residues in TCM. This not only reflects China’s high-level emphasis on the quality and safety of TCM but also demonstrates the continuous progress made by China in the field of TCM safety supervision. Basis on this study, by systematically reviewing the development history of the detection standards for exogenous harmful residues in TCM and analyzing the revisions and updates of these detection standards in the Chinese Pharmacopoeia 2025 Edition, deeply explores the key points of the changes in the monitoring standards for exogenous harmful residues in TCM in the Chinese Pharmacopoeia 2025 Edition. Moreover, it interprets the future development directions of the detection of exogenous residues in TCM, aiming to provide a reference for the formulation of TCM safety supervision policies.

OBJECTIVETo observe the effect of Euphorbia kansui (E. KS) alcohol extracts on urination and kidney-related expressions of mice injected with normal saline and to discuss its impact on kidney.

METHODMice intraperitoneally injected with normal saline were observed for urination and changes in kidney-related histiocytic factors of after intragastrical administration of E. KS and compared with normal mice.

RESULTE. KS alcohol extracts can promote urination of mice injected with normal saline and enhance peripheral serum creatinine, with no obvious pathological change showed in tissue sections. It had a certain effect on reducing AQP2 expression and enhancing TNF-alpha expression.

CONCLUSIONEuphorbia kansui in large dose has a remarkable effect on kidney but may be accompanied with pathological reactions to some extent, especially the dose of 1.2 g x kg(-1). The pathological reactions may be related with increased serum creatinine and TNF-alpha expression.

Animals ; Aquaporin 2 ; genetics ; Euphorbia ; Interleukin-1beta ; genetics ; Kidney ; drug effects ; metabolism ; Male ; Mice ; Mice, Inbred ICR ; Plant Extracts ; pharmacology ; RNA, Messenger ; analysis ; Tumor Necrosis Factor-alpha ; genetics ; Urination ; drug effects

Objective To investigate the effects of parenteral nutrition with ω-3 fatty acids on nutrition,inflammatory response,immunity and prognosis in criticallyill cancer patients.Methods 60 critically ill cancer patients were randomly divided into study group and the control group,30 cases each.All Patients were given isonitrogen and isocalorie enteral and parenteral nutrition for 2 weeks,which added ω-3 fatty acids in the study group by parenteral nutrition.The indicators of nutrition,inflammation,immune function were detected weekly.prognostic indicators (mortality,intensive care unit [ICU] length of stay,infectious complications) were compared.Results The indicators of nutrition,inflammatory reaction and immune function of study group were significantly improved than control group,and length of stay in ICU of study group was shorter than control group.There were less mortality and morbidity of infection complications in the study group compared with control group,but difference were not significant (P =0.13 and P=0.165).Conclusion ω-3 fatty acids supplementation of parenteral nutrition in critically ill cancer patients can improve nutritional status and immune function,reduce inflammatory response,shorten ICU length of stay,but not significantly improve ICU mortality and reduce infectious complications.

Objective:To analyze the causes of SARS-CoV-2 nosocomial infection among healthcare workers (HCWs) and explore the effective precaution strategies in Emergency Center.Methods:The data of SARS-CoV-2 infected HCWs from January 5 to March 2, 2020 were retrospectively analyzed and compared under different conditions in Emergency Center of Zhongnan Hospital of Wuhan University.Results:Totally 13 SARS-CoV-2 infected HCWs (12 confirmed cases and 1 suspected case) were included in this study. The overall infection rate was 17.8% (13/73). The infection rates in outpatient/rescue room, isolation observation room and isolationin patient ward were 11.8% (4/34), 20.0% (3/15), 25% (6/24), respectively. The infection rate of physician was 13.0% (3/23), and the infection rate of nurse was 20.0% (10/50). All the infected HCWs had the definite exposure with confirmed or suspected COVID-19 patients. One asymptomatic cases were identified by laboratory findings of SARS-CoV-2 infection screening. There was no new confirmed SARS-CoV-2 infected HCWs after February 5, 2020. All the infected HCWs were cured.Conclusions:Under the epidemic of COVID-19, HCWs of Emergency Center have a high risk of occupational exposure and infection, especially for staffs working in COVID-19 isolation units. Scientific prevention and control management can effectively reduce the risk of SARS-CoV-2 infections and ensure the occupational safety for HCWs in Emergency Center.

