Objective To investigate the expression of phosphorylated mammalian target of rapamycin (p-mTOR) and phosphorylated eukaryotic translation initiation factor 4E binding protein 1 (p-4EBP1) in pathologic scar,and comprehend its role and significance in the pathologic scar formation.Methods SP immunohistochemical method was used to detect the expression of p-mTOR and p-4EBP1 in 20 cases of keloid,20 cases of hypertrophic scar,20 cases of non-pathologic scar and 20 cases of normal skin tissue.The positive rates of expression in different tissues were analyzed,and the relationship in pathological scar was explored.Results The positive rates of p-mTOR and p-4EBP1 in keloidand hypertrophic scar were 75.0％ (15/20),60.0％ (12/20) and 60.0％ (12/20),50.0％ (10/20),nom-pathologic scars were 20％ (4/20),10％ (2/20);normal skin tissue were 10％ (2/20),5％ (1/20),which were higher respectively compared with the two control groups (P＜ 0.05);there was a highly positive correlation between p-mTOR and p-4EBP1 expression in pathologic scar (r=0.323,P＜0.05).Conclusions p-mTOR and p-4EBP1 might be involved and cooperated in promoting the progress of pathologic scars.

Surgery management is key to surgical quality control. The authors presented the IT system design for surgery anesthesia of the children′s hospital of Fudan University, featuring all-process information support by means of IT development and process reengineering. Such a process comprises perioperative patient handover, medication, surgical safety check, and intraoperative care. This surgery anesthesia system development has interconnected hospital information systems within and beyond operation rooms in terms of informationization. It proves that the system can effectively enhance safety and convenience of surgery related works and supervision, reducing error exposure of surgical operations and ensuring patient safety.

Objective:To summarize the experience on accurate prevention and control of children′s emergency department during the epidemic of novel coronavirus Omicron variant.Methods:We retrospectively analyzed the strategies and management experience of emergency prevention and control of novel coronavirus infection in emergency department at Children′s Hospital of Fudan University from March to May 2022.Results:As a designated hospital for treating pediatric patients who contracted novel coronavirus in Shanghai, the emergency department in our hospital was confronted with the dual pressure of critical patients treatment and pandemic prevention and control.We carefully studied a series of laws and regulations, as well as the newest edition of Chinese clinical guidance for novel coronavirus pneumonia diagnosis and treatment, and combined with the characteristics of novel coronavirus infection in children, then formulated the independent emergency department, fever clinics and novel coronavirus clinics; Updated the emergency department pre-examination triage process, the precautions pratice of clinical stuffs and disfection strategy, and established the second emergency department.From the beginning of March to the end of May 2022, a total of about 12 000 patients were admitted to the emergency department in our hospital, including 704 patients in the resuscitation room, 652 patients in the observation room, and 164 patients in the emergency ward.There were six patients with novel coronavirus infection in the emergency department.Neither nosocomial infection nor occupational exposure occurred.Conclusion:After 3 months of practice, the results showed that it can fully guarantee the timely treatment of critically ill children and achieved zero cross-infection in the hospital, which has important reference significance for the treatment of children, epidemic prevention, control during the novel coronavirus epidemic.

