Da Qinjiaotang is the 54^th formula of the 100 formulas in the Catalogue of Ancient Classical Formulas （the first batch） ，and it originated from the Collection of Writings on the Mechanism of Disease， Suitability of Qi， and Safeguarding of Life Discussed in Plain Questions. Da Qinjiaotang is composed of Gentiana macrophylla， Glycyrrhizae Radix et Rhizoma， Ligusticum chuanxiong， Angelica sinensis， Paeonia lactiflora， Asari Radix et Rhizoma， Notopterygium incisum， Saposhnikoviae Radix， Scutellariae Radix， Gypsum， Angelica dahurica， Atractylodis Macrocephalae Rhizoma， Rehmanniae Radix， Rehmanniae Radix Praeparata， Poria， and Angelicae Pubescentis Radix. It is a classical formula for treating strokes. Da Qinjiaotang is widely used in modern clinical practices for treating ischemic stroke， peripheral facial paralysis， cervical spondylosis， rheumatic arthritis， neurodermatitis， and other multisystem diseases. Therefore， following the Principles of Textual Research on the Key Information of Ancient Classical Famous Formulas， the authors collected the ancient Chinese medical literature of Da Qinjiaotang by the method of bibliometrics and screened out 177 valid data， involving 100 ancient books of traditional Chinese medicine. Based on the historical evolution， composition， dosage， method of preparation， and preparation of the original medicinal materials of Da Qinjiaotang， a systematic study was carried out. It was found that among the 175 records of the main diseases and syndromes， stroke （144） was the most， accounting for 82.29% of the total diseases and syndromes. Later generations mostly followed the practice of LIU Wansu in using Da Qinjiaotang to treat stroke caused by "weak blood and inability to nourish tendon"， featuring "hands and feet cannot move， stiff tongue hinders speaking"， as well as other symptoms， such as slant of the mouth， hemiplegia， numbness of the limbs， paroxysmal pain， and acerbic syncope. The treatment scope was expanded， covering tendon dryness， clonic convulsion， spasm syndrome， and arthralgia syndrome. At the same time， it was found that there was a controversy between "internal wind" and "external wind" in the treatment of stroke by Da Qinjiaotang. LIU Wansu thought that stroke was caused by internal factors， created the theory of "hot stroke"， and used Da Qinjiaotang to treat "internal wind". Many doctors in later generations focused on treating the "external wind" of "internal deficiency and evil". There were 76 valid data on the composition of drugs， 59 of which had doses for each drug. It was suggested to use the modern conversion dosage of the original formula， with 41.30 g per dose. The drug should be boiled in 600 mL water until 300 mL， decocted once， and taken in a warm state after removing the dregs anytime. Through the analysis and study of the ancient books about Da Qinjiaotang， the paper clarified its historical evolution and confirmed its key information， so as to provide the ancient literature evidence for the research and development of the classical famous formula Daqinjiaotan and its better clinical application.

