This article systematically reviews and verifies the name， origin， production area， quality evaluation， harvesting， processing and other aspects of Cynanchi Atrati Radix et Rhizoma（CARR） by consulting relevant ancient and modern literature， in order to provide a basis for the development and utilization of famous classical formulas containing this herb. Through textual research， Baiwei has been the official name for CARR， though it also bears alternative names such as Chuncao， Popo Zhenxianbao， Longdan Baiwei. The mainstream base is the roots and rhizomes of Cynanchum atratum. Historical records indicate primary producing areas include Shandong， Anhui， Jiangsu， Shaanxi and Shanxi. Since the late Ming dynasty， varieties from Juxian， Yishui and Rizhao in Shandong have been highly regarded as authentic， commonly known as eastern Baiwei. Since modern times， its quality has been summarized as fine， slender， and straight fibrous roots， pale yellow exterior， whiter interior， and dryness with easy breakability are considered superior. The harvesting time before the Song dynasty was on the third day of the third lunar month， but after the Song dynasty， harvesting was possible in both spring and autumn. The initial processing methods of CARR in ancient times included drying in the shade， removing Lu（the little rhizomes which are on tap of roots）， and removing mustaches， modern methods involve washing and sun-drying. During the Northern and Southern dynasties， processing methods included steaming. In the Song dynasty， drying and light stir-frying were predominant， while wine washing emerged in the Ming dynasty. Modern practices primarily involve using raw， stir-frying or honey processing. Regarding the medicinal properties of CARR， both ancient and modern texts agree it has a bitter and salty taste and is non-toxic. Records prior to the Qing dynasty predominantly describe its nature as extremely cold， while mainstream herbal texts after the Qing dynasty generally characterize it as cold. Before the Ming dynasty， there were no records of its meridian tropism. It was not until the Qing dynasty that it was recorded in the lung meridian. Modern records mainly refer to the stomach， liver， and kidney meridians. Throughout history， its main functions have been to clear heat， diuresis， nourish Yin， and replenish essence， primarily treating Yin deficiency and fever syndrome. Based on the research results， it is suggested that when developing famous classical formulas containing CARR， the dried roots and rhizomes of C. atratum can be selected as its medicinal source. If there are no specific processing requirements， raw products can be selected as medicine. If the processing requirements are specified， corresponding processed products can be selected as medicine according to the original formula requirements.

This article systematically analyzes the historical evolution of the name， origin， medicinal parts， producing area， harvesting and processing， nature， flavor and efficacy of Piperis Longi Fructus by referring to the materia medica， medical books， and prescription books of past dynasties， combined with the relevant modern literature， in order to provide a basis for the development and utilization of famous classical formulas containing this herb. According to the herbal textual research， the name of Piper longum first appeared in Nanfang Caomuzhuang， and it also has other aliases such as Biboli， Halou， and Hujiaohua. Historically， the origin of Piperis Longi Fructus has been P. longum of the Piperaceae family. In ancient times， both the fruit and root were used as medicine， and since the Republic of China， the fruit has been mainly used as medicine. The medicinal part is the dried， nearly ripe or ripe fruit spikes. Piperis Longi Fructus is native to India and has been introduced into China since the Tang dynasty. In the Ming dynasty， Bencao Pinhui Jingyao clearly stated that the genuine producing area was "Duanzhou"， present-day Zhaoqing in Guangdong province. Nowadays， it is planted in Guangdong， Guangxi， Hainan， Yunnan and other regions. Historically and currently， harvesting occurs in autumn. The ancient processing method uniformly involved removing the stems， soaking in the sourest vinegar overnight， baking， and scraping off the peels and grains with a knife until clean. In modern times， impurities are removed， and it is dried in the sun and crushed when used. The properties， functions and applications of P. longum are basically the same in ancient and modern times. It tastes pungent， is warm in nature， and non-toxic. It has the effects of warming the middle-jiao to dispel cold， lowering Qi and relieving pain， and is used for cold pain in the epigastrium and abdomen， vomiting， diarrhea， chest pain， headache， and toothache. Based on the research results， it is recommended that when developing famous classical formulas containing Piperis Longi Fructus， the dried nearly ripe or ripe fruit spikes of P. longum should be used. If there are no clear processing requirements， it is recommended to use the raw products for medicinal use， and the specific processing methods can refer to the relevant requirements under Piperis Longi Fructus in the 2025 edition of the Pharmacopoeia of the People's Republic of China. If processing requirements such as soaking in vinegar and peeling are clearly specified， it is recommended to follow the ancient methods.

