Jiuwei Xifeng Granules have become a Chinese patent medicine in the market. Because the formula contains Os Draconis, a top-level protected fossil of ancient organisms, the formula was to be improved by replacing Os Draconis with Ostreae Concha. To evaluate whether the improved formula has the same effectiveness and safety as the original formula, a randomized, double-blind, parallel-controlled, equivalence clinical trial was conducted. This study enrolled 288 tic disorder(TD) of children and assigned them into two groups in 1∶1. The treatment group and control group took the modified formula and original formula, respectively. The treatment lasted for 6 weeks, and follow-up visits were conducted at weeks 2, 4, and 6. The primary efficacy endpoint was the difference in Yale global tic severity scale(YGTSS)-total tic severity(TTS) score from baseline after 6 weeks of treatment. The results showed that after 6 weeks of treatment, the declines in YGTSS-TSS score showed no statistically significant difference between the two groups. The difference in YGTSS-TSS score(treatment group-control group) and the 95%CI of the full analysis set(FAS) were-0.17[-1.42, 1.08] and those of per-protocol set(PPS) were 0.29[-0.97, 1.56], which were within the equivalence boundary [-3, 3]. The equivalence test was therefore concluded. The two groups showed no significant differences in the secondary efficacy endpoints of effective rate for TD, total score and factor scores of YGTSS, clinical global impressions-severity(CGI-S) score, traditional Chinese medicine(TCM) response rate, or symptom disappearance rate, and thus a complete evidence chain with the primary outcome was formed. A total of 6 adverse reactions were reported, including 4(2.82%) cases in the treatment group and 2(1.41%) cases in the control group, which showed no statistically significant difference between the two groups. No serious suspected unexpected adverse reactions were reported, and no laboratory test results indicated serious clinically significant abnormalities. The results support the replacement of Os Draconis by Ostreae Concha in the original formula, and the efficacy and safety of the modified formula are consistent with those of the original formula.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Double-Blind Method ; Drugs, Chinese Herbal/therapeutic use* ; Tic Disorders/drug therapy* ; Treatment Outcome

By employing the analytic hierarchy process(AHP), the CRITIC method(a weight determination method based on indicator correlations), and the AHP-CRITIC hybrid weighting method, the weight coefficients of evaluation indicators were determined, followed by a comprehensive score comparison. The grey correlation analysis was then performed to analyze the results calculated using the hybrid weighting method. Subsequently, a backpropagation-artificial neural network(BP-ANN) model was constructed to predict the extraction process parameters and optimize the extraction process for Shenxiong Huanglian Jiedu Granules(SHJG). In the extraction process, an L_9(3~4) orthogonal experiment was designed to optimize three factors at three levels, including extraction frequency, water addition amount, and extraction time. The evaluation indicators included geniposide, berberine, ginsenoside Rg_1 + Re, ginsenoside Rb_1, ferulic acid, and extract yield. Finally, the optimal extraction results obtained by the orthogonal experiment, grey correlation analysis, and BP-ANN method were compared, and validation experiments were conducted. The results showed that the optimal extraction process involved two rounds of aqueous extraction, each lasting one hour; the first extraction used ten times the amount of added water, while the second extraction used eight times the amount. In the validation experiments, the average content of each indicator component was higher than the average content obtained in the orthogonal experiment, with a higher comprehensive score. The optimized extraction process parameters were reliable and stable, making them suitable for subsequent preparation process research.
Drugs, Chinese Herbal/analysis* ; Neural Networks, Computer

A nodule in the right middle lobe of the lung was treated by a combination of cone-beam CT,three-dimensional registration for fusion imaging,and electromagnetic navigation bronchoscopy-guided thermal ablation.The procedure lasted for 90 min,with no significant bleeding observed under the bronchoscope.The total radiation dose during the operation was 384 mGy.The patient recovered well postoperatively,with only a small amount of blood in the sputum and no pneumothorax or other complications.A follow-up chest CT on the first day post operation showed that the ablation area completely covered the lesion,and the patient was discharged successfully.
Humans ; Bronchoscopy/methods* ; Catheter Ablation/methods* ; Cone-Beam Computed Tomography ; Electromagnetic Phenomena ; Imaging, Three-Dimensional ; Lung Neoplasms/diagnostic imaging* ; Tomography, X-Ray Computed