Da Qinjiaotang is the 54^th formula of the 100 formulas in the Catalogue of Ancient Classical Formulas （the first batch） ，and it originated from the Collection of Writings on the Mechanism of Disease， Suitability of Qi， and Safeguarding of Life Discussed in Plain Questions. Da Qinjiaotang is composed of Gentiana macrophylla， Glycyrrhizae Radix et Rhizoma， Ligusticum chuanxiong， Angelica sinensis， Paeonia lactiflora， Asari Radix et Rhizoma， Notopterygium incisum， Saposhnikoviae Radix， Scutellariae Radix， Gypsum， Angelica dahurica， Atractylodis Macrocephalae Rhizoma， Rehmanniae Radix， Rehmanniae Radix Praeparata， Poria， and Angelicae Pubescentis Radix. It is a classical formula for treating strokes. Da Qinjiaotang is widely used in modern clinical practices for treating ischemic stroke， peripheral facial paralysis， cervical spondylosis， rheumatic arthritis， neurodermatitis， and other multisystem diseases. Therefore， following the Principles of Textual Research on the Key Information of Ancient Classical Famous Formulas， the authors collected the ancient Chinese medical literature of Da Qinjiaotang by the method of bibliometrics and screened out 177 valid data， involving 100 ancient books of traditional Chinese medicine. Based on the historical evolution， composition， dosage， method of preparation， and preparation of the original medicinal materials of Da Qinjiaotang， a systematic study was carried out. It was found that among the 175 records of the main diseases and syndromes， stroke （144） was the most， accounting for 82.29% of the total diseases and syndromes. Later generations mostly followed the practice of LIU Wansu in using Da Qinjiaotang to treat stroke caused by "weak blood and inability to nourish tendon"， featuring "hands and feet cannot move， stiff tongue hinders speaking"， as well as other symptoms， such as slant of the mouth， hemiplegia， numbness of the limbs， paroxysmal pain， and acerbic syncope. The treatment scope was expanded， covering tendon dryness， clonic convulsion， spasm syndrome， and arthralgia syndrome. At the same time， it was found that there was a controversy between "internal wind" and "external wind" in the treatment of stroke by Da Qinjiaotang. LIU Wansu thought that stroke was caused by internal factors， created the theory of "hot stroke"， and used Da Qinjiaotang to treat "internal wind". Many doctors in later generations focused on treating the "external wind" of "internal deficiency and evil". There were 76 valid data on the composition of drugs， 59 of which had doses for each drug. It was suggested to use the modern conversion dosage of the original formula， with 41.30 g per dose. The drug should be boiled in 600 mL water until 300 mL， decocted once， and taken in a warm state after removing the dregs anytime. Through the analysis and study of the ancient books about Da Qinjiaotang， the paper clarified its historical evolution and confirmed its key information， so as to provide the ancient literature evidence for the research and development of the classical famous formula Daqinjiaotan and its better clinical application.

Objectives:To analyze the safety of coronary artery stent rotational atherectomy due to stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment. Methods:A total of 19 patients with coronary artery disease who underwent coronary artery stent rotational atherectomy for the above reasons in 7 large heart centers in China from 2016 to 2022 were collected.Their baseline data,procedure process data,procedural complications,the occurrence of procedure-related adverse events(type 4a myocardial infarction,emergency coronary artery bypass grafting,and all-cause death)during hospitalization and major adverse cardiovascular events(MACE,including target vessel revascularization,stroke,all-cause death,and recurrent myocardial infarction)during post-discharge follow-up were retrospectively collected. Results:The mean age of the 19 patients was 70(64,73)years,and 13 patients were males.The mean left ventricular ejection fraction was(56.89±8.76)%.Radial artery approach was used in 13 patients,11 patients used 1 burr during the intervention period,6 patients used 2 burrs,and 2 patients used 3 burrs.The average times of burr passing through the lesion was(7.00±4.23)times.The surgical success rate was 100%,and the immediate lumen acquired area was(1.23±0.78)mm2.Drug-eluting stents were successfully implanted in all patients after spinning.Coronary slow blood flow occurred in 1 case after rotational grinding,which was improved after drug treatment.The burr was entrapmented in 3 cases and successfully pulled out after operation.No coronary artery perforation,coronary artery dissection,coronary artery spasm,emergency thoracotomy,or death occurred during the operation,and no procedure-related adverse events occurred during hospitalization.During 3 to 24 months of follow-up,1 patient underwent target vessel revascularization,and there were no MACE in other patients. Conclusions:Coronary artery stent rotational atherectomy in patients with stent underexpansion,in-stent restenosis,stent deformation,stent damage,and guide wire entrapment,is a feasible option,with a high surgical success rate and satisfactory safety.None of the patients experienced MACE during long-term follow-up.