This article systematically analyzes the historical evolution of the name， origin， medicinal parts， producing area， harvesting and processing， nature， flavor and efficacy of Piperis Longi Fructus by referring to the materia medica， medical books， and prescription books of past dynasties， combined with the relevant modern literature， in order to provide a basis for the development and utilization of famous classical formulas containing this herb. According to the herbal textual research， the name of Piper longum first appeared in Nanfang Caomuzhuang， and it also has other aliases such as Biboli， Halou， and Hujiaohua. Historically， the origin of Piperis Longi Fructus has been P. longum of the Piperaceae family. In ancient times， both the fruit and root were used as medicine， and since the Republic of China， the fruit has been mainly used as medicine. The medicinal part is the dried， nearly ripe or ripe fruit spikes. Piperis Longi Fructus is native to India and has been introduced into China since the Tang dynasty. In the Ming dynasty， Bencao Pinhui Jingyao clearly stated that the genuine producing area was "Duanzhou"， present-day Zhaoqing in Guangdong province. Nowadays， it is planted in Guangdong， Guangxi， Hainan， Yunnan and other regions. Historically and currently， harvesting occurs in autumn. The ancient processing method uniformly involved removing the stems， soaking in the sourest vinegar overnight， baking， and scraping off the peels and grains with a knife until clean. In modern times， impurities are removed， and it is dried in the sun and crushed when used. The properties， functions and applications of P. longum are basically the same in ancient and modern times. It tastes pungent， is warm in nature， and non-toxic. It has the effects of warming the middle-jiao to dispel cold， lowering Qi and relieving pain， and is used for cold pain in the epigastrium and abdomen， vomiting， diarrhea， chest pain， headache， and toothache. Based on the research results， it is recommended that when developing famous classical formulas containing Piperis Longi Fructus， the dried nearly ripe or ripe fruit spikes of P. longum should be used. If there are no clear processing requirements， it is recommended to use the raw products for medicinal use， and the specific processing methods can refer to the relevant requirements under Piperis Longi Fructus in the 2025 edition of the Pharmacopoeia of the People's Republic of China. If processing requirements such as soaking in vinegar and peeling are clearly specified， it is recommended to follow the ancient methods.

Objective To explore the application efficacy of refined management on antimicrobial agents in a chest specialty hospital.Methods Multiple measures were implemented through perfecting management systems and processes,as well as conducting knowledge training,such as multi-dimensional specialized prescription reviewing,optimizing information systems,and implementing grid-based management of clinical pharmacist.A refined manage-ment mode for antimicrobial agents in a chest specialty hospital has been established.Antimicrobial management in-dicators for the whole hospital and each clinical specialty in 2023(before management)and 2024(after manage-ment)were analyzed.Results Compared with 2023,antimicrobial use rate among hospitalized patients in 2024 de-creased from 47.48％to 45.92％,and antimicrobial use density(AUD)decreased from 46.28 defined daily doses(DDDs)/(100 person·day)to 39.73 DDDs/(100 person·day).The ratio of antimicrobial cost to total drug cost decreased from 12.71％to 9.51％,and the per capita cost of antimicrobial use decreased from 1 344.18 Yuan to 975.52 Yuan.The use rate of prophylactic antimicrobial agents for class Ⅰ incision surgery increased from 84.48％to 89.52％,and the rationality rate increased from 69.25％to 94.53％.The management indicators of each clinical specialty improved significantly.Conclusion Through adopting a series of refined management measures,antimi-crobial management modes that are suitable for the actual situation of the hospital has been constructed,and obvious efficacy was achieved.Clinical application of antimicrobial agents is more standardized and rational.

