The prescription of Qidong Yixin oral liquid is derived from the experience of national medical master Ren Jixue in treating viral myocarditis （VMC）. It has the functions of tonifying Qi， nourishing the heart，calming the mind， and relieving palpitations. It is used to treat VMC and angina pectoris of coronary heart disease caused by deficiency of both Qi and Yin. However，the understanding of its efficacy evidence， advantageous aspects， dosage and administration， and medication safety remains insufficient in clinical practice. Therefore，the development of the Expert Consensus on the Clinical Application of Qidong Yixin Oral Liquid （hereinafter referred to as consensus） was initiated. Consensus strictly followed the process and methods of the expert consensus on the clinical application of Chinese patent medicines of the China Association of Chinese Medicine，successively completing multiple tasks such as the consensus project initiation，determination of clinical problems，evidence search and evaluation，formation of recommendation opinions and consensus suggestions，solicitation of opinions，peer review， submission for review and release， and so on. Consensus formed a total of 10 recommendation opinions and 12 consensus suggestions，clarifying the clinical positioning，efficacy advantages，syndrome differentiation，dosage and administration，combination therapy，timing of medication，adverse reactions，contraindications， and precautions of Qidong Yixin oral liquid，indicating that it has good clinical advantages and safety in the treatment of VMC and angina pectoris of coronary heart disease，providing norms and references for physicians to safely and rationally apply Qidong Yixin oral liquid. Consensus was reviewed and approved for release by the Standardization Office of the China Association of Chinese Medicine on December 23， 2024. Standard number：GSCACM-376-2024.

To investigate the clinical application value of indocyanine green(ICG) fluorescence-guided thoracoscopic lung lesion resection under the diagnosis related group(DRG) payment system, and to provide reference for the management of new medical technologies in healthcare institutions.

OBJECTIVE To provide references for medical institutions’ outpatient pharmacies to increase the scanning rate， scanning efficiency and scanning accuracy of drug traceability codes.METHODS A total of 4 157 unscanned traceability code records from the first two‑week period of June 2025 were selected from the outpatient pharmacy of our hospital. Pareto chart was adopted to analyze the reasons for unscanned codes， and the Objective-Rules-Training-Check-Culture （ORTCC） model was utilized to carry out fine management. The traceability code scanning rate， pharmacists’ work efficiency （number of prescriptions dispensed per pharmacist per hour， number of drug boxes dispensed per pharmacist per hour）， patients’ medication-waiting time and dispensing errors were compared among four periods： before scanning implementation （June 2024）， before management intervention （June 2025）， the first phase after management （September 2025）， and the second phase after management （December 2025）， so as to evaluate the management effects.RESULTS The traceability code scanning rates in the first phase and second phase after management were remarkably higher than those before management （ P ＜0.05）， and the scanning rate in the second phase after management was obviously higher than that in the first phase after management （ P ＜0.05）. Compared with the period before scanning implementation， the number of prescriptions dispensed per pharmacist per hour， the number of drug boxes dispensed per pharmacist per hour， decreased significantly and patients’ medication-waiting time prolonged markedly before management （ P ＜0.05）. In the second phase after management， both the number of prescriptions dispensed per pharmacist per hour and the number of drug boxes dispensed per pharmacist per hour increased significantly， and patients’ medication-waiting time shortened greatly in contrast with the status before management （ P ＜0.05）. Besides， no statistically significant differences were found in the number of drug boxes dispensed per pharmacist per hour and patients’ medication-waiting time between the second phase after management and the period before scanning implementation （ P ＞0.05）.After the implementation of traceability-code scanning management， dispensing errors presented a gradually declining trend in each stage.CONCLUSIONS The fine management system for outpatient drug traceability codes constructed based on Pareto chart and ORTCC model can improve the traceability code scanning rate and pharmacists’ work efficiency of outpatient pharmacies， and reduce drug dispensing errors.