Objective:To investigate the application of virtual reality (VR) technology on intraoperative pain in patients undergoing peritoneal dialysis (PD)-related procedures with local infiltration anesthesia and the satisfaction.Methods:It was a single-center, prospective, concurrent controlled study. Patients were divided into two groups: VR group and control group. In the VR group, patients wore a VR headset to watch soothing audio and video content during surgery, while the control group underwent routine procedures. Intraoperative pain and satisfaction were assessed using the visual analog scale (VAS) and a 5-point satisfaction scale within 30 minutes of surgery. In addition, tolerance of the VR experience in the VR group was assessed using the VR sickness questionnaire.Results:A total of 43 patients were included in the study, including 25 males (58.1%). Chronic glomerulonephritis [17 cases (39.5%)] and diabetic nephropathy [6 cases (14.0%)] were the main primary diseases. There were 23 cases in the control group and 20 cases in the VR group. There were no significant differences between the two groups in age, sex ratio, proportion of primary disease, diabetes, hypertension, distribution of operation methods, preoperative vital signs and operation time (all P>0.05). VAS pain score was significantly lower in the VR group than that in the control group (5.90±2.38 vs. 7.43±1.67, t=2.469, P=0.018). The percentage of patients who were satisfied was 89.5% (17/19) in the VR group and 78.3% (18/23) in the control group, but there was no significant difference (chi-square test for continuity correction, χ2=0.308, P=0.579). Three patients in the VR group withdrew from the study due to severe discomfort, while the remaining participants found the VR experience to be tolerable. Common adverse effects included fatigue and blurred vision. Conclusions:The application of VR technology in PD-related procedures has been effective in reducing intraoperative pain when combined with local infiltration anesthesia. Furthermore, the utilization of VR technology in PD-related procedures is associated with a safe and tolerable outcome, despite the observation of some adverse effects.

Objective:To evaluate the efficacy of homodimer neutrophil gelatinase- associated lipocalin (H-NGAL) rapid test kit in diagnosing peritoneal dialysis (PD)-associated peritonitis (PDAP).Methods:It was a multicenter prospective observational study. The PD patients from the nephrology clinics or wards at four hospitals: the First Affiliated Hospital of Nanchang University, the Third Hospital of Hebei Medical University, Taian Central Hospital, and Weifang People's Hospital from December 27, 2021, and July 18, 2022 were enrolled. The patients were categorized into PDAP and non-PDAP groups based on whether PDAP occurred at the time of enrollment. PD effluent samples were collected, and H-NGAL test was performed. The patients or their families used cassette-type, strip-type, and pen-type H-NGAL test kits to detect H-NGAL. Healthcare professionals only used the cassette-type H-NGAL kit to detect H-NGAL. All participants completed a questionnaire regarding the instructions for use of H-NGAL kit before testing, and a summary of patient experience and evaluation questionnaires after testing. The sensitivity, specificity, compliance rate, and 95% confidence interval ( CI) of H-NGAL rapid test kit for diagnosing PDAP were calculated using clinical diagnosis as the standard. Kappa test was used to assess the consistency between H-NGAL detection results and clinical diagnoses. Results:A total of 221 PD patients were enrolled, with 42 PDAP patients and 179 non-PDAP patients. The sensitivity and specificity of H-NGAL rapid test kit for diagnosing PDAP were 100% (95% CI 91.62%-100%) and 99.44% (95% CI 96.90%-99.90%), respectively, with accuracy rate of 99.55% (95% CI 97.48%-99.92%). The positive agreement rate was 97.67% (95% CI 87.94%-99.59%), and the negative agreement rate was 100% (95% CI 97.89%-100%). The consistency evaluation results showed that kappa value was 0.985 (95% CI 0.956-1.000). The results obtained by patients and their families using the H-NGAL rapid test kits were consistent across all three methods (cassette, strip, and pen-type H-NGAL test kits), and the results obtained by using the H-NGAL rapid test kits were also consistent between non-healthcare professionals and healthcare professionals. The kit instruction questionnaire and the experience and evaluation questionnaire showed that the overall satisfaction of patients with the H-NGAL rapid test kits was very good. Conclusions:H-NGAL rapid test kit exhibits high sensitivity and specificity in diagnosing PDAP and can serve as a rapid diagnostic method for PDAP.

