ObjectiveTo explore the clinical safety of Feilike Mixture （FLK） in the real world. MethodsThe safety of all children who received FLK from 29 institutions in 12 provinces between January 21，2021 and December 25，2021 was evaluated through prospective centralized surveillance and a nested case control study. ResultsA total of 3 035 juveniles were included. There were 29 research centers involved，which are distributed across 12 provinces，including one traditional Chinese medicine （TCM） hospital and 28 general hospitals. The average age among the juveniles was （4.77±3.56） years old，and the average weight was （21.81±12.97） kg. Among them，119 cases （3.92%） of juveniles had a history of allergies. Acute bronchitis was the main diagnosis for juveniles，with 1 656 cases （54.46%）. FLK was first used in 2 016 cases （66.43%），and 142 juvenile patients had special dosages，accounting for 4.68%. Among them，92 adverse drug reactions （ADRs） occurred，including 73 cases of gastrointestinal system disorders，10 cases of metabolic and nutritional disorders，eight cases of skin and subcutaneous tissue diseases，two cases of vascular and lymphatic disorders，and one case of systemic diseases and various reactions at the administration site. The manifestations of ADRs were mainly diarrhea，stool discoloration，and vomiting，and no serious ADRs occurred. The results of multi-factor analysis indicated that special dosages （the use of FLK）［odds ratio （OR） of 2.642， 95% confidence interval （CI） of 1.105-6.323］，combined administration： spleen aminopeptide （OR of 4.978， 95%CI of 1.200-20.655），and reason for combined administration： anti-infection （OR of 1.814， 95%CI of 1.071-3.075） were the risk factors for ADRs caused by FLK. Conclusion92 ADRs occurred among 3 035 juveniles using FLK. The incidence of ADRs caused by FLK was 3.03%，and the severity was mainly mild or moderate. Generally，the prognosis was favorable after symptomatic treatment such as drug withdrawal or dosage reduction，suggesting that FLK has good clinical safety.

OBJECTIVE To evaluate the cost-effectiveness of finerenone combined with standard treatment regimen in the treatment of diabetic nephropathy （DN）. METHODS From the perspective of healthcare service providers， a Markov model was established to simulate the dynamic changes of each stage in DN patients who received finerenone combined with the standard treatment regimen or the standard treatment regimen alone based on the phase Ⅲ clinical trial study of finerenone for DN. Markov model was used to perform the cost-effectiveness of long-term effects and the costs of the two therapies with a simulation cycle of 4 months， a simulation period of 15 years and an annual discount rate of 5%. At the same time， one-way sensitivity analysis and probability sensitivity analysis were performed， and the stability of the results was validated. RESULTS Accumulative cost of the standard treatment regimen was 579 329.54 yuan， and the accumulative utility was 8.052 4 quality-adjusted life year （QALYs）； the accumulative cost of finerenone combined with the standard treatment regimen was 332 520.61 yuan， and the accumulative utility was 8.187 4 QALYs. Finerenone combined with the standard treatment regimen was more cost-effective. The results of one-way sensitivity analysis showed that dialysis status utility value， DN stage 3 utility value and DN stage 4 utility value had a great influence on the incremental cost-effectiveness ratio， but did not affect the robustness of the model. The results of probability sensitivity analysis showed that finerenone combined with the standard treatment regimen was more cost-effective with 100% probability. CONCLUSIONS For DN patients， finerenone combined with the standard treatment regimen is more cost-effective as an absolute advantage option.

Objective To collect data on imported malaria cases in Jiangsu Province from 2019 to 2023 after malaria elimination and to analyze the current epidemic situation and prevention and control measures of imported malaria, discussing future prevention and control strategies. Methods Malaria case information for Jiangsu Province from 2019 to 2023 was extracted and downloaded from the China Information System for Disease Control and Prevention (CISDCP) as well as the Jiangsu Provincial malaria epidemic database. Statistical analysis was conducted using Stata 12.0 and SPSS 16.0 software. Results From 2019 to 2023, a total of 534 cases of malaria were directly reported online in Jiangsu Province, with annual cases numbering 244, 90, 32, 36, and 132 respectively, all being laboratory-confirmed imported malaria cases from abroad. During the COVID-19 pandemic from 2020 to 2022, the number of imported malaria cases significantly decreased, with several months reporting zero cases. Among the 534 malaria cases, the vast majority were individuals who had traveled to countries in sub-Saharan Africa and Southeast Asia for work, business, international studies, or tourism. Over the five years, the median, minimum, and maximum days for patients from onset of illness to health-seeking were 1(0,12), 1(0,8), 0(0,6), 0(0,10), and 1(0,18) days, with a statistically significant difference in health-seeking time among patients (Fisher's exact test, P=0.03). Over the past three years of the COVID-19 pandemic, compared to outside centralized isolation stations, malaria cases within centralized isolation stations were diagnosed in a shorter time (Fisher exact test, P=0.007). A total of 24 severe malaria cases were reported, with no deaths, including 23 cases of P. falciparum and 1 case of P. ovale. Conclusions After the elimination of malaria, imported malaria cases in Jiangsu Province have sharply decreased due to the impact of the COVID-19 pandemic. Malaria cases in centralized isolation stations (CIS) for COVID-19 control of Jiangsu Province are more likely to be promptly diagnosed, and the timeliness from onset to health-seeking among malaria patients returning from high-malaria areas improved. As COVID-19 prevention and control policies adjusted, there has been a sharp increase in imported malaria cases in 2023. It's still necessary to strengthen measures for malaria prevention and control and maintain the capacity to prevent malaria re-transmission in Jiangsu Province.

