Objective:Applying bibliometrics to analyze the research history, hotspots and trends of Traditional Chinese Medicine (TCM) interventions in edema-related diseases, and to provide reference for the revision of diagnostic and therapeutic criteria for edema in TCM.Methods:The literature about edema treated with TCM was retrieved from CNKI, Wanfang, VIP, CBM from 1 st. Jan 1995 to 25 th. May 2022. CiteSpace and VOSviewer softwares were used to draw the knowledge map, and analyze the co-occurrence relationship and clustering characteristics of the institution, author, keywords and mechanism hotspots. Results:Totally 3 198 articles were included. The annual number of documents issued generally shows a spiral rise trend. Liaoning University of Chinese Medicine published the most articles. Core authors published the most articles were Sun Wei (13 articles); the team with the highest cooperation intensity was Yang Hongtao's team; keywords formed 7 clusters. Hotspot mechanisms included metabolic disorders, immune balance, anti-inflammation, calcium and phosphorus metabolism. Keywords in the past 7 years were membranous nephropathy, chronic heart failure, diabetes, lymphedema etc.Conclusions:The attention paid to the intervention of TCM in the field of edema is generally on the rise, and has decreased in the past two years. The research categories focus on the experience of famous doctors, clinical trials, and mechanistic studies, and nephropathy-related edema has been the focus of research; diabetic nephropathy, chronic heart failure, metabolomics, and immunotherapy are expected to be the focus of attention in the next stage.

Objective:To analyze the efficacy evaluation criteria of the existing TCM treatment for edema RCT research, and to provide reference for the construction of unified standards.Methods:The batabases CNKI, WanFang Data, VIP, CBM, Pubmed and Web of Science were retrieved. The randomized controlled trials for the treatment of edema of TCM research, from September 1, 1993 to July 31, 2022, were screened and included. The content of efficacy evaluation, performed statistics on evaluation standard, the curative effect evaluation indexes, as well as standard composition, usage were extracted. We analyzed the characteristics, application and problems of the existing efficacy evaluation criterion.Results:A total of 123 Chinese articles were included. The included literature involved nephrogenic edema, cardiogenic edema, idiopathic edema, apoplexy limb edema and other edema. In recent years, randomized controlled trials on the treatment of edema by TCM have mainly used four efficacy evaluation criteria. Of which the Guidelines for Clinical Research on New Chinese Medicines (Trial) in 2002 had the highest utilization rate of 29.27%. Secondly, the utilization rate of Standard for Diagnosis and Curative Effect of TCM Diseases and Syndromes was 21.14%. The rest of the criteria were used by less than 6%. While 39.02% of the literature did not use the standards or used self-designed standards. Among the composition of efficacy evaluation indices, the application rate of TCM syndrome or symptom efficacy index was the highest (91.87%), the utilization rate of the Minnesota Living with Heart Failure Questionnaire Indicators was only 4.88%; biochemical tests accounted for a large proportion of Western medical indicators, while the measurement of edema severity was rarely applied. Conclusions:At present, the evaluation criteria of edema curative effect are diversified and insufficiently popularized, which need to be further screened and improved. It is suggested to construct a TCM edema efficacy evaluation model based on the characteristics of edema syndrome, comprehensively evaluate the efficacy from multiple dimensions such as TCM syndromes, western medicine indicators, and quality of life, and improve the scientific indicators.

Objective To assess the gastric contents before cesarean section using antral cross-sectional area (CSA) measured by ultrasonography.Methods One hundred and seventy-seven American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients,aged 20-44 yr,undergoing cesarean section,were enrolled in this study.The antral CSA in the semi-recumbent and right lateral decubitus positions was measured through the ultrasound images of the antrum in the sagittal plane below xiphoid before anesthesia and qualitatively graded.Qualitative grade 0 was considered as the gold standard,and the receiver operating characteristic (ROC) curve of CSA in assessing the preoperative gastric contents was plotted.Results The critical value of ROC curve of CSA in the semi-recumbent position was 6.025 cm2.The critical value of ROC curve of CSA in the right lateral decubitus position was 9.095 cm2.Conclusion CSA ＜ 6.025 cm2 measured by ultrasonography in the semi-recumbent position or CSA＜9.095 cm2 measured by ultrasonography in the right lateral decubitus position can confirm that the gastric emptying state is achieved before cesarean section.

