Objective:To investigate the value of vasoactive inotropic score (VIS) in assessing adverse outcomes in neonates with early-onset sepsis (EOS).Methods:A retrospective study was conducted on 110 neonates with EOS admitted to the Affiliated Suzhou Hospital of Nanjing Medical University from January 2020 to March 2024. The patients were divided into a survival group ( n=88) and a death group ( n=22). Perinatal factor, and complications were compared between the two groups using t test, Mann-Whitney U test, and Chi-square test. Logistic regression analysis was used to identify the risk factors for death in patients with EOS, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of VIS for death in EOS patients. Results:The gestational age and birth weight of the death group were lower than those of the survival group [29.4 (26.8-35.3) weeks vs. 32.8 (30.1-37.2) weeks, 1 050.0 (737.5-2 162.5) g vs. 1 700.0 (1 212.5-2 587.5) g, Z values were－2.16 and－2.30, both P<0.05]. Compared with the survival group, the proportion of asphyxia [45.5% (10/22) vs. 21.6% (19/88)], low temperature [27.3% (6/22) vs. 8.0% (7/88)], mechanical ventilation [100.0% (22/22) vs. 54.5% (48/88)], disseminated intravascular coagulation [22.7% (5/22) vs. 3.4% (3/88)], persistent pulmonary hypertension [36.4% (8/22) vs. 11.4% (10/88)] and pulmonary hemorrhage [40.9% (9/22) vs. 8.0% (7/88)] were higher in the death group ( χ2=5.16, 4.59, 15.71, 7.09, 6.32 and 12.84, all P<0.05). The VIS values at 24 hours and 48 hours after admission in the death group were 15.0 (10.0-18.1) and 18.8 (12.8-30.0), respectively, which were higher than those in the survival group [10.0 (7.5-10.0) and 10.0 (7.5-10.0), Z values were－4.60 and－4.94, respectively, both P<0.05].Logistic regression analysis showed that 24-h VIS value ( OR=1.163, 95% CI: 1.018-1.328), 48-h VIS value ( OR=1.114, 95% CI: 1.031-1.204), birth asphyxia ( OR=3.815, 95% CI: 1.017-14.310), and pulmonary hemorrhage ( OR=4.470, 95% CI: 1.174-17.017) were independent risk factors for death (all P<0.05). ROC curve analysis showed that the optimal cutoff value for predicting death was 11 for 24-h VIS, with an area under the curve (AUC) of 0.807, Youden's index of 0.466, sensitivity of 68.2%, and specificity of 78.4%, and 12.5 for 48-h VIS, with an AUC of 0.851, Youden's index of 0.659, sensitivity of 95.5%, and specificity of 70.5%. Conclusions:The VIS value after the onset of EOS is closely related to the outcome. A 48-h VIS value exceeding 12.5 is associated with a high risk of death.

