Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.

Objective:To explore the application effect of " visual nursing map" in coronary artery bypass grafting (CABG).Methods:A retrospective analysis was made on 76 patients who underwent CABG in Beijing Friendship Hospital, Capital Medical University from June 2021 to June 2023. 38 cases admitted from June 2021 to May 2022 were included in the control group, and 38 cases admitted from June 2022 to June 2023 were included in the observation group. The control group was given intraoperative routine nursing, and the observation group was given "visual nursing map" nursing measures on this basis. The preoperative preparation time and intraoperative pause time between the two groups were observed and compared. The measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for inter-group comparison. Counting data were expressed as cases and percentages, and Chi-square test was used for inter-group comparison. Results:In the control group, the preoperative preparation time was (93.2±8.5) min, and the longest procedure was the placement of electrosurgical equipment and instrument trolley, which were (6.4±0.8) min and (32.6±3.5) min, respectively. The intraoperative pause time was (7.3±0.7) min, and the longest time was the unskilled nursing cooperation of proximal and distal vascular anastomosis and the incomplete preparation of sterile surgical materials, which were (2.2±0.4) min and (1.4±0.3) min, respectively. In the observation group, the preoperative preparation time and intraoperative pause time were significantly reduced compared with the control group after the use of "visual nursing map" management on the basis of the control group, which were (79.4±5.4) and (93.2±8.5) min, (4.4±0.6) and (7.3±0.7) min, respectively, and the differences were statistically significant ( P<0.05). Conclusion:The application of "visual nursing graph" in CABG can effectively reduce the preoperative preparation time and intraoperative pause time, and should be further promoted.

Objective:To compare the differences in chemical compositions before and after processing by different processing methods; To optimize the processing method of Atractylodes lancea Rhizoma.Methods:Atractylodes lancea Rhizoma was processed by stir-frying with bran and treating with rice washing water. The volatile and non-volatile components of raw Atractylodes lancea Rhizoma, bran-fried Atractylodes lancea Rhizoma and rice washing water treated Atractylodes lancea Rhizome were qualitatively analyzed by headspace gas chromatography-mass spectrometry (HS-GC-MS) and ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry (UPLC-Q-Orbitrap HRMS), and the differences in chemical composition before and after processing were compared.Results:The volatile components of the three different products were determined to have 18 common components, such as agarospirol, β-eudesol, etc. In addition, 86 non-volatile components were determined. The peak area response value of atractylodin, the index component prescribed by pharmacopoeia, decreased after processing, but there was little difference in bran stir-frying and rice-washed water frying.Conclusions:Different processing methods have certain effects on the chemical composition of Atractylodes lancea Rhizoma. Among them, the bran-frying method is superior in improving the quality of preparations, reducing production costs and improving production efficiency. The bran-fried product can be used as raw material for preparation production.

Objective To investigate the reparative effect of astragaloside IV on hypoxia-reoxygenation-induced cardiomyocyte injury by regulating the thioredoxin-interacting protein(TXNIP)-Nod-like receptor protein 3(NLRP3)pathway.Methods H9c2 cardiomyocytes were divided into control group,hypoxia-reoxygenation group,astragaloside IV low-and high-dose groups,astragaloside IV high-dose+pcDNA-NC group,and astragaloside IV high-dose+pcDNA-TXNIP group.After intervention,H9c2 proliferation was measured by Cell Counting Kit 8(CCK-8)assay,apoptosis was detected by flow cytometry,lactate dehydrogenase(LDH)and superoxide dismutase(SOD)activities were determined by WST-8 assay,probebyreactive oxygen species(ROS)generation was measured by 2',7'-dichlorodihydrofluorescein diacetate(DCFDA)fluorescent,enzyme-linked inmunosorbent assay(ELISA)was used to quantify interleukin 6(IL-6)and tumor necrosis factor α(TNF-α)levels,Western Blot was used to analyze the protein expression of TXNIP and NLRP3.Results Compared with the control group,the hypoxia-reoxygenation group showed significantly decreased cell survival rate and SOD activity(P＜0.05),with increased apoptosis rate,LDH level,ROS generation,IL-6 and TNF-α levels,and protein expression levels of TXNIP and NLRP3(P＜0.05).Compared with the hypoxia-reoxygenation group,the cell survival rate and SOD activity in the low-dose and high-dose astragaloside IV groups were significantly increased(P＜0.05),and the apoptosis rate,LDH level,ROS production,IL-6 and TNF-α levels and protein expression levels of TXNIP and NLRP3 were significantly decreased(P＜0.05).Compared with the high-dose astragaloside IV+pcDNA-NC group,the cell survival rate and SOD activity in the high-dose astragaloside IV+pcDNA-TXNIP group were significantly decreased(P＜0.05),and the apoptosis rate,LDH level,ROS production,IL-6 and TNF-α levels and protein expression levels of TXNIP and NLRP3 were significantly increased(P＜0.05).Conclusion Astragaloside IV may alleviate hypoxia-reoxygenation-induced cardiomyocyte damage by downregulating key proteins in the TXNIP-NLRP3 pathway.

