Erchentang is a classic formula widely used by medical practitioners throughout history. In this paper，ancient and modern literature of Erchentang were collected， and bibliometrics was employed to analyze its historic evolution，prescription meaning，herbs origin， processing method，preparation methods， and clinical application. A total of 84 pieces of data were collected， and 58 pieces of data involving 53 ancient medical Chinese books were screened， sorted， and processed. Combined with research of modern scholars，the research has found that the Erchentang originated from the Taiping Huimin Huiye Shijie Fang compiled by the Imperial Medical Bureau of the Song Dynasty. The basic information about the origin of the drugs is quite clear. Pinelliae rhizoma in the formula is the dried tuber of Pinellia ternata. Citri exocarpium rubrum is the dried mature peel of Citrus reticulata and its cultivated varieties， with the inner white membrane removed. Poria is the whitest dry sclerotia of Poria cocos； Glycyrrhizae radix et rhizoma is the dried root and rhizome of the Glycyrrhiza uralensis. The dosage is 5.70 g Pinelliae rhizome and Citri exocarpium rubrum， 3.43 g Poria， and 1.69 g Glycyrrhizae radix et rhizoma praeparata cum melle. During the decoction process， the above-mentioned herbs should be chopped， with 300 mL water， 7 g ginger in thick slices， and 2 g Mume fructus added， and it was then simmered together to 180 mL. After removing the medicinal residue， it can be taken warmly. Erchentang has the effect of drying dampness and resolving phlegm， regulating Qi and harmonizing the middle. It can be used in treating the syndrome of phlegm and dampness，as well as symptoms such as frequent cough，white phlegm，fullness in chest and diaphragm，nausea and vomiting，limb drowsiness，anorexia，dizziness，palpitations，white and greasy tongue coating， and slippery pulse. The above results provide reference for future research and development of Erchentang.

OBJECTIVE To develop a method for the determination of tacrolimus （TAC） concentration in human whole blood and to apply it in clinical therapeutic drug monitoring. METHODS Whole blood samples were processed by protein precipitation with methanol. The determination was performed using liquid chromatography-tandem mass spectrometry （LC-MS/MS）， with ascomycin serving as the internal standard. Chromatographic separation was carried out on a Kinetex F5 100Å column with a mobile phase consisting of 0.1 mmol/L ammonium acetate containing 0.2 mmol/L formic acid and methanol. Gradient elution was performed at a flow rate of 0.4 mL/min. The injection volume was 5 μL. Detection was conducted using multiple reaction monitoring （ m / z 821.6→768.6 for TAC； m / z 809.4→756.1 for ascomycin） with an electrospray ionization source in positive ion mode. The study focused on 86 whole blood samples collected from 83 pedi atric patients who received TAC therapy at Children’s Hospital of Nanjing Medical University from September 1 to 30， 2025. The aforementioned method was employed to measure the TAC concentration in the whole blood samples. The correlation and agreement between the aforementioned method and the traditional enzyme multiplied immunoassay technique （EMIT） were evaluated through Spearman correlation analysis， Bland-Altman analysis， and Passing-Bablok regression analysis. RESULTS The linear range of TAC was 0.5-100 ng/mL； the evaluation results for accuracy， precision， extraction recovery， matrix effect， and stability tests all met the relevant requirements. Clinical application results showed that the median concentration of TAC in pediatric whole blood measured by LC-MS/MS and EMIT methods were 4.4 and 4.0 ng/mL， respectively. Moreover， the two methods exhibited a strong correlation （correlation coefficient of 0.848 1） and good agreement （average relative deviation of 6.5%）. CONCLUSIONS A reliable LC-MS/MS method for the determination of TAC concentration in human whole blood is successfully established. This method demonstrates strong correlation and good agreement with the EMIT method， making it suitable for clinical therapeutic drug monitoring.

