As an exclusive Miao medicine of Honwing Pharma （Guizhou） Co. Ltd.， Yifei Zhike capsules are both a prescription drug and an over-the-counter （OTC） drug. Its main ingredients include Ranunculus ternatus and Panax notoginseng. With the effects of nourishing Yin and moistening the lungs， as well as relieving cough and reducing phlegm， Yifei Zhike capsules are often used in the treatment of acute and chronic bronchitis， pulmonary tuberculosis， and other diseases. However， there is insufficient understanding of their efficacy， suitable syndromes， and safety in clinical practice， with a lack of relevant expert consensus on clinical application. To standardize their clinical application， 30 experts from the fields of respiratory medicine， pharmacy， and evidence-based medicine were invited to develop an Expert Consensus on the Clinical Application of Yifei Zhike Capsules （Consensus for short） through evidence-based medicine methods. The Consensus clarified the syndrome characteristics， disease stages， dosages， treatment courses， combined medication， and other norms in the treatment of acute/chronic bronchitis and pulmonary tuberculosis and could be applicable to clinical physicians and pharmacists in medical and health institutions at all levels. In disease diagnosis， it provided diagnostic criteria for traditional Chinese medicine and Western medicine and clarified that the suitable traditional Chinese medicine syndrome was the syndrome of Qi-Yin deficiency with intermingled phlegm-blood stasis. Clinical studies have confirmed that Yifei Zhike capsules combined with standard anti-tuberculosis therapy can effectively improve the symptoms of pulmonary tuberculosis patients， increase the sputum smear conversion rate， and promote the absorption of lesions. When treating acute cough caused by respiratory tract infections， Yifei Zhike capsules can increase the markedly effective rate and the seven-day disappearance rate of cough symptoms. Meanwhile， recommendations for specific usage， dosages， and treatment courses were given for different diseases， and it was pointed out that long-term medication required key monitoring of adverse reactions. In safety， the adverse reactions of Yifei Zhike capsules involved multiple aspects such as the digestive system and allergic reactions， and pregnant women and women during menstruation were prohibited from using it. In addition， modern research has shown that Yifei Zhike capsules have an adjuvant therapeutic effect on tuberculous pleurisy and may be effective for inflammatory and benign pulmonary nodules. However， further research should be conducted on the toxicological safety of long-term medication. The formulation of the Consensus provides a scientific basis for the rational clinical application of Yifei Zhike capsules， which helps to improve clinical efficacy and reduce medication risks.

As an exclusive Miao medicine of Honwing Pharma （Guizhou） Co. Ltd.， Yifei Zhike capsules are both a prescription drug and an over-the-counter （OTC） drug. Its main ingredients include Ranunculus ternatus and Panax notoginseng. With the effects of nourishing Yin and moistening the lungs， as well as relieving cough and reducing phlegm， Yifei Zhike capsules are often used in the treatment of acute and chronic bronchitis， pulmonary tuberculosis， and other diseases. However， there is insufficient understanding of their efficacy， suitable syndromes， and safety in clinical practice， with a lack of relevant expert consensus on clinical application. To standardize their clinical application， 30 experts from the fields of respiratory medicine， pharmacy， and evidence-based medicine were invited to develop an Expert Consensus on the Clinical Application of Yifei Zhike Capsules （Consensus for short） through evidence-based medicine methods. The Consensus clarified the syndrome characteristics， disease stages， dosages， treatment courses， combined medication， and other norms in the treatment of acute/chronic bronchitis and pulmonary tuberculosis and could be applicable to clinical physicians and pharmacists in medical and health institutions at all levels. In disease diagnosis， it provided diagnostic criteria for traditional Chinese medicine and Western medicine and clarified that the suitable traditional Chinese medicine syndrome was the syndrome of Qi-Yin deficiency with intermingled phlegm-blood stasis. Clinical studies have confirmed that Yifei Zhike capsules combined with standard anti-tuberculosis therapy can effectively improve the symptoms of pulmonary tuberculosis patients， increase the sputum smear conversion rate， and promote the absorption of lesions. When treating acute cough caused by respiratory tract infections， Yifei Zhike capsules can increase the markedly effective rate and the seven-day disappearance rate of cough symptoms. Meanwhile， recommendations for specific usage， dosages， and treatment courses were given for different diseases， and it was pointed out that long-term medication required key monitoring of adverse reactions. In safety， the adverse reactions of Yifei Zhike capsules involved multiple aspects such as the digestive system and allergic reactions， and pregnant women and women during menstruation were prohibited from using it. In addition， modern research has shown that Yifei Zhike capsules have an adjuvant therapeutic effect on tuberculous pleurisy and may be effective for inflammatory and benign pulmonary nodules. However， further research should be conducted on the toxicological safety of long-term medication. The formulation of the Consensus provides a scientific basis for the rational clinical application of Yifei Zhike capsules， which helps to improve clinical efficacy and reduce medication risks.