Objective To introduce an information system into the medical waste collection and transportation manage-ment process in medical and health institutions and assess its impact on collection and transportation.Methods The relevant in-dex data,such as the total amount of medical waste,per capita waste output,and handover weight error rate of a certain tertiary hospital in Guangzhou,were compared between pre-and post-introduction of the information system.Results After the intro-duction of the system,the total output of medical waste decreased by 2％year-on-year,the average daily output of medical waste per hospital bed decreased by 13％year-on-year,and the error rate between the in-hospital transfer volume and the waste disposal by medical waste companies decreased from 4.54％to 0.47％.Conclusion The medical waste treatment information system can improve the accuracy of collection and transportation data,and reduce medical wastes,thereby improving the management of medical waste treatment,and enhancing the collection and transportation efficiency of medical wastes.

Objective Against the backdrop of the country's initiative to channel high-quality medical resources to grassroots levels,the development model of public hospitals with multiple campuses has become a trend.This paper aims to pro-vide a reference for achieving the coordinated development of multiple campuses.Methods Taking the Traditional Chinese Med-icine Hospital Affiliated to Guangzhou Medical University as an example,this paper analyzed the patient satisfaction in public hospitals with multiple campuses,and studied the service differences and their causes from the perspective of patients' perception in different campuses.Results In 2024,the patient satisfaction scores of Tianhe,Zhuji,and Tongde branches were 89.15,89.91,and 88.71 respectively.For outpatient service satisfaction,the highest-scoring items were the consultation environment(91.19)at Tianhe branch,hospital services(91.99)at Zhuji branch,and the consultation process(89.35)at Tongde branch.Regarding inpatient service satisfaction,the highest scores in all three branches were for hospital management,while the lowest scores were for logistics services.Conclusion There are differences in patient satisfaction among different branches.There are significant differences in outpatient services among the branches.The satisfaction scores of non-medical services such as the envi-ronment and process in Tianhe branch are relatively high,while the scores of hospital services in Zhuji branch and Tongde branch are relatively high.However,the evaluations of inpatient services among the branches are relatively consistent.The satisfaction scores,from high to low,are in the order of hospital management＞diagnosis and treatment services＞consultation process＞inpatient environment＞logistics services.

Metabolic disorders and immunosuppression exist in peripartal cows,and glutamine(GLN)has the potential efficacy to improve the negative energy balance(NEB)and the function of neutrophil(polymorphonuclear granulocyte,PMN)in peripartal cows.The aim of the present study was to investigate the effects of supplementation with rumen-protected GLN on the metabo-lism and the phagocytosis function of PMN in peripartal cows.Twenty Chinese Holstein cows with similar age,parity,body condition score and expected date of delivery were selected and divided into CON(n=10,fed basal diet)and GLN groups(n=10,supplemented with 180 g/d of rumen-protected GLN).During the test period of 42 d,blood samples were collected at-21,-14,-7,0,7,14 and 21 d.Milk production was recorded at 7,14 and 21 d,respectively.The results showed that:serum GLN concentrations in peripartal cows continued to decrease until they increased after 7 d postpartum,suggesting that peripartal cows may be in a state of GLN deficiency.The serum GLN content of the cows increased significantly(P＜0.05)from-7 to 21 d after GLN supple-mentation,indicating that supplementation was effective.The blood glucose concentration of peri-partal cows increased on the day of parturition but decreased postpartum,and the concentrations of non-esterified fatty acid(NEFA)and β-hydroxybutyrate(BHBA)in the blood increased postpar-tum,which indicated that peripartal cows had a physiological NEB.Blood glucose concentration in-creased significantly(P＜0.01)at-7,14 and 21 d after GLN supplementation,and blood concen-trations of NEFA and BHBA decreased significantly(P＜0.01)postpartum,suggesting that peri-partal cows had a NEB alleviated by GLN supplementation.Serum malondialdehyde(MDA)con-centration of periparturient cow peaked on the day of parturition but declined postpartum,and the concentration of MDA reached a peak on the day of delivery but declined postpartum,and the total antioxidant capacity(T-AOC)level continued to decline until it increased on the day of parturi-tion,indicating that peripartal cows were in a state of oxidative stress.Serum MDA concentration significantly decreased(P＜0.05)and serum T-AOC level significantly increased(P＜0.05)after GLN supplementation,indicating that antioxidant capacity of peripartal cows was improved by GLN supplementation.The concentration of serum pro-inflammatory factor IL-β peaked on the day of parturition and then decreased,the concentration of TNF-α peaked on the day of parturition and then decreased,and the concentration of anti-inflammatory factor IL-10 continued to decrease,which indicated that there was an inflammatory reaction in the cows during the periparturient peri-od.However,the levels of IL-1β on the day of delivery and postpartum decreased significantly(P＜0.01),the levels of TNF-α decreased(P＜0.05),and the levels of IL-10 increased significantly(P＜0.01)throughout the peripartum period,which indicated that GLN supplementation im-proved the anti-inflammatory ability of periparturient dairy cows.The phagocytosis function of PMN in peripartal cows was significantly reduced from-14 d to the day of parturition(P＜0.01),and the phagocytosis function of neutrophils was significantly enhanced after GLN supple-mentation at-14(P＜0.05),14 and 21 d(P＜0.01),which indicated that intrinsic immune func-tion of peripartal cows was enhanced by supplementation of GLN.GLN supplementation did not significantly affect milk production of cows at three weeks postpartum.In conclusion,supplemental rumen-protected GLN alleviated NEB,alleviated systemic oxidative stress and inflammatory re-sponse,and enhanced phagocytosis of PMN in peripartal cows,which has some potential for clini-cal application.