[Objective] To analyze the loss rate of platelet donors and evaluate the strategies for establishing a platelet donor bank. [Methods] A total of 1 443 donors who joined the HLA and HPA gene donor bank for platelets in Henan Province from 2018 to 2020 were included in this study. Data on the total number of apheresis platelet donations, annual donation frequency, age at enrollment, donation habits (including the number of platelets donated per session and whether they had previously donated whole blood), and enrollment location were collected from the platelet donor information management system. Donor loss was determined based on the date of their last donation. The loss rates of different groups under various conditions were compared to assess the enrollment strategies. [Results] By the time the platelet bank was officially operational in 2022, 421 donors had been lost, resulting in an loss rate of 29% (421/1 443). By the end of 2023, the overall cumulative loss rate reached 52% (746/1 443). The loss rate was lower than the overall level in groups meeting any of the following conditions: total apheresis platelet donations exceeding 50, annual donation frequency of 10 or more, age at enrollment of 40 years or older, donation of more than a single therapeutic dose per session, or a history of whole blood donation two or more times. Additionally, loss rates varied across different enrollment locations, with higher enrollment numbers generally associated with higher loss rates. [Conclusion] Through a comprehensive analysis of donor loss, our center has adjusted its strategies for establishing the donor pool. These findings also provide valuable insights for other blood collection and supply institutions in building platelet donor banks.

Objective To retrospectively analyze multicenter data from domestic sources, aiming to explore the link between intrahepatic cholangiocarcinoma (ICC) tumor size and prognosis, establishing a classification system based on tumor size. Methods Between December 2011 and September 2018, 280 ICC patients from 13 hospitals were included. The tumor size prognosis cutoff was identified by the minimum P-value method, and the classification's overall survival related effectiveness was assessed by Kaplan-Meier analysis. Results All 280 patients were divided into the group of tumor maximum diameter ≤4 cm and >4 cm. Tumor size was confirmed as an independent prognosis factor by multivariate COX regression analysis (HR=2.110, 95% CI: 1.358-3.280). Conclusions The tumor size dichotomy classification system based on the Chinese patient group can expediently predict ICC prognosis and offers an important basis for selecting post-operative individualized adjuvant therapy and follow up plans.

Objective To investigate the association between serum C-X-C motif chemokine ligand 14(CXCL14)level and carotid atherosclerotic plaques(CAP)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 262 patients with T2DM(T2DM group)and 131 healthy individuals(control group)who underwent physical examinations in Ganzhou Municipal Hospital from January 2022 to February 2025 were selected at a ratio of 2∶1.T2DM patients were further divided into CAP group(112 cases)and non-CAP group(150 cases)based on the presence or absence of CAP.Serum CXCL14 level was measured using enzyme-linked immunosorbent assay.The correlation between serum CXCL14 level and clinical characteristics in CAP patients was analyzed.The association between serum CXCL14 level and CAP in T2DM patients was assessed using multivariate Logistic regression and restricted cubic spline(RCS)regression.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the predictive value of serum CXCL14 level for CAP in T2DM patients.Results The serum CXCL14 level of patients in T2DM group was significantly higher than that in control group(P＜0.05).The age of patients in CAP group was significantly older than that in non-CAP group,and the course of diabetes mellitus was significantly longer than that in non-CAP group.The proportions of hypertension,fasting plasma glucose,fasting insulin,2-hour plasma glucose,glycosylated hemoglobin,homeostasis model assessment of insulin resistance index,low density lipoprotein cholesterol,hypersensitive C-reaction protein,interleukin-6,and CXCL14 level were all significantly higher than those in non-CAP group(P＜0.05).Multivariate Logistic regression analysis showed that after adjusting for general information,glycolipid metabolism indicators,and inflammatory indicators,higher CXCL14 level was an independent risk factor for CAP in patients with T2DM(P＜0.05).RCS regression analysis showed that after adjusting for general information,glycolipid metabolism indicators,and inflammatory indicators,the CXCL14 level was associated with the risk of CAP in T2DM patients,and presented a positive dose-response relationship(P＜0.05).The ROC curve showed that area under the curve of serum CXCL14 for evaluating CAP in T2DM patients was 0.772,and the sensitivity and specificity were 58.9％and 82.0％,respectively.Conclusion Elevated serum CXCL14 level is positively associated with an increased risk of CAP in patients with T2DM and has a high assessment efficiency for CAP in T2DM patients.

