Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Renal interstitial fibrosis（RIF） is the main pathological manifestation of chronic kidney disease. Due to the complexity of the mechanism， there is no specific treatment for RIF in clinical practice. The abnormal activation of the phosphatidylinositol 3-kinase （PI3K）/protein kinase B（Akt） signaling pathway and the activation of downstream target genes are key drivers of RIF induction and progression. Traditional Chinese medicine has the characteristics of precise efficacy and minimal toxic side effects， and the occurrence and development of RIF can be regulated by multiple targets and mutual coordination. This review focuses on the PI3K/Akt signaling pathway and summarizes the potential targets and regulatory mechanisms of traditional Chinese medicine in the treatment of RIF. It is found that various effective ingredients （such as sinomenine， mangiferin， coumarin derivates from Hydrangea paniculata， etc.） and formulas （such as Fushengong decoction， Qi-Bang-Yi-Shen formula， etc.） of traditional Chinese medicine can inhibit fibroblast proliferation， improve inflammation and oxidative stress， maintain mitochondrial stability， and slow down ferroptosis through this pathway， thereby delaying the occurrence and progression of RIF.

Objective To compare the changes of brain voxel-mirrored homotopic connectivity(VMHC)of patients before and after Tai Chi Chuan training based on functional magnetic resonance imaging(fMRI)technology;To discuss the central effect mechanism of Tai Chi Chuan in treating chronic fatigue syndrome(CFS).Methods A total of 25 CFS patients(experiment group)and 27 healthy individuals(control group)were recruited to undergo a 1-month Tai Chi Chuan intervention.All receive one month of Tai Chi Chuan training.Differences in SF-36 scores and VMHC between CFS patients and HCs were compared.Results Before training,the SF-36 scores in the experimental group were significantly lower than those in the control group(P<0.001),and the VMHC in the bilateral inferior occipital gyrus,paracentral lobule,lingual gyrus,insula and superior temporal gyrus brain areas were weakened.After training,the scores of SF-36 in the experimental group significantly increased(P<0.001),and the VMHC in bilateral inferior occipital gyrus,superior temporal gyrus,anterior cuneiform lobe and paracentral lobule were significantly enhanced.The difference in whole brain VMHC was positively correlated with the difference in energy scores in SF-36(r=0.456,P=0.025);some scores of SF-36 in the control group significantly increased(P<0.05),and no significant changes in VMHC were observed in brain regions.Conclusion Tai Chi Chuan can effectively improve the quality of life of patients with CFS.This change may be related to the enhancement of functional connections in brain regions such as inferior occipital gyrus,superior temporal gyrus,precuneus,paracentral lobule,et al.

Objective This study aims to investigate the primary target and potential mechanism of mangiferin(MF)in treating oral submucous fibrosis(OSF)through Gene Expression Omnibus(GEO)database chip mining,network pharmacology,and molecular docking techniques.Methods Potential therapeutic targets for OSF were identified using GEO chip data.The potential targets of MF were predicted,and disease-related targets for OSF were col-lected from databases.A Venn diagram was created using the EVenn platform to identify overlapping targets.The protein-protein interaction(PPI)network was constructed using the STRING database.Gene ontology(GO)and Kyoto Encyclope-dia of Genes and Genomes(KEGG)enrichment analyses were performed using the DAVID platform.Cytoscape 3.10.1 software was used to visualize a drug-target-pathway-disease network,while AutoDocktools 1.5.6 software was employed for molecular docking analysis.Results A total of 356 potential targets for MF and 360 disease-related targets for OSF were obtained from multiple databases.The top 15 key target proteins in the PPI network were selected as significant candi-dates.GO function and KEGG pathway enrichment analyses revealed that MF treatment primarily involved advanced gly-cation end products-receptor(AGE-RAGE),epidermal growth factor receptor(EGFR),and other signaling pathways associ-ated with OSF pathogenesis.Molecular docking analysis demonstrated that MF exhibited a strong binding activity toward AKT serine kinase 1(AKT1),tumor necrosis factor(TNF),and other core targets.Conclusion These findings suggest that MF may exert its therapeutic effects on OSF through a multitarget approach involving various signaling pathways.

Objective:To evaluate the safety and effectiveness of capsule endoscopy for the diagnosis of intestinal diseases in children.Methods:Clinical data of 113 pediatric patients who received capsule endoscopy in Xi'an Children's Hospital from October 2018 to September 2020 were retrospectively analyzed. The completion rate, passage time of stomach and small intestine, lesion detection rate, adverse reactions and complications of capsule endoscopy were analyzed.Results:Among 113 pediatric patients, 78 (69.03%) were male and 35 (30.97%) were female. The age was (99.8±44.7) months (9-195 months), and 31 (27.43%) were under 7 years old. The minimum weight was 9 kg and the minimum height was 70 cm. Eighty-seven pediatric patients (76.99%) swallowed capsules orally (the oral group) with the minimum age of 4 years and 3 months. Capsules were implanted in 26 pediatric patients (23.01%) under gastroscopy (the gastroscopic group), with the maximum age of 9 years and 2 months. Unexplained abdominal pain (47.79%) and unexplained gastrointestinal bleeding (31.89%) were common in the pediatric patients. The completion rate of capsule endoscopy was 97.35% (110/113), and the detection rate of lesions in small intestine was 31.81% (35/110). The passage time of small intestine in the gastroscopic group was significantly longer than that of the oral group (461.04±129.27 min VS 288.23±107.84 min, t=5.646, P<0.01). There was no significant difference in the passage time of stomach or small intestine among different genders, different ages or different endoscopic examination results ( P>0.05). The positive results of capsule were not correlated with the method of ingestion ( P=0.401, OR=2.562, 95% CI:0.284-23.077), gender ( P=0.154, OR=2.352, 95% CI:0.726-7.616), age ( P=0.949, OR=1.007, 95% CI:0.816-1.242), examination reason ( P=0.246) or small intestine passage time ( P=0.219, OR=1.003, 95% CI:0.998-1.008). No complications such as capsule retention occurred in any pediatric patient. Conclusion:Capsule endoscopy in children is noninvasive, rapid and simple, which can improve the diagnostic rate of small intestinal diseases in children, and can be further promoted in pediatric patients.

