Infant functional constipation is one of the common clinical symptoms in infancy stage,so far we do not have a specific diagnostic criteria and treatment for infant functional constipation.In this paper,we reviewed the diagnostic methods,clinical evaluation,differential diagnosis,and treatment recommendations according to recent research results for infant functional constipation.

Objective The expression of chemokine C-X-C motif ligand 13 (CXCL13) within liver in primary biliary cholangitis (PBC) patients is significantly increased, but its origin and mechanism is not clear yet.The study aimed to investigate the expression of CXCL13 in the liver of mice through establishing a mouse model of PBC.Methods C57BL/6 mice were randomly divided into experiment group (n=20) control group(n=10).The mice in the experimental group were intraperitoneally injected with polyriboinosinic polyribocytidylic acid (Poly I:C) while the mice in control group were injected with PBS of the same volume.The level of serum AMA was quantified by ELISA and intrahepatic inflammatory cells were assessed by HE staining.Kupffer cells, liver sinusoidal endothelial cells, and infiltrating lymphocytes in the liver of mice were collected by in situ perfusion enzyme digestion and magnetic bead separation methods.The transcriptional level of intrahepatic CXCL13 in liver tissues and cell subpopulations were detected by qPCR.Results The serum AMA titers of the mice in experiment group increased gradually with the prolonging of modeling time and the positive rates at the 4th, 8th, and 12th week after the first injection of Poly I:C were 5.9%, 52.9% and 76.5% respectively.While the serum AMA titers of the mice in control group were at a lower level through the modeling process, with only 2 mice presenting a little higher level above positive cutoff value at the 12th week.The results of HE staining in liver tissues of both groups showed that there were a great amount of intensely infiltrating inflammatory cells in the mice of experimental group while no inflammatory cell infiltration were found in the mice of control group.The separation purity of Kupffer cells and liver sinusoidal endothelial cells in the mice of experiment group tested by flow cytometry were 76%-80%, 68%-72% respectively.Compared with the CXCL13 mRNA level in Kupffer cells [2.34(0.22-8.64)], the expression levels in liver sinusoidal endothelial cells and infiltrating lymphocytes declined[0.27(0.03-1.64), 0.05(0-0.22), P<0.05].Conclusion The chemokine CXCL13 is predominantly produced by Kupffer cells in the liver of PBC mice established by Poly I:C injection.

Objective To explore the feasibility of mechanical chest compression to establish a rat model of car?diopulmonary resuscitation ( CPR) . Methods 4?month old healthy male Sprague Dawley rats were randomly divided into control group ( n=6 ) and model group ( n=10 ) . After induction of anaesthesia with 10% chloraldurate ( 3 ml/kg, i. p. ) , tracheal intubation and left femoral artery cannulation were performed. Under electrocardiographic and artery blood pressure monitoring, tracheal obstruction ( TO) was performed to rats in model group. At 2 min after the cardiac arrest ( CA) occurred, CPRs were administered to the rats using a self?made animal chest compressor, which provided chest?com?pression at a rate of 200 bpm. Results Shortly after TO, rats in the model group had respiratory arrest, cyanosis and ar?rhythmia. Electrocardiography indicated that CA occurred within 4-5 min, with a decreased artery systolic blood pressure ( <40 mmHg) and a zero pulse pressure. Return of spontaneous circulation ( ROSC) after the CPR was successfully a?chieved in 8 rats (80%), with a transient reperfusion arrhythmia. Finally, 60% of the rats (n=6) recovered to con?sciousness and survived for 24 hrs. The serum biochemical analysis indicated that there were electrolyte disturbances, aci?dosis, impaired renal functions and increased myocardial enzyme spectrum. Pathological examination revealed cardiac rhab? domyolysis, no?reflow phenomenon in renal glomeruli, decrease of neurons and pulmonary congestion in the model group rats. Conclusions Mechanical chest compression can provide minimal cardiac output for the requirement of CPR incardiac arrestin rats. It is feasible to establish rat CPR model with the mechanical chest compression.