Objective To investigate the prevalence and symptoms of pertussis in patients with cough,and to predict individual risk based on the combination of symptoms.Methods A total of 1 025 patients with cough or contact with pertussis patients were included.Pertussis was confirmed by nasopharyngeal swab PCR.Patients were divided into the juvenile group(278 cases)and the adult group(747 cases)according to age.The duration of cough from onset to study participation,the visual analogue(VAS)score of cough degree and the number of basic symptoms(paroxysmal cough,vomiting after cough,crowing cough,pauses in breathing after cough and fever)were compared between the two groups.The confirmed patients were further grouped by age,and the different symptoms were compared.70%of the sample was used as the training set.Based on the combination of symptoms(paroxysmal cough,post-cough vomiting,chick-crooning cough and pauses in inspirations after coughing),multivariate Logistic regression was used to establish the prediction model and draw the nomogram.30%of the sample was used as the validation set,and the receiver operating characteristic(ROC)curve was drawn.The differentiation of the area under the curve(AUC)evaluation model was calculated.The calibration degree of the model was evaluated by Hosmer-Lemeshow test,and calibration curve was drawn to evaluate the model.Results By PCR,163 cases(15.9%)were confirmed as pertussis.The juvenile group had a longer duration of cough from onset to study participation than the adult group(P＜0.05).The VAS score of cough severity was higher,and the number of basic symptoms of pertussis was more(P＜0.01).In confirmed cases,the proportion of paroxysmal cough,vomiting after cough,crowing cough and inspiratory pause after cough was higher in the juvenile group than that in the adult group(P＜0.01).In the diagnosed cases,the incidence of paroxysmal cough and post-cough vomiting were higher in the＜1-year-old group compared to the 1-9-year-old group and the≥10-year-old group(P＜0.05).The combination of paroxysmal cough,vomiting after cough,crowing cough and inspiratory pause after cough was selected by Logistic regression analysis to establish a nomogram model.The AUC of this model in the training set was 0.852,and the Hosmer-Lemeshow test χ2=0.208,P=0.901,and in the verification set,the AUC was 0.899,and the Hosmer-Lemeshow test χ2=4.202,P=0.122.The predicted value in the calibration curve was very close to the theoretical value in the training set and the verification set,and the fitting degree was high.Conclusion The infection rate of pertussis is high in patients with cough.The nomogram model based on combined symptoms has a better prediction effect on pertussis differentiation,which can provide reference for the monitoring of pertussis.

