ObjectiveTo investigate the therapeutic effects and mechanism of decoctions from four kinds of processed products of Aconiti Radix Lateralis Praeparata（ARLP） in deficiency-cold syndrome. MethodsA total of 36 SD rats were randomly divided into the control group， model group， Shengfupian（SFP） group， Paofuzi（PFZ） group， Heishunpian（HSP） group and Paofupian（PFP） group with 6 rats in each group. Except for the control group， rats in other groups were administered hydrocortisone sodium succinate via intramuscular injection to induce a cold deficiency syndrome model. After 14 consecutive days， each ARLP decoction pieces was administered via continuous gastric lavage at a dose of 12 g·kg^-1·d^-1 for 7 d， while the control and model groups received an equivalent volume of physiological saline. After the end of administration， body weight， spleen weight and thymus weight were measured for calculating the spleen and thymus indexes. Hematoxylin-eosin（HE） staining was used to observe the pathological morphology of adrenal tissue. The fully automatic biochemistry analyzer was used to measure the total cholesterol（TC）， triglyceride（TG）， lactic dehydrogenase（LDH） and lactate（LAC） levels in serum. Enzyme-linked immunosorbent assay（ELISA） was employed to measure the contents of 17-hydroxycorticosteroid（17-OHCS）， cortisol（CORT）， triiodothyronine（T₃）， thyroxine（T₄）， thyrotropin（TSH）， immunoglobulin（Ig） M， IgG， cyclic adenosine monophosphate（cAMP） and cyclic guanosine monophosphate（cGMP）. Western blot was used to measure the protein expression levels of protein kinase A（PKA）， cAMP response element-binding protein（CREB）， silent information regulator 1（Sirt1） and peroxisome proliferator-activated receptor γ coactivator-1α（PGC-1α）. And high performance liquid chromatography（HPLC） was used to determine the content of major alkaloids， followed by Pearson correlation analysis with pharmacodynamic indicators. ResultsAfter modeling， compare with the control group， the model rats exhibited symptoms such as lethargy and loose stools， mild abnormalities were observed in adrenal tissue structure， and both spleen and thymus indices were significantly reduced（P<0.01）. Thyroid， adrenal and immune system functions were suppressed， with decreased serum cAMP level and significantly elevated cGMP level（P<0.01）. Compared with the model group， the adrenal injury by hydrocortisone sodium succinate were repaired and the spleen index were increased significantly in all four ARLP groups（P<0.05， P<0.01）. The thymus index in SFP and PFZ groups were increased significantly（P<0.05）. The contents of T₃， TSH， 17-OHCS and CORT were increased significantly in SFP and PFZ groups（P<0.05）. In addition， the content of IgG in SFP， PFZ and PFP groups were increased significantly（P<0.01）， while the content of IgM in PFZ and HSP groups were also increased significantly（P<0.05）. Regarding the cyclic nucleotide system， PFZ significantly elevated cAMP level while reducing cGMP level（P<0.05）， exhibiting the most pronounced effect among the four decoction pieces. For energy metabolism indicators， PFZ significantly improved abnormal markers including TC， TG， LDH， and LAC（P<0.05）. HSP showed marked improvement effects on TG， LDH， and LAC（P<0.05）. Both PFZ and SFP significantly elevated the expression levels of PKA， CREB， Sirt1， and PGC-1α proteins（P<0.01）. Additionally， the diester alkaloids in ARLP showed a strong positive correlation with TG， IgG， and CORT， a strong negative correlation with LAC， a moderate positive correlation with T₄， and moderate negative correlations with cAMP and spleen index. Monomeric alkaloids showed strong positive correlations with TG and IgG， strong negative correlations with LAC， moderate positive correlations with CORT and T₄， and moderate negative correlations with cAMP and spleen index. However， the content of water-soluble alkaloids showed strong positive correlations with TC， LDH， 17-OHCS， T₃， TSH， and thymus index， moderate positive correlations with cAMP， CORT， T₄， and spleen index， and moderate negative correlation with cGMP. ConclusionAmong different processed ARLP decoction pieces， PFZ processed according to ZHANG Zhongjing's method exhibits the most potent warming and cold-dispelling effects. Its pharmacological actions are mediated through regulating the thyroid， adrenal， immune， cyclic nucleotide systems， and material-energy metabolism pathways. Among these， water-soluble alkaloids show strong or moderate correlations with more indicators of deficiency-cold syndrome and exhibit the highest content in PFZ. Therefore， PFZ processed according to ZHANG Zhongjing's method may exert its warming and cold-dispelling effects through water-soluble alkaloids.

