The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

By combining the origin and research progress of the combination of disease and syndrome, the core pathogenesis, this article explored the research ideas and methods of the core pathogenesis of TCM. It is found that modern TCM is mostly guided by the idea of classification-staging-syndrome differentiation, the main prescription of the main disease, the special prescription of the special disease, and the idea of "dynamic-fixed sequential". The tongue image syndrome differentiation method, clustering analysis method, drug test syndrome method, compound pathogenesis method, "evidence-based pathogenesis-syndrome treatment system" research model, and the integration of traditional Chinese and Western medicine theory were used to explore the core pathogenesis of TCM under the condition of disease. Combined with the advantages of modern medical disease differentiation and TCM syndrome differentiation, the individualized diagnosis and treatment methods of integrated traditional Chinese and Western medicine have been continuously improved, in order to solve the stage contradictions of different clinical stages, effectively delay the progression of the disease and improve the prognosis of the disease.

Replantation of traumatic amputation in children has its own characteristics. This consensus primarily focuses on the issues related to the treatment of traumatically amputated limb injuries in children. Organised along a timeline, the consensus summarises domestic and international clinical experiences in emergency care and injury assessment of traumatic limb amputation limbs, indications and contraindications for replantation surgery, principles and procedures of replantation surgery, postoperative medication and management, as well as rehabilitation in children. The aim of this consensus is to propose standardise the treatment protocols for limb replantation for children therefore to serve as a reference for clinical practitioners in medical practices, and further improve the treatment and care for the traumatic limb amputations in children.

Objective:To explore the scanning and image reconstruction parameters, post-processing technology and effect of clinical application of Force CT microvascular anatomy imaging technology.Methods:From April 2019 to June 2021, 50 cases of free tissue flap transfer were reviewed in Department of Hand and Foot Surgery of Provincial Hospital Affiliated to Shandong First Medical University, including 34 males and 16 females in 3-67 (mean, 37) years old. In which, 33 cases were free flap, 10 were free composite tissue flap and 7 were digit reconstruction. CTA image score and clinical application evaluation were performed respectively. Follow-up was conducted by outpatient visit, telephone call and WeChat.Results:The qualified rate of Force CT microvascular anatomy imaging in 73 parts of 50 patients and the coincidence rate with clinical practice were 100%. All tissue flaps and reconstructed digits survived completely. No vascular compromise and other complicatiors occurred. The postoperative follow-up was 3 to 15 months, with an average of 11 months, and the flap healed well. Of the 7 reconstructed digits, 6 were satisfactory in appearance and 1 was reconstructed with flap plasty because of digit bloat.Conclusion:Force CT microvascular anatomical imaging technology can accurately display and reconstruct microvessels, and has guiding significance for the design and transfer of free tissue flap, which has a good promotion value.

Objective:To investigate the value of ultrasound in the diagnosis of hourglass-like fascicular constrictions of the anterior interosseous nerve.Methods:From July 2010 to July 2020, 12 patients with hourglass-like fascicular constrictions of the anterior interosseous nerve diagnosed in Shandong Medical Imaging Research Institute Affiliated to Shandong University were retrospectively analyzed. The characteristics of the high-frequency ultrasonographic images were summarized and compared with clinical surgery.Results:The hourglass-like fascicular constrictions of the anterior interosseous nerve were all located in the median nerve of the distal upper arm in 12 patients, including 9 cases of single hourglass change and 3 cases of multiple hourglass like changes. High-frequency ultrasound can accurately locate the location of the hourglass-like fascicular constrictions of the anterior interosseous nerve and the extent of neuropathy. The sonogram of hourglass-like fascicular constrictions of the anterior interosseous nerve showed single or multiple hourglass-like changes in the median nerve of the distal upper arm. The nerve fasciculars on both sides of hourglass-like changes were thickened. There was significant difference between the diameter of the affected fascicular and the corresponding position of the contralateral fascicular[(0.20±0.04)cm vs (0.11±0.03)cm, P<0.01]. There was significant difference between the cross-sectional area of the median nerve at the widest part of the lesion side and the corresponding position of the contralateral side[(0.14±0.03)cm 2 vs (0.09±0.03)cm 2, P<0.01]. Conclusions:High-frequency ultrasound is the preferred image method for the diagnosis of hourglass-like fascicular constrictions of the anterior interosseous nerve.

