This study developed a core outcome set(COS) for traditional Chinese medicine(TCM) interventions in diabetic peripheral neuropathy(DPN), standardizing evaluation metrics for TCM efficacy and providing a new framework for DPN treatment and management. A systematic search was conducted across databases, including CNKI, Wanfang, and PubMed, targeting clinical trial literature published between January 1, 2013, and January 1, 2023. The search focused on extracting outcome indicators and measurement tools used in TCM treatments for DPN. Retrospective data collection was performed from January 2018 to June 2023, involving 200 DPN patients hospitalized at the Department of Endocrinology of the First Affiliated Hospital of Anhui University of Chinese Medicine. Additionally, semi-structured interviews were conducted with inpatients, outpatients, their families, and nursing staff to further refine and enhance the list of outcome indicators. After two rounds of Delphi questionnaire survey and consensus meeting, a consensus was reached. The study initially retrieved 3 421 publications, of which 170 met the inclusion criteria after review. These publications, combined with retrospective analysis and semi-structured interviews, supplemented the list of indicators. After two rounds of Delphi surveys, experts agreed on 24 indicators and 6 measurement tools. The final COS determined by expert consensus meeting included 5 domains and 13 outcome indicators: neurological function signs, quality of life, TCM syndrome score, nerve conduction velocity, current perception threshold test, fasting blood glucose, 2 h postprandial blood glucose, glycated hemoglobin, complete blood count, urinalysis, liver function test, kidney function test, and electrocardiogram.
Humans ; Diabetic Neuropathies/drug therapy* ; Medicine, Chinese Traditional/methods* ; Drugs, Chinese Herbal/therapeutic use* ; Retrospective Studies ; Treatment Outcome ; Male ; Female

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To establish a real-time fluorescent quantitative PCR for the detection of torque teno virus types 7 (TTV7), 8 (TTV8) and 10 (TTV10) and analyze its performance in clinical sample detection.Methods:Specific primers were designed based on the gene sequences of TTV7, TTV8 and TTV10 in GenBank. Recombinant plasmids of pMD19-T-TTV7, pMD19-T-TTV8 and pMD19-T-TTV10 were constructed and used as positive standard control to establish a real-time fluorescent quantitative PCR based on FAM-Eclipse probe method. The specificity and sensitivity of the established method were evaluated. Moreover, it was validated in terms of clinical sample detection.Results:The standard curve equations of the real-time fluorescent quantitative PCR for detecting TTV7, TTV8 and TTV10 were y=-0.340 2 x+ 114.780 0 ( R2=0.998 8), y=-0.351 1 x+ 114.940 0 ( R2=0.995 3) and y=-0.348 9 x+ 115.020 0 ( R2=0.991 7), respectively, and there was no cross-reaction with other viruses. The detection sensitivity of the established method for TTV7, TTV8 and TTV10 were 108 copies/μl, 84 copies/μl and 98 copies/μl, and the positive detection rates in clinical pediatric serum samples were 10.9%, 2.1% and 4.3%, respectively. Conclusions:The established real-time fluorescent quantitative PCR for detection of TTV7, TTV8 and TTV10 was featured by strong specificity and high sensitivity, which could be used for rapid TTV detection in clinical serum samples.

OBJECTIVE: To explore the association among job burnout, tolerance to uncertainty and working with sickness in clinical nurses. METHODS: A total of 1 159 clinical nurses from 10 cities in Henan Province and Fujian Province were recruited by stratified cluster sampling method and tested by questionnaires including the Chinese Perceived Stress Scale-14, the Intolerance of Uncertainty Scale-12, the Sickness Presenteeism Questionnaire, and the Maslach Burnout Inventory-general Survey. Bootstrap was used to analyze the association among perceived stress, tolerance to uncertainty, working with sickness and job burnout. RESULTS: Perceived stress score was(31.4±4.8), and 802(69.2%) of nurses had high perceived stress level. The score of tolerance to uncertainty was(29.8±8.5), and the score of working with sickness score was(5.5±2.0). The job burnout score was(47.9±11.8), and 570(49.2%) nurses had job burnout. Bootstrap test results showed that the perceived stress score positively affected job burnout score [standardized partial regression coefficient(β)=0.30, P<0.01]. Working with sickness score played a regulatory role between perceived stress and job burnout scores(β=0.16, P<0.01), and tolerance to uncertainty score played an intermediary role between perceived stress and job burnout scores(β=0.08, P<0.01). The regulating effect of working with sickness score played a role through the mediation of tolerance to uncertainty score. CONCLUSION: Job burnout was very serious in clinical nurses. Perceived stress can directly or through tolerance to uncertainty affect the job burnout of clinical nurses and is synergistically affected by sickness presenteeism.