Objective:To explore the construction of abdominal aortocaval fistula (ACF) model in adenine-induced renal failure rats, and to provide a suitable animal model for subsequent mechanism and intervention researches.Methods:Adult female Sprague-Dawley rats (250-300 g) were fed with 0.75% adenine diet (renal failure group, n=60) and the same diet without adenine (control group, n=10) for 4 weeks, and the rats were randomly grouped by block randomization method with a ratio of 6∶1. Thirty rats in the renal failure group were randomly selected by block randomization method at a ratio of 1∶1 to undergo laparotomies to establish ACF models (renal failure+ACF group). The serum creatinine, blood urea nitrogen detection and Masson staining were used to evaluate the establishment of renal failure model. Small animal ultrasound imaging system was applied to verify the successful construction of the ACF model. After 6 weeks of ACF observation, blood samples were collected from the heart of rats, and ACF-vascular tissues were collected for pathological study (HE staining). Results:At 4 weeks of feeding, compared with the control group, serum creatinine [(63.8±23.5) μmol/L vs. (33.0±3.8) μmol/L, Z=3.651, P<0.001] and blood urea nitrogen [(13.1±6.9) mmol/L vs. (5.3±0.6) mmol/L, Z=3.254, P=0.001] in the renal failure group were both higher. Masson staining showed renal tubulointerstitial inflammatory cell infiltration, renal tubular epithelial cell atrophy, interstitial fibrosis and vascular injury. Five rats sacrificed after ACF surgeries, and the survival rate was 83.3%. Doppler ultrasound showed turbulent blood flow of arterial to venous shunt at the anastomosis of open ACF (23/25) in the renal failure+ACF group. HE staining showed typical eccentric neointimal hyperplasia in the outflow tract of ACF vein in the renal failure+ACF group. Conclusions:The adenine-induced ACF rat model is successfully constructed, and ACF shows typical eccentric neointimal hyperplasia. The ACF construction would provide a reliable animal model to study the mechanism and intervention of neointimal hyperplasia for autologous arteriovenous fistula.

Aim Based on the apoptotic pathway mediated by receptor interacting protein kinase(RIP)1-RIP3-mixed spectrum kinase domain like protein(MLKL), to explore the effects of naringenin on ovarian granulosa cell apoptosis in rats with polycystic ovary syndrome(PCOS). Methods SD rats were randomly assigned into normal control group, model group, naringenin group, RIP1 inhibitor(Nec-1)group, RIP1-RIP3-MLKL necrosis signal activator(Z-VAD-fmk)group, naringenin+Z-VAD-fmk group, 15 rats per group. ELISA method was performed to measure the levels of IL-1β and TNF-α in ovarian tissue. HE method was performed to observe the shape of the ovary. Granular cells were isolated from ovarian tissue, and flow cytometry was performed to measure apoptosis rate and necrosis rate. Immunohistochemistry was performed to measure the positive expression of p-RIP1 in ovarian tissue. Western blot was employed to detect the expression of RIP1-RIP3-MLKL pathway. Results RIP1 specific inhibitor Nec-1 and naringenin could block the phosphorylation and activation of RIP1, inhibit the RIP1-RIP3-MLKL signaling pathway, reduce the inflammation level in PCOS rats, and alleviate the necrosis and apoptosis of ovarian granulosa cells(P<0.05). Z-VAD-fmk could promote the activation of RIP1-RIP3-MLKL pathway, aggravate the apoptosis of ovarian granulosa cells, and partially weaken the anti-apoptosis effect of naringenin(P<0.05). Conclusions Naringenin may inhibit the apoptosis of ovarian granulosa cells in PCOS rats by blocking the activation of the necrotic apoptotic pathway mediated by RIP1-RIP3-MLKL.

