Objective To clarify the current development status and research hotspots in the field of experimental drug management in China through data mining by bibliometric. Methods Key words such as “experiment”, “drug”, and “management” were used to search the Chinese literature in China National Knowledge Infrastructure （CNKI）. The title, author name, author affiliation, Chinese abstract, Chinese keywords, publication period, journal name, and other content of the literature were extracted from the literature. Cluster analysis was performed by CNKI literature visualization analysis system, CiteSpace and other software, and a network knowledge map was drawn. Results The literature in the field of experimental drug management in China was first published in 1994, and a total of 140 articles were published until 2022. Among them, 20 articles were supported by relevant funds, and the keyword co-occurrence frequency was highest among “subjects”. The most frequently published medium was the Chinese Pharmacological Yearbook. Conclusion At present, the quantity and quality of literature in the field of experimental drug management in China were relatively small, and the cooperation and communication among authors were not close. The funding from various fund projects in this field was also lacking. These factors led to a lower overall development level and slower development speed in this field.

OBJECTIVE To explore the value of preoperative serum laboratory indicators in the diagnosis of postop-erative abdominal infection in patients with perihilar cholangiocarcinoma.METHODS We retrospectively collected 444 patients who underwent radical resection of perihilar cholangiocarcinoma at the First Medical Center of the People's Liberation Army General Hospital from Jan.2021 to Apr.2023.According to whether postoperative ab-dominal cavity infection occurred,patients were divided into an infection group(52 cases)and a no-infection group(392 cases).The general clinical data,intraoperative and postoperative conditions of the two patient groups were compared.Multivariate logistic regression analysis was employed to investigate the predictive value of preoperative laboratory indicators in the diagnosis of postoperative abdominal infections.RESULTS The abdominal cavity infec-tion rate was 11.71％in patients undergoing radical resection of perihilar cholangiocarcinoma.Compared with the non-infection group,the infection group had significantly higher intraoperative red blood cell transfusion vol-umes,higher incidence rates of postoperative biliary fistula and a longer postoperative hospital stay(P＜0.05).Preoperative serum total protein,C-reactive protein(CRP),carcinoembryonic antigen(CEA),carbohy-drate antigen(CA)125,CA15-3,and CA72-4 were independent risk factors in predicting postoperative abdominal cavity infection in patients with perihilar cholangiocarcinoma(P＜0.05).The receiver operating characteristic(ROC)analysis results showed that the area under the curve(AUC)value of the combination of these six indica-tors for diagnosing postoperative abdominal cavity infection in perihilar cholangiocarcinoma was 0.873(95％CI:0.818-0.929),with a sensitivity of 73.1％(95％CI:0.590-0.844)and a specificity of 87.0％(95％CI:0.833-0.902).CONCLUSION Preoperative peripheral blood CRP,total protein and tumor markers of patients with peri-hilar cholangiocarcinoma have high diagnostic values for postoperative abdominal cavity infection.

Objective:To evaluate the effect of the degree of neuromuscular blockade on the intraoperative surgical conditions and postoperative recovery quality in patients undergoing lumbar interbody fusion.Methods:In this randomized controlled trial, 100 patients of either sex, aged 18-79 yr, with a body mass index of 18.5-35.0 kg/m 2, of American Society of Anesthesiologists Physical Status classification < Ⅳ, scheduled for elective lumbar interbody fusion at the Affiliated Hospital of Xuzhou Medical University from August to October 2024, were allocated into 2 groups ( n=50 each) using stratified randomization based on the number of lumbar segments: deep neuromuscular blockade group (group D) and moderate neuromuscular blockade group (group M). The intraoperative post-tetanic count was maintained at 1 or 2 in group D, and the intraoperative train-of-four was maintained at 1 or 2 in group M. The scores for surgical conditions, duration of operation, blood loss, length of incision, occurrence of severe hypoxemia after extubation, requirement for rescue analgesia in post-anesthesia care unit, 15-item Quality of Recovery scale score and length of stay were recorded. Results:Compared with group M, the scores for surgical conditions were significantly increased, the rate of rescue analgesia in post-anesthesia care unit was decreased, 15-item Quality of Recovery scale scores were increased at 3 days after surgery ( P<0.05), and no significant changes were found in the duration of operation, blood loss, length of incision, incidence of severe hypoxemia after extubation and length of hospital stay in group D ( P>0.05). Conclusions:Compared with moderate neuromuscular blockade, deep neuromuscular blockade can provide better surgical conditions and improve the quality of early postoperative recovery for patients undergoing lumbar interbody fusion.