Objective:To explore the relationship and underlying mechanisms between servant leadership and satisfaction of medical staff in tertiary hospitals, and to provide references for improving satisfaction of medical personnel.Methods:From January to June 2023, a questionnaire survey was conducted among on-duty medical staff at a tertiary hospital in Guangzhou using a simple random sampling method. Data corresponding to four key variables: servant leadership, hospital management level, affective commitment, and satisfaction of medical staff were collected. SPSS 25.0 software was used to perform independent samples t-tests and one-way analysis of variance (ANOVA) to examine group differences, and Pearson correlation analysis was conducted to explore the relationships among multiple variables. Amos 24.0 software was employed to construct a structural equation model to conduct confirmatory factor analysis of the four key variables, analyze potential mediating effects, and use multi-group analysis to examine differences in path parameters and structure among groups. Results:A total of 632 valid questionnaires were obtained. The satisfaction score of medical staff was (4.50±0.66)(maximum score was 5 points). Age, years of work experience, and job category had statistically significant effects on satisfaction of medical staff ( F = 5.799, 6.483, 7.671; P = 0.001). All four key variables were significantly positively correlated ( P<0.001). Servant leadership, hospital management level, and affective commitment all had direct positive effects on satisfaction of medical staff, with path coefficients of 0.207, 0.386, and 0.345, respectively ( P <0.05, critical ratio>1.96). Hospital management level and affective commitment each had independent partial mediating effects between servant leadership and satisfaction of medical staff (path coefficients of 0.353 and 0.067, respectively; P = 0.007, 0.018). They also jointly exerted a chain mediating effect (path coefficient of 0.243, P = 0.013). Differences in path effects among different job categories (clinical doctors, nurses, and administrative support staff) were statistically significant ( χ2 = 43.344, df = 24, P = 0.009). Conclusions:The servant leadership in tertiary hospitals can directly influence the satisfaction of medical staff, as well as indirectly influence it through emotional commitment and hospital management level. Moreover, the mechanisms of influence vary among medical staff of different professional categories. Tertiary hospitals should introduce and promote servant leadership styles, enhance the servant leadership behaviors of management personnel, and strengthen the synergistic effects of servant leadership, hospital management level, and affective commitment. Differential adjustment mechanisms should be implemented for different job categories.

Objective To investigate the current nursing practice of nurses specializing in nutritional support in ICUs and analyze their influencing factors in order to improve the training program and promote the development of standardized and precise nursing practice.Methods Convenience sampling method was used to select nutritional support nurses in ICUs in 29 provinces(autonomous regions and municipalities)from October 2023 to March 2025,and the self-developed questionnaire on nursing practice behaviors of nutritional support nurses in ICUs was used to conduct the survey.SPSS 21.0 software was used for descriptive analysis and multiple linear regression analysis.Results A total of 774 questionnaires were distributed,and 766 valid questionnaires were collected,with a recovery rate of 98.97％,and the score of the questionnaire on nursing practice behaviors of nurses specializing in nutritional support in ICU was(90.41±1 1.82).The results of multiple linear regression analysis showed that gender,presence of a nutritional support nursing team in the hospital,a standardized process of nutritional support nursing in the department,clear positional responsibilities of the nutritional support nursing team members,and inclusion of the nutritional support status of the patients in the quality management of the department were the factors influencing the nursing practice behavior scores of the nurses specializing in nutritional support in ICUs(P＜0.05).Conclusion Nurses in the ICUs have a high level of nursing practice behavior,but there is a need for further standardization in parenteral nutrition infusion and monitoring of complications.ICU nursing managers should formulate improvement strategies to address the weaknesses of clinical practice,strengthen nutritional support training,and improve the quality management program,and further improve the practical ability of nurses specializing in nutritional support.

Objective:To evaluate the effect of 5th generation mobile communication technology(5G) remote robot-assisted cholecystectomy on postoperative recovery and quality of life in patients with gallstones.Methods:Clinical data of patients who underwent 5G remote robotic cholecystectomy(20 cases) vs traditional robotic cholecystectomy(20 cases) at Gansu Provincial People's Hospital from May to September 2023 were retrospectively analyzed. Intraoperative and postoperative related indexes were compared between the two groups, and changes in pain analog scores before, 12 hours, and 24 hours after surgery, and global quality of life (GIQLI) scores before and 3 months after surgery were evaluated.Results:There was no significant difference between the two groups in terms of intraoperative and postoperative conditions (intraoperative blood loss, operative time, time to exhaustion, and length of hospital stay). Patients' pain analog scores at 12 and 24 hours postoperatively were lower than preoperatively, but the differences were not statistically significant( P>0.05). In addition, there was no significant difference in recovery indicators between the two groups compared to the control group ( P>0.05). Conclusion:The postoperative recovery metrics of 5G tele-robotic-assisted cholecystectomy were consistent with the results of conventional robotic surgery.

