Objective To explore the mechanism of Shen Hong capsule in preventing and treating acute mountain sickness based on biological information platform and in vitro experiment. Methods Traditional Chinese Medicine Systems Pharmacology （TCMSP） and Traditional Chinese Medicine Information Database （TCMID） were used to obtain the active components and predicted targets of Shen Hong capsule. Therapeutic Target Database （TTD）, Disease Gene Network （DisGeNET） database and GeneCards database were used to search for the targets of acute mountain sickness related diseases, and the potential therapeutic targets were obtained. The protein-protein interaction （PPI） was analyzed by Search Tool for the Retrieval of Interacting Genes/Proteins （STRING）, the Database for Annotation, Visualization, and Integrated Discovery （DAVID） online platform was used to analyse the Gene Ontology （GO） and the Kyoto Encyclopedia of Genes and Genomes （KEGG） signal pathway enrichment. The network information was visualized by Cytoscape software, the key targets in PPI network were obtained according to the topology data, and the binding ability of main active components and key therapeutic targets were analyzed by molecular docking. The validation of the main active components was performed by liquid chromatography-mass spectrometry （LC-MS）. The hypoxia model was created by H9c2 cells, apoptosis was visualized by Hoechst33342 staining, and key target proteins were verified by Western blot. Results 91 active components, 3 main active components and 150 predicted targets were selected from Shen Hong capsule. 515 targets of altitude sickness-related diseases and 37 targets of Shen Hong capsule regulating altitude sickness-related diseases were screened out. 44 related signal pathways, such as HIF-1 signal pathway, PPAR signal pathway, drug metabolism - cytochrome P450, were enriched and analyzed. TNF, IL1B, VEGFA, NOS3, EGFR, ESR1, PPARG, NR3C1, HMOX1 and IFNG were 10 key targets. The molecular docking results showed that the docking conformations between the main active components and the key targets were stable. The three main active components of quercetin, luteolin and kaempferol were identified by LC-MS, and in vitro experiments proved that Shen Hong capsule could relieve acute hypoxia injury by regulating the expression of HIF-1α, PPARG, NOS3, and TNF. Conclusion Shen Hong capsule could regulate the body’s hypoxia response and metabolism through multi-component, multi-target and multi-channel ways, so as to prevent and treat acute mountain sickness. This study provided a direction for further exploring the mechanism of Shen Hong capsule, and also provided a theoretical basis for further development and clinical application.

Objective:To analyze the clinical characteristics, treatments and prognoses of carotid artery dissection (CAD).Methods:Nine patients with CAD, admitted to Department of Neurology, Air Force Medical Center of PLA from May 2010 to April 2024, were chosen; the clinical and imaging data, treatments and prognoses (mRS score≤2: good prognosis) of the patients were retrospectively analyzed.Results:(1) Among the 9 patients with CAD, histories of hypertension, diabetes, head and neck trauma, and radiotherapy were noted 3, 2, 4 and 1 patients, respectively; and unclear past history was noted in 1 patient. Carotid ultrasound was performed in 9 patients: slow blood flow of the internal carotid artery with stenosis or occlusion in 7 patients and normal blood flow of the internal carotid artery in 2 patients were noted. MRA in 5 patients showed severe stenosis or subtotal occlusion in the internal carotid artery. DSA in 8 patients showed CAD plus severe stenosis or subtotal occlusion. (2) After ineffective antiplatelet therapy in 3 patients and ineffective anticoagulant therapy in 2 patients, carotid artery stenting (CAS) was performed; direct CAS was given in one patient, and anticoagulant therapy was given in 3 patients. (3) After 3 months of treatment, 9 patients had a good prognosis; carotid ultrasound in 4 patients showed vascular recanalization; MRA re-examination in 3 patients showed vascular recanalization. DSA re-examination in 1 patient showed vascular recanalization; CTA re-examination in 1 patient showed moderate stenosis of the right internal carotid artery.Conclusion:CAD causes are various; CAD should be considered in patients with neck trauma combined with stroke; endovascular treatment should be considered when antiplatelet/anticoagulant therapy are not effective.

