OBJECTIVE To establish an ion chromatography method for the simultaneous determination of chloride， sulfate and bicarbonate ions in Polyethylene glycol electrolyte powder （Ⅲ）. METHODS The chromatographic column was a Dionex IonpacTM AS11-HC anion analysis column， with a Dionex IonPacTM AG11-HC guard column. The mobile phase was 10 mmol/L potassium hydroxide at an isocratic elution flow rate of 1.2 mL/min. The detector was a conductivity detector， and the suppressor was a Dionex AERS with a suppressor current of 30 mA. The column temperature was maintained at 30 ° C， and the injection volume was 10 μL. Chloride and sulfate contents were calculated by external standard method， while bicarbonate content was determined by double logarithmic fitting standard curve method. RESULTS Under these chromatographic conditions， chloride， sulfate and bicarbonate ions were effectively separated with linear ranges of 0.055 to 0.219 mg/mL （r＝0.999 9）， 0.155 to 0.618 mg/mL （r＝1.000 0）， and 0.065 to 0.121 mg/mL （r＝0.999 9）， respectively. The recoveries were 98.06% to 101.34%， 97.37% to 101.25%， and 97.16% to 99.81%， respectively， with RSDs of 1.1%， 1.3% and 1.0% （n＝9）. The RSDs for the evaluation of precision， accuracy， stability and ruggedness were all less than 2%. CONCLUSIONS The established ion chromatography is simple， rapid， accurate， precise and durable， can simultaneously determine the contents of chloride， sulfate and bicarbonate ions in Polyethylene glycol electrolyte powder （Ⅲ）， which is suitable for its quality control.

Perimenopausal syndrome （MPS）， a common endocrine system disease， is one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in endocrinology， gynecology， and interdisciplinary fields of both Western and Chinese medicine to discuss the advantages and challenges of diagnosing and treating MPS with Western medicine， TCM， and integrative medicine. Experts at the conference believe that MPS is initiated by estrogen decline and rooted in deficiency， with the pathogenesis being imbalance between Yin and Yang in the kidney. The hormone replacement therapy in Western medicine for menopause can rapidly alleviate related symptoms by quickly restoring the estrogen level and timely detect and delay complications of menopause， whereas such a therapy has certain risks， necessitating close monitoring of adverse reactions. Moreover， the various contraindications and precautions limit the clinical application of the hormone replacement therapy. TCM has advantages in synergistically alleviating symptoms such as hot flashes， sweating， sleep disorders， and emotional abnormalities of MPS without causing obvious adverse reactions. However， its efficacy is slower than the hormone replacement therapy， and the TCM evidence for preventing and treating complications of menopause remains unclear. Three suggestions were proposed for the future development of both Western and TCM for ameliorating MPS. First， an integrated diagnosis and treatment system for MPS with both Western and Chinese medicine should be established. Second， high-quality evidence-based interventions for MPS should be developed with TCM alone or in combination with Western medicine. Third， efforts should be made to promote the new TCM drug development and the interdisciplinary cooperation for treating MPS.

Objective To investigate the effect of mesenchymal stem cells(MSCs)combined with immunosuppressants(IS)on immune rejection in a rat model of liver transplantation.Methods F344 rats were divided into Normal group(without any intervention),PS group(injected with an equal volume of normal saline),MSC group(injected with MSC),IS group(injected with IS),and MSC+IS group(injected with MSC and IS),with 8 rats in each group.For all rats except those in the Normal group,the Kamada's double-cuff method was used to establish a model of orthotopic liver transplantation,without reconstruction of the hepatic artery.HE staining and Masson staining were performed for rat liver tissue,and the degree of liver fibrosis was analyzed;immunohistochemical experiments were used to measure the infiltration of T cells and NK cells,and immunofluorescence assay was used to analyze macrophage M2 polarization.A one-way analysis of variance was used for comparison of continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups.The Kaplan-Meier method was used to plot survival curves,and the log-rank test was used for survival analysis.Results Compared with the PS group,the MSC+IS group had a significantly prolonged survival time(P＜0.01),and the MSC group,the IS group,and the MSC+IS group had a significant improvement in the histological structure of the liver and a significant reduction in the degree of liver fibrosis(all P＜0.000 1),as well as a significant reduction in the infiltration of NK and T cells(all P＜0.000 1)and a significant increase in the degree of macrophage M2 polarization(all P＜0.000 1).The MSC+IS group had a significantly better effect than the MSC group and the IS group.Conclusion MSCs combined with IS can improve liver histopathology,reduce inflammatory cell infiltration,promote macrophage M2 polarization,and exert an immunosuppressive effect in rats after liver transplantation.

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 investigate the influencing factors of treatment decision dilemma in the pa-tients with intracranial aneurysm.Methods A total of 210 patients with intracranial aneurysms hospitalized in the neurosurgery department of this hospital from January to December 2022 were selected as the research subjects.The questionnaire survey on the patients was conducted by using the general data questionnaire,De-cision Dilemma Scale (DDS),Perceptive Social Support Scale (PSSS) and Hospital Anxiety and Depression Scale (HADS).Results The scores of decisional dilemma,perceived social support,anxiety and depression of the patients with intracranial aneurysm were (38.08±14.05) points,(50.59±3.38) points,(11.12±3.46) points and (9.56±2.11) points respectively.The multiple linear regression analysis showed that the age,fam-ily per capita monthly income,aneurysm diameter,social support and anxiety were the main influencing fac-tors of treatment decision dilemma in the patients with intracranial aneurysm (P<0.05).Conclusion The de-cision-making dilemma in the patients with intracranial aneurysms is in a moderate level.Medical care staff should for-mulate the targeted decision support measures according to the patient' s age,economic status,aneurysm size,patient's social support and anxiety situation to help the patients to improve their decision-making level.

