Objective To assess the clinical effectiveness and safety of relinqing pharmaceutical preparations for the treatment of uncomplicated urinary tract infection(UTI). Methods The genitourinary infection, urinary tract infection, pyelonephritis, cystitis, stranguria and urethritis were used as key words to search at CNKI,VIP,SinoMed,PubMed,Wan Fang and Cochrane Library Databases up to April 2015. Data of randomised controlled trials (RCTs) comparing treatments using relinqing were included in this study. The quality of the literature was evaluated by the method of Cochrane handbook 5.1.0. Data extraction was carried out independently by two authors. RevMan 5.2 software was used for Meta-analysis. Results Five RCTs were included that involved a total of 471 uncomplicated UTIs. Analysis of four studies showed a higher rates of effectiveness for uncomplicated UTI in the treatment with relinqing plus antibiotics than those of antibiotics alone [RR and 95%CI:1.15 (1.08-1.23), P<0.001]. Analysis of two studies showed a higher rates of bacterial clearance for uncomplicated UTI in the treatment with relinqing plus antibiotics than those of antibiotics alone [RR and 95% CI: 4.04 (1.78-9.16)]. Conclusion Data from five small studies suggest that relinqing as an independent intervention or in conjunction with antibiotics may be beneficial for treating uncomplicated UTIs. However, the small number and poor quality of the included studies meant that it is not possible to formulate robust conclusion on the use of relinqing for uncomplicated UTI either alone or as an adjunct to antibiotics.

Thirty-four cases out of 830 children with diarrhea were confirmed to be positive of fecal cryptosporidial oocysts with IFA technique and monoclonal antibodies in a period of 2 years. These 34 cases could be diagnosed as cryptosporidial enteritis. Their age ranged from 4 months to 7. 6 years with an average of 2. 5?1. 7 years. The stool was frothy and watery in appearance. High incidence occurred form June to September. Determination of PHA skin test, LBT and serum Ig was performed on 27 patients before, during and after the treatment of Astragalus membranaceus Bunge and Sophora flavescens Ait ( 2 traditional Chinese herb medicines). It was found that diarrhea lasted 10. 9?7. 1 days and oocyst shedding lasted 21. 5? 12. 3 days. Before treatment) PHA skin test showed an erythema of 7. 9?2. 4 mm in diameter, and LBT value was 48. 7%?10. 1% and they returned to normal after treatment.It is suggested that hot safrain-methylene blue stain and modified acid-fast stain of the stool be performed in those children with diarrhea of unknown etiology as a routine screening for cryptosporidial oocysts. The 2 Chinese herb medicines may have a repelling effect on the parasites and be. helpful to the cell immunity of the patients. Asymptomatic carriers of cry-tosporidial oocysts may be the source of infection.

Objective To compare the short-term and long-term therapeutic effects of oral rehydration salts,metoprolol or midodrine hydrochloride in children with postural tachycardia syndrome (POTS).Methods Two hundred and forty-four children with POTS diagnosed in the First Hospital Peking University of from Dec.2004 to Jan.2013 were followed up in clinics or by telephone.They were divided into oral rehydration salt group (n =75),metoprolol group (n =66) and midodrine hydrochloride group (n =103).The patients were followed up for 3 ～ 100 months.Results After 3 months of treatment,the symptom scoring of the three groups was improved greatly as compared with the baseline data.Therapeutic effect of midodrine hydrochloride group was significantly superior to metoprolol group and oral rehydration salt group (x2 =8.750,P =0.013).One hundred and forty-two out of 244 children were followed up and their head-up tilt test(HUT)was repeated.The HR increment of children in 3 groups became smaller as compared with before treatment (P ＜ 0.05).After follow-up,the symptom scoring was improved greatly as compared with the baseline scoring (P ＜ 0.05).The short-term effect of midodrine hydrochloride group was significantly better than that of metoprolol group or oral rehydration salt group (x2 =8.750,P =0.013).The Kaplan-Meier curves showed that the long-term effect of midodrine hydrochloride group was significantly superior to metoprolol group and oral rehydration salt group (89.3％vs 78.8％,P =0.033;89.3％ vs 76.0％,P =0.002).Conclusion Oral rehydration salts,midodrine hydrochloride or metoprolol were all effective for POTS in children.And the short-term and long-term effect of midodrine hydrochloride might be superior to metoprolol and oral rehydration salts.

