Objective To investigate the clinical efficacy of Compound Shenghua Prescription(derived from Shenghua Decoction)assisting tranexamic acid in the treatment of postpartum hemorrhage and to observe its effect on plasma antithrombin Ⅲ(AT-Ⅲ),D-dimer(D-D)and fibrinogen(FIB)levels.Methods A total of 216 patients with postpartum hemorrhage admitted to Shijiazhuang Maternal and Child Health Hospital from January 2023 to March 2024 were selected.The patients were randomly divided into conventional group and trial group by random number table method,with 108 cases in each group.Two groups of patients were given postpartum routine treatment of blood transfusion,anti-shock,fluid infusion,and promoting uterine contraction.Additionally,the conventional group was given tranexamic acid treatment,and the trial group was given Compound Shenghua Prescription assisting tranexamic acid treatment.The course of treatment for the two groups covered 3 days.Before and after treatment,the changes of traditional Chinese medicine(TCM)syndrome scores and levels of coagulation factors and inflammation-stress factors in the two groups were observed.Time for the symptom improvement,hospitalization time,clinical efficacy and incidence of adverse reactions were compared between the two groups.Results(1)After 3 days of treatment,the total effective rate of the trial group was 98.15%(106/108)and that of the conventional group was 91.67%(99/108).The curative effect of the trial group was significantly superior to that of the conventional group(P＜0.05).(2)The duration of bleeding symptoms,hemostasis time,time for the bloody lochia disappearance and hospitalization time in the trial group were significantly shorter than those in the conventional group(P＜0.01).(3)After 3 days of treatment,the scores of primary symptoms,secondary symptoms,and tongue and pulse manifestations in the two groups were significantly lowered compared with those before treatment(P＜0.05),and the decrease in the trial group was significantly superior to that in the conventional group(P＜0.01).(4)After 3 days of treatment,the levels of plasma D-D and FIB in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the level of plasma AT-Ⅲ was significantly increased compared with that before treatment(P＜0.05).The decrease of plasma D-D and FIB levels and the increase of plasma AT-Ⅲ level in the trial group were significantly superior to those in the conventional group(P＜0.01).(5)After 3 days of treatment,the levels of serum C-reactive protein(CRP),lipid peroxide(LPO)and interleukin 8(IL-8)in the two groups were significantly decreased compared with those before treatment(P＜0.05),and the level of serum superoxide dismutase(SOD)was significantly increased compared with that before treatment(P＜0.05).The decrease of serum CRP,LPO and IL-8 levels and the increase of serum SOD level in the trial group were significantly superior to those in the conventional group(P＜0.01).(6)The incidence of adverse reactions in the trial group was 8.33%(9/108),and that in the conventional group was 10.19%(11/108).There was no significant difference between the two groups(P＞0.05).Conclusion Compound Shenghua Prescription assisting tranexamic acid is effective in the treatment of postpartum hemorrhage.It can effectively shorten the bleeding time,relieve clinical symptoms,improve coagulation function and inhibit the expression of inflammation-stress factors.

