Objective:To comprehensively identify, describe and evaluate the research evidence on the application of ERAS in perioperative head and neck cancer by using the method of evidence mapping, so as to understand the research status and provide reference for clinical practice and future research in this field.Methods:Adopting an evidence-integrated research approach, PubMed, Embase, CINAHL, Web of Science, Cochrane Library, CNKI, Wanfang, VIP and Chinese Biomedical Literature Database were searched by computer. In addition, relevant references and grey literature databases such as OpenGrey were manually searched until August 25, 2024, to screen and summarize the included literature, and different quality evaluation tools were used to evaluate the quality of the included studies. The present research situation was presented with text and graphs.Results:A total of 105 articles were included, including 101 original studies and 4 systematic reviews/Meta-analyses. The number of published literature showed an increasing trend over time, but it fluctuated in a zigzag pattern. The most published studies were in China, and the study population was mainly patients with laryngeal and oral cancer, with a sample size of 51-100 cases. The results of methodology quality evaluation showed that the quality of most studies was relatively low. The intervention measures mainly involved 9 subjects, such as pre-rehabilitation, nutritional support, prevention of nausea and vomiting, and the outcome indicators involved 2 aspects related to patients and hospital. More attention was paid to outcome indicators such as complication rate and length of stay, while less attention was paid to outcome indicators such as condition of sputum and survival time. Most outcome effects were shown to be "beneficial", but some outcome effects were still controversial.Conclusions:ERAS has generally shown positive effects in perioperative application of head and neck cancer, but the quality of most studies is low. More high-quality clinical studies are needed in the future to provide more sufficient evidence for the application of ERAS in this field.

Objective Based on the connotation of high-quality development,it aims to establish an evaluation index system for assessing the qualification of public hospitals to expand bed capacity,providing a reference tool for evaluating suitable hospital scale.Methods A hospital bed resource usage database and indicator system were established based on policy reports and relevant studies.Multiple rounds of expert consultations were conducted to select indicators and set"red lines"to ensure scientific validity and practicality.Results An evaluation system was created with 4 dimensions and 12 indicators for existing hospital campus bed expansion,and 3 dimensions and 4 indicators for new sub-campus expansion.The feasibility of pilot testing was good.Conclusion The proposed indicators effectively explain the aspects of medical service quality and efficiency,sustainability,and patient satisfaction under the framework of high-quality development,offering solutions to address bed resource misallocation.

Hyperuricemia is a chronic metabolic disease resulting from purine metabolic dysfunction and is classified under the category of"blood turbidity"in traditional Chinese medicine.Our team termed it"acid turbidity,"and its pathogenesis is closely related to the dynamic evolution of the clear and the turbid components.With the change of modern people's diet structure,the incidence of hyperuricemia is increasing annually owing to the intake of fatty,sweet foods and alcohol.Therefore,this paper explores hyperuricemia from the"indigestion of spleen and stomach"theory.The core pathogenesis of hyperuricemia is indigestion of spleen and stomach,the inversion of clear and turbid substances,and endogenous acid turbidity.The initial manifestation of hyperuricemia is the internal retention of acid turbidity and ascending-descending disharmony;the gradual manifestation of this disease is that indigestion causes heat,and acid turbidity transforms into poison;the final manifestation of this disease is that secular indigestion causes deficiency and the inversion of clear and turbid substances.It can be summarized into three syndromes:syndromes of internal retention of dampness-turbidity,dampness-heat toxin amassment,and dampness-heat due to spleen deficiency.Therefore,this paper proposes to treat the disease according to different syndromes,with ascending the clear and descending the turbid as the core of treatment.And the therapeutic approach employs the flexible application of three methods:transportation,resolving,and transformation.For syndrome of internal retention of dampness-turbidity,treatment focuses on promoting spleen transportation to eliminate dampness;for syndrome of dampness-heat toxin amassment,the strategy is to resolve indigestion and purge heat;and for syndrome of dampness-heat due to spleen deficiency,the aim is to resolve turbidity and clear heat.By ascending the clear and descending the turbid,so that"returning the clear and the turbid to the original,"the spleen and stomach regain harmony,functions of ascending and descending are reestablished,and hyperuricemia can be effectively managed.

