Systematically sort out the successful development experience and current shortcomings of various aspects of combined Chinese and Western medicine first aid,and on this basis,we discuss the development ideas of combined Chinese and Western medicine first aid.Based on the complementary advantages of the combination of Chinese and Western medicines in first aid,it takes the special diseases with bottlenecks in the efficacy of the current single system as an entry point,and further optimizes the combination of Chinese and Western medicines in first aid through the dynamic and sequential coordination of Chinese medicine's holistic conditioning and Western medicine's targeted treatment,and promotes the development of the synergistic strategy of the first aid of Chinese and Western medicines,so as to better play the advantageous roles of the combination of Chinese and Western medicines in first aid to enhance the clinical efficacy,reduce the toxicity and side-effects,and improve the prognosis of the diseases.We also strive to promote the improvement of the dosage form of traditional first aid prescriptions and the technical innovation of the production process,so as to realize the improvement of the key indexes such as the timeliness of the onset of action,the controllability of the quality,and the targeting of the efficacy of the Chinese medicinal preparations in the first aid,in order to better support and guarantee the medicines for the first aid of the combination of traditional Chinese and Western medicines.At the same time,we should also promote the systematic construction of the standardized operation specification and efficacy evaluation system of acupuncture and moxibustion,explore the integration of acupuncture and moxibustion with modern first aid,and optimize acupuncture and moxibustion intervention strategies in emergency departments to enhance the efficacy of first aid under the restriction of medical equipments.The proposal of these suggestions may provide some enlightenment in the development of the idea of integrating Chinese and Western medicine in emergency care,and may have some reference value for the development of emergency medicine model with Chinese characteristics.

Systematically sort out the successful development experience and current shortcomings of various aspects of combined Chinese and Western medicine first aid,and on this basis,we discuss the development ideas of combined Chinese and Western medicine first aid.Based on the complementary advantages of the combination of Chinese and Western medicines in first aid,it takes the special diseases with bottlenecks in the efficacy of the current single system as an entry point,and further optimizes the combination of Chinese and Western medicines in first aid through the dynamic and sequential coordination of Chinese medicine's holistic conditioning and Western medicine's targeted treatment,and promotes the development of the synergistic strategy of the first aid of Chinese and Western medicines,so as to better play the advantageous roles of the combination of Chinese and Western medicines in first aid to enhance the clinical efficacy,reduce the toxicity and side-effects,and improve the prognosis of the diseases.We also strive to promote the improvement of the dosage form of traditional first aid prescriptions and the technical innovation of the production process,so as to realize the improvement of the key indexes such as the timeliness of the onset of action,the controllability of the quality,and the targeting of the efficacy of the Chinese medicinal preparations in the first aid,in order to better support and guarantee the medicines for the first aid of the combination of traditional Chinese and Western medicines.At the same time,we should also promote the systematic construction of the standardized operation specification and efficacy evaluation system of acupuncture and moxibustion,explore the integration of acupuncture and moxibustion with modern first aid,and optimize acupuncture and moxibustion intervention strategies in emergency departments to enhance the efficacy of first aid under the restriction of medical equipments.The proposal of these suggestions may provide some enlightenment in the development of the idea of integrating Chinese and Western medicine in emergency care,and may have some reference value for the development of emergency medicine model with Chinese characteristics.

Professor Wang Jinda,as the founder of emergency medicine combining traditional Chinese and Western medicine,not only integrated the profoundness of Chinese medicine and the precision of western medicine,but also made bold innovations and breakthroughs on this basis.This article aims to review and deeply study the evolution and contribution professor Wang Jinda's academic thoughts over the past 50 years,including the establishment of the acute"three failure"rescue research laboratory[professor Wang Jinda took the lead in introducing the specialty of emergency medicine into China and established the first emergency medicine research institution in China,the acute"three failure"(heart,lung,kidney)rescue research laboratory and the intensive care unit(ICU)of the Tianjin First Central Hospital],the proposal of the"three symptoms and methods"and the"simultaneous treatment of bacterial toxin and inflammation"theory[the treatment of sepsis,disseminated intravascular coagulation(DIC),and multiple organ dysfunction syndrome(MODS)was summarized as"three symptoms and three methods",namely,the syndrome of toxic heat and the of clearing away heat and toxic materials,the syndrome of blood stasis and the method of promoting blood circulation and removing blood stasis,and the syndrome of acute deficiency the method of supporting the healthy qi and consolidating the foundation],and the development of the Xuebijing injection(under the guidance of professor Wang Jinda's thoughts,the Xuebijing injection,which was modified from the"Xuefu Zhuyu decoction"of the Qing dynasty Wang Qingren has been proven by various experimental studies and clinical observations that it can improve the treatment effect of critical diseases such as sepsis through various mechanisms),which reveals his achievements in the field of emergency medicine for critical diseases.At the same time,his academic achievements have been verified by evidence-based medicine and have definite clinical value in the of critical diseases,and also provide references for subsequent clinical research.