Objective To evaluate the feasibility of endooscopic minimally invasive McKeown esophagectomy in the treatment of esophageal carcinoma. Methods From June 2012 to August 2015, the data of 180 patients with esophageal carcinoma was retrospectively analyzed. The patients were divided into endoscopy McKeown esophagectomy group (EME group) and open McKeown esophagectomy group (OME group), each group had 90 patients. The clinical pathological data, perioperative data and postoperative complications between the two groups were analyzed. Results The operation time in EME group was longer than that in OME group [(289 ± 30) min vs. (252 ± 28) min, t= 8.063, P< 0.05]. The intraoperative blood loss and postoperative blood loss on the first day after operation in EME group were less than those in OME group [(178.94 ± 47.84) ml vs. (323.44 ± 59.51) ml, t=17.952, P<0.05; (220.93 ± 49.07) ml vs. (362.59 ± 68.37) ml, t= -15.968, P< 0.05]. There was no significant difference between the two groups in the number of lymph node dissection (t= -1.913), postoperative hospitalization days (χ2= 4.858) and postoperative complications (exact probability method) (all P> 0.05). Conclusions Endoscopic minimally invasive McKeown esophagectomy has the same effect as open surgery, and trauma is small. Therefore, for the patients who are suitable for the minimally invasive surgery, it can be preferred.

Objective: To evaluate diagnostic value of three noninvasive examinations for coronary heart disease (CHD).Methods:A total of 500 subjects, who were suspected of CHD, first received diagnostic coronary angiography (CAG) and hospitalized in our department from May 2014 to May 2015, were selected.According to CAG results, they were divided into non-CHD control group (n=106), single vessel coronary disease group (n=199), double-vessel coronary disease group (n=95) and multi-vessel coronary disease group (n=100, ≥three vessel disease).Besides CAG, all subjects accomplished one of following examinations at least: (1) 24h dynamic ECG (Holter);(2) real-time three-dimensional echocardiography(RT-3DE);(3) radionuclide myocardial perfusion imaging (RMPI).Sensitivity, specificity and accuracy of these three examinations in diagnosing CHD were evaluated.Results: With CAG as the gold standard, compared with Holter and RT-3DE, there were significant rise in sensitivity(68.4%, 69.0% vs.92.9%), specificity (62.9%, 81.4% vs.88.5%) and accuracy (67.1%, 71.2% vs.91.9%) of RMPI (P<0.01 all), only specificity of RT-3DE was significantly higher than that of Holter, P=0.019.Conclusion:Noninvasive examination can be used as important method diagnosing CHD, which are important measures for noninvasive diagnosing and assessing CHD.Accuracy, sensitivity and specificity of RMPI are high, which is worth extending.

Objective: To assess the diagnostic rate, safety and clinical application of percutaneous renal masses biopsy for advanced renal cell carcinoma patients.Methods: In this retrospective study, we collected the data of renal masses from the patients who underwent renal masses biopsy under ultrasound from April 2001 to December 2014 in Peking University First Hospital.A total of 75 patients who were undiagnosed or diagnosed with advanced renal cell carcinoma by the imageological method were enrolled in this study.The patient and lesion characteristics such as tumor size, pathology of tumor, histologic subtype, pathological grade, biopsied location and biopsied cores were recorded and analyzed.Results: Among all the 75 patients, biopsy was diagnostic in 64 cases (85.3%) and non-diagnostic in 11 cases (14.7%).Of the 64 diagnostic biopsies, 60 were malignant, including 37 (61.7%) renal cell carcinoma (RCC), 13 (21.7%) urothelial carcinoma and 10 (16.7%) other malignant masses.Of all the RCC subjects, 24 suffered from clear cell RCC, 5 papillary RCC, 3 collecting duct carcinomas, 1 unclassified RCC and 4 unknown subtypes.The 11 non-diagnostic biopsied samplings included inflammatory, blood and extrarenal tissue and normal renal tissue.The proportion of collecting duct carcinoma in RCC was 10.8% and the proportion of squamous carcinoma in urothelial carcinoma was 23.1%, which were both higher than the previous research findings.For the male and female groups, non-diagnostic yields were 6.5% and 30.4%, respectively (P=0.022).Of all the 75 patients, 13 renal cell carcinoma patients underwent the surgical treatment and got the results of postoperative pathology.Comparing preoperative biopsy pathological diagnosis with postoperative pathological diagnosis, we found the diagnostic correct rates for benign and malignant lesions, pathological subtype and pathological grade were 100%, 81.8% and 60%, respectively.Mild macroscopic hematuria occurred in 1 case after RMB and there were no serious complications in all the cases.Conclusion: Percutaneous renal masses biopsy under ultrasound with a high diagnostic rate which can define the histologic subtype of renal cell carcinoma.With targeted therapy, more and more patients whose evaluation suggests local advanced disease or metastatic tumors adopt renal tumor biopsy to define the histologic subtype, which could avoid unnecessary surgical treatment.