Objective:To observe the changes of central visual acuity and extracentral visual acuity in eyes with non-arteritic central retinal artery occlusion (NA-CRAO).Methods:A retrospective clinical study. From January 1, 2017 to December 31, 2024, 140 patients (140 eyes) diagnosed with NA-CRAO through ophthalmic examination at Department of Ophthalmology of First People's Hospital of Xianyang City were included in the study. All affected eyes underwent best corrected visual acuity (BCVA), visual field, intraocular pressure, fundus color photography, optical coherence tomography (OCT), and fluorescein angiography (FFA) examinations. After a clear diagnosis, conservative treatment such as reducing intraocular pressure, relieving spasms, and dilating blood vessels should be given immediately. Simultaneously, intravenous and/or arterial thrombolysis therapy should be administered based on the patient's overall condition. Under the same treatment conditions as other treatments, 33 eyes were treated with hyperbaric oxygen therapy within 24 hours after seeking medical attention. The changes in central visual acuity (BCVA) and peripheral visual acuity of the affected eye one month after treatment were observed. BCVA improvement of ≥ 1 line was defined as the increase of no light sensitivity to light sensitivity or above, and the increase of light sensitivity to 0.01 or above. The visual acuity outside the center was determined by the 0 ° axis in front of the eyeball at eye level, and was 10 ° outside visual acuity on the temporal side. Multivariate analysis using logistic regression analysis.Results:Among the 140 cases (140 eyes), there were 84 males (84 eyes) and 56 females (56 eyes). The mean age was (63.89±10.78) years. The duration of illness from the onset of symptoms to the time of diagnosis was 48 (2-720) hours. 6, 1, 14, 47, 41, 16, and 15 eyes were diagnosed with BCVA without light perception, uncertain light perception, manual/anterior, digital/anterior, 0.01-0.10, and ≥ 0.10, respectively. FFA examination revealed delayed arm retinal circulation time and filling of the retinal artery trunk to the peak, with changes in the "arterial front" observed in 126 eyes. OCT examination showed extensive edema and unclear structure in the inner layer of the retina in all patients. Out of 140 eyes, 122 were treated with intravenous thrombolysis and 4 with arterial thrombolysis; 14 eyes did not receive thrombolytic therapy. After treatment, 38 eyes (27.1 %) showed an improvement of BCVA ≥ 1; 67 eyes (47.9%) did not show an improvement in BCVA, and the affected eye had a BCVA of approximately 0.6 without light perception; 17 eyes (12.1 %) showed improvement in peripheral vision, and the peripheral vision of the affected eyes ranged from 0.01 to 0.1, all of whom were patients undergoing intravenous thrombolysis, and prior to treatment, this group of patients had complete blindness in the coarse side visual field of the Amsler grid, and their out of center visual acuity could not be measured. Among the 33 eyes treated with hyperbaric oxygen therapy, 24 eyes (72.7%) showed an increase in BCVA after treatment; 9 eyes did not improve, among which 4 eyes (12.1%) showed improvement in out of center visual acuity. Among the 107 eyes that did not receive hyperbaric oxygen therapy, 49 eyes (45.8%) showed an increase in BCVA after treatment. There was no improvement in 58 eyes (54.2%), among which 13 eyes (12.1%) showed an improvement in out of center visual acuity. The results of logistic regression analysis showed that intravenous thrombolysis and hyperbaric oxygen therapy were independent predictive factors for the improvement of central and extra central visual acuity ( P<0.05). Conclusions:Hyperbaric oxygen therapy within 24 hours of seeking medical attention for patients with NA-CRAO disease course ≤ 1 month has a significant effect on the recovery of central and extra central vision. Intravenous thrombolysis and hyperbaric oxygen therapy are independent predictive factors for the improvement of central and extra central vision.

The significance of the retinal neurovascular unit(NVU)in glaucoma has been established,and it holds po-tential as an effective therapeutic target for neurodegenerative disorders such as glaucoma in the future.NVUs are a cell community composed of neurons,glial cells,and vascular cells,and they engage in the physiological and pathological inter-actions between retinal neurovasculature through neurovascular coupling(NVC).As a representative neurodegenerative disorder of the retina,glaucoma is closely associated with retinal microvasculature and glial cells,rendering the normal functioning of the NVU particularly crucial.In this paper,the structural foundation of the NVU was reviewed,including the leading and coordinating roles of retinal neurons and glial cells in the NVU,and the role of NVCs in regulating retinal blood flow,metabolism,and the clearance of toxic substances.Furthermore,the associations of the components of the NVU and their functional abnormalities with glaucoma were elucidated.This paper will deepen the understanding of the mechanisms of glaucoma from a neurovascular perspective,and provide new preventive directions or therapeutic targets for neuropro-tection in glaucoma.