Objective:To evaluate the clinical value and safety of an intraperitoneal chemotherapy port technique in patients with gastric cancer and peritoneal metastases undergoing intraperitoneal chemotherapy.Methods:This was a retrospective, descriptive case analysis. From November 2022 to October 2024, patients diagnosed with gastric cancer and peritoneal metastases at Wuxi Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine with an expected survival >3 months, underwent laparoscopic exploration combined with implantation of an intraperitoneal chemotherapy port [PORT-A-CATH II system (Model 21-4055-24)] implantation. The procedure was as follows: (1) after laparoscopic exploration, a 4-cm skin incision was made at a predetermined site and a subcutaneous pocket created by dissecting to the muscle fascia and removing subcutaneous fat as needed to position the port septum 0.5-1.0 cm from the skin surface; (2) under direct laparoscopic visualization, the abdominal cavity was punctured and a guidewire inserted, followed by an 8.5 Fr sheath, through which a catheter with three trimmed side holes was placed after removal of the sheath; (3) the catheter length in the abdominal cavity was adjusted to 25–30 cm and the catheter trimmed, and connected to the port base, ensuring it extended beyond the connector's visible hole; (4) the whole port was placed within the subcutaneous pocket, and non-absorbable sutures used to create a double purse-string suture at the catheter's abdominal entry, forming an anti-reflux ring; (5) non-absorbable sutures were used to securely fix the port to the fascia through its four base holes and the exposed catheter segments on the fascia sutured and buried; (6) patency was confirmed by injecting saline and followed by intermittent skin closure provided there was no bleeding; and (7) the catheter tip was positioned in the pelvic cavity under laparoscopic guidance. Postoperatively, the patients underwent normothermic intraperitoneal and systemic treatment. The port infusion protocol involved disinfecting the skin (>10 cm diameter) around the port, confirming the puncture site, inserting a Huber needle vertically at 90° to the port base, infusing 100 mL saline to ensure patency, followed by continuous infusion of 1000 mL paclitaxel solution, and sealing with 20 mL saline before removing the needle. No saline flushing was required between chemotherapy infusions. The primary outcomes were the incidence and management of complications post-port implantation.Results:The study cohort comprised 225 patients with gastric cancer and peritoneal metastases. Using standardized port implantation and postoperative puncture procedures, the complication rate during follow-up was 14.2% (32/225), including effusion in 14 patients (6.2%), port infection in 10 (4.4%), incision dehiscence in four (1.8%), port inversion in two (0.9%), hematoma in one (0.4%), and catheter rupture in one (0.4%). Seventy-five percent (24/32) of patients with complications recovered and continued using the port after conservative treatments (e. g., aspiration of effusions, antibiotic therapy, incision management), whereas the remaining 25.0% (8/32) with complications required surgical removal of the port because the treatment was ineffective. The presence of preoperative ascites ( P=0.019) and peritoneal cancer index score>15 ( P=0.038) were significantly associated with development of complications. Conclusions:Our standardized procedure for intraperitoneal chemotherapy port implantation is safe and feasible for patients with gastric cancer and peritoneal metastases, having a low overall complication rate. Most complications can be successfully managed with conservative treatment, the device thus providing reliable support for intraperitoneal chemotherapy.

