Objective To observe the clinical curative effect of skin-region drainage therapy combined with Sanpian Decoction in treating migraine.Methods A total of 90 cases of migraine patients were randomly divided into combination group and acupuncture group,45 cases in each group.The combination group was treated with skinregion drainage therapy combined with oral use of Sanpian Decoction,and the acupuncture group was treated with conventional acupuncture therapy.Seven days constituted one treatment course,and the clinical efficacy of the two groups was evaluated after 3 courses of treatment.Results (1) The total effective rate of the combination group and acupuncture group was 95.6％ and 82.2％ respectively,and there were significant differences between the two groups (P ＜ 0.05).(2) After treatment and 3 months after treatment suspension,the pain scores of the two groups were significantly decreased(P ＜ 0.01 compared with those before treatment),and the pain scores of the combination group were lower than those of the acupuncture group (P ＜ 0.01).Conclusion The skin-region drainage therapy combined with Sanpian Decoction exerts certain effect in treating migraine.

Transanal total mesorectal excision (taTME) is a hot topic surgical approach in the field of colorectal surgery. However, the therapeutic effect of this surgical approach is controversial. Based on the accumulated experience and evidence, the domestic and international consensus and guidelines on taTME have been updated and improved. The importance of taTME registry study is emphasized again in the 'International expert consensus guidance on indications, implementation and quality measures for transanal total mesorectal excision' published in 2020. The implementation of prospective case registration is the fundamental premise to ensure the quality of data and the advancing data collection methods and online platform construction can further improve the quality of data. Based on the latest taTME international consensus, the authors discuss the importance of case registry study to improve the data quality of taTME registry study and provide reliable and timeliness evidence based medicine in the field of colorectal surgery.

Objective] To explore the treatment of Lanshi Micang disease with tumors related diagnosis and treatment method, in order to have a more comprehensive understanding of anal fistula, so as to broaden the mind, improve the clinical efficacy. [Method] FromLanshi Micang-Anal Fistulaof eight prescriptions for treatment of hemorrhoids and analysis, on the basis of combining the characteristics of compatibility with tumors inDongyuan effect testand the specific prescription, made analysis of anal fistula, diagnosis and treatment of anal fistula for the study of LI Dongyuan thought. [Results] LI Dongyuan from dampness, heat, wind, dryness four on the treatment of anal fistula, with angelica, Gentiana and blood dryness of medicine, to Shufeng pain, Xinrun and blood on regulation of syndrome treatment, paid attention to diet to restore the anal fistula. [Conclusion] LI DongyuanLanshi Micangis rich in content, the treatment of anal fistula has experience, as of today, the diagnosis and treatment on anorectal diseases of clinical thought still has important guiding significance.

Objective To observe the protective effect of rhein-arginine (RhA) on rats ankylenteron and to explore the anti-inflammatory mechanism. Methods Sixty male SD rats were randomly divided into 6 groups:normal control group,model group,dexamethasone group (in the dose of 10 mg?kg-1) and low-,medium-and high-dose RhA groups (in the dose of 7.5 mg?kg-1,15 mg?kg-1,30 mg?kg-1 respectively). Except that the normal control group,the rats in other groups were induced ankylenteron. Intraperitoneal injection of saline was administered to the rats in the normal control group and the model group,and dexamethasone group and RhA groups were given the corresponding drugs according to the experimental design. The treatment lasted 7 days. On the 8th day after surgery the blood samples of each group were collected. The levels of interleukin-1?(IL-1?),interleukin-4(IL-4)and tumor necrosis factor-?(TNF-a)were determined by enzyme linked immunosorbent assay. Grades of ntestinal adhesion were ranked by macroscopic observation. The adhesive tissues between cecum and abdominal wall were taken for pathological observation and the determination of hydroxyproline (Hyp) content. Results RhA significantly relieved the experimental intestinal adhesion,Obviously decreased the levels of IL-1?and TNF-?,and inhibited the hyperplasia of fibrous connective tissue. However,there was no significant impact on the level of IL-4. Conclusion RhA can effectively prevent the information of postoperative ankylenteron by inhibiting the expression of inflammatory cytokines and reducing the inflammatory response.

