In clinical practice， it has been observed that pediatric viral pneumonia in the acute phase often present with pronounced heat manifestations， including high fever， flushed face， and rapid pulse， but heat-clearing medicinals alone frequently fails to achieve satisfactory clinical outcomes. Based on traditional Chinese medicine （TCM） theory， it is proposed that during the acute phase of the disease， the pathological process of "exuberant fire consuming qi" often occurs earlier than the appearance of clinical qi deficiency manifestations. Analysis in conjunction with modern viral immunology research findings suggests that the core pathological mechanism of viral infection lies in a vicious cycle of immune overactivation and immune function impairment， and this process shares certain similarities with the TCM pathogenesis of "exuberant fire consuming qi". Therefore， it is proposed that in the acute phase of pediatric viral pneumonia， if there is persistent high fever and poor response to antipyretics， heat-clearing medicinals should be administered in adequate doses to eliminate the "exuberant fire"， while sweet-warm qi-supplementing medicinals， such as huangqi （Radix Astragali） and Dangshen （Radix Codonopsis）， should be introduced early to reinforce healthy qi and help restore immune homeostasis. Meanwhile， as exuberant fire may damage yin， Huangjing （Rhizoma Polygonati） may be added to supplement both qi and yin， along with sweet-cool yin-nourishing medicinals， such as Beishashen （Radix Glehniae）， Maidong （Radix Ophiopogonis） and Tianhuafen （Radix Trichosanthis）， to moisten the yin fluids.

Objective To explore the epidemiological characteristics and treatment outcomes of venomous snake bites in Yunnan Province from 2023 to 2024.Methods A retrospective analysis was performed on 1,727 snakebite cases collected from 16 administrative regions in Yunnan Province between January 2023 and December 2024,focusing on the following indicators:(1)demographic characteristics(age and gender distribution);(2)characteristics of injury events(location,time distribution,and affected body parts);(3)composition of venomous snake species;(4)clinical features and treatment protocols;(5)efficacy evaluation indicators(time for local symptom relief,duration of hospital stay,and follow-up results).Results High-incidence areas for snake bites in Yunnan Province included Wenshan(308/1727),Kunming(285/1727),Qujing(270/1727),Lincang(139/1727),Baoshan(120/1727),and Dali(105/1727),with incidents primarily occurring from June to September.The most frequently encountered venomous snake species were Ovophis and Trimeresurus,known for their hemotoxic venom.Bite victims were mainly young adults.Clinical manifestations primarily included pain and swelling,with bites mainly occurring on limbs and in mountainous or forested areas.Anti-venom treatment concentrated on anti-ancistrodon acutus serum.Swelling generally subsided within 2(2,3)days,with an average hospital stay of 4(3,5)days.96.46%of patients receiving standardized treatment fully recovered,with a follow-up disability rate of 0.35%.Conclusion The incidents of venomous snake bites in Yunnan Province have significant regional and seasonal concentration,with Wenshan,Kunming,Qujing and other areas being high-risk areas.The peak period of incidents is from June to September in summer,and the main types of snakes causing injuries are those containing blood toxins;The victim group is mainly young people,and bites often occur in the limbs,with typical symptoms of pain and swelling;The main treatment is anti snake serum;Snake bite patients who receive formal diagnosis and treatment have a higher recovery rate and a lower follow-up disability rate,but there is still a need to raise public awareness of standardized diagnosis and treatment for snake bites.

