Objective To observe the clinical efficacy of therapy of resolving blood stasis and tranquilizing mind in the treatment of insomnia with internal blockage of blood stasis type.Methods A parallel randomized controlled trial was conducted on 88 cases of insomnia patients with internal blockage of blood stasis type who admitted to Bao'an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine from January 2024 to June 2024.The patients were randomly divided into an observation group and a control group,with 44 cases in each group.The observation group was treated with the self-made Huayu Anshen Prescription(modified Xuefu Zhuyu Decoction)orally following the therapy of resolving blood stasis and tranquilizing mind,while the control group was treated with Dexzopiclone Tablets orally.The course of treatment for the two groups covered four weeks.The changes in the scores of traditional Chinese medicine(TCM)syndrome,Pittsburgh Sleep Quality Index(PSQI),Self-Rating Depression Scale(SDS),and Self-Rating Anxiety Scale(SAS)in the two groups before and after treatment were observed,and then the clinical efficacy and medication safety of the patients in the two groups were evaluated.Results(1)After four weeks of treatment,the total effective rate of the observation group was 86.36%(38/44)and that of the control group was 70.45%(31/44),and the intergroup comparison showed that the clinical efficacy of the observation group was significantly superior to that of the control group,the difference being statistically significant(χ2=8.080,P<0.05).(2)After treatment,the scores of TCM syndrome,PSQI,SDS,and SAS of patients in the two groups were all significantly decreased compared with those before treatment(P<0.01),and the decrease in the observation group was significantly superior to that in the control group,the differences all being statistically significant(P<0.05).(3)During the treatment,there were no obvious adverse reactions occurred in the two groups,with higher safety.Conclusion Therapy of resolving blood stasis and tranquilizing mind for treating insomnia with internal blockage of blood stasis type can effectively alleviate patients'clinical symptoms,improve their sleep quality and relieve depression and anxiety,with stronger clinical efficacy and higher safety.

Objective To investigate the clinical efficacy of Xiaozhi Tea(composed of Eupatorii Herba,Nelumbinis Folium,Chrysanthemi Flos,Cassiae Semen,Crataegi Fructus,bran-fried Atractylodis Macrocephalae Rhizoma,Poria,Pseudostellariae Radix,Citri Reticulatae Pericarpium,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle)combined with Atorvastatin Calcium Tablets for the treatment of hyperlipidemia patients with turbid phlegm obstruction syndrome.Methods A retrospective cohort study was conducted in 200 hyperlipidemia patients with turbid phlegm obstruction syndrome who visited the outpatient department of Shenzhen Bao'an Traditional Chinese Medicine Hospital Group from September 2023 to September 2024.The patients were equally divided into a trial group and a control group based on the treatment regimen,with 100 cases in each group.The control group received oral use of Atorvastatin Calcium Tablets alone,while the trial group received Xiaozhi Tea in addition to Atorvastatin Calcium Tablets orally,both groups were treated for 8 weeks.Changes in traditional Chinese medicine(TCM)syndrome scores and lipid profiles of total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)in the two groups were observed before and after treatment.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)There were 3 patients in the control group dropping out due to lack of follow-up data,leaving 197 patients who eventually completed the study,100 cases in the trial group and 97 cases in the control group.(2)After 8 weeks of treatment,the total effective rate in the trial group was 97.00%(97/100)and that in the control group was 87.63%(85/97).The intergroup comparison(tested by chi-square test)showed that the trial group showed significantly stronger efficacy than the control group(P＜0.05).(3)Both groups exhibited significant reductions in TCM syndrome scores after treatment in comparison with those before treatment(P＜0.05),and a more pronounced reduction was presented in the trial group(P＜0.05).(4)Both groups showed decreased TC,TG,and LDL-C levels(P＜0.05)and increased HDL-C level after treatment in comparison with those before treatment(P＜0.05).The trial group demonstrated more obvious reduction of TC,TG,LDL-C,and more obvious elevation of HDL-C than the control group(P＜0.05).(5)In terms of safety,no severe adverse reactions occurred in either group.The incidence of adverse reactions in the trial group was 1.00%(1/100)and that in the control group was 2.06%(2/97),with no statistically significant difference between groups(P＞0.05).Conclusion Xiaozhi Tea combined with Atorvastatin Calcium Tablets exerts certain efficacy in treating hyperlipidemia with turbid phlegm obstruction syndrome,and is effective on significantly improving lipid profiles and clinical symptoms.The combination therapy demonstrates superior efficacy compared to Atorvastatin Calcium Tablets alone.