Objective:To evaluate the effect of the degree of neuromuscular blockade on the intraoperative surgical conditions and postoperative recovery quality in patients undergoing lumbar interbody fusion.Methods:In this randomized controlled trial, 100 patients of either sex, aged 18-79 yr, with a body mass index of 18.5-35.0 kg/m 2, of American Society of Anesthesiologists Physical Status classification < Ⅳ, scheduled for elective lumbar interbody fusion at the Affiliated Hospital of Xuzhou Medical University from August to October 2024, were allocated into 2 groups ( n=50 each) using stratified randomization based on the number of lumbar segments: deep neuromuscular blockade group (group D) and moderate neuromuscular blockade group (group M). The intraoperative post-tetanic count was maintained at 1 or 2 in group D, and the intraoperative train-of-four was maintained at 1 or 2 in group M. The scores for surgical conditions, duration of operation, blood loss, length of incision, occurrence of severe hypoxemia after extubation, requirement for rescue analgesia in post-anesthesia care unit, 15-item Quality of Recovery scale score and length of stay were recorded. Results:Compared with group M, the scores for surgical conditions were significantly increased, the rate of rescue analgesia in post-anesthesia care unit was decreased, 15-item Quality of Recovery scale scores were increased at 3 days after surgery ( P<0.05), and no significant changes were found in the duration of operation, blood loss, length of incision, incidence of severe hypoxemia after extubation and length of hospital stay in group D ( P>0.05). Conclusions:Compared with moderate neuromuscular blockade, deep neuromuscular blockade can provide better surgical conditions and improve the quality of early postoperative recovery for patients undergoing lumbar interbody fusion.

OBJECTIVE To explore the value of preoperative serum laboratory indicators in the diagnosis of postop-erative abdominal infection in patients with perihilar cholangiocarcinoma.METHODS We retrospectively collected 444 patients who underwent radical resection of perihilar cholangiocarcinoma at the First Medical Center of the People's Liberation Army General Hospital from Jan.2021 to Apr.2023.According to whether postoperative ab-dominal cavity infection occurred,patients were divided into an infection group(52 cases)and a no-infection group(392 cases).The general clinical data,intraoperative and postoperative conditions of the two patient groups were compared.Multivariate logistic regression analysis was employed to investigate the predictive value of preoperative laboratory indicators in the diagnosis of postoperative abdominal infections.RESULTS The abdominal cavity infec-tion rate was 11.71％in patients undergoing radical resection of perihilar cholangiocarcinoma.Compared with the non-infection group,the infection group had significantly higher intraoperative red blood cell transfusion vol-umes,higher incidence rates of postoperative biliary fistula and a longer postoperative hospital stay(P＜0.05).Preoperative serum total protein,C-reactive protein(CRP),carcinoembryonic antigen(CEA),carbohy-drate antigen(CA)125,CA15-3,and CA72-4 were independent risk factors in predicting postoperative abdominal cavity infection in patients with perihilar cholangiocarcinoma(P＜0.05).The receiver operating characteristic(ROC)analysis results showed that the area under the curve(AUC)value of the combination of these six indica-tors for diagnosing postoperative abdominal cavity infection in perihilar cholangiocarcinoma was 0.873(95％CI:0.818-0.929),with a sensitivity of 73.1％(95％CI:0.590-0.844)and a specificity of 87.0％(95％CI:0.833-0.902).CONCLUSION Preoperative peripheral blood CRP,total protein and tumor markers of patients with peri-hilar cholangiocarcinoma have high diagnostic values for postoperative abdominal cavity infection.

