Objective:To explore the clinical efficacy of the fourth-generation minimally invasive surgery (MIS) for the treatment of hallux valgus.Methods:A retrospective analysis was conducted on 26 patients (42 feet) who underwent fourth-generation MIS for hallux valgus at Peking University People's Hospital from October 2019 to March 2023. The patients included 5 males (9 feet) and 21 females (33 feet), with an average age of 49.9±15.1 years (range 19-75 years). The hallux valgus deformity was corrected through minimally invasive extra-articular transverse osteotomy of the distal metatarsal combined with Akin osteotomy, fixation with a single fully threaded screw, and lateral soft tissue release after osteotomy. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured before surgery and at the final follow-up. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and the visual analogue scale (VAS) were used to evaluate the treatment efficacy.Results:All 26 patients (42 feet) were followed up for a mean duration of 9.6±5.2 months (range 6-30 months). All 42 feet successfully underwent surgery, with an average operation time of 69.1±16.2 minutes (range 30-105 minutes) and an average blood loss of 10.0±7.4 ml (range 1-30 ml). No serious complications such as major vessel, nerve, or tendon damage occurred during the surgery for any patient. During the follow-up, one foot developed stiffness in the first metatarsophalangeal joint due to a lack of timely functional exercise after surgery. No other complications such as recurrence, delayed union, or nonunion were observed. By the final follow-up, one patient (2 feet) requested removal of the internal fixation. The HVA before surgery and at the final follow-up was 29.5±7.4 and 9.2±4.6, respectively, while the IMA was 11.9±3.8 and 5.0±3.6. The AOFAS score improved from 56.6±10.2 to 91.7±6.8, and the VAS score decreased from 5.2±2.3 to 0.9±1.1, all with significant differences ( P<0.05). Conclusion:The fourth-generation minimally invasive surgery for hallux valgus, characterized by minimally invasive transverse osteotomy, fixation with a single fully threaded screw, lateral soft tissue release after osteotomy, and Akin osteotomy is simple, safe, effective and easy to operate with fewer complications.

To investigate the prevalence of influenza D virus(IDV)in cattle and swine populations in Jilin Province,China,277 nasopharyngeal swabs were collected from livestock exhibiting influ-enza-like symptoms for IDV detection.Virus isolation was performed using swine testicular(ST)cells for PCR-positive samples,followed by comprehensive analyses including whole-genome se-quencing,phylogenetic analysis,electron microscopic observation of viral morphology,and glycosy-lation site prediction.Two IDV strains were successfully isolated from bovine samples,designated as D/bovine/China/JL22/2024(JL22)and D/bovine/China/JL34/2024(JL34).These strains were demonstrated to have specific hemagglutination activity against turkey red blood cells,while no he-magglutination to chicken,rabbit,or guinea pig erythrocytes.Virus-inoculated ST cells exhibited distinct cytopathic effects(CPE)within 48 h,with a hemagglutination titer of 4 log2 in the culture supernatant.Phylogenetic analysis of the hemagglutinin-esterase-fusion(HEF)gene indicated that these strains were most closely related to the Japanese isolate D/Yamagata2019,belonging to the YAMA2019 lineage.Genomic sequence analysis showed the absence of genetic reassortment in these isolates.In this study,two IDV strains were successfully isolated and characterized,which provides preliminary insights into their genomic sequences and biological properties.The findings confirm the presence of IDV in bovine populations in Jilin Province and provide the fundamental data for future epidemiological surveillance and control strategies of IDV.