Objective To explore the correlation between anxiety and depression, treatment compliance and social support level in elderly patients with coronary heart disease. Methods A cross-sectional study was conducted on 325 patients with coronary heart disease who were treated in this hospital from June 2023 to June 2025 Pearson correlation analysis was used to examine the correlations between the level of social support [Social Support Rating Scale (SSRS)] and treatment compliance [12-item Medication Compliance Scale (MAS)], anxiety [Hamilton Anxiety Scale (HAMA)], and depression [Hamilton Depression Scale (HAMD)]. Logistic regression analysis was conducted to analyze the factors related to treatment compliance of coronary heart disease. Results SSRS score was positively associated with MAS score, and negatively correlated with HAMA score and HAMD score in patients with coronary heart disease (P<0.05). Logistic regression analysis suggested that age, education level, living alone, cardiac function grading, mini-mental state examination scale score, SSRS score, HAMA score and HAMD score were independently correlated with treatment compliance in patients with coronary heart disease (P<0.05). Conclusion The level of social support in patients with coronary heart disease is positively correlated with treatment compliance, and negatively correlated with anxiety and depression, and social support level, anxiety and depression are independent related factors affecting treatment compliance.

Objective: To evaluate the cost utility of different influenza vaccination strategies for primary and secondary school students in Anshun City, so as to provide healtheconomic evidence for influenza prevention and control in this population. Methods: Based on the demographic data of 380 700 students aged 5-14 in Anshun City in 2024, a decision tree model for different influenza vaccination strategies was constructed. The incremental cost utility ratio (ICUR) and net monetary benefit (NMB) were calculated, and sensitivity analysis was performed to assess the robustness of the model results. Results: For influenza vaccination among primary and secondary school students in Anshun City, compared with the selfpaid strategy (2% coverage), the free strategy (45% coverage) and the target strategy (70% coverage) both yielded an ICUR of -7 874.29 yuan per quality adjusted life year (QALY). When using 1 and 3 times the per capita Gross Domestic Product (GDP) as the willingness to pay thresholds, the per capita Net Monetary Benefit (NMB) was 1 000, 1 600 and 2 900, 4 500 RMB, respectively. The number of influenza infections or school absenteeism decreased by 25% and 40%, while saving a total cost of (46.779 5 and 73.976 8) million yuan, and increasing QALY by 5 940.79 and 9 394.73, respectively. Sensitivity analysis showed that within the reasonable fluctuation range of parameters, the ICUR remained consistently lower than the one and three times willingness to pay. Furthermore, 99% of the simulation results for both the free and target strategies fell below those thresholds, indicating high robustness of the model results. Conclusion Implementing free and target influenza vaccination strategies for primary and secondary school students in Anshun City offer distinct cost utility advantages, and the advantage enhances as the vaccination coverage rate increases.

Objective To evaluate the pharmacokinetics(PK)and pharmacodynamics(PD)of propofol injectable emulsion,and to assess the bioequivalence of test and reference formulations in healthy Chinese adult volunteers.Methods Thirty-two healthy Chinese adult volunteers were recruited and randomly assigned to a fasting.single-dose,two-period and double-crossover study.Propofol was given to eligible subjects at a speed of 30 μg·kg-1·min-1 for 30 min.The concentration of propofol in plasma was determined by avalidated high performance liquid chromatography-tandem mass spectrometery(HPLC-MS/MS)method.The PK parameters of the two preparations were calculated.Bispectral index(BIS)was measured to calculate the PD parameters of two formulations.Adverse events during the trial were recorded.Results Thirty-one volunteers were included in the pharmacokinetic parameter set.The mean values of PK parameters of test andreference formulations were as follows:Cmax were(660.87±110.25)and(683.13±125.75)ng·mL-1;AUC0-t were(473.50±86.03)and(478.40±80.25)h·ng·mL-1;AUC0-∞ were(500.45±96.49)and(507.84±88.00)h·ng·mL-1;tmax were 0.47(0.25,0.53)and 0.50(0.40,0.54)h;t1/2 were(2.97±1.74)and(3.08±1.82)h.Thirty-one volunteers were included in the bioequivalence set.The 90％confidence intervals(CI)for the geometric mean ratios of Cmax,AUC0-t,AUC0-∞ were 92.64％-101.39％,96.43％-101.00％,95.67％-100.70％,respectively.The mean values of PD parameters of test and reference formulations were as follows:BISmin were(75.94±13.66)and(74.39±12.32);BISAUC0-60minwere 5 569.85±182.78 and 5 575.68±166.19;T-BISmin were 23.00 and 29.00 min,respectively.There were no serious adverse events.Conclusion Two formulations of propofol injectable emulsion were bioequivalent and both of them exhibited good safety.

