ObjectiveTo observe the clinical efficacy and safety of Yuyin Lidan granules （YYLD） in preventing the recurrence of common bile duct stones （CBDS） in patients with liver and gallbladder dampness-heat syndrome following endoscopic retrograde cholangiopancreatography （ERCP）. MethodsThis randomized， parallel， controlled trial enrolled postoperative CBDS-ERCP patients who met the inclusion and exclusion criteria. Sixty-four patients were randomly assigned to an observation group or a control group， with 32 cases in each. Both groups received conventional Western medical treatment after ERCP， while the observation group additionally received YYLD for 8 weeks. The follow-up period lasted for 1 year. The efficacy indicators included bile bilirubin levels， traditional Chinese medicine （TCM） syndrome scores， clinical efficacy rate， pancreatitis and inflammation markers， postoperative liver function， and CBDS recurrence rate at 1-year follow-up， which were used to jointly evaluate the clinical efficacy and safety of both groups. ResultsA total of 56 patients completed the study and were included in the final analysis， i.e.， 29 in the observation group and 27 in the control group. Baseline characteristics were comparable between the two groups. Compared with pre-treatment and with the control group after treatment， the bile bilirubin level in the observation group significantly decreased （P<0.05）. After treatment， the clinical cure and marked improvement rates were higher in the observation group than in the control group， showing a statistically significant difference in overall clinical efficacy （P<0.05）. Compared with pre-treatment， the primary and secondary symptoms in the observation group， as well as the primary symptom and the secondary symptom of nausea and vomiting in the control group （weeks 4 and 8）， were significantly reduced （P<0.05）. Compared with the control group after treatment， the observation group showed significant reductions in the primary symptom of loose stools/constipation （day 5 and week 4） and in three secondary symptoms， i.e.， bitter taste and sticky dry mouth， abdominal distension and poor appetite （throughout the treatment period）， and general heaviness and fatigue （day 5 and week 4）， with statistical differences （P<0.05）. Compared with pre-treatment， both groups showed decreased lipase and urinary amylase levels （P<0.05）. However， no significant between-group differences were observed in pancreatitis or inflammation-related indices after treatment. Compared with pre-treatment， all liver function indicators in the observation group and alanine aminotransferase （ ALT ）， γ-glutamyl transferase （ γ-GT ）， alkaline phosphatase （ALP）， and conjugated bilirubin in the control group significantly decreased at weeks 4 and 8 （P<0.05）. Compared with the control group after treatment， only serum total bilirubin and unconjugated bilirubin were significantly reduced in the observation group during the treatment period （P<0.05）. ConclusionYYLD combined with conventional Western medical treatment can effectively regulate bilirubin metabolism （in bile and serum）， improve TCM clinical symptoms， and prevent CBDS recurrence after ERCP in patients with liver and gallbladder dampness-heat syndrome. This regimen is safe and effective and is worthy of further clinical research and promotion.

ObjectiveBased on the clinical characteristics of chronic gouty arthritis （CGA） in both traditional Chinese and western medicine， this study aims to systematically evaluate the clinical concordance of existing CGA animal models， providing recommendations for establishing animal models that align with the pathological characteristics of CGA and the manifestations of traditional Chinese medicine syndromes. MethodsBy comprehensively retrieving Chinese and international databases such as China National Knowledge Infrastructure， Wanfang， VIP Chinese Science and Technology Periodical Database （VIP）， and PubMed， all relevant literature on CGA animal models was collected. Based on the guidelines， the diagnostic criteria of both traditional Chinese and western medicine were summarized and organized. The evaluation indicators for the CGA model were constructed with reference to existing evaluation modes， and the CGA animal models were analyzed to systematically evaluate the clinical concordance of existing models. ResultsThe current methods used to construct CGA animal models mainly include monosodium urate crystal induction， high-protein diet induction （poultry lack urate oxidase）， and high-fat diet combined with urate oxidase inhibitors and joint injection. Based on 11 pieces of included literature， the traditional Chinese and western medicine scoring data of each model were extracted， and the average scoring values of all models were ultimately calculated. The results show that the average clinical concordances of existing CGA animal models in both traditional Chinese and western medicine are 43.33% and 64.44%， respectively. Among them， the model with the highest clinical concordance rate is the one with a high-fat diet combined with potassium oxonate to induce hyperuricemia plus joint injection， achieving 83.33% clinical concordance in western medicine and 60% in traditional Chinese medicine. This model aligns well with the pathogenic characteristics and pathological changes of clinical CGA. ConclusionAlthough current CGA animal models can simulate some pathological characteristics of CGA， they struggle to comprehensively reflect the complex pathological processes of CGA and the characteristics of traditional Chinese medicine syndromes. Therefore， in the future， it is necessary to establish the CGA animal models that incorporate the clinical disease and syndrome characteristics of traditional Chinese and western medicine and formulate the uniform model evaluation criteria， providing more precise tools for CGA mechanism research and the development of traditional Chinese medicine.