Objective:To explore the clinical efficacy of the fourth-generation minimally invasive surgery (MIS) for the treatment of hallux valgus.Methods:A retrospective analysis was conducted on 26 patients (42 feet) who underwent fourth-generation MIS for hallux valgus at Peking University People's Hospital from October 2019 to March 2023. The patients included 5 males (9 feet) and 21 females (33 feet), with an average age of 49.9±15.1 years (range 19-75 years). The hallux valgus deformity was corrected through minimally invasive extra-articular transverse osteotomy of the distal metatarsal combined with Akin osteotomy, fixation with a single fully threaded screw, and lateral soft tissue release after osteotomy. The hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured before surgery and at the final follow-up. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system and the visual analogue scale (VAS) were used to evaluate the treatment efficacy.Results:All 26 patients (42 feet) were followed up for a mean duration of 9.6±5.2 months (range 6-30 months). All 42 feet successfully underwent surgery, with an average operation time of 69.1±16.2 minutes (range 30-105 minutes) and an average blood loss of 10.0±7.4 ml (range 1-30 ml). No serious complications such as major vessel, nerve, or tendon damage occurred during the surgery for any patient. During the follow-up, one foot developed stiffness in the first metatarsophalangeal joint due to a lack of timely functional exercise after surgery. No other complications such as recurrence, delayed union, or nonunion were observed. By the final follow-up, one patient (2 feet) requested removal of the internal fixation. The HVA before surgery and at the final follow-up was 29.5±7.4 and 9.2±4.6, respectively, while the IMA was 11.9±3.8 and 5.0±3.6. The AOFAS score improved from 56.6±10.2 to 91.7±6.8, and the VAS score decreased from 5.2±2.3 to 0.9±1.1, all with significant differences ( P<0.05). Conclusion:The fourth-generation minimally invasive surgery for hallux valgus, characterized by minimally invasive transverse osteotomy, fixation with a single fully threaded screw, lateral soft tissue release after osteotomy, and Akin osteotomy is simple, safe, effective and easy to operate with fewer complications.

To investigate the prevalence of influenza D virus(IDV)in cattle and swine populations in Jilin Province,China,277 nasopharyngeal swabs were collected from livestock exhibiting influ-enza-like symptoms for IDV detection.Virus isolation was performed using swine testicular(ST)cells for PCR-positive samples,followed by comprehensive analyses including whole-genome se-quencing,phylogenetic analysis,electron microscopic observation of viral morphology,and glycosy-lation site prediction.Two IDV strains were successfully isolated from bovine samples,designated as D/bovine/China/JL22/2024(JL22)and D/bovine/China/JL34/2024(JL34).These strains were demonstrated to have specific hemagglutination activity against turkey red blood cells,while no he-magglutination to chicken,rabbit,or guinea pig erythrocytes.Virus-inoculated ST cells exhibited distinct cytopathic effects(CPE)within 48 h,with a hemagglutination titer of 4 log2 in the culture supernatant.Phylogenetic analysis of the hemagglutinin-esterase-fusion(HEF)gene indicated that these strains were most closely related to the Japanese isolate D/Yamagata2019,belonging to the YAMA2019 lineage.Genomic sequence analysis showed the absence of genetic reassortment in these isolates.In this study,two IDV strains were successfully isolated and characterized,which provides preliminary insights into their genomic sequences and biological properties.The findings confirm the presence of IDV in bovine populations in Jilin Province and provide the fundamental data for future epidemiological surveillance and control strategies of IDV.

Objective To investigate the current situation and existing problems regarding the diagnosis and treatment integrating traditional Chinese and western medicine in the emergency departments of various general hospitals in China to provide a reference for the development of integrated traditional Chinese and western medicine emergency medicine. Methods From November 18,2022 to February 28,2023,an online questionnaire survey was conducted among 291 hospitals in 21 provinces/municipalities directly under the Central Government across the country,which was based on the members of the Emergency Medicine Professional Committee of the Chinese Association of the Integration of Traditional Chinese and Western Medicine. The questionnaire covered 5 aspects:basic information of hospitals and emergency departments,personnel allocation,medical quality management,equipment allocation,and traditional Chinese medicine techniques and skills (including the application of traditional Chinese medicine and non-drug treatment of traditional Chinese medicine). A comparative study was carried out between the "hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine" and "western medicine hospitals" on the current situation of integrated traditional Chinese and western medicine diagnosis and treatment in the emergency department. Results A total of 291 valid questionnaires were collected,covering 291 hospitals in 21 provinces and municipalities directly under the Central Government across the country. Among them,142 were hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine,and 149 were western medicine hospitals. The number of doctors in the emergency departments of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were significantly less than that of western medicine hospitals[individuals:11.00 (7.00,18.75) vs. 20.00 (13.00,31.00),P<0.01]. Specifically,the numbers of traditional Chinese medicine doctors,integrated traditional Chinese and western medicine doctors,and "western medicine doctors learning traditional Chinese medicine" in these hospitals were significantly higher than those in western medicine hospitals[individuals:4.00 (2.00,9.00) vs. 0.00 (0.00,0.00),1.00 (0.00,4.00) vs. 0.00 (0.00,0.00),2.00 (0.00,5.00) vs. 0.00 (0.00,0.00),all P<0.01],while the number of western medicine doctors was significantly less