Objective:To investigate the effects of botulinum toxin A (BTX-A) injection on ocular surface in patients with blepharospasm and dry eye.Methods:In this prospective study, 56 patients (83 eyes) with essential blepharospasm who were treated with BTX-A in the Department of Ophthalmology of Jiaxing Hospital of Traditional Chinese Medicine from April 2020 to January 2022 were included. The patients were divided into blepharospasm with dry eye group (group A, 50 eyes) and simple blepharospasm group (group B, 33 eyes) according to whether they were accompanied by dry eye. The Oculus Keratograph was used to evaluate tear meniscus height (TMH), tear break-up time (BUT), ocular bulbar redness, and corneal fluorescein staining. The OPD-Scan III analyzer was used to measure the corneal surface regularity index. The Ocular Surface Disease Index and meibomian gland analysis were performed to diagnose dry eye before treatment. Paired t-tests and Wilcoxon signed-rank tests were conducted to analyze the data. In patients with unilateral conditions, the ocular surface data of the affected and healthy eyes were compared before treatment. The severity of blepharospasm was evaluated in both groups before treatment and 1 week after treatment. Results:Among the 56 patients, 57.1% (32/56) were diagnosed with dry eye. One week after BTX-A injection treatment, both groups demonstrated varying degrees of improvement in their conditions. In patients with unilateral blepharospasm, pre-treatment ocular surface examinations indicated that the affected eye had a lower tear BUT of (6.67 ± 3.86) seconds and a lower TMH of (0.18 ± 0.07) mm compared with the healthy eye, which showed (10.20 ± 5.95) seconds for BUT and (0.20 ± 0.05) mm for TMH ( t = -3.94, -2.44, both P < 0.05). Additionally, the ocular bulbar redness value was significantly higher in the affected eye [(1.75 ± 0.38)] than in the healthy eye [(1.65 ± 0.47), t = 2.16, P < 0.05]. After treatment, both groups exhibited significant increases in BUT and TMH compared with their pre-treatment values ( t = -6.27, -4.21, -2.56, -3.12, all P < 0.05). Furthermore, both groups showed significant decreases in ocular bulbar redness values compared with pre-treatment values ( t = 3.04, 3.32, both P < 0.05). In group A, the corneal fluorescein staining score post-treatment was significantly lower than the pre-treatment value ( Z = 2.10, P < 0.05). However, in group B, the FL score did not show a significant difference between pre-treatment and post-treatment. ( Z = 0.03, P > 0.05). There were also no significant differences in the surface regularity index between the two groups both before and after treatment ( t = 1.35, 0.65, both P > 0.05). Conclusions:Blepharospasm can affect the stability of the tear film on the ocular surface, and BTX-A injection can help relieve dry eye caused by essential blepharospasm.

Objective To investigate the prevalence and symptoms of pertussis in patients with cough,and to predict individual risk based on the combination of symptoms.Methods A total of 1 025 patients with cough or contact with pertussis patients were included.Pertussis was confirmed by nasopharyngeal swab PCR.Patients were divided into the juvenile group(278 cases)and the adult group(747 cases)according to age.The duration of cough from onset to study participation,the visual analogue(VAS)score of cough degree and the number of basic symptoms(paroxysmal cough,vomiting after cough,crowing cough,pauses in breathing after cough and fever)were compared between the two groups.The confirmed patients were further grouped by age,and the different symptoms were compared.70%of the sample was used as the training set.Based on the combination of symptoms(paroxysmal cough,post-cough vomiting,chick-crooning cough and pauses in inspirations after coughing),multivariate Logistic regression was used to establish the prediction model and draw the nomogram.30%of the sample was used as the validation set,and the receiver operating characteristic(ROC)curve was drawn.The differentiation of the area under the curve(AUC)evaluation model was calculated.The calibration degree of the model was evaluated by Hosmer-Lemeshow test,and calibration curve was drawn to evaluate the model.Results By PCR,163 cases(15.9%)were confirmed as pertussis.The juvenile group had a longer duration of cough from onset to study participation than the adult group(P＜0.05).The VAS score of cough severity was higher,and the number of basic symptoms of pertussis was more(P＜0.01).In confirmed cases,the proportion of paroxysmal cough,vomiting after cough,crowing cough and inspiratory pause after cough was higher in the juvenile group than that in the adult group(P＜0.01).In the diagnosed cases,the incidence of paroxysmal cough and post-cough vomiting were higher in the＜1-year-old group compared to the 1-9-year-old group and the≥10-year-old group(P＜0.05).The combination of paroxysmal cough,vomiting after cough,crowing cough and inspiratory pause after cough was selected by Logistic regression analysis to establish a nomogram model.The AUC of this model in the training set was 0.852,and the Hosmer-Lemeshow test χ2=0.208,P=0.901,and in the verification set,the AUC was 0.899,and the Hosmer-Lemeshow test χ2=4.202,P=0.122.The predicted value in the calibration curve was very close to the theoretical value in the training set and the verification set,and the fitting degree was high.Conclusion The infection rate of pertussis is high in patients with cough.The nomogram model based on combined symptoms has a better prediction effect on pertussis differentiation,which can provide reference for the monitoring of pertussis.