ObjectiveBased on real-world clinical data of traditional Chinese medicine （TCM）， a Cox proportional hazards model was built to predict the risk factors of complications in patients with Corona Virus Disease 2019 （COVID-19） or influenza A/B， and the cumulative occurrence function graph was used to present the prediction output. MethodThe medical records of the patients with respiratory infectious diseases， including COVID-19 and influenza A/B， treated in the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from November 2022 to October 2023 were collected. The data from the electronic medical record system were integrated into a data warehouse. The information of the patients with respiratory diseases caused by influenza A and B viruses and SARS-CoV-2 from November 2022 to October 2023 was retrospectively collected. The information involved age， gender， disease course， past medical history， laboratory test results， tongue manifestation， pulse manifestation， TCM syndrome， and main therapeutic drugs. The outcome indicators of whether complications occurred were obtained by telephone follow-up and review of readmission records. The data was divided into a training set and a validation set in a ratio of 70% and 30%， respectively. In the training set， the Cox proportional hazards model was used to identify the key factors affecting patient complications. Then， the combination of variables was optimized by stepwise elimination method， and an efficient complication risk assessment model was constructed， which was visualized in the form of histogram. The C-index， receiver operating characteristic （ROC） curve， calibration error graph， and decision curve analysis were employed to comprehensively measure the prediction performance of the model. ResultThe history of chronic lung diseases ［hazard ratio （HR） 4.46， 95% confidence interval （95%CI） 1.79-11.12］， Qi deficiency （HR 5.74， 95%CI 2.14-15.39）， thready and weak pulse （HR 4.45， 95%CI 1.88-10.50）， hormone use history （HR 4.57， 95%CI 2.04-10.23）， procalcitonin （PCT>10 μg·L^-1） （HR 1.23， 95%CI 0.06-0.86）， serum amyloid A （SAA）>100 mg·L^-1 （HR 9.80， 95%CI 7.24-59.75）， and platelet （PLT）>303×10⁹ /L （HR 5.66， 95%CI 2.01-16.00） were the risk factors for complications. Chinese medicine intervention （HR 0.20， 95%CI 0.06-0.70） was the protective factor for complications. Based on the above risk factors， the prediction model was constructed. In the training set， the C-index was estimated to be 0.765， and the CI was within the range of 0.667 to 0.859. In the validation set， the C-index was 0.804， and the CI varied within the range of 0.773 to 0.855. The temporal variation graph of C-index was then described. The area under the ROC curve （AUC） at 5， 10， 15 months was 0.61， 0.72， and 0.79 in the training set and 0.60， 0.67， and 0.62 in the validation set， respectively. In addition， calibration and decision curves were drawn for 5， 10， 15 months for both training and validation sets， which showed that the model had good calibration performance and was effective in clinical practice. ConclusionThe history of chronic lung diseases， Qi deficiency， thready and weak pulse， hormone use history， PCT>10 μg·L^-1， SAA>100 mg·L^-1， and PLT>303×10⁹ /L were risk factors for complications in patients with COVID-19 or influenza A/B， while Chinese medicine intervention was a protective factor. The prediction model was established based on the indicators above. The model showcased excellent distinguishing performance， calibration performance， and clinical practicability， providing scientific support for the prevention and control of complications caused by respiratory viral infections.

Injury of the posterior pelvic ring can easily be caused by high-energy impact,and sacroiliac joint dislocation is the most common.The sacroiliac joint,as the hub of load transfer between the trunk and lower extremities,is essential to maintain the stability of the posterior pelvic ring,and once dislocation occurs,restoring the stability of the posterior pelvic ring by timely surgery is necessary.The current surgical approaches for the internal fixation of sacroiliac joint are mainly divided into anterior approach and posterior approach.The choice of the surgical approach directly affects the exposure of the surgical field,the stability of internal fixation and the prognosis of patients;therefore,it is particularly important to select the appropriate surgical approach and fixation method.In this paper,we briefly review the selection of sacroiliac joint fixation points,surgical approaches and postoperative complications.

