In recent years,experts of international nephrology,emergency medicine and other disciplines tend to substitute acute kidney injury for acute renal failure.There is a new point of view about the definition,diagnostic criteria,staging,management and prognosis of acute kidney injury.With diagnostic criteria constantly updated,it comes up to an expectation of united criteria as well as reaching a consensus.Continuously looking for more suitable for both time window of clinical diagnosis and clinical observation indicators,and clinically making out much more scientific and reasonable standard of diagnosis and staging,which contribute to early detection and early intervention as a result of eventually mortality rate reduction.This paper gives an interpretation for the procedure of evolution about diagnostic criteria on acute kidney injury in children according to the related literatures updated in recent years.

Acute kidney injury(AKI) is a common critical syndrome involving multidisciplinary among pediatric clinical disorders.Early identification and early intervention in severe cases with kidney damage,which can reduce mortality and improve prognosis.Renal replacement therapy(RRT) is an important means in the treatment of AKI,but there is still lacking of ideal and general modality and doses of RRT at present.Understanding the risks and benefits of each modality of RRT in the treatment of AKI is helpful to evaluate RRT's influence on the prognosis of children in AKI.Therefore the selection of modality of RRT should clinically be based on hospital conditions and specific patient characteristics,in order to assure that the choice of modality of RRT is the most suitable for the individual.

Objective To understand the research status,hotspots and trends of Wuzhuyu Decoction;To provide reference for relevant research.Methods The literature related to Wuzhuyu Decoction was retrieved from CNKI,VIP,Wanfang Data and CBM databases from the establishment to February 28,2023.NoteExpress 3.6 was used to merge and deduplicate,and the author,organization and keywords were mapped and interpreted by CiteSpace 6.1.R6 software.Results A total of 822 articles were included,and the number of publications showed a wave upward trend;the top journals were New Chinese Medicine,Henan Traditional Chinese Medicine and Sichuan Traditional Chinese Medicine;the main research institutions were Beijing University of Chinese Medicine,China Academy of Chinese Medical Sciences and Shandong University of Traditional Chinese Medicine;a total of 566 authors were involved,and the authors with more publications included Wang Zhimin(12),Gong Muxin(9)and Bi Kaishun(5);high-frequency keywords included"headache","Shang Han Lun","TCM therapy"and so on.Conclusion Wuzhuyu Decoction is effective in treating chronic gastritis,hypertension and other primary diseases,which is a research hotspot in this field.It is a research trend in this field to explore its active components by high performance liquid chromatography and explain its action mechanism and target at the molecular level.

Objective To understand the research status,hotspots and trends of animal medicinal materials;To provide reference for future research.Methods The literature related to animal medicinal materials was retrieved from CNKI,VIP,Wanfang Data and CBM from January 1,2000 to April 30,2023.NoteExpress 3.6 was used to merge and deduplicate,and the author,institution and keywords were mapped and interpreted by CiteSpace 6.1.R6 software.Results A total of 1 169 articles were included,and the overall publication quantity in this field showed a stable fluctuation trend;the top journals were Lishizhen Medicine and Materia Medica Research,China Journal of Chinese Materia Medica and Modern Chinese Medicine;the main research institutions were China Academy of Chinese Medical Sciences,Changchun University of Chinese Medicine and Chinese Academy of Medical Sciences;a total of 676 authors were involved,and the authors with more publications included Zhang Hui(22),Liu Rui(15),Lin Zhe and Ma Shuangcheng(14);high-frequency keywords included"identification","TCM resources","clinical application"and so on.Conclusion Resource survey of animal medicinal materials,standardized breeding of medicinal animals,development of alternatives to rare medicinal animal resources,and construction of quality standard system for animal medicinal materials are the research hotspots in this field.The basic research of pharmacodynamic substances of animal medicinal materials based on the integrated analysis strategies of proteomics,peptideomics and transcriptomics,and the revelation of the signaling pathways and targets of animal medicinal materials from the molecular biology level are the research trends in this field.

Objective:To explore the clinical application and long-term safety of hydroxychloroquine sulfate (HCQ) in the treatment of rheumatic diseases.Methods:A multi-center cross-sectional study was conducted between August 2017 and August 2018 in a random sample of eleven medical institutions of rheumatology and immunology in China. Patients who took HCQ for more than 3 months were enrolled into this study. The cumulative dose and long-term side effects of HCQ were recorded. The changes of laboratory indexes before and after treatment with HCQ were analyzed. Categorical variables were presented with counts and proportions, and evaluated by Chi-square test. Continuous parametric data were presented as Mean±standard deviation, and evaluated by Student's t test or Mann-Whitney U test. P-values less than 0.05 were considered statistically significant. Results:A total of 886 patients with rheumatic diseases were enrolled into this study, including 505 cases with systemic lupus erythematosus (57.0%), 210 cases with rheumatoid arthritis (23.7%), 80 cases with Sj?gren's syndrome (9.0%), 57 cases with undifferentiated connective tissue disease (6.4%), 12 cases of systemic vasculitis (1.4%), 10 cases of mixed connective tissue disease (1.1%), 7 cases of myositis (0.8%) and 5 cases with systemic sclerosis (0.6%). The most common long-term side effects of HCQ was skin or mucous lesions (12.4%) and vision problems (8.0%). Other adverse reactions included problems of digestive system (3.0%), nervous system (2.1%), musculoskeletal system (1.1%) and cardiovascular system (0.9%). 140 cases (15.8%) had stopped taking HCQ during the treatment. More than half of them decided to stop taking medicine by themselves. Fifty-four patients (6.1%) stopped using HCQ due to side effects while 24 of them took it again, and another 12 patients (1.4%) stopped the drug due to remission of illness. Patients were divided into three groups according to the cumulative dose of HCQ: less than 500 g, 500-1 000 g and more than 1 000 g respectively. There was significant difference in the incidence of long-term side effects among the three groups ( χ2=6.382, P=0.041). The last group (more than 1 000 g) suffered the highest incidence of long-term adverse reactions (37.1%). No severe adverse drug reactions were observed in this study. Conclusion:Hydroxychloroquine is widely used in the treatment of rheumatic diseases. The incidence of long-term side effects is 20.4%, is 6.1% lead to drug withdrawal, which are especially related to the cumulative doses. It should be adjusted properly according to the clinical application.