Objective:To investigate the value of vasoactive inotropic score (VIS) in assessing adverse outcomes in neonates with early-onset sepsis (EOS).Methods:A retrospective study was conducted on 110 neonates with EOS admitted to the Affiliated Suzhou Hospital of Nanjing Medical University from January 2020 to March 2024. The patients were divided into a survival group ( n=88) and a death group ( n=22). Perinatal factor, and complications were compared between the two groups using t test, Mann-Whitney U test, and Chi-square test. Logistic regression analysis was used to identify the risk factors for death in patients with EOS, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of VIS for death in EOS patients. Results:The gestational age and birth weight of the death group were lower than those of the survival group [29.4 (26.8-35.3) weeks vs. 32.8 (30.1-37.2) weeks, 1 050.0 (737.5-2 162.5) g vs. 1 700.0 (1 212.5-2 587.5) g, Z values were－2.16 and－2.30, both P<0.05]. Compared with the survival group, the proportion of asphyxia [45.5% (10/22) vs. 21.6% (19/88)], low temperature [27.3% (6/22) vs. 8.0% (7/88)], mechanical ventilation [100.0% (22/22) vs. 54.5% (48/88)], disseminated intravascular coagulation [22.7% (5/22) vs. 3.4% (3/88)], persistent pulmonary hypertension [36.4% (8/22) vs. 11.4% (10/88)] and pulmonary hemorrhage [40.9% (9/22) vs. 8.0% (7/88)] were higher in the death group ( χ2=5.16, 4.59, 15.71, 7.09, 6.32 and 12.84, all P<0.05). The VIS values at 24 hours and 48 hours after admission in the death group were 15.0 (10.0-18.1) and 18.8 (12.8-30.0), respectively, which were higher than those in the survival group [10.0 (7.5-10.0) and 10.0 (7.5-10.0), Z values were－4.60 and－4.94, respectively, both P<0.05].Logistic regression analysis showed that 24-h VIS value ( OR=1.163, 95% CI: 1.018-1.328), 48-h VIS value ( OR=1.114, 95% CI: 1.031-1.204), birth asphyxia ( OR=3.815, 95% CI: 1.017-14.310), and pulmonary hemorrhage ( OR=4.470, 95% CI: 1.174-17.017) were independent risk factors for death (all P<0.05). ROC curve analysis showed that the optimal cutoff value for predicting death was 11 for 24-h VIS, with an area under the curve (AUC) of 0.807, Youden's index of 0.466, sensitivity of 68.2%, and specificity of 78.4%, and 12.5 for 48-h VIS, with an AUC of 0.851, Youden's index of 0.659, sensitivity of 95.5%, and specificity of 70.5%. Conclusions:The VIS value after the onset of EOS is closely related to the outcome. A 48-h VIS value exceeding 12.5 is associated with a high risk of death.

The membranous tube of sanjiao （三焦） is not only the path of the transport of fluid and qi， but the way of the invasion of pathogenic factors， therefore， it cooperates with the skin mucous membrane physically and influence on each other pathologically. It is believed that the core pathogenesis of chronic urticaria is pathogens intruding sanjiao， membrane collaterals acute spasm， and fluid and qi disturbance， of which defense qi insufficiency and pathogens intruding sanjiao initiates the disease， while struggle between healthy and pathogenic qi and membrane collaterals acute spasm is the intermediate stage， and disturbed fluid， qi and blood movement is the terminal stage. Following the core treatment principle of dredging sanjiao， the internal treatment is to open striae and interstices and dispel pathogens out using self-made Guben Shufeng Decoction（固本疏风汤）modifications， and the external treatment is to dredge and regulate membrane collaterals， move qi and fluid， and treat sanjiao simultaneously， commonly using cutting therapy on Danzhong （RN 17） to move qi and fluid， seal umbilical therapy on Shenque （RN 8） to supplement and nourish ying-wei （营卫）， and natural moxibustion on Xuehai （SP 10） to move blood and unblock collaterals.

This article summarized the clinical experience of Professor AI Rudi in staged treatment according to pattern differentiation of systemic lupus erythematosus （SLE）. It is believed that SLE is characterized by kidney yin deficiency and heat toxin obstruction as the core disease mechanism. The staged treatment principle is to nourish yin and clear heat， invigorate blood and resolve toxins. In the early stage of heat toxins accumulation， the focus is on treating the branch and strengthen the kidneys as early as possible， recommending self-designed Liangxue Xiaofeng Powder （凉血消风散） with modifications. In the middle stage， there is yin deficiency with internal heat， which requires nourishing kidney yin and eliminating pathogenic factors. The prescription suggested is self-designed Shouwu Dihuang Decoction （首乌地黄汤）. In the late stage， there is yin impairment affecting yang， which requires a gradual consolidation of the foundation and harmonization of yin and yang， usually with Zhenwu Decoction （真武汤） and Zishen Tongguan Powder （滋肾通关散） with modifications. At the same time， the treatment emphasizes the integration of Chinese and Western medicine， and use of self-designed Ershen Dihuang Pill （二参地黄丸） after initial remission to consolidate the effect and prevent relapse. External treatment should also be given importance to， and Hongyou Ointment （红油膏） can be used to treat SLE skin lesions， reduce swelling， and relieve pain.