Objective To investigate the epidemiological information of patients in pre-hospital medical care for our large and medium-sized cities and probe the patients' characteristic. Method The data in 2008 were exported from the computer databases of 8 large and medium-sized cities' emergency medical centers in our country.The thorough records of data were conducted to statistical analysis. Results ( 1 ) The scheduling time, running time, rescue time, returning time, total time and service radius in the pre-hospital medical care group were 2.16± 1.10(min), 14.01 ±6.82(min), 12.12±5.96(min), 14.08± 6.85(min), 42.34± 20.21(min)and 8.50±4.18(km), and the above parameter in the non-death group were 2.19 ± 1.13(min), 14.15 ± 7.14(min),11.60±6.72(min), 14.92 ±6.89(min), 41.86± 19.53(minutes) and 8.63±4.31(Km), and the above parameter in the death group were 2.10± 1.08(min), 13.68 ± 7.14(min), 25.25 ± 12.34(min), 13.75±6.48(min), 54.74 ± 25.47(min) and 7.86± 3.91(Km), and the above parameter in the non-sudden cardiac death group were2.09± 1.03(min), 13.58±6.78(min), 25.53± 12.34(min), 13.60± 6.54(min), 53.79±23.77(min) and 7.67 ± 3.86(Km), and the above parameter in the sudden cardiac death group were 2.12 ±1.02(min), 14.10±7.05(min), 24.79± 12.08(min), 13.79±6.61(min), 54. 80 ± 25. 36( min) and 7.90±3.92(Km) respectively. The scheduling time, running time, returning time and service radius in the death group were less than those of the non-death group, but the rescue time and total time of the former were more than those of the latter respectively ( P ＜ 0.05 or P ＜ 0. 001 ). The scheduling time and returning time didn' t have significant difference between the sudden cardiac death group and the non-sudden cardiac death group respectively ( P ＞ 0.05), but the running time, total time and service radius of the sudden cardiac death group were more than those of the non-sudden cardiac death group, and the rescue time of the former was less than that of the latter respectively ( P ＜ 0.05 or P ＜ 0.001 ). (2)The patients' amount in pre-hospital medical care group, the non-death group, the death group, the non-sudden cardiac death group and the sudden cardiac death group were at most in first quarter, and the least time slice of patients' amount were 4:00～ 6:00, 4:00～6:00, 4:00～ 6:00, 22:00～ 24:00, 2:00～4:00 respectively, and the most time slice of patients' amount were 20:00～ 22:00, 20:00～22:00, 8:00～ 10:00, 2:00 ～ 4:00, 8:00 ～ 10:00 respectively. (3)In 241 876 cases of pre-hospital medical care group, the patients' amount of trauma was at most, whose age grades was by far among21 ～50, and the others in sequence were nervous system, circulatory system, other group, digestive system, respiratory system and poisoning group respectively, whose age grades in nervous system, circulatory system and respiratory system was by far above 51, especially above 70. The patients' age grades in other group and digestive system had two climax age groups, which the one was 21 ～ 30, and the other was above 70. The patients' age grades in poisoning group was by far among 21 ～ 50, which the patients' amount of acute alcoholism was at the most. (4) In 12 568 cases of death group, the death amount of circulatory system, other group, respiratory system, nervous system and digestive system ranked at the lst,2nd,4th,5th 8th respectively, whose age grades was by far above 51, especially above 70,and the patients' amount of sudden cardiac death was at the most in the death amount of circulatory system. The death amount of trauma and poisoning group ranked at the 3rd, 6th respectively, whose age grades was by far among 21 ～ 50. (5)The total amount, the death amount and the sudden cardiac death amount of male patients were more than those of female patients. (6)The percentage of the death group to the pre-hospital medical care group was 5.20%, and the percentage of the sudden cardiac death group to the pre-hospital medical care group was 1.29%,and the percentage of the sudden cardiac death group to the death group was 24.87 %, and the percentage of the sudden cardiac death group to the circulatory system group was 67.33 %. Conclusions ( 1 )The trauma and the sudden cardiac death are the overriding reason of disease and the overriding reason of death in our large and medium-sized cities respectively. (2) It is very important to cut the death rate of the middle-old age patients by strengthening prevention and cure of cardiovascular and cerebrovascular diseases, discerning the critical illness early and improving the level of pre-hospital medical care. (3)It is a strong method to decrease the total amount and the death amount of the trauma, especially in traffic accident, by strengthening safety in production, observing traffic regulation and enhancing the legal awareness.