Objective Against the backdrop of the country's initiative to channel high-quality medical resources to grassroots levels,the development model of public hospitals with multiple campuses has become a trend.This paper aims to pro-vide a reference for achieving the coordinated development of multiple campuses.Methods Taking the Traditional Chinese Med-icine Hospital Affiliated to Guangzhou Medical University as an example,this paper analyzed the patient satisfaction in public hospitals with multiple campuses,and studied the service differences and their causes from the perspective of patients' perception in different campuses.Results In 2024,the patient satisfaction scores of Tianhe,Zhuji,and Tongde branches were 89.15,89.91,and 88.71 respectively.For outpatient service satisfaction,the highest-scoring items were the consultation environment(91.19)at Tianhe branch,hospital services(91.99)at Zhuji branch,and the consultation process(89.35)at Tongde branch.Regarding inpatient service satisfaction,the highest scores in all three branches were for hospital management,while the lowest scores were for logistics services.Conclusion There are differences in patient satisfaction among different branches.There are significant differences in outpatient services among the branches.The satisfaction scores of non-medical services such as the envi-ronment and process in Tianhe branch are relatively high,while the scores of hospital services in Zhuji branch and Tongde branch are relatively high.However,the evaluations of inpatient services among the branches are relatively consistent.The satisfaction scores,from high to low,are in the order of hospital management＞diagnosis and treatment services＞consultation process＞inpatient environment＞logistics services.

