Notoginseng Radix et Rhizoma as a traditional Chinese herbal medicine has now been recognized and paid attention to by the pharmaceutical community.Modern phytochemical studies have shown that Panax notoginseng saponin is the main chemical compo-nent of Notoginseng Radix et Rhizoma.Modern pharmacological studies and clinical applications have revealed that it has anti-cancer,antioxidant and cardiovascular disease effects.In this study,we reviewed the research progress of the main chemical components and pharmacological effects of Notoginseng Radix et Rhizoma,with the aim of providing assistance for the clinical application and later stud-ies of Notoginseng Radix et Rhizoma.

Objective:To evaluate the influencing factors and predictive value of renal function recovery in elderly patients with heart failure(HF)and acute renal injury(AKI)after intermittent veno-venous hemofiltration(IVVH)using critical care ultrasound.Methods:The clinical data of elderly patients with heart failure(NYHF grade Ⅲ~Ⅳ)complicated with acute kidney injury(stage 2~stage 3)who underwent intravenous veno-venous hemofiltration(IVVH)in the critical care unit(CCU)of our hospital were retrospectively analyzed.The demographic information of the patients and the changes in clinical biochemical and critical care ultrasound monitoring parameters before and after 7 days of IVVH were recorded.Based on the recovery of renal function, the patients were divided into two groups: a renal function recovery group and a renal function non-recovery group.Logistic regression and Receiver Operating Characteristic Curve(ROC)curve analysis were performed to determine the predictive value of various influencing factors on the recovery of renal function in patients.Results:A total of 178 patients were enrolled in this study.After starting IVVH treatment, renal function recovered in 143 cases at 30 days, and in 138 cases at 90 days.However, renal function did not recover in 35 cases at 30 days, and in 40 cases at 90 days.The proportion of NYHF Ⅲ patients、the proportion of diabetic patients、the decrease of Beta 2-microglobulin(β2-MC)、the decrease of Cystain C(CysC)、the increase of venous transit time index(VTI)、the increase of Cardiac Output(CO)and the decrease in renal blood flow resistance index(RI)in the recovery groups at both 30 days and 90 days was significantly higher than that in the non-recovery group(all P<0.05).The total treatment time of IVVH in the recovery group was significantly shorter than that in the non-recovery group, with 30 days and 90 days( P<0.05).Logistic analysis revealed that the total treatment time of IVVH( OR=1.067, P<0.001), VTI( OR=0.652, P=0.024), CO( OR=0.037, P<0.001), and RI(OR<0.001, P=0.010)of the interlobar artery were identified as independent factors influencing the recovery of renal function in AKI patients at 30 days and 90 days after IVVH treatment.The ROC curve demonstrated the predictive value of various independent influencing factors for 30-day renal function recovery.The area under the curve(AUC)for VTI was 0.610(95% CI: 0.513-0.707), for CO it was 0.760(95% CI: 0.656-0.864), and for RI it was 0.694(95% CI: 0.589-0.799).Similarly, the ROC curve showed the predictive value of these factors for renal function recovery at 90 days.The AUC for VTI was 0.654(95% CI: 0.564-0.744), for CO it was 0.697(95% CI: 0.605-0.789), and for interlobar artery RI it was 0.605(95% CI: 0.495-0.715). Conclusions:The venous transit time index(VTI), cardiac output(CO), and renal interlobar artery RI, monitored by critical care ultrasound, are independent factors that can be used to evaluate the recovery of renal function in elderly patients with HF and AKI after IVVH treatment.Additionally, the changes in these parameters within 7 days after IVVH treatment have a high predictive value for the improvement of renal function in elderly patients after 30 days and 90 days.

Objective To cultivate the ability of laboratory resident physicians in multiple aspects and enhance their post-competence for laboratory medicine.Methods The residents recruited into the Cancer Hospital of China Academy of Medical Sciences Laboratory Base were divided into junior residents and senior residents.According to the different training contents and objectives,the exploration of the hierarchically progressive training model was carried out,which mainly included three aspects:training plan,process training and process assessment.Results After the implementation of the hierarchical progressive training model,the average theoretical score and the average score in the skill operation examination of the residents increased to over 90 and 95,respectively.Meanwhile,the comprehensive clinical ability was also improved.Breakthroughs of teaching,scientific research and honor were achieved from"nothing"before the implementation to"something"after the implementation,and it actively promoted the improvement of the post-competency of the residents in laboratory medicine.Conclusion The application of the hierarchically progressive training mode in standardized training of residents in laboratory medicine could play a good role in promoting the training of post-competence for residents.