Objective:To analyze the clinical characteristics, treatments and prognoses of carotid artery dissection (CAD).Methods:Nine patients with CAD, admitted to Department of Neurology, Air Force Medical Center of PLA from May 2010 to April 2024, were chosen; the clinical and imaging data, treatments and prognoses (mRS score≤2: good prognosis) of the patients were retrospectively analyzed.Results:(1) Among the 9 patients with CAD, histories of hypertension, diabetes, head and neck trauma, and radiotherapy were noted 3, 2, 4 and 1 patients, respectively; and unclear past history was noted in 1 patient. Carotid ultrasound was performed in 9 patients: slow blood flow of the internal carotid artery with stenosis or occlusion in 7 patients and normal blood flow of the internal carotid artery in 2 patients were noted. MRA in 5 patients showed severe stenosis or subtotal occlusion in the internal carotid artery. DSA in 8 patients showed CAD plus severe stenosis or subtotal occlusion. (2) After ineffective antiplatelet therapy in 3 patients and ineffective anticoagulant therapy in 2 patients, carotid artery stenting (CAS) was performed; direct CAS was given in one patient, and anticoagulant therapy was given in 3 patients. (3) After 3 months of treatment, 9 patients had a good prognosis; carotid ultrasound in 4 patients showed vascular recanalization; MRA re-examination in 3 patients showed vascular recanalization. DSA re-examination in 1 patient showed vascular recanalization; CTA re-examination in 1 patient showed moderate stenosis of the right internal carotid artery.Conclusion:CAD causes are various; CAD should be considered in patients with neck trauma combined with stroke; endovascular treatment should be considered when antiplatelet/anticoagulant therapy are not effective.

Objective:To explore the association between environment exposure and hormone-sensitive cough in patients with chronic cough.Methods:Clinical data of 197 patients with chronic cough visited outpatient clinic of the Second Affiliated Hospital of Guangzhou Medical University from June 2016 to June 2021 were retrospectively analyzed, including 130 cases of corticosteroid responsive cough (CRC, 66.0%) and 67 cases of non-corticosteroid responsive cough (NCRC, 34.0%). The association between living environment exposure and hormone sensitivity was examined with a binary logistic regression analysis.Results:Among 197 patients with chronic cough, there were 82 males (41.6%) and 115 females (58.4%). 75.1% (148/197) had a history of smoking, and 16.8% (33/197) had a history of allergies. 66.0% (130/197) lived in the city center, 18.3% (36/197) had a chemical factory around their place of residence, 11.2% (22/197) renovated their homes within the first six months of the disease, 15.7% (31/197) purchase new furniture, 54.3% (107/197) plant flowers and plants in their houses, 21.3% (42/197) keep pets in their houses, 79.2% (156/197) had lived in their houses for more than 2 years, 71.1% (140/197) had cockroaches in their houses, 16.2% (32/197) had mold in their houses, 83.3% (164/197) had a frequency of air conditioning cleaning exceeds 2 months per time.There were 130 patients (66.0%) with CRC and 67 patients (34.0%) with NCRC.Binary logistic regression analysis showed that living close to the main road ( OR=2.296, 95% CI: 1.350-3.904, P=0.002), living near chemical factories ( OR=3.322, 95% CI: 2.158-5.573, P<0.001), history of allergy ( OR=2.175, 95% CI: 1.165-4.058, P=0.015), purchasing new furniture within 6 months ( OR=2.828, 95% CI: 1.402-5.706, P=0.004), cotton and linen curtains ( OR=1.875, 95% CI: 1.038-3.388, P=0.037) were positively correlated with CRC; while down and wool pillowcases and quilts ( OR=0.142, 95% CI: 0.033-0.602, P=0.008; OR=0.207, 95% CI: 0.067-0.640, P=0.006) and low ventilation frequency ( OR=0.281, 95% CI: 0.131-0.603, P=0.001) were negatively correlated with CRC. Conclusion:Hormone-sensitive cough patients account the most of chronic cough cases, and there are differences in the living environment exposure between CRC and NCRC patients, which provides information for corresponding interventions to prevent and manage CRC.