Metabolic disorders and immunosuppression exist in peripartal cows,and glutamine(GLN)has the potential efficacy to improve the negative energy balance(NEB)and the function of neutrophil(polymorphonuclear granulocyte,PMN)in peripartal cows.The aim of the present study was to investigate the effects of supplementation with rumen-protected GLN on the metabo-lism and the phagocytosis function of PMN in peripartal cows.Twenty Chinese Holstein cows with similar age,parity,body condition score and expected date of delivery were selected and divided into CON(n=10,fed basal diet)and GLN groups(n=10,supplemented with 180 g/d of rumen-protected GLN).During the test period of 42 d,blood samples were collected at-21,-14,-7,0,7,14 and 21 d.Milk production was recorded at 7,14 and 21 d,respectively.The results showed that:serum GLN concentrations in peripartal cows continued to decrease until they increased after 7 d postpartum,suggesting that peripartal cows may be in a state of GLN deficiency.The serum GLN content of the cows increased significantly(P＜0.05)from-7 to 21 d after GLN supple-mentation,indicating that supplementation was effective.The blood glucose concentration of peri-partal cows increased on the day of parturition but decreased postpartum,and the concentrations of non-esterified fatty acid(NEFA)and β-hydroxybutyrate(BHBA)in the blood increased postpar-tum,which indicated that peripartal cows had a physiological NEB.Blood glucose concentration in-creased significantly(P＜0.01)at-7,14 and 21 d after GLN supplementation,and blood concen-trations of NEFA and BHBA decreased significantly(P＜0.01)postpartum,suggesting that peri-partal cows had a NEB alleviated by GLN supplementation.Serum malondialdehyde(MDA)con-centration of periparturient cow peaked on the day of parturition but declined postpartum,and the concentration of MDA reached a peak on the day of delivery but declined postpartum,and the total antioxidant capacity(T-AOC)level continued to decline until it increased on the day of parturi-tion,indicating that peripartal cows were in a state of oxidative stress.Serum MDA concentration significantly decreased(P＜0.05)and serum T-AOC level significantly increased(P＜0.05)after GLN supplementation,indicating that antioxidant capacity of peripartal cows was improved by GLN supplementation.The concentration of serum pro-inflammatory factor IL-β peaked on the day of parturition and then decreased,the concentration of TNF-α peaked on the day of parturition and then decreased,and the concentration of anti-inflammatory factor IL-10 continued to decrease,which indicated that there was an inflammatory reaction in the cows during the periparturient peri-od.However,the levels of IL-1β on the day of delivery and postpartum decreased significantly(P＜0.01),the levels of TNF-α decreased(P＜0.05),and the levels of IL-10 increased significantly(P＜0.01)throughout the peripartum period,which indicated that GLN supplementation im-proved the anti-inflammatory ability of periparturient dairy cows.The phagocytosis function of PMN in peripartal cows was significantly reduced from-14 d to the day of parturition(P＜0.01),and the phagocytosis function of neutrophils was significantly enhanced after GLN supple-mentation at-14(P＜0.05),14 and 21 d(P＜0.01),which indicated that intrinsic immune func-tion of peripartal cows was enhanced by supplementation of GLN.GLN supplementation did not significantly affect milk production of cows at three weeks postpartum.In conclusion,supplemental rumen-protected GLN alleviated NEB,alleviated systemic oxidative stress and inflammatory re-sponse,and enhanced phagocytosis of PMN in peripartal cows,which has some potential for clini-cal application.

Objective: To explore the effects of sleep on subsequent day physical activity (PA) in children and adolescents, so as to provide a reference for refining PA intervention strategies and further investigating their underlying mechanisms. Methods: Through searching databases including Web of Science Core Collection, PubMed, EBSCOhost, ScienceDirect, Cochrane Library, CNKI, Wanfang and VIP cross sectional, cohort and experimental studies on sleep and subsequent day PA among children and adolescents were identified, with the searching period spanning from database inception to June, 2025. Based on the characteristics of the included literature, two sleep variables[sleep duration (SD) and sleep efficiency (SE)] and three physical activity variables[moderate to vigorous physical activity (MVPA), light physical activity (LPA), and total physical activity (TPA)] were selected. The relationship between these two types of variables was analyzed for pooled effect sizes using Stata 17.0. Results: A total of 14 studies were included, with 64.3% published in 2018 or later, involving 11 361 children and adolescents from 17 countries. Meta analysis results showed that both SD ( ES=0.04, 95%CI =0.01-0.07) and SE ( ES=0.24, 95%CI =0.01-0.47) were positively correlated with subsequent day MVPA (both P <0.05). However, no statistically significant associations were found with LPA ( ES=-0.04, 95%CI =-0.13 to 0.06; ES=-0.02, 95%CI =-0.15 to 0.11) or TPA( ES=0.09, 95%CI =-0.02 to 0.20; ES=0.02, 95%CI = -0.03 to 0.06)(all P >0.05). Subgroup analysis revealed that in the "≤6 years" subgroup, SD and SE were positively correlated with TPA ( ES=0.22, 95%CI =0.09-0.35) and MVPA ( ES=1.19, 95%CI =1.06-1.32), respectively; in the "6-12 years" subgroup, SD was positively correlated with MVPA ( ES=0.05, 95%CI =0.02-0.08); in the "≥12 years" subgroup, SE was positively correlated with LPA ( ES=0.08, 95%CI =0.00-0.16), while SD was negatively correlated with LPA ( ES=-0.23, 95%CI = -0.31 to -0.16) (all P <0.05). Conclusion Adequate SD and good SE can effectively enhance subsequent day MVPA among children and adolescents, although these sleep effects vary by age group.