Acute pancreatitis(AP)is a frequently encountered acute abdominal syndrome in clinical settings,and the integrated model of traditional Chinese and Western medicine(TCM-WM)has demonstrated notable advantages in the diagnosis and treatment of AP.To systematize and standardize clinical practices related to develop clinical pathway for integrated TCM-WM diagnosis and treatment of AP,which enhances the efficiency and quality of patient care.This pathway focuses on AP,a common acute and life-threatening disease within the digestive system,and outlines that the central pathological mechanism involves pancreatic injury and localized inflammation resulting from the abnormal activation of pancreatic enzymes.It has the characteristics of rapid onset,multiple causes,and complex manifestations.Severe cases can be life-threatening.At present,conventional treatments encompass a diverse range of modalities.Moreover,traditional Chinese medicine(TCM)holds distinct advantages in alleviating relevant symptoms,and TCM-WM is gaining increasing prevalence.To enhance the standardization and consistency of diagnostic and therapeutic practices,this clinical pathway clearly delineates the target patient population,which includes individuals diagnosed with abdominal pain disorder according to TCM and with AP in accordance with WM criteria,as well as the corresponding inclusion standards.The diagnostic framework integrates both TCM and WM guidelines,and further incorporates disease staging,severity grading,and syndrome differentiation to support a comprehensive and integrated diagnostic strategy.The treatment integrates approaches from both TCM and WM.Within the WM framework,interventions consist of basic supportive care,infection control,nutritional support,and the management of complications.In the context of TCM,the protocol includes syndrome differentiation and corresponding therapeutic strategies(Distinct syndrome patterns are identified and managed during the acute and convalescent phases),such as acupuncture and retention enema.This clinical pathway addresses multiple key components,including preventive strategies,post-treatment follow-up,criteria for evaluating therapeutic efficacy,admission and discharge,admission examination protocols,discharge criteria,and the rationale for deviations or withdrawal from the pathway.It is designed to provide a systematic and standardized reference framework for relevant clinical practices.

Acute pancreatitis(AP)is a frequently encountered acute abdominal syndrome in clinical settings,and the integrated model of traditional Chinese and Western medicine(TCM-WM)has demonstrated notable advantages in the diagnosis and treatment of AP.To systematize and standardize clinical practices related to develop clinical pathway for integrated TCM-WM diagnosis and treatment of AP,which enhances the efficiency and quality of patient care.This pathway focuses on AP,a common acute and life-threatening disease within the digestive system,and outlines that the central pathological mechanism involves pancreatic injury and localized inflammation resulting from the abnormal activation of pancreatic enzymes.It has the characteristics of rapid onset,multiple causes,and complex manifestations.Severe cases can be life-threatening.At present,conventional treatments encompass a diverse range of modalities.Moreover,traditional Chinese medicine(TCM)holds distinct advantages in alleviating relevant symptoms,and TCM-WM is gaining increasing prevalence.To enhance the standardization and consistency of diagnostic and therapeutic practices,this clinical pathway clearly delineates the target patient population,which includes individuals diagnosed with abdominal pain disorder according to TCM and with AP in accordance with WM criteria,as well as the corresponding inclusion standards.The diagnostic framework integrates both TCM and WM guidelines,and further incorporates disease staging,severity grading,and syndrome differentiation to support a comprehensive and integrated diagnostic strategy.The treatment integrates approaches from both TCM and WM.Within the WM framework,interventions consist of basic supportive care,infection control,nutritional support,and the management of complications.In the context of TCM,the protocol includes syndrome differentiation and corresponding therapeutic strategies(Distinct syndrome patterns are identified and managed during the acute and convalescent phases),such as acupuncture and retention enema.This clinical pathway addresses multiple key components,including preventive strategies,post-treatment follow-up,criteria for evaluating therapeutic efficacy,admission and discharge,admission examination protocols,discharge criteria,and the rationale for deviations or withdrawal from the pathway.It is designed to provide a systematic and standardized reference framework for relevant clinical practices.