Objective: To understand the epidemiological characteristics of a pertussis outbreak in Guangzhou, so as to provide references for outbreak response and prevention strategies. Methods: From April 5 to June 9, 2024, case screening was conducted among 246 preschool children, 35 staff members, and one full time school nurse in a kindergarten in Guangzhou based on case definition. Field epidemiological investigation methods were employed to collect relevant information, and screening samples were collected from individuals involved in the outbreak. The clinical manifestations, epidemiological characteristics, and risk factors for transmission of the outbreak were analyzed, with rate comparisons performed using the χ 2 test. Results: There were a total of 15 confirmed cases of pertussis in the kindergarten. The main clinical manifestations included intermittent cough in 14 cases ( 93.33 %), sputum production in 5 cases (33.33%), fever in 2 cases (13.33%), paroxysmal spasmodic cough in 1 case (6.67%), and vomiting in 1 case (6.67%). There was no statistically significant difference in the reporting rates of interrupted cough symptoms between pertussis cases (93.33%) and non pertussis cases (92.86%)( χ 2=3.74, P >0.05). The cases were aged 4-5 years, including 5 males and 10 females. The interval between symptom onset and diagnosis ranged from 2 to 25 days, with a median of 10 days. The outbreak involved two classes, with attack rates of 48.28% and 3.45%, respectively. Laboratory testing confirmed 14 close contacts positive for Bordetella pertussisnucleic acid. Among close contacts, only one received prophylactic medication as required. Conclusion The outbreak is a pertussis outbreak in a kindergarten caused by Bordetella pertussis infection, demonstrating distinct temporal and spatial clustering characteristics.

ObjectiveTo evaluate the safety and efficacy of oxycodone versus sufentanil for postoperative analgesia in patients with moderate to severe obstructive sleep apnea （OSA） undergoing uvulopalatopharyngoplasty （UPPP）. MethodsWe enrolled 73 consecutive patients with moderate-to-severe OSA （confirmed by polysomnography） scheduled for elective UPPP under general anesthesia at our institution between August 2023 and August 2025. Patients were randomly assigned to receive oxycodone （n = 37） or sufentanil （n = 36） using a random number table . The sufentanil group received 1.5 μg per kilogram of body weight， and the oxycodone group received 0.9 mg per kilogram； both groups used patient-controlled intravenous analgesia （PCIA） pumps with a total volume of 100 mL. A 2 mL loading dose was administered 10 minutes before the end of surgery， followed by a background infusion of 2 mL per hour， 2 mL bolus doses on demand， an 8-minute lockout interval， and a maximum hourly volume of 10 mL. We assessed pain scores （Numerical Rating Scale） at rest and during swallowing， Ramsay sedation scores， morphine-equivalent opioid consumption， PCIA bolus demands， patient satisfaction， time to first oral intake， and adverse events （including respiratory depression， nausea， and vomiting） at 4， 12， 24， and 48 hours postoperatively. ResultsBaseline characteristics were well balanced between the two groups （all P＞0.05）. No significant between-group differences were observed in resting and swallowing NRS scores or Ramsay sedation scores at each postoperative time point， PCIA satisfaction， time to first oral intake， or adverse event incidence across all postoperative time points （all P＞0.05）. Morphine-equivalent opioid consumption was significantly lower in the oxycodone group at all time points， as were unsuccessful PCIA bolus demands at 24 and 48 hours postoperatively （both P＜0.05）. ConclusionsLow-dose oxycodone provided analgesic efficacy similar to that of sufentanil for PCIA after UPPP in patients with moderate-to-severe OSA， with no significant between-group differences in adverse events， time to first oral intake， or satisfaction .The oxycodone group had numerically lower adverse event rates and a shorter time to first oral intake， suggesting a favorable safety profile and potential benefits for reducing opioid-related events and facilitating earlier recovery in this patient population.