The significance of the retinal neurovascular unit(NVU)in glaucoma has been established,and it holds po-tential as an effective therapeutic target for neurodegenerative disorders such as glaucoma in the future.NVUs are a cell community composed of neurons,glial cells,and vascular cells,and they engage in the physiological and pathological inter-actions between retinal neurovasculature through neurovascular coupling(NVC).As a representative neurodegenerative disorder of the retina,glaucoma is closely associated with retinal microvasculature and glial cells,rendering the normal functioning of the NVU particularly crucial.In this paper,the structural foundation of the NVU was reviewed,including the leading and coordinating roles of retinal neurons and glial cells in the NVU,and the role of NVCs in regulating retinal blood flow,metabolism,and the clearance of toxic substances.Furthermore,the associations of the components of the NVU and their functional abnormalities with glaucoma were elucidated.This paper will deepen the understanding of the mechanisms of glaucoma from a neurovascular perspective,and provide new preventive directions or therapeutic targets for neuropro-tection in glaucoma.

Objective:To observe the changes of central visual acuity and extracentral visual acuity in eyes with non-arteritic central retinal artery occlusion (NA-CRAO).Methods:A retrospective clinical study. From January 1, 2017 to December 31, 2024, 140 patients (140 eyes) diagnosed with NA-CRAO through ophthalmic examination at Department of Ophthalmology of First People's Hospital of Xianyang City were included in the study. All affected eyes underwent best corrected visual acuity (BCVA), visual field, intraocular pressure, fundus color photography, optical coherence tomography (OCT), and fluorescein angiography (FFA) examinations. After a clear diagnosis, conservative treatment such as reducing intraocular pressure, relieving spasms, and dilating blood vessels should be given immediately. Simultaneously, intravenous and/or arterial thrombolysis therapy should be administered based on the patient's overall condition. Under the same treatment conditions as other treatments, 33 eyes were treated with hyperbaric oxygen therapy within 24 hours after seeking medical attention. The changes in central visual acuity (BCVA) and peripheral visual acuity of the affected eye one month after treatment were observed. BCVA improvement of ≥ 1 line was defined as the increase of no light sensitivity to light sensitivity or above, and the increase of light sensitivity to 0.01 or above. The visual acuity outside the center was determined by the 0 ° axis in front of the eyeball at eye level, and was 10 ° outside visual acuity on the temporal side. Multivariate analysis using logistic regression analysis.Results:Among the 140 cases (140 eyes), there were 84 males (84 eyes) and 56 females (56 eyes). The mean age was (63.89±10.78) years. The duration of illness from the onset of symptoms to the time of diagnosis was 48 (2-720) hours. 6, 1, 14, 47, 41, 16, and 15 eyes were diagnosed with BCVA without light perception, uncertain light perception, manual/anterior, digital/anterior, 0.01-0.10, and ≥ 0.10, respectively. FFA examination revealed delayed arm retinal circulation time and filling of the retinal artery trunk to the peak, with changes in the "arterial front" observed in 126 eyes. OCT examination showed extensive edema and unclear structure in the inner layer of the retina in all patients. Out of 140 eyes, 122 were treated with intravenous thrombolysis and 4 with arterial thrombolysis; 14 eyes did not receive thrombolytic therapy. After treatment, 38 eyes (27.1 %) showed an improvement of BCVA ≥ 1; 67 eyes (47.9%) did not show an improvement in BCVA, and the affected eye had a BCVA of approximately 0.6 without light perception; 17 eyes (12.1 %) showed improvement in peripheral vision, and the peripheral vision of the affected eyes ranged from 0.01 to 0.1, all of whom were patients undergoing intravenous thrombolysis, and prior to treatment, this group of patients had complete blindness in the coarse side visual field of the Amsler grid, and their out of center visual acuity could not be measured. Among the 33 eyes treated with hyperbaric oxygen therapy, 24 eyes (72.7%) showed an increase in BCVA after treatment; 9 eyes did not improve, among which 4 eyes (12.1%) showed improvement in out of center visual acuity. Among the 107 eyes that did not receive hyperbaric oxygen therapy, 49 eyes (45.8%) showed an increase in BCVA after treatment. There was no improvement in 58 eyes (54.2%), among which 13 eyes (12.1%) showed an improvement in out of center visual acuity. The results of logistic regression analysis showed that intravenous thrombolysis and hyperbaric oxygen therapy were independent predictive factors for the improvement of central and extra central visual acuity ( P<0.05). Conclusions:Hyperbaric oxygen therapy within 24 hours of seeking medical attention for patients with NA-CRAO disease course ≤ 1 month has a significant effect on the recovery of central and extra central vision. Intravenous thrombolysis and hyperbaric oxygen therapy are independent predictive factors for the improvement of central and extra central vision.

