Objective:To determine the median effective dose (ED 50) of oliceridine inhibiting responses to insertion of the gastroscope when combined with propofol in obese patients. Methods:In this prospective study, American Society of Anesthesiologists Physical Status classification I or Ⅱ patients of either sex, with a body mass index of ≥28 kg/m 2, undergoing elective painless gastroscopy, were selected. Propofol 1.5 mg/kg was slowly injected intravenously 2 min after intravenous injection of oliceridine. Gastroscopy was performed after the patient′s eyelash reflex disappeared and the jaw was relaxed. The optimal dose was determined by modified Dixon′s up and down method. The initial dose of oliceridine was 0.015 mg/kg, and the ratio between the two successive concentrations was 1.0∶1.2. If the patient had a positive response that affected the examination operation such as swallowing, bucking and body movement during insertion of the gastroscope, the next patient received a higher dose, or conversely if negative, a lower dose was given in the next patient. This process was repeated until the 7th turning point occurred. The ED 50 and 95% confidence interval of olicerdine inhibiting responses to insertion of the gastroscope were calculated by probit method. Results:A total of 21 patients were included in this study, the ED 50 of olicerdine inhibiting responses to implantation of the gastroscope was 0.016 mg/kg, and the 95% confidence interval was 0.010-0.023 mg/kg when combined with propofol 1.5 mg/kg in obese patients. One patient developed hypoxemia. One patient had mild dizziness after operation. Conclusions:The ED 50 of olicerdine inhibiting responses to implantation of the gastroscope is 0.016 mg/kg when combined with propofol 1.5 mg/kg in obese patients.

Objective Exploring the clinical efficacy of using autologous rib cartilage grafting to reconstruct finger hemiarticular defects.Methods From August 2022 to February 2024,for 6 patients with hemiarticular surface defects in the metacarpophalangeal joints and interphalangeal joints of 8 fingers,costal cartilage was used for joint remodeling and transplantation to reconstruct the hemiarticular surface defects of the fingers.All 8 joint transplants in 6 patients were two-stage surgeries.In the first stage,antibiotic bone cement was used to fill the space-occupying lesions,and in the second stage,costal cartilage joint remodeling was performed to reconstruct the finger joint defects.Postoperative follow-up and assessment of fracture healing according to Paley fracture healing scoring criteria.Outpatient and WeChat follow-up,upper limb function is evaluated according to the upper limb functional assessment standards of the Chinese Medical Association Hand Surgery Society.Record VAS pain score.Results In this group,there were a total of 6 patients with 8 cases of hemiarticular defects.Among them,2 patients had two joint surgical sites,while the remaining 4 patients had a single joint surgical site.There were 2 cases of metacarpophalangeal joint head defects,2 cases of proximal articular surface defects,3 cases of proximal articular head defects,and 1 case of thumb proximal articular head defect.After surgery,8 out of 6 patients'hand wounds healed successfully.All patients were followed up for 6-12 months postoperatively,with an average of 9 months.The VAS pain score(affected finger)for the last follow-up was 0-2 points,with an average of 0.6 points.According to Paley's scoring criteria,all 6 patients had excellent fracture healing.According to the evaluation criteria for upper limb functional assessment of the Chinese Medical Association Hand Surgery Society,3 cases were rated as excellent,3 cases were rated as good,and 2 cases were rated as fair.Conclusion For patients with half joint defects on one side of the finger,rib rib cartilage was used for joint reconstruction,which significantly improved the joint shape and function at the defect site,and reduced joint pain scores.

Indwelling urinary catheterization is one of the most widely used invasive procedures in clinical practice, playing a critical role in disease diagnosis, treatment, and monitoring. In 2024, the European Association of Urology Nurses (EAUN) released the Best Practice Guidelines for Indwelling Urinary Catheterization in Adults-Transurethral and Suprapubic Catheterization (hereinafter referred to as the Guideline), aiming to provide evidence-based clinical guidance and health education information for healthcare professionals. This article interprets the section on "Nursing Principles" within the Guideline, which spans the entire process of catheter management. Key aspects covered include pre-insertion preparation, catheter insertion procedure, catheter maintenance and securement, observation of urine color, prevention of constipation, and catheter removal. The aim is to help urology nurses and related healthcare personnel gain an in-depth understanding of the recommendations in the Guideline, promote its standardized application in clinical practice, improve the quality of indwelling catheter care, and ensure patient safety.