ObjectiveTo evaluate the safety and efficacy of oxycodone versus sufentanil for postoperative analgesia in patients with moderate to severe obstructive sleep apnea （OSA） undergoing uvulopalatopharyngoplasty （UPPP）. MethodsWe enrolled 73 consecutive patients with moderate-to-severe OSA （confirmed by polysomnography） scheduled for elective UPPP under general anesthesia at our institution between August 2023 and August 2025. Patients were randomly assigned to receive oxycodone （n = 37） or sufentanil （n = 36） using a random number table . The sufentanil group received 1.5 μg per kilogram of body weight， and the oxycodone group received 0.9 mg per kilogram； both groups used patient-controlled intravenous analgesia （PCIA） pumps with a total volume of 100 mL. A 2 mL loading dose was administered 10 minutes before the end of surgery， followed by a background infusion of 2 mL per hour， 2 mL bolus doses on demand， an 8-minute lockout interval， and a maximum hourly volume of 10 mL. We assessed pain scores （Numerical Rating Scale） at rest and during swallowing， Ramsay sedation scores， morphine-equivalent opioid consumption， PCIA bolus demands， patient satisfaction， time to first oral intake， and adverse events （including respiratory depression， nausea， and vomiting） at 4， 12， 24， and 48 hours postoperatively. ResultsBaseline characteristics were well balanced between the two groups （all P＞0.05）. No significant between-group differences were observed in resting and swallowing NRS scores or Ramsay sedation scores at each postoperative time point， PCIA satisfaction， time to first oral intake， or adverse event incidence across all postoperative time points （all P＞0.05）. Morphine-equivalent opioid consumption was significantly lower in the oxycodone group at all time points， as were unsuccessful PCIA bolus demands at 24 and 48 hours postoperatively （both P＜0.05）. ConclusionsLow-dose oxycodone provided analgesic efficacy similar to that of sufentanil for PCIA after UPPP in patients with moderate-to-severe OSA， with no significant between-group differences in adverse events， time to first oral intake， or satisfaction .The oxycodone group had numerically lower adverse event rates and a shorter time to first oral intake， suggesting a favorable safety profile and potential benefits for reducing opioid-related events and facilitating earlier recovery in this patient population.

Objective To study the traditional Chinese medicine(TCM)syndromes of patients with chronic heart failure(CHF)combined with diuretic resistance by using the Wenyang Huayin Yangxin Prescription,and to observe its therapeutic efficacy.Methods A total of 68 CHF patients complicated with diuretic resistance and who had Yangqi deficiency and presenting blood stasis syndrome combined with Tanyin were randomly assigned to a control group and an observation group.The control group was given intravenous furosemide(≥ 80 mg/d)via infusion pump in addition to standard Western medical treatment,while the observation group was given intravenous furosemide(＜80 mg/d)via infusion pump along with the Wenyang Huayin Yangxin Prescription(30 g Astragalus,15 g Poria,15 g Baizhu,15 g Chuanxiong,10 g Danfu tablet,10 g Cassia,10 g Alisma,and 10 g Zhimu).The quantitative index of diuretic resistance was used as the primary outcome measure.In addition,the differences between the two groups in TCM syndromes,cardiac function-related indicators,incidence of endpoint events,and readmission rate were compared.Results After 2 weeks of treatment,the filtration sodium excretion fraction(FENa)in the observation group was(0.18±0.04)％,while that of the control group was(0.16±0.03)％,showing a statistically significant difference(P=0.037).The 24-hour urine volume and urine Na+/K+ratio in the observation group increased significantly from baseline levels and were higher than those in the control group(P＜0.05).The differences in the changes of 24-hour urine volume,urine sodium,FENa,and urine Na+/K+ratio between the two groups were statistically significant(P＜0.05).The TCM syndrome scores decreased in both groups after 2 weeks of treatment,with the observation group showing a significantly greater reduction compared with the control group(P＜0.001).The differences in the changes of TCM syndrome scores between the two groups were statistically significant(P＜0.001).After 2 weeks of treatment,the observation group showed significant improvements in palpitations,shortness of breath,facial and limb edema,spontaneous sweating,chest tightness(pain),asthma,and oliguria compared with the baseline data(P＜0.05),while the control