Objective To observe the effects of Qingre Paidu Capsule on NF-κB and IL-1βin acute gouty arthritis model rats induced by monosodium urate crystals (MSU);To explore its preventive and therapeutic mechanism for acute gouty arthritis. Methods Sixty SD rats were randomly divided into normal group, model group, diclofenac sodium group, and Qingre Paidu Capsule high, medium and low dose groups. Rats in different treatment groups were given corresponding medicines by gavage for 7 days. On the fifth day, after 1 hour of gastric perfusion, acute gouty arthritis rat model was established by MSU injection in ankle joint cavity. All rats were sacrificed and materials were taken 48 h after the model was established. The morphological changes in the synovial tissue of ankle joint were observed by light microscope. The expression levels of NF-κB and IL-1β in the articular leachate were monitored by ELISA. Results The expression levels of NF-κB and IL-1βin the articular leachate of Qingre Paidu Capsule each dose group and diclofenac sodium group were obviously lower than the model group (P<0.05, P<0.01). Histopathologic examination revealed that Qingre Paidu Capsule could abate tissue swelling of ankle joints, reduce inflammatory cell infiltration of synovial tissues and improve the pathologic changes of the hyperplasia of synovium and so on. Conclusion Qingre Paidu Capsule play the anti-inflammatory role by inhibiting the expressions of NF-κB and IL-1βin articular tissue of rats.

OBJECTIVE:To revise the accreditation standards of the national clinical pharmacy key specialty,promote the nor-malization and standardization of clinical pharmacy services and improve the service level of clinical pharmacy in our country. METHODS:Based on JCI international hospital accreditation ideas,suggestions for Clinical Pharmacy State Clinical Key Program Construction Score Standard for trial implementation (900 points) published by former Ministry of Health in 2012,were put for-ward. RESULTS & CONCLUSIONS:For the problems that there were lack of pharmacy service institutional management,process control and quality management standards,some classification programs were not clear,and did not fully reflect the clinical phar-macy service quality and work effect evaluation requirements,corresponding revisions were proposed in terms of basic conditions, information management,clinical pharmacy work management system,etc. The revised standard pays more attention and refines the quality system construction in system,standard,process,quality control,effect evaluation,which can promote the enhance-ment of our clinical pharmacy service levels,normalization and standardization of clinical pharmacy services.

Objective To investigate clinical effect of combined laparoscopic and endoscopic submucosal resection for the gastric antrum-body tumors originated from the muscularis propria.Methods A total of 8 patients with gastric antrum-body tumors originated from the muscularis propria were treated by combined laparoscopic and endoscopic submucosal resection from Jan 2013 to Apr 2014.All patients were diagnosed as having gastric antrum-body tumors originated from the muscularis propria by preoperative endoscopic ultrasonography.Endoscopy showed that the surface mucosa of tumors were normal in all patients.Tumors were found in the gastric antrum-body front wall in 4 cases,and in the back wall in 2 cases,and in the lesser omental bursa in 1 case,and in the greater omental bursa in 1 case.The tumors size was from 1.5 to 3.5 cm,averaging (2.4 ± 0.7) cm.The therapeutic procedure included three phases.The lesion was first exposed with laparoscopy.Then,the fluid was injected into the submucosa in the part of tumor by endoscopy.Finally the tumor was resected by laparoscopy.These patients were followed up and analyzed retrospectively.Results Combined laparoscopic and endoscopic submucosal resection was successfully performed in all patients.All tumors were resected completely.Sever bleeding,infection or death were not found in any patients.Postoperative pathology and immunohistochemistry staining confirmed 6 stromal tumors and 2 neurofibroma.All patients were followed up for 6 months,and there was no recurrent case.Gastric mucosa and function were normal in all patients.Conclusion Combined laparoscopic and endoscopic submucosal resection is a simple,safe and effective method for gastric antrum-body tumors originated from the muscularis propria,and leads to little complication.