Objective:To summarize the experience of the precise prevention and control strategy of novel coronavirus infection in the pediatric intensive care unit(PICU)during the epidemic of the Omicron variant.Methods:A retrospective analysis was performed on the strategies and management experience of precise prevention and control of novel coronavirus infection in PICU at Pediatric Hospital of Fudan University from March 1 to May 10, 2022.Results:According to the national and Shanghai novel coronavirus infection prevention and control standards, the PICU in our hospital, in accordance with the specialty characteristics of PICU, cooperated with the hospital′s department of infection and medical department to jointly construct a precise ward management strategy for the outbreak of the omicron mutants infection.Precise prevention and control management strategies were formulated from four aspects: the admission process of critically ill children, the division of PICU ward areas and nosocomial infection protection, the reception management system for children′s family members, and the " bubble management" system for PICU staff, and run them for 3 months.During the epidemic, there was no nosocomial infection of novel coronavirus infection in children or medical staff.During the period, a total of 140 critically ill children were admitted, including 87 cases transferred from the general ward in the hospital, 48 cases from the emergency department(non-febrile, 3 cases transferred by the transfer team), four cases from fever clinic, and one case from control ward.Four of the critically ill children had no emergency nucleic acid test report when they were admitted to the PICU.Among the 140 critically ill children, 54 patients received mechanical ventilation, 18 patients received blood purification, and two patients were monitored after liver transplantation.Seventy-eight (55.7%) children had underlying diseases.Conclusion:During the current round of novel coronavirus epidemic in Shanghai, PICU in our hospital formulated the admission and ward management procedures for critically ill children, which ensured the prevention and control of nosocomial infection of novel coronavirus, and at the same time ensured the treatment of critically ill children to the greatest extent.

To explore the medication regularity of Tibetan medicine in the treatment of spleen and stomach diseases, analyze the potential drug targets and interactions of the prescriptions, and reveal the mechanism of Tibetan medicine in the treatment of spleen and stomach diseases. The prescriptions in Tibetan medicine for treatment of spleen and stomach diseases were collected, and Traditional Chinese Medicine Inheritance Support System (TCMISS) was used to analyze the association rules between the herbs and discover the core herbs and new prescriptions. The integrated pharmacology platform V1.0 software was used to construct "herb-compound-target" network and investigate the interactions between various herbs and related pathways of Tibetan medicine Wuwei Shiliu powder in the treatment of spleen and stomach diseases. Among the 216 prescriptions of Tibetan medicine in the treatment of spleen and stomach diseases, pomegranate seed was used at a highest frequency (118 times), followed by white cardamom (107 times) and comatose (107 times). 12 new prescriptions were evolved by using the association rules (support>=34%, confidence>=0.85). 5 242 related drug targets and 20 related pathways were obtained from classic formula Wuwei Shiliu Powder (FDR<0.01). It was proposed that Tibetan medicine treatment for spleen and stomach diseases was mainly based on proliferation of "stomach fire" and the main drugs were for regulating Qi-flowing for strengthening spleen. The mechanism may be associated with regulation of digestive juice secretion, proton pump, mitochondria, regulation of intestinal digestion and immunity, the body's immunity to microorganisms function and other multiple targets and pathways to achieve the joint intervention.