Objective To compare the changes of the medical animal resources(MAR)in Sichuan based on the data of the 3rd Chinese Materia Medica Resource Inventory(CMMRI,1983-1986)and the 4th CMMRI(2020-2022).Methods After field investigation and identification of the photos of the animals,the data of the MAR in Sichuan found in the 4th CMMRI were analyzed and compared with the data of 3rd CMMRI.Results 745 species of MAR were found in Sichuan during the 4th CMMRI,including 212 families and 468 genera.Compared with the 108 species found in 3rd CMMRI,the number of MAR in Sichuan had greatly increased,The Aves was found to have 243 species of MAR,which is the most plenty one among the 7 classes.There were 14 families which have more than 10 species of MAR.The family,Cyprinidae had 48 species of MAR.There were 33 common Chinese medicinal herbs and 3 genuine medicinal materials including Cordyceps sinensis,musk and Venenum bufonis were found in this investigation.The new distributions of Liangshan Cordyceps and Cordyceps gunnii were found in the investigation,and the new resources of Atypus heterothecus was found in Mountain Emei.There were 140 species of key protection of wild medicinal animals,including 44 species of animals under first-class protection and 96 species of animals under second-class protection.There were 230 species of animals which had important ecological,scientific,and social values,too.Conclusion Sichuan was plenty of medical animal resources and the protection of the forest musk deer,the Cordyceps sinensis and the pangolin was need to be strengthened.

Objective:To evaluate the clinical efficacy of intermediate frequency pulse electrical stimulation combined with TCM directional drug penetration therapy in the treatment of patients with lumbar spinal stenosis.Methods:Randomized controlled trial. Totally 90 patients with lumbar spinal stenosis who were treated between July 2018 and December 2021 in the hospital were selected according to randomized controlled trial design, and they were divided into the two groups through the random number table method, with 45 cases in each group. The control group was given non-steroidal anti-inflammatory drugs+conventional intermittent traction + intermediate frequency pulse electrical stimulation, and the combined group was treated with TCM directional drug penetration therapy on the basis of the control group. Both groups were continuously treated for 1 month. The TCM syndromes were scored before and after treatment, and Visual Analogue Scale (VAS) was used to evaluate the pain degree. Japanese Orthopedic Association (JOA) and Oswestry Disability Index (ODI) were applied to assess the dysfunction degree and quality of life, and the clinical efficacy was assessed.Results:The total effective rate was 95.56% (43/45) in combined group and was 82.22% (37/45) in control group, with statistical significance ( χ2=4.05, P=0.044). The scores of lumbago pain, articular soreness, knee soreness and weakness and impaired activity and total score in combined group after treatment were lower than those in the control group ( t=18.40, 15.81, 15.40, 26.50, 59.575, P<0.01), and the JOA score was higher than that of the control group ( t=5.62, P<0.01), while the ODI score was lower than that of the control group ( t=9.43, P<0.01). The time-point effect and between-group effect of VAS score in combined group were lower than those in the control group with the extension of time ( F=240.00, 17.19, P<0.01), and there was an interaction effect between decrease and treatment method ( F=6.66, P<0.01). Conclusion:Intermediate frequency pulse electrical stimulation combined with TCM directional drug penetration therapy is helpful to relieve the pain, improve the lumbar dysfunction degree and enhance the quality of life and clinical efficacy in patients with lumbar spinal stenosis.

Hepatic cholesterol accumulation is an important contributor to hypercholesterolemia, which results in atherosclerosis and cardiovascular disease (CVD). ATP-citrate lyase (ACLY) is a key lipogenic enzyme that converts cytosolic citrate derived from tricarboxylic acid cycle (TCA cycle) to acetyl-CoA in the cytoplasm. Therefore, ACLY represents a link between mitochondria oxidative phosphorylation and cytosolic de novo lipogenesis. In this study, we developed the small molecule 326E with an enedioic acid structural moiety as a novel ACLY inhibitor, and its CoA-conjugated form 326E-CoA inhibited ACLY activity with an IC₅₀ = 5.31 ± 1.2 μmol/L in vitro. 326E treatment reduced de novo lipogenesis, and increased cholesterol efflux in vitro and in vivo. 326E was rapidly absorbed after oral administration, exhibited a higher blood exposure than that of the approved ACLY inhibitor bempedoic acid (BA) used for hypercholesterolemia. Chronic 326E treatment in hamsters and rhesus monkeys resulted in remarkable improvement of hyperlipidemia. Once daily oral administration of 326E for 24 weeks prevented the occurrence of atherosclerosis in ApoE^-/- mice to a greater extent than that of BA treatment. Taken together, our data suggest that inhibition of ACLY by 326E represents a promising strategy for the treatment of hypercholesterolemia.

