The term"heat stroke"originates from the integration of modern traditional Chinese and Western medicine.In clinical practice,the complementary advantages of the two medical systems can significantly enhance the clinical diagnosis and treatment level of heat stroke.Through comprehensively analyzes the traditional Chinese medicine(TCM)nomenclature for heat stroke,proposing that heat stroke is a type of sunstroke characterized by intense and pure yang nature,specifically referring to symptoms caused directly or indirectly by hot weather.It can be referenced under the categories of Zhongye,Shuwen,Yinshu/Yangshu,Shujue,and Shufeng for treatment.The article reviews the TCM diagnostic and therapeutic thinking for heat stroke,summarizing its etiology and pathogenesis,including summerheat directly entering the Yangming,heat entering the heart and nutrient-blood aspects,evil combined with water(post-emergency),dual injury of qi and fluid(post-mild recovery),and phlegm-stasis obstructing collaterals(post-severe recovery).Based on years of clinical experience and combining the different clinical manifestations of heat stroke with TCM's four diagnostic methods,the article proposes a treatment plan that integrates Chinese and Western medicine,combining disease differentiation with syndrome differentiation.The main syndromes summarized include high fever with spasms(Yangming heat excess syndrome),diarrhea(Yangming fu syndrome-intestinal sweating),high fever with coma(heat entering the heart-nutrient syndrome),high fever with convulsions(extreme heat generating wind syndrome),heat stroke-induced coagulopathy(heat entering the blood aspect syndrome),edema after fluid resuscitation(Taiyang water retention syndrome),recovery phase(dual injury of qi and fluid syndrome),and sequelae(phlegm-stasis obstructing collaterals syndrome).For treatment,Baihu Jia Renshen decotion combined with Zengye Chengqi decotion is used for nourishing yin and increasing fluids,relaxing tendons,and stopping spasms for Yangming heat excess syndrome;Baihu decotion combined with Zengye decotion for clearing summerheat and nourishing yin for Yangming fu syndrome-intestinal sweating;Qingying decotion for clearing the nutrient aspect and cooling blood,penetrating heat,and nourishing yin for heat entering the heart-nutrient syndrome;Lingjiao Gouteng decotion for clearing heat and cooling the liver,extinguishing wind,and calming spasms for extreme heat generating wind syndrome;Wuling powder for draining and eliminating water retention for Taiyang water retention syndrome;Wang's Qing Shu Yiqi decotion for clearing summerheat and reducing fever,benefiting qi,and generating fluids for dual injury of qi and fluid syndrome;and Sanjia powder for clearing residual heat,resolving phlegm,and removing stasis from collaterals for phlegm-stasis obstructing collaterals syndrome.Starting from TCM theory and linking it with practice,the article combines Western disease differentiation with TCM syndrome differentiation,aiming to provide new ideas for the clinical treatment of heat stroke.

A 58-year-old female patient with breast cancer received treatment with pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)injection after adjuvant chemotherapy.The serum creatinine level of the patient gradually increased from the normal baseline value to 199.3 μmol·L-1.The patient was diagnosed as acute kidney injury(AKI),after stopping the medication and providing symptomatic treatment,the patient's renal function gradually improved.The patient completed subsequent chemotherapy as planned without reusing PEG-rhG-CSF injection,and other medications and dosages remained unchanged.Renal function remained stable during follow-up.Naranjo's Assessment Scale was used to evaluate the association between PEG-rhG-CSF injection and AKI,the result was"probable."There are few reports of AKI occuring with PEG-rhG-CSF injection,and this case provides evidence for clinical safe medication.

A 58-year-old female patient with breast cancer received treatment with pegylated recombinant human granulocyte colony-stimulating factor(PEG-rhG-CSF)injection after adjuvant chemotherapy.The serum creatinine level of the patient gradually increased from the normal baseline value to 199.3 μmol·L-1.The patient was diagnosed as acute kidney injury(AKI),after stopping the medication and providing symptomatic treatment,the patient's renal function gradually improved.The patient completed subsequent chemotherapy as planned without reusing PEG-rhG-CSF injection,and other medications and dosages remained unchanged.Renal function remained stable during follow-up.Naranjo's Assessment Scale was used to evaluate the association between PEG-rhG-CSF injection and AKI,the result was"probable."There are few reports of AKI occuring with PEG-rhG-CSF injection,and this case provides evidence for clinical safe medication.

