BACKGROUND: The clinical impact of post-percutaneous coronary intervention (PCI) quantitative flow ratio (QFR) in patients treated with PCI for chronic total occlusion (CTO) was still undetermined. METHODS: All CTO vessels treated with successful anatomical PCI in patients from PANDA III trial were retrospectively measured for post-PCI QFR. The primary outcome was 2-year vessel-oriented composite endpoints (VOCEs, composite of target vessel-related cardiac death, target vessel-related myocardial infarction, and ischemia-driven target vessel revascularization). Receiver operator characteristic curve analysis was conducted to identify optimal cutoff value of post-PCI QFR for predicting the 2-year VOCEs, and all vessels were stratified by this optimal cutoff value. Cox proportional hazards models were employed to calculate the hazard ratio (HR) with 95% CI. RESULTS: Among 428 CTO vessels treated with PCI, 353 vessels (82.5%) were analyzable for post-PCI QFR. 31 VOCEs (8.7%) occurred at 2 years. Mean value of post-PCI QFR was 0.92 ± 0.13. Receiver operator characteristic curve analysis shown the optimal cutoff value of post-PCI QFR for predicting 2-year VOCEs was 0.91. The incidence of 2-year VOCEs in the vessel with post-PCI QFR < 0.91 (n = 91) was significantly higher compared with the vessels with post-PCI QFR ≥ 0.91 (n = 262) (22.0% vs. 4.2%, HR = 4.98, 95% CI: 2.32-10.70). CONCLUSIONS Higher post-PCI QFR values were associated with improved prognosis in the PCI practice for coronary CTO. Achieving functionally optimal PCI results (post-PCI QFR value ≥ 0.91) tends to get better prognosis for patients with CTO lesions.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Spine fracture and dislocation are common traumatic spinal conditions that often require surgical intervention due to compromised spinal stability. Surgical approaches include anterior, posterior, and combined anterior-posterior spinal procedures. According to the specific surgical requirements, patients may be placed in the prone position or repositioned between prone and supine positions during surgery. Intraoperative repositioning has become an essential step in patient positioning. However, during repositioning, patients with spinal fracture and dislocation are at increased risk for complications such as hemodynamic instability, nerve injury, and pressure injuries to the skin and soft tissue. Notably, due to the instability of the spinal cord, even minor manipulations can further exacerbate the damage, potentially leading to severe outcomes like paraplegia. Although the current clinical guidelines provide instructive recommendations for standard position, there remains no specific protocols for intraoperative repositioning in patients with spine fracture and dislocation. With a concern for the lack of clinical studies on positioning techniques, risk prevention, and operational norms for special patients, no applicable guidelines or standards are available. A consensus was required to provide clinical reference, meet the requirements of surgical treatment, and minimize the safety risks of patients caused by improper placement of positions. Professional Committee of Operating Room Nursing of Shaanxi Nursing Association organized experts in nursing management and operating room nursing from major hospitals across China to formulate Expert consensus on intraoperative repositioning for patients with spinal fracture and dislocation ( version 2025). The consensus provides 11 recommendations covering pre-repositioning preparation, intraoperative maneuvers, and post-repositioning observation, aiming to provide references for clinical standardization of the intraoperative repositioning process and protection of patients′ safety.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To study the effect of Sinisan on the ultra structure of hippo-campus to the intervention in rats with post-traumatic stress disorder(PTSD).Methods SD rats were divided equally into 5 groups,each group had ten rats:blank control group,model group,negative control group,positive control group and experimental group.The blank control group did not copy the model,the normal feeding.Model group,repetitive post-traumatic stress disorder model was induced by current stimulation,but not treated.Negative control group,equal volume of 0.9％ NaC1.Positive control group (paroxetine hydrochloride 0.42 mg · mL-1) and experimentalgroup (Sinisan,containing crude drug 0.24 g · mL-1).It given to drugs 1 h before the model establishment.The rats were administered with 10 mL · kg-1,once a day,for a total of 7 d.In each group,rats was cardiac perfusion and the hippo-campus tissue was collected.The changes of ultra structure of CA1 and CA3 area in hippo-campus with rats were observed by transmission electron microscope.Results In the blank control group,the CA1 and CA3 neurons in the hippocampus were rich in cytoplasmic organelles,and the mitochondria were round or long,the structure of the mitochondrial cristae was clear,the rough endoplasmic reticulum was like a cord like distribution,and the ribosome was abundant.Compared with the blank control group,the organelle of CA1 and CA3 area in hippo-campus of the model group were significantly damaged,the cytoplasm was open,the mitochondria were swollen,the mitochondrial membrane and cristae disappeared,and the rough endoplasmic reticulum was dilated.The results showed that the damage of the organelles in the hippocampal neurons of rats was induced by the electric shock.The model group was similar to the negative control group,which indicated that there was no significant effect on the stress of rats after intragastric administration.The intracellular organelles in the CA1 and CA3 neurons in the hippocampus of the positive control group and the experimental group were significantly recovered,and the changes in the two groups were similar.These results suggest that both paroxetine hydrochloride and Sinisan can significantly improve the structure of CA1 and CA3 neurons in the hippocampus of PTSD rats.Conclusion Snisan as traditional Chinese medicine compound can significantly improve the hippocampus of rats with PTSD CA1 and CA3 neurons.