ABSTRACT OBJECTIVE To explore the correlation between HPLC fingerprint and analgesic efficacy of Zhejiang vinegar Corydalis Rhizoma, and to screen out the material basis of analgesic effect of Zhejiang vinegar Corydalis Rhizoma.METHODS Established HPLC fingerprint of Zhejiang vinegar Corydalis Rhizoma and dysmenorrhea model in rats. The weight loss rate, writhing response, serum malondialdehyde(MDA), estradiol(E2), prostaglandin E2(PGE2) and prostaglandin F2α(PGF2α) levels were used as the evaluation indexes of analgesic efficacy. Combined with chemometrics, the main active components of analgesic effect of Zhejiang vinegar Corydalis Rhizoma and the important components with great contribution to the content were screened.RESULTS The fingerprints of different batches of Zhejiang vinegar Corydalis Rhizoma were established, and nine components were identified; compared with the blank group, the weight loss rate, writhing reaction, MDA, E2 and PGF2α levels in the model group were significantly increased. Compared with the model group, the above indexs in the administration group was decreased. Compared with the blank group, the PGE2 level in the model group was significantly decreased. Compared with the model group, the PGE2 level in the administration group was significantly increased. The vinegar Corydalis Rhizoma produced in Zhejiang had a good analgesic effect, and the main active components of its analgesic effect were protopine, palmatine hydrochloride, and dehydrocorydaline. The important components with greater contribution to the content were tetrahydropalmatine, protopine, palmatine hydrochloride and stylopine.CONCLUSION The efficacy of Zhejiang vinegar Corydalis Rhizoma is the result of the combined action of multiple components, and each component has a strong correlation with the pharmacodynamic indexes. This study provides a reference for the screening of analgesic material basis of Zhejiang vinegar Corydalis Rhizoma.

Objective:To explore the collaborative innovation development mechanism of hospitals and research institutes, fully integrate the institute personnel with hospitals, and conduct classified management and performance appraisal, promoting the integrated development of hospitals and research institutes.Methods:The idea of personnel classification, the establishment of an integrated research team, and technical team groupings and service directions were determined through key informant interviews, research ability and technical strength surveys, and other research methods; The performance appraisal scheme of research teams were established by using literature analysis and optimization and Delphi expert investigation; The platform team assessment programs were established by qualitative research methods.Results:Built a position setting framework for research institutes, formed hospital-institute integrated research teams around the hospital's clinical advantageous disciplines with researchers and clinical staff, set up platform teams based on existing equipment and technicians′ specialties, established a performance appraisal scheme for research teams based on Science and Technology Evaluation Metrics(STEM), determined a full-dimensional comprehensive performance evaluation scheme for the technology platforms based on service volume and quality.Conclusions:This study formulated a set of position setting and performance evaluation schemes that fit with the current situation of municipal research institutes, and explored a new scientific research cooperation mechanism of resource sharing, team co-construction, and technology sharing, which can provide a certain reference value for the reform of other medical research institutes.

This paper summarized the clinical experience of AI Rudi in the treatment facial hormone-dependent dermatitis with the method of clearing heat and protecting yin. It is believed that the key pathogenesis is the heat toxin accumulation， yin depletion and collaterals obstruction. The clinical treatment should focus on “heat exuberance” and “yin depletion”. It is advocated that “half treatment is from heat and half from yin” is the general principle， and the treatment is staged. In the acute phase， the treatment is half from cooling blood and dispersing wind to dispel heat pathogen， and half from protecting fluid and moisturizing skin to strengthen yin； and the modified Liangxue Xiaofeng Powder （凉血消风散） could be used. In the chronic phase， half treatment is from clearing residual toxin to eliminate heat pathogen， and half from nourishing yin and unblocking collaterals to strengthen yin， for which Xuanmai Ganju Decoction and Erzhi Pills （玄麦甘桔汤合二至丸） can be used and modified according to the symptoms. At the same time， we should pay attention to the simultaneous internal and external treatment， and emphasize the importance of daily protection in the treatment of the disease.

