This paper summarizes Professor HAN Mingxiang's clinical experience in treating chronic obstructive pulmonary disease （COPD）. He believes that the key pathomechanism of COPD in the acute exacerbation stage is the invasion of external pathogens triggering latent illness， while lung qi deficiency is the primary mechanism in the stable stage. The core pathological factors throughout disease progression are deficiency， phlegm， and blood stasis. Treatment emphasizes a staged and syndrome-based approach. During the acute exacerbation stage， for wind-cold invading the lung syndrome， the self-formulated Sanzi Wenfei Decoction （三子温肺汤） is used to relieve the exterior， dispel cold， warm the lung， and resolve phlegm. For phlegm-dampness obstructing the lung syndrome， Huatan Jiangqi Fomulation （化痰降气方） is prescribed to warm the lung， transform phlegm， descend qi， and calm wheezing. For phlegm-heat obstructing the lung syndrome， Qingfei Huatan Fomulation （清肺化痰方） is applied to clear heat， resolve phlegm， moisten the lung， and stop coughing. For phlegm and blood stasis interlocking syndrome， Qibai Pingfei Fomulation （芪白平肺方） is used to tonify qi， resolve phlegm， and activate blood circulation to remove stasis. During the stable stage， for lung qi deficiency syndrome， Shenqi Wenfei Decoction （参芪温肺汤） is employed to warm the lung， tonify qi， resolve phlegm， and eliminate turbidity. For lung-spleen qi deficiency syndrome， Shenqi Buzhong Decoction （参芪补中汤） is utilized to strengthen the spleen， tonify qi， and reinforce metal （lung） from earth （spleen）. For lung-kidney deficiency syndrome， Shenqi Tiaoshen Fomulation （参芪调肾方） is prescribed to tonify the lung， warm yang， and regulate kidney function to calm wheezing. These strategies provide insights into the traditional Chinese medicine treatment of COPD.

Objective : To observe the brain tissue injury during hypoxia-ischemia, as well as the pathological changes and the expression of ferroptosis-related factors after the use of Shenfu injection(SFI), and to explore the protective effect of SFI on hypoxic-ischemic brain injury(HIBD) by inhibiting ferroptosis. Methods : An animal model of HIBD in SD rats was constructed and intervened with SFI. Pathologic changes in brain tissue were observed by HE staining methods. Nissen staining was used to observe neuron survival. Glutathione Peroxidase 4(GPX4) and Divalent Metal Transporter 1(DMT1) expression were detected in brain tissue by Western blot, immunohistochemistry and immunofluorescence. Reduced Glutathione(GSH), Lactate Dehydrogenase(LDH), Malondialdehyde(MDA), Superoxide Dismutase(SOD) and tissue iron content were determined with the kits. BV-2 microglial cell line(BV2) cells were culturedin vitroand divided into control group(Ctrl group), oxygen-glucose deprivation group(OGD group), iron ferroptosis-inducing group(Erastin group), iron ferroptosis-inhibiting group(Fer-1 group), Shenfu injection group(SFI group), and Erastin+Shenfu injection group(Erastin+SFI group). 2′,7′-Dichlorodihydrofluorescein diacetate(DCFH-DA) reactive oxygen species(ROS) fluorescent probe was used to detect the ROS release level; Immunofluorescence was used to observe intracellular GPX4, DMT1 expression. Results : Compared with the Sham group, rats in the HIBD group showed significant neuronal cell damage in brain tissue, decreased GPX4 expression(P<0.01), increased DMT1 expression(P<0.01), decreased GSH and SOD levels(P<0.01), and increased LDH, MDA and tissue iron levels(P<0.05,P<0.05,P<0.01). In contrast, after the intervention of SFI, GPX4 expression was elevated(P<0.01), DMT1 expression decreased(P<0.01), GSH and SOD levels were elevated(P<0.01), and LDH, MDA, and tissue iron levels decreased(P<0.05,P<0.05,P<0.01). The cells experiments showed that compared with the Ctrl group, the OGD group had a significantly higher ROS content and a decrease in the expression of GPX4 fluorescence intensity, and an increase in the fluorescence intensity of DMT1(P<0.01), compared with the OGD group, the ROS content was reduced in the SFI group, while the expression of GPX4 was elevated and the expression of DMT1 was reduced(P<0.01). Conclusion Hippocampal and cortical regions are severely damaged after HIBD in neonatal rats, and their brain tissues show decreased expression of GPX4 and increased expression of DMT1. The above suggests that ferroptosis is involved in HIBD brain injury in neonatal rats. In contrast, Shenfu injection has a protective effect on HIBD experimental animal model and BV2 cell injury model by reducing iron aggregation and ROS production.