Objective:To understand the prevalence and genotype characteristics of enterovirus and Coxsackie virus in hand, foot and mouth disease (HFMD) patients in Qinghai province from 2015 to 2018.Methods:The throat swabs of HFMD patients were collected for virus isolation and RT-PCR in Qinghai province. The nucleotide sequence of the amplified products was determined and analyzed, and the gene evolution tree was constructed with reference to the sequence of some strains of NCBI.Results:From 2015 to 2018, 1 738 samples of clinical diagnosis positive cases were collected, including 326 EV-A71 cases, accounting for 18.76%, 237 CV-A16 cases, accounting for 13.64%, 628 CV-A6 cases, accounting for 36.13%. There were statistically significant differences among different genotypes in 4 years (EV-A71, χ2=245.315, P<0.001; CV-A16, χ2=27.680, P<0.001; CV-A6, χ2=702.713, P<0.001). A total of 317 cell culture isolates were obtained after isolation with RD cells. After sequence, DNA sequences of typical genotypes were selected for sequence analysis, from 2017 to 2018. The homology of all genotypes of VP1 was between 59% and 100%, the homology was 93% to 100% in 19 strains of EV-A71, the homology was 92% to 100% in 20 strains of CV-A16, the homology was 97% to 99% in 6 strains of CV-A6. According to the evolutionary tree, the sequences of EV-A71 strains are all on the C4a branch of the evolutionary tree in Qinghai province; 18 strains of CV-A16 were B1b and 2 stains were 1D; 5 strains of CV-A6 were D3 and 1 was B1. Conclusions:From 2015 to 2018, the prevalent genotypes of HFMD shifted from EV-A71 to CV-A16 and CV-A6 in Qinghai province, The EV-A71 genotype in Qinghai province has always been C4a genotype. There are different genotypes of CV-A16 and CV-A6. The nucleotide sequence differences between different genotypes are large, and the sequence variation among the same gene is small.

Objective: To investigate the genetic characteristics of enterovirus A group 71 type (EV-A71) and etiological features of hand, foot and mouth disease (HFMD) in Xining city in 2017. Methods: The pharyngeal swab specimens were collected from HFMD patients, and detected by real-time reverse transcription-polymerase chain reaction (RT-PCR). For EV-A71 positive samples, virus isolation was performed. Then RNA of EV-A71 strains was extracted, and then VP1 coding region was amplified by RT-PCR. The phylogenetic tree was constructed by comparing with other genotypes and sub-genotypes strains of EV-A71. Results: Total 57 strains of EV-A71 were isolated in Xining city in 2017, which all belonged to genotype C4a, and could be divided into two different lineages by phylogenetic analysis. The epidemic strains of EV-A71 in Xining City was closely related to other provinces of China in 2017. Conclusions C4a was the dominant genotype of EV-A71 in Xining city in 2017, and no other genotype was detected. In addition, EV-A71 isolated from Xining city was co-evolved with EV-A71 in other provinces of China.

Objective To evaluate the difference of Doumas′method and 15 commercial serum total protein ( TP ) methods based on EP9-A3.Methods Serum panels were quantified for TP with Doumas′method and measured in parallel with 15 commercial methods.The linear regression analyses were performed, followed by calculating relative deviation and 95%CI between commercial method and Doumas′method at three different medical decision levels (45 g/L, 60 g/L, 80 g/L).We also calculated relative deviation, 95% limit of agreement ( LoA ) and 95% CI based on classical and improved Bland-Altman method at three different medical decision levels.If both the relative deviation and 95%CI were within 5%, we conside red the commercial serum total protein method was comparable to Doumas′method.Results (1) All assays presented high correlation ( r>0.975, P<0.001) with the Doumas′method.All assays showed that the relative deviations and 95%CIs were within the biological total error goal (5%) at medical decision levels based on regression analysis.(2) Based on classical and improved Bland-Altman method, fourteen of 15 commercial methods showed that the relative deviations and 95%CIs were within +/-5%. Conclusions All commercial assays are comparable to Doumas′method at medical deviation levels.There is no difference between regression analysis and Bland-Altman method for comparison study.

This paper introduces the comparative approach including its implication,implementing ways and values in efferent nervous pharmacological teaching from characteristics of efferent nervous pharmacology.It can be concluded that comparative approach is the suitable teaching method in the teaching of efferent nervous pharmacology.