Malignant hyperthermia(MH)is a rare perioperative disease with autosomal dominant inheritance,and its pathogenesis involves specific gene mutations.Its clinical feature is that conventional anesthetics can trigger abnormally high metabolic reactions in skeletal muscles.Although the incidence of this disease is low,the condition is dangerous,progresses rapidly,and has a high mortality rate;Its treatment relies on early diagnosis,timely application of the specific drug Dantrolene Sodium,and rapid and orderly comprehensive symptomatic supportive treatment.MH is a critical perioperative emergency that can occur during surgery.It presents with symptoms such as hyperpyrexia,metabolic acidosis,rhabdomyolysis,and dysfunction of multiple organ systems.If not treated promptly,it can quickly lead to life-threatening arrhythmias and cardiac arrest.This condition serves as an essential teaching example in anesthesia crisis resource management.As an effective teaching method,scenario simulation exercises can comprehensively enhance medical staff's personal technical,non-technical,and teamwork abilities through simulating emergency scenarios,teaching assessments,and retrospective discussions,especially suitable for comprehensive management training of fatal diseases.Many countries internationally have incorporated simulation exercises for MH into their routine teaching and training systems.The effectiveness of teaching and training for anesthesiologists in MH and their ability to handle anesthesia crisis events have been continuously improved through a periodic training model.This article systematically reviews the research progress and practical experience of scenario simulation exercises in emergency training for MH,with a focus on exploring how to establish a scenario simulation exercise plan for emergency application and comprehensive symptomatic support treatment of Dantrolene Sodium based on the actual situation in China,providing reference for improving the teaching and training quality of MH and other clinical crisis events.

Malignant hyperthermia(MH)is a rare perioperative disease with autosomal dominant inheritance,and its pathogenesis involves specific gene mutations.Its clinical feature is that conventional anesthetics can trigger abnormally high metabolic reactions in skeletal muscles.Although the incidence of this disease is low,the condition is dangerous,progresses rapidly,and has a high mortality rate;Its treatment relies on early diagnosis,timely application of the specific drug Dantrolene Sodium,and rapid and orderly comprehensive symptomatic supportive treatment.MH is a critical perioperative emergency that can occur during surgery.It presents with symptoms such as hyperpyrexia,metabolic acidosis,rhabdomyolysis,and dysfunction of multiple organ systems.If not treated promptly,it can quickly lead to life-threatening arrhythmias and cardiac arrest.This condition serves as an essential teaching example in anesthesia crisis resource management.As an effective teaching method,scenario simulation exercises can comprehensively enhance medical staff's personal technical,non-technical,and teamwork abilities through simulating emergency scenarios,teaching assessments,and retrospective discussions,especially suitable for comprehensive management training of fatal diseases.Many countries internationally have incorporated simulation exercises for MH into their routine teaching and training systems.The effectiveness of teaching and training for anesthesiologists in MH and their ability to handle anesthesia crisis events have been continuously improved through a periodic training model.This article systematically reviews the research progress and practical experience of scenario simulation exercises in emergency training for MH,with a focus on exploring how to establish a scenario simulation exercise plan for emergency application and comprehensive symptomatic support treatment of Dantrolene Sodium based on the actual situation in China,providing reference for improving the teaching and training quality of MH and other clinical crisis events.

Talents are the main force for the development of traditional Chinese medicine（TCM）， and the construction of TCM talents and the reformation of talent evaluation system are essential to promote the inheritance and innovation of TCM. At present， we are still exploring and developing in the fields of the formulation， implementation and evaluation indicators of TCM talent evaluation system. However， there are shortcomings and difficulties. For instance， insufficient stratification in the evaluation， excessive emphasis on the quantity of achievements， neglecting the quality of the achievements and the actual contribution， imperfect assessment indicators， and the weak characteristics of TCM. Therefore， national ministries and commissions have jointly issued a document requesting to break the four only and set a new standard， in order to promote the construction of a scientific and technological talent evaluation system oriented by innovation value， ability and contribution. For the evaluation of TCM clinical talents， China Association for Science and Technology commissioned China Association of Chinese Medicine to build the China Clinical Cases Library of TCM（CCCL-TCM）， which aims at collecting the most authoritative and representative TCM clinical cases and exploring the advantages of applying clinical cases as masterpiece of achievement in TCM clinical talents evaluation. CCCL-TCM can promote the construction of a talent evaluation system that is more in line with the development characteristics of TCM industry， and to carry out relevant pilot in TCM colleges and institutions across the country in order to promote the reformation of TCM talent evaluation system.

Objective:To investigate the clinical efficacy of alendronate combined with hyperbaric oxygen on elderly patients with osteoporosis (OP) and its effect on serum bone metabolism.Methods:A total of 80 elderly patients with OP admitted to the Department of Orthopedics of the Fourth People’s Hospital of Shenyang from January 2017 to December 2019 were selected and divided into control group ( n=40) and observation group ( n=40) by the random number table method. The control group received alendronate, while the observation group received alendronate combined with hyperbaric oxygen treatment. Both groups received six months of treatment. Fasting venous blood was collected before and after treatment, and serum levels of N-terminal osteocalcin (N-MID), bone-specific alkaline phosphatase (BAP), N-terminal propeptide of type I procollagen (PINP), and carboxy-terminal peptide of type I collagen (CTX) in the two groups were measured by electrochemiluminescence immunoassay (ECLI). The scores of numeric rating scale (NRS) for pain assessment were collected before and after treatment; and the clinical efficacies of the two groups after treatment were observed. Results:The total effective rate of the observation group (85.00%) was significantly higher than that of the control group (65.00%); after treatment, the NRS score of the observation group was significantly lower than that of the control group; the levels of serum N-MID, BAP, PINP, and CTX in the observation group were significantly lower than those in the control group; all the differences were statistically significant ( P<0.05). Conclusion:Alendronate combined with hyperbaric oxygen can reduce the levels of serum N-MID, BAP, PINP, and CTX in elderly patients with OP and relieve their pain significantly with good clinical efficacy, which can be widely used in clinical practice.