Objective:To investigate the distribution rules of artemisia pollen and the clinical sensitization characteristics of allergic rhinitis (AR) induced by artemisia pollen in three urban and rural areas of Inner Mongolia.Methods:From March to October 2019, in 3 central cities (Chifeng, Hohhot, Ordos) and rural areas of Inner Mongolia, an epidemiological investigation method combining multi-stage stratified random sampling and face-to-face questionnaire survey was adopted to screen suspected AR patients, and skin prick test (SPT) was applied for diagnosis. At the same time, pollen monitoring was carried out in 3 areas to analyze the distribution and clinical sensitization characteristics of artemisia pollen.SPSS26.0 statistical software was used to process all the data. Chi-square test was used to compare rates among different age, sex, region and nationality, Spearman test was used to describe correlation analysis, and pairwise comparison of positive rates among multiple samples was used Bonferroni method.Results:Among the 6 393 subjects, 1 093 cases were diagnosed with AR, and the prevalence of AR was 17.10% (1 093/6 393). Among them, pollen-induced allergic rhinitis, the prevalence of PiAR was 10.97% (701/6 393), accounting for 64.14%(701/1 093).The highest incidence was in the youth group (20-39 years old), accounting for 46.94% (329/701).The diagnosed prevalence was higher in females than in males (11.35% vs. 10.64%, χ2 value 12.304, P<0.001).The prevalence rate of ethnic minority was higher than that of Han nationality (13.01% vs. 10.65%, χ2 value 6.296, P=0.008).The prevalence in urban areas was also significantly higher than that in rural areas (18.40% vs. 5.50%, χ2 value 10.497, P<0.001).There was significant difference in prevalence rate among the three regions in Inner Mongolia (6.06% in Chifeng, 13.46% in Hohhot, 16.39% in Ordos, χ2 value 70.054, P<0.001).The main clinical symptoms of artemisia PiAR were sneezing (95.58%), nasal congestion (91.73%) and nasal itching (89.30%).Allergic conjunctivitis accounted for 79.60% (558/701), chronic sinusitis for 55.63% (390/701), asthma for 23.25% (163/701).The pattern of artemisia pollen sensitization was mainly multiple sensitization, and the frequency of clinical symptoms and clinical diseases induced by hypersensitization with other allergens accounted for more than that caused by single artemisia pollen. The spread period of Artemisia pollen in the three regions was from June to October, and the peak state was in August in summer. The peak time of clinical symptoms in artemisia PiAR patients was about 2 weeks earlier than the peak time of pollen concentration, and the two were significantly positively correlated ( R=0.7671, P<0.001). Conclusion:Artemisia pollens are the dominant pollens in late summer and early autumn in Inner Mongolia, and the prevalence of artemisia PiAR is high. Controlling the spread of Artemisia pollens is of great significance for the prevention and treatment of AR.

Objective To investigate the clinical efficacy of therapy of clearing heat,percolating dampness and lowering turbidity combined with Silibin Meglumine Tablets in the treatment of non-alcoholic steatohepatitis(NASH)patients with abnormal alanine aminotransferase(ALT)level of damp-heat accumulation type.Methods A retrospective study was conducted.According to the medication,80 patients with NASH with abnormal ALT level of damp-heat accumulation type were divided into control group and observation group,with 40 cases in each group.The control group was treated with Silibin Meglumine Tablets,and the observation group was treated with therapy of clearing heat,percolating dampness and lowering turbidity on the basis of treatment for the control group.The course of treatment covered 12 weeks.The changes of liver function indicators of ALT,aspartate aminotransferase(AST),and gamma glutamyl transpeptidase(GGT),blood lipid indicators of total cholesterol(CHOL)and triglyceride(TRIG),and the degree of hepatic steatosis in the two groups were observed before and after treatment.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After 12 weeks of treatment,the total effective rate of the observation group was 95.00%(38/40),and that of the control group was 77.50%(31/40).The curative effect of the observation group was significantly superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the levels of ALT,AST and GGT in the two groups were significantly lower than those before treatment(P＜0.05),and the decrease of ALT,AST and GGT in the observation group was significantly superior to that in the control group(P＜0.05).(3)After treatment,the levels of CHOL and TRIG in the two groups were significantly lower than those before treatment(P＜0.05),and the decrease of CHOL and TRIG in the observation group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the degree of hepatic steatosis in the two groups was significantly lower than that before treatment(P＜0.05),and the decrease of the degree of hepatic steatosis in the observation group was significantly superior to that in the control group(P＜0.05).(5)During the treatment,no obvious adverse reactions occurred in the two groups,indicating high safety.Conclusion The therapy of clearing heat,percolating dampness and lowering turbidity combined with Silibin Meglumine Tablets exerts certain effect in the treatment of NASH patients with abnormal ALT level of damp-heat accumulation type,and the therapy can significantly enhance the clinical efficacy of Silibin Meglumine Tablets alone for NASH.

