The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

Aim To construct a DC-targeted modified(lacto-N-fucop-entose Ⅲ,LewisX)Pseudomonas aeruginosa(PA)DNA vaccine PLGA nanoparticle(LewisX-PLGA)loading PA PcrV and OprF genes combination,and provide a new idea for the prevention of PA clinical infection.Methods The PLGA nano-particles loading PA PcrV and OprF combined DNA(PLGA+PcrV/OprF)or loading pEGFP(PLGA+pEGFP)were pre-pared by double emulsification-solvent evaporation method.On this basis,the DC-SIGN-targeted ligand LewisX was connected to the surface of PLGA nanoparticles by amide condensation reac-tion.LewisX-modified PLGA-PcrV/OprF(LewisX-PLGA+PcrV/OprF)and LewisX-modified PLGA-pEGFP(LewisX-PL-GA+pEGFP)were prepared.Particle size,Zeta potential,en-capsulation rate and drug loading were evaluated to characterize LewisX-PLGA+PcrV/OprF.The cytotoxicity of LewisX-PLGA+PcrV/OprF was investigated by CCK-8.DC targeting of LewisX-PLGA+pEGFP was validated in vitro transfection.Further,LewisX-PLGA+PcrV/OprF lysosome escape was used to evalu-ate the targeting performance of LewisX-modified PLGA nanopar-ticles loading DNA in vitro.The immunoefficacy of the nanopar-ticles was evaluated by detecting the level of lymphocyte prolifer-ation,humoral immunity and immune protection.Results The diameter of LewisX-PLGA+PcrV/OprF was(201.17±1.6)nm.The encapsulation efficiency of LewisX-PLGA+PcrV/OprF was(85.72±5.3)％.The Zeta potential of LewisX-PLGA+PcrV/OprF was+(31.17±1.8)mV.In the DC2.4 cytotoxici-ty test,the cell survival rates were above 85％.The results of fluorescence microscopy after LewisX-PLGA+pEGFP transfec-tion in vitro showed that LewisX-PLGA+pEGFP was more readi-ly taken up by DC2.4,and LewisX-PLGA+pEGFP had a DC-SIGN specific targeting performance.The CLSM's observation of LewisX-PLGA+Pcrv/OprF showed that more DNA escaped from the lysosome into the cytoplasm.The results suggested that LewisX-PLGA had DC2.4 targeting performance.Because DC2.4 cells endocyted more LewisX-PLGA+Pcrv/OprF into the lysosome,the amount of DNA carried by the nanoparticles esca-ping into the cytoplasm increased.in vivo immune results showed that the lymphocyte proliferation level and antibody titer level of targeted DNA vaccine increased significantly,further improved the survival rate of mice infected with acute pneumoni-a,and reduced the bacterial load of mouse lungs.Conclusions The DC-SIGN-targeted aptamer-modified PA DNA vaccine nanoparticle LewisX-PLGA can be successfully constructed.It promotes the transfection of DNA into DC.It promotes the endo-cytosis of PA DNA vaccine into the DC lysosome and the escape of PA DNA into the cytoplasm.This results in a significant im-mune response in body,which enhances the protective efficacy of vaccine.

Objective To explore clinical effect of allogeneic peroneal bone marrow support combined with plate internal fixation in treating Neer type Ⅳ proximal humeral fractures.Methods From December 2017 to December 2020,12 patients with Neer type Ⅳ proximal humeral fractures were treated with allogeneic peroneal bone marrow support combined with plate internal fixation,including 7 males and 5 females,aged from 56 to 78 years old;the time from injury to operation ranged from 1 to7 days.Operative time,fracture healing time and complications during follow-up were observed,and clinical efficacy was e-valuated by Constant-Murley score at the latest follow-up.Results All patients were obtained follow up for 20 to 29 months.All patients got bone healing and incisicons were healed at stage Ⅰ,operative time ranged from 95 to 138 min,blood loss ranged from 210 to 275 ml,fracture healing time ranged from 14 to 18 weeks.Two patients occurred postoperative shoulder stiffness and recovered after 2 weeks of passive exercise.There were no complications such as infection,poor wound healing,and fail-ure(fracture and loosening)of internal fixators occurred.Constant-Murley shoulder function score ranged from 69 to 89 at the latest follow up,2 patients got excellent results,9 good and 1 fair.Conclusion The application of allogeneic fibular bone mar-row placement could provide effective support for medial humerus,which is conducive to assisting reduction of fracture end,re-ducing occurrence of internal fixation failure caused by collapse of humerus head and screw perforation,and significantly im-proving function of shoulder joint.