Objective To investigate the effectiveness of real-time tracking and virtual reality technology(RTVI)used to assist the intraoperative alignment of the trauma orthopaedic surgery robot for the treatment of femoral neck fractures and its impact on the treatment outcome.Methods A retrospective analysis was conducted on 60 patients with femoral neck fractures treated with trauma orthopedic robotic surgery from September 2020 to September 2022.Patients were divided into two groups according to whether RTVI technology was used during surgery to assist robotic surgery.There were 28 patients in the RTVI group(12 males and 16 females),with an average age of(46.2±9.3)years old ranging from 28 to 60 years old.There were 32 patients in the simple Tianji surgical robot group,including 15 males and 17 females,aged(48.2±7.8)years old ranging from 32 to 58.The number of registered fluoroscopy,operation time,total number of intraoperative fluoroscopy,intraoperative blood loss,and hospitalization time of the two groups of patients were observed and recorded.All patients received regular follow-up after surgery,and hip X-rays were routinely reviewed to record Garden alignment index,fracture healing time,postoperative complications,and Harris score.Results All 60 patients were followed up.The RTVI group was followed up for 9 to 16 months with an average of(13.0±l.2)months,and the Tianji surgical robot group alone was followed up for 10 to 14 months with an average of(12.0±1.3)months.During the follow-up period,the femoral neck fractures of both groups of patients healed well,and no complications such as internal fixation loosening and incision infection occurred.The number of registered fluoroscopy,operation time,and number of intraoperative fluoroscopy of patients in the RTVI group were significantly better than those in the simple Tianji surgical robot group(P＜0.01).There was no statistically significant difference in intraoperative blood loss,hospital stay,Garden alignment index,fracture healing time,and hip Harris score between two groups(P＞0.05).Conclusion Although RTVI technology assisted by the surgical robot for femoral neck fracture surgery has little impact on its postoperative outcome,it can effectively reduce the operating time,the number of intraoperative X-ray projections,and the risk of intraopera-tive radiation exposure to patients.It also shortened the learning curve of the operator and better reflected the precision and ef-ficiency of the trauma orthopaedic surgery robot.

Objective:To investigate the role of cardiopulmonary combined diaphragm ultrasound in predicting the weaning from mechanical ventilation in patients of total anomalous pulmonary venous connection after cardiac surgery in children.Methods:105 patients with TAPVC after cardiac surgery were included and admitted to Beijing Anzhen Hospital from January 2020 to September 2023, and median age was 6 months, including 61 males and 44 females. Echocardiography was routinely performed before surgery, clinical indicators such as age, weight, sex, cardiopulmonary bypass, activated coagulation time were recorded at the same time. And bedside cardiopulmonary combined diaphragm ultrasound was performed after the patient successfully passed the spontaneous breathing test. Ultrasound measurements include atrial septal defect diameter, left ventricular end-diastolic diameter, left ventricular ejection fraction, right ventricular area change fraction, tricuspid annular plane systolic excursion, pulmonary venous diameter, pulmonary ultrasound score, and diaphragm thickening fraction, According to whether the offline was successful, patients were divided into two groups: successful extubation group (78 cases) and extubation failure group (27 cases). The t-test was used for mean comparison. The Mann- Whitney U test was used for median comparison. Pearson χ2 test was used for counting data. Univariate analysis was used to determine the parameters with significant statistical differences in predicted weaning failure, and multivariate logistic regression analysis was included to find independent prediction parameters. The statistical parameters between the two groups were used to draw the receiver operating characteristic curves, and then the ROC curves were comprehensively plotted by the combining indexes. Results:The age, weight, left ventricular diastolic diameter, and atrial septal defect diameter of the the failure group were smaller than those in the weaning group, and the differences were statistically significant ( P<0.05). There were statistically significant differences in cardiopulmonary bypass and activated coagulation time in the weaning failure group ( P<0.05). There were no significant differences in gender and preoperative pulmonary venous flow velocity between the two groups ( P>0.05). Multivariate logistic regression analysis showed that postoperative left ventricular ejection fraction, pulmonary venous flow velocity, and pulmonary ultrasound score diaphragm thickening fraction were significantly correlated with weaning failure ( P<0.05), area under the ROC curve( AUC) were 0.736, 0.761, 0.868 and 0.829( P<0.05), and the optimal cut-off values were 0.50, 160 cm/s, 14 scores and 27% respectively. The AUC of cardiopulmonary combined diaphragm with ultrasound index for predicting weaning failure was 0.966, the sensitivity was 96.3%, and the specificity was 89.9%, which was significantly higher than that of other ultrasound indicators. Conclusion:Bedside cardiopulmonary combined diaphragm ultrasound has important clinical value in predicting ventilator evacuation of patients after total anomalous pulmonary venous connection, and its accuracy is higher than that of single-organ ultrasound.