Objective To evaluate the effects of different reconstruction algorithms on image quality for Philips GEMINI PET/CT. Methods Jaszczak phantom were scanned on the GEMINI PET/CT system, and the raw data were reconstructed using filtered-back projection with Hanning filter (FBP-Hanning), filtered-back projection with Butterworth filter (FBP-Butterworth), ordered subset expectation maximization (OSEM), row-action maximum likelihood algorithm (RAMLA) and three-dimensional row-action maximum likelihood algorithm (3D-RAMLA), respectively. The resolution, uniformity, contrast of images and the time of different reconstruction algorithms were compared. Results The reconstruction time was 180 s, 130 s, 120 s, 85 s and 80 s for 3D-RAMLA, RAMLA, OSEM, FBP-Hanning and FBP-Butterworth respectively in phantom studies. The smallest rods with diameter of 4.8 mm of the phantom could be observed for FBP- Butterworth and 6.4 mm for other algorithms in case of high counts. The image contrast of 3D-RAMLA were better than that other algorithms, and the image uniformity of 3D-RAMLA and RAMLA were better than those of other algorithms. The resolution, uniformity and contrast of images with all algorithms decreasd in case of low counts, and the image quality of FBP-Butterworth was not good enough for clinical studies. Conclusion Image quality is variable with different reconstruction algorithms. For clinical PET imaging, it is necessary to choose proper algorithms.

Traditional Chinese medicine (TCM) has a long history in treating infectious diseases, and the form of intervention varies with different medical conditions and disease types. "The battle field of Chinese doctor for anti-epidemic" was formed in fighting against severe acute respiratory syndrome (SARS) epidemics in China, and from the battle, valuable experiences of using TCM for prevention and treatment had been obtained. During responding to coronavirus disease 2019 (COVID-19) epidemics, we followed the principle of keeping summary and perfection while treament. And a whole process of TCM pattern or a model was organized, including early prevention in communities, cluster intervention in isolated places, comprehensive intervention in mobile cabin hospitals, centralized treatment in designated hospitals and rehabilitation support in rehabilitation posts. Thus, the innovation of whole process of TCM intervention was involved in the "trench warfare" strategy and platform system for prevention and treatment of new infectious COVID-19 epidemics. At different stages or conditions, different TCMs were used to play advantageous roles to solve various problems and elevate the effects of prevention and treatment of the disease. The construction of TCM mobile cabin hospitals was an innovation of organization form that might offset the constraints in technology and scale of simple community isolation or simple hospital treatment, exploring a new way for TCM to cope with public health emergencies.

Objective To investigate the efficacy of SPECT/CT in detecting parathyroid lesions in chronic kidney disease (CKD) with secondary hyperparathyroidism (sHPT) patients.Methods Within 2 weeks before parathyroidectomy (PTX),52 patients of CKD with sHPT underwent 99Tcm-sestamibi (99Tcm-MIBI) dual-phase planar and delayed SPECT/CT scintigraphy.Taking surgical pathology as the golden standards,the sensitivity,specificity and accuracy of dual-phase planar,SPECT,CT and SPECT/CT were calculated and compared.Results Totally 172 lesions were detected in surgical operation,including 13 parathyroidomas (PM),26 adenomatoid hyperplasias (AH) and 133 diffuse parathyroid hyperplasias (PH).The sensitivity of 99Tcm-MIBI dual-phase planar,SPECT,CT and SPECT/CT was 55.81％ (96/172),70.35％ (121/172),79.65％ (137/172) and 81.40％ (140/172),respectively,while the specificity was 92.05％(81/88),90.91％ (80/88),76.14％ (67/88),93.18％ (82/88),the accuracy was 68.08％ (177/260),77.31％ (201/260),78.46％ (204/260) and 85.38％ (222/260),respectively.The sensitivity of SPECT/CT was superior to that of SPECT (x9 =17.053,P＜0.001) and 99Tcm-MIBI dual-phase planar (x2 =44.000,P＜0.001).SPECT/CT was superior to CT (x2 =10.316,P =0.001) for specificity,and superior to CT (x2 =13.136,P＜0.001),SPECT (x2 =14.815,P＜0.001) or 99Tcm-MIBI dual-phase planar (x2=39.706,P＜0.001) for accuracy.Conclusion SPECT/CT fusion imaging is better in localization of parathyroid lesions of CKD with sHPT patients than 99Tcm-MIBI dual-phase planar,SPECT or CT imaging alone.