Professor Wang Jinda,as the founder of emergency medicine combining traditional Chinese and Western medicine,not only integrated the profoundness of Chinese medicine and the precision of western medicine,but also made bold innovations and breakthroughs on this basis.This article aims to review and deeply study the evolution and contribution professor Wang Jinda's academic thoughts over the past 50 years,including the establishment of the acute"three failure"rescue research laboratory[professor Wang Jinda took the lead in introducing the specialty of emergency medicine into China and established the first emergency medicine research institution in China,the acute"three failure"(heart,lung,kidney)rescue research laboratory and the intensive care unit(ICU)of the Tianjin First Central Hospital],the proposal of the"three symptoms and methods"and the"simultaneous treatment of bacterial toxin and inflammation"theory[the treatment of sepsis,disseminated intravascular coagulation(DIC),and multiple organ dysfunction syndrome(MODS)was summarized as"three symptoms and three methods",namely,the syndrome of toxic heat and the of clearing away heat and toxic materials,the syndrome of blood stasis and the method of promoting blood circulation and removing blood stasis,and the syndrome of acute deficiency the method of supporting the healthy qi and consolidating the foundation],and the development of the Xuebijing injection(under the guidance of professor Wang Jinda's thoughts,the Xuebijing injection,which was modified from the"Xuefu Zhuyu decoction"of the Qing dynasty Wang Qingren has been proven by various experimental studies and clinical observations that it can improve the treatment effect of critical diseases such as sepsis through various mechanisms),which reveals his achievements in the field of emergency medicine for critical diseases.At the same time,his academic achievements have been verified by evidence-based medicine and have definite clinical value in the of critical diseases,and also provide references for subsequent clinical research.

Brucellosis can lead to pathological changes of multiple systems. Capillary leak syndrome (CLS) is a clinical syndrome caused by different reasons, mainly characterized by hypotension, hypoproteinemia and systemic edema. The condition is critical and the clinical manifestations are complex, and multiple organ dysfunction syndrome (MODS) may occur in severe cases. CLS caused by brucellosis is extremely rare. The diagnosis and treatment of a patient with brucellosis complicated with CLS and MODS was analyzed in this paper, in order to improve the knowledge of clinicians about brucellosis and its complications.

Objective:To investigate the mechanism of interleukin-6 (IL-6) /signal transducers and activators of transcriptional 3 (STAT3) /helper T cell 17 (Th17) signaling pathway in lung injury of rats with sepsis intervened by forsythia, with a view to provide experimental basis for the role and mechanism of forsythia in the treatment of sepsis.Methods:In July 2021, 30 healthy Wistar male rats were selected and randomly divided into sham operation group, model group and treatment group, with 10 rats in each group. The rat model of sepsis was established by cecal ligation and puncture. 2 h after recovery, the rats were given traditional Chinese medicine forsythia orally, twice a day at an interval of 12 h. The wet/dry mass ratio (W/D) of lung tissue was detected 24 h after surgery. The morphological changes of lung tissue were detected by HE staining. Flow cytometry was used to detect Th17 population in peripheral blood. The expression levels of IL-6 and interleukin-17A (IL-17A) in serum were determined by enzyme-linked immunosorbent assay. The mRNA expression levels of IL-17A and IL-6 in lung tissues were detected by reverse transcription-polymerase chain reaction. The expression levels of STAT3 and IL-17A in lung tissue were determined by Western blotting.Results:Compared with model group, the W/D of lung tissue in treatment group was decreased, and the difference was statistically significant ( P<0.05). HE staining of lung tissue showed that compared with the model group, the degree of lung lesion and injury was reduced in the treatment group. Compared with sham operation group, the proportion of Th17 cells in CD4 lymphocytes in peripheral blood of rats in model group was significantly increased ( P<0.05). Compared with model group, the proportion of Th17 cells in CD4 lymphocytes in peripheral blood of rats in treatment group was significantly decreased ( P<0.05). Compared with sham operation group, peripheral blood serum IL-6 and IL-17 of rats in model group were significantly increased ( P<0.05). Compared with model group, IL-6 and IL-17 in peripheral blood serum of rats in treatment group were decreased ( P<0.05). Compared with sham operation group, the expressions of IL-17A and IL-6 mRNA in lung tissue of model group were significantly increased ( P<0.05). Compared with model group, the expressions of IL-17A and IL-6 mRNA in lung tissue of rats in treatment group were significantly decreased ( P<0.05). Compared with sham operation group, the protein expressions of STAT3 and IL-17A in lung tissue in model group were significantly increased ( P<0.05). Compared with model group, the pritein expressions of STAT3 and IL-17A in lung tissue in treatment group were significantly decreased ( P<0.05) . Conclusion:Forsythia plays a role in alleviating lung injury by down-regulating the expressions of the signaling pathway IL-6/STAT3/Th17, which providing a new target for the treatment of sepsis induced lung injury.

