Objective: To develop a quality appraisal tool for case reports in traditional Chinese medicine (TCM) based on their characteristics. [Methods]: An extensive literature search was conducted in Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and China Science and Technology Journal Database (CSTJ), focusing on expert consensus statements and checklists for TCM case reports. Relevant items were extracted, and a Delphi method involving 34 experts was used in two rounds to rate each item on a 5-point Likert scale. Items were screened based on measures of central tendency and coordination (including total score, mean score, percentage of items rated as unimportant, and coefficient of variation). The weighted average method was used to determine item weights and construct the appraisal tool. Internal consistency was assessed using Cronbach’s α coefficient. The finalized tool was pilot-tested by two reviewers independently appraising 20 case reports, with an additional four reviewers evaluating 5 of these cases to compare inter-rater consistency. Results: A total of 9 513 articles were retrieved, and 96 items from 25 articles were extracted. After two rounds of the Delphi method, 27 items across 10 domains were retained. The Cronbach’s α coefficient was 0.72 in the first round (acceptable range), and 0.96 in the second round, indicating strong internal consistency. The tool was piloted by six reviewers, achieving a kappa value of 0.663 and a Kendall’s coefficient of concordance of 0.845, demonstrating high consistency among reviewers. Conclusion The developed TCM case report quality appraisal tool, consisting of 27 items in 10 domains, offers a scientific and reliable means of assessing the quality of TCM case reports. The tool showed high consistency and practical utility, and its application is expected to enhance the standardization, scientific rigor, and evidence quality of TCM case reports, facilitating the integration of traditional medical knowledge with modern evidence-based standards.

The historical evolution of the fire-processing of Aconiti Lateralis Radix Praeparata(Fuzi)was explored by literature research and the re-practice of ancient processing method.The literature research showed that the Han Dynasty was the beginning of fire-processing of Fuzi,and the processing techniques of Fuzi varied.During the Jin and Tang Dynasties,ash fire was preferred for fire-processing techniques;in the Song Dynasty,the concept of fully-processing and the method of macerating Fuzi with liquid before fire-processing appeared;in the Jin and Yuan Dynasties,the processing criterion of presenting yellow color inside and outside and the remedial methods after fire-processing were put forward;in the Ming Dynasty,the techniques of water-macerating,fire-processing,slicing and baking became the mainstream,and the Qing Dynasty further refined the techniques in terms of process details.After the founding of the People's Republic of China,the sand-scalding technique developed from the local processing experiences and standards has disengaged from the ancient methods.The literature evidence and the re-practice of ancient processing method revealed that the traditional fire-processing techniques on Fuli such as ash-fire-processing,water-macerating before fire-processing,and quenching after fire-processing,are all about the control of temperature and processing time and the criterion of presenting yellow color inside and outside.For the preparation of Fuzi standard in the formulas containing Fuzi,it is recommended to process Fuzi at the temperature of simulated hot ashes in an oven,and the standard should be uniformly yellow after processing.

Objective To investigate the guiding value and safety of three tracers in identifying sentinel lymph nodes(SLN)for lymph node dissection during radical surgery for early-stage cervical cancer.Methods A total of 114 patients with early-stage cervical cancer from January 2021 to No-vember 2022 were selected as the study subjects.They were randomly divided into methylene blue group,nano-carbon group,and indocyanine green(ICG)group according to the random number ta-ble method,with 38 cases in each group.All three groups underwent radical surgery.The methylene blue group used methylene blue for SLN identification during surgery,the nano-carbon group used nano-carbon,and the ICG group used ICG fluorescence imaging.The SLN identification status and surgery-related indicators were compared among the three groups.Trauma indicators[serum cortisol(Cor),epinephrine(E),adrenocorticotropic hormone(ACTH),and C-reactive protein(CRP)]were compared among the three groups before surgery and on 1,3,and 7 d after surgery.Tumor markers[carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 125(CA125),and carbohydrate antigen 199(CA199)]were compared among the three groups before surgery and 3 months after surgery.The complication rates and recurrence rates were also compared among the three groups.Results The tracing time in the ICG group was shorter than that in the nano-carbon and methylene blue groups,and the tracing time in the nano-carbon group was shorter than that in the methylene blue group(P＜0.05).In terms of the success rate and number of identified SLN,the nano-carbon group was higher than the ICG and methylene blue groups,and the ICG group was higher than the methylene blue group(P＜0.05).Regarding the SLN resection time,the nano-car-bon group had the shortest time,and the methylene blue group had the longest time,with a statisti-cally significant difference(P＜0.05).The serum levels of CEA,AFP,CA125,and CA199 in the three groups decreased significantly 3 months after surgery compared with those before surgery(P＜0.05).The within-group effects of one-way repeated-measures analysis of variance showed that the serum levels of Cor,E,ACTH,and CRP in the three groups increased first and then decreased on 1,3,and 7 d,with statistically significant differences(P＜0.05).There was no statistically signif-icant difference in the complication rates among the three groups(P＞0.05).During the 1-year fol-low-up,2 patients were lost during follow-up in the nano-carbon group,1 in the ICG group,and 2 in the methylene blue group.No recurrence was found in any of the three groups.Conclusion Among the three tracers,ICG has the shortest time for tracing SLN during radical surgery for early-stage cer-vical cancer.Nano-carbon exhibits relatively high application value compared with the other two tracers,and it guides the scope of lymph node dissection and demonstrates certain safety.