Objective:To analyze the current research status and hot spots of metabolic syndrome after renal transplantation, and provide reference for domestic research in this field.Methods:Computer retrieval of the literature related to renal transplantation metabolic syndrome in the Chinese Biomedical Literature Service System and the Web of Science core collection database was conducted from January First, 2002 to December 31, 2022. The retrieval results were analyzed using Citespace.6.1.R3c software.Results:After screening, a total of 1024 papers related to metabolic syndrome of renal transplantation were included, including 409 Chinese papers and 615 English papers. In the past 20 years, the number of papers related to metabolic syndrome of renal transplantation in foreign countries has increased progressively, and the overall domestic literature has not increased significantly. Domestic and international research focuses mainly on the epidemiology, pathogenesis, risk factors and related hazards of metabolic syndrome in renal transplantation.Conclusions:The research on metabolic syndrome in renal transplantation has received more and more attention, and still has great research prospects. The risk factors and intervention methods of metabolic syndrome in renal transplantation have been the research focus of scholars at home and abroad in recent years. Chinese scholars can further explore on the basis of previous research, strengthen the exchange and cooperation between different fields, institutions and countries, so as to optimize and improve the related research of metabolic syndrome in kidney transplantation.

ObjectiveTo analyze the quantity-quality transfer of standard decoction of Ginseng Radix et Rhizoma（GRR） decoction pieces produced by fresh and traditional cutting， and to provide reference for quality control and application development of the decoction pieces produced by fresh cutting. MethodTen batches of representative GRR decoction pieces produced by fresh and traditional cutting and their standard decoctions were prepared by standard process， and high performance liquid chromatography（HPLC） fingerprint of the standard decoction was established and performed on an Agilent EC-C₁₈ column（4.6 mm×150 mm， 2.7 μm） with acetonitrile（A）-0.1% phosphoric acid aqueous solution（B） as the mobile phase for gradient elution（0-23 min， 18%-21%A； 23-35 min， 21%-28%A； 35-80 min， 28%-32%A）， and the detection wavelength was 203 nm. Then similarity evaluation， principal component analysis（PCA） and partial least squares-discriminant analysis（PLS-DA） of fingerprint of the standard decoction were performed to screen the differential components with variable importance in the projection（VIP） value>1. Quantitative analysis was carried out on the screened known differential components， and combined with the indicators of the dry extract rate and the transfer rate， to explore the differences in the quantity-quality transfer between the standard decoction of GRR decoction pieces produced by fresh and traditional cutting. ResultThe fingerprint similarity of the standard decoction of GRR decoction pieces produced by fresh and traditional cutting was more than 0.950， and 18 common peaks were identified， including 9 identified common peaks. The results of PCA and PLS-DA showed that there were some differences in the contents of index components between the two standard decoctions. The contents of ginsenoside Rg₁， Re and Ro in GRR decoction pieces produced by fresh cutting were higher than those in traditional decoction pieces， while the contents of ginsenoside Rb₁， Rc ， Rb₂ and Rd were lower than those in traditional decoction pieces. The contents of ginsenoside Rg₁， Re， Rb₁ and Ro in the standard decoction of GRR decoction pieces produced by fresh cutting were higher than those in the standard decoction of traditional decoction pieces， while the contents of ginsenoside Rc ， Rb₂ and Rd were comparable between the two standard decoctions. Compared with the standard decoction of the traditional decoction pieces， the average transfer rates of ginsenoside Rg₁， Rb₁， Rc， Rb₂ and dry extract rate of the standard decoction of GRR decoction pieces produced by fresh cutting were significantly increased（P<0.05）， and the average transfer rate of ginsenoside Re and Rd also increased， but the difference was not statistically significant. ConclusionThe dry extract rate， content and transfer rate of index components of standard decoction of GRR decoction pieces produced by fresh cutting are better than those of the standard decoction of traditional decoction pieces， which can provides data support for the subsequent clinical application of fresh cutting products.