than that in western medicine hospitals[individuals:4.00 (1.00,7.50) vs. 25.50 (16.00,37.00),P<0.01]. The number of nurses in the emergency departments of hospitals of traditional Chinese medicine and integrated traditional Chinese was significantly less than that of western medicine hospitals[individuals:23.00 (16.00,38.75) vs. 42.00 (30.00,80.00),P<0.01]. The numbers of traditional Chinese medicine nurses,"western medicine nurses learning traditional Chinese medicine" in these hospitals were also significantly higher than those in western medicine hospitals[individuals:1.50 (0.00,5.75) vs. 0.00 (0.00,0.00),1.00 (0.00,7.75) vs. 0.00 (0.00,0.00),all P<0.01],while the number of western medicine nurses was significantly less than that in western medicine hospitals[individuals:15.00 (9.00,25.00) vs. 42.00 (27.00,79.00),P<0.01]. In the situation of medical quality management,the setting rates of emergency clinics,resuscitation rooms and observation rooms in western medicine hospitals were close to those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine,but the setting rates of emergency department wards and emergency intensive care units (EICU) and the number of beds were significantly higher than those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine[setting rate of emergency department wards:70.47％ vs. 53.52％,setting rate of EICU:67.11％ vs. 47.89％,number of beds (individuals):18.00 (0.00,30.00) vs. 2.00 (0.00,12.00) and 8.00 (0.00,12.00) vs. 0.50 (0.00,7.00),all P<0.01]. In terms of the number of visits in 2022,the annual total number of emergency visits (10000 person-times) in western medicine hospitals:6.60 (3.38,12.00) vs. 4.00 (1.25,7.00),the number of visits to the resuscitation room (10000 person-times):0.40 (0.12,1.00) vs. 0.17 (0.05,0.50) and the annual discharge volume of EICU (number of case):216.00 (0.00,550.00) vs. 0.00 (0.00,187.50) were all higher than those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine (all P<0.01). In addition,the success rate of rescue in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine was similar to that in western medicine hospitals,and the participation rate of traditional Chinese medicine in the treatment of the resuscitation room was significantly higher than that in western medicine hospitals (P<0.01). In the situation of equipment allocation,hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine had fewer numbers of equipment than western medicine hospitals (all P<0.01). The proportion of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine equipped with non-drug treatment equipment of traditional Chinese medicine was significantly higher than that of western medicine hospitals (all P<0.01). In the application of traditional Chinese medicine techniques and skills,the proportions of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine in using Chinese patent medicines,agreed prescriptions,syndrome differentiation and treatment prescriptions,etc. were all higher than those of western medicine hospitals (application rate of Chinese patent medicines:81.69％ vs. 61.74％,application rate of agreed prescriptions:61.97％ vs. 16.78％,application rate of syndrome differentiation and treatment prescriptions:61.27％ vs. 19.46％,all P<0.01). The application rates of decoction pieces,non-decoction agreed with prescriptions,injections,hospital preparations and other dosage forms in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were all significantly higher than those in western medicine hospitals (application rate of decoction pieces:29.58％ vs. 4.70％,the application rate of non-decoction agreed prescriptions:40.85％ vs. 7.38％,application rate of injections:80.28％ vs. 53.02％,application rate of hospital preparations:33.80％ vs. 12.75％,all P<0.01). The application proportions of oral administration,nasal feeding,enema,gastric lavage,external use,intravenous injection,etc. in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were all higher than those in western medicine hospitals (oral application rate:71.13％ vs. 42.28％,nasal feeding application rate:47.18％ vs. 26.17％,enema application rate:48.59％ vs. 19.46％,gastric lavage application rate:21.13％ vs. 6.04％,external use application rate:53.52％ vs. 16.78％,intravenous injection application rate:71.83％ vs. 54.36％,all P<0.01). The application proportions of some drugs such as Shenmai/Shengmai injection,Tianma injection in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were higher than those in western medicine hospitals (application rate of Shenmai/Shengmai injection:59.15％ vs. 35.57％,application rate of Tianma injection:40.85％ vs. 10.07％,application rate of Danshen Honghua injection:30.99％ vs. 14.77％,application rate of Angong Niuhuang pill:26.76％ vs. 12.08％,P<0.01). The proportions of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine in carrying out traditional Chinese medicine non-drug treatment operations such as acupuncture,acupoint application,cupping,scraping,bone-setting,moxibustion,press needles,collateral pricking method,etc. were higher than those in western medicine hospitals (application rate of acupuncture:65.49％ vs. 11.41％,application rate of acupoint application:60.56％ vs. 10.07％,application rate of cupping:32.39％ vs. 4.70％,application rate of scraping:28.17％ vs. 2.01％,application rate of bone-setting:26.76％ vs. 10.74％,application rate of moxibustion:24.65％ vs. 5.37％,application rate of press needles:17.61％ vs. 1.34％,application rate of collateral pricking method:16.90％ vs. 0.67％,all P<0.01). Conclusion The proportion of integrated traditional Chinese and western medicine personnel in the emergency departments of hospitals in China is relatively low,and the utilization rate and equipment rate of non-drug treatment of traditional Chinese medicine and traditional Chinese medicine emergency drugs are not high. It is necessary to strengthen the cultivation of integrated traditional Chinese and western medicine skills of emergency department doctors and the application of non-drug treatment of traditional Chinese medicine and traditional Chinese medicine emergency drugs to improve the ability of integrated traditional Chinese and western medicine emergency treatment.