TCM dispensing is the most basic clinical pharmaceutical work of TCM.In recent years,based on the 9 key technologies of TCM dispensing,the TCM dispensing industry has ushered in great development,and innovative TCM dispensing information system and intelligent dispensing equipment have appeared.This article sorted out the current situation of TCM dispensing industry and looked forward to its future development route.The results showed that the introduction of new technology and new equipment in the key technical links of procurement acceptance,dispensing review,TCM decocting,medication guidance and so on have improved the quality of dispensing service and ensured the quality and safety of medication.In the development of modern TCM dispensing industry,it is necessary to improve the quality control standard system,service standard system and core equipment standard system in the standardization of dispensing technology;in terms of talent cultivation in the field of dispensing,it is necessary to focus on restructuring and building new educational models to cultivate new medical talents that intersect medical and engineering fields;in terms of informatization and intelligence,it is necessary to develop intelligent equipment that is more in line with the characteristics of TCM,and further promote and improve the"shared TCM pharmacy"model.Through improving the content of TCM clinical pharmaceutical care,developing new technology and equipment of TCM dispensing,and improving the level of dispensing service and education,it is expected to gradually realize the standardization,informatization and intelligent development of modern TCM dispensing industry.

Objective To retrospectively analyse the use of TCM injections in Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from 2019 to 2023;To evaluate the reasonableness of its clinical use of medication;To provide theoretical guidance for clinical work in the new situation.Methods Relevant data on the use of TCM injections in a hospital from 2019 to 2023 were collected,and the research method of retrospective analysis was used to analyse their use and medication law.Results From 2019 to 2023,the overall amount of use of TCM injections and the ratio of the amount of use of Western patent medicines showed a downward trend year by year;the amount of anti-neoplastic drugs TCM injections ranked in the first place although it decreased year by year,and the amount of use of enucleating agents and oncological auxiliary drugs TCM injections showed a downward trend;the changes in the consumption of TCM injections,the defined daily doses,and the defined daily cost fluctuated greatly,which was relevant to the medical insurance policy and the inclusion of the nationally negotiated medicines;both the infection of COVID-19 and medical policy played a great influence on the application of TCM injections.Conclusion The use of TCM injections is subject to changes in policy and the influence of social environment,and the supervision of the use of TCM injections should be strengthened to ensure the rational use of medication and medication safety for patients.

Objective To analyze the use of Chinese patent medicines containing toxic TCM decoction pieces in Beijing Hospital of Traditional Chinese Medicine of Capital Medical University(hereinafter referred to as"our hospital")from 2021 to 2023;To provide references for reasonable management of Chinese patent medicines containing toxic TCM decoction pieces in medical institutions.Methods The Chinese patent medicines containing toxic TCM decoction pieces from 2021 to 2023 were collected in our hospital.Statistics on the number of varieties,efficacy and sales amount of Chinese patent medicines containing toxic TCM decoction pieces were performed.Results From 2021 to 2023,there were 110 kinds of Chinese patent medicines containing toxic TCM decoction pieces and 10 kinds of Chinese patent medicines containing TCM decoction pieces with heavy toxicity,among which the ones of promoting blood circulation and removing blood stasis ranked first.The top 3 TCM decoction pieces with heavy toxicity were raw Aconiti Kusnezoffii Radix,raw Aconiti Radix,Strychni Semen;the top 5 TCM decoction pieces with toxicity were Cinnabaris,Realgar,processed Aconiti Kusnezoffii Radix,Aconiti Lateralis Radix Praeparata,Scorpio;the top 3 TCM decoction pieces with light toxicity were Armeniacae Semen Amarum,Hirudo,Eupolyphaga Steleophaga.The top 15 Chinese patent medicines containing toxic TCM decoction pieces in our hospital was relatively stable,especially the Guanjie Kebi Pills in the first place.Conclusion Based on the analysis of the use of Chinese patent medicines containing toxic TCM decoction pieces from 2021 to 2023,this article discuss measures to ensure the safe use of Chinese patent medicines containing toxic TCM decoction pieces,with certain feasibility and necessity.

