A patient with a history of sulfonamide allergy and dermatomyositis was admitted to the hospital due to secondary infection.After admission,a comprehensive examination confirmed the presence of Pneumocystis jirovecii pneumonia(PJP)along with cytomegalovirus(CMV)and Klebsiella pneumoniae infections.Clinical pharmacists actively participated in the treatment process by referring to relevant clinical guidelines.For patients with Pneumocystis jirovecii infection,compound sulfamethoxazole(TMP-SMX)should be considered as the primary choice,while desensitization treatment is recommended for those with a history of sulfonamide allergy.Prior to treatment,the patient had pre-existing liver insufficiency and was on long-term glucocorticoid therapy,with complex medications.The clinical pharmacists provided individualized pharmaceutical care for this case,assisting clinicians in formulating scientifically and reasonably tailored drug treatment plans.They also offered new insights and references for selecting appropriate drugs considering the patient's previous sulfonamide allergies.After sulfonamide desensitization,the patients were administered a combination of TMP-SMX and carpofungin for anti-PJP treatment,along with ganciclovir for anti-CMV treatment,resulting in favorable therapeutic outcomes.

To establish a method for determining 26 inorganic elements in earthworm polypeptide and determine the elemental content in different batches of earthworm polypeptide, microwave digestion method was used to pre-treat the samples, and ICP-MS method was used to determine the content of 26 elements in different batches of earthworm polypeptide. The linear relationships of 26 elements were good in the range of 0-1 000 μg·L^-1, with R² greater than 0.999, precision RSD 0.21%-2.71%, repeatability RSD 0.19%-4.69%, stability RSD 0.11%-4.24%, and recovery rates of 82.41%-116.16%. The data was plotted using Origin 2022 software to characterize the distribution of elements content. SPSS 27.0 was used for principal component analysis, and SIMCA 14.1 software was used for OPLS-DA analysis. The results showed that among the 26 elements, the higher content of earthworm polypeptide was K, Na, and Ca, followed by Zn, Fe, Al, B and other trace elements, In, Sc, Co, Pb, Bi and other elements had little or no detectable content, and there were differences in the content of polypeptide in different batches. This study provides a theoretical basis for the production quality control, quality evaluation and drug efficacy application of earthworm polypeptide through the determination and analysis of the elements and content of earthworm polypeptide.

Objective To explore the effect and mechanism of hydroxysafflor yellow A(HSYA)on autophagy in bEnd.3 cells after oxygen-glucose deprivation(OGD).Methods The bEnd.3 cells were divided into normal group(conventional culture),model group(OGD model),HSYA group(OGD model+75 μmol·L-1 HSYA),3-methyladenine(3MA)group(5 mmol·L-1 3MA+OGD model)and 3 MA+HSYA group(5 mmol·L-1 3 MA+OGD model+75 μmol·L-1 HSYA).The level of apoptosis was determined by TUNEL fluorescence staining;Western blot was used to detect the expression of autophagy,blood brain barrier(BBB)related proteins;real time fluorescence quantitative polymerase chain reaction method for determining the expression of sirtuin-1(SIRT1)and forkhead box protein O3a(FOXO3A)mRNA.Results In the normal group,model group,HSYA group,3MA group and 3MA+HSYA group,the positive cells selected for TUNEL staining were 5.00±1.00,28.00±2.00,21.00±3.00,35.33±2.51 and 29.67±2.52;the expression levels of microtubule-associated protein 1 light chain 3-Ⅱ/-Ⅰ(LC3-Ⅱ/-Ⅰ)were 0.90±0.20,1.34±0.10,1.95±0.14,0.76±0.15 and 1.14±0.09;sequestosome 1(P62)were 0.99±0.02,0.60±0.02,0.38±0.01,0.67±0.04 and 0.54±0.01;occludin were 1.39±0.17,0.62±0.15,1.00±0.09,0.40±0.13 and 0.80±0.15;zonula occludens-1(ZO-1)were 1.63±0.20,0.64±0.06,0.98±0.14,0.37±0.14 and 0.87±0.04;SIRT1 mRNA were 1.00±0.00,0.75±0.07,1.69±0.09,0.31±0.02 and 0.56±0.01;FOXO3A mRNA were 1.00±0.00,0.80±0.05,1.47±0.09,0.40±0.01 and 0.62±0.09,respectively.Significant differences were found between model group and normal group,HSYA group and model group,3MA+HSYA group and 3MA group(P＜0.05,P＜0.01,P＜0.001).Conclusion HSYA may enhance autophagy levels in bEnd.3 cells after OGD through the SIRT1/FOXO3A pathway,inhibit cell apoptosis and alleviate BBB damage.