Objective:To investigate the distribution rules of artemisia pollen and the clinical sensitization characteristics of allergic rhinitis (AR) induced by artemisia pollen in three urban and rural areas of Inner Mongolia.Methods:From March to October 2019, in 3 central cities (Chifeng, Hohhot, Ordos) and rural areas of Inner Mongolia, an epidemiological investigation method combining multi-stage stratified random sampling and face-to-face questionnaire survey was adopted to screen suspected AR patients, and skin prick test (SPT) was applied for diagnosis. At the same time, pollen monitoring was carried out in 3 areas to analyze the distribution and clinical sensitization characteristics of artemisia pollen.SPSS26.0 statistical software was used to process all the data. Chi-square test was used to compare rates among different age, sex, region and nationality, Spearman test was used to describe correlation analysis, and pairwise comparison of positive rates among multiple samples was used Bonferroni method.Results:Among the 6 393 subjects, 1 093 cases were diagnosed with AR, and the prevalence of AR was 17.10% (1 093/6 393). Among them, pollen-induced allergic rhinitis, the prevalence of PiAR was 10.97% (701/6 393), accounting for 64.14%(701/1 093).The highest incidence was in the youth group (20-39 years old), accounting for 46.94% (329/701).The diagnosed prevalence was higher in females than in males (11.35% vs. 10.64%, χ2 value 12.304, P<0.001).The prevalence rate of ethnic minority was higher than that of Han nationality (13.01% vs. 10.65%, χ2 value 6.296, P=0.008).The prevalence in urban areas was also significantly higher than that in rural areas (18.40% vs. 5.50%, χ2 value 10.497, P<0.001).There was significant difference in prevalence rate among the three regions in Inner Mongolia (6.06% in Chifeng, 13.46% in Hohhot, 16.39% in Ordos, χ2 value 70.054, P<0.001).The main clinical symptoms of artemisia PiAR were sneezing (95.58%), nasal congestion (91.73%) and nasal itching (89.30%).Allergic conjunctivitis accounted for 79.60% (558/701), chronic sinusitis for 55.63% (390/701), asthma for 23.25% (163/701).The pattern of artemisia pollen sensitization was mainly multiple sensitization, and the frequency of clinical symptoms and clinical diseases induced by hypersensitization with other allergens accounted for more than that caused by single artemisia pollen. The spread period of Artemisia pollen in the three regions was from June to October, and the peak state was in August in summer. The peak time of clinical symptoms in artemisia PiAR patients was about 2 weeks earlier than the peak time of pollen concentration, and the two were significantly positively correlated ( R=0.7671, P<0.001). Conclusion:Artemisia pollens are the dominant pollens in late summer and early autumn in Inner Mongolia, and the prevalence of artemisia PiAR is high. Controlling the spread of Artemisia pollens is of great significance for the prevention and treatment of AR.

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.

Polysaccharides are the important material basis of traditional Chinese medicine（TCM）， and have various pharmacological activities such as immunomodulation， antitumor and anti-aging. Due to the large molecular weight of TCM polysaccharides， their structural analysis and oral absorption mechanism are facing technical challenges， and the current research on their structure-activity relationships has made some breakthroughs， while the research on their oral absorption mechanisms is relatively slow. In-depth study of the oral absorption mechanism of TCM polysaccharides is not only crucial for the interpretation of their action pathways and efficacy in vivo， but also helpful for the interpretation of their pharmacological effects， rational clinical applications and the discovery of new targets. In recent years， the application of fluorescent labeling and isotopic labeling methods has provided new technical means for the oral absorption studies of polysaccharides， which has promoted the development of oral absorption studies of TCM polysaccharides. In this paper， we reviewed the oral absorption pathways and labeling techniques of TCM polysaccharides， and concluded that they can be absorbed orally through transmembrane， cellular bypass， and M-cell-mediated transport， of which transmembrane pathway is the main absorption pathway， and summarized the labeling reactions of four fluorescent labeling and isotopic labeling methods with TCM polysaccharides， which can provide references for evaluating the absorption pathways of TCM polysaccharides， screening active TCM polysaccharides， establishing pharmacodynamic models and comprehensively elucidating the mechanism of TCM polysaccharides.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.

Objective To evaluate the safety and effectiveness of laparoscopic radical resection of colorectal cancer without indwelling gastric tube during the perioperative period for postoperative rehabilitation of patients.Methods A total of 90 patients who underwent laparoscopic radical resection for colorectal cancer in our hospital from January 2021 to January 2023 were selected as the study objects,they were randomly divided into the observation group and the control group,with 45 cases in each group.The time of first postoperative exhaust and defecation,postoperative hospital stay,and the occurrence of complications such as throat pain,nausea and vomiting,pulmonary infection,intestinal obstruction,and anastomotic fistula of patients were compared between the two groups.Results The time of first postoperative exhaust and defecation and postoperative hospital stay of patients in the observation group were shorter than those in the control group,with statistically significant differences(P<0.05).The incidence of throat pain and nausea and vomiting of patients in the observation group was lower than that in the control group,with statistically significant difference(P<0.05);However,there was no statistically significant difference in postoperative complications such as pulmonary infection,intestinal obstruction,and anastomotic fistula of patients between the two groups(P>0.05).Conclusion Laparoscopic radical resection of colorectal cancer without indwelling gastric tube during the perioperative period will not increase the incidence of postoperative complications such as pulmonary infection,intestinal obstruction,and anastomotic fistula,instead,it can reduce the incidence of postoperative throat pain and nausea and vomiting,shorten hospital stay,and accelerate postoperative recovery of patients.