Objective:To observe the clinical and imaging features of patients with retinal vein occlusion (RVO) complicated with retinal artery occlusion (RAO).Methods:A retrospective clinical study. Fifteen patients with 15 eyes with RVO combined with RAO and macular edema diagnosed by ophthalmology examination in the Department of Ophthalmology, First People's Hospital of Xianyang City during 2 years from February 1, 2022 to January 31, 2024 were included in the study. Branch retinal vein occlusion (BRVO) combined with branch retinal artery occlusion (BRAO) occurred in 3 cases and 3 eyes. Central retinal vein occlusion (CRVO) complicated with central retinal artery occlusion (CRAO) in 12 eyes. Best corrected visual acuity (BCVA), intraocular pressure, scanning laser ophthalmoscope, optical coherence tomography (OCT), fluorescein fundus angiography (FFA) and serum homocysteine were all performed. OCT angiography (OCTA) was performed in 6 eyes. All eyes were treated with intravitreal injection of anti-vascular endothelial growth factor drugs. After the initial 1 treatment, dosage was assessed as needed. Follow-up was performed every month for 12 months after treatment. FFA inspection was performed at 3 months. During follow-up, it was found that there were no perfusion areas of capillaries, and retinal laser photocoagulation therapy was given in time. Fundus manifestations, FFA, OCT, OCTA characteristics and causes of disease were analyzed retrospectively.Results:There were 15 eyes in 15 cases, 9 eyes in 9 males; 6 women with 6 eyes. Age was (61.0±9.7) years. All complained of painless vision loss in one eye. All eyes were positive for relative afferent pupillary disorder. Contralateral congenital optic disc defect was in 1 case; hypertension was in 6 cases; hyperhomocysteinemia was in 2 cases; cerebral infarction was in 3 cases; coronary heart disease was in 1 case. CRVO combined with CRAO was in 12 eyes BCVA light sensitivity-0.25. The BCVA of BRVO combined with BRAO were 0.1, 0.4 and 0.25, respectively. All the patients had retinal edema in the posterior pole of the eye, venous sinuous, dilated, thin arteries and stiff shape. The retina presents with flaky or flame-like bleeding. Posterior polar retinal lint patch was in 13 eyes. In 12 eyes with CRVO combined with CRAO, optic disc edema was observed and the boundary was not clear. In 3 eyes with BRVO combined with BRAO, no obvious abnormality was found in the optic disc, and the boundary was clear. FFA examination showed no or prolonged arterial filling, delayed retinal vein laminar flow, relatively slow or even no capillary filling, macular arteriole atretosis to varying degrees, arch ring structure destruction, optic disc telangiectasia and fluorescein leakage. OCT examination showed that the middle and inner layers of the retina were thickened to varying degrees, the diffuse reflex was enhanced, the interlayer structure was unclear, and the reflex of the lower retinal tissue was weakened. The blood flow density of superficial capillary plexus and deep capillary plexus (DCP) decreased in 6 eyes undergoing OCTA examination. Decreased or interrupted blood flow in the vascular bed of DCP. During the follow-up period, there were 13 eyes with no perfusion area of retinal capillary. The time of occurrence was (1.14±0.95) (0-2) months, and the area was 10-75 disc area. Optic nerve atrophy occurred in 5 eyes. At the last follow-up, visual acuity increased, unchanged and decreased in 12, 2 and 1 eyes, respectively.Conclusions:The pathogenesis of RVO-RAO is complicated. Most RVO and RAO occurred simultaneously, and a few RVO occurred several days after RAO. Although the RAO manifestations are not typical, the radiographic features are both RVO and RAO. Compared with BVRO combined with BRAO, the prognosis of visual acuity in CRAO patients with CRVO is worse.