Objective To systematically evaluate of the difference in clinical outcomes between Da-Vinci robot-assisted thoracoscopic surgery (RATS) and video-assisted thoracoscopic surgery (VATS) for mediastinal tumor resection. Methods Online databases including The Cochrane Library, PubMed, EMbase, Web of Science, SinoMed, CNKI, and Wanfang were searched by two researchers independently from inception to October 10, 2022. The quality of the included literature was evaluated using the Newcastle-Ottawa Scale (NOS). The meta-analysis was performed by RevMan 5.3. Results A total of 23 studies with 5 646 patients were enrolled in the final study. The NOS scores of the studies were≥6 points. The results of meta-analysis showed that compared with the VATS group, the blood loss was less [MD=−18.11, 95%CI (−26.12, −10.09), P＜0.001], time of postoperative drainage tube retention [MD=−0.79, 95%CI (−1.09, −0.49), P＜0.001] and postoperative hospitalization time [MD=−1.00, 95%CI (−1.36, −0.64), P＜0.001] were shorter, postoperative day 1 drainage [MD=−5.53, 95%CI (−9.94, −1.12), P=0.010] and total postoperative drainage [MD=−88.41, 95%CI (−140.85, −35.97), P=0.001] were less, the rates of postoperative complications [OR=0.66, 95%CI (0.46, 0.94), P=0.020] and conversion to thoracotomy [OR=0.32, 95%CI (0.19, 0.53), P＜0.001] were lower, and the hospitalization costs were higher [MD=2.60, 95%CI (1.40, 3.79), P＜0.001] in the RATS group. The operative time was not statistically different between the two groups [MD=5.94, 95%CI (−1.45, 13.34), P=0.120]. Conclusion RATS mediastinal tumor resection has a high safety profile. Compared with VATS, patients have less intraoperative blood loss, a lower rate of conversion to thoracotomy, and shorter postoperative tube time and hospital stay, which is more conducive to rapid postoperative recovery.

Objective To systematically evaluate the difference in clinical outcomes between subxiphoid video-assisted thoracoscopic surgery (SVATS) and intercostal video-assisted thoracoscopic surgery (IVATS) for anterior mediastinal tumor resection. Methods Online databases including The Cochrane Library, PubMed, EMbase, Web of Science, Sinomed, CNKI, Wanfang from inception to December 19, 2022 were searched by two researchers independently for literature comparing the clinical efficacy of SVATS and IVATS in treating anterior mediastinal tumors. Two researchers independently screened literature and extracted relevant data. The quality of the included literature was evaluated using the Newcastle-Ottawa Scale (NOS). The meta-analysis was performed by RevMan 5.3. Results A total of 12 studies with 1 517 patients were enrolled. NOS score≥6 points. The results of meta-analysis showed that compared with the IVATS, SVATS had less blood loss (MD=−17.76, 95%CI −34.21 to −1.31, P=0.030), less total postoperative drainage volume (MD=−70.46, 95%CI −118.88 to −22.03, P=0.004), shorter duration of postoperative drainage tube retention (MD=−0.84, 95%CI −1.57 to −0.10, P=0.030), lower rate of postoperative lung infections (OR=0.33, 95%CI 0.16 to 0.70, P=0.004), lower postoperative 24 h VAS pain score (MD=−1.95, 95%CI −2.64 to −1.25, P＜0.001) and 72 h VAS pain score (MD=−1.76, 95%CI −2.55 to −0.97, P＜0.001), and shorter postoperative hospital stay (MD=−1.12, 95%CI −1.80 to −0.45, P=0.001). There was no statistical difference in the operation time, the incidence of postoperative complications, incidence of postoperative phrenic nerve palsy or incidence of postoperative arrhythmia (P＞0.05). Conclusion SVATS for the treatment of anterior mediastinal tumors has high safety. Compared with the IVATS, the patients have less intraoperative blood loss and postoperative drainage volume, lower risk of postoperative pulmonary infection, less postoperative short-term pain, and shorter postoperative catheter duration and hospital stay, which is more conducive to rapid postoperative recovery.