Objective To investigate the sleep structure of Parkinson's disease (PD) patients with rapid eye movement sleep behavior disorder (RBD) and its correlations with cognitive function, depressive state and motor function. Methods A total of 120 PD patients were enrolled in this study, and divided into PD+RBD group (n=45) and PD group (n=75) based on the presence or absence of RBD. Sleep structure was recorded for both groups. The scores of the Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Unified Parkinson's Disease Rating Scale Part Ⅲ (UPDRS-Ⅲ) and Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT) were compared between the two groups. The correlations of MoCA, HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores with sleep structure in the PD+RBD group were analyzed. Results The PD+RBD group showed significantly higher percentage of non-rapideye movement (NREM) at stage 1, arousal index, periodic limb movements during sleep (PLMS) and apnea-hypopnea index (AHI) compared to the PD group, while the percentages of NREM at stage 3, rapid eye movement (REM) sleep, sleep efficiency and lowest oxygen saturation were significantly lower (P < 0.05). The PD+RBD group also had significantly higher HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores, and significantly lower MoCA scores compared to the PD group (P < 0.05). In the PD+RBD group, the percentages of NREM at stage 1, arousal index, PLMS and AHI were positively correlated with HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores, and negatively correlated with MoCA scores (P < 0.05). Conversely, the percentages of NREM at stage 3, REM sleep, sleep efficiency and lowest oxygen saturation were negatively correlated with HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores, and positively correlated with MoCA scores (P < 0.05). Conclusion PD patients with RBD exhibit disrupted sleep structure, which is closely associated with cognitive function, depressive state, motor function, and autonomic nervous system function.

Objective To investigate the current situation and existing problems regarding the diagnosis and treatment integrating traditional Chinese and western medicine in the emergency departments of various general hospitals in China to provide a reference for the development of integrated traditional Chinese and western medicine emergency medicine. Methods From November 18,2022 to February 28,2023,an online questionnaire survey was conducted among 291 hospitals in 21 provinces/municipalities directly under the Central Government across the country,which was based on the members of the Emergency Medicine Professional Committee of the Chinese Association of the Integration of Traditional Chinese and Western Medicine. The questionnaire covered 5 aspects:basic information of hospitals and emergency departments,personnel allocation,medical quality management,equipment allocation,and traditional Chinese medicine techniques and skills (including the application of traditional Chinese medicine and non-drug treatment of traditional Chinese medicine). A comparative study was carried out between the "hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine" and "western medicine hospitals" on the current situation of integrated traditional Chinese and western medicine diagnosis and treatment in the emergency department. Results A total of 291 valid questionnaires were collected,covering 291 hospitals in 21 provinces and municipalities directly under the Central Government across the country. Among them,142 were hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine,and 149 were western medicine hospitals. The number of doctors in the emergency departments of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were significantly less than that of western medicine hospitals[individuals:11.00 (7.00,18.75) vs. 20.00 (13.00,31.00),P<0.01]. Specifically,the numbers of traditional Chinese medicine doctors,integrated traditional Chinese and western medicine doctors,and "western medicine doctors learning traditional Chinese medicine" in these hospitals were significantly higher than those in western medicine hospitals[individuals:4.00 (2.00,9.00) vs. 0.00 (0.00,0.00),1.00 (0.00,4.00) vs. 0.00 (0.00,0.00),2.00 (0.00,5.00) vs. 0.00 (0.00,0.00),all P<0.01],while the number of western medicine doctors was significantly less than that in western medicine hospitals[individuals:4.00 (1.00,7.50) vs. 25.50 (16.00,37.00),P<0.01]. The number of nurses in the emergency departments of hospitals of traditional Chinese medicine and integrated traditional Chinese was significantly less than that of western medicine hospitals[individuals:23.00 (16.00,38.75) vs. 42.00 (30.00,80.00),P<0.01]. The numbers of traditional Chinese medicine nurses,"western medicine nurses learning traditional Chinese medicine" in these hospitals were also significantly higher than those in western medicine hospitals[individuals:1.50 (0.00,5.75) vs. 0.00 (0.00,0.00),1.00 (0.00,7.75) vs. 0.00 (0.00,0.00),all P<0.01],while the number of western medicine nurses was significantly less than that in western medicine hospitals[individuals:15.00 (9.00,25.00) vs. 42.00 (27.00,79.00),P<0.01]. In the situation of medical quality management,the setting rates of emergency clinics,resuscitation rooms