Under the background of breaking the " five only" evaluation criteria, continuously optimizing the scientific research performance evaluation system of hospitals to mobilize the enthusiasm and creativity of scientific researchers and guide the direction of scientific research development plays an important role in enhancing the overall scientific research capability of hospitals. Through literature analysis and expert consultation, a certain hospital has constructed a personal scientific research performance evaluation index system for medical staff in tertiary public hospitals, oriented towards innovation quality and member contributions, and began to implement it throughout the hospital in 2021. This index system included four categories of scientific research performance: vertical scientific research projects, academic influence, science and technology awards, and transformation of achievements, with a total of 20 indicators. The annual scientific research performance score of an individual would serve as the basis for the distribution of year-end scientific research performance and an important reference for applying for key and major projects within the hospital. After the application of this evaluation index system, the enthusiasm of medical staff for scientific research has been effectively stimulated. The average individual scientific research performance score increased from 0.974 in 2020 to 1.220 in 2023. All scientific research indicators involved in the evaluation system have shown growth, with a significant increase in high-quality results. This evaluation system can provide a reference for the scientific research performance evaluation of public hospitals under the background of breaking the " five only" evaluation criteria.

Objective To investigate the efficacy and safety of spinal endoscopic decompression through 45° puncture foraminal approach in treatment of L5/S1 lumbar disc herniation(LDH).Methods Clinical data of 130 patients with L5/S1 level LDH from January 2021 to January 2023 were retrospectively analyzed.These patients were divided into two groups based on the spinal endoscopic surgery approach.Observation group(67 patients)underwent spinal endoscopic decompression via 45° puncture,while the control group(63 patients)underwent spinal endoscopic decompression using the traditional transforaminal endoscopic spinal system(TESSYS)technique.Perioperative indicators such as operation time,X-ray fluoroscopy time,and hospital stay were recorded for both groups.Visual analogue scale(VAS)scores for low back pain and lower limb pain,as well as the Oswestry disability index(ODI)were assessed before surgery and at 1 day,3 months,6 months,and 12 months after operation.The overall efficacy was evaluated using the modified MacNab criterion at 12 months postoperatively.Results All the patients in both groups successfully underwent spinal endoscopic decompression.The observation group had significantly shorter average operation time and intraoperative X-ray fluoroscopy time compared to the control group,the differences were statistically significant(P＜0.05).There was no significant difference in hospital stay between the two groups(P=0.505).Compared to preoperative values,both groups showed a significant decreasing trend in VAS scores for low back pain,lower limb pain,and ODI at 1 day,3 months,6 months,and 12 months after operation,the differences were statistically significant(P＜0.05).The observation group had significantly low back pain VAS score,lower limb pain VAS score and ODI at 1 day and 3 months after operation compared to the control group(P＜0.05).There were no statistically significant differences in low back pain VAS score,lower limb pain VAS score and ODI between the two groups 6 and 12 months after operation(P＞0.05).At 12 months after operation,the excellent and good rate was 95.5％ in observation group and 85.7％ in control group,with no significant difference between the two groups(P=0.054).No surgery-related complications occurred in either group.During postoperative follow-up,6 patients(9.5％)in control group experienced recurrence of low back pain and lower limb pain due to recompression of nerve roots by residual herniated material,while no recurrence was observed in observation group,the difference was statistically significant(P=0.035).Conclusion Both the 45° puncture technique and the traditional TESSYS technique can achieve satisfactory decompression effects in patients with LDH at the L5/S1 segment undergoing transforaminal spinal endoscopic decompression surgery.However,the 45° puncture technique can shorten the operation time and X-ray fluoroscopy time,resulting in more pronounced early postoperative improvement and a lower recurrence rate.It is worthy clinical application.

Objective To design a digital intelligence-driven critical treatment platform to implement integrated treatment procedure inside and outside the hospital and intelligent whole-course managment from pre-hospital emergency care to discharge for critically ill patients.Methods The platform was designed with 5G,IoT,big data and aritificial intelligence techniques and developed with Java language,which adopted Oracle database-based data management and front-end and back-end separation mode,with the front end realized by Vue.js framework and the back end by microservice architecture.There were five functional modules for pre-hospital emergency care,multidisciplinary joint diagnosis and treatment,critical care,quality control management and post-discharge follow-up involved in the platform.Results The platform developed simplified the treatment procedure,enhanced the timeliness of emergency care,decreased the workload of nursing staffs and improved medical service efficiency and working efficiency effectively.Conclusion The platform increases first aid quality and treatment efficiency and provides critically ill patients with high-quality medical experience.[Chinese Medical Equipment Journal,2025,46(1):38-43]