Objective:To explore the safety and efficacy of laparoscopic non-blocking partial nephrectomy assisted by high power lateral green laser in the treatment of T 1a renal tumor. Methods:The clinical data of 10 patients with T1a stage renal tumor from February 2021 to April 2021 in department of urology, Gongli hospital affiliated to Naval Military Medical University were retrospectively analyzed. There were 7 males and 3 females, aged 47.0-74.0 years, with average of(58.8±9.7)years old. The diameter of the tumor ranged from 2.0 cm to 3.8 cm, with an average of (3.1±0.6)cm. There were 6 cases on the left side and 4 cases on the right side, locate on lumbar side in 9 cases and ventral sied in 1 case. The R. E.N.A.L score was 4.0-6.0, with an average of (5.0±0.8). The preoperative creatinine was 66.9-90.1μmol/L, with an average of (75.1±9.0)μmol/L, preoperative GFR of 44. 6- 67. 3 ml /min, with an average of(56.7±7.7)ml/min, preoperative hemoglobin level of 119.0-156.0g/L, with an average of (135.8±11.4)g/L. All patients underwent laparoscopic non-blocking partial nephrectomy assisted by 180w lateral green laser, free the surrounding area of the tumor fully and completely expose the renal tumor. The laser fiber was placed through the green laser hand piece, and the fiber was connected with normal saline to wash the strip. The initial green laser vaporization power was set at 80W, and the hemostasis power at 35W.About 3mm away from the edge of the tumor, and one optical fiber away from the renal parenchyma, the renal parenchyma was cut with 80W power. In order to reduce the interference by smoke, high-pressure flushing was used through the optical fiber while vaporizing, and an attractor was used to push and peel the tumor. In case of bleeding during operation, hemostatic power can be used to close the bleeding point and gradually advance until the tumor was completely removed. The wounds of renal inner medulla and renal outer cortex were continuously sutured in 1-3 layers with barbed suture. It involved 9 cases via retroperitoneal approach and 1 case via abdominal approach. The operation time, postoperative hemoglobin decrease, extraction time of negative pressure drainage, postoperative hospital stay, postoperative pathology and postoperative complications were recorded, and the serum creatinine level and GFR level of the affected side were followed up 1 month after operation.Results:All the operations were successfully completed, and there was no conversion to open surgery or radical nephrectomy. One case changed to scissors fast resection and sutured hemostasis due to severe intraoperative bleeding. The operation time was 90.0-120.0 min, with the average of (104.5±9.0)min. The postoperative hemoglobin level was 96.0-132.0g/L, with an average of (115.2±11.8)g/L, and the difference was statistically significant ( P<0.05). The postoperative hemoglobin decreased from 12.0g/L to 25.0g/L, with an average of (20.6±4.6)g/L. The time of vacuum drainage was 5.0-7.0 days, with an average of (5.7±0.7)d. Postoperative hospital stay was 6.0-8.0 days, with an average of (6.7±0.7)d. No bleeding, urinary leakage and other complications occurred in all patients. There were 7 cases of clear cell carcinoma, 2 cases of papillary renal cell carcinoma and 1 case of angiomyolipoma. All margins were negative. One month after operation, creatinine ranged from 66.0 to 90.4μmol/L, with an average of (76.8±8.3)μmol/L, which was not significantly different compared with that before operation ( P>0.05). One month after operation, GFR was 45.1-60.8 ml/min, and with an average of (55.5±4.7)ml/min, and there was no significant difference compared with preoperative data( P>0.05). Conclusions:For T 1aN 0M 0 stage and exophytic renal tumors, laparoscopic non-blocking partial nephrectomy assisted by lateral green laser is safe and effective.