Objective: To understand prevalence and trend of drinking behavior among middle school students in Quzhou during 2012 to 2022, and to provide a basis for formulating scientific and effective intervention measures for adolescent drinking. Methods: By using stratified cluster sampling method, a questionnaire survey using Zhejiang adolescent health related behavior questionnaire was conducted anonymously in selected classes in May 2012, 2017 and 2022, respectively. Changes of drinking behavior of middle school students in different years were analyzed. Results: The prevalence of ever drinking, current drinking and drunkenness among middle school students in Quzhou decreased from 58.05%, 22.70% and 21.25% in 2012 to 41.83%, 15.35% and 11.54% in 2022, respectively ( χ 2 trend =82.69, 30.00，58.24, P <0.01). In the past 30 days, 66.67% of students reported drinking 1-2 days, the proportion of drinking for 3-5 days increased from 16.36% in 2012 to 26.19% in 2022, the proportion of drinking for 6-19 days decreased from 13.03% in 2012 to 3.40% in 2022. The proportion of buying alcohol increased from 22.12% in 2012 to 35.03% in 2022. The results of the three surveys showed that, now drinking rates, drinking rates, Male students (27.88%，23.96%，18.75%；24.69%，17.44%，13.75%) was higher than the girls (17.60%，17.25%，11.31%；17.87%，10.61%，8.91%)， non ordinary high schools (33.96%，34.69%，22.77%；33.65%，23.91%，19.49%) were higher than ordinary high schools (25.82%，18.80%， 12.62 %；25.82%，17.35%，9.94%) and junior middle school (16.53%，15.83%，12.22%；13.93%，8.47%，7.35%). Conclusion Progress in adolescent drinking control is being made in Quzhou, with the prevalence of ever drinking, current drinking and drunkenness significantly decreased. It is necessary to strengthen the control of drinking behavior among middle school students from the aspects of school, family and society, especially for boys and students in non ordinary high school students.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.

Objective:To evaluate the efficacy and safety of Hymagic-4D multi-essence (miniHA, acetylated sodium hyaluronate, sodium hyaluronate, sodium hyaluronate cross-linked polymer) on sensitive skin.Methods:The clinical trial was conducted from April 2, 2019 to April 30, 2019 in the Cosmetic Dermatology Laboratory of the Third Affiliated Hospital of Sun Yat-Sen University. A total of 33 subjects (average age of 43±9.5) completed the trial. Subjects diagnosed as sensitive skin according to the criteria were enrolled. Hymagic-4D were randomly applied on one side of the face while macromolecular hyaluronic acid was applied on opposite side for 28 days. Skin biophysical properties, lactic test, clinical efficacy and safety were evaluated by the investigators at day 0, day 7, day 14 and day 28. Skin water content, TEWL and a*value were measured at the same time.Results:Dates showed that at day 7, day 14 and day 28, the a* values on Hymagy-4D using side were 8.54±3.08, 8.87 ±3.21 and 8.39±3.21, lower than that on the side of control 9.48±3.09, 9.51±3.30 and 9.03±2.95 ( P<0.01); skin roughness score, dryness score and erythema score on hymagy-4d using side were significantly lower than before ( P<0.01), and significantly lower than that on the control side ( P<0.01). Hydration, TEWL, pH value, L value and total score of lactic acid tingling test which were significantly improved on both facial skin compared to the baseline ( P<0.05) showed no statistical difference between two facial sides ( P>0.05) during 28-day treatment. Conclusions:This study demonstrates that Hymagic-4D has more effective in repairing skin barrier and inhibiting skin inflammation than single component hyaluronic acid on sensitive skin persons.

Objective To evaluate the role of transthoracic echocardiography ( T T E ) and transesophageal echocardiography( T EE) in the process of transapical mitral valve repair using a novel edge‐to‐edge device( ValveClamp) and this device′s efficacy and safety in a preliminary clinical trial . Methods Six patients with moderate to severe or severe degenerative mitral regurgitation ( DM R) confirmed by T T E and T EE were enrolled . T T E was performed pre and post procedure as well as 30 days post procedures . Related cardiac structure and hemodynamic parameters ,including mitral regurgitation area ( MRA‐max ) , vena contracta width ( VCW ) ,mitral valve effective orifice area ( M VEOA ) ,left ventricular end diastolic diameter ( LVEDD ) , left ventricular end systolic diameter ( LVESD ) , left ventricular ejection fraction ( LVEF) ,max and mean mitral valve pressure gradient ( M VPG‐max and M VPG‐mean) were recorded and evaluated in a central core laboratory . Results All the procedures were successfully performed .M RA‐max , VCW and M VEOA decreased significantly post procedures ( all P ＜ 0 .000 ) , and they remained no significant changes within 30 days post procedures ( all P ＞ 0 .05 ) . M eanwhile ,M VPG‐max and M VPG‐mean slightly increased ( all P ＜0 .01 ) and left atrial anterior‐posterior dimension attenuated 30 days post procedures( P ＜0 .05) ,but all M VPG‐mean were lower than 5 mm Hg ( 1 mm Hg＝0 .133 kPa) . T here were no significant changes in other hemodynamic parameters ( all P ＞ 0 .05) . Conclusions T ransapical mitral valve repair using ValveClamp can be performed safely and a significant reduction in mitral regurgitation can be achieved in patients with DM R . T EE and T T E facilitate the patient selection for ValveClamp procedures as well as perioperative navigation and assessment .