group showed improvements only in facial and limb edema,asthma,and oliguria(P＜0.05).Except for the asthma syndrome after 2 weeks of treatment,the observation group showed better outcomes in spontaneous sweating,chest tightness(pain),asthma,and oliguria at various time points after treatment compared with the control group(P＜0.05).After 2 weeks of treatment,the observation group had significantly better cardiac output(CO)and stroke volume(SV)compared with those of the control group(P＜0.05).The differences in the changes in N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),SV,and CO between the two groups were statistically significant(P＜0.05).After 24 weeks of follow-up,no significant differences in the incidence of end-point events or readmission rates between the two groups were observed.Conclusion The Wenyang Huayin Yangxin Prescription,combined with low-dose intravenous furosemide administered through an infusion pump,can improve the TCM syndromes of patients with Yangqi deficiency and blood stasis syndrome combined with Tanyin in addition to CHF complicated by diuretic resistance.This treatment improves the patients'heart function and diuretic resistance,reduces the intravenous dosage of diuretic,and enhances clinical efficacy.This approach should be more widely applied in clinical settings.

Objective:To analyze the risk factors for in-hospital malignant ventricular arrhythmia (MVA) in acute myocardial infarction (AMI) and to construct and validate a risk prediction model.Methods:This study was a retrospective cohort study. Patients aged≥18 years who were admitted to Qilu Hospital of Shandong University with a diagnosis of AMI and underwent coronary angiography (CAG) from May 2016 to March 2023 were selected, and the patients' clinical routine test indicators and CAG results were collected. Univariate and bidirectional stepwise logistic regression were used to screen out the risk factors for constructing the best prediction model. The prediction model was constructed by combining the results of multivariate logistic regression. The Hosmer-Lemeshow test and ROC curve, calibration curve, and decision curve were drawn to evaluate the model. The nomogram was drawn to visualize the model, and the Bootstrap self-sampling method was used for internal validation. The ROC curve was drawn to evaluate the predictive performance of each risk factor and prediction model. Finally, a multicollinearity test was performed.Results:Among the 4 205 patients finally included in the study, 115 patients (2.735%) developed MVA during hospitalization. The predictive factors screened out included age (X1), diastolic blood pressure (X2), respiratory rate (X3), blood glucose (X4), serum potassium (X5), logarithmic NT-proBNP (X6), myocardial infarction type (NSTEMI=X7, unclassified=X8), J wave (X9), Killip grade (Ⅱ=X10, Ⅲ=X11, Ⅳ=X12), and the regression equation was ln(p/1-p)=-4.699+0.029×X1-0.012×X2+0.059×X3+0.148×X4-1.175×X5+0.866×X6-1.427×X7-0.475×X8+0.758×X9+0.294×X10+0.902×X11+1.815×X12. The area under the ROC curve (AUC) of the model was 0.855 (95% CI: 0.816-0.894), and the Hosmer-Lemeshow test ( χ2=14.178, P=0.077) and the calibration curve showed that the predicted probability was consistent with the actual probability. The probability threshold of 0% to 65% had a better clinical net benefit. The area under the internal validation ROC curve (AUC) was 0.855, 95% CI: 0.813-0.891. The prediction performance of the nine variables was stronger than that of any single variable. There was no multicollinearity between the variables. Conclusions:Age, diastolic blood pressure, respiratory rate, blood glucose, serum potassium, NT-proBNP, type of AMI, J wave, and Killip class are forecasting indicator for in-hospital MVA in AMI. The risk prediction model based on the above factors has good predictive performance.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Neurogenic bladder(NB)is one of the most challenging urinary system disorders,with spinal cord injury(SCI)being an important etiological factor.Animal models provide crucial tools for investigating the pathogenesis,therapeutic strategies,and novel drug screening for NB subsequent to SCI.We reviewed and synthesized recent literature on NB animal models after SCI from both domestic and international sources.This review summarizes and analyzes research advancements using these models in terms of animal species,SCI segments,modeling techniques,and evaluation indicators,with the aim of offering insights and guidance for future experimental research based on animal models of NB following SCI.