Objective To study on intervene function of Sinisan with the ultra structure of hippo-campus in rats with sleep disorder induced by post traumatic stress disorder.Methods Fifty SD rats were divided equally into five groups:blank control group,model group,negative control group,positive control group and experimental group.The control blank group did not copy the model,do not receive drugs,the normal feeding.Model group,repetitive post-traumatic stress disorder model was induced by current stimulation,but not receive drugs.Negative control group,equal volume of 0.9％ NaCl.Positive control group (paroxetine hydrochloride 0.42 mg ·mL-1) and experimental group (Sinisan,containing crude drug 0.24 g · mL-1).It given to drugs 1 h before the model establishment.The rats were administered with 10 mL · kg-1,once a day,for a total of 7 d.The changes of ultra structure of CA1 and CA3 area in hippo-campus with rats were observed by transmission electronmicroscope.Results In the blank control group,the hippocampal neurons were clearly defined,and the synaptic space was obvious in the CA1 and CA3 area.Compared with the blank control group,in the model group,the synaptic structure of hippocampal neurons was significantly changed,the synaptic vesicles were reduced and the synaptic structure was not clear in the CA1 and CA3 area.Compared with the model group,the negative control group was same too,which indicated that there was no significant stress effect on the rats after intragastric administration of saline.Compared with the negative control group,positive control group and experimental group hippocampal neurons synapse structure was restored,and the two groups were similar in the CA1 and CA3 area.Conclusion Transmission electronmicroscope was used to study the ultra structure of CA1 and CA3 in rats hippo-campus with characteristic difference.

Objective To study the influence of Sinisan on hippocampal CA1 and CA3 neuron spatiotemporal characteristics in rats with post-traumatic stress disorder(PTSD).Methods SD rats were divided into five groups:normal group,blank group,model group,control group,experimental group.Except for normal group and blank group,the rats in other groups were stimulated by the current stimulation plus dark claustrophobic method to replicate the posttraumatic stress disorder (PTSD) model.The blank group and model group were given 0.9％ NaCl 10 mL · kg-1 at 1 h before making the model.The control group and experimental group was given paroxetine hydrochloride 0.42 mg · mL-1 and Sinisan(containing crude drug 0.24 g · mL-1) by intragastric administration,respectively.The model replicated 7 d,and each electric shock was 30 min every morning and afternoon.The neural coding on amplitude in hippocampal CA1 and CA3 were detected by the M-NEMEA after administration,and the spectral density spectrum was obtained from Neuro explorer neural data analysis software.Results The power spectral densities of CA1 and CA3 in hippocampus of rats were determined,they were (-109.08 ± 15.41) and (-108.46 ± 13.16)dB in normal group,(-110.17 ± 14.30)and (-109.54 ± 14.16)dB in blank group,and the differences were not statistically significant (all P ＞ 0.05).Compared with the blank group,the power spectral densities of hippocampus in the model group decreased significantly,which were (-117.39 ± 14.97),(-122.51 ± 16.42) dB,and the differences were statistically significant (all P ＜0.01).Compared with the model group,the power spectral densities of the experimental group in hippocampus were significantly higher (P＜0.01),which were (-110.83 ±11.40),(-110.36 ±10.87)dB.Conclusion The Sinisanhas significant positive effect on hippocampal neuron signal intensity.

