The theory of constitution in traditional Chinese medicine （TCM） has emerged as a new discipline in recent years. Constitution plays a vital role in the onset，progression，transformation，and prognosis of diseases. At present，some clinical scholars have adopted a novel diagnostic and treatment model of "constitution differentiation-disease identification-syndrome differentiation"，in which constitution is regarded as a core element throughout the diagnostic and therapeutic process. Constitution is closely associated with etiology，onset，pathogenesis，syndrome differentiation，and treatment. Against this background，the construction of animal models based on constitution holds far-reaching significance for advancing clinical research. This paper focuses on the construction and evaluation of rodent models with Qi-deficiency constitution，aiming to explore how to further induce Qi-deficiency syndromes and related disease states on the basis of Qi-deficiency constitution models，thereby developing an integrated animal model that embodies the trinity of "constitution-disease-syndrome". The establishment of this model not only provides a solid experimental foundation for the development of new therapies and drugs in TCM targeting specific constitutions，diseases，and syndromes，but also greatly promotes the modernization and scientific advancement of TCM theory. By comprehensively applying multidisciplinary technologies and methods，the study evaluates the model's validity，reliability，and practicality，with the aim of opening new avenues for future research in TCM and promoting the development of the field.

The theory of constitution in traditional Chinese medicine （TCM） has emerged as a new discipline in recent years. Constitution plays a vital role in the onset，progression，transformation，and prognosis of diseases. At present，some clinical scholars have adopted a novel diagnostic and treatment model of "constitution differentiation-disease identification-syndrome differentiation"，in which constitution is regarded as a core element throughout the diagnostic and therapeutic process. Constitution is closely associated with etiology，onset，pathogenesis，syndrome differentiation，and treatment. Against this background，the construction of animal models based on constitution holds far-reaching significance for advancing clinical research. This paper focuses on the construction and evaluation of rodent models with Qi-deficiency constitution，aiming to explore how to further induce Qi-deficiency syndromes and related disease states on the basis of Qi-deficiency constitution models，thereby developing an integrated animal model that embodies the trinity of "constitution-disease-syndrome". The establishment of this model not only provides a solid experimental foundation for the development of new therapies and drugs in TCM targeting specific constitutions，diseases，and syndromes，but also greatly promotes the modernization and scientific advancement of TCM theory. By comprehensively applying multidisciplinary technologies and methods，the study evaluates the model's validity，reliability，and practicality，with the aim of opening new avenues for future research in TCM and promoting the development of the field.

Objective:To investigate the clinical application of ultrasound-guided cervical plexus block combined with superior laryngeal nerve block in tracheotomy for burn patients.Methods:A total of 88 burn patients who underwent tracheotomy from January 2022 to December 2022 were divided into observation group(44 cases)and matched group(44 cases).The matched group received conventional general anesthesia,while the observation group underwent ultrasound-guided cervical plexus block combined with superior laryngeal nerve block.The operation time,anesthetic effect,intraoperative hemodynamic parameters,postoperative complications,and patient satisfaction were compared.Results:The surgery time in the observation group was shorter than that in the matched group(P＜0.05).The anesthetic effect in the observation group was superior to that in the matched group,with more stable intraoperative hemodynamics,and smaller fluctuations in heart rate and mean arterial pressure(P＜0.05).The incidence of postoperative cough reflex,hoarseness,postoperative pain score,and respiratory complications in the observation group were lower than those in the matched group(P＜0.05).Patient satisfaction in the observation group was higher than that in the matched group(P＜0.05).Conclusion:Ultrasound-guided cervical plexus block combined with superior laryngeal nerve block for tracheotomy in burn patients can effectively improve anesthetic effect,reduce operation time,stabilize intraoperative hemodynamics,reduce postoperative complications,and improve patient satisfaction,which is worthy of clinical application.