Objective:To investigate the clinical characteristics and perinatal outcomes of preeclampsia (PE) with severe fetal growth restriction (FGR) as the initial symptom.Methods:This retrospective cohort study included cases of singleton live births with PE and severe FGR delivered at Fujian Maternity and Child Health Hospital from January 2012 to December 2022. The cases were divided into two groups based on the sequence of severe FGR and hypertension onset: the severe FGR-first group and the hypertension-first group. General data, clinical characteristics, pregnancy complications, and neonatal outcomes were analyzed between the two groups. Statistical analyses were performed using t-tests, Mann-Whitney U tests, and Chi-square tests. Multivariate linear regression or logistic regression analyses were used to adjust for the effects of confounding factors on perinatal outcomes. Results:(1) A total of 307 cases were included in the study, with 194 cases (63.2%) in the severe FGR-first group and 113 cases (36.8%) in the hypertension-first group. Compared to the hypertension-first group, the severe FGR-first group had a higher proportion of severe FGR before 32 weeks, later gestational age at PE diagnosis, lower proportion of early-onset PE, greater gestational age at pregnancy termination, and shorter interval from PE diagnosis to pregnancy termination [40.7% (46/113) vs. 59.3% (115/194), χ2=9.87; (32.8±5.1) weeks vs. (35.6±3.4) weeks, t=5.12; 52.2% (59/113) vs. 25.8% (50/194), χ2=21.80; (34.7±3.1) weeks vs. (36.0±3.2) weeks, t=3.43; all P<0.01]. There was no statistically significant difference in the interval between the diagnosis of severe FGR and hypertension between the two groups. (2) Compared to the hypertension-first group, the severe FGR-first group had a lower preterm birth rate and a higher incidence of premature rupture of membranes [69.0% (78/113) vs. 46.9% (91/194), χ2=14.12; 9.7% (11/113) vs. 19.1% (37/194), χ2=4.72; both P<0.05]. After adjusting for differences in gestational age at termination of pregnancy using multivariate logistic regression analysis, the results showed no statistically significant differences in the incidence of pregnancy complications between the two groups. (3) Compared with the hypertension-first group, the severe FGR-first group had higher neonatal birth weight [(1 757±605) g vs. (2 067±684) g, t=4.12], longer birth length [(41.7±4.3) cm vs. (43.4±4.6) cm, t=3.10], and heavier placentas [(399±158) g v s. (486±147) g, t=2.36]. The rates of cesarean section, severe small for gestational age, and low birth weight were lower [85.8% (97/113) vs. 68.6% (133/194), χ2=11.35; 65.5% (74/113) vs. 49.5% (96/194), χ2=7.40; 87.6% (99/113) vs. 69.6% (135/194), χ2=12.80; all P<0.05]. There were no statistically significant differences in the 1-minute Apgar scores and NICU admission rates between the two groups. After adjusting for differences in gestational age at termination of pregnancy using multivariate regression analysis, it was found that compared with the hypertension-first group, the severe FGR-first group had heavier neonates and a lower risk of cesarean section [ OR (95% CI) were 80.18 (0.95-159.42) and 0.51 (0.26-0.99), both P<0.05]. Conclusions:Pregnant women with severe FGR preceding PE have a later onset of PE and relatively better perinatal outcomes compared to those with hypertension preceding PE. It is necessary to strengthen the monitoring of blood pressure fluctuations in pregnant women with severe FGR preceding PE and fetal growth in pregnant women with hypertension preceding PE.

