This paper analyzes the characteristics of highly cited papers published in Chinese Clinical Pharmacology and Therapeutics in the past ten years,in order to explore the influence and re-search value of these papers.Highly cited papers are an important index to evaluate the scientific re-search level of scholars and research institutions,so this study focuses on the characteristics of their number,citation frequency,number of co-authors and regional distribution.The paper uses bibliomet-rics to analyze the publication trend and citations of highly cited papers.The results show that during the observation period,the number of highly cited papers decreases year by year,and there is a signifi-cant correlation between cited frequency and publi-cation time.In addition,the number of co-authors presents a normal distribution,among which the number of co-authors is the largest,indicating that moderate cooperation has a positive effect on the influence of papers.From the perspective of geo-graphical distribution,the author group of the mag-azine is relatively dispersed,covering many regions of the country,among which Anhui,Hunan and Zhejiang have become the main sources of high-quality manuscripts.The finding reflects the maga-zine's wide reach across the country.The results of this study provide empirical support for under-standing the characteristics of highly cited papers and emphasize the importance of research collabo-ration and geographical factors in research publica-tion.Through the analysis of highly cited papers,this paper provides references for subsequent re-searchers in selecting research topics and coopera-tion methods,and also provides beneficial sugges-tions for improving the research level and influence of clinical pharmacology in China.

This paper analyzes the characteristics of highly cited papers published in Chinese Clinical Pharmacology and Therapeutics in the past ten years,in order to explore the influence and re-search value of these papers.Highly cited papers are an important index to evaluate the scientific re-search level of scholars and research institutions,so this study focuses on the characteristics of their number,citation frequency,number of co-authors and regional distribution.The paper uses bibliomet-rics to analyze the publication trend and citations of highly cited papers.The results show that during the observation period,the number of highly cited papers decreases year by year,and there is a signifi-cant correlation between cited frequency and publi-cation time.In addition,the number of co-authors presents a normal distribution,among which the number of co-authors is the largest,indicating that moderate cooperation has a positive effect on the influence of papers.From the perspective of geo-graphical distribution,the author group of the mag-azine is relatively dispersed,covering many regions of the country,among which Anhui,Hunan and Zhejiang have become the main sources of high-quality manuscripts.The finding reflects the maga-zine's wide reach across the country.The results of this study provide empirical support for under-standing the characteristics of highly cited papers and emphasize the importance of research collabo-ration and geographical factors in research publica-tion.Through the analysis of highly cited papers,this paper provides references for subsequent re-searchers in selecting research topics and coopera-tion methods,and also provides beneficial sugges-tions for improving the research level and influence of clinical pharmacology in China.

Hemorrhage is the primary early clinical manifestation in pediatric trauma patients and is the main cause of hypovolemic shock.The goal of fluid resuscitation is to optimize perfusion to terminal organs and provide adequate oxygen supply.During the resuscitation process,it is important to follow damage control surgery and damage control resuscitation protocols to prevent hypotension.It is recommended to administer low titer group O whole blood or component blood early in the resuscitation process,while minimizing the use of large volumes of crystalloid fluids.Continuous monitoring of the child’s condition is necessary during resuscitation,with particular attention to vital signs,laboratory tests,and imaging studies.Bedside ultrasound can quickly assess the injury site and changes in hemodynamics during resuscitation,providing a basis for precise individualized treatment.

Hemorrhage is the primary early clinical manifestation in pediatric trauma patients and is the main cause of hypovolemic shock.The goal of fluid resuscitation is to optimize perfusion to terminal organs and provide adequate oxygen supply.During the resuscitation process,it is important to follow damage control surgery and damage control resuscitation protocols to prevent hypotension.It is recommended to administer low titer group O whole blood or component blood early in the resuscitation process,while minimizing the use of large volumes of crystalloid fluids.Continuous monitoring of the child’s condition is necessary during resuscitation,with particular attention to vital signs,laboratory tests,and imaging studies.Bedside ultrasound can quickly assess the injury site and changes in hemodynamics during resuscitation,providing a basis for precise individualized treatment.