This research is launched to look for the medication rules and characteristics of Tibetan medicine in the treatment of gZav-Grib( apoplexy sequelae). HIS records of gZav-Grib patients were selected from the Tibetan Hospital of Tibet Autonomous Region and Tibetan Hospital of the city of Naqu. SPSS Modeler,Gephi and other data mining and visualization software were used to study the actual law of drug use in the treatment of gZav-Grib in Tibetan medicine. Finally,479 cases of gZav-Grib patients in Tibetan medicine were included. Their average age is 63 and average hospital stay was 32 days. In total,82 Tibetan medicine prescriptions were used for treating gZav-Grib. The frequency in the front is Twenty-flavor Chenxiang Pills( 338 times),Ruyi Zhenbao Pills( 322 times),and Seventy-flavor Zhenzhu Pills( 315 times). According to the regularity of Tebitan medicine,they were applied in different time periods including the early morning,morning,noon,and evening,for example,in the early morning: Seventy-flavor Zhenzhu Pills,morning: Ruyi Zhenbao Pills,noon: Eighteen-flavor Dujuan Pills,evening: Twenty-flavor Chenxiang Pills. In the clinical joint,18 groups were found in the 10% support and 70% confidence. There are two prescriptions confidence more than 80% which nature focus on Gan,Ruan,Xi,Liang,Dun,Han,Wen. gZav-Grib of Tibetan medicine can be divided into two types: r Lung-Grib type and k Hrag-Grib type,in which the medicine of r Lung-Grib type takes Seventy-flavor Zhenzhu Pills as the core prescription,while the medicine of k Hrag-Grib type takes Ruyi Zhenbao Pills as the core prescription. It is found that the treatment of gZav-Grib by Tibetan medicine is mainly dominated by the treatment idea about " Therapeutic r Lung and blood,Consideration of venous diseases". Treatment functions is promoting the circulation of Qi,clearing blood heat and getting rid of bad blood,achieving the purpose of treating both principal secondary aspect of gZav-Grib. The research methods based on the HIS can't only optimize the Tibetan treating gZav-Grib sequela treatment plan and rule of medication,but also provide the scientific basis for Tibetan medicine treat gZav-Grib.
Data Mining ; Humans ; Medical Records ; Medicine, Tibetan Traditional ; Software ; Stroke ; complications ; drug therapy ; Tibet

“Ro Nus ZhurJes” theory is the core content of Tibetan medicine property theory, and also the core compatibility law of Tibetan medicine. It takes six tastes of medicine as the surface medicinal property, three tastes after digestion by "three gastropyretie" as the inner medicinal property, eight properties and seventeen effects as the deep medicinal property, and its essential property is the special medicinal property, forming a multi-level medicinal property theory, but its internal structure still needs to be unified and sorted out, clinical practicability needs to be further improved. In this paper, literature mining, Tibetan medicine theory, vector structural model, K-means clustering analysis, Gephi 0.9.2 visualization and other methods were used to sort out the theory of Tibetan medicinal properties. It was found that the inherent structure of Tibetan medicine properties had the multi-dimensional structural characteristics of "seven medicinal properties+three characteristics", and that the same medicinal properties would overlap, while the opposite medicinal properties would offset and could be expressed by vectors. Therefore, the vector structural model of "Ro Nus ZhurJes" of Tibetan medicine was proposed in this paper. Taking twenty-five-flavor Yuganzi powder(skyu-ru-nyer-lnga) and 92 commonly used Tibetan medicine prescriptions as examples, the rates of single prescription with seventeen effects and multiple prescriptions acting on three factors were analyzed. The model analysis results were highly consistent with the clinical efficacy, and the main diseases were the same, which showed that this model had a high degree of fitting and interpretation. It could effectively and intuitively quantify the properties of Tibetan medicine prescriptions and uncover the complex hidden knowledge of Tibetan medicine theory. In the future, the vector structural model of "Ro Nus ZhurJes" will be applied to analyze the classical prescriptions of Tibetan medicine, and the fitting evaluation and modification optimization will be carried out continuously in order to improve the practicability of theory of Tibetan medicine property in the big data environment and provide methodological reference for the quantification of medicinal property of Tibetan medicine prescriptions.