The term"heat stroke"originates from the integration of modern traditional Chinese and Western medicine.In clinical practice,the complementary advantages of the two medical systems can significantly enhance the clinical diagnosis and treatment level of heat stroke.Through comprehensively analyzes the traditional Chinese medicine(TCM)nomenclature for heat stroke,proposing that heat stroke is a type of sunstroke characterized by intense and pure yang nature,specifically referring to symptoms caused directly or indirectly by hot weather.It can be referenced under the categories of Zhongye,Shuwen,Yinshu/Yangshu,Shujue,and Shufeng for treatment.The article reviews the TCM diagnostic and therapeutic thinking for heat stroke,summarizing its etiology and pathogenesis,including summerheat directly entering the Yangming,heat entering the heart and nutrient-blood aspects,evil combined with water(post-emergency),dual injury of qi and fluid(post-mild recovery),and phlegm-stasis obstructing collaterals(post-severe recovery).Based on years of clinical experience and combining the different clinical manifestations of heat stroke with TCM's four diagnostic methods,the article proposes a treatment plan that integrates Chinese and Western medicine,combining disease differentiation with syndrome differentiation.The main syndromes summarized include high fever with spasms(Yangming heat excess syndrome),diarrhea(Yangming fu syndrome-intestinal sweating),high fever with coma(heat entering the heart-nutrient syndrome),high fever with convulsions(extreme heat generating wind syndrome),heat stroke-induced coagulopathy(heat entering the blood aspect syndrome),edema after fluid resuscitation(Taiyang water retention syndrome),recovery phase(dual injury of qi and fluid syndrome),and sequelae(phlegm-stasis obstructing collaterals syndrome).For treatment,Baihu Jia Renshen decotion combined with Zengye Chengqi decotion is used for nourishing yin and increasing fluids,relaxing tendons,and stopping spasms for Yangming heat excess syndrome;Baihu decotion combined with Zengye decotion for clearing summerheat and nourishing yin for Yangming fu syndrome-intestinal sweating;Qingying decotion for clearing the nutrient aspect and cooling blood,penetrating heat,and nourishing yin for heat entering the heart-nutrient syndrome;Lingjiao Gouteng decotion for clearing heat and cooling the liver,extinguishing wind,and calming spasms for extreme heat generating wind syndrome;Wuling powder for draining and eliminating water retention for Taiyang water retention syndrome;Wang's Qing Shu Yiqi decotion for clearing summerheat and reducing fever,benefiting qi,and generating fluids for dual injury of qi and fluid syndrome;and Sanjia powder for clearing residual heat,resolving phlegm,and removing stasis from collaterals for phlegm-stasis obstructing collaterals syndrome.Starting from TCM theory and linking it with practice,the article combines Western disease differentiation with TCM syndrome differentiation,aiming to provide new ideas for the clinical treatment of heat stroke.

This paper reported a 15-year-old girl with β-thalassemia major became dependent on blood transfusions from 6 months after birth whose blood transfusion needs increased with age.The girl started treatment with thalidomide at the age of 15.She became transfusion independent one month after starting thalidomide treatment,and her hemoglobin levels were maintained at 98-109 g·L-1.However,the girl subsequently developed symptoms of dizziness and fatigue in the 11th month of thalidomide treatment.Her hemoglobin was decreased and indirect antiglobulin test and direct antiglobulin test were positive.She was diagnosed with new onset autoimmune hemolytic anemia,which was considered to be related to thalidomide,and the association of adverse reactions was evaluated as"possible".Indirect antiglobulin test and direct antiglobulin test were negative after drug withdrawal and glucocorticoid therapy.Therefore,patients with thalassemia who are treated with thalidomide should be carefully monitored for the development of autoimmune hemolytic anemia.