and observation rooms in western medicine hospitals were close to those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine,but the setting rates of emergency department wards and emergency intensive care units (EICU) and the number of beds were significantly higher than those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine[setting rate of emergency department wards:70.47％ vs. 53.52％,setting rate of EICU:67.11％ vs. 47.89％,number of beds (individuals):18.00 (0.00,30.00) vs. 2.00 (0.00,12.00) and 8.00 (0.00,12.00) vs. 0.50 (0.00,7.00),all P<0.01]. In terms of the number of visits in 2022,the annual total number of emergency visits (10000 person-times) in western medicine hospitals:6.60 (3.38,12.00) vs. 4.00 (1.25,7.00),the number of visits to the resuscitation room (10000 person-times):0.40 (0.12,1.00) vs. 0.17 (0.05,0.50) and the annual discharge volume of EICU (number of case):216.00 (0.00,550.00) vs. 0.00 (0.00,187.50) were all higher than those in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine (all P<0.01). In addition,the success rate of rescue in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine was similar to that in western medicine hospitals,and the participation rate of traditional Chinese medicine in the treatment of the resuscitation room was significantly higher than that in western medicine hospitals (P<0.01). In the situation of equipment allocation,hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine had fewer numbers of equipment than western medicine hospitals (all P<0.01). The proportion of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine equipped with non-drug treatment equipment of traditional Chinese medicine was significantly higher than that of western medicine hospitals (all P<0.01). In the application of traditional Chinese medicine techniques and skills,the proportions of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine in using Chinese patent medicines,agreed prescriptions,syndrome differentiation and treatment prescriptions,etc. were all higher than those of western medicine hospitals (application rate of Chinese patent medicines:81.69％ vs. 61.74％,application rate of agreed prescriptions:61.97％ vs. 16.78％,application rate of syndrome differentiation and treatment prescriptions:61.27％ vs. 19.46％,all P<0.01). The application rates of decoction pieces,non-decoction agreed with prescriptions,injections,hospital preparations and other dosage forms in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were all significantly higher than those in western medicine hospitals (application rate of decoction pieces:29.58％ vs. 4.70％,the application rate of non-decoction agreed prescriptions:40.85％ vs. 7.38％,application rate of injections:80.28％ vs. 53.02％,application rate of hospital preparations:33.80％ vs. 12.75％,all P<0.01). The application proportions of oral administration,nasal feeding,enema,gastric lavage,external use,intravenous injection,etc. in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were all higher than those in western medicine hospitals (oral application rate:71.13％ vs. 42.28％,nasal feeding application rate:47.18％ vs. 26.17％,enema application rate:48.59％ vs. 19.46％,gastric lavage application rate:21.13％ vs. 6.04％,external use application rate:53.52％ vs. 16.78％,intravenous injection application rate:71.83％ vs. 54.36％,all P<0.01). The application proportions of some drugs such as Shenmai/Shengmai injection,Tianma injection in hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine were higher than those in western medicine hospitals (application rate of Shenmai/Shengmai injection:59.15％ vs. 35.57％,application rate of Tianma injection:40.85％ vs. 10.07％,application rate of Danshen Honghua injection:30.99％ vs. 14.77％,application rate of Angong Niuhuang pill:26.76％ vs. 12.08％,P<0.01). The proportions of hospitals of traditional Chinese medicine and integrated traditional Chinese and western medicine in carrying out traditional Chinese medicine non-drug treatment operations such as acupuncture,acupoint application,cupping,scraping,bone-setting,moxibustion,press needles,collateral pricking method,etc. were higher than those in western medicine hospitals (application rate of acupuncture:65.49％ vs. 11.41％,application rate of acupoint application:60.56％ vs. 10.07％,application rate of cupping:32.39％ vs. 4.70％,application rate of scraping:28.17％ vs. 2.01％,application rate of bone-setting:26.76％ vs. 10.74％,application rate of moxibustion:24.65％ vs. 5.37％,application rate of press needles:17.61％ vs. 1.34％,application rate of collateral pricking method:16.90％ vs. 0.67％,all P<0.01). Conclusion The proportion of integrated traditional Chinese and western medicine personnel in the emergency departments of hospitals in China is relatively low,and the utilization rate and equipment rate of non-drug treatment of traditional Chinese medicine and traditional Chinese medicine emergency drugs are not high. It is necessary to strengthen the cultivation of integrated traditional Chinese and western medicine skills of emergency department doctors and the application of non-drug treatment of traditional Chinese medicine and traditional Chinese medicine emergency drugs to improve the ability of integrated traditional Chinese and western medicine emergency treatment.