AIM To study the secondary metabolites from the endophytic fungi Candida sp.of Berberis atrocarpa Schneid.METHODS The ethyl acetate fraction and petroleum ether fraction from the secondary metabolites of Candida sp.fermentation extract were separated and purified by silica gel,Sephadex LH-20 and preparative liquid chromatography,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Eighteen compounds were isolated and identified as 1-phenyl-1,2-ethanediol(1),4-hydroxyphenethyl alcohol(2),4-hydroxybenzoic acid(3),4-hydroxyphenylacetic acid(4),3-hydroxyphenylacetic acid(5),3-methylsulfinyl propionic acid(6),phenylacetic acid(7),(S)-N-nitroso-1-amino-p-hydroxy phenylethanol(8),2-phenylacetamide(9),p-hydroxybenzaldehyde(10),ethyl 2-(4-hydroxyphenyl)acetate(11),dibutyl phthalate(12),5,5'-dimethoxybiphenyl-2,2'-diol(13),3-indolealdehyde(14),N-acetyl-L-phenylalanine(15),9-hydroxy-10E,12Z-octadecadienoic acid(16),9-hydroxy-10E,12E-octadecadienoic acid(17),(6E)-5-methylene-6-tetradecenoic acid(18).CONCLUSION Compounds 1,3-8 and 10-18 are isolated from Candida sp for the first time.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To investigate the condylar resorption and influencing factors in post mandibular distraction osteogenesis of the hemifacial microsomia patients.Methods:This retrospective study investigated the clinical data of hemifacial microsomia patients who underwent mandibular distraction osteogenesis in the Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from October 2008 to August 2021. Three-dimensional models of pre-operation and pre-distractor extraction were created by the analysis of CT data via ProPlan CMF 3.0. The height and volume of the condyle were measured. Data were analyzed statistically. According to the changes of condylar height and volume pre- and post-operation, the condylar height resorption rate and volume resorption rate could be calculated. The volume resorption rate of the affected side between Type-Ⅱa and Type-Ⅱb hemifacial microsomia patients, hemifacial microsomia patients whether wearing a bite plate, prereproductive and adolescent hemifacial microsomia patients were compared with the Mann-Whitney U test. The Spearman correlation coefficient analysis was used to determine the correlations of the condylar volume resorption rate and condylar height resorption rate in the affected side with measurements of elogation distance, preoperative condylar height, patient age, and distractor remaining time in mandible. P<0.05 indicates that the difference was statistically significant. Results:Forty-seven Type-Ⅱa hemifacial microsomia patients(36 male patients, 11 female patients) were included, patient age ranged from 5 to 20 years and the mean age was (8.49±2.60) years, 36 patients were in the prereproductive age(5-<10 years old), and 11 patients were in the adolescent age(10-20 years old). Forty-six Type-Ⅱb hemifacial microsomia patients(34 male patients, 12 female patients) were included, patient age ranged from 5 to 20 years and the mean age was (8.93±3.43) years. Thirty-six patients were in the prereproductive age(5-<10 years-old), and ten patients were in the adolescent age(10-20 years-old). The follow-up period of Type-Ⅱa hemifacial microsomia patients was (8.49±2.60) months, and the follow-up period of Type-Ⅱb hemifacial microsomia patients was (9.79±2.59) months. Facial asymmetry was improved effectively. Surgical part of the bone had good osteogenesis. Mouth opening and closing, speech, and eating were all normal. The condylar volume resorption rate 34.8%(19.1%, 54.3%) in the affected side of Type-Ⅱa hemifacial microsomia was significantly associated with the elogation distance ( r=0.46, P=0.001), and it had no correlation with the height of the affected condyle ( r=-0.12, P=0.421), age of patients ( r=-0.06, P=0.691), and distractor remaining time in mandible ( r=-0.10, P=0.517). The condylar volume resorption rate 61.0%(11.2%, 95.0%) in the affected side