Objective To evaluate the efficacy,safety and cost-effectiveness of ertugliflozin in the treatment of type 2 diabetes mellitus by rapid health technology assessment to provide a basis for clinical decision-making.Methods PubMed,Embase,the Cochrane Library,CNKI,WanFang Data,VIP database and health technology assessment(HTA)related websites and databases were searched from the inception date to January 2024.Two researchers independently screened the literature,extracted the data,assessed the quality and carried out the qualitative analysis.Results A total of 27 articles were included,in which 2 HTA reports,24 systematic reviews/meta-analyses and 2 pharmacoeconomic studies.Compared with placebo,ertugliflozin could significantly lower hemoglobin Alc level,fasting plasma glucose,hospitalization for heart failure,body weight and blood pressure levels,but there were no significant difference in all-cause mortality,cardiovascular mortality and composite renal outcome.In terms of safety,there were no significant difference in the risk of urinary tract infections,fracture,amputation and symptomatic hypoglycemia between ertugliflozin and placebo or other hypoglycemic drugs.However,ertugliflozin increased the risk of ketoacidosis,genital mycotic infections and lowered of estimated glomerular filtration rate.Pharmacoeconomic studies showed that ertugliflozin had better cost-utility and cost-effectiveness in type 2 diabetes in China.Conclusion Ertugliflozin is effective and safety in treating type 2 diabetes mellitus,but it's necessary to carry out the head to head studies among efficacy,safety and economics research in China.

Objective To investigate the changes of T cell subsets including Th1,Th2,Th17 and Treg in the hand,foot and mouth disease(HFMD) patients.Methods 35 EV71 induced HMFD patients and 12 non-infectious children were included in this study.Patients were divided into mild symptoms group and severe symptoms group.The ratios of Th1,Th2,Th17 and Treg were analyzed by flow cytometry.Results Sixteen mild cases and 19 severe cases were included in the 35 patients.No statistical difference of children′s age and sex were found among the groups(P>0.05).The proportion[M(P25,P75)] of Th1 cells of mild and severe groups were 10.65%(8.73%,14.08%) and 15.51% (13.47%,18.31%),respectively,which were significantly higher than normal control group 5.51% (3.61%,8.61%)(P<0.05).The proportion of Th2 cells of mild and severe groups were 4.32%(2.60%,5.32%) and 3.87% (2.34%,5.32%),no significant difference from control group 2.11% (1.02%,5.11%)(P<0.05).The proportion of Th17 cells of mild and severe groups were 8.32%(5.25%,12.33%),7.36% (5.05%,11.9%),significantly higher than that of normal control group 4.23% (2.44%,6.22%)(P<0.05).The proportion of Treg cells of mild and severe groups were 1.46% (0.31%,2.73%),1.59%(0.35%,2.62%),no significant difference from the control group 1.78% (0.31%,2.77%)(P<0.05).Conclusion The Th1/Th2 and Th17/Treg ratios of HFMD patients with EV71 virus infection were changed,and the Th1 and Th17 cells may play an important role in the in the disease and body′s resistance.

ObjectiveTo explore the role of the lymphocyte subsets in the peripheral blood in diagnosis, treatment and prognosis of hemophagocytic lymphohistiocytosis (HLH) in children.MethodA total of 30 children with HLH were enrolled in this study and treated according to the HLH-2004 diagnostic guidelines. 20 children with HLH entered complete remission (CR) and 10 children with HLH died. Thirty age-matched healthy children were selected as normal controls. T cell subsets in the pe-ripheral blood were measured by lfow cytometry.ResultsCompared with control group, CD3+T and CD8+T cells were signiif-cantly increased, CD4+T and CD3-CDl6+CD56+ NK cells were signiifcantly decreased, and CD4+/CD8+ cell ratio was signiifcantly decreased in 20 CR children and 10 died children with HLH in acute phase (P<0.05). CD19+B cells was not statistically different in 20 CR children and 10 died children with HLH in acute phase from control group (P>0.05). In acute phase, the lymphocyte subsets were not statistically different between 20 CR children and 10 died children (P>0.05). In 20 CR children, the proportion of CD3-CD16+CD56+NK in CR phase was statistically different than that in acute phase (P<0.05).ConclusionsChildren with HLH have obvious changes in peripheral blood lymphocyte subsets and have cellular immunity disorders. Dynamic detection of the changes may help determine the therapeutic effect and prognosis of HLH.