Objective:To investigate the imaging follow-up value of discectomy and Modic changes caused by endolate fracture.Methods:Forty-six patients with end-plate fractures admitted to Changxing People′s Hospital during January to December 2016 were selected as subjects and followed up for 1 year. All patients underwent MRI examination to analyze the changes of Modic, disc degeneration and lumbar function recovery before and after follow-up.Results:A total of 230 lumbar intervertebral discs in 46 patients in this group had Modic changes. After 1 year′s follow-up, Modic changes occurred in 185 lumbar intervertebral discs in 46 patients. Modic changes occurred in L 5-S 1 [38.92%(72/185)] and L 4 - L 5 [40.0%(74/185)] segments. After 1 year′s follow-up, the rate of intervertebral disc 3-4 grade was higher than that before discharge [70.43%(162/230) vs. 60.43%(139/230)], the rate of intervertebral disc 6-8 grade was lower than that before discharge[8.70%(20/230) vs. 15.22%(35/230)], and the differences were statistically significant ( χ2 = 5.085, 4.646, P<0.05). After 1 year′s follow-up, the lumbar spine function score was significantly higher than that before discharge [(23.47 ± 2.86) scores vs. (9.15 ± 1.32) scores], and the difference was statistically significant ( P<0.05). Conclusions:Diffusion-weighted MR imaging has the characteristics of convenient operation, good repeatability and high accuracy. It is suitable for diagnosis and follow-up of disc degeneration and Modic change caused by endplate fracture. It is worthy of clinical promotion.

Objective:To evaluate the effectiveness of HIV/syphilis joint self-testing in promoting syphilis testing among men who have sex with men (MSM).Methods:In July 2019, the research participants were recruited through the Danlan website (https://www.danlan.org). Participants who met the selection criteria, and were randomly assigned into one of the three study groups (1∶1∶1) including HIV/syphilis joint self-testing group and lottery incentive self-testing group and control group. Self-test reagents were mailed to HIV/syphilis joint self-testing group and lottery incentive self-testing group, and the subjects in control group were encouraged to go to offline locations for testing. One month later, follow-up was conducted to evaluate the differences in the testing rates of syphilis among the three groups.Results:A total of 145 subjects were included in this study, including 48 in control group, 49 in HIV/syphilis joint self-testing group and 48 in lottery incentive self-testing group. During the follow-up period, the self-testing rate of syphilis was 74.4% (32/43) in HIV/syphilis joint self-testing group, 70.0% (28/40) in lottery incentive self-testing group and 36.4% (16/44) in control group. Multivariate logistic analysis revealed that the proportions of syphilis testing in HIV/syphilis joint self-testing group and lottery incentive self-testing group were 5.38 (95% CI: 2.06-14.04) times and 4.54 (95% CI: 1.75-11.74) times higher than that in control group during the follow-up period. Conclusions:HIV/syphilis joint self-testing and lottery-incentives-prompted self-testing significantly increased the testing rate of syphilis in MSM, respectively. HIV/syphilis joint self-testing is feasible for promotion.

Objective:To establish an Epstein-Barr virus-transformed peripheral blood B cell line (BCL), and explore its phenotypic characteristics, the ability to secrete antibodies and cytokines, and the ability to present hepatitis B virus (HBV) antigen peptide.Methods:Peripheral blood mononuclear cells (PBMCs) were isolated from patients with HBV infection. Epstein-Barr virus supernatant was incubated to construct BCL. The expression of CD19, CD138, CD38, CD27 and the production levels of IFN - γ, IL-10, IL-6 were detected by flow cytometry. BCL loaded with HBV antigen peptide was incubated with in vitro-expanded autologous T cells. Intracellular staining was used to detect the level of interferon-gamma produced by T cells.Results:Compared with untransformed peripheral blood B cells, BCL had high expression levels of CD138, CD38 and CD27, and the difference was statistically significant ( P < 0.05), while the level of IL-6 production was decreased, and the difference was statistically significant ( P < 0.01). BCL loaded with HBV antigen peptide had significantly enhanced the production of interferon-gamma by in vitro-expanded autologous T cells, and the difference was statistically significant ( P < 0.01). Conclusion:BCL highly expresses CD138, CD38 and CD27, but its ability to produce IL-6 decreases. BCL can improve the immune response efficiency of HBV-specific T cells to HBV antigen peptide, and serve as a new tool for hepatitis B immune research.