Objective:Investigating the migration pattern of microorganisms in the oil-water phase during the prep-aration of sterile test solutions for drugs by extraction method,providing reference for the pre-treatment of oil-based matrix test samples.Methods:Inoculate 6 strains of test bacteria separately into sterile isopropyl tetradecanoate,simulate the sample preparation process of extraction method,and detect the growth status of microorganisms in oil-water phase;Detect the recovery ratio of each test bacterium in the aqueous phase using the extraction method.Select semi-solid oily matrix samples and prepare the test solution using extraction method.Establish a sterility test method according to Part 1101 of the 2020 edition of the Chinese Pharmacopoeia.Results:After extraction,the recovery ratio of each test bacteria in the water phase is in the range of 0.64-0.89.After the oily matrix sample is extracted,the water phase is taken for microbial test,which effectively solves the problems of filter membrane blockage and difficult antibacterial removal,and is beneficial to the subsequent microbial inspection.Conclusion:The extraction method can improve the accuracy and sensitivity of microbial detection in the prepara-tion of test solutions for oily matrix samples.The applicability test of the established sterile inspection method meets the requirements of the Chinese Pharmacopoeia.

Background and Aims:Intrahepatic cholangiocarcinoma(ICC)is a highly malignant liver tumor,with an increasing incidence worldwide,particularly in Asia.Although radical surgical resection is currently the only potentially curative treatment,the high recurrence rate and low postoperative overall survival(OS)rate of ICC remain major clinical challenges.Adjuvant therapy(AT)and neoadjuvant therapy(NAT)are important strategies to reduce postoperative recurrence and prolong OS.Several studies have shown certain efficacy of these treatments.However,the specific efficacy and safety of combined NAT and AT in ICC treatment require further validation.This study was conducted to evaluate the value of combining NAT and AT in improving the therapeutic outcomes of ICC patients through a multicenter retrospective analysis,so as to provide scientific evidence for optimizing treatment strategies.Methods:The clinicopathologic data of 576 patients with ICC who underwent radical resection and were pathologically confirmed from 13 hospitals in China between December 2011 and December 2017 were retrospectively collected.Patients were grouped based on their treatment modality:NAT+AT group,AT group,and non-NAT/AT group.The three patient groups were matched pairwise in a 1∶1 ratio using propensity score matching(PSM)to balance baseline data.The Kaplan-Meier method was used to analyze OS and disease-free survival(DFS),and subgroup analyses were conducted according to the 8th edition of the AJCC TNM staging system.Results:A total of 395 ICC patients were included in the final analysis,with 42 patients(10.6%)in the NAT+AT group,62 patients(15.7%)in the AT group,and 291 patients(73.7%)in the non-NAT/AT group.Before PSM,significant differences were observed between groups in terms of CA19-9,liver function Child-Pugh classification,intraoperative blood loss,surgical margin,differentiation grade,vascular invasion,ECOG score,and lymph node dissection ratio(all P<0.05).After PSM,there were no significant differences in baseline characteristics between the groups(all P>0.05).After matching,the median OS and DFS in the NAT+AT group were significantly better than in the AT and non-NAT/AT groups(both P<0.05),while there were no significant differences in OS and DFS between the AT and non-NAT/AT groups(both P>0.05).Subgroup analysis showed that in TNM stage I patients,DFS in the NAT+AT group was significantly better than in the non-NAT/AT group(P<0.05),but OS was not significantly different(P>0.05).In TNM stage Ⅱ and Ⅲ patients,both OS and DFS in the NAT+AT and AT groups were significantly better than in the non-NAT/AT group(both P<0.05),and DFS in the NAT+AT group was significantly better than in the AT group in TNM stage Ⅲ patients(P<0.05).Conclusion:NAT combined with AT provides better survival benefits for patients with locally advanced ICC,but its benefit for early-stage ICC patients is limited.However,the retrospective design and sample size limitations of this study may affect the stability of the results,and future large-sample,multicenter,prospective studies are needed for further validation.