of Type-Ⅱb hemifacial microsomia was significantly associated with the height of the affected condyle ( r=-0.45, P=0.002) and had weak correlation with the elogation distance ( r=0.29, P=0.049), and it had no correlation with age of patients ( r=0.06, P=0.705), and distractor remaining time in mandible ( r=0.21, P=0.157). However, there was no significant difference in terms of the condylar volume resorption rate of the affected side between Type-Ⅱa and Type-Ⅱb hemifacial microsomia ( z=-1.90, P=0.058). Whether the hemifacial microsomia patients wearing a bite plate following mandibular distraction osteogenesis did not affect the condylar volume resorption rate of the affected side ( z=-1.17, P=0.242 in Type-Ⅱa hemifacial microsomia, z=-0.17, P=0.869 in Type-Ⅱb hemifacial microsomia). The condylar volume resorption rate of the affected side had no significant difference between prereproductive and adolescent hemifacial microsomia patients ( z=-0.18, P=0.860 in Type Ⅱa hemifacial microsomia, z=-1.50, P=0.134 in Type-Ⅱb hemifacial microsomia). Conclusion:Condylar resorption of the affected side would happen in post mandibular distraction osteogenesis of the hemifacial microsomia patients, and the condylar resorption rate of the affected side has relationship with the elogation distance and affected preoperative condylar height.

Objective:To investigate the condylar resorption and influencing factors in post mandibular distraction osteogenesis of the hemifacial microsomia patients.Methods:This retrospective study investigated the clinical data of hemifacial microsomia patients who underwent mandibular distraction osteogenesis in the Department of Maxillofacial Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences from October 2008 to August 2021. Three-dimensional models of pre-operation and pre-distractor extraction were created by the analysis of CT data via ProPlan CMF 3.0. The height and volume of the condyle were measured. Data were analyzed statistically. According to the changes of condylar height and volume pre- and post-operation, the condylar height resorption rate and volume resorption rate could be calculated. The volume resorption rate of the affected side between Type-Ⅱa and Type-Ⅱb hemifacial microsomia patients, hemifacial microsomia patients whether wearing a bite plate, prereproductive and adolescent hemifacial microsomia patients were compared with the Mann-Whitney U test. The Spearman correlation coefficient analysis was used to determine the correlations of the condylar volume resorption rate and condylar height resorption rate in the affected side with measurements of elogation distance, preoperative condylar height, patient age, and distractor remaining time in mandible. P<0.05 indicates that the difference was statistically significant. Results:Forty-seven Type-Ⅱa hemifacial microsomia patients(36 male patients, 11 female patients) were included, patient age ranged from 5 to 20 years and the mean age was (8.49±2.60) years, 36 patients were in the prereproductive age(5-<10 years old), and 11 patients were in the adolescent age(10-20 years old). Forty-six Type-Ⅱb hemifacial microsomia patients(34 male patients, 12 female patients) were included, patient age ranged from 5 to 20 years and the mean age was (8.93±3.43) years. Thirty-six patients were in the prereproductive age(5-<10 years-old), and ten patients were in the adolescent age(10-20 years-old). The follow-up period of Type-Ⅱa hemifacial microsomia patients was (8.49±2.60) months, and the follow-up period of Type-Ⅱb hemifacial microsomia patients was (9.79±2.59) months. Facial asymmetry was improved effectively. Surgical part of the bone had good osteogenesis. Mouth opening and closing, speech, and eating were all normal. The condylar volume resorption rate 34.8%(19.1%, 54.3%) in the affected side of Type-Ⅱa hemifacial microsomia was significantly associated with the elogation distance ( r=0.46, P=0.001), and it