Objective To revise Guidelines for Diagnosis and Treatment of Commom Diseases of Pediatrics in Traditional Chinese Medicine·Recurrent Respiratory Tract Infections in Children through the Delphi method-based expert questionnaire survey.Methods Bsaed on a comprehensive literature review,the expert questionnaire was developed for the 2024 Edition of the guidelines.Using the Delphi method,the questionnaire was distributed in three rounds to gather expert opinions.Statistical analyses were conducted on expert positivity coefficients and consensus levels,evaluated by expert familiarity,the concentration of expert opinions,and their degree of coordination.Results After three rounds of consultation,consensus was achieved among experts regarding the terminology and definitions,diagnosis,syndrome differentiation,treatment,prevention and health related to recurrent respiratory tract infections in children.This led to the formulation of a draft version of the 2024 Edition of the guidelines for further consultation.Conclusion The participating experts were geographically diverse,held senior titles,and possessed extensive clinical experience,ensuring the credibility of the findings.Their high level of engagement throughout the survey process indicates strong motivation.The content of the expert questionnaire of the Guidelines for the Diagnosis and Treatment of Traditional Chinese Medicine in Children with Recurrent Respiratory Tract Infections in Children(2024 Edition)objectively reflects the core perspectives of the experts,and the results are authentic and reliable,providing a solid foundation for the development of the guidelines.

Objective To revise Guidelines for Diagnosis and Treatment of Commom Diseases of Pediatrics in Traditional Chinese Medicine·Recurrent Respiratory Tract Infections in Children through the Delphi method-based expert questionnaire survey.Methods Bsaed on a comprehensive literature review,the expert questionnaire was developed for the 2024 Edition of the guidelines.Using the Delphi method,the questionnaire was distributed in three rounds to gather expert opinions.Statistical analyses were conducted on expert positivity coefficients and consensus levels,evaluated by expert familiarity,the concentration of expert opinions,and their degree of coordination.Results After three rounds of consultation,consensus was achieved among experts regarding the terminology and definitions,diagnosis,syndrome differentiation,treatment,prevention and health related to recurrent respiratory tract infections in children.This led to the formulation of a draft version of the 2024 Edition of the guidelines for further consultation.Conclusion The participating experts were geographically diverse,held senior titles,and possessed extensive clinical experience,ensuring the credibility of the findings.Their high level of engagement throughout the survey process indicates strong motivation.The content of the expert questionnaire of the Guidelines for the Diagnosis and Treatment of Traditional Chinese Medicine in Children with Recurrent Respiratory Tract Infections in Children(2024 Edition)objectively reflects the core perspectives of the experts,and the results are authentic and reliable,providing a solid foundation for the development of the guidelines.

Objective    To retrospectively analyze the surgical treatment of Stanford type A aortic dissection after coronary artery stenting, and to explore the surgical techniques and surgical indications. Methods    Clinical data of 1 246 consecutive patients who underwent operations on Stanford type A aortic dissection from April 2016 to July 2019 in Beijing Anzhen Hospital were retrospectively analyzed. Patients with Stanford type A aortic dissection after coronary artery stenting were enrolled. Results    Finally 19 patients were collected, including 16 males and 3 females with an average age of 54±7 years ranging from 35 to 66 years. There were 11 patients in acute phase, 15 patients with AC (DeBakey Ⅰ) type and 4 patients with AS (DeBakey Ⅱ) type. In AC type, there were 10 patients receiving Sun's surgery and 5 patients partial arch replacement. Meanwhile, coronary artery bypass grafting was performed in 7 patients and mitral valve replacement in 1 patient. Stents were removed from the right coronary artery in 4 patients. In this group, 1 patient died of multiple organ failure in hospital after operation combined with malperfusion of viscera. Eighteen patients recovered after treatment and were discharged from hospital. The patients were followed up for 30 (18-56) months. One patient underwent aortic pseudoaneurysm resection, one thoracic endovascular aortic repair, one emergency percutaneous coronary intervention due to left main artery stent occlusion, and one underwent femoral artery bypass due to iliac artery occlusion. Conclusion    Iatrogenic aortic dissection has a high probability of coronary artery bypass grafting at the same time in patients with Stanford type A aortic dissection after coronary artery stenting. Complicated type A aortic dissection after percutaneous coronary intervention should be treated with surgery aggressively.