BACKGROUND:Numerous studies have demonstrated that estrogen can regulate the proliferation and migration of endothelial progenitor cel s (EPCs), while EPCs can also promote the function and activity of bone marrow mesenchymal stem cel s (BMSCs) in vitro. OBJECTIVE:To evaluate the ability of the BMSCs and EPCs which construct the composite cel sheet in the repair of alveolar bone defect in ovariectomized rats. METHODS:BMSCs/EPCs composite sheet, EPCs sheet and BMSCs sheet were respectively implanted into the defects of the alveolar bone in ovariectomized rats. Rats with no implantation served as control group. Repaired alveolar bone was assessed by gross examination, histological observation and micro-CT scan at 2, 4, 8 weeks after operation. RESULTS AND CONCLUSION:BMSCs/EPCs composite sheet has greater osteogensis activity and bone repair capacity than BMSCs or EPCs sheet alone.

Objective: To study the effects of estrogen on the degenerative changes of condylar cartilage and subchondral bone in rats. Methods: 18 female SD rats aged 6 weeks were divided into control(C),unilateral anterior cross-bite(UAC) and UAC treated with estrogen(UAC + E) groups(n = 6). UAC metal prosthesis was cemented to the left incisors of maxilla and mandible of the rats in group UAC and UAC + E. Rats in UAC + E group were given pexitoneal injection of 80 μg 17β-estradiol per day. The rats in group C were untreated. Animal were sacrificed at the 4th weeks. The micro-structure of subchondral bone was observed by Micro-CT scanning. HE staining,Safranin O staining,immunohistochemical staining,TUNEL staining and TRAP staining for the observation of pathological changes of histomorphology,extracellular matrix,chondrocyte apoptosis in condylar cartilage,and osteoclasts number in subchondral bone. Results: UAC and UAC + E group showed evident osteoarthritis(OA)-like lesions. Compare with UAC group,there was a significant decrease in the expression of proteoglycan(P ＜ 0. 05),type Ⅱ collagen(P ＜ 0. 01),and a significant increase in the number of apoptotic chondrocytes(P ＜ 0. 01) in UAC + E group. As for subchondral bone,the BV/TV,Tb. Th parameters in C and UAC + E groups were significant higher than in UAC group(P ＜ 0. 01),while the BS /BV,Tb. N,Tb. Sp parameters and the osteoclasts number in C and UAC + E groups were significant fewer than in UAC groups(P ＜ 0. 01). There was no significant difference in bone ultra-parameters and osteoclasts number between C and UAC + E groups(P＞ 0. 05). Conclusion: In the model of rat TMJOA induced by unilateral anterior crossbite prosthesis,supra-physiological level of estrogen can reverse bone loss in subchondral bone,but accelerate the degradation of condylar cartilage.

Objective The incidence of coronary microvascular disease(CMVD)is increasing annually.According to traditional Chinese medicine(TCM),CMVD belongs to the category of"collaterals",and qi deficiency and blood stasis are the main syndrome type of CMVD.Notably however,no studies have reported on the use of animal models of CMVD with qi deficiency and blood stasis.The current study therefore aimed to establish and evaluate a rat model of CMVD with qi deficiency and blood stasis syndrome.Methods Forty-five male SD rats were divided randomly into sham group,CMVD group,and CMVD + QXXY group(n = 15 rats per group).Rats in the CMVD + QXXY group were randomly deprived of sleep for 14～16 h/day for 6 weeks,and the model of qi deficiency syndrome was established.Animals in the sham group and the CMVD group were fed normally for 6 weeks.After 6 weeks,rats in the CMVD and CMVD + QXXY groups were anesthetized,their chests were opened,and embolic microspheres(40～120 μm)were injected into the left ventricle.Rats in the sham group underwent thoracotomy without injection of embolic microspheres.On day 7 after operation,relevant detection indicators were measured in each group.Results Compared with the sham group,the CMVD group showed a significant decrease in left ventricular ejection fraction and left ventricular shortening rate,while the activities of creatine kinase MB isoenzyme(CK-MB)and lactate dehydrogenase(LDH)were significantly increased.Heart function,hemorheology,myocardial enzyme index,and the degree of myocardial cell damage differed significantly between the CMVD + QXXY group compared with the sham group.Conclusions A rat model of CMVD + qi deficiency + blood stasis syndrome can be successfully established by sleep deprivation combined with intraventricular injection of embolic microspheres.This model will be suitable for the study of the pathogenesis of CMVD and the mechanisms of TCM.