Objective To evaluate the pharmacokinetics(PK)and pharmacodynamics(PD)of propofol injectable emulsion,and to assess the bioequivalence of test and reference formulations in healthy Chinese adult volunteers.Methods Thirty-two healthy Chinese adult volunteers were recruited and randomly assigned to a fasting.single-dose,two-period and double-crossover study.Propofol was given to eligible subjects at a speed of 30 μg·kg-1·min-1 for 30 min.The concentration of propofol in plasma was determined by avalidated high performance liquid chromatography-tandem mass spectrometery(HPLC-MS/MS)method.The PK parameters of the two preparations were calculated.Bispectral index(BIS)was measured to calculate the PD parameters of two formulations.Adverse events during the trial were recorded.Results Thirty-one volunteers were included in the pharmacokinetic parameter set.The mean values of PK parameters of test andreference formulations were as follows:Cmax were(660.87±110.25)and(683.13±125.75)ng·mL-1;AUC0-t were(473.50±86.03)and(478.40±80.25)h·ng·mL-1;AUC0-∞ were(500.45±96.49)and(507.84±88.00)h·ng·mL-1;tmax were 0.47(0.25,0.53)and 0.50(0.40,0.54)h;t1/2 were(2.97±1.74)and(3.08±1.82)h.Thirty-one volunteers were included in the bioequivalence set.The 90％confidence intervals(CI)for the geometric mean ratios of Cmax,AUC0-t,AUC0-∞ were 92.64％-101.39％,96.43％-101.00％,95.67％-100.70％,respectively.The mean values of PD parameters of test and reference formulations were as follows:BISmin were(75.94±13.66)and(74.39±12.32);BISAUC0-60minwere 5 569.85±182.78 and 5 575.68±166.19;T-BISmin were 23.00 and 29.00 min,respectively.There were no serious adverse events.Conclusion Two formulations of propofol injectable emulsion were bioequivalent and both of them exhibited good safety.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Objective To investigate the efficacy and safety of spinal endoscopic decompression through 45° puncture foraminal approach in treatment of L5/S1 lumbar disc herniation(LDH).Methods Clinical data of 130 patients with L5/S1 level LDH from January 2021 to January 2023 were retrospectively analyzed.These patients were divided into two groups based on the spinal endoscopic surgery approach.Observation group(67 patients)underwent spinal endoscopic decompression via 45° puncture,while the control group(63 patients)underwent spinal endoscopic decompression using the traditional transforaminal endoscopic spinal system(TESSYS)technique.Perioperative indicators such as operation time,X-ray fluoroscopy time,and hospital stay were recorded for both groups.Visual analogue scale(VAS)scores for low back pain and lower limb pain,as well as the Oswestry disability index(ODI)were assessed before surgery and at 1 day,3 months,6 months,and 12 months after operation.The overall efficacy was evaluated using the modified MacNab criterion at 12 months postoperatively.Results All the patients in both groups successfully underwent spinal endoscopic decompression.The observation group had significantly shorter average operation time and intraoperative X-ray fluoroscopy time compared to the control group,the differences were statistically significant(P＜0.05).There was no significant difference in hospital stay between the two groups(P=0.505).Compared to preoperative values,both groups showed a significant decreasing trend in VAS scores for low back pain,lower limb pain,and ODI at 1 day,3 months,6 months,and 12 months after operation,the differences were statistically significant(P＜0.05).The observation group had significantly low back pain VAS score,lower limb pain VAS score and ODI at 1 day and 3 months after operation compared to the control group(P＜0.05).There were no statistically significant differences in low back pain VAS score,lower limb pain VAS score and ODI between the two groups 6 and 12 months after operation(P＞0.05).At 12 months after operation,the excellent and good rate was 95.5％ in observation group and 85.7％ in control group,with no significant difference between the two groups(P=0.054).No surgery-related complications occurred in either group.During postoperative follow-up,6 patients(9.5％)in control group experienced recurrence of low back pain and lower limb pain due to recompression of nerve roots by residual herniated material,while no recurrence was observed in observation group,the difference was statistically significant(P=0.035).Conclusion Both the 45° puncture technique and the traditional TESSYS technique can achieve satisfactory decompression effects in patients with LDH at the L5/S1 segment undergoing transforaminal spinal endoscopic decompression surgery.However,the 45° puncture technique can shorten the operation time and X-ray fluoroscopy time,resulting in more pronounced early postoperative improvement and a lower recurrence rate.It is worthy clinical application.