OBJECTIVE To build a Tibetan-language medication service platform based on “internet+” and evaluate its effect on improving medication compliance and safety of Tibetan patients with chronic disease. METHODS Medication guidance contents of commonly used drugs in the outpatient department were summarized， translated and recorded in Tibetan-language or video to form a “text-audio-video” multi-dimensional “internet+ ” Tibetan-language medication service platform. A total of 387 Tibetan outpatients with chronic disease in our hospital after the implementation of “internet+” Tibetan-language medication service platform （from January 2024 to June 2024） in our hospital were selected as the intervention group， and 387 Tibetan outpatients before the implementation （from January 2023 to June 2023） were selected as the control group. Patients in the control group received conventional window-based Chinese-language medication services， while patients in the intervention group received both conventional window-based Chinese-language medication service and “internet+ ” Tibetan-language medication service. The medication compliance of patients was evaluated using the 12-item Medication Compliance Scale. A six-level causality assessment was conducted as the principles for analyzing adverse drug reactions （ADR） set by the National Center for ADR Monitoring. Additionally， statistics were compiled on the occurrence of ADR that were assessed as “definite”“probable” or “possible” in the causality assessment. RESULTS The proportion （31.0%） of patients with good medication compliance and compliance scores [39.0 （37.0，42.0）] of patients in the intervention group were significantly better than control group [7.0%， 21.0（19.0， 23.0）]（ P＜0.05）. There were no statistically significant differences in the incidence of various types of ADR or the overall incidence between the two groups （P＞0.05）. CONCLUSIONS The “internet+” Tibetan-language medication service platform is constructed successfully； the service can effectively improve the medication compliance of Tibetan-language patients， but its effect on improving the medication safety of patients is limited.

Objective To observe the clinical efficacy of acupuncture in treating chronic insomnia disorder based on Huang Yuanyu's theory of"central qi ascending and descending,harmony of the four dimensions"regarding visceral qi movement.Methods Sixty patients diagnosed with chronic insomnia disorder at the Preventive Treatment Department of Yangjiang Hospital of Traditional Chinese Medicine from March 2022 to February 2023.The patients were randomly divided into an observation group and a control group according to a random number table,with 30 cases in each group.The observation group received acupuncture therapy,while the control group received oral administration of Alprazolam Tablets.The treatment duration spanned 4 weeks with 1 course per week.Clinical efficacy was evaluated after 1 month,and the changes in the Pittsburgh Sleep Quality Index(PSQI)scores and Hamilton Anxiety Rating Scale(HAMA)scores were observed.The Hamilton Depression Rating Scale(HAMD)scores were compared between groups before and after treatment.Results(1)After treatment,the PSQI scores of the two groups of patients were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the PSQI scores,and the difference was statistically significant(P＜0.05).(2)After treatment,the HAMA scores and HAMD scores in the two groups of patients were significantly improved(P＜0.05),an the observation group in improvement of HAMA and HAMD was significantly superior to the control group,with statistically statistical significance(P＜0.05).(3)The total effective rate was 83.33%(25/30)in the observation group and 70.00%(21/30)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Acupuncture based on the ascending and descending of visceral qi movement theory significantly alleviates anxiety and depressive states while improving sleep quality in patients with chronic insomnia disorder,demonstrating notable clinical efficacy.

Aim To investigate the effects of naringenin on atherosclerotic plaque extracellular matrix remodeling and plaque stability.Methods Murine vascular smooth muscle cells were isolated and treated with various doges of naringenin.ApoE-/-mice were fed with high-fat diet and received naringenin by lavage for 16 weeks.Intraplaque nec-rotic core,contents of collagen and fibrous cap thickness were measured by Sirius red-Haematoxylin staining.Elastin was detected by Van Gieson staining.Matrix metalloproteinase(MMP)activity was determined by gelatin zymography and fluorescence-gelatin staining.Results Naringenin(50 μmol/L)increased signal tansducer and activator of transciption 6(STAT6)phosphorylation and promoted tissue inhibitor of metalloproteinase-3(TIMP-3)expression by 3.1-fold(P＜0.001).After naringenin(80 mg/kg)treatment,compared with the control group,the area of plaque necrotic core in aor-tic root decreased by 53％(P＜0.01),the thickness of fibrous caps increased by nearly 50％(P＜0.05),and the degree of elastic fiber degradation decreased.At the same time,naringenin promoted the expression of TIMP-3 in plaques,and corre-spondingly reduced the activity of MMP in plaques.Lentivirus mediated inhibition of TIMP-3 expression in vivo could reduce the protective effect of naringenin on plaque stability.Conclusion Naringin can increase the expression of TIMP-3 in smooth muscle cells,improve the composition of extracellular matrix,and promote the stability of atherosclerotic plaque.