Objective    To investigate effectiveness and safety of transcatheter aortic valve replacement in the treatment of aortic regurgitation. Methods     PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, Wanfang Data and VIP were searched from inception to August 2021. According to the criteria of inclusion and exclusion, two reviewers independently screened the literature, extracted the data and evaluated the quality of the included studies. Then, Stata 16.0 software was used for meta-analysis. Subgroup meta-analysis of valve type used and study type was performed. Results    Twenty-five studies (12 cohort studies and 13 single-arm studies) were included with 4 370 patients. Meta-analysis results showed that an incidence of device success was 87% (95%CI 0.81-0.92). The success rate of the new generation valve subgroup was 93% (95%CI 0.89-0.96), and the early generation valve subgroup was 66% (95%CI 0.56-0.75). In addition, the 30-day all-cause mortality was 7% (95%CI 0.05-0.10), the 30-day cardiac mortality was 4% (95%CI 0.01-0.07), the incidence of pacemaker implantation was 10% (95%CI 0.08-0.13), and the incidence of conversion to thoraco-tomy was 2% (95%CI 0.01-0.04). The incidence of moderate or higher paravalvular aortic regurgitation was 6% (95%CI  0.03-0.09). Conclusion     Transcatheter aortic valve replacement for aortic regurgitation is safe and yields good results, but some limitations can not be overcome. Therefore, multicenter randomized controlled trials are needed to confirm our results.

Coronary microcirculation disorder after myocardial ischemia reperfusion （MIR） is a prominent problem in the treatment of coronary heart disease. According to the physiological commonality between “collaterals-sweat pore qi and fluid” and coronary microcirculation， and the evolution of the course of MIR， it is believed that “heart collateral stasis obstruction， sweat pore constraint and block” is the cause of coronary microcirculation disorder. The evolution of the pathogenesis can be divided into three periods. During the myocardial ischemia period， the pathogenesis is heart collaterals obstruction and sweat pores empty， while during the ischemia reperfusion period， it is internal formulation of deficiency wind， spasms of collaterals or slight heart collaterals obstruction； in the coronary microcirculation disorder period， sweat pores constraint and block， constraint transforming into heat， qi and fluid failing to diffuse are the pathogenesis. The corresponding treatment principle is assisting dredge with supplementation， and supplementing deficiency to dispel stasis； treating wind and blood simultaneously， and extinguishing wind to arrest convulsion； clearing heat and cooling blood， and diffusing qi and unblocking qi and fluid. Moreover， it is recommended to treat the heart and lungs simultaneously， and regulate the heart and liver at the same time.

Tendon-bone healing is a complex biological process. Multiple signaling pathways are involved in tendon-bone healing， including transforming growth factor-β signaling pathway， bone morphogenetic protein signaling pathway， Wnt signaling pathway， fibroblast growth factor signaling pathway and nuclear transcription factor-κB signaling pathway. This paper summarizes the research status of traditional Chinese medicine regulating related signaling pathways to promote tendon-bone healing. It is found that a variety of traditional Chinese medicine monomers or herbal extracts （such as baicalein， icariin， total flavonoids of Drynaria fortunei， parthenolide， total saponins of Panax notoginseng， etc.） and traditional Chinese medicine compounds （such as Taohong siwu decoction， Liuwei dihuang pill， Xujin jiegu liquid， etc.） can promote bone formation， anti-inflammatory， anti-oxidation， by regulating the above signaling pathways， thereby effectively promoting tendon-bone healing.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.