Objective: Randomized controlled trials (RCTs) of Chinese patent medicines and classic traditional Chinese medicine prescriptions were systematically reviewed from both Chinese and English journals published in 2023. A preliminary summary and evaluation were conducted on the generation and translation of clinical evidence for these treatments. This analysis aims to inform future research on clinical efficacy evaluation and guide the rational application of evidence. Methods: RCTs of Chinese patent medicines and classic traditional Chinese prescriptions published in 2023 were comprehensively retrieved from the Artificial Intelligence Clinical Evidence Database for Chinese Patent Medicine (AICED-CPM), with supplementary searches conducted in China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (SinoMed), Cochrane Library, PubMed, Embase, and Web of Science. The study characteristics and methodological quality of these RCTs were systematically analyzed and evaluated. Results: A total of 1 443 RCTs of Chinese patent medicines were included, comprising 1 399 Chinese articles and 44 English articles. Additionally, 334 RCTs of classic traditional Chinese medicine prescriptions were found, with 331 published in Chinese and 3 in English. 196 567 participants were included, covering 585 types of Chinese patent medicines (487 oral, 61 injectable, and 37 topical) and 179 classic traditional Chinese medicine prescriptions. The involved studies encompassed 22 types of diseases, with research primarily focusing on diseases of the circulatory system, the respiratory system, and the genitourinary system. The sample sizes ranged from 18 to 3 777 participants, and most studies were conducted at a single center. Methodologically, the implementation of allocation concealment and blinding remained insufficiently emphasized. Conclusion Overall, compared with 2022, both the number of RCT publications and their methodological quality have improved in 2023, with heightened attention to research on diseases of the genitourinary system. However, quality control and standardized management in the design and implementation processes still require enhancement to produce more high-quality clinical evidence and accelerate the translation and application of this evidence.

Objective:To investigate the curative effects of the superficial peroneal artery perforator flap carrying two and more homologous perforators in repairing hand and foot wounds.Methods:A retrospective observational study was conducted. From January to September 2021, 23 patients with hand and foot wounds combined with bone or tendon exposure who met the inclusion criteria were admitted to Suzhou Ruihua Orthopaedic Hospital, including 16 males and 7 females, aged 23 to 68 years. After expansion of the wound, the wound area was 3.0 cm×2.0 cm to 11.0 cm×4.0 cm. All the wounds were repaired with the superficial peroneal artery perforator flap carrying two and more homologous perforators. The area of the resected flap was 4.0 cm×2.0 cm to 12.0 cm×5.0 cm. All the wounds in donor areas were sutured directly. During the operation, the resection of the flap, the number and caliber of carried perforators, the caliber of superficial peroneal artery, the length of vascular pedicle, and the number of accompanying veins of the superficial peroneal artery were recorded. The survival of the flap, the occurrence of complications, and the wound healing in the donor area were observed after operation. The recovery of the donor and recipient areas was followed up. At the last follow-up, the comprehensive evaluation scale was used to evaluate the curative effect of flap repair, and the sensory grading scale was used to evaluate the sensory function of the recipient area.Results:Totally 24 flaps were successfully resected in surgical operations, carrying 56 superficial peroneal artery perforators in total, with the caliber of perforators of 0.20-0.70 mm. The calibers of all perforators carried by 7 flaps were smaller than 0.40 mm. Nineteen flaps carried 2 perforators each, 3 flaps carried 3 perforators each, 1 flap carried 4 perforators, and 1 flap carried 5 perforators. During the operation, the superficial peroneal artery was resected with a caliber of 0.40-1.50 mm, the vascular pedicle was 2-6 cm in length, and each superficial peroneal artery had two accompanying veins. After operation, all the flaps survived smoothly, no vascular crisis or distal necrosis occurred, and the wounds healed well in the donor area. During the follow-up of 6 to 10 months after operation, the color, texture, and elasticity of the recipient area were good. Among them, 6 recipient areas were thinned and reshaped because of bloating. There was only linear scar and no obvious scar hyperplasia or pigmentation in the donor area, without significant change in sensory or motor function. At the last follow-up, the curative effect evaluation of flap repair was excellent in 22 flaps and good in 2 flaps, and the sensory function evaluation of the recipient area was grade S 3 in 1 area and grade S 2 in 23 areas. Conclusions:The superficial peroneal artery perforator flap with two and more homologous perforators has sufficient and reliable blood supply and is effective in repairing hand and foot wounds. It provides an ideal solution for the clinical problem in which the original operation scheme is abandoned due to the existence of only multiple slender perforators of caliber smaller than 0.40 mm, and only a single perforator in the operative field that cannot satisfy the needs of the flap blood supply and recipient area.