BACKGROUND:The repair process of myocardial injury involves complex cellular and molecular mechanisms,especially mitochondrial calcium homeostasis,macrophage autophagy and pyroptosis pathways.Traditional Chinese medicine(TCM)has shown significant clinical efficacy in improving myocardial injury,but its mechanism of action needs to be thoroughly investigated. OBJECTIVE:To investigate the role of mitochondrial calcium homeostasis-mediated macrophage autophagy and pyroptosis pathways in myocardial injury,and to summarize the progress of TCM in this field. METHODS:A computerized search was performed for relevant literature from the database inception to March 2024 in the Web of Science,PubMed and CNKI.The search terms were"mitochondrial calcium homeostasis,macrophage autophagy,macrophage pyroptosis,traditional Chinese medicine,myocardial injury,myocardial injury reperfusion"in Chinese and English.Through literature review,we analyzed the relationship between mitochondrial calcium homeostasis and macrophage autophagy and pyroptosis,explored the mechanism of their roles in myocardial injury,and summarized the pathways of multi-targeted,multi-pathway effects of TCM. RESULTS AND CONCLUSION:The maintenance of mitochondrial calcium homeostasis has been found to be closely related to the normal function of cardiomyocytes.Macrophages can participate in the repair process of myocardial injury through autophagy and pyroptosis pathways.Autophagy contributes to cell clearance and regulation of inflammatory response,while pyroptosis affects myocardial repair by releasing inflammatory factors.TCM regulates mitochondrial calcium homeostasis and macrophage function through multiple mechanisms.For example,astragalosid regulates calcium homeostasis by lowering mitochondrial membrane potential and inhibiting cytochrome C,and epimedium glycoside plays a role in reducing β-amyloid deposition.In addition,herbal compounds and single drugs promote myocardial repair by activating or inhibiting specific signaling pathways,such as PI3K/AKT and nuclear factor-κB signaling pathways.Future studies should focus on the interactions between mitochondrial calcium homeostasis,autophagy and pyroptosis pathways,as well as how TCM can exert therapeutic effects through these pathways to provide new strategies and drugs for the treatment of myocardial injury.

Objective To establish a highly sensitive,stable,and universally applicable ultra-high-performance liquid mass spectrometry tandem method(UPLC-MS/MS)for simultaneous determination of nirmatrelvir and ritonavir blood concentrations in human plasma.Methods The separation was performed on an ACQUITY UPLC BEH C18 column(2.1 mm× 50 mm,1.7 μm)with gradient elution,and the mobile phase consisted of 0.1％formic acid-water and 100％acetonitrile at the flow rate of 0.3 mL·min-1.The column temperature was 45℃,and the injection volume was 2 μL.Electrospray ionization as ion source(ESI+)was used as the ion source and multiple reactions monitoring mode(nirmatrelvir m/z 500.20→319.10,nirmatrelvir-D9 m/z 508.59→328.10,ritonavir m/z 721.30→426.10,13C,2H3-ritonavir m/z 725.30→426.10)was adopted.Thirty patients with coronavirus disease 2019(COVID-19)treated with nirmatrelvir and ritonavir at the People's Hospital of Changxing County in Jan.2023 were selected to measure their steady-state trough concentrations of nirmatrelvir and ritonavir after 3 days of treatment.Results The linear range of nirmatrelvir was 0.100-10.0 μg·mL-1(R2=0.997 2),and the linear range of nirmatrelvir was 0.050-5.00 μg·mL-1(R2=0.995 2).The recovery rates of nirmatrelvir and lopinavir were both＞90％and the intra-batch and inter-batch precision relative standard deviations(RSDs)were both＜10％.Additionally,the recovery ranges for nirmatrelvir and lopinavir were 91.5％-97.0％,and the matrix effects ranged from 92.4％to 97.7％.The results of clinical samples showed that the plasma concentrations of nirmatrelvir and ritonavir in patients with COVID-19 varied greatly among individuals.Conclusion The method for simultaneous determination of nirmatrelvir and ritonavir concentrations in human plasma established in this study is convenient,highly specific,highly accurate,with high precision,which is suitable for monitoring the concentrations of nirmatrelvir and ritonavir in patients.