Objective To investigate the effect and potential mechanism of Desmodium renifolium(Linn.)Schindl on ovariectomized osteoporosis rat model.Methods Sixty 3-month-old female SD rats were randomly divided into Sham group,model group,Xianlin Gubao group(0.24 g·kg-1),Desmodium renifolium low-dose group(1.35 g·kg-1,medium-dose group(2.7 g·kg-1)and high-dose group(5.4 g·kg-1).Osteoporosis was induced by performing double ovariectomy in rats.After 14 weeks treatment,the contents of osteocalcin(BGP),osteoprotectin(OPG)and alkaline phosphatase(ALP)in serum were determined.Hematoxylin-eosin(HE)staining was used to observe the changes of bone trabeculae.The osteoclast progenitor-cell line RAW264.7 was divided into negative control group,Receptor activator of nuclear factor-κB ligand(RANKL)group,Xianlin Gubao group,Desmodium renifolium low-dose,medium-dose and high-dose drug groups.The RANKL group and drug groups were induced with 50 ng·mL-1 RANKL.Meanwhile,Xianlin Gubao group and different concentrations of drug-containing serum of Desmodium renifolium,were added for intervention.Tartrate-resistant acid phosphatase(TRAP)staining was performed 10 days after intervention to observe the differentiation of osteoclasts,and quantitative real-time PCR(qPCR)was used to determine the mRNA expression.Results Compared with Sham group,the contents of OPG in serum of model group were significantly decreased(P<0.01),while ALP and BGP were significantly increased(P<0.01),bone trabeculae were significantly reduced,broken,sparsely arranged,and the space between bone trabeculae was large,the OPG mRNA expression in model group were significantly decreased(P<0.01),and the mRNA expression of receptor activator of nuclear factor-κB ligand(RANKL),TNF receptor associated factor 6(TRAF6),nuclear factor of activated t-cells,cytoplasmic 1(NFATC1),cathepsin K(CTK)and calcitonin receptor(CALCR)in model group were significantly increased(P<0.01),all these aspects showed remarkable improvement after Desmodium renifolium intervention.After 10 days of RAW264.7 culture,no osteoclasts were found in the Control group.Compared with the negative control group,osteoclasts in RANKL group were significantly increased,treatment with Desmodium renifolium markedly decreased osteoclast number,the result of RANKL/RANK/OPG signaling mRNA expression were consistent with the animal experiments.Conclusion Desmodium renifolium exerts effects on osteoporosis in ovariectomized rats,its mechanism might be realized by inhibiting osteoclast proliferation and differentiation,and regulating OPG/RANKL/RANK signaling pathway.

Shift handover is a process of transferring power and responsibility between medical staff,and it is also a basic part of medical activities.Intensive care unit(ICU)is the core area for the treatment of critically ill patients,with complex patient conditions and fine and diverse treatment.If clinical information cannot be shared accurately and in time,it will lead to the delay of the patient's condition,diagnosis and treatment plan.At the same time,the omission of handover information and communication problems can easily lead to safety risks,prolonged hospital stay and increased number of readmissions.Therefore,as one of the important links in ICU diagnosis and treatment and nursing work,accurate,complete and effective handover can ensure the rapid and accurate transmission of patient information and promote the smooth development of diagnosis and treatment and nursing work.This paper reviews the application scope of ICU shift handover model,analyzes the main characteristics,application status and application effects of ICU shift model,and discusses the problems and shortcomings of the existing ICU shift model,in order to provide a reference for further optimizing the quality of ICU shift.PRISMA extension for scoping reviews(PRISMA-ScR)as methodological guidance,we conducted a systematic search across major databases including PubMed,Web of Science,Embase,Cumulative Index to Nursing and Allied Health Literature(CINAHL),and Chinese databases(Wanfang,CNKI,Chinese Medical Association,CBM)using both subject headings and free-text terms).The search time limit was from the establishment of the database to July 18,2024.The preliminary retrieved literature bibliographer was imported into Endnote 20.0 software,and the obtained literature was selected and screened by two researchers.A total of 14 articles were included,of which 10 were from China and 4 were from the United States,and all were published between 2012 and 2022.The analysis showed that the ICU shift mode mainly included improved shift mode,group system shift mode,anti-shift mode,checklist type shift sheet mode and electronic information ICU shift.The shift mode showed diversified characteristics,optimized staffing to a certain extent,standardized the specific content and process of shift,and improved the quality of shift.Significant advances have been made in information delivery and quality of care.However,domestic research is mostly focused on the improvement of the shift mode,which faces the shortcomings of increasing workload,coordination and communication challenges,and the scientification and standardization of tools.Electronic information technology makes up for the shortcomings of information omission in the traditional shift process through the advantages of automatic data collection and information collection,and shows positive results in the process of shift.Future research needs to further explore the basis of not increasing the load of ICU clinical medical staff,ensuring the efficiency of shift and normal work flow.Pay attention to the intelligent,standardized and personalized construction of ICU shift,improve the quality of diagnosis and treatment and nursing,and ensure the safety of patients.