Objective To investigate the clinical significance of neutrophil-to-lymphocyte ratio(NLR),systemic immune-inflammatory index(SII),systemic inflammation response index(SIRI),and aggregate index of systemic inflammation(AISI)in chronic kidney disease(CKD)patients complicated with heart failure.Methods This study enrolled 190 CKD patients complicated with heart failure(case group)and 30 CKD patients without heart failure(control group)who treated in the outpatient and inpatient departments of Wenling Hospital of Traditional Chinese Medicine from January 2022 to December 2024.Differences in NLR,SII,SIRI,and AISI between the two groups were compared,and the relationship between these inflammatory markers and traditional Chinese medicine(TCM)syndrome types in CKD patients complicated with heart failure was analyzed.Logistic regression analysis and receiver operating characteristic(ROC)curve were used for evaluating the predictive efficacy of NLR,SII,SIRI,and AISI for illness severity of CKD complicated with heart failure.Results(1)The levels of NLR,SII,SIRI,and AISI in the case group were significantly higher than those in the control group(P＜0.01).(2)In CKD patients complicated with heart failure,NLR,SII,SIRI,and AISI were positively correlated with N-terminal pro-brain natriuretic peptide(NT-proBNP)levels(P＜0.01).(3)Among the CKD patients complicated with heart failure of fundamentally deficiency syndromes,spleen-kidney yang deficiency syndrome was the most prevalent,followed by spleen-kidney qi-yin deficiency syndrome,spleen-kidney qi deficiency syndrome,and yin-yang deficiency syndrome.Among the CKD patients complicated with heart failure of incidentally excess syndromes,blood stasis syndrome was the most common,followed by damp-heat syndrome,urinary toxin retention syndrome,and water-damp syndrome.(4)In CKD patients complicated with heart failure of fundamentally deficiency syndromes,NLR,SII,SIRI,and AISI levels ranked in the decreasing sequence in the syndromes of yin-yang deficiency,spleen-kidney yang deficiency,spleen-kidney qi-yin deficiency,and spleen-kidney qi deficiency;in the patients with incidentally excess syndromes,the levels ranked in the decreasing sequence in urinary toxin retention,damp-heat syndrome,blood stasis syndrome,and water-damp syndrome(P＜0.05).(5)Multivariate logistic regression identified NLR,SII,SIRI,and AISI as independent risk factors for illness severity of CKD complicated with heart failure(P＜0.01).(6)ROC curve analysis demonstrated high values of NLR,SII,SIRI,and AISI in differentiating illness severity of CKD complicated with heart failure(P＜0.01).Conclusion Inflammatory markers of NLR,SII,SIRI,and AISI exhibit significant correlation with illness severity of CKD complicated with heart failure,suggesting their potentiality as biological markers for TCM syndrome differentiation and disease progression assessment in this population.

Objective To investigate the correlation between insulin resistance markers[triglyceride-glucose(TyG)index],inflammatory indicators[neutrophil-to-lymphocyte ratio(NLR),C-reactive protein(CRP)],and traditional Chinese medicine(TCM)syndromes in patients with diabetic kidney disease(DKD)complicated by carotid atherosclerosis(CAS).Methods This retrospective study enrolled 300 DKD patients with CAS(case group)and 30 DKD patients without CAS(control group).Differences in TyG index,NLR,and CRP levels were compared between groups.The relationships between these markers and carotid intima-media thickness(IMT)/plaque area were analyzed,along with their variations across TCM syndromes.Logistic regression and receiver operating characteristic(ROC)curve analyses were performed to evaluate the predictive value of TyG index,NLR,and CRP for plaque stability and prognosis.Results(1)The TyG index,NLR,and CRP levels in patients with DKD and CAS were significantly higher than those in patients with DKD alone(P＜0.01).(2)The TyG index,NLR,and CRP were significantly positively correlated with IMT and plaque area(P＜0.01).(3)In patients with DKD combined with CAS,the TyG index,NLR,and CRP levels in those with unstable plaques were significantly higher than those with stable plaques(P＜0.01).(4)Among the distribution of TCM syndromes in patients with DKD combined with CAS,the qi and yin deficiency syndrome had the highest proportion(33.33％),followed by spleen and kidney yang deficiency syndrome(28.67％),yin and yang deficiency syndrome(22.00％),and turbid toxin and stasis obstruction syndrome(16.00％).(5)Among patients with DKD and CAS,the TyG index,NLR,and CRP levels in patients with different TCM syndromes decreased in the following order:turbid toxin and stasis obstruction syndrome,yin and yang deficiency syndrome,spleen-kidney yang deficiency syndrome,and qi and yin deficiency syndrome.(6)Logistic regression analysis results showed that TyG index,NLR,and CRP levels were closely associated with plaque stability in patients with DKD combined with CAS(P＜0.05 or P＜0.01).(7)ROC analysis showed that these markers have high prognostic value in DKD-CAS(P＜0.01).Conclusion TyG index,NLR,and CRP may serve as potential biomarkers for TCM syndrome differentiation and prognosis assessment in DKD-CAS.