Objective This study focuses on the construction and cultivation of young administrative management per-sonnel in Shanghai's public hospitals,aiming to provide scientific support for the development of high-quality young administra-tive management professionals in public hospitals.Methods Utilizing an anonymous online survey,this research collected data on the current state of subjective well-being and its influencing factors among the targeted groups from hospitals.Analysis of vari-ance and multivariate analysis were conducted to analyze potential factors affecting their sense of well-being.Results A total of 171 cases were included in the survey,with an average score of 80.37.This group of respondents exhibited a higher level of sub-jective well-being compared to the national norm.Notably,young administrative staff who had obtained Shanghai residency,had a surplus income,spent time with family after work,had career advancement opportunities,felt a strong connection to their work's value,and received affirmation from family members,demonstrated higher subjective well-being scores,with significant statisti-cal differences(P＜0.05).Conversely,those with an income ranging from 0 to 100 000,and those who felt overwhelmed by their current roles,scored lower on well-being,with significant statistical differences(P＜0.05).Conclusion This study sug-gests that by bolstering professional security and job stability,fostering a set of correct values and a sense of work identity,and improving job satisfaction and competence,the subjective well-being of this group can be further elevated.This,in turn,can in-ject new momentum into the high-quality development of public hospitals.

Objective:To study the effects of the combined application of NaF and Nisin on Streptococcus mutans(S.mutans).Meth-ods:The minimum inhibitory concentration(MIC)of Nisin and NaF against S.mutans was determined by microdilution method respec-tively.The fractional inhibitory concentration(FIC)was calculated by checkerboard method.The inhibition effect of the combination of NaF and Nisin at(NF)the same MIC concentration on acid production and acid resistance of S.mutans was detected.Crystal violet staining was used to detect the effects of NF in the inhibition of the biofilm formation,and the damage and dispersion of the established biofilms.The changes of the biofilms were observed by CLSM.Results:The MIC of NaF and Nisin was 0.6 mg/mL and 20 mg/mL re-spectively.The FIC was 0.75.The 1/8×MIC NF showed significantly higher inhibition on acid production and biofilm formation than 1/4×MIC NaF or Nisin(P＜0.05),but it has no obvious dispersion effect on established biofilms.The 1/2×MIC NF showed stronger in-hibition effect on the acid resistance of S.mutans in the membrane than 1×MIC NaF or Nisin(P＜0.05).At the concentration of 2x MIC,any component didn't cause obvious damage on the established biofilm structure.Conclusion:Nisin and NaF have synergistic in-hibitory effects on the proliferation,acid production,acid resistance and biofilm formation of S.mutans.

Wuhutang is the 51st Chinese medicine prescription of Han ethnic group on in the catalogue of ancient classical prescriptions （the second batch） ，which originated from Renzhai' Straight Diections Prescriptions （《仁斋直指方》） by YANG Shiying in the Song dynasty，it is composed of 5 medicines， including Ephedrae Herba，Armeniacae Semen Amarum， Glycyrrhizae Radix et Rhizoma， tea and Gypsum Fibrosum. It treats shortness of breath and phlegm. Following the principle of textual research on the key information of ancient classical famous prescriptions， the author collected and recorded the ancient books of traditional Chinese medicine of Wuhutang with the method of Bibliometrics， and screened out 53 valid data， involving 41 ancient books. Based on the historical evolution， drug composition， main treatment of disease and syndrome， drug dosage， method of preparation and usage， drug origin and processing， the author conducted a dig and a systematic study of Wuhutang. The results show that：in the later generations， besides inheriting the original prescription， the composition of medicine was added or subtracted， and the frequency of addition of Mori Cortex was the most；in the treatment of disease and syndrome， most of them inherited the original prescription mainly treating asthma syndrome， also see in the treatment of asthma， cough and other lung disease， in the drug dosage and method of use ， it is suggested to inherit the original prescription， the dosage of each medicine is： Ephedrae Herba 2.89 g， Armeniacae Semen Amarum 4.13 g， Glycyrrhizae Radix et Rhizoma 1.65 g， tea 3.30 g， Gypsum Fibrosum 6.20 g， decoction， take warm clothes before eating；on the source of medcine，ephedra is made from the dried herbaceous stems of Ephedra sinica （Ephedraceae），bitter almond is made from the dried and mature seeds of Prunus armeniaca （Rosaceae），Licorice is made from the dried roots and rhizomes of Glycyrrhiza uralensis（Legumes）， tea is made from the buds leaves of Camellia sinensis（Camellia），plaster is made from Gypsum Fibrosum of sulfate mineral gypsum family. At the same time， we collected and sorted the modern clinical application literature of Wuhutang， and obtained 73 effective literatures， all of which are for the treatment of respiratory system diseases， especially for children's pneumonia and asthma， and mostly belong to"phlegm-heat obstructing the lung syndrome". Through the analysis and study of ancient books and modern applied literature， the historical evolution and prescription evolution of Wuhutang are clarified， and its key information is determined， in order to provide more accurate reference for the research and development of the classic Wuhutang and the rational addition and subtraction of the application.