Objective:To explore the application of sentinel lymph node biopsy (SLNB) and its prognostic value in the treatment of acral melanoma.Methods:We retrospective analyzed 118 patients who underwent sentinel lymph node biopsy from Mar 2012 to Jun 2019 with effective follow-up data available in our institute. We ruled out palpable regional lymph node metastasis with preoperative imaging of MRI and ultrasonography, used the 99Tc m-Dextran (Dx) as a tracer, with intraoperative γ-ray probe positioning for SLN capture. Wide resection and reconstruction in primary lesion followed by complete lymph node dissection were underwent SLN positive patients. Cox regression model were used to analyze the prognostic factors. Results:The patients had an average disease history of 53.6 months (2-360 months), the primary lesion located at hands and feet in 84 cases, while 27 cases were subungual and 7 cases were cutaneous. The mean Breslow depth was 3.6 mm, and 72 cases (61.0%) combined with ulceration. The average number of SLN was 2.8, the SLN positive rate was 24.6% (29/118), and the false-negative rate was 2.5% (3/118). There were 24 cases (20.3%) developed clinically positive metastasis, including 7 cases displayed distant metastasis combined with lymph node metastasis (5.9%), 8 cases with clinically positive lymph node metastasis alone (6.8%), and 9 cases with distant metastasis (7.6%). There were 33 patients in stage Ⅰ, 56 patients in stage Ⅱ and 29 patients in stage Ⅲ, with a 5-years overall survival rate of 69.5%. The Breslow depth is an independent risk factor of SLN positive. While Breslow depth, SLN status, SLN positive number and clinically detectable metastasis are independent prognostic factors of the overall survival ( P<0.05). Conclusions:Patients without clinically positive regional lymph node metastasis under imaging and physical examinations, SLNB can provide accurate pathologic staging and play an accurate prediction role in the prognostic evaluation. SLNB should be carried out routinely in clinical practice.

Objective:To explore the application of sentinel lymph node biopsy (SLNB) and its prognostic value in the treatment of acral melanoma.Methods:We retrospective analyzed 118 patients who underwent sentinel lymph node biopsy from Mar 2012 to Jun 2019 with effective follow-up data available in our institute. We ruled out palpable regional lymph node metastasis with preoperative imaging of MRI and ultrasonography, used the 99Tc m-Dextran (Dx) as a tracer, with intraoperative γ-ray probe positioning for SLN capture. Wide resection and reconstruction in primary lesion followed by complete lymph node dissection were underwent SLN positive patients. Cox regression model were used to analyze the prognostic factors. Results:The patients had an average disease history of 53.6 months (2-360 months), the primary lesion located at hands and feet in 84 cases, while 27 cases were subungual and 7 cases were cutaneous. The mean Breslow depth was 3.6 mm, and 72 cases (61.0%) combined with ulceration. The average number of SLN was 2.8, the SLN positive rate was 24.6% (29/118), and the false-negative rate was 2.5% (3/118). There were 24 cases (20.3%) developed clinically positive metastasis, including 7 cases displayed distant metastasis combined with lymph node metastasis (5.9%), 8 cases with clinically positive lymph node metastasis alone (6.8%), and 9 cases with distant metastasis (7.6%). There were 33 patients in stage Ⅰ, 56 patients in stage Ⅱ and 29 patients in stage Ⅲ, with a 5-years overall survival rate of 69.5%. The Breslow depth is an independent risk factor of SLN positive. While Breslow depth, SLN status, SLN positive number and clinically detectable metastasis are independent prognostic factors of the overall survival ( P<0.05). Conclusions:Patients without clinically positive regional lymph node metastasis under imaging and physical examinations, SLNB can provide accurate pathologic staging and play an accurate prediction role in the prognostic evaluation. SLNB should be carried out routinely in clinical practice.