Percutaneous coronary intervention(PCI)has been widely applied in the clinical treat-ment of coronary atherosclerotic heart disease and achieved good therapeutic effects.However,vascu-lar restenosis caused by postoperative vascular re-modeling still needs attention,which seriously af-fects the long-term efficacy of PCI.The prevention of vascular restenosis is of great significance for cardiovascular diseases.Traditional Chinese medi-cine natural products,with their characteristics of multiple targets,low toxicity and high safety,have attracted increasing attention in recent years.More and more studies have found that traditional Chi-nese medicine natural products have the effect of preventing and treating vascular restenosis and can effectively control its occurrence and development.This article reviews the effects and mechanisms of flavonoids,alkaloids,terpenoids and glycosides,polysaccharides and polyphenols and other tradi-tional Chinese medicine natural products in pre-venting vascular restenosis,and analyzes and sum-marizes the differences in the effects and mecha-nisms of various natural products,providing new ideas for the development of safe and effective drugs to prevent vascular restenosis.

Objective Patients with acute coronary syndrome(ACS)combined with chronic kidney disease(CKD)are at high risk of major adverse cardiovascular events(MACE),and early prediction is crucial for improving prognosis.Non-invasive detection methods,due to their simplicity and safety,have become important tools for assessing risks in such patients.This study aims to evaluate the application value of non-invasive detection indicators in predicting MACE in ACS patients with CKD.Methods The study included 216 ACS patients with CKD,divided into a Non-MACE group(n=149)and a MACE group(n=67).General patient data,non-invasive detection indicators,electrocardiogram(ECG),and cardiac function indicators were collected.Univariate and multivariate logistic regression analyses were performed to explore the relationship between these indicators and MACE.A nomo-gram prediction model was constructed,and its performance was evaluated using ROC curve analysis,calibration curve,and decision curve analysis.Results Univariate analysis showed that age,BMI,SVR,SVRI,HRV,QTd,SDNN,LVEF,LVEDd,SCOPA-AUT score,and GRACE score were significantly associated with MACE.Multivariate analysis identified SVRI,QTd,SDNN,LVEF,LVEDd,SCOPA-AUT score,and GRACE score as independent risk factors for MACE.ROC curve analysis revealed that the model had an AUC value of 0.979,sensi-tivity of 0.925,specificity of 0.966,and accuracy of 0.9537,indicating high diagnostic accuracy.Calibration curve and decision curve analyses further confirmed the model's reliability.Conclusion Non-invasive detection indicators,including SVRI,QTd,SDNN,LVEF,LVEDd,SCOPA-AUT score,and GRACE score,have significant value in predicting MACE in ACS patients with CKD.The constructed prediction model provides an effective tool for clinical risk assessment.

Percutaneous coronary intervention(PCI)has been widely applied in the clinical treat-ment of coronary atherosclerotic heart disease and achieved good therapeutic effects.However,vascu-lar restenosis caused by postoperative vascular re-modeling still needs attention,which seriously af-fects the long-term efficacy of PCI.The prevention of vascular restenosis is of great significance for cardiovascular diseases.Traditional Chinese medi-cine natural products,with their characteristics of multiple targets,low toxicity and high safety,have attracted increasing attention in recent years.More and more studies have found that traditional Chi-nese medicine natural products have the effect of preventing and treating vascular restenosis and can effectively control its occurrence and development.This article reviews the effects and mechanisms of flavonoids,alkaloids,terpenoids and glycosides,polysaccharides and polyphenols and other tradi-tional Chinese medicine natural products in pre-venting vascular restenosis,and analyzes and sum-marizes the differences in the effects and mecha-nisms of various natural products,providing new ideas for the development of safe and effective drugs to prevent vascular restenosis.