Objective Exploring the clinical efficacy of using autologous rib cartilage grafting to reconstruct finger hemiarticular defects.Methods From August 2022 to February 2024,for 6 patients with hemiarticular surface defects in the metacarpophalangeal joints and interphalangeal joints of 8 fingers,costal cartilage was used for joint remodeling and transplantation to reconstruct the hemiarticular surface defects of the fingers.All 8 joint transplants in 6 patients were two-stage surgeries.In the first stage,antibiotic bone cement was used to fill the space-occupying lesions,and in the second stage,costal cartilage joint remodeling was performed to reconstruct the finger joint defects.Postoperative follow-up and assessment of fracture healing according to Paley fracture healing scoring criteria.Outpatient and WeChat follow-up,upper limb function is evaluated according to the upper limb functional assessment standards of the Chinese Medical Association Hand Surgery Society.Record VAS pain score.Results In this group,there were a total of 6 patients with 8 cases of hemiarticular defects.Among them,2 patients had two joint surgical sites,while the remaining 4 patients had a single joint surgical site.There were 2 cases of metacarpophalangeal joint head defects,2 cases of proximal articular surface defects,3 cases of proximal articular head defects,and 1 case of thumb proximal articular head defect.After surgery,8 out of 6 patients'hand wounds healed successfully.All patients were followed up for 6-12 months postoperatively,with an average of 9 months.The VAS pain score(affected finger)for the last follow-up was 0-2 points,with an average of 0.6 points.According to Paley's scoring criteria,all 6 patients had excellent fracture healing.According to the evaluation criteria for upper limb functional assessment of the Chinese Medical Association Hand Surgery Society,3 cases were rated as excellent,3 cases were rated as good,and 2 cases were rated as fair.Conclusion For patients with half joint defects on one side of the finger,rib rib cartilage was used for joint reconstruction,which significantly improved the joint shape and function at the defect site,and reduced joint pain scores.

Indwelling urinary catheterization is one of the most widely used invasive procedures in clinical practice, playing a critical role in disease diagnosis, treatment, and monitoring. In 2024, the European Association of Urology Nurses (EAUN) released the Best Practice Guidelines for Indwelling Urinary Catheterization in Adults-Transurethral and Suprapubic Catheterization (hereinafter referred to as the Guideline), aiming to provide evidence-based clinical guidance and health education information for healthcare professionals. This article interprets the section on "Nursing Principles" within the Guideline, which spans the entire process of catheter management. Key aspects covered include pre-insertion preparation, catheter insertion procedure, catheter maintenance and securement, observation of urine color, prevention of constipation, and catheter removal. The aim is to help urology nurses and related healthcare personnel gain an in-depth understanding of the recommendations in the Guideline, promote its standardized application in clinical practice, improve the quality of indwelling catheter care, and ensure patient safety.

Objective Based on the three tools of the AGREE Next Steps Consortium(AGREE Ⅱ),China Clinical Guidelines Evaluation System(AGREE-China)and Scientificity Transparency Applicability Rankings(STAR),the methodological quality of Chinese medicine clinical treatment guidelines for coronary heart disease published by domestic institutions was systematically evaluated.Methods Computer system retrieval of China National Knowledge Infrastructure(CNKI),WanFang Data,Chinese Science and Technology Journal Database(VIP),China Biology Medicine(CBM)and Yimai Tong,and collect clinical practice guidelines of traditional Chinese medicine for coronary heart disease issued by domestic institutions(including expert consensus).The search period was from the establishment of the database to December 31,2023.Results A total of 21 guidelines were included.AGREE Ⅱ recommended 13 for grade A and 8 for grade B.The approval-China review strongly recommends 12,weakly recommends 8,and does not recommend 1.The highest STAR rating is a 4.0 star recommendation and the lowest is a 1.5 star recommendation.Conclusions There are a large number of TCM diagnosis and treatment guidelines and expert consensus on coronary heart disease in China,but the quality is uneven.It is suggested that the future guideline formulation should pay attention to the evidence-based principle,promote the standardization and standardization of the guideline formulation,and improve the scientific and applicability of the guideline.

