As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

Clinically,carotid atherosclerotic stenosis(CASS)is an important cause of stroke in China.The optimal treatment option for asymptomatic carotid atherosclerotic stenosis(ACAS)has not been conclusive,which is still a hot issue in recent years.With the development of endovascular interventional technique,and patient's higher requirements for recovery speed and comfort level,the carotid artery stenting(CAS)has been used more frequently than carotid endarterectomy(CEA).Therefore,the relative benefit of CAS for the treatment of ACAS requires further evaluation.This paper aims to make a comprehensive review about CAS for the treatment of ACAS,focusing on the indications,efficacy,complications and factors affecting curative efficacy,so as to provide reference for selecting the treatment method of the patients.

Objective:To analyze the drug survival rate and safety of dupilumab in the treatment of atopic dermatitis (AD) in elderly patients.Methods:Clinical data were collected from patients diagnosed with AD and treated with dupilumab at the Hospital of Dermatology, Chinese Academy of Medical Sciences from May 2021 to May 2023, and were retrospectively analyzed. The patients aged ≥ 60 years were selected as a study group, and disease severity-matched patients aged <60 years served as a control group. Follow-up was conducted from the start of treatment until 24 weeks after the start of treatment. Drug survival rate and safety were analyzed and compared between the two groups. Drug survival rate was determined through Kaplan-Meier survival analysis; differences in drug survival rate between the two groups were analyzed using the log-rank test; chi-square test was used to compare the reasons for treatment discontinuation between the two groups.Results:The study group and the control group each included 45 patients with AD, and the disease severity of patients in the study group was matched with that in the control group. At 24 weeks after the start of treatment, there was a significant difference in the overall drug survival rate of dupilumab between the study group (37.8%, 17/45) and the control group (57.8%, 26/45; P = 0.030). Among the 45 elderly patients with AD in the study group, a significant difference was observed in the proportion of patients with nodular prurigo phenotype between the patients who completed the 24-week treatment (4/17) and those who did not complete (0, P = 0.007). Main reasons for dupilumab withdrawal in the 28 patients in the study group were poor response (8/28, 28.6%), followed by unaffordability (5/28, 17.9%) and persistent clinical remission (4/28, 14.3%), and the adverse reactions included conjunctivitis (2 cases) and suspected systemic anaphylaxis (3 cases) ; the main reasons for dupilumab discontinuation in 19 patients in the control group were poor response (7/19, 36.8%) and persistent clinical remission (6/19, 31.6%), and the adverse reaction was injection site reaction in 1 case; there was no significant difference in the composition of reasons for drug withdrawal between the two groups. Conclusion:Dupilumab generally exhibited good safety in elderly patients with AD, but its drug survival rate was lower than that in the younger patients.

【Objective】 To evaluate and analyze the impact of COVID-19 epidemic on inventory of red blood cells (RBCs)in local and municipal blood stations in China, and to provide reference for the management of public health emergencies. 【Methods】 Relevant data from 2018 to 2021 were collected, and the differences in the volume of qualified RBCs, the usage efficiency of inventory RBCs, the average daily distribution of RBCs,the blood distribution rate of RBCs prepared by 400 mL whole blood, the difference in the average storage days of RBCs at the time of distribution, the average daily inventory of RBCs and the time of the average daily inventory of RBCs to maintain the distribution in 24 local and municipal blood stations in China during the COVID-19 epidemic and non-epidemic periods were retrospectively analyzed. 【Results】 Compared with non-epidemic periods, the volume of qualified RBCs [(117 525.979 ±52 203.175)U] and the average daily distribution of RBCs [( 156. 468 ± 70. 186) U ] increased significantly, but the usage efficiency of inventory RBCs decreased(97.24%±0.51%) significantly (P<0.05).There was no significant difference in the blood distribution rate of RBCs prepared by 400 mL whole blood(73.88%±20.30%), the average storage days of RBCs distribution(13.040 ±3.486), the average daily stock quantity of RBCs[(2 280.542 ±1 446.538) U ] and the time of the average daily inventory of RBCs to maintain the distribution[(15.062 ±7.453) d] (P>0.5). 【Conclusion】 During the COVID-19 epidemic, the inventory management of RBCs operated well, the overall inventory remained relatively stable, the stock composition and storage period showed no significant change.

Objective:To evaluate the clinical efficacy and safety of omalizumab in the treatment of chronic spontaneous urticaria (CSU) .Methods:Clinical data were collected from 60 patients, who were diagnosed with CSU and received subcutaneous injections of omalizumab at a dose of 300 mg once every 4 weeks for 3 sessions in Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from March 2020 to September 2020, and retrospectively analyzed. At weeks 0, 2, 4, 6, 8, 10 and 12, urticaria activity score over 7 days (UAS7) and chronic urticaria quality of life (CU-Q2oL) score were used to evaluate clinical symptoms and quality of life of patients. Changes in the use of other drugs were evaluated before and after the treatment with omalizumab. Paired t test was used to compare UAS7 or CU-Q2oL score before and after treatment. Results:All the 60 CSU patients received 12 weeks of omalizumab treatment. The baseline UAS7 score was 22.37 ± 8.88 points; after one session of the treatment, the UAS7 score dropped to 2.01 ± 5.13 points, reaching the treatment plateau; at week 12, it dropped to 0.6 ± 2.63 points, and 0 point (complete control) in 93.3% of the patients, 1-6 points (favorable control) in 3.3%; the time required for UAS7 score to decrease to 0 point was 22.4 ± 3.2 days. The baseline CU-Q2oL score was 34.10 ± 15.01 points; after one session of the treatment, the CU-Q2oL score dropped to 2.41 ± 7.18 points, reaching the treatment plateau; at week 12, it was 0.56 ± 2.90 points; the time required for CU-Q2oL score to drop to 0 point was 21.15 ± 16.02 days. After the combination treatment with omalizumab, a gradual decrease in dosage or withdrawal of previous therapeutic drugs was realized. At week 12, 39 patients (65%) achieved complete control, and withdrew all therapeutic drugs except omalizumab. During the treatment and follow-up, omalizumab showed good safety, and no adverse reactions were observed.Conclusion:Omalizumab at a dose of 300 mg once every 4 weeks is markedly effective and safe for the treatment of CSU, providing a new treatment option for CSU patients with poor response to traditional therapy.

Objective To establish a HPLC fingerprints of Biyuanjing capsules. Methods The column was Agilent SB-C₁₈(4.6mm×250 mm, 5 µm). The mobile phase was acetonitrile-water with gradient elution at a flow rate of 1.0 ml/min. The detection wavelength was 210 nm. The detection time was 80 min. Results The HPLC fingerprints of Biyuanjing capsules were established. Twenty common peaks were confirmed, of which, 15 peaks were belonging to each crude drug and 5 peaks were identified as chemical components. The overall similarity of the fingerprints of 10 batches of samples was above 90% comparing with the control. Conclusion This method can be used for the quality control of Biyuanjing capsules.

Objective To explore the clinical value of a new scoring system for gastric cancer screening in hospital visits.Methods A new scoring system for gastric cancer screening was used to retrospectively analyze data of patients who visited Wenzhou Central Hospital for various digestive symptoms from April 2017 to August 2018 and met the screening requirements.All patients were divided into three groups according to the grading results of the new scoring system:low-risk group (0-11 points),medium-risk group (12-16 points) and high-risk group (17-23 points).A comparative analysis was performed on the detection of gastric cancer and gastric precancerous conditions among the three groups.Results A total of 2 674 patients were included in this study,1 694(63.35％) in the low-risk group,833(31.15％) in the medium-risk group,and 147(5.50％) in the high-risk group.The total detection rate of gastric cancer was 2.73％ (73/2 674).The detection rates were 1.06％ (18/1 694),4.32％ (36/833) and 12.93％ (19/147) in the three groups,respectively.There were significant differences in the detection rate of gastric cancer between any two of the three groups (all P ＜ 0.05).The detection rates of early gastric cancer in medium-risk group [2.04％ (17/833)] and high-risk group [4.08 ％ (6/147)] were significantly higher than that in the low-risk group[0.35％(6/1 694),all P＜0.05].Conclusion The new gastric cancer screening scoring system can not only significantly improve the detection rate of gastric cancer in hospital visits,but also improve the diagnostic rate of early gastric cancer.

Objective Based on Chinese guidelines for the management of ischemic stroke, a standardized stroke management program was performed to provide intensive education and training for medical physicians, aiming to enhance their knowledge and ability for ischemic stroke prevention and treatment, thereby reducing patients′ in-hospital cost and length of stay, and improving patients′ clinical prognosis. Methods This study was conducted in 20 general hospitals throughout Hainan province. A total of 163 physicians from 20 hospitals involved in the management of stroke patients were trained by highly experienced physicians based on the Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2014 and the Chinese guidelines for secondary prevention of ischemic stroke and transient ischemic attack 2014. Prior to and post the standardized stroke management training, the data of 3218 and 3367 patients with ischemic stroke were respectively collected. Quality of life assessments including the Barthel index (BI) and the modified Rankin Scale (mRS) score of all patients were recorded at baseline and after discharge. The length of stay and in-hospital cost were directly collected from the hospital information system. Results Physicians′ knowledge and ability manifested as testing scores were significantly improved after training (78.2 ± 15.5 vs 55.6 ± 10.7, t=69.1, P<0.01). The average length of stay of post-training patients was significantly shorter than that of pre-training patients ((8.7 ± 0.9) vs (11.7 ± 1.5) days, t=97.9, P<0.01). The average in-hospital cost of post-training patients was significantly less than that of pre-training patients ((7681.7 ± 1397.7) vs (11846.2 ± 2514.6) Yuan, t=82.5, P<0.01). Both BI (68.2 ± 3.2 vs 43.5 ± 5.3, t=227.7, P<0.01) and mRS score (2.74±0.51 vs 3.65±0.71, t=59.5, P<0.01) were significantly improved for post-training patients. Multivariate linear regression analysis illustrated that standardized stroke management was negatively associated with in-hospital cost (r=-0.461, P<0.01), length of stay (r=-0.357, P<0.01) and mRS score (r=-0.298, P<0.01), and was positively associated with levels of BI (r=0.376, P<0.01). Conclusion Standardized stroke management program might be a cost-effective choice for the management of ischemic stroke as it reduces the in-hospital cost and improves patients′BI and mRS levels.

Objective To investigate the effect of real-case-based training and examination method in ICU nurses training. Methods A test group of multi-level real-case-based training was established and took the examination of nurses in ICU. The examination included the ability of disease observation and assessment, clinical thinking, application of nursing procedure and so on. The frequency of assessment was divided into three parts:once a month, every three months and every six months. Results After the real-case-based training and examination program, the comprehensive score of ICU nurses at excellent and favorable level were improved. The excellent and favorable rates of the first and the fourth season were 31. 6% and 59. 6%, which had a significant difference (χ2 =9. 161,P<0. 05). The nursing quality of the second half of year was significantly improved. There was no case of pressure sore, unplanned extubation, out for inspection. The compliance of hand washing and bed raise was improved. The incidence of ventilator associated pneumonia, catheter related bloodstream infection and urinary tract infection was decreased. The nurse training examination, education level and learning atmosphere were significantly improved (P <0. 05). Conclusions The real-case-based training and examination model can effectively improve the ICU nurses′ clinical nursing competency, and it also can promote the enthusiasm and the quality of nursing.