Objective To discuss the application of 3D laser scanner and computer technology in restoration of the accident scene and reconstruction of the accident process, as well as identification of the driver-passenger relationship. Methods The scene of a traffic accident, the accident vehicle and the vehicle of the same type as accident vehicle were scanned using 3D laser scanner. The accident scene, traces and accident vehicle were integrated using computer technology to restore the accident scene, and the accident process was reconstructed and analyzed by combining the characteristics of the body injuries. Results By restoring the accident scene and reconstructing the accident process with 3D laser scanner, it was determined that Wu was in the driving seat at the time of the accident. Conclusion It is more objective and scientific to use 3D laser scanning technology to restore the accident scene, reconstruct the accident process and analyze the moving track of the driver and passengers in the vehicle. It will help to improve the accuracy of forensic identification of road traffic accidents.
Accidents, Traffic ; Computer Simulation

Objective: To investigate the current status and changes of disease burden of cardio-cerebrovascular diseases in 1990 and 2016 for Beijing people. Methods: Using the results of the Global Burden of Diseases Study 2016 (GBD 2016) to describe deaths status and disease burden of cardio-cerebrovascular diseases in Beijing. The measurement index included the total deaths, years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted years (DALY). Using the average world population from 2000 to 2025 as standard population to calculate the age-standardized mortality rate, DALY rate, YLL rate and YLD rate. Results: The age-standardized mortality rate of cardio-cerebrovascular diseases was 209.24 per 100 000. In 2016, DALY, YLL and YLD of cardio-cerebrovascular was 875.6, 733.6 and 142.0 thousand person-years, respectively, which has increased by 58.05%, 44.24% and 213.47%, respectively, than that in 1990. The age-standardized DALY rate and age-standardized YLL rate of cardio-cerebrovascular diseases in 2016 was 3 552.24 and 2 988.01 per 100 000 which has decreased by 47.90% and 52.43%, respectively, than that in 1990. The age-standardized YLD rate of cardio-cerebrovascular diseases in 2016 was 564.23 per 100 000 which increased by 5.10% than that in 1990. In 2016, the total death of cerebrovascular disease and ischemic heart disease was 17.6 thousand and 23.7 thousand, respectively. DALY was 396.3 and 393.6 thousand person-years in 2016, while 330.2 and 162.7 thousand person-years in 1990, which has increased by 20.02% and 141.92%, respectively. Conclusions: The disease burden of cardio-cerebrovascular disease is serious, especially the burden of cerebrovascular disease and ischemic heart disease. The disability burden of cerebrovascular disease is serious. The disease burden of ischemic heart disease has multiplied.
Beijing ; Cerebrovascular Disorders ; Cost of Illness ; Disabled Persons ; Humans ; Mortality, Premature ; Quality-Adjusted Life Years

Objective: To understand the consistency of ALK Ventana-D5F3 immunohistochemistry (IHC) interpretation in Chinese lung adenocarcinoma among histopathologists from different hospitals, and to recommend solution for the problems found during the interpretation of ALK IHC in real world, with the aim of the precise selection of patients who can benefit from ALK targeted therapy. Methods: This was a multicenter and retrospective study. A total of 109 lung adenocarcinoma cases with ALK Ventana-D5F3 IHC staining were collected from 31 lung cancer centers in RATICAL research group from January to June in 2018. All cases were scanned into digital imaging with Ventana iSCANcoreo Digital Slide Scanning System and scored by 31 histopathologists from different centers according to ALK binary (positive or negative) interpretation based on its manufacturer′s protocol. The cases with high inconsistency rate were further analyzed using FISH/RT-PCR/NGS. Results: There were 49 ALK positive cases and 60 ALK negative cases, confirmed by re-evaluation by the specialist panel. Two cases (No. 2302 and No.2701) scored as positive by local hospitals were rescored as negative, and were confirmed to be negative by RT-PCR/FISH/NGS. The false interpretation rate of these two cases was 58.1% (18/31) and 48.4% (15/31), respectively. Six out of 31 (19.4%) pathologists got 100% accuracy. The minimum consistency between every two pathologists was 75.8%.At least one pathologist gave negative judgement (false negative) or positive judgement (false positive) in the 49 positive or 60 negative cases, accounted for 26.5% (13/49), 41.7% (25/60), respectively, with at least one uncertainty interpretation accounted for 31.2% (34/109). Conclusion There are certain heterogeneities and misclassifications in the real world interpretation of ALK-D5F3 IHC test, which need to be guided by the oncoming expert consensus based on the real world data.