Background: Pyroptosis is involved in the occurrence of acute pancreatitis, but its role in remote organ injury remains unclear. Aims: To investigate the role and mechanism of NLRP3 inflammasome-dependent pyroptosis in acute pancreatitis- related lung injury. Methods: Thirty-two male Sprague-Dawley rats were randomly divided into four groups: control group, severe acute pancreatitis (SAP) group, Z-WEHD-FMK (caspase-1 inhibitor) group and disulfiram (GSDMD inhibitor) group. Experimental SAP was constructed by using 5% sodium taurocholate in the latter 3 groups. Serum levels of amylase, lipase, procalcitonin, and the myeloperoxidase (MPO) activity were determined; the severity of pancreatic and lung injuries was assessed by histopathology and lung wet/dry weight ratio; serum levels of pyroptosis-related inflammatory cytokines and the expressions of proteins involved in pyroptosis pathway in lung tissue were measured by ELISA method and immunohisto- chemistry and Western blotting, respectively. Results: Compared with the control group, the serum biochemical indices, MPO activity, and interleukin (IL)-1β, IL-18 levels in SAP group were significantly increased with aggravated pancreatic and lung tissue injuries; meanwhile, the expressions of NLRP3, caspase-1 and GSDMD in lung tissue were significantly up- regulated (all P<0.05). Pretreatment with caspase-1 or GSDMD inhibitors reduced the severity of pancreatic and lung tissue injuries, improved the serum biochemical indices and MPO activity, and ameliorated the increased pyroptosis - related inflammatory cytokines and pyroptosis pathway - related proteins (all P<0.05). Conclusions: NLRP3/caspase - 1/GSDMD pathway mediated pyroptosis plays an important role in acute pancreatitis-related lung injury, and inhibition of pyroptosis pathways might be a new direction for its treatment.

Objective:To explore the application and practice of "flipped classroom" in the teaching of general surgery interns.Methods:A total of 20 internship groups (3 to 5 people in each group) were randomly selected from the general surgery practice group in the Department of General Surgery of the Second Clinical Medical College of North Sichuan Medical College. They were randomly divided into the flipped group (45 people) and the traditional group (40 people), with 10 subgroups in each group. The flipped group adopted the flipped classroom teaching mode (students' self-study by handing out materials before class, students and teachers' discussion in class, and students and teachers' evaluation after class), while the control group adopted the current conventional teaching mode (students' preview before class, teachers' explanation in class, and teachers' question answering after class). At the end of the teaching, a questionnaire was used to evaluate the participation and completion of each student. The teaching effect was evaluated by medical history collection and case analysis. The participation, completion, and teaching effect between the two groups were compared and analyzed. SPSS 23.0 software was used for t-test and Chi-square test. Results:The participation of the flipped group was better than that of the traditional group [(17.45±1.83) vs. (15.57±1.52)], and the difference was statistically significant ( P < 0.05). There was no statistically significant difference between the flipped group and the traditional group. There was no significant difference in medical history collection scores between the two groups. The case analysis of the flipped group was better than that of the traditional group [(87.30±6.06) vs. (81.50±5.88), P < 0.05]. The questionnaire shows that about 90% of the students think that flipped classroom can improve their interest in learning [96% (43/45)], improve their autonomous learning ability [89% (40/45)], and have better learning effect. At the same time, 78% (35/45) of students think that learning time is too long. Conclusion:The flipped classroom teaching model can improve the teaching participation of general surgery students, improve students' interest in learning, improve their self-learning ability, and improve students' thinking ability of medical record analysis.

Acupuncture and Tuina are the main non-drug therapies for low back pain, which are recommended by the guidelines. Acupuncture and Tuina can alleviate pain, which is regarded as conditional specific outcome, and improve mental, emotional problems, as non-conditional specific outcomes. There are some problems of the outcome assessment of acupuncture and Tuina treatment for pain such as insufficient evaluation of specific effect and unclear evaluation of characteristic outcome. Therefore, the key to above problems is to construct a Specific ouTcomE Assessment Modal of acupuncture and Tuina treatment for pain (STEAM-A&T) based on the qualitive and quantitative methods. By describing the experience, narrative expression, feelings and needs of patients who receiving acupuncture and Tuina treatment, the item banks of acupuncture and Tuina treatment effect are constructed, and the characteristic outcome of acupuncture and Tuina for pain will be screened, and then the relationship model among outcomes is constructed and optimized, which reflected the characteristics of acupuncture and Tuina for pain from multiple dimensions, multiple levels and multiple views. We reveal the relationship between the outcome of acupuncture and Tuina for pain. It will provide a new theory and methods for the construction of specific outcome assessment modal of Traditional Chinese Medicine.

