OBJECTIVE To provide technical support for improving recognition rate of adverse drug events （ADEs） related to traditional Chinese medicine （TCM） formula granules and decoction pieces among inpatient patients. METHODS By referencing the global trigger tool （GTT） whitepaper， literature on adverse reactions to TCM， and expert review opinions， ADE trigger items for TCM formula granules and decoction pieces used in the inpatients were established. GTT was applied to analyze ADEs in inpatients who had used TCM formula granules and decoction pieces in our hospital from August 2013 to August 2023， utilizing the Chinese Hospital Pharmacovigilance System. The effectiveness of GTT and the characteristics of these ADEs were analyzed. RESULTS A total of forty-eight triggers were established， including thirty-two laboratory test indexes， thirteen clinical symptoms， and three antidotes. Among the 1 682 patients included， GTT identified 652 potential ADEs， 284 true positive ADEs，with a trigger rate of 38.76% and a positive predictive value of 43.56%. After review by the auditor， 278 cases of ADEs were finally confirmed， with an incidence rate of 16.53%， significantly higher than the number of spontaneously reported ADEs during the same period （0）. The 278 cases of ADEs were mostly grade 1 （223 cases）， mainly involving hepatobiliary system， gastrointestinal system， blood- lymphatic system， etc；a total of 219 types of TCMs are involved，and the top five suspected TCMs used at a frequency higher than 1% were Poria cocos， Codonopsis pilosula， Atractylodes macrocephala， fried Glycyrrhiza uralensis， and Scutellaria baicalensis. CONCLUSIONS The established GTT can improve the recognition rate of ADEs for hospitalized patients using traditional Chinese medicine formula granules and decoction pieces.

Objective:To explore associated factors of post-discharge depressive symptom severity in patients with bipolar disorder.Methods:A longitudinal follow-up was conducted to investigate the demographic,behavioral,and clinical characteristics,and social function among discharged patients with bipolar disorder who met the DSM-5 diagnostic criteria.Clinical characteristics were assessed with the Hamilton Depression Scale(HAMD)and Brief Psychiatric Rating Scale(BPRS).Single factor and multivariate regression were carried out to explore the associat-ed factors of depressive symptom severity in patients with bipolar disorder.Results:A total of 298 discharged pa-tients with bipolar disorder were face-to-face interviewed to complete the follow-up survey.At follow-up time,psy-chotic symptoms(standardized(β)=0.18),housework((β)=0.23),social interaction((β)=0.17)and BPRS total score((β)=0.46)were positively associated with HAMD total score.Productive labor and work((β)=-0.27)and person-al life management((β)=-0.15)were negatively associated with HAMD total scores.Conclusion:Post-discharge depressive symptom severity in bipolar disorder patients is influenced by multiple factors.Effective management of psychotic symptoms,combined with enhanced community-based social rehabilitation and functional recovery,may help reduce the persistence or worsening of depressive symptoms and improve prognosis.

Objective:To analyze and compare the clinical efficacy of minimally invasive modified Bristow-Latarjet and Bankart prosthesis in the treatment of recurrent shoulder dislocation.Methods:A total of 58 patients with recurrent shoulder dislocation treated in the Hubei Minzu University Affiliated Minda Hospital from October 2019 to December 2022 were retrospectively selected, and 29 patients underwent minimally invasive modified Bristow-Latarjet (Latarjet group) and 29 patients underwent Bankart prosthesis (Bankart group). The basic conditions of surgery, postoperative shoulder joint activity, and postoperative Rowe Shoulder Function Score (Rowe score) of the two groups were compared. The shoulder function recovery of the patients was evaluated using the American Shoulder and Elbow Association Scoring (ASES) system and the University of California at Los Angeles (UCLA) shoulder joint scoring system, and the incidence of complications between the two groups were compared.Results:The operation time, incision length, intraoperative bleeding volume, recovery working time, and reset loss in the Latarjet group were shorter than those in the Bankart group: (45.56 ± 12.18) min vs. (70.35 ± 18.14) min, (4.04 ± 0.82) cm vs. (6.75 ± 0.95) cm, (61.54 ± 8.88) ml vs. (86.07 ± 7.53) ml, (13.31 ± 3.21) weeks vs.(16.24 ± 3.33) weeks, (0.97 ± 0.19) mm vs.(1.24 ± 0.35)mm, there were statistical differences ( P<0.01). The outreach and forward angles in the Latarjet group were higher than those in the Bankart group: (138.25 ± 10.36)° vs. (98.15 ± 9.64)°, (140.14 ± 10.43)° vs. (93.79 ± 8.84)°, there were statistical differences ( P<0.01). The total effective rate in the Latarjet group was higher than that in the Bankart group: 96.55%(28/29) vs. 75.86%(22/29), there was a statistical difference ( χ2 = 5.22, P = 0.022). The Rowe scores after operation in the Latarjet group were higher than that in the Bankart group: (82.52 ± 15.89) scores vs. (66.78 ± 15.34) scores, there was a statistical difference ( P<0.01). The scores of self-assessment and physician assessment of ASES system and UCLA shoulder scores after operation in the Latarjet group were higher than those in the Bankart group: (36.13 ± 8.45) scores vs. (30.17 ± 8.48) scores, (40.03 ± 9.54) scores vs. (34.25 ± 8.74) scores, (32.08 ± 2.44) scores vs. (27.49 ± 2.56) scores, there were statistical differences ( P<0.05). The complication rate in the Latarjet group was lower than that in the Bankart group: 6.90%(2/29) vs. 31.03%(9/29), there was a statistical difference ( χ2 = 5.50, P = 0.019). Conclusions:The minimally invasive modified Bristow-Latarjet in the treatment of recurrent dislocation of the shoulder joint is superior to Bankart prosthesis in terms of shoulder functional recovery and postoperative rehabilitation.

