Background and Aims:Spontaneous isolated superior mesenteric artery dissection(SISMAD)is a relatively common type of visceral artery dissection,typically presenting with acute abdominal pain.In severe cases,it may lead to intestinal ischemia or even necrosis.With the widespread use of imaging techniques such as CT angiography(CTA),the detection rate of SISMAD has significantly increased.However,there is still controversy regarding its optimal treatment strategy,especially in choosing between conservative management and endovascular intervention,as no unified standard currently exists.This study aimed to compare the short-and medium-term outcomes of the two treatment modalities by retrospectively analyzing the clinical data of SISMAD patients treated at our center in order to provide evidence for individualized treatment decisions.Methods:A retrospective analysis was conducted on 174 patients diagnosed with SISMAD at Ningbo Second Hospital between January 2018 and December 2023.Among them,30 patients received conservative treatment,and 144 underwent endovascular intervention(including stent implantation alone or in combination with coil embolization of the false lumen).All patients were diagnosed using CTA or superior mesenteric artery angiography and classified accordingly.Patients were followed up at 1 month and 1 year after treatment to assess clinical symptom relief and radiological outcomes,including dissection remodeling and stent patency.Results:In the conservative group,the symptom relief rate was 90.0%at 1 month and 92.8%at 1 year;in the interventional group,the corresponding rates were 99.3%and 98.6%.The difference in symptom relief at 1 month was statistically significant(P=0.016),while the difference at 1 year was not(P>0.05).Subgroup analysis by classification showed that the interventional group generally had higher symptom relief rates than the conservative group across all types.However,none of the differences reached statistical significance(all P>0.05).The conservative group showed poorer symptom control in type Ⅲpatients,including one death.The technical success rate of endovascular treatment was 99.3%,with no cases of stent displacement or occlusion within 1 year.The complete remodeling rate was 86.8%,and the stent patency rate was 100.0%.Some patients had minor mural thrombus formation within the stent without evidence of flow obstruction.Conclusion:Endovascular intervention offers a high technical success rate and favorable short-and medium-term efficacy in SISMAD patients,particularly for type Ⅱ and Ⅲ cases with compromised true lumen perfusion.Treatment strategies should be tailored based on the dissection type and the degree of true lumen compression to improve clinical outcomes and reduce associated risks.

Background and Aims:Spontaneous isolated superior mesenteric artery dissection(SISMAD)is a relatively common type of visceral artery dissection,typically presenting with acute abdominal pain.In severe cases,it may lead to intestinal ischemia or even necrosis.With the widespread use of imaging techniques such as CT angiography(CTA),the detection rate of SISMAD has significantly increased.However,there is still controversy regarding its optimal treatment strategy,especially in choosing between conservative management and endovascular intervention,as no unified standard currently exists.This study aimed to compare the short-and medium-term outcomes of the two treatment modalities by retrospectively analyzing the clinical data of SISMAD patients treated at our center in order to provide evidence for individualized treatment decisions.Methods:A retrospective analysis was conducted on 174 patients diagnosed with SISMAD at Ningbo Second Hospital between January 2018 and December 2023.Among them,30 patients received conservative treatment,and 144 underwent endovascular intervention(including stent implantation alone or in combination with coil embolization of the false lumen).All patients were diagnosed using CTA or superior mesenteric artery angiography and classified accordingly.Patients were followed up at 1 month and 1 year after treatment to assess clinical symptom relief and radiological outcomes,including dissection remodeling and stent patency.Results:In the conservative group,the symptom relief rate was 90.0%at 1 month and 92.8%at 1 year;in the interventional group,the corresponding rates were 99.3%and 98.6%.The difference in symptom relief at 1 month was statistically significant(P=0.016),while the difference at 1 year was not(P>0.05).Subgroup analysis by classification showed that the interventional group generally had higher symptom relief rates than the conservative group across all types.However,none of the differences reached statistical significance(all P>0.05).The conservative group showed poorer symptom control in type Ⅲpatients,including one death.The technical success rate of endovascular treatment was 99.3%,with no cases of stent displacement or occlusion within 1 year.The complete remodeling rate was 86.8%,and the stent patency rate was 100.0%.Some patients had minor mural thrombus formation within the stent without evidence of flow obstruction.Conclusion:Endovascular intervention offers a high technical success rate and favorable short-and medium-term efficacy in SISMAD patients,particularly for type Ⅱ and Ⅲ cases with compromised true lumen perfusion.Treatment strategies should be tailored based on the dissection type and the degree of true lumen compression to improve clinical outcomes and reduce associated risks.

