Based on the thinking of programmatization and proceduralization， this study integrated traditional Chinese medicine （TCM） classic theories with modern knowledge expression technologies to construct a "formula-symptom" syndrome differentiation thinking model centered on "symptom clustering-main syndrome screening-formula adaptation"， and explored the standardization and intelligentization path of TCM syndrome differentiation and treatment. By establishing the mapping relationship model between formulas and syndromes including quantitative weight analysis of chief， deputy， assistant and envoy medicines， designing the logical hierarchical structure of formula-syndrome decision tree （application of three-level decision tree and fuzzy logic）， and formulating the procedural design of four diagnostic methods （structured collection， correlation model， and dynamic correction mechanism）， the standardization and visualization of the syndrome differentiation process are realized. This model can be transformed into the core data set for artificial intelligence training. Through ternary knowledge graph and machine learning algorithms， it can improve the repeatability of syndrome differentiation and the efficiency of diagnosis and treatment， and implement the strategy of "group model + individual modification" to balance the conflict between quantification and individualization. The core value of this model lies in promoting the objectification and precision development of TCM syndrome differentiation and treatment through the integration of traditional syndrome differentiation thinking and modern system science.

Iron is indispensable for the viablility of nearly all living organisms, and it is imperative for cells, tissues, and organisms to acquire this essential metal sufficiently and maintain its metabolic stability for survival. Disruption of iron homeostasis can lead to the development of various diseases. There is a robust connection between iron metabolism and infection, immunity, inflammation, and aging, suggesting that disorders in iron metabolism may contribute to the pathogenesis of arthritis. Numerous studies have focused on the significant role of iron metabolism in the development of arthritis and its potential for targeted drug therapy. Targeting iron metabolism offers a promising approach for individualized treatment of arthritis. Therefore, this review aimed to investigate the mechanisms by which the body maintains iron metabolism and the impacts of iron and iron metabolism disorders on arthritis. Furthermore, this review aimed to identify potential therapeutic targets and active substances related to iron metabolism, which could provide promising research directions in this field.

YOU Zaijing,a doctor of Wumen region,and a famous expert of Treatise on Pathogenic Diseases, also made great achievements in warm diseases. He cleared the source of cold pathogenic diseases and warm diseases, distinguish the difference between them. He put forward the importance of correcting and understanding the disease nomenclature. He explained the names of warm diseases,wind-warm disonder, pestilence,damp-warm disease,warm toxin and warm malaria.He divided warm diseases into newly acquired warm disease, warm disease caused by incubating pathogens, warm disease mixed with dampness and pestilence.He used pungent and cool natured drugs and the method of regulating lung to treat wind warm diseases.In the treatment of warm toxin, he used the method of venting pathogen with cool-scattered natured drugs. In the treatment of warm disease caused by incubating pathogens,he used the method of clearing away heat, nourishing yin and venting pathogen. In the treatment of dampness-warm disease, he used the method of eliminating dampness and heat separately. In the treatment of pestilence, he took the location of disease as the core.According to the different disease locations of the pestilence, different treatment methods and prescriptions were selected.He listed five methods of treating pestilence and established a theoretical framework for the treatment of pestilence,embodying the thought of guiding the trend along the development.He put forward the theory of Six Channels directing Cold and Warm early.He tried to use the syndrome differentiation of six channels system to direct all exogenous diseases such as cold pathogenic diseases and warm diseases. He was the pioneer advocator of the cold-warm combined theory. His views on warm diseases had a profound impact on later doctors. This paper summarizes his main points, analyzes his theory, and provides inspiration for the diagnosis and treatment of warm diseases.