The compilation instructions for the Expert Consensus on Clinical Application of Yifei Zhike Capsules systematically expound the development background， methodological framework， and core achievements of this consensus. In view of the problems existing in the clinical application of Yifei Zhike Capsules， such as insufficient efficacy evidence and lack of standardized syndrome differentiation， the Institute of Basic Research in Clinical Medicine， China Academy of Chinese Medical Sciences took the lead and collaborated with 21 tertiary grade-A hospitals and research institutions across China to form a multidisciplinary expert group （comprising 30 experts in clinical medicine， pharmacy， and methodology）. The compilation work was carried out in strict accordance with the World Health Organization （WHO） guidelines， the GB/T 1.1-2020 standard， and the writing specifications for the explanatory notes of expert consensus on clinical application of Chinese patent medicines. Through systematic literature retrieval （including 32 studies， with 24 clinical studies）， Grading of Recommendations Assessment， Development and Evaluations （GRADE）-based evidence grading， and multiple rounds of discussions using the nominal group method （25 experts voted to determine 17 clinical questions）， 5 evidence-based recommendations and 11 expert consensus suggestions were formed. It is clarified that this medicine （Yifei Zhike Capsules） is applicable to the treatment of expectoration/hemoptysis in acute and chronic bronchitis and the adjuvant treatment of pulmonary tuberculosis. It is recommended that it can be used alone or in combination with anti-tuberculosis drugs. The safety evaluation shows that this medicine mainly induces the following adverse reactions： mild gastrointestinal reactions （such as nausea and abdominal pain） and rashes. The contraindicated populations include pregnant women and women during menstruation. The compilation process of the consensus underwent three rounds of expert letter reviews， two rounds of peer reviews， and quality control assessments to ensure methodological rigor and clinical applicability. In addition， through policy alignment， academic promotion， and a dynamic revision mechanism， the standardization of clinical application was promoted， providing a demonstration for the evidence-based transformation of characteristic therapies of Miao medicine.

Background The current increasing trend of new cases of occupational noise-induced deafness indicates that the hearing loss of occupational population has not been effectively controlled in China. It is of great significance to study the characteristics of hearing loss among noise-exposed workers and its related factors. Objective To investigate characteristics and influencing factors of hearing loss among occupational noise-exposed workers in a large machinery maintenance enterprise, and to provide a scientific basis to prevent and control noise-induced hearing loss. Methods A cross-sectional survey was conducted to investigate male Han occupational noise-exposed workers in a large mechanical maintenance enterprise. We acquired demographic characteristics, occupational exposure history, and individual life behavior characteristics of the workers through questionnaires, collected occupational exposure level data from annual occupational disease hazard factor surveillance reports, obtained pure tone hearing threshold test data through occupational health examinations, and estimated individual noise exposure levels using cumulative noise exposure (CNE). According to the results of pure tone air conduction hearing threshold test, the workers were divided into a hearing loss group and a normal hearing group. The chi-square test was employed to compare the occupational exposure characteristics and individual life behavior characteristics between the two groups. Additionally, the trend chi-square test was utilized to analyze the changing trends of age, length of service, CNE, and hearing loss rate within the two groups. The relationship between high-frequency hearing loss in both ears and its related influencing factors was assessed by a multiple logistic regression model. Results The M (P₂₅, P₇₅) of CNE for the 2531 occupational noise-exposed workers was 97.51 (95.39, 99.96) dB(A)·year. The incidence of hearing anomaly, binaural high-frequency hearing anomaly, random ear high-frequency hearing anomaly, binaural low-frequency hearing anomaly, and random ear low-frequency hearing anomaly were 22.48%, 16.59%, 22.13%, 2.77%, and 3.52%, respectively. High-frequency hearing threshold increase was the main reason for hearing anomaly (98.42%). In comparison to the CNE ≤ 97 dB(A)·year group, the 97 dB(A)·year100 dB(A)·year group experienced a 36.4% and 52.3% increase in the risk of bilateral high-frequency hearing loss, respectively. The smoking group exhibited a 43.5% elevated risk of bilateral high-frequency hearing loss when compared to the non-smoking group. Conversely, the group frequently wearing hearing protection equipment demonstrated a 23.6% lower risk of bilateral high-frequency hearing loss in comparison to the group occasionally wearing protective equipment. The data suggested that CNE＞97 dB(A)·year and smoking might be independent risk factors for bilateral high-frequency hearing loss, and frequently wearing hearing protection equipment might be an important protective factor. Conclusion Increased CNE and smoking can elevate the risk of high-frequency hearing loss, while personal hearing protection can effectively reduce the risk of hearing loss.