Objective:To improve the ability of aviation physicians and physical examiners in differential diagnosis of primary angiitis of the central nervous system (PACNS) and the level of aeromedical assessment by exploring the diagnosis and treatment of PACNS.Methods:The clinical diagnosis and treatment of a pilot with PACNS were reported and the related literatures were reviewed.Results:The clinical manifestation of the fighter trainer pilot was numbness of the left finger, and then gradually appeared numbness and weakness of the left face and left upper limb more than 1 month. The initial diagnosis was viral encephalitis and acute disseminated encephalomyelitis and the hormonal shock treatment was ineffective. The final diagnosis was PACNS. The patient′s condition was improved by cyclophosphamide shock treatment. Aeromedical assessment concluded that the pilot was temporarily grounded.Conclusions:Pilot with PACNS is rarely reported and easy to be misdiagnosed due to the clinical and imaging findings are lack of specificity. The aeromedical assessment of PACNS pilots should be individualized according to the severity of illness, type of aircraft and flight duties.

Shift handover is a process of transferring power and responsibility between medical staff,and it is also a basic part of medical activities.Intensive care unit(ICU)is the core area for the treatment of critically ill patients,with complex patient conditions and fine and diverse treatment.If clinical information cannot be shared accurately and in time,it will lead to the delay of the patient's condition,diagnosis and treatment plan.At the same time,the omission of handover information and communication problems can easily lead to safety risks,prolonged hospital stay and increased number of readmissions.Therefore,as one of the important links in ICU diagnosis and treatment and nursing work,accurate,complete and effective handover can ensure the rapid and accurate transmission of patient information and promote the smooth development of diagnosis and treatment and nursing work.This paper reviews the application scope of ICU shift handover model,analyzes the main characteristics,application status and application effects of ICU shift model,and discusses the problems and shortcomings of the existing ICU shift model,in order to provide a reference for further optimizing the quality of ICU shift.PRISMA extension for scoping reviews(PRISMA-ScR)as methodological guidance,we conducted a systematic search across major databases including PubMed,Web of Science,Embase,Cumulative Index to Nursing and Allied Health Literature(CINAHL),and Chinese databases(Wanfang,CNKI,Chinese Medical Association,CBM)using both subject headings and free-text terms).The search time limit was from the establishment of the database to July 18,2024.The preliminary retrieved literature bibliographer was imported into Endnote 20.0 software,and the obtained literature was selected and screened by two researchers.A total of 14 articles were included,of which 10 were from China and 4 were from the United States,and all were published between 2012 and 2022.The analysis showed that the ICU shift mode mainly included improved shift mode,group system shift mode,anti-shift mode,checklist type shift sheet mode and electronic information ICU shift.The shift mode showed diversified characteristics,optimized staffing to a certain extent,standardized the specific content and process of shift,and improved the quality of shift.Significant advances have been made in information delivery and quality of care.However,domestic research is mostly focused on the improvement of the shift mode,which faces the shortcomings of increasing workload,coordination and communication challenges,and the scientification and standardization of tools.Electronic information technology makes up for the shortcomings of information omission in the traditional shift process through the advantages of automatic data collection and information collection,and shows positive results in the process of shift.Future research needs to further explore the basis of not increasing the load of ICU clinical medical staff,ensuring the efficiency of shift and normal work flow.Pay attention to the intelligent,standardized and personalized construction of ICU shift,improve the quality of diagnosis and treatment and nursing,and ensure the safety of patients.