Objective To compare the effects of using three different filling appliances,CompothixoTM resin filler,conventional resin filler,and SonicFill sonic handpiece,on marginal microleakage after auxiliary resin filling of class Ⅱ cavities.Methods A total of 40 permanent molars extracted from the Department of Stomatology,Affiliated Hospital of Shandong Second Medical University(Weifang Medical University Affiliated Hospital)from October 2020 to February 2021 were collected and randomly divided into four groups:A,B,C,and D.Standard class Ⅱ cavities were prepared in the proximal and distal middle of the isolated teeth,filled according to the standard filling requirements of the instruments in each grouping,dissected after temperature cycling and methylene blue staining,and the dye penetration depths of the dental tissues and restorative axial and gingival walls were observed and graded under the body-view microscope to calculate the microleakage degree scores.Results Microleakage occurred in four groups,and tested by the Mann-Whitney U test,the microleakage scores of group A was higher than those of the other three groups(P<0.05);There was no statistically significant difference between groups B and C(P>0.05);The scores of groups B and C were higher than those of group D(P<0.05).Group A had higher microleakage scores than group D(P<0.05),and there was no statistically significant difference between the remaining groups(P>0.05).Conclusion The use of the CompothixoTM resin filler is beneficial in reducing microleakage between the resin and the tooth tissue when compared to conventional filling appliances;Compare with the SonicFill handpiece,the use of the CompothixoTM resin filler is not conducive to the reduction of microleakage between the SonicFill ultrasonic resin and the tooth tissue.

Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

Objective:To establish an automatic potentiometric method for determination of fluoride in urine.Methods:The fluorine level in human urine was determined by an automatic potentiometric titrator. Methodological experimental analysis of the linear range, detection limit, precision, and accuracy (quality control sample testing and actual sample spiking recovery experiment) of the method were carried out. The determination results of 33 urine samples were compared with those of the national health industry standard Determination of Fluoride in Urine - Ion Selective Electrode Method (WS/T 89-2015).Results:The linear range of the standard curve of urine fluoride in the automatic potentiometric determination method was 0.1 - 10.0 mg/L. The range of linear correlation coefficient ( r) was 0.999 6 to 0.999 9. The minimum detection limit of urine fluoride was 0.01 mg/L (sampling volume was 10.0 ml). The relative standard deviation ( RSD) range for precision experiments was 0.00% to 3.45%. The quality control samples of the national urine fluoride external quality control assessment in 2022 were determined, and the results were within the range of the consensus value. The spiked recovery experiment was carried out, the recovery rate ranged from 100.0% to 104.4%, with a total average recovery rate of 102.1%. The method comparison experiment showed that there was no statistically significant difference between the test results of automatic potentiometric method and the standard method recommended by the national urine fluoride health industry ( t = - 0.90, P = 0.375). Conclusions:A method has been successfully established, achieving automation of the reagent addition and detection process of urine fluoride samples after sampling. It has the characteristics of wide linear range, low detection limit, good precision, and high accuracy, and is suitable for rapid and automatic determination fluoride level of large quantities of urine samples.