This study aimed to explore the rule of Tibetan medicine in clinical treatment of hypertension( k Hrag-rLung-stod-vtshangs) and analyze the characteristics of its prescriptions. One hundred and thirty-seven cases of hypertension treated Tibetan medicine were collected. Data mining,Gephi,Cytoscape and other methods and software were used to analyze the characteristics of Tibetan medicine. The results showed that there were 44 cases of r Lung-type hypertension in clinical medical records,while 57 cases of k Hrag-type hypertension. There were 103 treatment prescriptions. The frequency of these prescriptions covered Twenty-five Yuganzi Pills( 96 times),Seventy Pearl Pills( 80 times),Eight Chenxiang Pills( 75 times),and Sanwei Ganlu Powder( 62 times),and they were highly correlated,with confidence greater than 95%. There were 332 prescriptions involved in the prescriptions which is core prescription medicines. This study first proposed the dosage analysis method of Tibetan medicine prescription medicines,and obtained the more dosage of Chebulae Fructus,Phyllanthi Fructus,Aucklandiae Radix,Aquilariae Lignum Resinatum and so on. The correlation analysis of the prescription medicines found that Carthami Flos,Myristicae Semen,Bambusae Concretio Silicea,Caryophylli Flos,Amomi Fructus Rotundus led by Tsaoko Fructus had a high correlation and a confidence greater than 75%. These herbs were guaranteed when Tibetan medicine was used in combination. The key drugs for protecting viscera and regulating the three gastric fires. The prescription is mainly cold,blunt,sparse and rough. Its efficacy focuses on the pathogenesis of blood fever,blood stickiness and venous blockage caused by heat,sharpness,odor and stickiness. It mainly treats Tibetan medicine diseases such as k Hrag-r Lung-stod-vtshangs and k Hrag-vpel( polyemia). It is suggested that Tibetan medicine has a three-in-one invisible treatment principle of " clearing blood-heat,opening vessel and regulating stomach-fire" in the treatment of hypertension,which attributed to both cardiovascular function and gastrointestinal metabolic function. This may be a significant and invisible knowledge of Tibetan medicine in the treatment of hypertension.
Data Mining ; Humans ; Hypertension ; drug therapy ; Medical Records ; Medicine, Tibetan Traditional ; Software

Objective: The Four Medical Tantras is a classic work of Tibetan medicine, in which drug treatment is one of the four main treatment methods, and prescriptions are the main form of clinical drug use. The study on the medication rules of The Four Medical Tantras has positive significance for the clinical medication research of Tibetan medicine. Method: Prescriptions recorded in Secret Medical Code and Follow-up Medical Code from The Four Medical Tantras were collected, the prescription database was constructed by Visual FoxPro 9.0, combined the dual perspectives of the " fifteen categories" (skabs bco lnga) of Tibetan medical diseases and the " eighteen practices" (lag len bco brgyad) of treatment, and Gephi 0.9.2 complex network was used to analyze its medication rules. Result: The Four Medical Tantras contained 2 695 Tibetan medicine prescriptions, average number of drugs in each prescription was 6.6, prescription composed of ≤ 7 drugs accounted for 69.2%of the total prescription. There were 1 002 kinds of medicines involved in the total prescription, of which 156 was the nodal degrees of Chebulae Fructus, Bambusae Concretio Silicea, Carthami Flos, Piperis Longi Fructus and Zingiberis Rhizoma and so on; followed by 91 nodal degrees of butter (mar), sugar, barley sweetener (sbang ma), honey and brown sugar and so on, which were Tibetan medicinal and edible medicines. According to the classification of diseases in the fifteen categories, there were 495 prescriptions for traumatology (mtshon rma), 323 for fever (tsha ba), 278 for toxics and 197 for three factors diseases. According to the treatment method of eighteen practices, 162 powder, 77 decoction, 84 laxative (bxhal) and others were used. Association rule analysis found that edge weights of Borneolum Syntheticum, Bambusae Concretio Silicea, Carthami Flos, Santali Albi Lignum and other cold medicines were 59, edge weights of pomegranate seeds, Piperis Longi Fructus, Cinnamomi Cortex, Amomi Fructus Rotundus and other warm medicines were 45. Conclusion: The Four Medical Tantras has some characteristics, including the medication rules of elliptic philosophy with cool-warm medicinal properties as the dual core, elimination-diarrhea (zhi-sbyong) as medication methods, weight of rlung-mkhris pa-bad kan as medication dialectical thinking and so on. Among them, the clinical application of butter, barley sweetener, sugar and other special delivery agents of Tibetan medicine is prominent. The prominent clinical application of special Tibetan medicines embodies the philosophy of Tibetan culture with the emphasis on overall balance. It has the multi-dimensional medication rule of " diet plus medicine, medicine plus therapy", and has positive significance for revealing the research on medication rules of Tibetan medicine.