Objective:To improve the ability of aviation physicians and physical examiners in differential diagnosis of primary angiitis of the central nervous system (PACNS) and the level of aeromedical assessment by exploring the diagnosis and treatment of PACNS.Methods:The clinical diagnosis and treatment of a pilot with PACNS were reported and the related literatures were reviewed.Results:The clinical manifestation of the fighter trainer pilot was numbness of the left finger, and then gradually appeared numbness and weakness of the left face and left upper limb more than 1 month. The initial diagnosis was viral encephalitis and acute disseminated encephalomyelitis and the hormonal shock treatment was ineffective. The final diagnosis was PACNS. The patient′s condition was improved by cyclophosphamide shock treatment. Aeromedical assessment concluded that the pilot was temporarily grounded.Conclusions:Pilot with PACNS is rarely reported and easy to be misdiagnosed due to the clinical and imaging findings are lack of specificity. The aeromedical assessment of PACNS pilots should be individualized according to the severity of illness, type of aircraft and flight duties.

ObjectiveTo explore the pharmacodynamic effects of total flavonoids of Paeonia suffruticosa flower （TFPFs） on rats with hyperuricemia and provide scientific data support for the research and development of therapeutic drugs for hyperuricemia. MethodThe hyperuricemia model was induced by adenine combined with ethambutol in rats. The rats were randomly divided into a blank control group， a model group， two positive control groups （allopurinol at 42 mg·kg^-1 and Tongfengshu tablets at 600 mg·kg^-1）， and high-， medium-， and low-dose TFPFs groups （260， 130， and 65 mg·kg^-1）. The general conditions of rats were observed and recorded， and the body weight was recorded once every 5 days. The 24-hour urine volume， water intake， uric acid （UA）， and urinary protein of rats were determined after the last administration. The kidney index was calculated. The pathological changes in thymus and spleen tissues of rats were observed by hematoxylin-eosin （HE） staining. The serum activities of UA， creatinine （Cr）， blood urea nitrogen （BUN）， malondialdehyde （MDA）， superoxide dismutase （SOD）， and total antioxidant capacity （T-AOC） of rats were determined. The xanthine oxidase （XOD） and adenosine deaminase （ADA） activities in the liver were detected. The content of uric acid transporter 1 （URAT1）， organic anion transporter 1 （OAT1）， and glucose transporter 9 （GLUT9） in the kidney was detected by enzyme-linked immunosorbent assay （ELISA）. ResultCompared with the results in the model group， TFPFs could improve the mental state of rats， increase the body weight（P<0.01）， promote UA excretion（P<0.01）， reduce the content of urinary protein（P<0.05）， relieve renal glomerular atrophy， renal tubular epithelial cell status， and urate crystal deposition in renal tubules， dwindle 24-hour urine volume， water intake， kidney index（P<0.05）， serum levels of UA， Cr， BUN， and MDA（P<0.05，P<0.01）， inhibit the activities of XOD（P<0.05） and ADA（P<0.05，P<0.01）in the liver， diminish the expression of GLUT9 in the renal homogenate（P<0.05）， and increase serum SOD and T-AOC activities as well as OAT1 expression（P<0.01） in the kidney. The pathological changes of thymus and spleen were improved. ConclusionTFPFs possess a protective effect on the kidney of rats with hyperuricemia， which is achieved by promoting uric acid excretion， inhibiting oxidation and the activity of key enzymes in uric acid synthesis， and regulating the expression of uric acid transporters.