Objective To explore the effect of pulmonary rehabilitation on activities of daily living(ADL)and pulmonary function in patients with chronic schizophrenia complicated with pulmonary infection at stable stage. Methods From January,2014 to July,2017,62 patients with chronic schizophrenia complicated with pulmonary infec-tion at stable stage were randomly divided into control group(n=31)and observation group(n=31).Both groups accepted routine medication,while the observation group received pulmonary rehabilitation for two months in ad-dition.The distance of 6-Minute Walk Test(6MWT),the modified Barthel index(MBI),modified British Medi-cal Research Council Dyspnea Scale (mMRC), C-reactive protein (CRP), Zung Anxiety Self-Rating Scale and Zung Depression Self-Rating Scale were compared before and after training. Results The total effective rate was higher in the observation group than in the control group(χ2=5.415,P=0.020).Com-pared with the control group,the distance of 6MWT increased(t=5.463,P=0.008),the score of MBI increased(t=2.142, P=0.028), the score of mMRC decreased (t=3.689, P=0.013), and the level of CRP decreased (t=-2.179,P=0.031)in the observation group.The scores of Zung Anxiety Self-Rating Scale(t=5.048,P=0.009) and Zung Depression Self-Rating Scale(t=-1.388,P=0.045)both decreased. Conclusion An early implementation of pulmonary rehabilitation could improve ADL and the exercise endurance,and reduce the incidence of infection in patients with chronic schizophrenia complicated with pulmonary infection at stable stage.

Objective To evaluate the clinical outcomes and report the second-look arthroscopic findings of reconstructed anterior cruciate ligament (ACL) using deep-frozen allograft.Methods Sixty-six patients undergoing ACL reconstruction using deep-frozen allograft in our institute with at least twelve months follow-up from January 2012 to March 2016 were included and received second-look arthroscopy.The patients consisted of 51 males and 15 females with an average age of 30.6 years (range,18 to 55 years) at the time of ACL reconstruction.Knee functions were evaluated by Lysholm score and International Knee Documentation Committee (IKDC) score.Knee stability was evaluated by drawer test,Lachman test and KT-1000 arthrometer.Second-look arthroscopic evaluation was performed in all patients,focused on continuity of the reconstructed ACL,the synovial coverage and subjective tension of the graft,and the prevalence of cyclops-like lesion and other changes after reconstruction procedures.Resuits All patients were followed up for average 18.3 months (range,12 to 36 months).Thirty-one patients underwent second-look arthroscopy from 12 to 18 months,and the other 35 patients underwent second-look arthroscopy from 18 to 36 months after ACL reconstruction.No infection,rejection reaction and other serious complication were reported after operation.The knee range of motion was normal in all cases,except that 10° extension limitation in one case.The Lysholm score significantly improved from preoperative 54.95±9.01 to 12 months postoperatively 86.14±5.86,and the IKDC improved from 54.79±9.12 to 85.11±5.77.Lachman test was positive in 8 cases,but negative in 58 cases postoperatively.KT-1000 arthrometer measurement showed that the side-toside difference significantly improved from preoperative 6.70± 1.24 mm to postoperative 1.52± 1.02 mm.Complete discontinuity occurred in 2 cases of the reconstructed grafts,graft tear in 4 cases.Cyclops-like mass was identified in 2 cases.The overall synovial coverage was slightly better in the patients who were followed up more than 18 months than those less than 18 months.However,there was no significant difference among the groups in the field of graft tension.The patients with taut grafts showed statistically better KT-1000 values (1.14±0.35 mm) than those with lax grafts (2.95±1.38 mm).Conclusion Frozen allograft could be a reasonable choice for ACL reconstruction.However,the graft integration and remodeling could tend to be slow.

Objective To enhance the diagnosis of cerebral infarction of the hematopathy patient by analyzing its causes and MRI manifestations.Methods Totally 36 hematopathy patients with cerebral infarction from April 2010 to November 2015 had their data discussed retrospectively on involved vessel,anatomic distribution and MRI manifestations.Results Of the 36 patients,12 ones had only an artery involved in and 24 ones had multi arteries affected,31 ones had multi cerebral infarction foci and 5 ones had single focus.The foci had high or slighdy high signals in T2WI and very high signals in DWI,and there were no enhancement or only gyrus-like enhancement around the foci found by enhanced scan.Conchusion MRI gains advantages over CT when used to diagnose and find the hematopaty patient with cerebral infarction,when it has to be differentiated with cerebral early infection and parenchymal infiltration.It's suggested that the hematopathy patient has to undergo MRI examination in case central nervous system symptoms especially cerebral infarction occur.