Objective:To investigate the clinical effect of preemptive analgesia with pentazocine on perioperative pain management in partial splenectomy.Methods:A total of 100 patients with traumatic splenic rupture who underwent partial splenectomy at Yiwu Central Hospital between October 2019 and November 2021 were randomly assigned to either the control group or the study group, with 50 patients in each group using the random number table method. Both groups received patient-controlled analgesia postoperatively. Additionally, the study group received intravenous pentazocine administration before surgery. The amount of anesthetic used during surgery, postoperative anesthesia recovery indices, postoperative pain response, serum inflammatory factor levels, and the number of effective patient-controlled analgesia pump presses within 48 hours postoperatively were recorded and evaluated. Any adverse drug reactions were also monitored.Results:The dosages of propofol [(462.24 ± 27.13) mg] and remifentanil [(365.98 ± 26.78) μg] in the study group were significantly lower than those in the control group [(511.82 ± 26.32) mg, (406.86 ± 26.08) μg, t = 14.49, 12.63, both P < 0.001). The recovery time of spontaneous breathing [(6.86 ± 0.97) minutes], anesthesia recovery time [(13.24 ± 0.82) minutes] and extubation time [(17.14 ± 1.07) minutes] were significantly shorter than those in the control group [(7.62 ± 0.90) minutes, (14.32 ± 0.84) minutes, (18.22 ± 1.06) minutes, t = 5.80, 8.58, 6.93, all P < 0.001]. The Visual Analogue Scale (VAS) scores in the study group were significantly lower than those in the control group at 24 and 48 hours after surgery, both in resting and coughing state ( t = 7.82, 9.31, 4.95, 8.47, all P < 0.001). The serum levels of tumor necrosis factor-alpha, interleukin-1, and interleukin-6 were significantly lower in the study group than in the control group ( t = 21.53, 25.61, 18.45, 16.90, 17.33, 14.86, all P < 0.001), while the serum level of interleukin-10 was significantly higher in the study group than in the control group ( t = -20.85, -19.61, both P < 0.001). The number of effective patient-controlled pump analgesia presses within 48 hours postoperatively in the study group [(6.24 ± 1.17) times] was significantly lower than that in the control group [(10.26 ± 1.34) times, t = 12.95, P < 0.05). In addition, the overall incidence of adverse drug reactions in the study group [4.00% (2/50)] was significantly lower than that in the control group [18.00% (9/50), χ2 = 5.01, P < 0.05]. Conclusion:Preemptive analgesia with pentazocine for patients undergoing partial splenectomy can effectively reduce the dosage of anesthetics during surgery and the dosage of analgesics after surgery, enhance the recovery from postoperative anesthesia, suppress postoperative inflammatory reactions, alleviate pain responses, and minimize the risk of adverse drug reactions.