OBJECTIVE: To explore the genetic etiology of a child featuring recurrent oral ulcer. METHODS: Clinical data of the child was collected. Whole exome sequencing was carried out for her. Candidate variant was verified by low-coverage massive parallel copy number variation sequencing (CNV-seq) of the family trio. RESULTS: The child, a 6-year-old girl, has featured recurrent fever and ulcers of the oral mucosa, vulvar and perianal regions. No pathogenic variant was found by whole exome sequencing. However, analysis of chromosome copy number variation using the whole exome sequencing data has revealed mosaicism of trisomy 8. CNV-seq assay has verified the variant in the child, with the percentage of mosaicism being 73%. No abnormality was found in neither of her parents. CONCLUSION A case of mosaicism trisomy 8 with recurrent oral ulcer as the first symptom was diagnosed, which has enriched the phenotypic data of trisomy 8 syndrome.
Humans ; Child ; Female ; Trisomy/genetics* ; Chromosomes, Human, Pair 8/genetics* ; DNA Copy Number Variations ; Oral Ulcer ; Mosaicism

OBJECTIVE To provide ideas for pharmaceutical care of Mycobacterium abscess infection. METHODS The diagnosis and treatment plan ，about a patient with M. abscess infection after resection of intervertebral neurilemmoma participated by clinical pharmacists ，was analyzed . According to the results of bacterial culture and drug sensitivity test of wound secretion ，the clinical pharmacist timely dealed with the adverse drug reactions during the treatment . For the tinnitus caused by the patient taking amikacin（0.4 g，intravenous drip ，q12 h），it was suggested to stop amikacin and replace it with linezolid ；however，the patient suffered from knee pain after taking linezolid . The clinical pharmacist once again suggested stopping linezolid ，continuing to use amikacin，and adjusting the dose to 0.8 g，intravenous drip ，q24 h；at the same time ，the patients were given medication guidance and ordered to have regular follow -up after discharge . RESULTS The physicians adopted the suggestions of clinical pharmacists ， and the patient did not suffer from tinnitus ，knee pain and other discomfort ，and the liver and kidney functions were normal . CONCLUSIONS Clinical pharmacists timely assist clinicians to adjust the medication plan ，which improves the effectiveness and safety of patients ’medication.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective: To investigate the effect of denture stomatitis of selective laser melting (SLM) titanium alloy for removable partial denture frameworks. Methods : Twenty patients with dentition defects in our hospital were divided into two groups according to the different methods of creating a removable partial denture framework: the SLM group and casting group. The success rate, placement rate, masticatory efficiency and incidence of denture stomatitis were compared. Experimental data were analyzed with SPSS20.0. Results : The success rate of the SLM framework group was 100.00%, which was higher than that of the casting group (90.00%) (P ＜ 0.01). The rate of framework placement in the SLM group was slightly lower than that in the casting group (P ＜ 0.05). The masticatory efficiency of the SLM group was higher than that of the casting group (0.783 ± 0.030 vs. 0.699 ± 0.037, P ＜ 0.001). The incidence of denture stomatitis (10.00%) in the SLM group was significantly lower than that in the casting group (30.00%) (P ＜ 0.001). Conclusion SLM is superior to the traditional casting method in mastication efficiency and reducing the incidence of denture stomatitis. This method can meet the clinical requirements, but the accuracy of the long-term stent needs to be improved.

Lead-time bias and length bias were common systematic errors in observational screening studies, which might be a common cause of overstating or distorting the true screening effects. One of key concerns in observational screening studies was how to estimate the screening effects based on the consideration of these two biases. This paper illustrated how to identify and correct the lead-time bias using the tumor volume doubling time and the non-homogeneous Poisson process, and how to correct the length bias using a weighted method. The application conditions of each method were also discussed to present several useful toolboxes to correct the lead-time bias and length bias appropriately and evaluate the effectiveness of the cancer screening program accurately.