In 1966, Yang Dongyue successfully transferred a second toe to hand for thumb reconstruction, which made a pioneering work for thumb and finger reconstruction. Cobbett firstly performed the human great toe transfer in 1968. In the following 20 years, there have been many reports of toe transplantation in different forms to reconstruct one or more hand digits. In 2007, Wang Zengtao reported a series of "comprehensive reconstructions of thumb and finger". The method is not a simple toe transplantation, but to reconstruct a new thumb or finger according to the structure and shape of normal thumb and finger. The tissue materials needed for digit reconstruction come from different parts of the body, and the toe is still retained in the foot with near-normal appearance and function. The concept of "comprehensive reconstruction of thumb and finger" has been thought as the new trend of digit reconstructions recently. This paper introduces the development of "comprehensive reconstruction of thumb and finger" in China, the common basic operation methods and the prospect for the future.

Objective: To report the effects of operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation. Methods: From January 2015 to January 2019, 16 patients with Sneppen Ⅴ talus fracture were treated at Department Ⅱ of Hand & Foot Microsurgery, The Second Affiliated Hospital to Inner Mongolia Medical University. They were 14 men and 2 women with a mean age of 38.4 years (range, from 20 to 55 years). All fractures were fixed with hollow compression screws through the approach for malleolus medialis Ⅴ osteotomy. The ankle and hindfoot functional scoring system developed by American Orthopaedic Foot and Ankle Society (AOFAS) was used to evaluate the clinical outcomes. Results: All patients were followed up for a mean time of 12.6 months (range, from 6 to 30 months). The mean operation time was 68.4 minutes (range, from 52 to 96 minutes); the mean amount of hemorrhage during operation was 96.8 mL (range, from 48 to 122 mL); the mean period of bone union was 4.8 months (range, from 3 to 8 months). The postoperative mean AOFAS score was 75.3 points (range, from 43 to 91 points). Complications occurred in 4 cases, including one case of talus ischemic necrosis, one case of partial talus ischemic necrosis accompanied by tibial arthritis, one case of subtalar arthritis, and one case of combined tibial, talar and subtalar arthritis. All incisions obtained primary healing, with no complications like infection, screw breakage, delayed union or nonunion. Conclusion Operative treatment of Sneppen Ⅴ talus fracture through the approach for malleolus medialis Ⅴ osteotomy plus hollow compression screw fixation can provide sufficient operative exposure to facilitate reduction and fixation of the talus fracture so that the ischemic necrosis of the talus and traumatic arthritis can be effectively reduced.

Objective To evaluate the value of ultrasonography in diagnosing intraneural ganglion cysts . Methods The ultrasonographic images of 12 patients with intraneural ganglion cysts confirmed by surgery and pathology were retrospectively analyzed . The ultrasonographic features were summarized . Results The ultrasonographic images showed the location ,number ,size ,shape ,boundary ,internal echo , involvement extent and blood supply in intraneural ganglion cysts clearly . Intraneural ganglion cysts showed cystic masses within peripheral nerve ,boundary clear ,irregular-shaped ,ill-acoustic transmissibility ,and separations are common ,color Doppler examination showed no blood flow inside the cysts . Conclusions High frequency sonography is the preferred imaging method for diagnosis of intraneural ganglion cysts .

Objective To explore the operative methods and clinical effects of the reverse island flap pedi-cled with the dorsoulnar artery of the thumb for skin coverage of the thumb tip. Methods From February, 2013 to July, 2016, there were 11 cases of thumb tip defect distal to the superior nail fold who were treated with reverse dor-soulnar island flap, which was located on the dorsoulnar side of proximal thumb, and rotated with a 2 mm-wide pedi-cle at the dorsal arcade of the proximal nail fold. The skin over the rotated pedicle was sutured tensionless and the donor site was sutured directly. Postoperative follow-up was done termly. Results All 11 flaps survived eventually, and 9 cases were followed-up with a period of 3-38 months. Benefitting from the fair colored, well textured, plump but not bulky flap, the restored thumb had a satisfactory figure. The thumb also had good algesthesia and thalposis togeth-er with the flap. The thumb had a nearly normal ROM of interphalangeal joint and metacarpophalangeal joint, and opening angle of first web compared with the contralateral side. Conclusion The reverse island flap of dorsoulnar thumb, which is nourished with a constant vessel, is easily harvested and reliable. The flap can be used to repair the small skin defect of the thumb tip with a good result and few complication.

Functionalized graphene oxide is prepared based on graphene. It has attracted great interest from all over the world due to its good solubility, biocompatibility, high loading rate, and easy modification. This paper summarizes the surface modification of graphene oxide, and its applications on anti-tumor, antibacteria, anti-hypertension, gene therapy and biosafety as a drug carrier, providing new methods and ideas in the biomedical field.