Objective:To investigate epidemiological and clinical characteristics of botulism, and the adverse events among those received botulinum antitoxin treatment.Methods:Patients with discharge diagnosis as botulism in the Second Affiliated Hospital of Xinjiang Medical University were enrolled between 2017 and 2021. The epidemiological and clinical characteristics were evaluated. Infection and mechanical ventilation as in-hospital outcomes according to baseline characteristics were analyzed. Patients with and without the interested outcomes were compared. The adverse outcomes among those received botulinum antitoxin treatment were investigated. Those with and without the adverse outcomes were also compared.Results:Sixty-seven cases of botulism were enrolled, and most cases got sick between January and March (32/67, 47.8%); among them 62 cases were Han ethnicity (92.5%); prevalence was highest in Aksu region (15/67, 22.4%); commonly seen symptoms and signs included fatigue (58/67, 86.6%), dysphagia (48/67, 71.6%), dizziness (42/67, 62.7%), ptosis (42/67, 62.7%), blurred vision (41/67, 61.2%), and limb weakness (35/67, 52.2%). Compared with patients without in-hospital infection ( n=52), patients with in-hospital infection ( n=15) were more likely to have severe botulism (0/52 vs 5/15, χ 2=19.79, P<0.001), diplopia (16/52, 30.8% vs 11/15, χ 2=8.77, P=0.003), dysarthria (17/52, 32.7% vs 11/15, χ 2=7.91, P=0.005), consciousness disorder (1/52, 1.9% vs 4/15, χ 2=10.32, P=0.008). Compared with patients without mechanical ventilation (62/67, 92.5%), patients with mechanical ventilation (5/67, 7.5%) were more likely to have severe botulism (5/5 vs 0/62, χ 2=41.17, P<0.001), and consciousness disorder (4/5 vs 1/62, 1.6%, χ 2=29.58, P<0.001). Among 67 cases of botulism, 19 cases (28.4%) had adverse events after receiving antitoxin treatment, with an average of 6.5 days from the antitoxin treatment beginning to the adverse event onset; among the 19 cases, 18 cases (94.7%) had rash. Age, sex, and severity did not differ between the groups with ( n=19) and without adverse events ( n=48) after receiving antitoxin treatment. Conclusions:Fatigue, dysphagia, dizziness, ptosis were the most frequent symptoms and signs in the botulism in Xinjiang Uygur Autonomous Region, China. Infection was a commonly seen complication of botulism, and proactive prevention and close monitoring were needed. Adverse events after receiving antitoxin were prevalent, and might not be associated with age, sex, and severity of botulism.

Objective:To observe the clinical effect of scraping therapy on lumbar disc herniation (LDH) with different syndromes.Methods:Using the convenient sampling method, a total of 30 non-emergency LDH patients who were admitted to Department of Orthopedics and Traumatology of Yangzhou Hospital of Traditional Chinese Medicine from July 2017 to June 2018 were selected as the research objects. Among them, there were 11 cases of qi stagnation and blood stasis syndrome, 8 cases of damp-heat obstruction syndrome, 7 cases of cold-damp obstruction syndrome and 4 cases of liver and kidney deficiency syndrome. Du meridian, the bladder meridian of Foot Taiyang, as well as Jiaji (EX-B2) in pathological or painful sections, Ashi point, Shenshu (BL 23) , and Weizhong (BL 40) were mainly scraped. The treatment interval is 2~5 days (the marks of scrapping fade) , twice of scrapping as a treatment course and a total of 3 courses involved in the whole treatment. Japanese Orthopaedic Association (JOA) Score, Visual Analogue Scale (VAS) , serum interleukin-1 β (IL-1β) and interleukin-10 (IL-10) were compared before and after scraping.Results:Compared with those before scraping, the JOA score increased, the VAS decreased, the serum IL-1β content decreased and the serum IL-10 content increased after scraping, and the differences were sttaistically significant ( P<0.01) . Among them, the JOA scores of patients with qi stagnation and blood stasis syndrome and cold-damp obstruction syndrome were higher than those of damp-heat obstruction syndrome and liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . The levels of serum IL-10 in patients with qi stagnation and blood stasis syndrome, damp-heat obstruction syndrome and cold-damp obstruction syndrome were higher than those in patients with liver-kidney deficiency syndrome, and the differences were statistically significant ( P<0.05) . Conclusions:The curative effect of scraping in the treatment of LDH is definite, and the curative effect is better for excessive syndromes.