Objective To evaluate the effect of parasternal intercostal plane block(PIB)on postopera-tive fatigue in elderly patients undergoing off-pump coronary artery bypass grafting(CABG).Methods A to-tal of 111 elderly patients undergoing elective off-pump CABG in Xuzhou Municipal Central Hospital from May 2021 to January 2023 were selected as the study subjects.The patients were divided into the control group(group C,n=55)and PIB group(group P,n=56)by adopting the random number table method.After induction of anesthesia,the patients in the group P received the ultrasound-guided bilateral PIB,and the group C received the equal volume of normal saline at the same site.The incidence rate of postoperative fatigue syn-drome(POFS)on postoperative 1,3,5,7 d and postoperative 8 weeks,NRS scores immediately after extuba-tion and at postoperative 12,24,48 h,postoperative opioid drugs consumption,ICU stay duration,hospitaliza-tion duration and adverse events occurrence were compared between the two groups.Results Compared with the group C,the incidence rates of POFS on postoperative 1,3,5,7 d and postoperative 8 weeks in the group P were significantly decreased,the NRS scores immediately after extubation and at postoperative 12,24 h in the group P were lower,the postoperative opioid drugs consumption were smaller,the ICU stay duration was shorter,and the differences were statistically significant(P＜0.05).The NRS score at postoperative 48 h and hospitalization duration had no statistical differences between the two groups(P＞0.05).No nerve block re-lated adverse events in the patients appeared during the study period.Conclusion The ultrasound guided PIB could effectively reduce the incidence rate of POFS in elderly patients undergoing off-pump CABG,promote the patients'prognosis and improve the recovery quality of the patients.

To evaluate bioequivalence and safety of two kinds of metformin hydrochloride sustained-release tablets (test preparation vs reference preparation) under the condition of fed and single administration.A single center, randomized, open, single-dose, two-period, two-sequence, and double-crossover design was used.32 healthy subjects took 0.5 g of test preparation or reference preparation under fed and single-dose administration.4 mL of venous blood was collected from before administration (0 h) to 1, 3, 4, 4.5, 5, 5.5, 6, 7, 8, 9, 10, 12, 15, 24, 36 and 48 h after administration.The concentration of metformin in plasma samples was detected, and then the pharmacokinetic parameters were calculated by WinNonlin 7.0 software.When the 90% confidence intervals of cmax, AUC0-t and AUC0-∞ geometric mean ratio of test preparation and reference preparation were within 80.00%-125.00% equivalent intervals respectively, the bioequivalence of the two preparations was proved.One subject fell off due to adverse events.The main pharmacokinetic parameters of test preparation and reference preparation as follows: cmax were (0.68 ± 0.14) and (0.65 ± 0.11) mg/L, AUC0-t were (7.33 ± 1.65) and (7.00 ± 1.89) h·mg/L, AUC0-∞ were (7.39 ± 1.67) and (7.06 ± 1.91) h·mg/L, respectively.The 90% confidence intervals of the geometric mean ratio of the two main pharmacokinetic parameters were 101.45%-109.14%, 100.08%-112.32% and 100.24%-112.28%, respectively, which fell within the bioequivalence interval of 80.00%-125.00%.There were no serious adverse events and unexpected adverse events during the trial.The results show that test preparation and reference preparation are bioequivalent under fed and single-dose administration, safe and well tolerated in healthy subjects.