Brucellosis can lead to pathological changes of multiple systems. Capillary leak syndrome (CLS) is a clinical syndrome caused by different reasons, mainly characterized by hypotension, hypoproteinemia and systemic edema. The condition is critical and the clinical manifestations are complex, and multiple organ dysfunction syndrome (MODS) may occur in severe cases. CLS caused by brucellosis is extremely rare. The diagnosis and treatment of a patient with brucellosis complicated with CLS and MODS was analyzed in this paper, in order to improve the knowledge of clinicians about brucellosis and its complications.

Objective:To investigate the mechanism of interleukin-6 (IL-6) /signal transducers and activators of transcriptional 3 (STAT3) /helper T cell 17 (Th17) signaling pathway in lung injury of rats with sepsis intervened by forsythia, with a view to provide experimental basis for the role and mechanism of forsythia in the treatment of sepsis.Methods:In July 2021, 30 healthy Wistar male rats were selected and randomly divided into sham operation group, model group and treatment group, with 10 rats in each group. The rat model of sepsis was established by cecal ligation and puncture. 2 h after recovery, the rats were given traditional Chinese medicine forsythia orally, twice a day at an interval of 12 h. The wet/dry mass ratio (W/D) of lung tissue was detected 24 h after surgery. The morphological changes of lung tissue were detected by HE staining. Flow cytometry was used to detect Th17 population in peripheral blood. The expression levels of IL-6 and interleukin-17A (IL-17A) in serum were determined by enzyme-linked immunosorbent assay. The mRNA expression levels of IL-17A and IL-6 in lung tissues were detected by reverse transcription-polymerase chain reaction. The expression levels of STAT3 and IL-17A in lung tissue were determined by Western blotting.Results:Compared with model group, the W/D of lung tissue in treatment group was decreased, and the difference was statistically significant ( P<0.05). HE staining of lung tissue showed that compared with the model group, the degree of lung lesion and injury was reduced in the treatment group. Compared with sham operation group, the proportion of Th17 cells in CD4 lymphocytes in peripheral blood of rats in model group was significantly increased ( P<0.05). Compared with model group, the proportion of Th17 cells in CD4 lymphocytes in peripheral blood of rats in treatment group was significantly decreased ( P<0.05). Compared with sham operation group, peripheral blood serum IL-6 and IL-17 of rats in model group were significantly increased ( P<0.05). Compared with model group, IL-6 and IL-17 in peripheral blood serum of rats in treatment group were decreased ( P<0.05). Compared with sham operation group, the expressions of IL-17A and IL-6 mRNA in lung tissue of model group were significantly increased ( P<0.05). Compared with model group, the expressions of IL-17A and IL-6 mRNA in lung tissue of rats in treatment group were significantly decreased ( P<0.05). Compared with sham operation group, the protein expressions of STAT3 and IL-17A in lung tissue in model group were significantly increased ( P<0.05). Compared with model group, the pritein expressions of STAT3 and IL-17A in lung tissue in treatment group were significantly decreased ( P<0.05) . Conclusion:Forsythia plays a role in alleviating lung injury by down-regulating the expressions of the signaling pathway IL-6/STAT3/Th17, which providing a new target for the treatment of sepsis induced lung injury.