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective Gallstone disease(GSD)is one of the common digestive tract diseases with a high worldwide prevalence.The effects of GSD on patients include but are not limited to the symptoms of nausea,vomiting,and biliary colic directly caused by GSD.In addition,there is mounting evidence from cohort studies connecting GSD to other conditions,such as cardiovascular diseases,biliary tract cancer,and colorectal cancer.Early identification of patients at a high risk of GSD may help improve the prevention and control of the disease.A series of studies have attempted to establish prediction models for GSD,but these models could not be fully applied in the general population due to incomplete prediction factors,small sample sizes,and limitations in external validation.It is crucial to design a universally applicable GSD risk prediction model for the general population and to take individualized intervention measures to prevent the occurrence of GSD.This study aims to conduct a multicenter investigation involving more than 90 000 people to construct and validate a complete and simplified GSD risk prediction model.Methods A total of 123 634 participants were included in the study between January 2015 and December 2020,of whom 43 929 were from the First Affiliated Hospital of Chongqing Medical University(Chongqing,China),11 907 were from the First People's Hospital of Jining City(Shandong,China),1 538 were from the Tianjin Medical University Cancer Institute and Hospital(Tianjin,China),and 66 260 were from the People's Hospital of Kaizhou District(Chongqing,China).After excluding patients with incomplete clinical medical data,35 976 patients from the First Affiliated Hospital of Chongqing Medical University were divided into a training data set(n=28 781,80% )and a validation data set(n=7 195,20% ).Logistic regression analyses were performed to investigate the relevant risk factors of GSD,and a complete risk prediction model was constructed.Factors with high scores,mainly according to the nomograms of the complete model,were retained to simplify the model.In the validation data set,the diagnostic accuracy and clinical performance of these models were validated using the calibration curve,area under the curve(AUC)of the receiver operating characteristic curve,and decision curve analysis(DCA).Moreover,the diagnostic accuracy of these two models was validated in three other hospitals.Finally,we established an online website for using the prediction model(The complete model is accessible at https://wenqianyu.shinyapps.io/Completemodel/,while the simplified model is accessible at https://wenqianyu.shinyapps.io/Simplified/).Results After excluding patients with incomplete clinical medical data,a total of 96 426 participants were finally included in this study(35 876 from the First Affiliated Hospital of the Chongqing Medical University,9 289 from the First People's Hospital of Jining City,1 522 from the Tianjin Medical University Cancer Institute,and 49 639 from the People's Hospital of Kaizhou District).Female sex,advanced age,higher body mass index,fasting plasma glucose,uric acid,total bilirubin,gamma-glutamyl transpeptidase,and fatty liver disease were positively associated with risks for GSD.Furthermore,gallbladder polyps,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,and aspartate aminotransferase were negatively correlated to risks for GSD.According to the nomograms of the complete model,a simplified model including sex,age,body mass index,gallbladder polyps,and fatty liver disease was constructed.All the calibration curves exhibited good consistency between the predicted and observed probabilities.In addition,DCA indicated that both the complete model and the simplified model showed better net benefits than treat-all and treat-none.Based on the calibration plots,DCA,and AUCs of the complete model(AUC in the internal validation data set=74.1%[95% CI:72.9%-75.3%],AUC in Shandong=71.7%[95% CI:70.6%-72.8%],AUC in Tianjin=75.3%[95% CI:72.7%-77.9%],and AUC in Kaizhou=72.9%[95% CI:72.5%-73.3%])and the simplified model(AUC in the internal validation data set=73.7%[95% CI:72.5%-75.0%],AUC in Shandong=71.5%[95% CI:70.4%-72.5%],AUC in Tianjin=75.4%[95% CI:72.9%-78.0%],and AUC in Kaizhou=72.4%[95% CI:72.0%-72.8%]),we concluded that the complete and simplified risk prediction models for GSD exhibited excellent performance.Moreover,we detected no significant differences between the performance of the two models(P>0.05).We also established two online websites based on the results of this study for GSD risk prediction.Conclusions This study innovatively used the data from 96 426 patients from four hospitals to establish a GSD risk prediction model and to perform risk prediction analyses of internal and external validation data sets in four cohorts.A simplified model of GSD risk prediction,which included the variables of sex,age,body mass index,gallbladder polyps,and fatty liver disease,also exhibited good discrimination and clinical performance.Nonetheless,further studies are needed to explore the role of low-density lipoprotein cholesterol and aspartate aminotransferase in gallstone formation.Although the validation results of the complete model were better than those of the simplified model to a certain extent,the difference was not significant even in large samples.Compared with the complete model,the simplified model uses fewer variables and yields similar prediction and clinical impact.Hence,we recommend the application of the simplified model to improve the efficiency of screening high-risk groups in practice.The use of the simplified model is conducive to enhancing the self-awareness of prevention and control in the general population and early intervention for GSD.