had no correlation with the height of the affected condyle ( r=-0.12, P=0.421), age of patients ( r=-0.06, P=0.691), and distractor remaining time in mandible ( r=-0.10, P=0.517). The condylar volume resorption rate 61.0%(11.2%, 95.0%) in the affected side of Type-Ⅱb hemifacial microsomia was significantly associated with the height of the affected condyle ( r=-0.45, P=0.002) and had weak correlation with the elogation distance ( r=0.29, P=0.049), and it had no correlation with age of patients ( r=0.06, P=0.705), and distractor remaining time in mandible ( r=0.21, P=0.157). However, there was no significant difference in terms of the condylar volume resorption rate of the affected side between Type-Ⅱa and Type-Ⅱb hemifacial microsomia ( z=-1.90, P=0.058). Whether the hemifacial microsomia patients wearing a bite plate following mandibular distraction osteogenesis did not affect the condylar volume resorption rate of the affected side ( z=-1.17, P=0.242 in Type-Ⅱa hemifacial microsomia, z=-0.17, P=0.869 in Type-Ⅱb hemifacial microsomia). The condylar volume resorption rate of the affected side had no significant difference between prereproductive and adolescent hemifacial microsomia patients ( z=-0.18, P=0.860 in Type Ⅱa hemifacial microsomia, z=-1.50, P=0.134 in Type-Ⅱb hemifacial microsomia). Conclusion:Condylar resorption of the affected side would happen in post mandibular distraction osteogenesis of the hemifacial microsomia patients, and the condylar resorption rate of the affected side has relationship with the elogation distance and affected preoperative condylar height.

The application of new-generation information technologies such as big data, the internet of things(IoT), and cloud computing in the traditional Chinese medicine(TCM)manufacturing industry is gradually deepening, driving the intelligent transformation and upgrading of the TCM industry. At the current stage, there are challenges in understanding the extraction process and its mechanisms in TCM. Online detection technology faces difficulties in making breakthroughs, and data throughout the entire production process is scattered, lacking valuable mining and utilization, which significantly hinders the intelligent upgrading of the TCM industry. Applying data-driven technologies in the process of TCM extraction can enhance the understanding of the extraction process, achieve precise control, and effectively improve the quality of TCM products. This article analyzed the technological bottlenecks in the production process of TCM extraction, summarized commonly used data-driven algorithms in the research and production control of extraction processes, and reviewed the progress in the application of data-driven technologies in the following five aspects: mechanism analysis of the extraction process, process development and optimization, online detection, process control, and production management. This article is expected to provide references for optimizing the extraction process and intelligent production of TCM.
Medicine, Chinese Traditional ; Drugs, Chinese Herbal ; Quality Control ; Big Data ; Algorithms

Novel coronavirus Omicron variant infection can cause severe illness and even death in certain populations. Omicron variant infection may lead to systemic inflammatory response, coagulation disorder, multi-organ dysfunction and other pathophysiological changes, which are different from other Novel coronavirus variants to a certain extent, so therapeutic strategies should not be the same. The National Medical Center for Major Public Health Events invited experts in fields of infectious diseases, respiratory medicine, intensive care, pediatrics and fever clinic to develop this quick guideline based on the current best evidence and extensive clinical practices. This quick guideline aims to standardize the diagnosis and treatment of novel coronavirus Omicron infection, and to improve the disease management abilities of clinicians.