Intracorporeal anastomosis in laparoscopic right hemicolectomy of colon cancer is becoming a hot spot in colorectal surgery. A number of retrospective studies have suggested that intracorporeal anastomosis has potential advantages in promoting postoperative recovery and reducing postoperative complications compared with conventional extracorporeal anastomosis. Several randomized controlled trials published recently have also confirmed that intracorporeal anastomosis can promote postoperative gastrointestinal function recovery and reduce postoperative pain, but there is still insufficient evidence to draw a conclusion about the incidence of complications, especially the anastomotic leakage rate. Heterogeneity of surgical techniques and unclear definition of anastomotic leakage are the main difficulties in current studies. Several high-quality prospective randomized controlled trials are currently under way, and high level of evidence is needed to objectively evaluate the laparoscopic right hemicolectomy of colon cancer. The authors review the relevant literatures at home and abroad, systematically elaborate the research status and prospects of digestive tract reconstruction after laparoscopic right hemicolectomy of colon cancer, in order to explore a new direction for the clinical research of colorectal surgery in China.

Objective To investigate the value of urinary calprotectin in differential diagnosis between prerenal and intrinsic pediatric acute renal injury(AKI).Methods A total of 68 cases with AKI were enrolled in this study,and they were divided into prerenal AKI group(25 cases) and intrinsic AKI group(43 cases) according to their tissue perfusion.The general data was collected,and the blood urea nitrogen(BUN),serum creatinie(Scr),BUN/Scr,potassium,fractional excretion of filtrated sodium(FENa),urine osmotic pressure,B-type natriuretic peptide (BNP),urinary calprotectin,neutrophil gelatinase-associated lipocalin (NGAL),kidney injury molecule 1 (Kim-1) were recorded and compared between the 2 groups.Results There were significant differences between prerenal AKI group and intrinsic AKI group in Scr[(439.0 ± 278.0) μmol/L vs.(603.0 ± 286.0) μmol/L,t =2.30,P ＜ 0.05],BUN/Scr (20.58 ±5.62 vs.14.93 ±4.32,t =4.65,P＜0.05),FENa[(1.5 ±0.6)％ vs.(8.1 ±2.6)％,t =12.46,P＜ 0.05],BNP[95.6(54.0,109.4) ng/L vs.512.3(320.1,520.3) ng/L,Z =2.21,P ＜0.05],urinary calprotectin [20.7(4.3,42.4) μg/L vs.402.4(60.1,498.7) μg/L,Z=3.13,P＜0.05] and NGAL[74.9(14.5,365.5) μg/L vs.684.2(56.2,1 502.5) μg/L,Z =2.35,P ＜0.05].Receiver operating characteristic curve analysis showed that urinary calprotectin[area under the curve(AUC) =0.940] and BNP(AUC =0.909) both had higher value in differential diagnosis.When the cut off value of calprotectin was 240.6 μg/L,its specificity was 96.0％ and the sensitivity was 86.0％.When the cut off value of BNP was 120.6 ng/L,its specificity was 92.0％ and the sensitivity was 90.7％.The diagnostic accuracy was low in Scr,but moderate in BUN,Scr,FENa and NGAL.BUN,potassium,urine osmotic pressure and Kim-1 had no diagnostic value.Conclusions Urinary calprotectin may have higher diagnostic value in the differential diagnosis between prerenal and intrinsic pediatric AKT.It can be used in the clinical diagnosis as a reference index.