Hyperuricemia is a chronic metabolic disease resulting from purine metabolic dysfunction and is classified under the category of"blood turbidity"in traditional Chinese medicine.Our team termed it"acid turbidity,"and its pathogenesis is closely related to the dynamic evolution of the clear and the turbid components.With the change of modern people's diet structure,the incidence of hyperuricemia is increasing annually owing to the intake of fatty,sweet foods and alcohol.Therefore,this paper explores hyperuricemia from the"indigestion of spleen and stomach"theory.The core pathogenesis of hyperuricemia is indigestion of spleen and stomach,the inversion of clear and turbid substances,and endogenous acid turbidity.The initial manifestation of hyperuricemia is the internal retention of acid turbidity and ascending-descending disharmony;the gradual manifestation of this disease is that indigestion causes heat,and acid turbidity transforms into poison;the final manifestation of this disease is that secular indigestion causes deficiency and the inversion of clear and turbid substances.It can be summarized into three syndromes:syndromes of internal retention of dampness-turbidity,dampness-heat toxin amassment,and dampness-heat due to spleen deficiency.Therefore,this paper proposes to treat the disease according to different syndromes,with ascending the clear and descending the turbid as the core of treatment.And the therapeutic approach employs the flexible application of three methods:transportation,resolving,and transformation.For syndrome of internal retention of dampness-turbidity,treatment focuses on promoting spleen transportation to eliminate dampness;for syndrome of dampness-heat toxin amassment,the strategy is to resolve indigestion and purge heat;and for syndrome of dampness-heat due to spleen deficiency,the aim is to resolve turbidity and clear heat.By ascending the clear and descending the turbid,so that"returning the clear and the turbid to the original,"the spleen and stomach regain harmony,functions of ascending and descending are reestablished,and hyperuricemia can be effectively managed.

Objective To investigate the mastery of the management knowledge of patients with atrial fibrillation after coronary artery bypass grafting by cardiac surgeons in Beijing tertiary hospitals, and the practice status and obstacles of following the guidelines for postoperative atrial fibrillation. Methods A convenient sampling method was used to select cardiac surgeons from four tertiary hospitals in Beijing, and a self-designed questionnaire on the management of postoperative atrial fibrillation patients was used. Results A total of 227 valid questionnaires were collected. Only 47.9% of doctors and 12.8% of nurses passed in knowledge, and 31.3% of doctors and 28.5% of nurses passed in behavior. Among them, risk factor assessment, preventive medication, stroke and bleeding risk assessment were the weakest. "Lack of departmental requirements" was identified as a common barrier to healthcare workers' adherence to guidelines. Job title and participation in training were common influencing factors that affected the knowledge and behavior of healthcare workers, and knowledge level was an important factor affecting healthcare worker behavior. Conclusion In order to improve the effect of CABG surgery and improve the quality of postoperative patient management, hospitals should further strengthen the knowledge and skills training of medical staff on the management guidelines of postoperative atrial fibrillation with CABG, formulate relevant systems to ensure the clinical implementation of guidelines.

Osteoporosis （OP） is a systemic metabolic disease with a strong correlation with age. The prevalence of osteoporosis is rising annually as a consequence of the growing issue of population ageing. The current treatments for OP have numerous shortcomings. In contrast， traditional Chinese medicine has a long history and a rich species diversity. Furthermore， recent years have seen an increase in the number of studies examining the anti-OP properties of traditional Chinese medicine. This may provide a safe and effective alternative strategy for the treatment of OP. The zebrafish， due to its favourable optical transparency and high homology with human genes， has been extensively employed as an animal research model in the investigation of human skeletal-related disease mechanisms and drug screening. This paper presents a review of anti-osteoporosis studies of traditional Chinese medicine using zebrafish as a model for osteoporosis. It also provides a summary of the experimental evaluation methods involved in such studies， an analysis of the current status of traditional Chinese medicine in the treatment of osteoporosis using zebrafish as a model， and a summary of the mechanism of action and the signalling pathways involved in traditional Chinese medicine in the anti-osteoporosis treatment of zebrafish. The current research status of Chinese medicine in the treatment of OP was analysed， as well as the mechanism of action of Chinese medicine against OP and the signalling pathways involved. Furthermore， the advantages and disadvantages of various zebrafish modelling methods of OP were compared with those of traditional animal models. The objective of this study is to provide a reference for the evaluation method of the zebrafish model in the study of bone-related diseases， as well as for the study of the mechanism of action of traditional Chinese medicine against OP and for the reference of the research and development of new drugs.