Objective:To evaluate the efficacy and safety of lopinavir/ritonavir (LPV/r) and arbidol in treating patients with coronavirus disease 2019 (COVID-19) in the real world.Methods:The clinical data of 178 patients diagnosed with COVID-19 admitted to Guangzhou Eighth People′s Hospital from January 20 to February 10, 2020 were retrospectively analyzed. According to patient′s antiviral treatment regimens, 178 patients were divided into 4 groups including LPV/r group (59 patients), arbidol group (36 patients), LPV/r plus arbidol combination group (25 patients) and the supportive care group without any antiviral treatment (58 patients). The primary end point was the negative conversion time of nucleic acid of 2019 novel coronavirus (2019-nCoV) by pharyngeal swab.Results:The baseline parameters of 4 groups before treatment was comparable. The negative conversion time of viral nucleic acid was (10.20±3.49), (10.11±4.68), (10.86±4.74), (8.44±3.51) days in LPV/r group, arbidol group, combination group, and supportive care group respectively ( F=2.556, P=0.058). There was also no significant difference in negative conversion rate of 2019-nCoV nucleic acid, the improvement of clinical symptoms, and the improvement of pulmonary infections by CT scan ( P>0.05). However, a statistically significant difference was found in the changing rates from mild/moderate to severe/critical type at day 7 (χ 2=9.311, P=0.017), which were 24%(6/25) in combination group, 16.7%(6/36) in arbidol group, 5.4%(3/56) in LPV/r group and 5.2%(3/58) in supportive care group. Moreover, the incidence of adverse reactions in three antiviral groups was significantly higher than that in supportive care group (χ 2=14.875, P=0.002). Conclusions:Antiviral treatment including LPV/r or arbidol or combination does not shorten the negative conversion time of 2019-nCoV nucleic acid nor improve clinical symptoms. Moreover, these antiviral drugs cause more adverse reactions which should be paid careful attention during the treatment.

Objective:To understand quality improvement (QI) in resuscitation and its impacts on the outcomes in very low birth weight infants (VLBWI).Methods:This was a retrospective study involving 318 cases of VLBWI born in Chongqing Health Center for Women and Children and transferred to the Neonatal Intensive Care Unit (NICU) in the same hospital from January 1, 2017 to December 31, 2019. All recruited VLBWIs were divided into three groups based on chronological order: pre-QI group (born in 2017, n=83), under-QI group (born in 2018, n=102) and post-QI group (born in 2019, n=133). The implementation and effects of different resuscitation strategies, including body temperature management, delayed cord clamping (DCC), respiratory support [continuous positive airway pressure (CPAP) in the delivery room, positive pressure ventilation or tracheal intubation] and oxygen therapy [initial fraction of inspired oxygen (FiO 2), maximum FiO 2 and pure oxygen resuscitation], and the neonatal outcomes in each year were analyzed and compared by trend Chi-square test, Kruskal-Wallis H test, Wilcoxon rank-sum test, analysis of variance and LSD test. Results:(1) The proportion of antenatal steroid exposure increased gradually during the three years [44.6% (37/83), 47.1% (48/102), 72.2% (96/133); χ2trend=18.218, P<0.001]. (2) From 2017 to 2019, the incidence of hypothermia on admission decreased [100.0% (83/83), 90.2% (92/102), 33.8% (45/133); χ2trend=136.042, P<0.001], without increasing the proportion of hyperthermia [0.0% (0/83), 1.0% (1/102), 0.0% (0/133); χ2trend=2.124, P=0.346]. (3) The proportion of VLBWIs receiving DCC increased annually [0.0% (0/83), 29.4% (30/102), 90.2% (120/133); χ2trend=178.659, P<0.001], and the concentration of capillary hemoglobin within 12-24 h after birth also increased [(190.1±34.8), (202.0±29.7), (213.6±32.3) g/L; LSD test, P<0.05]. The incidence of suspected polycythemia (capillary hematocrit >68%) increased annually[7.2%(6/83), 7.8%(8/102), 17.3(23/133); χ2trend=5.825, P=0.016]; While the incidence of confirmed polycythemia (venous hematocrit >65%) was not increased[1.3%(1/80), 2.0%(2/100), 4.8%(6/126); χ2trend=2.333, P=0.127] after excluding those untested cases. (4) The use of CPAP in delivery room increased annually [0.0% (0/83), 28.4% (29/102), 87.2%(116/133); χ2trend=167.721, P<0.001], while that of positive pressure ventilation [44.6% (37/83), 31.9% (32/102), 28.6% (38/133); χ2trend=5.371, P=0.020], and the proportion of intubation within 1 min after birth [100.0% (31/31), 45.0% (9/20), 35.0%(7/20); χ2trend=37.467, P<0.001] and overall intubation [37.3% (31/83), 19.6% (20/102), 15.0% (20/133); χ2trend=13.566, P<0.001] decreased year by year. There was no difference in the percentage of infants receiving chest compression or epinephrine, or with low Apgar scores during the three years (all P>0.05). (5) The initial inhaled FiO 2 [30%(21%-100%), 30%(21%-100%) vs 40(25%-100%)] as well as the highest FiO 2 [40%(21%-100%), 30%(21%-100%) vs 40%(25%-100%)] were significantly lower in 2018 and 2019 than in 2017(all P<0.017). The proportion of infants receiving pure oxygen resuscitation decreased year by year [13.3% (11/83), 1.0% (1/102), 0.8% (1/133); χ2trend=17.719, P<0.001]. There was no statistical difference in radial artery blood gas analysis, the proportion of infants receiving pulmonary surfactant or mechanical ventilation, the highest value of percutaneous bilirubin, the incidence of hyperbilirubinemia, necrotizing enterocolitis, periventricular intraventricular hemorrhage, bronchopulmonary dysplasia, or mortality during hospitalization (all P>0.05). Conclusions:Resuscitation QI program helps reduce the incidence of hypothermia, increased the hemoglobin level after birth, and lessen the use of positive pressure ventilation and tracheal intubation in VLBWIs, without influencing the resuscitation effect or increasing the risk of short-term adverse outcomes.