The insufficient reporting of adverse reactions of Chinese proprietary medicines is common. In addition, there is a lack of safety information in the specifications of Chinese proprietary medicines, which led to less evidence for clinical safety of Chinese proprietary medicines in clinical practice. It is urgent to carry out post-marketing clinical safety re-evaluation of Chinese proprietary medicine. Developing a clinical safety evaluation data set for Chinese proprietary medicine may reduce the insufficient reporting of safety information and the inconsistency of data reporting in similar studies, as well as include more studies in systematic reviews, so that they can provide higher-level evidence for clinical safety of Chinese proprietary medicine. This paper proposes a method for developing core data set of clinical safety evaluation of Chinese proprietary medicine: firstly, the application scope of core data set for clinical safety evaluation was determined according to the characteristics of diseases, population, research objectives, administration methods, evaluation methods, etc. Systematic reviews and semi-structured interviews should be conducted to develop the list of original items for clinical safety evaluation. Based on the list, Delphi surveys can be developed in different stakeholders. Then the final core data set can be developed via consensus meetings.

Objective: To conduct a comprehensive and systematic review of the efficacy and safety of Wenxin Keli (WXKL) in the treatment of atrial fibrillation (AF) . Methods: Seven databases (PubMed, The Cochrane Library, Web ofScience, CNKI, Wanfang Database, VIP and SinoMed) were searched to identify relevant randomized controlled trials (RCTs) from inceptions to 1 October, 2018. Two review authors independently assessed the methodological quality andanalyzed data by Cochrane handbook and the Rev Man 5.3 software. Begg.s test was conducted to assess publication biasvia Stata 14 software. Results: Twenty-four RCTs with 2246 patients were included in this review. Compared with blankcontrol, placebo or western medicine alone, WXKL alone or combined with western medicine could effectively reducerapid ventricular rate (MD=-7.14, 95％CI:-8.42——5.87), the frequency and duration of AF. It could also shorten thesinus rhythm conversion time (MD=-3.04, 95％CI:-3.47——2.61), increase the sinus rhythm conversion rate (RR=1.19, 95％ CI: 1.09～1.29) and decrease recurrence rate of AF (RR=0.28, 95％ CI: 0.13-0.59) . Besides, WXKL alone orcombined with western medicine was beneficial for improving the left ventricular ejection fraction (LVEF) (MD=3.44, 95％ CI: 0.87-6.01), left ventricular end diastolic diameter (LVEDD) (MD=-2.47, 95％ CI:-2.86——2.08), left atrialdiameter (LAd) (MD=-0.91, 95％CI:-1.58——0.25) and P wave dispersion (Pd) (MD=-4.04, 95％CI:-4.15——3.93) .WXKL combined with low-dose amiodarone was superior to conventional-dose amiodarone alone in improving themaximum P wave (Pmax) (MD=-8.25, 95％ CI:-10.33——6.17), and WXKL combined with conventional-doseamiodarone is more effective (MD=-13.10, 95％CI:-13.65——12.55) . Compared with the control group, the treatmentgroup had fewer adverse reactions, and the Begg.s test did not find any publication bias. Conclusion: WXKL alone orcombined with western medicine exhibited better therapeutic effects in the treatment of AF, but these results still needhigh-quality evidence to verify.