Objective Based on the three tools of the AGREE Next Steps Consortium(AGREE Ⅱ),China Clinical Guidelines Evaluation System(AGREE-China)and Scientificity Transparency Applicability Rankings(STAR),the methodological quality of Chinese medicine clinical treatment guidelines for coronary heart disease published by domestic institutions was systematically evaluated.Methods Computer system retrieval of China National Knowledge Infrastructure(CNKI),WanFang Data,Chinese Science and Technology Journal Database(VIP),China Biology Medicine(CBM)and Yimai Tong,and collect clinical practice guidelines of traditional Chinese medicine for coronary heart disease issued by domestic institutions(including expert consensus).The search period was from the establishment of the database to December 31,2023.Results A total of 21 guidelines were included.AGREE Ⅱ recommended 13 for grade A and 8 for grade B.The approval-China review strongly recommends 12,weakly recommends 8,and does not recommend 1.The highest STAR rating is a 4.0 star recommendation and the lowest is a 1.5 star recommendation.Conclusions There are a large number of TCM diagnosis and treatment guidelines and expert consensus on coronary heart disease in China,but the quality is uneven.It is suggested that the future guideline formulation should pay attention to the evidence-based principle,promote the standardization and standardization of the guideline formulation,and improve the scientific and applicability of the guideline.

Objective:To determine the median effective dose (ED 50) of oliceridine inhibiting responses to insertion of the gastroscope when combined with propofol in obese patients. Methods:In this prospective study, American Society of Anesthesiologists Physical Status classification I or Ⅱ patients of either sex, with a body mass index of ≥28 kg/m 2, undergoing elective painless gastroscopy, were selected. Propofol 1.5 mg/kg was slowly injected intravenously 2 min after intravenous injection of oliceridine. Gastroscopy was performed after the patient′s eyelash reflex disappeared and the jaw was relaxed. The optimal dose was determined by modified Dixon′s up and down method. The initial dose of oliceridine was 0.015 mg/kg, and the ratio between the two successive concentrations was 1.0∶1.2. If the patient had a positive response that affected the examination operation such as swallowing, bucking and body movement during insertion of the gastroscope, the next patient received a higher dose, or conversely if negative, a lower dose was given in the next patient. This process was repeated until the 7th turning point occurred. The ED 50 and 95% confidence interval of olicerdine inhibiting responses to insertion of the gastroscope were calculated by probit method. Results:A total of 21 patients were included in this study, the ED 50 of olicerdine inhibiting responses to implantation of the gastroscope was 0.016 mg/kg, and the 95% confidence interval was 0.010-0.023 mg/kg when combined with propofol 1.5 mg/kg in obese patients. One patient developed hypoxemia. One patient had mild dizziness after operation. Conclusions:The ED 50 of olicerdine inhibiting responses to implantation of the gastroscope is 0.016 mg/kg when combined with propofol 1.5 mg/kg in obese patients.