Objective: To evaluate the diagnostic performance of conventional ultrasound, compression elastography (CE) and acoustic radiation force impulse imaging (ARFI) in diff erential diagnosis of benign and malignant breast tumors. Methods: A total of 98 patients with liver lesions were included in the study. The images of conventional ultrasound, CE and the values of virtual touch tissue quantiifcation (VTQ) of breast lesions were obtained. hTe diagnostic performance of conventional ultrasound, CE and ARFI were assessed by using pathology as the gold standard, and then evaluate the diagnosis effciency of these three approaches in differential diagnosing benign and malignant breast tumors. Results: The specificity, sensitivity and accuracy in the diagnosis of malignant breast tumors for conventional ultrasound were 80.0%, 81.1% and 81.7%, respectively, whereas for CE elastic score were 85.7%, 86.7% and 86.3%, respectively. With a cutoff value of 3.71 for the SR, the sensitivity, speciifcity, accuracy in diagnosis of malignant breast tumors were 97.1%, 83.3% and 88.4%, respectively. With a cutoff value of 3.78 m/s for VTQ, the sensitivity, speciifcity, accuracy in diagnosis of malignant breast tumors were 94.3%, 91.7% and 92.6%, respectively. The difference in diagnosis efficiency among ARFI, CE and conventional ultrasound in differential diagnosis of benign and malignant breast tumors was signiifcant (P<0.05). Conclusion: Conventional ultrasound, CE and ARFI are all useful for the differential diagnosis of benign and malignant breast tumors. But the diagnosis effciency of ARFI is superior to CE and conventional ultrasound. The three approaches can help each other in differential diagnosis of benign and malignant breast tumors.

Objective To systematically evaluate the comprehensive effect of subglottic secretion drainage (SSD) on patients with mechanical ventilation (MV) in intensive care unit (ICU). Methods The randomized controlled clinical trials (RCTs) comparing SSD (intervention group) versus non-SSD (control group) in adult patients with MV in ICU was collected through the databases such as the PubMed database of the National Library of Medicine, CNKI, Wanfang database and the Chinese journal of science and technology database (VIP). The subjects were ICU patients with MV, and the retrieval time ranged from January 2006 to December 2016. Two reviewers independently screened the studies according to the inclusive and exclusive criteria, extracted the data, and assessed the quality. Then RevMan 5.3 software was used for Meta-analysis. Sensitivity analysis was performed using Stata 11.0 software. Funnel plot was used to analyze publication bias. Results In the 1004 documents obtained from preliminary screening, a total of 13 studies involving 2052 patients were enrolled after excluding duplicated documents and literature did not meet the inclusion criteria, with 1021 patients in intervention group, and 1031 in control group. Meta-analysis showed that compared with control group, the application of SSD in patients with MV could contribute to the reduction of the incidence of ventilator-associated pneumonia [VAP; risk ratio (RR) = 0.54, 95% confidence interval (95% CI) = 0.46-0.64, P < 0.00001], the duration of MV [mean difference (MD) = -3.29, 95%CI = -4.53 to -2.05, P < 0.00001] and length of hospital stay (MD = -4.27, 95% CI = -7.36 to -1.18, P = 0.007) were shortened, while there was no significant difference in ICU or hospital mortality rate between the intervention group and control group (RR = 0.89, 95%CI = 0.73-1.09, P = 0.25). The sensitivity analysis for studies enrolled in Meta-analysis of MV duration showed that individual research results were stable through step remove of the included literatures and combined calculation of the remaining literature value, suggesting that individual research results were stable, and would not have a significant impact on the overall results. The results of the funnel analysis showed that there was a symmetry in the inclusion studies, and no significant publication bias was found. Conclusions SSD did have effect in reducing the incidence of VAP, shortening the duration of MV and length of hospital stay, while there was no significant effect on reducing mortality rate. Effective use of SSD is an important measure to prevent VAP. It is necessary to objectively evaluate the clinical effect of SSD.