Tuina (Chinese massage) is an important part of Traditional Chinese Medicine. It is a simple and inexpensive technique, and has shown effectiveness for muscle and bone diseases, visceral diseases, gynecological diseases, and common diseases in children. This paper aims to analyze the factors influencing the effects of Tuina. The factors included the aspects of diagnosis, treatment, prognosis, patient factors and doctor-patient communication. During the treatment of Tuina, doctors should carry out good doctor-patient communication, properly evaluate and exam patients, and clarify diagnosis, take appropriate Tuina techniques according to the patients' constitution, health condition, and comorbidity. Only in such way, could Tuina achieve effectiveness and safety.

Objective:To explore the type and composition of thalassemia gene variation in children in Ningbo City, and to analyze its correlation with erythrocyte parameters.Methods:From January 2019 to December 2020, 785 children who underwent thalassemia gene testing in Ningbo Women and Children's Hospital were selected as the retrospective research subjects to analyze the type and composition of thalassemia gene variation in local children. A total of 238 thalassemia gene mutation carriers and 100 healthy children (control group) who underwent physical examination during the same period were selected for routine blood test to analyze the correlation between thalassemia gene mutation types and serological indexes.Results:Among the 785 children who underwent thalassemia gene testing, 571 were confirmed as carriers of thalassemia gene mutation, with a detection rate of 72.7%, including 228 cases of α-thalassemia, 337 cases of β-thalassemia, and 6 cases of αβ-complex type thalassemia. It covered 17 variant types and 25 gene combinations. There were significant differences in red blood cell count (RBC), hematokrit (HCT), hemoglobin concentration (Hb), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV) and red blood cell distribution width (RDW) between the control, α-thalassemia and β-thalassemia groups ( H/ F = 125.03, 86.24, 141.06, 192.99, 121.46, 198.63, 178.06, P < 0.001). And there were statistically significant differences in HCT, Hb, MCH, MCV and RDW among the four common genotypes (-- SEA/αα, β IVS-Ⅱ-654/β N, β CD41-42/β N and β CD17/β N) in this test ( F = 5.03, 3.34, 6.24, 10.33, 6.83, P < 0.05). Conclusion:The genotypes of children with thalassemia in Ningbo City are diverse, and the erythrocyte parameters are different among different genotypes.

Aortic aneurysm (AA) is a vascular disease involving the progressive dilation of aorta diameter. It is usually asymptomatic but with high mortality once rupture. Currently, there is no effective pharmacologic treatment. MicroRNA specifically refers to non-coding small RNAs consisting of 19-25 nucleotides. The characteristic of microRNA targeting multiple genes seems to form a complicated regulation network, which receives considerable attention. Emerging studies show that microRNAs are closely related to the occurrence and development of AA. Many microRNAs are involved in multiple cell processes and functions and may participate in the pathogenesis of AA, including endothelial cell dysfunction, inflammatory cell infiltration, smooth muscle cell apoptosis, and extracellular matrix degradation. This article will describe the animal models for AA research and the latest progression of microRNA and AA.

Objective:To observe the motor capacity of patients early after cardiac surgery using a cardiopulmonary exercise test.Methods:Patients who had performed a cardiopulmonary exercise test within 3 months after cardiac surgery were included in this retrospective study. Patients who took the test within 30 days of the operation formed a discharge group ( n=20), those within 30 to 60 days and 60 to 90 days formed the one month and two month groups ( n=10 for both). The discharge group was further divided into an aortic surgery group ( n=9), a bypass surgery group ( n=6) and a valve surgery group ( n=5) according to their procedure. The exercise capacity of each person was measured in terms of the changes in heart rate and systolic pressure from the resting to the anaerobic threshold stage. Anaerobic threshold, peak oxygen uptake and carbon dioxide ventilation equivalent were also recorded. Results:All of the patients completed the cardiopulmonary exercise test above the anaerobic threshold, and no adverse events such as exercise accidents occurred. At the anaerobic threshold the average heart rate of the discharge group was (8.8±7.1)bpm, significantly lower than the averages of the one month and two months groups: (17.0±5.9) and (18.3±10.5)bpm respectively. The average anaerobic thresholds and peak oxygen uptakes of the 1 month and 2 months groups were not significantly different, but they were all significantly higher than the discharge group′s averages. There were, however, no significant differences among the groups in the average changes in their systolic pressure and carbon dioxide ventilation equivalent. Moreover, the average anaerobic threshold and peak oxygen uptake of the aortic surgery group and the bypass surgery group were significantly lower than the valve surgery group′s averages.Conclusions:Postoperative motor ability after cardiac surgery improves significantly for at least 30 days. Patients who have received aortic or bypass surgery have significantly lower exercise capacity than those after valve surgery.