Objective:To assess effect of detection of plasma N terminal pro brain natriuretic peptide (NT‐proBNP) and serum cystatin C (Cys C) combined Global Registry of Acute Coronary Events (GRACE) score on heart func‐tion and prognosis in patients with acute coronary syndrome (ACS) .Methods :According to GRACE score ,a total of 136 ACS patients were divided into low risk group (n=29) ,intermediate risk group (n=39) and high risk group (n=68) .Serum Cys C level and plasma NT‐proBNP level were measured in all groups .Incidence rate of major ad‐verse cardiovascular events (MACE) within three and six months was counted .Results:Among ACS patients ,com‐pared with low risk group ,there were significant rise in levels of NT‐proBNP [ (165.80 ± 51.62) ng/L vs .(193.13 ± 74.64) ng/L vs .(985.45 ± 152.69) ng/L] and Cys C [ (0.83 ± 0.38) mg/L vs .(0.9 ± 0.25) mg/L vs .(1.23 ± 0.23) mg/L] ,left ventricular end‐diastolic diameter [six months: (50 ± 3) mm vs .(55 ± 3) mm vs .(59 ± 5) mm] ,significant reduction in left ventricular ejection fraction [LVEF ,six months: (55 ± 7)% vs .(49 ± 5)% vs . (40 ± 7)% ] ,and significant rise in incidence rate of MACE (six months:2.94% vs .9.55% vs .30.88% ) ,and a‐bove indexes in high risk group were significantly higher than those of intermediate risk group except LVEF signifi‐cantly reduced , P<0.05 or <0.01 ;Pearson correlation analysis indicated that NT‐proBNP and Cys C levels were positively correlated with GRACE score (r=0.72 , P<0.05 ; r=0.65 , P<0.05) respectively .Conclusion:NT‐proBNP and Cys C level detection combined GRACE score could exactly response heart function and prognosis .

OBJECTIVE:To establish a method for simultaneous determination of the contents of geniposide and liquiritin in Xinshenning tablets. METHODS:HPLC was performed on the column of Inertsil ODS-3 with mobile phase of acetonitrile-water (gradient elution) at flow rate of 1.0 ml/min,the column temperature was 25 ℃,detection wavelength was 238 nm and the vol-ume was 10 μl. RESULTS:The mass concentration range was 16.3-407.9 μg/ml for geniposide(r=0.999 9) and 7.4-185.9 μg/ml for liquiritin(r=0.999 9);RSDs of precision,stability and reproducibility tests were no more than 1.63%;average recoveries were 99.05%(RSD=1.28%,n=9)and 98.00%(RSD=1.84%,n=9),respectively. CONCLUSIONS:The established method is accu-rate,sensitive and simple,and can be used for the contents determination of geniposide and liquiritin in Xinshenning tablets.

Objective To develop a multiplex touchdown PCR for simultaneous detection of extended-spectrum β-lactamases (ESBLs )-producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus (MRSA ). Methods Blood culture positive specimens from 102 hospitalized patients were collected between March 2013 and September 2014,four pairs of specific primers were designed based on SHV,TEM,and OXA genes of ESBLs-pro-ducing Enterobacteriaceae and MecA gene of MRSA,drug-resistant genes were amplified with single touchdown PCR and multiplex touchdown PCR, the results were compared with Kirby-Bauer disk diffusion method. Results Each single PCR amplified a specific band,four drug-resistant genes were also detected by multiplex touchdown PCR;the lower detection limits of multiplex touchdown PCR for DNA of MecA,SHV,TEM,and OXA were 4.37 ng,2.19 ng,4.53 ng,and 3.59 ng,respectively.Compared with Kirby-Bauer disk diffusion method, the overall sensitivity and specificity of multiplex touchdown PCR were 100.00% and 88.24% respectively,for ES-BLs were 100.00% and 87.23% respectively,for MRSA were both 100.00%.Conclusion A higher sensitivity and specificity multiple touchdown PCR assay has been developed,and it can be used in the rapid diagnosis and epidemi-ology investigation of bloodstream infection caused by ESBLs-producing Enterobacteriaceae and MRSA,and is help-ful for guiding antimicrobial use in clinic.