Objective: To investigate the effect and safety of intensive hyperthermia combined with low-dose cisplatin plus radiotherapy in the treatment of patients with locally advanced NSCLC. Methods: From January 2012 to December 2015, 104 patients with locally advanced NSCLC were chosen in the Second People's Hospital of Weifang and randomly divided into two groups according to the digital table, with 52 patients in each group.The control group was given low-dose cisplatin plus radiotherapy, and the observation group was given intensive hyperthermia on the basis of control group.The ORR, DCR, median OS, median PFS, KPS score, the levels of coagulation function index and tumor markers before and after treatment and incidence of side effects in the two groups were compared. Results: The DCR of the observation group was significantly higher than that of the control group(86.54% vs.69.23%, χ²=8.24, P<0.05). The median OS and median PFS of the observation group were significantly longer than those of the control group(11.9 months vs.8.3 months; 7.5 months vs.4.7 months, t=2.56, 3.01, P<0.05). The KPS scores after treatment of the observation group were significantly higher than those of the control group and before treatment[(75.49±8.94)points vs.(68.65±7.06)points; (75.49±8.94)points vs.(62.23±6.34)points, t=2.78, 5.11, all P<0.05]. The levels of coagulation function index and tumor markers after treatment of the observation group were significantly lower than those of the control group and before treatment(t=3.14, 2.67, 3.59, 7.31; 4.89, 4.02, 4.70, 9.21; 2.44, 2.60, 3.20; 3.15, 3.78, 4.06; all P<0.05). There was no statistically significant difference in the incidence of side effects between the two groups(P>0.05). Conclusion Intensive hyperthermia combined with low-dose cisplatin plus radiotherapy in the treatment of patients with locally advanced NSCLC can efficiently control disease progress, increase survival benefits, higher quality of life, improve coagulation function, reduce the levels of tumor markers and possess satisfactory safety.

Objective To investigate the safety and efficacy of mechanical thrombectomy (MT) compared with In?tra-arterial Thrombolysis (IAT) treatment in patients with severe acute ischemic stroke (AIS) caused by large cerebral ar?tery occlusion. Method The patients with AIS caused by large cerebral artery occlusion and underwent MT or IAT from 2005 May to 2014 May was included. A retrospective analysis was conducted on the onset to emergency(OTE)time, emergency to acupuncture(ETA)time, acupuncture to recanalization (ATR) time, stroke severity as measured by the Na?tional Institutes of Health Stroke Scale (NIHSS) score, and site of arterial occlusion on magnetic resonance angiography (MRA). A comparison was made between MT and IAT patients in rates of recanalization, symptomatic intracranial bleed?ing (SIB), mortality, and functional outcome. Three-month favourable outcome was defined as a modified Rankin Scale (mRS) score≤2. Result One hundred and two AIS patients were treated with MT and 50 with IAT. There was no differ?ence between MT and IAT groups with regard to demographics, onset NIHSS score (13.37±6.95 vs. 12.70±6.11;P=0.572) and discharge NIHSS score (8.40 ± 6.69 vs. 7.53 ± 7.28, P= 0.522) and the change of NIHSS score (3.87 ± 7.14 vs. 4.26 ± 5.42, P=0.766). There were significantly differences between MT and IAT groups in the OTE time (Median 300 min vs. 120 min,Z=-5.704,P=0.000) , ATR time (Median 30 min vs. 65 min,Z=-5.011,P=0.001) ,recanalization (91.2%vs. 60.0%,P =0.01),the rate of AIB(21.7% vs. 36.0%,P =0.046),3-month mortality (16.6% vs. 26.0%,P =0.043). The above parameters were better in MT group than in the IAT group. There were no significant differences between MT and IAT groups in the rate of SIB (12% vs. 16%,P =0.055), the NIHSS change(Median 3 vs. 4,Z =-0.236,P =0.823) and mRS score on 90d ( 48.2%vs. 46.0%, P=0.823). MT patients had significantly higher percentages of stent use (22.5%vs. 8%,P=0.018) . The Recanalization for ICA(81.8%vs. 55.6%,P=0.048),BA(93.1%vs. 55.6%,P=0.032)and MCA( 97.5% vs. 60.0%,P =0.026)was higher in MT group than in IAT group .The SIB rate for ICA(13.8% vs. 33.3%,P =0.000),BA(13.8%vs. 33.3%,P=0.000)was lower in MT group than in IAT group . The mortality rate of was significant?ly lower in MT than in IAT group for MCA (2.5%vs. 20.0%,P=0.000) . the good outcome rate for BA was higher in MT group than in IAT group(41.3%vs. 22.2%,P﹤0.01). Conclusions Compared to IAT,MT can provide broader time win?dow,higher recanalization rate and better outcome in patients with severe acute ischemic stroke (AIS) caused by large ce?rebral artery occlusion.