OBJECTIVE：To investig ate the application and trend o f tranexamic acid in the orthopedic inpatient ，and to provide reference for rational drug use. METHODS ：The consumption of tranexamic acid ，the distribution of orthopedics diseases using tranexamic acid and route of administration were analyzed in 3 sub-departments （joint surgery department ，spinal surgery department，orthopedic trauma department ）from 4 third-grade class-A hospitals of Chongqing during 2017 to 2020. RESULTS ： The total consumption of tranexamic acid used in orthopaedic department had increased year by year in the past 4 years，with increase of 6.2％-52.2％，and the consumption of tranexamic acid in various departments also increased year by year ；from 2017 to 􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂􀤂 书辅料标明情况及风险控制建议 [J].中国药师，2018，21 中华中医药杂志，2018，33（6）：2225-2229. （18）：2020-2022. [10] 孟菲，李学林.中成药说明书中规格项存在的问题与探 [ 7 ] 国家药典委员会.中华人民共和国药典：二部[S]. 2010年 讨[J].当代医学，2015，21（12）：14-15. 版.北京：中国医药科技出版社，2010：1014. [11] 国家食品药品监督管理局 .中成药规格表述技术指导原 [ 8 ] 孟菲，李学林.中成药说明书中功能主治项表述方法的探 则：征求意见稿 [EB/OL].（2017-10-11）[2020-12-20]. 讨[J].中医药临床杂志，2015，27（1）：111-112. https：//www.nmpa.gov.cn/xxgk/zhqyj/zhqyjyp/20171011- [ 9 ] 田硕，郭晖，苗明三.中成药说明书完善的思考及实践[J]. 151401184.html. [12] 王裴芳.我国中成药说明书中老年人用药项的调查分 Δ基金项目：重庆市科技计划项目-技术预见与制度创新项目（No. 析[J].中国药房，2015，26（29）：4055-4057. cstc2018jsyj-zdcxX0052）；重庆市社会科学规划项目（No.2019QNGL31） [13] 林志健，周伟龙，张冰，等.中成药说明书中儿童用药信息 ＊硕士研究生 。研究方向 ：社会医学 、卫生事业管理 。电话： 023-68485178。E-mail：351389583@qq.com 的修订完善思考 [J].药物流行病学杂志 ，2018，27（4）： # 通信作者：教授，硕士生导师，硕士。研究方向：医事法学、卫生 244-248. 政策、卫生事业管理。电话：023-68485178。E-mail：puchuan68@sina. （收稿日期：2021-01-07 修回日期：2021-05-26） com （编辑：罗 瑞） ·1622· China Pharmacy 2021Vol. 32 No. 13 中国药房 2021年第32卷第13期 2019，joint surgery department accounted for the largest prop ortion（59.2％ ，53.5％ ，47.2％）to use tranexamic acid ，and orthopedic trauma department accounted for the largest proportion （39.2％）in 2020. On the whole ，top 4 orthopedic diseases in the list of the consumption of tranexamic acid were joint replacement （25.5％-29.6％），hip fracture （19.3％-23.6％），diaphysis fracture （13.5％-18.6％）and pelvic and acetabular fracture （8.2％-14.0％）. The route of administration for tranexamic acid in spinal surgery department ，joint surgery department and orthopedic trauma department was mainly intravenous application every year （accounting for 55.1％-81.0％，46.9％-77.1％，49.3％-73.3％，44.9％-71.5％）. CONCLUSIONS ：The consumption of tranexamic acid in orthopedic inpatients is increased year by year ，and is dominated by joint surgery department and orthopedic trauma department. The route of tranexamic acid is still mainly intravenous administration ，which is safe and reliable.

Objective:To understand the changing trends of HIV testing rates, with a focus on HIV self-testing, and to evaluate the impact of HIV self-testing on expanding HIV testing among MSM in China in past few years.Methods:MSM were recruited online nationwide via a gay social networking app (Blued) from 2013 to 2016 and 2018. The survey collected information about socio-demographic backgrounds, sexual behaviors, and prior HIV testing experiences, including HIV self-testing. Trend analyses were conducted.Results:Respectively, 1 342, 1 424, 1 173, 2 105 and 699 MSM were recruited nationwide from 2013 to 2016, and in 2018. The mean age was (30.6±6.6)years in 2013 and showed a decreasing trend afterwards. The HIV testing rate was 60.0% (805/1 342) in 2013 and there was a rising trend from 2013 to 2016, and 2018 (trend Z =19.3, P <0.001), reaching a peak at 77.3% (540/699) in 2018. Further, the HIV self-testing rate increased from 19.3% (259/1 342) in 2013 to 58.1% (406/699) in 2018 ( χ2=237.5, P <0.001). The proportion of MSM who had HIV self-testing among prior HIV testers significantly increased from 32.2% (259/805) to 75.2% (406/540) during the study period (trend Z =14.3, P <0.001). Conclusions:The HIV testing rate, HIV self-testing rate and proportion of men who had HIV self-testing among former HIV testers among web-based Chinese MSM showed substantial increases from 2013 to 2016,and 2018. This suggests that HIV self-testing may have a significant effect on the expansion of HIV testing coverage in MSM, and has important public health implications for HIV/AIDS prevention in China.