Objective To construct an aptamer-functionalized carboxylated graphene oxide(CGO)fluo-rescent sensor to achieve highly sensitive and specific detection of ketamine(KET)and its metabolite norketamine(NK)using an aptamer capable of simultaneously recognizing KET and NK.Methods A specific aptamer for simultaneous recognition of KET and NK was screened using graphene oxide-sys-tematic evolution of ligand by exponential enrichment(GO-SELEX)and molecular docking tech-niques.The aptamer,labeled with Cy5 fluorescence,was chemically conjugated to CGO to construct an aptamer-functionalized CGO fluorescent sensor.By optimizing detection conditions,including the mass concentration of CGO,aptamer concentration,reaction temperature,and incubation time,quantita-tive analysis of the target analytes was achieved using the ratio of fluorescence intensity changes be-fore and after target addition.The stability of the sensor in biological matrices was evaluated by moni-toring fluorescence intensity changes over incubation time in blank blood and urine,in comparison with the traditional physical adsorption-based CGO fluorescent sensor.Spiked recovery experiments in blank blood and urine were conducted to compare performance with that of HPLC-MS/MS.Results A specific aptamer A5 was selected and chemically conjugated with CGO to construct the aptamer-functionalized CGO fluorescent sensor.Under optimized conditions,the proposed fluorescent sensor ex-hibited a linear detection range of 1.0-5.0 ng/mL for KET,with a limit of detection(LOD)of 0.86 ng/mL;while for NK,the linear detection range was 1.0-5.0 ng/mL,with an LOD of 0.70 ng/mL.Com-pared with the CGO fluorescent sensor constructed via physical adsorption,this sensor demonstrated greater stability in blood and urine.The spiked recovery rates of KET and NK in blank blood and urine ranged from 81.50%to 110.03%,exhibiting detection performance comparable to that of HPLC-MS/MS.Conclusion The aptamer screening method offers a novel approach for selecting aptamers tar-geting drugs and their metabolites.The constructed aptamer-functionalized CGO fluorescent sensor pro-vides an efficient and reliable strategy for the high-performance detection of KET and NK.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.

Objective:To Exploring the protective effect of hearing protectors worn by noise workers in the petrochemical industry and the factors affecting the protective effect of hearing protectors.Methods:From June 2021 to July 2023, 929 petrochemical workers were selected as the research subjects through cluster sampling. The noise exposure of workers and the usage of two types of hearing protectors were surveyed through questionnaire surveys and on-site occupational hygiene surveys. The protective effect of hearing protectors were evaluated by testing the PAR of workers. If the noise exposure value of workers minus the PAR value was less than 85 dB (A) , it was considered passed. Otherwise, it was considered not passed. The passing rate of the protective effect test of hearing protectors was analyzed through chi square test and the influencing factors for the effectiveness of workers hearing protectors in test were explored through single factor analysis and logistic regression models.Results:Among the research subjects, 80.5% of workers (748/929) had noise exposure levels greater than 85 dB (A) . The passing rate (80.9%) of the earmuff is greater than that of the earplug (52.6%) , and the median of PAR of the earmuff is 22 (16, 25) , which is greater than that of the earplug 15 (3, 22) dB dB, with a statistically significant difference ( P<0.001) . Univariate analysis and logistic regression models showed that length of service, exposure level to noise, and wearing comfort were the influencing factors of earplug protection effect ( P<0.05) , while wearing comfort was the influencing factor of earmuff protection effect ( P<0.05) . Conclusion:This study indicates that the protective effect of hearing protectors on workers in the petrochemical enterprise is poor, and the protective effect of earmuffs is greater than that of earplugs. Working experience, noise exposure level, and wearing comfort are the influencing factors of earplug protection effect, while wearing comfort is the influencing factor of earplug protection effect.