Objective:To summarize the morphological characteristics of the transverse branch of lateral femoral circumflex artery (LFCA) using digital subtraction angiography (DSA) and explore its clinical significance.Methods:A retrospective observational study was conducted. From October 2020 to May 2021, 62 patients with soft tissue injuries in the extremities were hospitalized in Suzhou Ruihua Orthopedic Hospital, including 40 males and 22 females, aged from 20 to 72 years. DSA was performed in the lateral femoral region of patients before the anterolateral thigh flap transplantation, and in combination with imaging scale to observe and measure the general condition of the blood vessels and the occurrence (with the occurrence rate being calculated), source artery, location of the origin point, direction of course, and the location of the perforating point of the cutaneous perforator of the transverse branch of LFCA, and in addition to classify the morphological characteristics of the transverse branch.Results:DSA detection showed that the femoral artery, the deep femoral artery, and the branches of LFCA were clearly distinguishable in 62 patients. Transverse branches of LFCA were observed in 59 patients, including 52 cases with a single transverse branch, and 7 cases with double transverse branches. The occurrence rate of transverse branches was 95.2% (59/62). A total of 66 transverse branches of LFCA were observed, of which 3 originated from the deep femoral artery, and 63 originated from the LFCA. The origin point of the transverse branch was 6.5-12.7 cm away from the anterior superior iliac spine. The transverse branch which was approximately perpendicular to the long axis of the body, originated outwards, ran between the ascending branch of LFCA and the oblique branch of LFCA, and branched along the way, with the trunk running under the greater trochanter. The perforating point of the cutaneous perforator of the transverse branch was 8.0-18.0 cm away from the anterior superior iliac spine. In the classification of morphological characteristics of the transverse branch of LFCA, the most common type was the one that originated from the same trunk with other branches of LFCA, accounting for 50.0% (31/62), followed by the one that originated from the singular trunk of LFCA (12 cases) or deep femoral artery (3 cases), accounting for 24.2% (15/62); the special type accounted for 21.0% (13/62), including 7 cases of double transverse branches and 6 cases of the transverse branch originated from the same trunk with multiple other branches of LFCA; those with small/absent transverse branch only accounted for 4.8% (3/62). Among the above-mentioned common trunk relationship of two branches, those with shared trunk of ascending and transverse branches were most frequently observed, accounting for 77.4% (24/31); those with shared trunks of the transverse and oblique branches (5 cases) and the transverse and descending branches (2 cases) accounted for 22.6% (7/31) altogether.Conclusions:A high incidence rate of the transverse branch of LFCA is observed through DSA. The transverse branch originates from the lateral femoral artery approximately perpendicular to the long axis of the body, mainly from the same trunk with another main branch of LFCA, especially the ascending branch. This positioning analysis can provide an important reference for the design and resection of anterolateral femoral flaps.

Objective:To investigate the therapeutic efficacy of bilobated superficial peroneal artery perforator flap in repairing two adjacent wounds of the fingers.Methods:A retrospective observational study was conducted. From January 2021 to January 2022, 15 patients with two adjacent wounds of the fingers who met the inclusion criteria were hospitalized in Suzhou Ruihua Orthopaedic Hospital, including 10 males and 5 females, aged 25 to 51 years. The area of single wound after debridement was from 2.5 cm×2.0 cm to 7.5 cm×2.5 cm. All the wounds were repaired by the bilobated superficial peroneal artery perforator flap from the lower leg. The single lobe area of bilobated flap was from 3.0 cm×2.0 cm to 8.0 cm×3.0 cm. The wounds in all the donor sites were sutured directly. During the operation, the number of resected flaps, the number and type of carried perforators were recorded, and the calibers of perforator and superficial peroneal artery and the length of vascular pedicle were measured. The survival of flap and the wound healing in the donor and recipient sites were recorded after operation. The recovery of donor and recipient sites were recorded during follow-up. At the last follow-up, the repair effect of flap was evaluated by the comprehensive evaluation scale, and the sensory function of flap was evaluated by the sensory function evaluation standard of British Medical Research Association.Results:During the operation, 15 bilobated flaps were successfully resected, carrying 36 superficial peroneal artery perforators, all of which were septocutaneous perforators with the caliber of 0.2-0.8 mm. The caliber of superficial peroneal artery was 0.4-1.1 mm and the length of vascular pedicle was 3-8 cm. After operation, all the flaps survived with no vascular crisis occurred, and the wounds in donor and recipient sites healed well. During the follow-up of 6 to 12 months, the color and texture of flaps were similar to those of normal tissue in the hand and the appearance of flap was good in 10 cases; the other 5 cases underwent the stage Ⅱ flap thinning and plastic surgery 6 months after operation due to the bloated appearance of flaps. There was only linear scar in the donor site of lower leg, with no obvious scar hyperplasia or pigmentation, and there was no obvious adverse effect on the sensation or motor function of the distal limbs in the donor area. At the last follow-up, the repair effect of flap of 15 patients was excellent in 11 cases and good in 4 cases, and the sensory function of the flap was evaluated as grade S 2 in all cases. Conclusions:The bilobated superficial peroneal artery perforator flap has high proportion of septocutaneous perforator, and the blood supply is sufficient and reliable. Using this flap to repair two adjacent wounds of the fingers causes minimal damage to the donor area, only one group of blood vessels is needed to be anastomosed to repair two wounds, the difficulty of microoperation is reduced, and good flap repair effect and sensory function can be obtained.