Objective:To analyze and compare the clinical efficacy of minimally invasive modified Bristow-Latarjet and Bankart prosthesis in the treatment of recurrent shoulder dislocation.Methods:A total of 58 patients with recurrent shoulder dislocation treated in the Hubei Minzu University Affiliated Minda Hospital from October 2019 to December 2022 were retrospectively selected, and 29 patients underwent minimally invasive modified Bristow-Latarjet (Latarjet group) and 29 patients underwent Bankart prosthesis (Bankart group). The basic conditions of surgery, postoperative shoulder joint activity, and postoperative Rowe Shoulder Function Score (Rowe score) of the two groups were compared. The shoulder function recovery of the patients was evaluated using the American Shoulder and Elbow Association Scoring (ASES) system and the University of California at Los Angeles (UCLA) shoulder joint scoring system, and the incidence of complications between the two groups were compared.Results:The operation time, incision length, intraoperative bleeding volume, recovery working time, and reset loss in the Latarjet group were shorter than those in the Bankart group: (45.56 ± 12.18) min vs. (70.35 ± 18.14) min, (4.04 ± 0.82) cm vs. (6.75 ± 0.95) cm, (61.54 ± 8.88) ml vs. (86.07 ± 7.53) ml, (13.31 ± 3.21) weeks vs.(16.24 ± 3.33) weeks, (0.97 ± 0.19) mm vs.(1.24 ± 0.35)mm, there were statistical differences ( P<0.01). The outreach and forward angles in the Latarjet group were higher than those in the Bankart group: (138.25 ± 10.36)° vs. (98.15 ± 9.64)°, (140.14 ± 10.43)° vs. (93.79 ± 8.84)°, there were statistical differences ( P<0.01). The total effective rate in the Latarjet group was higher than that in the Bankart group: 96.55%(28/29) vs. 75.86%(22/29), there was a statistical difference ( χ2 = 5.22, P = 0.022). The Rowe scores after operation in the Latarjet group were higher than that in the Bankart group: (82.52 ± 15.89) scores vs. (66.78 ± 15.34) scores, there was a statistical difference ( P<0.01). The scores of self-assessment and physician assessment of ASES system and UCLA shoulder scores after operation in the Latarjet group were higher than those in the Bankart group: (36.13 ± 8.45) scores vs. (30.17 ± 8.48) scores, (40.03 ± 9.54) scores vs. (34.25 ± 8.74) scores, (32.08 ± 2.44) scores vs. (27.49 ± 2.56) scores, there were statistical differences ( P<0.05). The complication rate in the Latarjet group was lower than that in the Bankart group: 6.90%(2/29) vs. 31.03%(9/29), there was a statistical difference ( χ2 = 5.50, P = 0.019). Conclusions:The minimally invasive modified Bristow-Latarjet in the treatment of recurrent dislocation of the shoulder joint is superior to Bankart prosthesis in terms of shoulder functional recovery and postoperative rehabilitation.

Objective:To explore associated factors of post-discharge depressive symptom severity in patients with bipolar disorder.Methods:A longitudinal follow-up was conducted to investigate the demographic,behavioral,and clinical characteristics,and social function among discharged patients with bipolar disorder who met the DSM-5 diagnostic criteria.Clinical characteristics were assessed with the Hamilton Depression Scale(HAMD)and Brief Psychiatric Rating Scale(BPRS).Single factor and multivariate regression were carried out to explore the associat-ed factors of depressive symptom severity in patients with bipolar disorder.Results:A total of 298 discharged pa-tients with bipolar disorder were face-to-face interviewed to complete the follow-up survey.At follow-up time,psy-chotic symptoms(standardized(β)=0.18),housework((β)=0.23),social interaction((β)=0.17)and BPRS total score((β)=0.46)were positively associated with HAMD total score.Productive labor and work((β)=-0.27)and person-al life management((β)=-0.15)were negatively associated with HAMD total scores.Conclusion:Post-discharge depressive symptom severity in bipolar disorder patients is influenced by multiple factors.Effective management of psychotic symptoms,combined with enhanced community-based social rehabilitation and functional recovery,may help reduce the persistence or worsening of depressive symptoms and improve prognosis.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

Adenoid cystic carcinoma (ACC) is a salivary gland malignant tumor which mainly occurs in the head, neck and the mammary gland, and is characterized with easy invasion of peripheral nerves, local easy recurrence after resection and painless distant metastasis. The treatment of ACC is usually based on surgical resection combined with postoperative radiotherapy. Patients with advanced disease usually cannot be cured, so far there is no ideal treatment regimen. Some studies have suggested that some targeted drugs show advantages in ACC patients who are insensitive or resistant to conventional therapy. This paper summarizes the research progress of molecular targeted therapy for ACC of salivary gland in order to provide new treatment options for ACC patients especially for those at advanced stage.