Objective:To assess the clinical efficacy and infection control outcomes of two-stage revision in managing periprosthetic joint infection (PJI) following primary total knee arthroplasty (TKA) utilizing either a low or high constrained prosthesis.Methods:A retrospective analysis was performed on 40 patients who underwent revision TKA in the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University from February 2019 to February 2022. According to the type of prosthesis selected in primary TKA, they were divided into low constrained prosthesis group and high constrained prosthesis group. There were 28 patients (28 knees) in the low constrained group, including 12 males and 16 females, aged 69.0(63.0, 74.0) years, with a body mass index of 25.18±0.55 kg/m 2. And there were 12 patients (12 knees) in the high-constrained group, including 5 males and 7 females, aged 66.5(65.0, 71.5) years, with a body mass index of 23.94±0.51 kg/m 2. All patients underwent two-stage revision surgery, with RHK used in 1 case and LCCK in 27 cases in the low-constrained prosthesis group. In the high-constrained prosthesis group, 3 patients were treated with RHK, 1 patient with PFC Sigma MBT, and 8 patients with LCCK. The preoperative and postoperative range of motion (ROM), Knee Society score (KSS), and postoperative infection control rate were compared between the two groups. Results:All patients were followed up. The follow-up time was 22.79±8.02 months in the low-constrained prosthesis group and 23.92±7.04 months in the high-constrained prosthesis group, with no significant difference between the two groups ( t=0.426, P=0.680). At the last follow-up, the KSS and ROM in the low-constrained prosthesis group were 77.96±9.74 and 93.48°±7.45°, respectively, significantly higher than 38.93±8.01 and 68.89°±9.44° before the operation ( P<0.05). The KSS score and ROM in the high-constrained prosthesis group were 67.83±8.31 and 80.08°±5.89° at the last follow-up, which were also significantly higher than those before operation (34.25±6.31 and 66.50°±10.48°, P<0.05). There was no significant difference in KSS and ROM between the two groups before operation ( P>0.05), but the KSS score and ROM in the low-constrained prosthesis group were significantly higher than those in the high-constrained prosthesis group at the last follow-up ( P<0.05). Bacterial culture results revealed that the primary infectious agents were coagulase-negative Staphylococcus and Staphylococcus aureus, with an overall infection control rate of 80% (32/40). The infection control rate was 89% (25/28) in the low-constrained prosthesis group and 58% (7/12) in the high-constrained prosthesis group, but the difference between the two groups was not statistically significant (χ 2=3.283, P=0.070). Conclusion:Two-stage revision effectively controls PJI, and the clinical outcomes of two-stage revision for PJI after primary TKA with a high-constrained prosthesis are inferior to those with a low-constrained prosthesis. Further exploration is needed to enhance efficacy.

Objective To carry out a proficiency testing of content determination of geniposide in Gardeniae fructus,evaluate the content determination ability of index components in traditional Chinese medicine in the laboratory of inspection and detection in drug-related fields,and improve the quality control ability of content determination of related laboratories.Methods The laboratory's capability-verification activities were conducted based on the CNAS-RL02 Rules for Proficiency Testing and ISO/IEC 17043 Conformity Assessment-General Requirements for Proficiency Testing.After preparing the sample,the results of homogeneity and stability tests were analyzed according to CNAS-GL003 Guidance on Evaluating the Homogeneity and Stability of Samples Used for Proficiency Testing.After the test results were qualified,they were used as proficiency testing samples and randomly distributed to participants.The results were collected,and the robust statistical method and the Z scores were used to analyze the results of these laboratories'reports.Results 403 laboratories in this proficiency testing program reported the results,of which 367 results were acceptable,accounting for 91.07％,17(4.22％)laboratories obtained suspicious results,and 19 laboratories gave unsatisfactory results,with the dissatisfaction rate of 4.71％.Conclusion The majority of the 403 participant laboratories have the ability to determine the content of geniposide in Gardeniae fructus by HPLC and the laboratory testing ability and quality management level of the drug monitoring system are high.This proficiency testing provides a basis for understanding the technical reserve capacity and management level of China's pharmaceutical inspection and testing laboratories,and provides technical support for future government supervision.

Polygoni multiflori radix praeparata is a processed product of Polygoni multiflori radix(Polygonum multiflorum Thunb.),and its main components include stilbene glycosides,anthraquinones,flavonoids,alkaloids,phenolic acids,etc.It has antioxidant,antianemic,anti-tumor,hypoglycemic,anti-inflammatory effects,etc,and is widely used in clinical practice.The processing technology is mainly stewinging with black bean juice,steaming,processing for 9 times and braising and simmering.After processing,the color deepens and the content of composition changes.By consulting domestic and foreign literature,the research on Polygoni multiflori radix praeparata is not comprehensive enough compared with Polygoni multiflori radix.Therefore,this paper mainly summarizes the processing technology,chemical composition and pharmacological activity of Polygoni multiflori radix preparata reported in the past 20 years,and provides a reference for further development of Polygoni multiflori radix preparata.