The "brain electric field" therapy is a novel electroacupuncture method created by Professor GAO Weibin to treat cerebral infarction in the recovery period. This therapy is suitable for the treatment of motor disorders, sensory disorders, cognitive disorders, hemianopsia and bulbar paralysis during the recovery period of cerebral infarction. Based on the different symptoms, the corresponding brain functional areas are selected, supplemented with Taiyang 2, Tunyan 2, Tiyan, Gongxue and Xiatianzhu. These points are attached to electric acupuncture apparatus, and stimulated with dense wave, at frequency of 50 Hz and tolerable intensity. This therapy presents a remarkable effect on cerebral infarction in the recovery period, providing the new approach to the treatment of this disease.
Humans ; Cerebral Infarction/therapy* ; Electroacupuncture ; Acupuncture Points ; Brain/physiopathology* ; Male ; Middle Aged ; Female

ObjectiveThrough a randomized， double-blind， double-simulation， positive-control， multicenter design， this study aimed to analyze the relationship between the dosage， efficacy， and safety of Pudilan anti-inflammatory oral liquid in treating acute pharyngitis/tonsillitis in adults caused by bacterial infection and validate the regulatory effect of Pudilan anti-inflammatory oral liquid on inflammatory markers such as serum amyloid A （SAA）， C-reactive protein （CRP）， white blood cells （WBC）， neutrophil percentage （NE%）， and erythrocyte sedimentation rate （ESR）， thereby exploring the feasibility of using Pudilan anti-inflammatory oral liquid as a substitute for antibiotics in the treatment of infectious diseases and providing a basis for rational clinical medication. MethodUsing a stratified randomized， double-blind， double-simulation， positive-control， multicenter design， 220 participants were enrolled from nine centers. The participants were randomly divided into three groups at 1∶1∶1 — a Pudilan anti-inflammatory oral liquid 20 mL group （73 cases）， a Pudilan anti-inflammatory oral liquid 10 mL group （73 cases）， and a control group （amoxicillin group， 74 cases）. The treatment course was 7 days. The study observed parameters including the total effective rate of sore throat， onset and disappearance time of sore throat， health status score， treatment time， and inflammation markers. Result①Dataset division： The 211 cases were included in the full analysis dataset （FAS）， 208 cases were included in the per-protocol dataset （PPS）， and 218 cases were included in the safety dataset （SS）. ② Efficacy evaluation： There were statistically significant differences （P<0.05） in the comparison of the three groups regarding the total effective rate of sore throat， disappearance time of sore throat， and health status. Both the 20 mL and 10 mL groups were non-inferior to the control group， and there was a statistically significant difference between the 20 mL and 10 mL dosage groups （P<0.05）. There was no statistically significant difference in the comparison of onset time of sore throat among the groups. CRP， WBC， and NE% of patients in all three groups significantly decreased on the 7^th day of treatment compared with those before treatment （P<0.01）. ③Safety evaluation： Adverse events mainly occurred in various examination indicators. There were no statistically significant differences in the comparison between groups， and no adverse reactions or serious adverse events occurred. ④Economic evaluation： The increased cost of the 10 mL and 20 mL dosage groups was entirely justified as compared with that in the control group. When comparing the 10 mL and 20 mL dosage groups， the 10 mL dosage group was deemed less advantageous. ConclusionPudilan anti-inflammatory oral liquid can be used alone as an alternative to antibiotics in the treatment of acute pharyngitis/tonsillitis caused by bacterial infection. It demonstrates good safety and can lower inflammation markers such as CRP， WBC， and NE%， suggesting its potential to reduce the body's inflammatory response. Its mechanism of action may be related to its multi-target regulatory mechanism.