Objective:To investigate the specific types of lateral meniscus injury in Schatzker type II tibial plateau fractures and its potential correlation with CT features of the lateral plateau.Methods:The data of 213 patients with Schatzker II tibial plateau fractures from August 2014 to June 2021 were retrospectively analyzed, including 132 males and 81 females, aged from 29 to 61 years, with an average of 44.9 years. All patients underwent arthroscopic evaluation of fracture reduction immediately after open reduction and internal fixation (ORIF). According to the actual situation during the operation, the types and locations of lateral meniscus injury were determined and the patients were divided into the meniscus injury group and non-injury group. By measuring lateral plateau depression (LPD) and lateral plateau widening (LPW) of the lateral tibial plateau on CT images, the correlation of which and lateral meniscus injury was analyzed. The optimal critical values of LPD and LPW for predicting lateral meniscus injury were obtained by drawing the relevant receiver operating characteristic (ROC) curves.Results:The meniscus injury group (109 patients) mainly showed injuries involving the mid-body and posterior horn of lateral meniscus (98.2%, 107/109) and LPD was 13.1±3.2 mm; while the LPD of 104 patients without meniscus injury was 9.1±3.0 mm with a statistical difference ( t=3.98, P<0.001). The LPW of meniscus injury group and non-injury groups was 8.0±1.3 mm and 6.7±1.6 mm, respectively, and the difference was statistically significant ( t=2.68, P=0.011). The optimal predictive critical point of LPD and LPW was 7.6 mm (sensitivity 90.3%, specificity 64.7%, area under the curve 0.834) and 7.3 mm (sensitivity 80.5%, specificity 58.8%, area under the curve 0.722). Conclusion:Schatzker II tibial plateau fractures combined with lateral meniscus injury is usually characterized by meniscus-joint capsule separation, rupture and longitudinal fracture. The mid-body and posterior horn of lateral meniscus injury is more likely to occur when LPD> 7.6 mm and/or LPW> 7.3 mm on coronal CT images.

Laboratory test is the routine method of diagnosis, monitoring and blood screening of HIV infection, and main basis for early diagnosis of AIDS. HIV is divided into HIV-1 and HIV-2 subtypes, HIV-1 infection is the major cause of AIDS pandemic, while HIV-2 infection occurs in limited areas in the world, mainly in West Africa. HIV-2 infection has been reported in China since 1998. They are sporadic cases, and mainly HIV-1/HIV-2 mixed infections. There are less concerns about HIV-2 detection in China at present, and domestic HIV-2 detection reagents have not come into the market. At present, the detection method of HIV-2 is mainly antibody test and nucleic acid test. The initial screening is through rapid test and other methods and the confirmation is depended on Western Blot and Line Immune Assay. According to the HIV antibody test results, HIV-2 infection is confirmed. With the rapid development of molecular biology, the diagnostic method of nucleic acid detection laboratory has made great progress.

Objective To determine the effect of enhanced hand hygiene on the morbidity of ventilator-associated pneumonia (VAP).Methods Clinical studies which were related to enhanced hand cleansing to the risk of VAP,which were published between July 1992 and June 2013 in English or Chinese were retrieved via computer and manual screening.Data were extracted according to appropriate inclusion and exclusion criteria and analyzed with RevMan 5.0 software.Results A total of 6 studies,all of which were performed with well controlled protocol,involving 28 461 mechanical ventilator days and 32 428 mechanical ventilator days were analyzed.The morbidity of VAP was 39.5 days per 1 000 mechanical ventilator days and 19.5 days per 1 000 mechanical ventilator days before and after enhanced hand cleaning,respectively.The methods of enhancing hand hygiene included feasible hand hygiene apparatus,long-term education,supervision and feedback,as well as increased hand cleaning compliance.All 6 eligible studies reported that enhanced hand washing lowered the risk of VAP,with risk reduction ranging from 29.8％ to 65.5％ with a mean reduction value of 50.6％.Meta analysis showed that enhanced hand cleaning could protect patients from VAP with odds ratio (OR) varying from 1.43 to 5.82 [pooled OR=2.23,95％ confidence interval (95％CI) 1.62-3.07,P＜0.000 01].It was showed in funnel chart that bias in the published articles was not significant.Conclusions Enhanced hand hygiene has an effect of prevention of VAP morbidity and is associated with lowered morbidity of VAP.However,the reliability of this conclusion is questionable because of poor quality of these studies.