Objective:To analyze the influencing factors and improvement paths of the cultivation of full-time doctoral scientific and technological innovation ability in large public hospitals, and propose countermeasures and suggestions.Methods:This studyed conducted a survey and analysis of 122 doctors from Linyi People′s Hospital in Shandong Province, and completed a current situation study based on the analysis results.Results:There was no significant difference between the two groups in gender, age, degree type, professional category, discipline level, Graduate School type, job type and other indicators. There were significant differences between the two groups in scientific research topic selection ability score, project design ability score, data analysis ability score, data interpretation ability score, project approval in recent 5 years, project level, number of SCI journal papers published in recent 5 years, cumulative impact factors of SCI journal papers, and annual number of academic activities ( P<0.05). Conclusions:The hospital can improve the scientific and technological innovation ability of full-time doctors by setting up a special cultivation plan, establishing an interdisciplinary team, optimizing scientific research management services, improving the evaluation and assessment system, and improving welfare protection.

Objective To investigate best timing of ultrasound-guided rectus sheath block in single-site laparoendoscopic surgery.Methods A total of 63 patients underwent elective single-site laparoendscopic surgery for benign gynecological tumors in Gynecology Ward of the Second Affiliated Hospital of Wenzhou Medical University from August 2021 to January 2022 were selected as study subjects.They were divided into Group E(32 cases)and Group O(31 cases)by using a random number table method.After excluding three cases,60 patients were finally admitted,with 30 cases in each group.Group E underwent preoperative ultrasound-guided rectus sheath block,and group O underwent postoperative ultrasound-guided rectus sheath block.Numerical rating scale(NRS)score of immediately after extubation(T1),12-hour after surgery(T2),and 24-hour after surgery(T3)in resting and active status were compared between two groups;mean arterial pressure and heart rate before and after incision were compared between two groups;intraoperative dose of remifentanil,postoperative oxycodone and rate of postoperative analgesic relief were compared between two groups;time of entry and operation were compared between two groups;and occurrence of nerve block complications in two groups was recorded.Results Overall analysis found that there were significant differences in comparison of time points and interaction of resting NRS scores in two groups(P<0.05),as well as there were significant differences in comparison of time points of active NRS scores in two groups(P<0.05).Further pairwise comparison,within-group comparison:NRS scores of rest status and active status at T2 and T3 in group O were significantly lower than those at T1(P<0.05);NRS scores for rest status at T3 was significantly lower than that at T1 in group E,and NRS scores for active status at T2 and T3 were significantly lower than those at T1 in group E(P<0.05).Comparison between groups:NRS scores for rest and active status at T1 were significantly lower in group E than that in group O(P<0.05).After skin incision,mean arterial pressure in group O was significantly higher than before skin incision,and heart rate in group O was significantly faster than before skin incision(P<0.05).No abdominal puncture,puncture site infection,local anesthetic poisoning,or other complications occurred in either group.Conclusion In single-site laparoendoscopic gynecological surgery,ultrasound-guided preoperative rectus sheath block can provide better analgesic effect for patients in the early postoperative stage,and changes in heart rate and mean arterial pressure before and after incision are smaller,which is worthy of recommendation.

Hepatic stellate cell(HSC)activation is a key link in the development of liver fibrosis.The metabolic reprogramming of activated HSC has become a hot topic in current research,especially the change of glycolysis is an important factor in regulating HSC activation.Based on the metabolic reprogramming in the process of HSC activation,this paper expounds the mechanism of regulating HSC activation and liver fibrosis through glycolysis,and reviews the research progress of traditional Chinese medicine and its active ingredients in regulating HSC glycolysis to prevent and treat liver fibrosis.Liver fibrosis is a complex pathological process involving multiple factors and pathways.From the perspective of regulating the glycolysis of activated HSC,it can provide a new idea for the development of anti-liver fibrosis drugs.