Abstract: Objective To develop an ELISA kit to detect IgG antibodies of Chikungunya virus (CHIKV), providing a new method for epidemiological investigation and detection in the field for CHIKV infection. Methods Using the CHIKV-specific recombinant protein pMal-chik23 as diagnostic antigen, HRP-labeled anti-IgG antibody as color-developing antibody, and the working concentration of diagnostic antigen, serum to be tested and second antibody were optimized using orthogonal. The reaction conditions of ELISA reaction, such as coating, blocking, incubation, and color-developing were systematically optimized. The cut-off value for ELISA detection was established based on the assessment of a large clinical sample set. On this basis, the specificity, sensitivity, and stability of the ELISA response were evaluated to develop and assemble a rapid ELISA kit for the detection of Chikungunya fever IgG antibodies. Results On the basis of systematic conditions optimization, an indirect ELISA kit for the detection of IgG antibodies against CHIKV was developed and assembled. The optimal reaction conditions were identified as 1.0 μg/mL antigen was coated using carbonate buffer at 4 ℃ for 24 hours. Then the microplate was blocked using HBV blocking solution at 37 ℃ for 4 hours. 100 μL/well samples to be tested were diluted at 1∶101, reacted at 37 ℃ for 40 minutes, and washed 4 times with PBST. Thus, HRP-labeled rabbit anti-human IgG was diluted at 1∶20 000, HRP-labeled sheep anti-mouse IgG was diluted at 1∶10 000, reaction at 37 ℃ for 30 minutes, and washed 5 times with PBST. Finally, 100 μL/well TMB solution was added and incubated at 37 ℃ for 10 minutes. Then terminate the reaction with 50 μL of 20% H2SO4 and measure the A450 value at dual wavelengths of 450/630 nm (A450) . The evaluation results showed that ELISA A450 of Chikungunya fever-positive samples were more than 0.43, while the ELISA A450 of negative samples was less than 0.04, and the S/N ratio > 10. Specificity test showed that the developed kit had no cross-reaction with 9 other similar arbovirus species such as Sindbis, Geta, Ross River, and Dengue virus. The stability evaluation of the reagent kit indicated that it had high stability, with a coefficient of variation (CV) within the microplate ranging from 0.76% to 2.12%, the coefficient of variation between the microplate ranged from 0.64% to 1.85%, and the coefficient of variation between batches ranged from 0.83% to 2.31%, all of which were less than 3%. The sensitivity of the kit did not decrease significantly after being stored at 4°C for 1 year. Conclusions A rapid indirect ELISA kit for the detection of Chikungunya fever IgG antibodies was successfully developed, exhibiting good sensitivity, specificity, and stability.

Dandy-Walker syndrome is one of the posterior fossa malformations, which is easily confused with arachnoid cyst or cerebellar dysplasia in clinical practice, leading to misdiagnosis. Dandy-Walker syndrome is easy to be combined with hydrocephalus, resulting in increased intracranial pressure, increased head circumference, growth retardation, spastic hemiplegia and other manifestations, and can also be accompanied by other nervous system malformations. On February 27, 2021, a child with Dandy-Walker syndrome with growth retardation as the primary manifestation was admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine. After multiple surgical treatment, the child's hydrocephalus was significantly improved. Through the analysis of the clinical data of the child's operation and the treatment of complications, it is helpful to improve the clinicians' understanding of the surgical treatment of the disease.

Trauma is a major cause of death in children.Hypoperfusion, tissue cell injury, inappropriate thrombin generation, fibrinogen depletion and dysregulated fibrinolysis are the main pathophysiological mechanisms of trauma induced coagulopathy.The conventional coagulation tests and thromboelastography are helpful for the diagnosis of trauma induced coagulopathy, and thromboelastography can guide clinical transfusion therapy. "Optimized end-organ perfusion" and "adequate oxygen delivery" are resuscitation goals.Active and correct pre-hospital treatment, damage control resuscitation, justified transfusions and antifibrinolytic therapy are helpful to improve the prognosis of children with trauma induced coagulopathy.