Objective:To explore the application effect of the teaching ward-round workshop on the teaching ability training for clinical teachers.Methods:From July to October 2019, 83 clinical teachers from The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University included in the study were divided into 8 groups for the training of teaching ward-round workshop. After the training, the evaluation results of clinical teaching ward-round, the satisfaction of clinical teaching ward-round, and the satisfaction of the workshop teaching model were compared. Chi-square test and t test were performed by SPSS 22.0. Results:The trainees were highly satisfied with the training mode of the teaching ward-round workshop. After the training, the clinical teaching ward-round assessment scores [(96.83±1.77) points] were higher than the average scores of the same period from April to June in 2019 [(91.25±2.86) points], with statistical significance ( P<0.05). In terms of satisfaction with clinical teaching ward rounds, the scores of 7 dimensions including preparation before ward rounds, highlighting the key and difficulties, and standard physical examination after the training were all higher than those before the training, with significant differences ( P<0.05). Conclusion:The training model of the teaching ward-round workshop helps to enhance the training effect, promote the teaching ability of clinical teachers, and improve the clinical teaching ward-round assessment results and satisfaction, which provides new ideas and references for the training of clinical medical professionals.

Objective:To evaluate the effect of tutorial system for medical undergraduates in a non-affiliated hospital of a medical university in Jiangsu.Methods:32 senior medical undergraduates in non-affiliated hospitals were divided into two groups. The experimental group adopted tutor-guided teaching, and the control group adopted traditional teaching. Professional theoretical knowledge, clinical ability, operational ability, foreign language level, basic research ability and participation of scientific research activities of students in the two groups were evaluated. SPSS 19.0 was used for t test, chi-square test and U test. Results:The results of operational ability ( t=3.537, P=0.000), the number of papers that had been read ( t=6.961, P=0.000), quality of these ( U=68.000, P=0.017), the number of literature reviews that had been written and reading notes ( χ2=4.747, P=0.000), participation in scientific research activities ( t=6.788, P=0.009) of students in the experimental group were better and higher than those in the control group. In the same period, there was no significant difference between the two groups in the scores of theoretical exam, clinical competence and foreign language tests. Conclusion:The implementation of tutorial system for medical students in non-affiliated hospitals is an effective measure to improve the quality of training. We should make full use of the short intership, to improve the comprehensive quality of students by establishing perfect rules, regulations and teaching evaluation system, and educate students in accordance with their own ability.

Objective:To summarize the scientific research management response strategies and practices of designated hospitals under the prevention and control of new coronary pneumonia, provide reference for the scientific and technological management of public health emergencies in domestic hospitals.Methods:Take the hospital scientific research management response under the prevention and control of the new coronavirus pneumonia epidemic in 2020 as an example, discuss and summarize the response strategies and mechanism establishment, work practice and existing problems of designated hospitals in the research management of prevention and control of public health emergencies represented by COVID-19 from the aspects of management system, resource integration, project operation, and scientific and technological service.Results:As a designated hospital of COVID-19 in Beijing, Youan hospital has actively carried out scientific and technological research on epidemic prevention and control while successfully completing patient treatment, established a scientific and efficient scientific and technological research management system, and integrated resources to form an efficient project operation mechanism, Providing a full range of scientific management services, providing policy and material guarantee for the rapid and high-quality completion of scientific and technological research on epidemic prevention and control.Conclusions:The scientific and technological research on public health emergencies has the characteristics of demand-driven, focused on key points, collaborative research, scientific decision-making, In order to carry out the research work smoothly, it is particularly important to form a benign interaction, straighten out the system, do a good job in long-term planning and layout, and establish a scientific and efficient research and management mechanism.