Objective: To investigate the epidemiological characteristics of 45 norovirus clusters in Baoshan District, Shanghai Municipality from 2019 to 2021, so as to provide the evidence for improving the management of norovirus clusters. Methods: The epidemiological characteristics and laboratory testing of 45 norovirus clusters were collected in Baoshan District from 2019 to 2021, and the temporal distribution, population distribution, distribution of places of norovirus clusters, clinical manifestations, laboratory testing results, origin of norovirus infection and transmission routes of norovirus clusters were analyzed using a descriptive epidemiological method. Results: A total of 45 norovirus clusters involving 29 379 individuals were reported in Baoshan District from 2019 to 2021, and 435 cases with norovirus infections were identified, with an average attack rate of 1.48%. Norovirus infection most often occurred from November to April of the following year, and the infection predominantly occurred among students (408 cases, 93.79%). There were 25 norovirus clusters in kindergartens (55.56%), 18 clusters in primary and middle schools (40.00%), one cluster in a social care facility and one cluster in a geriatric ward. Vomiting was the predominant clinical symptom (416 cases, 95.63%). The positive rate of norovirus was 37.35% in 597 samples. There were 40 norovirus clusters caused by the norovirus GⅡ genotype (88.89%), and the median duration of the norovirus cluster was 6 days (interquartile range, 1 day). In addition, 82.22% of the norovirus clusters reported to centers for disease control and prevention within 1 day,and 88.89% of the clusters were transmitted through human to human transmission or vomitus of cases. Conclusion The norovirus clusters predominantly occur in winter/spring and among students in Baoshan District from 2019 to 2021. Kindergartens and primary and middle schools are main places of norovirus infections, and the norovirus GⅡ genotype is the main type of pathogens. Human-to-human transmission and exposure to patients' vomitus are the main routes of transmission.

Objective: To systematically evaluate the influencing factors for medication compliance in patients with comorbidities of chronic diseases, so as to provide the evidence for improving medication compliance. Methods: Literature on influencing factors for medication compliance in patients with comorbidities of chronic diseases were retrived from CNKI, Wanfang Data, VIP, SinoMed, PubMed, Web of Science, Cochrane Library and Embase from inception to January 20, 2024. After independent literature screening, data extraction, and quality assessment by two researchers, a meta-analysis was performed using RevMan 5.4 and Stata 16.0 softwares. Literature were excluded one by one for sensitivity analysis. Publication bias was assessed using Egger's test. Results: Initially, 7 365 relevant articles were retrieved, and 35 of them were finally included, with a total sample size of about 150 000 individuals. There were 30 cross-sectional studies and 5 cohort studies; and 11 high-quality studies and 24 medium-quality studies. The meta-analysis showed that the demographic factors of lower level of education (OR=2.148, 95%CI: 1.711-2.696), lower economic income (OR=1.897, 95%CI: 1.589-2.264), male (OR=0.877, 95%CI: 0.782-0.985), living alone (OR=2.833, 95%CI: 1.756-4.569) and unmarried (OR=2.784, 95%CI: 1.251-6.196); the medication treatment factors of polypharmacy (OR=1.794, 95%CI: 1.190-2.706), potentially inappropriate medication (OR=2.988, 95%CI: 1.527-5.847), low frequency of daily medication (OR=0.533, 95%CI: 0.376-0.754) and adverse drug reactions (OR=3.319, 95%CI: 1.967-5.602); the disease factors of long course of disease (OR=2.118, 95%CI: 1.643-2.730), more comorbidities (OR=1.667, 95%CI: 1.143-2.431) and cognitive impairment (OR=2.007, 95%CI: 1.401-2.874); and the psychosocial factors of poor belief in taking medication (OR=1.251, 95%CI: 1.011-1.547), poor self-rated health (OR=1.990, 95%CI: 1.571-2.522) and being guided by healthcare professionals (OR=0.151, 95%CI: 0.062-0.368) were the influencing factors for medication compliance in patients with chronic comorbidities. Conclusion The medication compliance in patients with comorbidities of chronic diseases is associated with demographic factors, pharmacological factors, disease factors and psychosocial factors, mainly including living alone, adverse drug reactions, course of disease, number of comorbidities and medication beliefs.