Objective:To explore the research hotspots of early enteral nutrition and analyze its development trend.Methods:The Web of Science core database was retrieved. HistCite and CiteSpace were used to conduct quantitative analysis and co-word clustering analysis of early enteral nutrition.Results:A total of 823 articles were retrieved, and the number of articles was increasing. The research hotspots of early enteral nutrition mainly included severe disease, esophageal cancer, acute pancreatitis, sepsis, malnourished patients and premature infants. At the same time, the selection of early enteral nutrition nutrients was also a research hotspot.Conclusions:Early enteral nutrition research in critically ill patients is mature, and other specialized fields can carry out specialized early enteral nutrition support based on the research on critically ill patients. In the future, comparative studies on the effects of different nutrients in early enteral nutrition can also be carried out.

Objective To summarize the international current status of anesthesia nursing research. Methods The nursing papers were searched across the databank of PubMed and Web of science between 1946 and 2017 and 2012 and 2017,respectively to look into the external characteristics of international anesthesia nursing publications. Using the methods of common words analysis, cluster analysis and citation analysis, we analyzed high frequency subjects and highly cited articles from 2012-2017, analyzing the highlights in the anesthesia nursing. Results 5,041 articles from 1946-2017 were included. The number of articles in anesthesia nursing field was relatively small in first 30 years,increasing year by year since 1970s and speeding up since 1990s.The average number of articles from 2012-2017 was all above 150.The 5,041 articles distributed in 1,260 journals.The top 10 journals accounted for 24.36% of the total number (1228/5041).The articles were mainly published in the developed countries in Europe and America.The hot spots in anesthesia nursing research included anesthesia management and pain management,professional skills of anesthesia nurses and medical team collaboration,intervention on psychological status and complications among perioperative patients. Conclusions The research of anesthesia nursing aboard has attracted more and more attention and formed several research highlights.Domestic research in the field is still at the early stage and in the future,domestic scholars can draw on foreign research highlights to carry out relevant research.

Objective To explore and construct specialist nursing practice of safety management of sedation and analgesia in interventional surgery in China.Methods From February 2016 to November 2017, literature analysis, semi-structured interviews and cross-sectional survey were used to establish the practice scope of specialized nursing in the safety management of sedation and pain relief in interventional surgery. Delphi expert advice consultation method was used to consult and screen related items, and the weight was determined by analytic hierarchy process.Results The positive coefficient of the two rounds of expert consultation was 100％, the expert authority coefficient Cr was 0.85. The coordination coefficients of the second round from the recognition degree, correlation degree and operability were 0.204, 0.228 and 0.215 respectively (P<0.01). Finally, a total of 3 dimensions (46 items), including preoperative evaluation (8 items), intraoperative management (36 items), and postoperative evaluation and monitoring (2 items).Conclusions In order to promote the safety management of sedation and pain relief in interventional surgery, a set of specialized nursing practice areas suitable for nurses were constructed.

Objective To understand current situation of surgery grading management in 22 hospitals from Beijing Municipal Administration of Hospitals,and to discuss the problems and to make suggestions for better application and management.Methods Based on general survey,Surgery of Grading Conditions of All Municipal Hospitals was issued to 22 municipal hospitals to make related staff fill related data.Results Except for 3 specialty hospitals,19 hospitals have launched the surgery grading management,while they are in different steps of implementing hierarchical directory,surgeon permission and dynamic management.These hospitals have different reference standards of making hierarchical directory.84.2％ hospitals give surgeons authorities according to levels of operations evaluated by professional title,surgery grade and doctors' technical skills.There are 14 hospitals applying information management on surgery grading.Conclusion Uniform criteria of hierarchical directory,extension of surgeon permission system and implementation of surgery grading information management will contribute to regulation fulfillment.