Bupleuri radix is the dried root of Bupleuri radix or narrow-leaved Bupleuri radix of the umbelliferae family,and it is the most commonly used traditional Chinese medicine,which was first published in Shennong's Classic of Materia Medica.It has a variety of pharmacological effects such as anti-inflammatory,antioxidant,hepatoprotective,antitumor,antidepressant,et al.In the modern study,the extract of Bupleuri radix mainly includes a variety of chemical components such as Bupleuri radix saponin,flavonoids and volatile oil.By reviewing the relevant literature at home and abroad,this paper summarizes the research progress on the chemical composition and pharmacological effects of Bupleuri radix,and points out the future research direction to provide a certain reference basis for the subsequent research.

Post traumatic depression (PTD) is a serious complication after traumatic brain injury, with high incidence rate; PTD seriously affects the rehabilitation, outcome and quality of life of patients. Due to unclear pathogenesis of PTD, effective treatments have not yet been found in clinical practice. Repetitive transcranial magnetic stimulation (rTMS), as a new non-invasive neuroregulatory technique, has been used in major depression disorder (MDD). Few clinical evidence on PTD treated by rTMS is noted and optimal rTMS treatment regimen has not yet been defined.This article reviews the clinical studies of rTMS in PTD in recent years, with a view to provide references for clinical application.

Objective To investigate the relationship between the ratio of soluble hemoglobin scavenger receptor 163 protein(sCD163)/soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK)in plasma and prognosis in patients with spontaneous acute cerebral hemorrhage(ACH).Methods From August 2020 to August 2022,90 patients with ACH admitted to the Department of Neurosurgery,Harison International Peace Hospital,Hengshui City were regarded as the research group.According to the Glasgow outcome scale,patients with ACH were separated into the poor prognosis group(n=38)and the good prognosis group(n=52).Another 45 healthy examinee who underwent physical examination were used as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to detect plasma sCD163 and sTWEAK levels,and the sCD163/sTWEAK ratio was calculated.Pearson method was applied to analyze the correlation between plasma sCD163,sTWEAK levels,sCD163/sTWEAK ratio and clinical data.Logistic regression was applied to analyze influencing factors of poor prognosis in patients with ACH.Receiver operating characteristic(ROC)was applied to analyze the predictive value of sCD163/sTWEAK ratio for poor prognosis of patients with ACH.Results The plasma levels of sCD163,sTWEAK and sCD163/sTWEAK ratio were obviously higher in the research group than those in the control group(P＜0.05).The plasma levels of sCD163,sTWEAK and sCD163/sTWEAK ratio were obviously lower in the good prognosis group than those in the poor prognosis group(P＜0.05).Hematoma volume,National Institutes of Health Stroke Scale(NIHSS)scores,hypertension and subtentorial hemorrhage were lower in the good prognosis group than those in the poor prognosis group,and low density lipoprotein cholesterol(LDL-C)was higher in the good prognosis group than that in the poor prognosis group(P＜0.05).Correlation analysis showed that plasma sCD163,and sTWEAK levels and the sCD163/sTWEAK ratio were positively correlated with bleeding site,hematoma volume,NIHSS score,white blood cell count,platelet count and neutrophil/lymphocyte ratio(NLR)(P＜0.05).Results of Logistic regression analysis showed that sCD163,sTWEAK,sCD163/sTWEAK ratio,hematoma volume,bleeding site and NIHSS score were influencing factors for poor prognosis in patients with ACH(P＜0.05).Results of receiver operating characteristic showed that the AUC of sCD163/sTWEAK ratio in evaluating poor prognosis of patients with ACH was 0.850,and the sensitivity and specificity were 86.84%and 69.23%.Conclusion The sCD163/sTWEAK ratio has a high level in the plasma of patients with ACH,which is associated with poor prognosis and has important value in predicting the prognosis of patients with ACH.

Pigeons show flocking and homing behaviors,which require characteristics including long-distance weight-bearing and continuous flight,with excellent navigation and spatial cognitive abilities.Pigeons have been widely used in animal robot research in recent years.Pigeon robots achieve motor behavior control by applying neural information intervention to specific neural targets in the pigeon's brain.This review summarizes research progress in pigeon robots based on the sensory system,motivation and emotional system or cortex and midbrain motor area respectively,according to the distribution of hierarchical multi-level neural regulatory targets in the pigeon's brain,with the aim of providing reference and guidance for further applied research into the use of pigeon robots in space perception,reconnaissance,and anti-terrorism search and rescue.