Objective To investigate the clinical characteristics and risk factors of plastic bronchitis(PB)occurrence in children patients with refractory Mycoplasma pneumoniae pneumonia(RMPP).Methods A retrospective analysis was performed on the clinical data of 399 children patients with RMPP treated by fiberoptic bronchoscopy hospitalized in this hospital from January 2017 to December 2019.The pa-tients were divided into the PB group(n=142)and non-PB group(n=257)according to whether or not find-ing PB under fiberoptic bronchoscopy.The differences in clinical characteristics,laboratory detection indicators and imageological manifestations were compared between the two groups.The risk factors of PB occurrence in children RMPP were analyzed.Results Compared with the non-PB group,the incidence rates of hypoxemia and extrapul-monary complications,and the highest body temperature in the PB group were higher,number of fever days and hospitalization days was longer,the proportions of hormone and intravenous injection of immunoglobulin were higher,the levels of NEUT,CRP,IL-6,AST,ALT LDH CK and D-Dimer and incidence rates of pulmo-nary atelectasis and pleural effusion were higher,the levels of PLT and lymphocytes were lower,and the differences were statistically significant(P＜0.05).The receiver operating characteristic(ROC)curve analy-sis results showed that the highest body temperature,NEUT,PCT,IL-6,AST and LDH could serve as the predictive indicators for PB occurrence in RMPP(P＜0.05).The multivariate logistic regression analysis re-sults showed that the highest body temperature＞39.8 ℃,NEUT＞72.9％,IL-6＞26.65 pg/mL,AST＞49.5 U/L and pulmonary atelectasis were the risk factors of PB occurrence in RMPP.Conclusion Should pay at-tention to the risk factors of PB occurrence in children patients with RMPP and take necessary preventive measures to improve their prognosis.

Objective To explore the effect of acute caffeine and theanine supplementation on coordi-nation and aerobic performance in mentally fatigued soccer players.Methods A randomized crossover de-sign was employed with 15 male amateur soccer players.Participants underwent three different interven-tions—caffeine(caffeine group),theanine(theanine group),and placebo(placebo group)—with a one-week washout period between each intervention.After each supplementation,participants performed a 45-minute Stroop task to induce mental fatigue,followed by a speed dribbling test(SDT)and the 30-15 intermittent fitness test(30-15IFT)to assess coordination and aerobic performance,respectively.Mea-surements included visual analog scale for mental fatigue(VAS-MF),motivation(VAS-MO),Brunel mood scale for fatigue(BRUMS-F)and vigor(BRUMS-V)pre-and post-Stroop task,response time(RT),response accuracy(ACC),average heart rate(HRave)during Stroop,mental exertion(VAS-ME)post-Stroop,rating of perceived exertion(RPE),HRave,and peak heart rate(HRpeak)during SDT and 30-15IFT.All data were analyzed using repeated measures ANOVA.Results The change in VAS-MF(ΔVAS-MF)before and after the Stroop task was lower in the caffeine group compared to the placebo group(P=0.064),while the theanine group showed similar ΔVAS-MF to the latter group(P=0.999).Both the caffeine and theanine groups had significantly faster RT(P=0.003 and 0.033,respectively)and higher ACC(P=0.006 and 0.033,respectively)during the Stroop task compared to the placebo group.Moreover,coordination performance in both the caffeine and theanine groups was better than the placebo group(P=0.096 and 0.078,respectively).Meanwhile,aerobic performance in the caffeine group was significantly better than the placebo group[time to exhaustion(TTE):P=0.012;last stage ve-locity of 30-15IFT(VIFT):P=0.007;maximal oxygen uptake(VO2max):P=0.008],whereas no significant differences were found between the theanine group and the placebo group in the aerobic performance(TTE:P=0.999;VIFT:P=0.999;VO2max:P=0.999).Conclusion Both acute caffeine and theanine supple-mentation can mitigate the negative effect of mental fatigue on coordination performance in soccer play-ers.Additionally,acute caffeine supplementation can also alleviate the negative impact of mental fa-tigue on aerobic performance.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