Objective:To explore the effect of augmented renal clearance(ARC)on 24-hour area under the concentration-time curve to minimum inhibitory concentration ratio(AUC 24/MIC)of vancomycin and prognosis in critical children, thus to provide proposal for individual dosage regimen. Methods:Sixty-five critical children treated with vancomycin, who suffered from sepsis/septic shock, were brought into this retrospective cohort study.According to estimate glomerular filtration rate, these children were divided into ARC group ( n=27) and normal group ( n=38). The influencing factor of AUC 24/MIC of vancomycin and therapy prognosis for two groups were detected and analyzed. Results:There were no significant differences between two groups in basic setting (age, sex, weight), scores of pediatric sequential organ failure assessment and pediatric risk of mortality Ⅲ, infection markers (C-reactive protein and procalcitonin), glutamic-pyruvic transaminase, hypoproteinemia, usage of diuretic and vasoactive agent( P>0.05). The patients from ARC group showed lower levels than those from normal group in AUC 24/MIC of vancomycin[375.2(300.8, 489.4) vs. 443.6(412.3, 593.2), Z=2.263, P=0.024] and it′s target achievement ratio (TAR)(40.7% vs. 76.3%, χ2=8.440, P=0.005). When usage of diuretic and vasoactive agent, the AUC 24/MIC of ARC group was lower than that of normal group( P<0.05). But there was no significant difference between ARC group and normal group regarding hypoproteinemia( P>0.05). The days of body temperature steady at least 48 hours[7.0(5.5, 9.0)d vs. 6.0(5.0, 8.0)d], the length of hospital stay[39.0(21.0, 58.0)d vs. 20.5(16.0, 28.0)d], the length of PICU stay[14.0(9.0, 31.5)d vs. 10.0(5.0, 15.0)d] were longer than those in normal group( P<0.05). There were no significant differences between ARC group and normal group regarding days of ventilation and infectious markers decreased at least 50%, as well as 28-days mortality( P>0.05). The multivariable analysis showed that the presence of ARC, hypoproteinemia, use of diuretics and vasoactive agent were significantly associated with AUC 24/MIC of vancomycin( P<0.05). Conclusion:ARC may down regulate levels of AUC 24/MIC and TAR of vancomycin.During ARC period, the usage of diuretic and vasoactive agent could affect the AUC 24/MIC of vancomycin.Individual dosage regimen should be employed for critical children suffered with ARC.

AIM: To study chronopharmacokinetics of helicid and its metabolites. METHODS: An HPLC-MS method for simultaneous determination of helicid and its three phase I metabolites were established and validated. At 8:00, 14:00 and 0:00, the rats were given helicid 50 mg/kg by gavage, respectively. Blood samples were collected from ophthalmic venous plexus. Then plasma concentration was measured. Pharmacokinetic behaviors of the original drug and its metabolites after administration at different time points were calculated and compared. RESULTS: This established HPLC-MS/MS method was successfully applied to simultaneous determination of helicid and its three metabolites in rat plasma after intragastric administration. Using AUC

Objective:To explore the clinical significance of thrombelastography (TEG) and conventional coagulation tests (CCTs) in the diagnosis of trauma-induced coagulopathy(TIC) and the risk factors for TIC.Methods:Traumatic patients hospitalized in PICU at Shengjing Hospital of China Medical University from December 1, 2017 to January 31, 2019 were divided into three groups according to injury severity score(ISS): non-severe group(≤16 points), severe group (17-25 points) and extremely severe group(>25 points). All patients received 2.5 mL of venous blood at admission/after 6 h, 12 h, 24 h, and 48 h injury to detect TEG and CCTs.The prevalence, time of onset, recovery time of coagulation function and risk factors for TIC were summarized.Results:A total of 64 cases were collected, including 18 non-critical cases, 28 critical cases and 18 extremely critical cases.TEG and CCTs were used to diagnose TIC in nine cases(14.1%)and four cases(6.3%), respectively.TIC could be diagnosed by TEG at 6 hours after trauma, and 12 hours for CCTs.TEG was used to diagnose four cases of hypercoagulability.Univariate analysis showed that female, blood transfusion, transfusion, shock, multiple organ dysfunction syndrome, mechanical ventilation, hypothermia, low age, low glasgow coma scale (GCS) and high ISS were all risk factors for TIC.Logistics regression analysis found that children with high-risk factors such as girl, hypothermia, shock and mechanical ventilation were 4.333, 17.889, 10.208, and 4.479 times more likely to develop TIC than those without high-risk factors.For every 1 score increase in the ISS score, the risk of TIC increased by 1.147.As the age increased by 1 year, GCS increased by 1 point, and the risk of TIC decreased by 0.765 and 0.817, respectively, which were protective factors for TIC.Conclusion:TEG and CCTs are consistent in the diagnosis of TIC, but TEG is more sensitive at an earlier stage and can detect hypercoagulability.Female, shock, hypothermia, low age, high ISS, and low GCS are risk factors for TIC.