Objective To evaluate the effect of remimazolam on the incidence of postoperative delirium(POD)in elderly lung cancer patients undergoing thoracoscopic surgery.Methods A total of 114 elderly patients who underwent unilateral thoracoscopic lung surgery at the Affiliated Hospital of Xuzhou Medical University from October 2024 to April 2025 were recruited in this trial.Patients were randomly assigned to remimazolam group(group R)and propofol group(group P).Anesthesia induction and maintenance were performed with remimazolam and propofol,respectively.In R group,0.5 mg of flumazenil was intravenously injected at the end of the surgery for specific antagonism.The incidence of delirium and Quality of Recovery-15(QoR-15)scores on the first and third postoperative days were compared between the two groups.Intraoperative hemodynamic parameters,total opi-oid dosage,fluid balance,tracheal tube extubation time after surgery,and the incidence of adverse reactions were recorded.Results There were no statistically significant differences between the groups in the incidence of POD or in QoR-15 scores(P>0.05).Compared with group P,patients in group R had a shorter extubation time(P<0.05),more stable hemodynamics,lower incidences of intra-operative hypotension and bradycardia,and reduced requirement for vasoactive drugs(P<0.05).The consumption of rescue analgesics in the post-anesthesia care unit(PACU)was also lower in group R(P<0.05).No significant differences were observed between the groups in the amounts of sufentanil and remifentanil administered,fluid balance,bispectral index(BIS)values,or the inci-dence of nausea and vomiting(P>0.05).Conclusion In elderly patients undergoing elective thoracoscopic sur-gery,remimazolam-based induction and maintenance of anesthesia did not significantly alter the incidence of POD or compromise postoperative recovery quality compared with propofol.However,the remimazolam group required fewer vasoactive agents and exhibited a shorter tracheal extubation time.

OBJECTIVES: To study the effect of prophylactic phenytoin (PHT) or levetiracetam (LEV) on busulfan (BU) blood concentration in children undergoing hematopoietic stem cell transplantation. METHODS: Pediatric patients conditioned with BU plus cyclophosphamide and fludarabine at the First People's Hospital of Chenzhou from September 2023 to February 2025 were retrospectively included. Patients were grouped by prophylactic antiepileptic regimen into PHT (n=24) and LEV (n=26). BU blood concentrations at the end of infusion (0 hour) and at 1, 2, and 4 hours post-infusion were compared between groups. RESULTS: At 0 hour post-infusion, BU blood concentrations did not differ significantly between groups (P>0.05). At 1, 2, and 4 hours post-infusion, BU blood concentrations were higher in the LEV group than in the PHT group (P<0.05). The area under the concentration-time curve from 0 to ∞ (AUC_0-∞) was greater in the LEV group (P<0.001), and the attainment rate of AUC_0-∞ was higher in the LEV group than in the PHT group (73% vs 21%, P<0.001). No significant differences were observed between groups in time to hematopoietic engraftment or in the incidence of BU-related adverse drug reactions (P>0.05). CONCLUSIONS Compared with PHT, LEV prophylaxis is associated with higher BU blood concentration and a higher AUC_0-∞ attainment rate. There is no observed difference in BU efficacy or safety between PHT and LEV.
Humans ; Levetiracetam/therapeutic use* ; Busulfan/pharmacokinetics* ; Hematopoietic Stem Cell Transplantation ; Male ; Female ; Child ; Child, Preschool ; Phenytoin/pharmacology* ; Infant ; Retrospective Studies ; Anticonvulsants/pharmacology* ; Adolescent

Traumatic brain injury(TBI)is a serious condition characterized by high rates of mortality and disability.Deaths caused by severe TBI usually occur within the first few hours after the injury.Timely and effective management of TBI during pre-hospital and emergency treatment phases is crucial for improving patients'prognosis.To address this issue,the Emergency Physicians Branch of the Chinese Medical Doctor Association,the Emergency Medicine Professional Committee of the People's Liberation Army,the Beijing Emergency Medicine Society,and the Chinese Emergency Medicine Specialist Association have jointly selected national experts in emergency medicine and neurosurgery to formulate the"Chinese Expert Consensus on the Pre-hospital and Emergency Diagnosis and Treatment of Adult Traumatic Brain Injury".This consensus consists of two parts focusing on pre-hospital and emergency diagnosis and treatment of TBI,with 24 recommendations put forward to guide relevant clinical practices in pre-hospital and emergency management.