Objective:To summarise the effect of free perforator flap of radial collateral artery on reconstruction of first web contracture after hand injury.Methods:Retrospective analysis was conducted based on the clinical data of patients with first web contracture after hand injury in the Department of Hand and Foot Surgery and Rehabilitation, Guangdong Work Injury Rehabilitation Hospital from November 2019 to June 2022. Ten patients, 8 males and 2 females aged between 27 and 51 years old with an average of 40.5 years old were included. There were 6 left hands and 4 right hands. Width and the included angle of first web were measured before surgery. Four hands were classified as severe first web contracture, and the rest of 6 hands had moderate first web contracture. After release scars of the first web, the areas of wound were 5.5 cm × 2.0 cm - 10.5 cm × 3.0 cm. The flaps sized were 6.0 cm×2.5 cm - 11.0 cm × 3.5 cm. All of flaps carried the posterior cutaneous nerve of forearm. Donor sites were closed directly. All patients were included in postoperative follow-up regularly through outpatient clinic or via WeChat reviews. The colour, texture, process in change of the transferred flaps, donor and recipient sites healing and complications were observed.Results:All 10 flaps survived and the wound healed by first intention. The patients received 7 to 15 months (10.5 months in average) of postoperative follow-up. The flaps were not bulky, texture and colour were satisfactory and without pigmentation. Protective sensations restored in 6 patients. At the last follow-up, average included angle of the first webs was 47.14°±1.68°, in comparison with 35.43°±3.60° before surgery. The average width of first webs was 5.34 cm±0.52 cm, in comparison with 3.17 cm±0.75 cm before surgery, the differences were statistically significant ( P<0.01). Eight hands were rated excellent, and 2 were good. There were only linear scars left at the donor sites, without sign of radial nerve injury. Conclusion:The free perforator flap of radial collateral artery is a safe and effective method for repair of first web contracture after hand injury.

Humans ; Clavicle ; Fractures, Bone/surgery*

Objective:To study the mechanism of Yangyin Yiqi mixture on the clinical symptoms in convalescent period of different types of pneumonia based on network pharmacology, so as to provide more options for the prevention and treatment of pneumonia with Traditional Chinese Medicine (TCM).Methods:Based on the TCM theory of "treating different diseases with the same method", the Integrative Pharmacology-Based Research Platform of Traditional Chinese Medicine (TCMIP) V 2.0 was used to screen the active components, action targets and disease targets of the herbs in Yangyin Yiqi mixture. The disease-target-medicine network map was constructed by Cytoscape software and the Reactome enrichment analysis of key targets were carried out.Results:Seven different types of clinical sympotms of pneumonia in convalescent period were established, including fatigue, tachypnea, thirst, palpitations, hyperhidrosis, poor appetite and cough. After the screening, a total of 276 active components and 177 key targets were obtained, 37 common targets of this herb and pneumonia were obtained. The key targets were associated with cell metabolism, apoptosis, inflammatory response, immune response, and stress response, etc. There are 17 common targets between Polygonatum and 7 clinical symptoms in the recovery period of different types of pneumonia. Reactome enrichment analysis showed that the pathways involved in the core genes of Yangyin Yiqi mixture in the treatment of the main symptoms of different types of pneumonia in the recovery period were mainly enriched in: by regulating genes and protein translation to affect the virus or cell function, immune regulation and inflammatory response and regulate the function of nervous system, and prevent viral canceration.Conclusions:The effective components in Yangyin Yiqi mixture may regulate phosphatidylinositol 3-kinase (PI3K), interleukin-4, interleukin-13 (IL-4, IL-13) and inhibitory kappa protein (IκBα) by intervention of PIK3CA, MAPK3, BCL2 and NF-κB2 and other targets to promote the recovery of pneumonia. This study could provide a theoretical basis for the prevention and treatment of pneumonia in the recovery period.