Enteropathogenic Escherichia coli(EPEC),a zoonotic foodborne pathogen,can induce severe and prolonged di-arrhea,thus substantially affecting global public health safety.To understand the pathogenicity of EPEC and its potential risk to human health,this study investigated the antimicrobial resistance and genome-wide characteristics of EPEC originating from ducks.After identification of EPEC with the plate method and PCR,antimicrobial susceptibility of the isolates was examined with the microbroth dilution method.In addition,analyses of serotype,sequence type(ST),and plasmid incompatibility groups were conducted with whole-genome sequencing(WGS)and bioinformatic methods.Ten EPEC isolates were identified,including serotypes O71∶H40 and O3∶H21.All EPEC strains exhibited multiple drug resistance.The highest proportion of resistance(100％)was observed to ciprofloxacin,streptomycin,tetracycline,and polymyxin B.In contrast,the isolates showed susceptibility to cefoxitin,amikacin,and imipenem.Furthermore,all strains carried the tetracycline resistance gene tet(A)and extended-spectrum β-lactamase(ESBL)resistance genes,including blaOXA-10,blaTEM-1A,and blaTEM-1B.Various virulence genes,associated primarily with the secretory system,were de-tected in the isolates.However,no bf p genes or per ARC genes were identified,thus indicating that the EPEC isolates were atypical EPEC(aEPEC).The results demonstrated the presence of multiple antimicrobial resistance,multiple resistance and viru-lence genes,and various plasmid incompatibility groups,thus in-dicating potential pathogenicity to humans.Strengthened monitoring of duck-derived EPEC is crucial to effectively control the spread of the pathogen and safeguard public health.

Seminal microbiome plays an important role in male reproductive health,and its composition may be associated with sperm quality,development of oligoasthenospermia,and pregnancy outcomes of assisted reproductive technology.Seminal microbiome may be transmitted to the partner and offspring,and consequently affect female reproduction and the health of offspring.The complete structure of seminal microbiome is difficult to find by conventional bacterial culture due to the length of time taken and restriction of condition.Next-generation sequencing(NGS)can reveal the complete composition of seminal microbiome and help elucidate the com-plex microbial-host interactions based on human physiology and pathophysiology.This review focuses on the composition of seminal mi-crobiome,its relationship with male infertility and the mechanism of its impairing sperm quality based on NGS,and summarizes the re-sults of NGS-based studies on the patterns of bacterial colonization in different anatomical parts of the male reproductive tract.Current studies have revealed a unique diversity of seminal microbiome structures,a close correlation of abnormal seminal microbiome structure with sperm quality and male fertility,and a possible probiotic microbiome in semen capable of supporting health function.So far,the source and composition of seminal microbiome,and its influence on fertility and pregnancy outcome are not yet clear,and the specific mechanism of its diversity affecting sperm needs to be further studied with larger sample sizes and appropriate control specimens.

Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To report single-center clinical experience with endovascular recanalization for non-acute symptomatic intracranial vertebral artery occlusion, to assess the feasibility and safety of endovascular recanalization and to propose the benefit group for selected patients.Methods:From January 2019 to December 2021, 92 patients with non-acute symptomatic intracranial vertebral artery occlusion who underwent endovascular recanalization were retrospectively analyzed. The patients were divided into three groups (low, medium and high-risk group) according to occlusion length, occlusion duration, occlusion nature, calcification of the occlusion segment, and occlusion angulation, and the indicators of patients in each group were analyzed, including the general baseline data of the patients, surgical status and follow-up results. The technical success and perioperative complication rates of low, medium and high-risk groups were calculated. Meanwhile, the differences between three groups were evaluated using the χ2 test for trend or ANOVA analysis. Results:The overall technical success rate of endovascular recanalization was 83.7% (77/92), and the perioperative complication rate was 10.9% (10/92). Among the 3 classification groups, the recanalization success rate from the low-risk group to the high-risk group was 100%, 93.3%, 27.8%( P=0.047), and gradually decreased; while the overall perioperative complication rate was 0, 10.0%, 38.9% ( P=0.001), and gradually increased; the proportion of 90-day mRS score 0-2 was 100%, 83.3%, 22.2% ( P=0.026), and progressively decreased; 77 patients with successful recanalization were followed up, the rate of restenosis/reocclusion was 0, 17.9%, 80.0%( P=0.001), and progressively increased. Patients in the low-and intermediate-risk groups performed well with endovascular recanalization. In 88 patients (4 patients lost to follow-up), a median clinical follow-up of 13 (7, 16) months, stroke or death beyond 30 days was 17.4% (16/92). Conclusions:Endovascular recanalization is safe and feasible for reasonably selected patients with non-acute symptomatic intracranial vertebral artery occlusion, especially in low-and medium-risk groups, and it also provides an alternative to conservative therapy for patients with non-acute symptomatic intracranial vertebral artery occlusion.

Mitochondria are the main site of energy metabolism in cardiomyocytes， and at the same time mediate apoptosis and immune response， so mitochondrial dysfunction is closely related to the development of heart failure. Combined with the pathogenesis of mitochondrial dysfunction and heart failure， it is proposed that the mitochondrial function is similar to "sweat pore - collaterals - zang and fu organs"， according to which the treatment of heart failure is based on the theory of "sweat pore - collaterals - zang and fu organs". It is believed that the core mechanism of heart failure is qi deficiency， and qi deficiency leads to the weakness of the sweat pore opening and closing， or even the sweat pore closure， then resulting in qi deficiency and blood stasis， collaterals stagnation fail to flourish， and qi， blood， and body fluids can not infiltrate and nourish zang-fu organs， so that the heart fail to be nourished， and the disease will develop. The treatment should be based on the method of boosting qi and opening sweat pore， using acridity to unblock the collaterals， and invigorating blood and draining water， with medicinal of boosting qi， invigorating blood， and draining water as treatment.