OBJECTIVE: To investigate the effectiveness of dorsal perforator flap of cross-finger proper digital artery in the treatment of finger soft tissue defect caused by high-pressure injection injury. METHODS: Between July 2011 and June 2020, 14 cases of finger soft tissue defect caused by high-pressure injection injury were repaired with dorsal perforator flap of cross-finger proper digital artery. All patients were male, with a mean age of 36 years (range, 22-56 years). The defects were located on the index finger in 8 cases, middle finger in 4 cases, and ring finger in 2 cases. The causes of injury include 8 cases of emulsion paint injection, 4 cases of oil paint injection, and 2 cases of cement injection. The time from injury to debridement was 2-8 hours, with a mean time of 4.5 hours. The soft tissue defects sized from 4.0 cm×1.2 cm to 6.0 cm×2.0 cm. The flaps sized from 4.5 cm×1.5 cm to 6.5 cm×2.5 cm. The donor site of the flap was repaired with skin graft. The pedicle was cut off at 3 weeks after operation, and followed by functional exercise. RESULTS: All flaps and skin grafts at donor sites survived, and the wounds healed by first intention. Twelve patients were followed-up 16-38 months (mean, 22.6 months). The texture and appearance of all flaps were satisfactory. The color and texture of the flaps were similar to those of the surrounding tissues. The two-point discrimination of the flap was 10-12 mm, with a mean of 11.5 mm. There were different degrees of cold intolerance at the end of the affected fingers. At last follow-up, the finger function was evaluated according to the Upper Extremity Functional Evaluation Standard set up by Hand Surgery Branch of Chinese Medical Association, 3 cases were excellent, 8 cases were good, and 1 case was poor. CONCLUSION The dorsal perforator flap of cross-finger proper digital artery can effectively repair finger soft tissue defect caused by high-pressure injection injury. The operation was simple, and the appearance and function of the finger recover well.
Humans ; Male ; Adult ; Female ; Perforator Flap ; Upper Extremity ; Fingers/surgery* ; Ulnar Artery ; Skin Transplantation

Objective:To investigate the volume management of intermittent veno-venous hemofiltration (IVVH) guided by critical care ultrasound in the treatment of acute kidney injury (AKI) in patients with heart failure (HF).Methods:A total of 216 patients with HF and AKI treated with IVVH in the coronary care unit (CCU) of the Third Central Hospital of Tianjin from April 2019 to June 2022 were selected as the study subjects, the patients were randomly divided into conventional guidance group (107 cases) and ultrasound guidance group (109 cases). According to the recovery of renal function, IVVH was performed 12 hours every day or 12 hours every other day. The conventional guidance group selected the conventional method to formulate IVVH prescription, and the ultrasound guidance group used critical care ultrasound to adjust the treatment parameters of IVVH on the basis of the conventional guidance group. Respiratory variation index (RVI) of inferior vena cava (IVC), right left ventricular end-diastolic transverse area ratio, early diastolic peak mitral flow velocity/mitral annulus velocity peak (E/E'), aortic flow velocity time integral (VTI), cardiac output (CO), bilateral lung ultrasound B-line range, bilateral renal interlobar arteries resistance index (RI) were recorded before and 3, 6, 9 hours after each treatment. The net dehydration rate was adjusted in real time according to the comprehensive results. Urine volume, serum creatinine (SCr), estimated glomerular filtration rate (eGFR), blood B-type brain natriuretic peptide (BNP), β 2-microglobulin (β 2-MG) and cystatin C (Cys C) levels of patients in both groups were monitored before and 3, 7 and 10 days after initial treatment, and renal function recovery and clinical prognostic indexes of patients in both groups were recorded. Results:The dehydration rate of the ultrasound guidance group was slow at the beginning of IVVH, and gradually increased after 6 hours, and the overall dehydration rate was significantly slower than that of the conventional guidance group. In the ultrasound guidance group using critical care ultrasound, the RVI gradually increased, the right left ventricular end-diastolic area ratio gradually decreased, the E/E' ratio gradually decreased, and the range of B-line of bilateral lungs gradually decreased, RI of bilateral renal interlobar arteries decreased. At 3, 7 and 10 days after the first IVVH, renal function related indexes in both groups were significantly improved compared with before treatment, and the decline rate of β 2-MG and Cys C in the ultrasound guidance group was faster than that in the conventional guidance group at early (3 days) [β 2-MG (mg/L): 3.69±1.31 vs. 3.99±1.45, Cys C (mg/L): 2.91±0.95 vs. 3.14±0.96, both P < 0.05], urine volume, SCr and eGFR at 7 days were also significantly improved compared with the conventional guidance group [24-hour urine volume (mL): 1 128.23±153.92 vs. 1 015.01±114.18, SCr (μmol/L): 145.86±32.25 vs. 155.64±28.42, eGFR (mL/min): 50.26±11.24 vs. 46.51±10.61, all P < 0.05]. The time of SCr recovery, the time of reaching polyuria, the total time of IVVH treatment, the time of non-invasive mechanical ventilation and the time of living in CCU in the ultrasound guidance group were shorter than those in the conventional guidance group. The incidences of hypotension, long-term RRT, incidence of major cardiovascular adverse event (MACE) and at 28-day mortality were all lower than those in the conventional guidance group. Kaplan-Meier survival curve showed that the 28-day cumulative survival rate in the ultrasound guidance group was significantly lower than that in the conventional guidance group (Log-Rank test: χ 2 = 3.903, P = 0.048). Conclusion:The strategy of IVVH guided by critical care ultrasound in the treatment of HF with AKI has unique advantages.

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.