Objective:To establish a new method for antimony cerium catalytic spectrophotometric detection (referred to as the new method) of urinary iodine.Methods:By utilizing the efficient catalytic ability of iodine for the oxidation-reduction reaction of antimony and cerium, a new method was applied to conduct linear relationship fitting curve, detection limit, pecision, accuracy and other experiments within the range of 0 - 300 μg/L urine iodine mass concentration. The method was compared with the Arsenic Cerium Catalytic Spectrometric Method (WS/T 107.1-2016) recommended national industry standard.Results:In the range of 0 - 300 μg/L urine iodine mass concentration, the correlation coefficients│ r│ of the fitted curves were > 0.999 0, and the qualitative detection limit was 7.96 μg/L (with a sampling volume of 0.25 ml). Four actual urine samples with different iodine mass concentrations were selected for precision experiments, and the relative standard deviation ( RSD) of the detection precision ranged from 0.96% to 2.87%, all < 5%. The actual urine sample spiked recovery range from 99.62% to 103.88%, with an overall average recovery rate of 101.75%. Two methods were used to detect 30 urine samples, and the difference in results was not statistically significant ( t = 0.68, P = 0.501). Conclusions:The new method has high reaction sensitivity and accuracy, avoiding the use of highly toxic substance arsenic trioxide. The antimony reagent used is safe, and the environmental pollution caused by waste liquid discharge is small. The detection steps are similar to Arsenic Cerium Catalytic Spectrometric Method, the laboratory urine iodine detection personnel do not need special training to operate and use it, which is suitable for the application and promotion of urine iodine detection in grassroots iodine deficiency disorders monitoring work.

Objective To study the correlation between traditional Chinese medicine(TCM)constitution and pathogenic factors in patients with ankylosing spondylitis(AS).Methods One hundred patients of AS and their family members who had medical consultation in the Fifth Hospital of Xi'an(i.e.,Shaanxi Hospital of Integrated Traditional Chinese and Western Medicine)in August 2019 and September 2020 were selected as the study subjects.The guidelines of Classification and Determination of Traditional Chinese Medicine Constitution issued by the China Association of Chinese Medicine were adopted to determine the traditional Chinese medicine(TCM)constitution types of the study subjects.The sociodemographic information,living habits,clinical symptoms,and TCM constitution types of the AS patients and their family members were collected by means of questionnaires and clinical investigations,and then the pathogenic factors of the patients with AS were investigated.The binomial Logistic regression model was used to analyze the correlation between TCM constitution types and pathogenic factors in patients with AS.Results(1)Among the 100 AS patients,the majority of them had the biased constitutions,and the biased constitutions with the occurrence frequency in descending order were yang deficiency constitution,qi deficiency constitution,and damp-heat constitution,which accounted for 33.00%,14.00%,and 18.00%,respectively.(2)The prevalence rates of AS in the first-,second-,and third-degree relatives of AS patients were 56.25%,40.00%and 25.00%,respectively.For the positive rates of human leukocyte antigen B27(HLA-B27)in AS patients and their family members,HLA-B27 in AS patients was all positive,while the positive rates of HLA-B27 in the first-,second-,and third-degree relatives of AS patients were 44.31%,30.67%and 15.63%,respectively.(3)The results of regression analysis showed that the disease duration of AS patients was significantly correlated with qi deficiency constitution,the grading of sacroiliac arthritis was correlated with qi stagnation constitution,and age was correlated with blood stasis constitution(P＜0.05 or P＜0.01).The results indicated that disease duration and age were the important factors affecting the constitution types of AS patients,and disease duration was closely related to qi deficiency while age was closely related to blood stasis.Conclusion AS is a highly hereditary autoimmune disease,and its onset is associated with HLA-B27.Yang deficiency is the basic constitution type of AS,and damp-heat constitution is the main constitution type in the progression of AS(especially in the active stage of the disease).The prolongation of the disease will exacerbate the illness condition of AS and then the manifestations of qi deficiency will be more obvious.

The structure and working principle of the multi-leaf collimator(MLC)optical system of Elekta linear accelerator were introduced.The causes for the faults of the MLC optical system were analyzed,and the fault repair and maintenance of the MLC optical system were summarized.References were provided for medical engineers to repair and maintain the MLC optical system.[Chinese Medical Equipment Journal,2024,45(1):76-83]