OBJECTIVE: To compare the effectiveness and shoulder function of reverse total shoulder arthroplasty (RTSA) and open reduction and internal fixation (ORIF) in the treatment of Neer three/four-part proximal humeral fractures in the elderly. METHODS: Randomized controlled analysis was conducted on 68 patients over 70 years old with Neer three/four-part proximal humeral fractures treated with RTSA or ORIF between January 2020 and June 2022. The patients were randomly divided into RTSA group ( n=32) and ORIF group ( n=36). There was no significant difference ( P>0.05) in the baseline data such as age, gender, body mass index, injured side, Neer classification, and preoperative Charlson comorbidity index, visual analogue scale (VAS) score, Constant shoulder score, Oxford shoulder score (OSS), and hemoglobin (Hb). The operation time, intraoperative blood loss, reduction of Hb on the 3rd day after operation, hospital stay, total cost of hospitalization, complication incidence, range of motion of shoulder joint at 2 years after operation, VAS score before operation and at 5 days and 1 month after operation, Constant shoulder score and OSS score before operation and at 2 years after operation, and imaging results during follow-up were recorded and compared between the two groups. RESULTS: Compared with the ORIF group, the RTSA group had longer operation time, less intraoperative blood loss, and higher total cost of hospitalization ( P<0.05). There was no significant difference in Hb reduction on the 3rd day after operation between the two groups ( P>0.05). The VAS scores significantly improved in both groups at 5 days and 1 month after operation ( P<0.05), but there was no significant difference between the two groups ( P>0.05). All patients were followed up 26-35 months, with an average of 31.2 months. In the RTSA group, there were 2 cases of poor healing of superficial incision and 1 case of transient nerve injury. There was no complication such as bone resorption around the prosthesis, lucent band, prosthesis loosening, or periprosthetic fracture in all patients. In the ORIF group, there was 1 case of poor healing of superficial incision, 3 cases of nonunion of fracture, 1 case of arthritis secondary to humeral head necrosis, and 1 case of bone absorption of large tuberosity, and no displacement or fracture failure of internal fixation was found in all patients. There was no significant difference in the incidence of complications [9.4% (3/32) vs 16.7% (6/36)] between the two groups [ OR (95% CI): 0.828 (0.171, 4.014), P=0.814]. In the RTSA group, 28 cases were graded 0 and 4 cases were graded 1 at 2 years after operation. Constant and OSS scores of RTSA group were significantly better than those of ORIF group ( P<0.05). The Constant score was significantly better than ORIF group in activity and strength, range of motion, lifting, abduction, and external rotation ( P<0.05), and there was no significant difference in pain, daily function, and internal rotation between the two groups ( P>0.05). The RTSA group had a significantly greater range of motion in lifting, abduction, and external rotation than ORIF group ( P<0.05), but there was no significant difference in internal rotation between the two groups ( P>0.05). CONCLUSION Application of RTSA as the initial treatment of Neer three/four-part proximal humeral fractures in the elderly can achieve better rehabilitation of joint activity and lower risk of early reoperation, and improve the quality of life of elderly fracture patients. However, the difficulty of revision and the high cost of treatment require the surgeon to pay full attention and strictly grasp the indications.
Humans ; Fracture Fixation, Internal/instrumentation* ; Male ; Female ; Shoulder Fractures/surgery* ; Arthroplasty, Replacement, Shoulder/methods* ; Aged ; Bone Plates ; Open Fracture Reduction/methods* ; Range of Motion, Articular ; Treatment Outcome ; Shoulder Joint/physiopathology* ; Aged, 80 and over ; Operative Time ; Postoperative Complications/epidemiology* ; Length of Stay

Acute kidney injury (AKI) has high morbidity and mortality, but effective clinical drugs and management are lacking. Previous studies have suggested that macrophages play a crucial role in the inflammatory response to AKI and may serve as potential therapeutic targets. Emerging evidence has highlighted the importance of forkhead box protein O1 (FoxO1) in mediating macrophage activation and polarization in various diseases, but the specific mechanisms by which FoxO1 regulates macrophages during AKI remain unclear. The present study aimed to investigate the role of FoxO1 in macrophages in the pathogenesis of AKI. We observed a significant upregulation of FoxO1 in kidney macrophages following ischemia-reperfusion (I/R) injury. Additionally, our findings demonstrated that the administration of FoxO1 inhibitor AS1842856-encapsulated liposome (AS-Lipo), mainly acting on macrophages, effectively mitigated renal injury induced by I/R injury in mice. By generating myeloid-specific FoxO1-knockout mice, we further observed that the deficiency of FoxO1 in myeloid cells protected against I/R injury-induced AKI. Furthermore, our study provided evidence of FoxO1's pivotal role in macrophage chemotaxis, inflammation, and migration. Moreover, the impact of FoxO1 on the regulation of macrophage migration was mediated through RhoA guanine nucleotide exchange factor 1 (ARHGEF1), indicating that ARHGEF1 may serve as a potential intermediary between FoxO1 and the activity of the RhoA pathway. Consequently, our findings propose that FoxO1 plays a crucial role as a mediator and biomarker in the context of AKI. Targeting macrophage FoxO1 pharmacologically could potentially offer a promising therapeutic approach for AKI.

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome