Objective:To analyze the influences of coronary angiography(CAG)of transradial artery on the success rate,radiation dose and safety in elderly patients with coronary heart disease(CHD).Methods:This study conducted a prospective study.A total of 150 elderly CHD patients who admitted to Heilongjiang Rad Cross Sengong General Hospital from November 2022 to November 2023 were selected,and they were randomly divided into three groups using a random number table,which included the femoral artery group(n=50),radial artery group(n=50),and ulnar artery group(n=50).The femoral artery group underwent CAG by using the femoral artery approach,and the radial artery group underwent CAG by using the radial artery approach,and the ulnar artery group underwent CAG by using the ulnar artery approach.The CAG success rate and CAG indicators[dosage of contrast agent,X-ray exposure time,time of conducting puncture,corrected TIMI frame count(CTFC)]were compared among the three groups.The radiation-related parameters[cumulative dose(CD),dose-area product(DAP)]also were compared among three groups.The patients'comfort degrees of three groups were assessed by adopting General Comfort Questionnaire(GCQ)at three time points(pre-CAG,during CAG,at the 12th hour post-CAG).In addition,the complications of three groups were recorded.Results:The numbers of success angiography were respectively 47 cases,48 cases and 46 cases in femoral artery group,radial artery group and ulnar artery group,and the success rates of them were respectively 94.00%(47/50),96.00%(48/50)and 92.00%(46/50),without statistically significant differences among three groups(P>0.05).There were not significant differences in the dosage of contrast agent,X-ray exposure time,time of conducting puncture,CTFC,CD and DAP among three groups(P>0.05).In the GCQ scores,the scores pre-CAG of all three groups were highest,followed by those at the 12th hour post-CAG,and then,those during CAG were lowest,which appeared a trend of rise after decline.The total incidence of complication was lowest(6.25%)in the radial artery group,followed by the ulnar artery group(10.87%),and that(21.28%)of the femoral artery group was the highest,but there was not statistically significant difference in that among three groups(P>0.05).Conclusion:The CAG success rates of the radial artery,femoral artery and ulnar artery are similar,and there is not significant difference in radiation dose.However,compared with CAG of femoral artery and ulnar artery,the CAG of radial artery has higher safety,and higher comfort degree at the same time.

The clinical characteristics of a neonatal patient with movement disorder and arthrogryposis (NDEEMA) caused by gain-of-function mutation of the SCN1A gene were reported in this article. The 1-year-and-9-month-old boy started seizures since 2 hours after birth. He had funnel-breast, dislocation of the hip, and bipedal varus. Genetic testing showed SCN1A gene de novo missense mutation c.706A>G(p.Ile236Val), causing overall gain-of-function effect. The frequency of seizures decreased significantly after treatment of oxcarbazepine.

Villitis of unknown etiology (VUE) occurs in up to 15% of term placentas. Patients with VUE exhibit increased incidence of gestational diabetes mellitus, gestational hypertension, and preeclampsia, with demonstrated recurrence risk. VUE contributes to various adverse pregnancy outcomes. Its pathogenesis involves abnormal maternal immune responses against fetal allografts and may relate to unidentified microbial infections. Currently, VUE diagnosis relies exclusively on placental pathological examination. Clinical management remains primarily symptomatic, though immunomodulatory therapies show potential. This review summarizes recent advances in VUE epidemiology, pathogenesis, clinical significance, pathological features, and preventive strategies, aiming to enhance clinical understanding of this condition.

This paper summarizes Professor LIU Fengbin's clinical experience in treating autoimmune liver disease （AILD） using the method of nourishing yin and removing stasis based on stage differentiation. He believes that the pathogenesis of AILD generally involves both deficiency in essence and excess in manifestation， with essence deficiency often presenting as liver and kidney yin deficiency， which may progress to spleen deficiency and yang deficiency over time. The excess manifestation commonly includes qi stagnation， blood stasis， damp-heat， and phlegm toxicity. Clinically， he advocates for the treatment principle of nourishing yin and removing stasis. On the foundation of nourishing liver and kidney yin， different pathological factors causing stasis are eliminated according to their nature. Treatment is also tailored to different stages of AILD. In the early and asymptomatic stages， liver qi stagnation and spleen deficiency are prominent， warranting a therapeutic approach of soothing the liver， regulating qi and strengthening the spleen. The modified Chaishao Qizhi Decoction （柴芍气滞汤） is used. During the symptomatic stage， pathogenic factors become more pronounced， often accompanied by a significant deficiency of vital qi， with damp-heat， water retention， and phlegm toxicity as key pathological features. The treatment should focus on strengthening the spleen and dispelling dampness， using modified Sijunzi Decoction （四君子汤） combined with Yinchen Wuling Powder （茵陈五苓散）. In the liver function decompensation stage， vital qi is severely deficient while pathogenic factors persist， with damp-heat， phlegm toxicity， and blood stasis obstructing the liver collaterals. Treatment should focus on nourishing blood， softening the liver， strengthening the spleen， and resolving stasis， using the modified Ruangan Yangxue Decoction （软肝养血汤）. Throughout the treatment process， emphasis is placed on tonifying the liver and kidneys while protecting yin fluids.

Chinese medicine therapy for removing gallstones is one of the methods for the treatment of cholelithiasis.In the view of Professor Liu Fengbin,attacking of external pathogens,improper diet and emotional disorders contribute to the main causes of cholelithiasis,and the pathogenesis of cholelithiasis is due to qi stagnation of both liver and gallbladder,and internal obstruction of damp-heat.The occurrence of cholelithiasis is closely related to deficiency of spleen and stomach,and is correlated with the pathological factors of turbid phlegm and blood stasis.For the Chinese medicine treatment of cholelithiasis,Professor Liu follows the principle of"treatment in accordance with three categories of etiological factors"(i.e,seasons,environment and body constitution).He advocates the integration of traditional Chinese medicine and western medicine,and is good at utilizing Lingnan herbs and distinctive herbs that can dissolve stones and remove stones.The treatment for cholelithiasis is mainly through the therapies of soothing liver and alleviating depression,clearing heat and removing dampness,and normalizing gallbladder function to remove stones,and is also supplemented by the therapies of invigorating spleen and replenishing qi,regulating qi to resolve phlegm,and activiting qi movement and blood circulation.Modified Da Chaihu Decoction plus Sijin Decoction is often used as a basic formula for treating cholelithiasis,which is mainly composed of Desmodii Styracifolii Herba,Galli Gigerii Endothelium Corneum,Bupleuri Radix,Curcumae Radix,Scutellariae Radix,Aucklandiae Radix,Aurantii Fructus Immaturus stir-fried with bran,Paeoniae Radix Rubra,Linderae Radix,and Rhei Radix et Rhizoma.

Professor Liu Fengbin,a renowned traditional Chinese medicine(TCM)expert in Guangdong Province,specializes in treating digestive system disorders of hepatobiliary and splenic diseases with Chinese herbal medicine,and has accumulated extensive experience in intervening viral hepatitis type B and hepatitis B-related liver fibrosis.Professor Liu proposes that dampness,heat,stasis,toxin,and deficiency are the primary pathogenic factors of hepatitis B-related liver fibrosis.The disease is rooted in the liver,and is also closely related to the spleen and kidney and involves the gallbladder,stomach,and triple energizer.Based on TCM dialectical thinking and years of clinical practice,Professor Liu summarized the"eight methods for treating liver diseases"for intervening hepatitis B-related liver fibrosis with Chinese medicine,i.e.,method of activating the spleen and stomach,method of clearing heat and dispelling dampness,method of dispelling dampness and resolving turbidity,method of enriching yin and subduing fire,method of warming yang and tonifying the kidney,method of softening the liver and nourishing blood,method of activating blood circulation and softening hardness,and method of calming the mind and improving sleep.In clinical practice,these methods are flexibly combined based on patients'syndrome types and manifestations.Moreover,Professor Liu is skilled in using herbal groups having Lingnan medicinal characteristics,such as herbal group for clearing heat and removing toxin,and draining dampness to relieve jaundice which is composed of Mallotus Apelta Radix et Rhizoma,Abri Herba and Phyllanthi Urinariae Herba,herbal group for promoting digestion to remove food retention which is composed of Fermentum Rubrum,Crataegi Fructus and Hordei Fructus Germinatus,herbal group for removing blood and eliminating mass group which is composed of vinegar-processed Curcumae Rhizoma,vinegar-processed Trionycis Carapax and Eupolyphaga Steleophaga,and herbal group for protecting liver and lowering enzyme which is composed of Hoveniae Semen and Schisandrae Chinensis Fructus.Professor Liu's medication experience for intervening hepatitis B-related liver fibrosis will provide valuable references for TCM clinical practice in the management of liver diseases.

The clinical characteristics of a neonatal patient with movement disorder and arthrogryposis (NDEEMA) caused by gain-of-function mutation of the SCN1A gene were reported in this article. The 1-year-and-9-month-old boy started seizures since 2 hours after birth. He had funnel-breast, dislocation of the hip, and bipedal varus. Genetic testing showed SCN1A gene de novo missense mutation c.706A>G(p.Ile236Val), causing overall gain-of-function effect. The frequency of seizures decreased significantly after treatment of oxcarbazepine.

Objective:To analyze the influences of coronary angiography(CAG)of transradial artery on the success rate,radiation dose and safety in elderly patients with coronary heart disease(CHD).Methods:This study conducted a prospective study.A total of 150 elderly CHD patients who admitted to Heilongjiang Rad Cross Sengong General Hospital from November 2022 to November 2023 were selected,and they were randomly divided into three groups using a random number table,which included the femoral artery group(n=50),radial artery group(n=50),and ulnar artery group(n=50).The femoral artery group underwent CAG by using the femoral artery approach,and the radial artery group underwent CAG by using the radial artery approach,and the ulnar artery group underwent CAG by using the ulnar artery approach.The CAG success rate and CAG indicators[dosage of contrast agent,X-ray exposure time,time of conducting puncture,corrected TIMI frame count(CTFC)]were compared among the three groups.The radiation-related parameters[cumulative dose(CD),dose-area product(DAP)]also were compared among three groups.The patients'comfort degrees of three groups were assessed by adopting General Comfort Questionnaire(GCQ)at three time points(pre-CAG,during CAG,at the 12th hour post-CAG).In addition,the complications of three groups were recorded.Results:The numbers of success angiography were respectively 47 cases,48 cases and 46 cases in femoral artery group,radial artery group and ulnar artery group,and the success rates of them were respectively 94.00%(47/50),96.00%(48/50)and 92.00%(46/50),without statistically significant differences among three groups(P>0.05).There were not significant differences in the dosage of contrast agent,X-ray exposure time,time of conducting puncture,CTFC,CD and DAP among three groups(P>0.05).In the GCQ scores,the scores pre-CAG of all three groups were highest,followed by those at the 12th hour post-CAG,and then,those during CAG were lowest,which appeared a trend of rise after decline.The total incidence of complication was lowest(6.25%)in the radial artery group,followed by the ulnar artery group(10.87%),and that(21.28%)of the femoral artery group was the highest,but there was not statistically significant difference in that among three groups(P>0.05).Conclusion:The CAG success rates of the radial artery,femoral artery and ulnar artery are similar,and there is not significant difference in radiation dose.However,compared with CAG of femoral artery and ulnar artery,the CAG of radial artery has higher safety,and higher comfort degree at the same time.

Villitis of unknown etiology (VUE) occurs in up to 15% of term placentas. Patients with VUE exhibit increased incidence of gestational diabetes mellitus, gestational hypertension, and preeclampsia, with demonstrated recurrence risk. VUE contributes to various adverse pregnancy outcomes. Its pathogenesis involves abnormal maternal immune responses against fetal allografts and may relate to unidentified microbial infections. Currently, VUE diagnosis relies exclusively on placental pathological examination. Clinical management remains primarily symptomatic, though immunomodulatory therapies show potential. This review summarizes recent advances in VUE epidemiology, pathogenesis, clinical significance, pathological features, and preventive strategies, aiming to enhance clinical understanding of this condition.

Objective:To explore the adverse cardiac event risk signals in arsenical for injection, improve the clinical understanding of the cardiac toxicity of arsenical.Methods:The risk signals of adverse cardiac events associated with arsenical for injection were mined using 3 methods, including reporting odds ratio (ROR) method, proportional reporting ratio (PRR) method, and the Medicines and Healthcare Products Regulatory Agency (MHRA) comprehensive standard method based on data in Shandong Provincial Center of Adverse Drug Reaction Monitoring (Shandong data) in China from the first quarter of 2003 to the fourth quarter of 2022 and the data in US FDA Adverse Event Reporting System (FAERS) database from the fourth quarter of 2003 to the third quarter of 2023. The definition of risk signal in ROR and PRR method was the number of adverse event reports ≥3 and the lower limit of 95% confidence interval ( CI) of ROR and PRR >1. The definition of risk signals in MHRA comprehensive standard method was the number of adverse event reports ≥3, PRR>2, and χ2>4. Results:There were a total of 358 reports on arsenical for injection in Shandong data, of which 275 (76.8%) were related to arsenious acid and sodium chloride injection, and 83 (23.2%) were related to arsenic trioxide for injection. Among the 358 reports, adverse cardiac reactions were reported in 25 reports (7.0%), and severe cases accounted for 28.0% (7/25). There were a total of 1 294 reports on ATO in FAERS, and adverse cardiac events were reported in 418 reports (32.3%), of which severe cases accounted for 62.2% (260/418). The signal mining results form 275 reports on arsenious acid and sodium chloride injection in Shandong data showed that QT interval prolonged, chest tightness, cardiopalmus, and palpitations were risk signals. Among them, the signal strength of QT interval prolonged was the strongest. A total of 35 adverse cardiac event signals were mined in FAERS data, of which the signal strength of QT interval prolonged and long QT syndrome were the strongest. In addition, the strength of 6 arrhythmia signals (bradyarrhythmia, supraventricular premature contraction, ventricular premature contraction, torsade de pointes, ventricular tachycardia, and atrioventricular block) and 6 cardiac organic lesion signals (pericarditis, endocarditis, pericardial effusion, myocarditis, mitral regurgitation, and cardiac enlargement) also ranked high.Conclusions:Arsenical for injection is strongly associated with cardiotoxicity, and the proportion of severe cases is relatively high. The cardiotoxicity mainly affects the QT interval, and can also manifest as various types of arrhythmias and some cardiac organic lesions.