Objective:To investigate the clinical efficacy of alendronate combined with hyperbaric oxygen on elderly patients with osteoporosis (OP) and its effect on serum bone metabolism.Methods:A total of 80 elderly patients with OP admitted to the Department of Orthopedics of the Fourth People’s Hospital of Shenyang from January 2017 to December 2019 were selected and divided into control group ( n=40) and observation group ( n=40) by the random number table method. The control group received alendronate, while the observation group received alendronate combined with hyperbaric oxygen treatment. Both groups received six months of treatment. Fasting venous blood was collected before and after treatment, and serum levels of N-terminal osteocalcin (N-MID), bone-specific alkaline phosphatase (BAP), N-terminal propeptide of type I procollagen (PINP), and carboxy-terminal peptide of type I collagen (CTX) in the two groups were measured by electrochemiluminescence immunoassay (ECLI). The scores of numeric rating scale (NRS) for pain assessment were collected before and after treatment; and the clinical efficacies of the two groups after treatment were observed. Results:The total effective rate of the observation group (85.00%) was significantly higher than that of the control group (65.00%); after treatment, the NRS score of the observation group was significantly lower than that of the control group; the levels of serum N-MID, BAP, PINP, and CTX in the observation group were significantly lower than those in the control group; all the differences were statistically significant ( P<0.05). Conclusion:Alendronate combined with hyperbaric oxygen can reduce the levels of serum N-MID, BAP, PINP, and CTX in elderly patients with OP and relieve their pain significantly with good clinical efficacy, which can be widely used in clinical practice.

There are two major problems in the clinical application of Traditional Chinese Medicine injection: inadequate instruction for clinical medication and unreasonable clinical application. The key of the problem is the lack of precise and evidence-based research. In view of the current problems, we should adopt the strategy of government drug administration department leading and gradually taking shape that a multi-collaboration platform of medical institutions, researchers and enterprises to jointly carry out precise and evidence-based research. The specific implementation path is the precise clinical positioning, improving monitoring and assessment system of adverse drug reactions. The medical institutions fully put into the evidence. Chinese medicine injection will be clear and specific in clinical location, with clear mechanism. Survival of the fittest enhances the core competitiveness of Chinese medicine injections and makes contributions to the cause of protecting human life and health.

In clinical practice, the application of Traditional Chinese Medicine injections (TCMIs) has several problems, for example, at some time, the components are complicated, the ingredients and pyrogen are uncontrollable, the usage, the dosage, and the drug interactions are unclear and the method of application is also ambiguous and non-standard. The factors have restricted the development of TCMIs. Based on the policies of the TCMI package inserts since 2006, this paper takes consideration of the problems and gives suggestions of making strict, normal and evidence-based TCMI package inserts.

The insufficient reporting of adverse reactions of Chinese proprietary medicines is common. In addition, there is a lack of safety information in the specifications of Chinese proprietary medicines, which led to less evidence for clinical safety of Chinese proprietary medicines in clinical practice. It is urgent to carry out post-marketing clinical safety re-evaluation of Chinese proprietary medicine. Developing a clinical safety evaluation data set for Chinese proprietary medicine may reduce the insufficient reporting of safety information and the inconsistency of data reporting in similar studies, as well as include more studies in systematic reviews, so that they can provide higher-level evidence for clinical safety of Chinese proprietary medicine. This paper proposes a method for developing core data set of clinical safety evaluation of Chinese proprietary medicine: firstly, the application scope of core data set for clinical safety evaluation was determined according to the characteristics of diseases, population, research objectives, administration methods, evaluation methods, etc. Systematic reviews and semi-structured interviews should be conducted to develop the list of original items for clinical safety evaluation. Based on the list, Delphi surveys can be developed in different stakeholders. Then the final core data set can be developed via consensus meetings.

This study introduces 5 methods of causality assessment of adverse drug reactions (ADRs) domestic and overseas. According to the assessment of ministry of public health of China, the key points about the relevance analysis have been illuminated for the post-evaluation of Chinese patent medicine. Under the guidance of the causality assessment, we should describe the ADR reports in detail and further detect the accurate ADR warning signals. In order to supplement the ADR information, more researches concerning the ADR mechanism should be fully explored.

The herb-drug combination is becoming more and more common. The safety evaluation method is a complex evaluation system. This paper analyzed Pubmed database from 2008 to 2018, and summarized the characteristics of safety evaluation method, and the characteristics are listed as below: (1) Exposure safety issues in real world; (2) The combination use is complex and difficult to evaluate. There are the existing safety assessment methods including literature induction, prospective test, questionnaire survey, etc. Although safety evaluation has been carried out from different angles, there is still a lack of comprehensive and reasonable safety evaluation method. The team tried to combine clinical phenotype and mechanism characteristics to provide more reasonable methodological support for clinical safety evaluation.