Objective:To compare the short-term efficacy of hip arthroscopic surgery assisted by platelet-rich plasma (PRP) and hip arthroscopy alone in the treatment of femoroacetabular impingement (FAI).Methods:A retrospective cohort study was performed on the clinical data of 133 FAI patients admitted to Fourth Medical Center of PLA General Hospital from January 2019 to January 2021. The patients included 86 males and 47 females, aged 19-71 years [(39.1±12.6)years]. A total of 67 patients were treated with hip arthroscopy alone (hip arthroscopy group), and 66 patients were treated with PRP after hip arthroscopy under ultrasound guidance (hip arthroscopy+PRP group). The two groups were compared before, at 12 months after surgery and at the last follow-up regarding the following items: Visual Analogue Scale (VAS), Modified Harris Hip Score, International Hip Outcome Tool-12 (iHOT-12), and Hip Outcome Score Activities of Daily Living Scale (HOS-ADL). The incidence rate of complications after surgery was compared between the two groups.Results:A total of 108 patients were followed up for 24-36 months [(28.5±3.8)months], while 25 patients were lost to follow-up because of withdrawal of consent, wrong telephone number, etc, including 11 patients (16.4%) in the hip arthroscopy group and 14 patients (21.2%) in the hip arthroscopy+PRP group. The values of VAS in the hip arthroscopy group before, at 12 months after surgery and at the last follow-up were 5.00(5.00, 7.00)points, 3.00(2.00, 3.75)points, and 1.00(0.00, 2.00)points, respectively; the values of Modified Harris Hip Score were 49.00(39.00, 57.00)points, 76.00(69.25, 82.00)points, and 86.00(82.00, 88.00)points, respectively; the values of iHOT-12 were 0.45(0.28, 0.58)points, 0.69(0.58, 0.80)points, and 0.81(0.70, 0.92)points, respectively; the values of HOS-ADL were 0.52(0.42, 0.68)points, 0.87(0.75, 0.93)points, and 0.93(0.86, 0.99)points, respectively. The scores of VAS in the hip arthroscopy + PRP group before, at 12 months after surgery and at the last follow-up were 6.00(5.00, 7.00)points, 3.00(2.00, 3.75)points, and 1.00(0.00, 2.00)points, respectively; the values of Modified Harris Hip Score were 46.50(37.00, 56.75)points, 78.00(72.00, 84.00)points, and 84.50(82.00, 88.00)points, respectively; the values of iHOT-12 were 0.42(0.26, 0.51)points, 0.66(0.58, 0.74)points, and 0.81(0.68, 0.88)points, respectively; the values of HOS-ADL were 0.54(0.38, 0.65)points, 0.87(0.72, 0.96)points, and 0.94(0.86, 1.00)points, respectively. In both groups, VAS, Modified Harris Hip Score, iHOT-12, and HOS-ADL were significantly improved at 12 months after surgery and at the last follow-up compared with those before surgery, and were further improved at the last follow-up compared with those at 12 months after surgery (all P<0.01). There were no significant differences in VAS, Modified Harris Hip Score, iHOT-12 and HOS-ADL between the two groups before, at 12 months after surgery and at the last follow-up (all P>0.05). There was no significant difference in the incidence rates of postoperative hip pain and clicking between the two groups (both P>0.05). Conclusion:Hip arthroscopy can considerably improve short-term hip symptoms and function in FAI patients, but the use of PRP treatment after hip arthroscopy cannot further improve its short-term efficacy in FAI patients.

The incidence of human brucellosis is on the rise worldwide. The disease can affect various systems. The clinical manifestations are complex and non-specific, and the diagnosis is difficult. Especially the clinicians in the non-epidemic areas have sporadic cases on the pest free areas. Lack of experience in diagnosis and treatment leads to misdiagnosis and mistreatment, which affects prognosis. This article reports on the epidemiology, clinical manifestations, laboratory tests and treatment of a patient with unexplained fever and brucellosis in our department in June 2019. Raise the attention of clinicians in non-epidemic areas to the disease and enhance people's awareness of protection in non-epidemic areas.