Objective To investigate the prevalence of dyslipidemia in subjects with type 2 diabetes mellitus in Beijing urban communities.Methods Total 3316 subjects with type 2 diabetes (age 20-80 years) were recruited from 15 urban community health centers in Beijing using a multi-stage random sampling approach.Dyslipidemia was diagnosed according to Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults:2007 version.Results Among 3316 diabetic subjects (1329 malesand 1987 females),75.6％ (2506/3316) had dyslipidemia,the prevalence was 72.5％ (964/1329)in men and 77.6％ (1542/1987) in women.The prevalence of hypertriglyceridemia and hypercholesterolemia was 41.9％ (1388/3316) and 48.1％ (1595/3316),respectively.31.5％ (1043/3316) subjects had high levels of low-density lipoprotein cholesterol (LDL-C) and 21.2％ (703/3316) had low high-density lipoprotein cholesterol (HDL-C).Among all subjects with dyslipidemia only 22.9％ (575/2506) took hypolipid agents.The overall blood lipid control rates of triglyceride (TG),total cholesterol (TC),LDL-C and HDL-C in 1393 subjects with dyslipidemia history were 48.0％ (669/1393),17.4％ (242/1393),30.9％ (430/1393) and 75.8％ (1056/1393),respectively.Diabetics with dyslipidemia had higher body mass index,waist circumference,blood pressure,plasma glucose and hemoglobin A1c.The prevalence of dyslipidemia in the overweight and uncontrolled-glucose group were 79.0％ (1678/2125),78.9％ (1756/2227),respectively.Logistic regression analysis showed that gender,age,body mass index and hemoglobin A1c were associated with dyslipidemia.Conclusions The prevalence of dyslipidemia in diabetic subjects in Beijing urban communities is high and less than one quarter patients take hypolipid agents.Age,body mass index and hemoglobin A1c are the risk factors of dyslipidemia in type 2 diabetic patients.

Objective To investigate current status of use of oral hypoglycemic drugs and insulin among adult patients with type 2 diabetes mellitus (T2DM) in urban community of Beijing.Methods In total,3297 T2DM patients aged more than 20 years from 15 urban communities of Beijing were studied.Their body weight,height,fasting plasma glucose level and glycosylated hemoglobin Alc (HbAlc) were measured.A door-to-door questionnaire survey on use of oral hypoglycemic drugs and insulin was conducted for them.All the T2DM patients surveyed were divided into four groups based on their received intervention.Results ①Of 3279 T2DM patients,454 (13.8％) received lifestyle intervention,971 (29.5％) used only one oral hypoglycemic drug,1179 (35.7％) with combined oral hypoglycemic drugs,and 693(21.0％) with insulin.②There was significant difference in average HbAlc among the four groups of T2DM patients with lifestyle intervention,only one oral hypoglycemic drug,combined oral hypoglycemic drugs,and insulin,with HbAI c of (7.0 ± 1.9) ％,(7.1 ± 1.5) ％,(7.4 ± 1.5 ) ％,and (7.5 ± 1.5 ) ％for them,respectively ( F =15.1,P ＜ 0.01 ).Proportions of the T2DM patients with HbAlc equal to or higher than 7.0％ were 32.2％,39.4％,52.1％ and 59.5％ for the four groups,respectively ( x2 =117.7,P ＜ 0.01 ).③In the T2DM patients with lifestyle intervention,32.2％ (146/454) of them with HbA1 c equal to or higher than 7.0％ were untreated with any oral hypoglycemic drug.In those with only one oral hypoglycemic drug,39.4％ (383/971) of them with HbAlc equal to or higher than 7.0％ were not treated with combined oral hypoglycemic drugs and/or insulin.In those with combined oral hypoglycemic drugs,52.1％ (614/1079) of them with HbAlc equal to or higher than 7.0％ were not received combined insulin treatment.④ Fasting plasma glucose level,treatment strategies,postprandial 2-h blood glucose level and length of the illness were independent risk factors for HbAlc level equal to or higher than 7.0％,with odds ratio (OR) of 1.757,1.256,1.175 and 1.031,respectively.⑤ In 2843 T2DM patients with oral hypoglycemie drugs and/or insulin treatment,1494 (52.6％ ) received biguanides and 693 received (24.4％ )insulin,respectively.Conclusions More than half of adult patients with T2DM do not meet the target of glycemic control of HbAlc less than 7.0％ in urban communities of Beijing,due to not active use of oral hypoglycemic drugs,and not timely adoption of combined use of oral hypoglycemic drugs and insulin therapy.

Objective: To investigate pharmacokinetics of propofol during anhepatic period of orthotopic liver transplantation (OLT) in children. Methods: In 5 children undergoing OLT, 2 mg/kg propofol was injected intravenously at the beginning of induction and anhepatic periods respectively. The plasma concentration of propofol was measured by reverse-phase high performance liquid chromatography(RP-HPLC), and the pharmacokinetics character of propofol between anhepatic and inducing periods were compared. Results: Propofol had wide distribution and high clearance, and its plasma concentration-time curves were fitted to a three-compartment open model. Conclusion: There is no difference of propofol metabolism between anhepatic and inducing periods, suggesting that there must be notable extra-hepatic metabolism when propofol used in children undergoing OLT.