Objective To study the effects of sleep latency to the intervention of Sinisan in rats with post-traumatic stress and sleep disorder (PTSD).Methods Fifty SD rats were divided equally into 5 groups:sham operation group,model group,negative control group group,positive control group and experimental group.PTSD model was made by claustrophobia,but not in sham operation group.The model group was not given the drug,the negative control group was given equal volume 0.9％ NaC1,and the positive control group was given paroxetine hydrochloride 0.42 mg · mL-1.The experimental group was perfused with the decoction of Sinisan (containing 0.24 g · mL-1) 10 mL · kg-1.The drug was administered 1 h before the stress model was administered once a day for a total of 7 d.After intervention on the 7th day,nonrapid eye movements sleep (NREMS) and eye movements sleep (REMS) were detected.Results The REMS and NREMS of sham operation group and model group were respectively (8.66 ± 3.04),(23.27 t 10.15) min;(65.90 ± 25.08),(109.36 ± 43.43) min,the differences between groups were statistically significant(all P ＜ 0.01);the result suggest that difficulty in falling asleep appears in rats after modeling.The REMS and NREMS of the positive control group and the experimental group were respectively (8.17 ±2.29),(6.83 ±2.84) min;(162.29 ±46.19),(195.24 ±67.96) min.Comparison between the drugs groups and model group,the difference was statistically significant (P ＜0.05,P ＜0.01).These Results suggested that both paroxetine hydrochloride and Sinisan can significantly promote the sleep of rats.Conclusion Traditional Chinese medicine compound Sinisan can obviously promote the rats with sleep disorder caused by PTSD.

Objective To study the function mechanism of the Sinisan on hippocampal neuron discharge amplitude in rats with post-traumatic stress disorder and sleep disorder.Methods Fifty SD rats were divided into blank group,model group,negative control group,positive control group and experimental group.The blank group did not copy the model,did not receive treatment,the normal feeding.The repetitive post-traumatic stress disorder model was induced by current stimulation in model group,but not treated.Negative control group was given equal volume of 0.9％ NaC1.Positive control group was given paroxetine hydrochloride 0.42 mg · mL-1 and experimental group was given Sinisan,containing crude drug 0.24 g · mL-1.The rats were administered with 10 mL · kg-1,once a day,for 7 d.Theneural coding on amplitude in hippocampal CA1/CA3 were detected by M-NEMEA after the treatment.Results The amplitude of the wave amplitude in model group were 63.73 ± 5.80,63.24 ± 6.29,significantly lower than those of negative control group,which were 90.95 ± 5.94,91.16 ± 8.18 (P ＜ 0.01).And the wave amplitude in positive control group were 87.12 ± 8.14,87.21 ± 7.94,and were 91.63 ± 7.30,91.39 ± 7.64 in experimental group,had significant difference with those in model group (P ＜ 0.01).Conclusion The Sinisan have significant positive effect on hippocampal neuron discharge amplitude.

The review aims to assess the effectiveness and safety Pudilan Xiaoyan oral liquid in treating pediatric suppurative tonsillitis systematically through searching relevant electronic database and collecting relevant literature. Meta-analysis was performed with the RevMan 5.3 software. Eighteen RCTs of 1 883 patients of pediatric suppurative tonsillitis were included. Meta-analysis showed that： compared with the application of antibiotics alone, combined with Pudilan can effectively improve the treatment of pediatric suppurative tonsillitis in efficacy rate and shorten the time of recovering normal temperature, the time of tonsil purulent discharge and can also reduce the extinction time of sore throat, antiadoncus or congestion subsided and appetite recovery. There was no severe adverse reaction during the treatment. Compared with the application of antibiotics alone, combined with Pudilan may be more effective and safe in the treatment of pediatric suppurative tonsillitis, which can not be strongly proved at present for lack of studies with high quality.