Objective:To explore the effectiveness of deep learning image reconstruction (DLIR) algorithm compared to adaptive statistical iterative reconstruction (ASIR-V) algorithm in improving the quality of low-dose brain CT images.Methods:Retrospective inclusion of patients who underwent brain CT examination in the People's Liberation Army General Hospital from November 2021 to August 2022. Four different algorithms were used to reconstruct low-dose CT scans of all patients to obtain 30% intensity ASIR-V (ASIR-V-30%) images, low intensity DLIR (DLIR-L) images, medium intensity DLIR (DLIR-M) images, and high intensity DLIR (DLIR-H) images. The regions of interest were selected from four sets of images, including superficial white matter, superficial gray matter, deep white matter, and deep gray matter, and their CT values and standard deviations were measured for calculating signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).Subjective evaluation of image quality was conducted by three neuroimaging physicians based on the Likert 5-component scale. The objective and subjective scores of the 4 groups of images were analyzed using ANOVA or Kruskal Wallis. If there are overall differences, pairwise comparisons were conducted within the group.Results:A total of 109 patients were enrolled, including 104 males and 5 females, aged 65-110 years (89.16 ± 9.53) years. The radiation exposure of brain CT low-dose scanning was (0.93 ± 0.01)mSv, significantly lower than that of conventional scanning (2.92 ± 0.01) mSv ( t = 56.15, P < 0.05). The differences in objective image quality analysis of ASIR-V-30%, DLIR-L, DLIR-M, and DLIR-H images of low-dose CT in SNR deep gray matter, SNR deep white matter, SNR superficial gray matter, SNR superficial white matter, CNR deep gray white matter, and CNR superficial gray white matter were statistically significant( F =98.23, 72.95, 68.43, 58.24, 241.13, 289.91, P < 0.05). Among them, DLIR-H images had the lowest noise in deep gray matter, deep white matter, superficial gray matter, and superficial white matter, and had statistically significant differences compared to other image groups ( t = 167.43, 275.46, 182.32, 361.54, P < 0.05). The subjective score of DLIR-H image quality was superior to ASIR-V-30%, DLIR-L, and DLIR-M, with the statistically significant difference ( t = 7.25, 8.32, 9.63, P < 0.05). Conclusions:Compared with ASIR-V, DLIR algorithm can effectively reduce image noise and artifacts in low-dose brain CT, and improve SNR and CNR. The subjective and objective image quality evaluation of DLIR-H is the best.

Objective:To evaluate and analyze the ultrasonic findings of idiopathic clubfoot and positional clubfoot deformities.Methods:Forty-nine newborn babies with congenital clubfoot were examined in the Department of Ultrasound of the Third Affiliated Hospital of Zhengzhou University from December 2020 to January 2022, Including 21 newborn babies(32 feet) with idiopathic clubfoot, and 28 babies(53 feet) with positional clubfoot. Twenty-two normal infants in the same period and the normal feet of the single clubfoot were selected as control group. The distance between medial malleolus and scaphoids of all feet were measured by ultrasound. The distance from the tangent line of the lateral edge of calcaneus to the midpoint of the lateral edge of the chondroid bone, medial soft tissue thickness and tibial calcaneal angle were measured by ultrasound. The data of idiopathic clubfoot group, positional clubfoot group and control group were statistically analyzed.Results:A total of 71 newborn babies with 142 feet were evaluated.The idiopathic clubfoot group had born and joint changes in the medial, lateral and posterior side, and the differences were statistically significant compared with the control group (all P<0.05). Compared with the control group, there were statistically significant differences in the medial and lateral side of the positional group(all P<0.05). But no significant changes in the posterior side( P>0.05). There were significant differences between medial and posterior side of idiopathic and positional clubfoot group (all P<0.05), but no significant differences in lateral side ( P>0.05). Conclusions:Ultrasonography can clearly display the tarsus bones in clubfoot, and observe the deformity changes of the idiopathic clubfoot and positional clubfoot.