ObjectiveTaking Achyranthis Bidentatae Radix（ABR） from different origins as samples， to quantitatively analyze the chemical composition and chromaticity of ABR with different processing degrees， and clarify the correlation and change law between color and composition in the processing process of ABR， so as to provide reference for the quality evaluation of processed products of ABR. MethodThe colorimeter is used to measure the chromaticity values of three kinds of processing degrees of ABR in different origins to show the color value change trend during the processing process， and the color parameters of wine-processed and salt-processed products of ABR with different processing degrees were analyzed by principal component analysis（PCA）， orthogonal partial least squares-discriminant analysis（OPLS-DA） and other analysis methods. The contents of eight representative components of ABR were measured by high performance liquid chromatography（HPLC）， the correlation between chromaticity and each representative component was analyzed by Pearson correlation analysis， and the applicability of the selected eight representative components was further verified by Fisher linear discriminant analysis， and the wine-processed and salt-processed products of ABR with different processing degrees were grouped according to the degree of processing， and 48 samples of wine-processed and salt-processed products with different processing degrees were used as training samples. Taking the contents of 5-hydroxymethylfurfural， polypodine B， β-ecdysterone， 25R-inokosterone， 25S-inokosterone， ginsenoside Ro， chikusetsusaponin Ⅳa and polysaccharides as variables， the discriminant function was established respectively， and 12 samples of wine-processed and salt-processed products of ABR with different processing degrees were back-tested to verify the discriminant function and test the reliability of the function. ResultPCA and OPLS-DA results showed that ABR samples with different processing degrees were classified into clusters， and the results could significantly distinguish different processed products. During the process of wine and salt processing， the contents of 5-hydroxymethylfurfural， ginsenoside Ro_， and chikusetsusaponin Ⅳa gradually increased with the deepening of the processing degree， while the contents of polypodine B， β-ecdysterone， 25R-inokosterone， 25S-inokosterone and polysaccharides showed a gradual decreasing trend， indicating these 8 components increased and decreased to different degrees in the process of wine and salt processing. The results of Pearson correlation analysis showed that the 5-hydroxymethylfurfural content of the samples with different processing degrees of wine-processed and salt-processed products were negatively correlated with the brightness value（L^*） and the total color difference value（E^*ab）（P<0.01）， and positively correlated with the red-green value（a^*） and the yellow-blue value（b^*）（P<0.01）， and that the content of polypodine B and polysaccharides were positively correlated with L^* and E^*ab（P<0.01）. The discriminant functions of wine-processed and salt-processed products of ABR were established by Fisher linear discriminant analysis， and their accuracy rates in the training samples were 93.75% and 95.83%， respectively. Twelve test samples of wine-processed and salt-processed products with different processing degree were back substitution， and the correct rate was 100%. ConclusionThe trend of composition and color changes of ABR with different processing degrees in different production areas is relatively consistent， and the color value can better distinguish ABR with different processing degrees， and the color of ABR is related to some representative components in the processing process， indicating that the color can provide reference for the identification of the processing degree of ABR and the prediction of component content.

Objective:To determine the median effective dose (ED 50) of oliceridine combined with propofol for analgesia during induced abortion in patients with different labor histories. Methods:This was a prospective study. American Society of Anesthesiologists Physical Status classification I or Ⅱ patients, aged 18-45 yr, with a body mass index of 20-28 kg/m 2, scheduled for elective induced abortion at Henan Provincial People′s Hospital (Zhengzhou University People′s Hospital) from July 1, 2024 to August 20, 2024, were selected. Patients were divided into a delivery group (group D) and a non-delivery group (group N) based on their histories of vaginal delivery. The modified Dixon′s up and down method was used to conduct the trial. Oliceridine was intravenously injected at a dose of 0.015 mg/kg in the first patient in each group, and the dose was determined based on the intraoperative body movement. The positive response was defined as the body movement of grade 2 or higher during induced abortion. If the response was positive, the next patient received a higher dose of oliceridine, or conversely, a lower dose was given. The ratio between the two successive concentrations was 1.2, and the trial was terminated until 7 turning points were achieved. The ED 50 and 95% confidence interval were calculated using the Dixon sequential method formula. The occurrence of adverse reactions was recorded. Results:A total of 54 patients were included in this study, with 25 in group D and 29 in group N. The ED 50 and 95% confidence interval of oliceridine for painless abortion were 0.019 (0.014-0.031) mg/kg and 0.026 (0.020-0.044) mg/kg in group D and group N, respectively. Compared with group D, the ED 50 of oliceridine for analgesia during induced abortion was significantly increased when combined with propofol in group N ( P<0.05). Patients in both groups experienced dizziness after intravenous oliceridine injection, and no other adverse reactions such as injection pain were observed. Conclusions:When combined with propofol, the ED 50 of oliceridine for analgesia is 0.019 mg/kg and 0.026 mg/kg during induced abortion in patients with and without vaginal delivery history, respectively. The analgesic potency of oliceridine is decreased in patients without a history of vaginal delivery compared to patients with a history of vaginal delivery.