【Objective】 To explore the feasibility of using autologous platelet-rich plasma (PRP) in the treatment of deep second-degree burns complicated with wound infection. 【Methods】 A retrospective analysis was conducted on the treatment process of a patient with deep second-degree burns and bacterial infection on the wound using autologous PRP. Clinical treatment highlights and outpatient follow-up were combined to discuss the feasibility and clinical effects of using autologous PRP in the treatment of burn wounds complicated with infection. 【Results】 The patient had a deep second-degree burn with a coagulase-negative Staphylococcus infection on the left lower limb. After one week of conventional wound dressing and antibiotic treatment, the patient's body temperature returned to normal. However, wound healing was slow and yellow secretion persisted. Subsequently, the burn wound was treated combined with topical autologous PRP. The wound pain score gradually decreased from 8 to 1. After 2 weeks, the bacterial culture of the wound secretion was negative, and the wound healed completely after 18 days. The wound scar score decreased from 5 to 2 at 1, 3 and 6 months after PRP treatment, and no obvious scar formation was observed. In the course of PRP treatment, there were no adverse reactions such as increased wound inflammation, abnormal blood routine and liver and kidney function test results. 【Conclusion】 For deep second-degree burn patients with localized wound bacterial infections who either refuse surgery or are not suitable for surgery, autologous PRP is a safer alternative that can effectively promote tissue regeneration and wound healing. The patient in this case achieved a curative effect in a short period of time.

Objective To understand the growth and development status and differences between small for gestational age(SGA)and appropriate for gestational age(AGA)preterm infants during corrected ages 0-24 months,and to provide a basis for early health interventions for preterm infants.Methods A retrospective study was conducted,selecting 824 preterm infants who received regular health care at the Guangzhou Women and Children's Medical Center from July 2019 to July 2022,including 144 SGA and 680 AGA infants.The growth data of SGA and AGA groups at birth and corrected ages 0-24 months were analyzed and compared.Results The SGA group had significantly lower weight and length than the AGA group at corrected ages 0-18 months(P<0.05),while there were no significant differences between the two groups at corrected age 24 months(P>0.05).At corrected age 24 months,85%(34/40)of SGA and 79%(74/94)of AGA preterm infants achieved catch-up growth.Stratified analysis by gestational age showed that there were significant differences in weight and length at corrected ages 0-9 months between the SGA subgroup with gestational age<34 weeks and the AGA subgroups with gestational age<34 weeks and≥34 weeks(P<0.05).In addition,the weight and length of the SGA subgroup with gestational age≥34 weeks showed significant differences compared to the AGA subgroups with gestational age<34 weeks and≥34 weeks at corrected ages 0-18 months and corrected ages 0-12 months,respectively(P<0.05).Catch-up growth for SGA infants with gestational age<34 weeks and≥34 weeks mainly occurred at corrected ages 0-12 months and corrected ages 0-18 months,respectively.Conclusions SGA infants exhibit delayed early-life physical growth compared to AGA infants,but can achieve a higher proportion of catch-up growth by corrected age 24 months than AGA infants.Catch-up growth can be achieved earlier in SGA infants with a gestational age of<34 weeks compared to those with≥34 weeks.

Traditional Chinese medicine has a long history of treating epidemic diseases.Numerous references are available.As early as the Yellow Emperor's Classic of Internal Medicine-Su Wen Chapter mentioned:"the five epidemics are all similar,regardless of their size,and the symptoms are similar".In the prevention and treatment of the coronavirus disease 2019(COVID-19),Chinese medicine has shown its unique advantages.Pulmonary infection is one of the most common diseases associated with sudden epidemic diseases,which is mostly induced by various infectious factors such as epidemic bacteria or viruses.If the patient has a history of chronic lung disease,it will further aggravate the clinical symptoms,and is easy to develop into severe pneumonia,with high mortality,rapid progress,long course of treatment,poor prognosis,and many complications,and the general antibiotic application is not as effective as desired."Jue heat overcomes the complex,Yin and Yang are complicated"comes from the chapter of Jueyin disease in Shanghan Lun(Treatise on Febrile Diseases),which is one of the typical features of fever occurring from illness to Jueyin.To explore the correlation between Jueyin disease and the pathogenesis of severe pneumonia from multiple angles,analyze the mechanism of Qingfei Paidu decoction in the treatment of Jueyin fever,better understand the essence of Zhang Zhongjing's prescription,and provide new ideas for the syndrome differentiation process of patients with pulmonary infection caused by epidemic diseases.At present,the prevention and control mechanism of COVID-19 in China has been gradually improved,the number of patients with COVID-19 has been gradually reduced,and the epidemic situation is easing.However,even so,it is still impossible to predict whether sudden and major epidemic diseases similar to COVID-19 will break out again in the future.