Objective:To explore the expression pattern of aryl hydrocarbon receptor (AhR) in mice peritoneal macrophages (PMs) after major trauma and analyze the effects of enhanced AhR expression on the inflammatory cytokine level and bactericidal ability after trauma.Methods:The experimental study method was used. Forty 6-8-week-old male C57BL/6J mice (the same mouse age, sex, and strain below) were divided into control group, post trauma hour (PTH) 2 group, PTH 6 group, and PTH 12 group according to the random number table (the same grouping method below), with 10 mice in each group. Mice in the latter 3 groups were constructed as severe trauma model with fracture+blood loss, while mice in control group were left untreated. The primary PMs (the same cells below) were extracted from the mice in control group, PTH 2 group, PTH 6 group, and PTH 12 group when uninjured or at PTH 2, 6, and 12, respectively. Then the protein and mRNA expressions of AhR were detected by Western blotting and real-time fluorescence quantitative reverse transcription polymerase chain reaction, respectively, and the gene expressions of AhR signaling pathway related molecules were analyzed by transcriptome sequencing. Twenty mice were divided into control group and PTH 6 group, with 10 mice in each group, and the PMs were extracted. The level of ubiquitin of AhR was detected by immunoprecipitation. Twelve mice were divided into dimethyl sulfoxide (DMSO) alone group, PTH 6+DMSO group, MG-132 alone group, and PTH 6+MG-132 group, with 3 mice in each group. After the corresponding treatment, PMs were extracted, and the protein expression of AhR was detected by Western blotting. Twenty mice were constructed as PTH 6 model. Then, the PMs were extracted and divided into empty negative control adenovirus (Ad-NC) group and AhR overexpression adenovirus (Ad-AhR) group. The protein expression of AhR was detected by Western blotting at 36 h after some PMs were transfected with the corresponding adenovirus. The rest cells in Ad-NC group were divided into Ad-NC alone group and Ad-NC+endotoxin/lipopolysaccharide (LPS) group, and the rest cells in Ad-AhR group were divided into Ad-AhR alone group and Ad-AhR+LPS group. The expressions of interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) in the cell supernatant were detected by enzyme-linked immunosorbent assay at 12 h after the corresponding treatment ( n=6). Twenty mice were obtained to extract PMs. The cells were divided into control+Ad-NC group, PTH 6+Ad-NC group, control+Ad-AhR group, and PTH 6+Ad-AhR group, and the intracellular bacterial load was detected by plate spread method after the corresponding treatment ( n=6). Data were statistically analyzed with one-way analysis of variance, least significant difference test, analysis of variance for factorial design, and independent sample t test. Results:Compared with 1.16±0.28 of control group, the protein expressions of AhR in PMs in PTH 2 group (0.59±0.14), PTH 6 group (0.72±0.16), and PTH 12 group (0.71±0.17) were all significantly decreased ( P<0.05). The overall comparison of the difference of AhR mRNA expression in PMs among control group, PTH 2 group, PTH 6 group, and PTH 12 group showed no statistical significance ( P>0.05). The AhR signaling pathway related molecules included AhR, AhR inhibitor, cytochrome P450 family member 1b1, cytochrome P450 family member 11a1, heat shock protein 90, aryl hydrocarbon receptor-interaction protein, and heat shock protein 70 interaction protein. The heat shock protein 90 expression of PMs in PTH 2 group was higher than that in control group, while the expressions of other molecules did not change significantly after trauma. Compared with that in control group, the level of ubiquitin of AhR in PMs in PTH 6 group was increased. Compared with that in DMSO alone group, the protein expression of AhR in PMs in PTH 6+DMSO group was decreased, while that in PMs in MG-132 alone group had no significant change. Compared with that in PTH 6+DMSO group, the protein expression of AhR in PMs in PTH 6+MG-132 group was up-regulated. At transfection hour 36, compared with that in Ad-NC group, the protein expression of AhR in PMs in Ad-AhR group was increased. At treatment hour 12, compared with those in Ad-NC+LPS group, the expressions of IL-6 and TNF-α in PM supernatant of Ad-AhR+LPS group were significantly decreased (with t values of 4.80 and 3.82, respectively, P<0.05). The number of intracellular bacteria of 1×10 6 PMs in control+Ad-NC group, PTH 6+Ad-NC group, control+Ad-AhR group, and PTH 6+Ad-AhR group was (3.0±1.8), (41.8±10.2), (1.8±1.2), and (24.2±6.3) colony forming unit, respectively. Compared with that in PTH 6+Ad-NC group, the number of intracellular bacteria of PMs in PTH 6+Ad-AhR group was significantly decreased ( t=3.61, P<0.05). Conclusions:Ubiquitin degradation of AhR in PMs of mice after major trauma results in decreased protein expression of AhR. Increasing the expression of AhR in post-traumatic macrophages can reduce the expressions of LPS-induced inflammatory cytokines IL-6 and TNF-α, and improve the bactericidal ability of macrophages after trauma.