To analyze the mediating role of anxiety and depression in perceived social support and fatigue in ICU patients′ families, and to provide a theoretical evidence for alleviating their fatigue status. A total of 223 family members of ICU patients who received treatment at the Affiliated Hospital of Jiangnan University from October 2020 to April 2021 were selected as the study subjects. The general data questionnaire, perceived social support scale (PSSS), generalized anxiety disorder scale (GAD-7), patient health questionnaire (PHQ-9) and fatigue assessment instrument (FAI) were used to conduct a survey. Among 223 family members of ICU patients, 155(69.51%) had fatigue problems. There were statistically significant differences in total fatigue scores of ICU patients′ family members in terms of gender, age, education level, relationship with patients, residence, payment method and per capita monthly income ( P<0.05). Anxiety, depression and fatigue were negatively correlated with perceived social support ( r are -0.353, -0.276 and -0.416, respectively, all P<0.01). Depression and fatigue were positively correlated with anxiety ( r are 0.808 and 0.703, respectively, all P<0.01), and fatigue was also positively correlated with depression ( r= 0.665, P<0.01). Anxiety and depression had a partial mediating effect on perceived social support and fatigue, and the total indirect effect size was 52.64%. Comprehensive intervention on the level of social support, anxiety and depression is helpful to improve the fatigue status of ICU patients′ family members.

AIM: To explore the promoting effect of 2-APB on skin wound healing in mice and its potential mechanism. METHODS: KM mice were divided into 5 groups: control group, DMSO group, low (50 mg/L), medium (100 mg/L) and high (200 mg/L) concentration 2-APB group. On the back of each mouse's skin use a circular punch about 1 cm on both sides of the midline of the spine to make a skin wound with a diameter of 10 mm and as deep as the fascia. The control group was only wrapped with gauze and no drugs were applied; the DMSO group was applied 1 g DMSO/Vaseline ointment per day; in the 2-APB group, apply 1 g of 2-APB/Vaseline ointment at a corresponding concentration every day. Pictures were taken the next day to observe the healing, and the material was taken on the 21st day, HE staining was used to observe the pathological morphology of the wound and western blot to detect TRPM7, TGF-β, collagen-I and IL-1β expression. RESULTS: Compared with the control group and the DMSO group, different concentrations of 2-APB could significantly promote skin wound healing in mice (P<0.01), but there was no significant difference in wound healing rate between the DMSO group and the control group group. The results of HE staining showed that, compared with the control group group and the DMSO group, 2-APB could increase the collagen content of the wound and the thickness of the dermis (P<0.01), but there was no significant difference between the DMSO group and the control group group. At the same time, 2-APB could also significantly increase the expression of TGF-β and Col-I on the wound, and inhibit the expression of TRPM7 and IL-1β. CONCLUSION: Different concentrations of 2-APB (50, 100 and 200 mg/L) can promote skin wound healing, and its mechanism may be related to the inhibition of TRPM7.

Group A Streptococcus (GAS) is a very important pathogen, especially for children.On a global scale, GAS is an important cause of morbidity and mortality.But the burden of disease caused by GAS is still unknown in China and also has not obtained enough attention.For this purpose, the expert consensus is comprehensively described in diagnosis, treatment and prevention of GAS diseases in children, covering related aspects of pneumology, infectiology, immunology, microbiology, cardiology, nephrology, critical care medicine and preventive medicine.Accordingly, the consensus document was intended to improve management strategies of GAS disease in Chinese children.