Objective:This work aims to assess the distribution of peripheral blood monocyte subsets, the expression level of the functional markers in rheumatoid arthritis (RA) patients, and analyze the correlation between the above indexes and the onset of RA.Methods:Peripheral blood mononuclear cells were collected and isolated from 62 RA patients, 52 healthy control (HC) and 12 disease control group′s patients via density centrifugation. The enrolled patients were attended or underwent physical examination in East Hospital, Tongji University from June 2020 to December 2021. Monocytes could be classified into classical (CM), intermediate (IM) and non-classical (NCM). Then, the flow cytometry was performed to examine the distribution of monocyte subsets and the measure the expression level of human leukocyte antigen DR (HLA-DR), intracellular tumor necrosis factor α (TNF-α) in peripheral blood monocytes. The statistical methods in this study mainly include: Kruskal-Wallis H test, Chi-Square test, Mann-Whitney U test, Wilcoxon matched-pairs signed ranks test, Spearman correlation coefficient test and Logistic regression analysis. The diagnostic value of IM proportion in RA was analyzed by ROC curve. Results:The monocytes number and monocytes proportion in white blood cells were much higher in RA [0.40 (0.40, 0.50), 7.60% (5.97%, 8.53%)] and disease control [0.40 (0.40, 0.68), 8.20% (5.85%, 10.28%)] compared with HC [0.30 (0.30, 0.40), 5.80% (5.03%, 6.38%)] ( H=24.733, P<0.001; H=27.469, P<0.001). A statistic-significant difference was detected among the proportion of CM[85.49%(76.91%,89.21%),88.94%(86.36%,91.72%),90.26%(80.25%, 92.56%)],IM[11.65%(8.47%,17.89%),7.89%(5.36%,10.75%), 5.56%(4.17%, 8.27%)], NCM[2.22%(1.39%, 3.74%), 2.49%(1.74%, 4.66%), 5.13%(3.39%, 9.85%)] in RA group, HC group and disease control group ( H=11.389, P=0.003; H=20.815, P<0.001; H=10.640, P=0.005). The proportion of CM was lower in RA and the IM proportion was increased in RA( P=0.003; P=0.003). The intracellular TNF-α level of monocytes in all three groups revealed the trend that IM>NCM>CM. The intracellular TNF-α in IM of RA was positively associated with serum TNF-α ( r=0.376, P=0.041). The HLA-DR expression in IM subsets were higher than CM and NCM subsets in all RA,HC and disease control groups. The expression of HLA-DR of IM in RA group and disease control was higher than HC group [8 611.50 (6201.3, 9890.8), 10 295.0 (7 899.0, 13632.0), 6 278.00(4 057.8, 9522.0), H=10.495, P=0.005]. There were no correlations between the proportion of peripheral blood IM and clinical characteristics CRP ( r=0.119, P=0.359), RF ( r=0.204, P=0.112) and ESR ( r=0.153, P=0.236). Logistic regression analysis showed that the proportion of IM ( OR=1.169, 95% CI 1.003-1.363, P=0.046), CRP ( OR=1.277, 95% CI 1.000-1.631, P=0.050), RF ( OR=1.179, 95% CI 1.080-1.287, P<0.001) are positively correlated with RA onset. The area under ROC curve for diagnosis of RA with IM proportion was 0.687, and the 95% confidence interval was 0.590-0.784, P<0.001. Conclusions:The distribution of monocyte subsets in peripheral blood of RA patients is abnormal. The increase in the proportion of IM, the enhanced antigen-presenting ability, and the increased level of TNF-α secretion in RA patients may play an important role in the pathogenesis of RA.

Objective:To explore the application effect of perioperative peripheral venous pathway chain management scheme in surgical patients.Methods:This study was a historical control study. Using the convenient sampling method, surgical patients who were admitted to Peking University People's Hospital from March to July 2018 were selected as the control group and they were given routine intravenous care. The surgical patients who were admitted from January to June 2019 were selected as the observation group, and they were given perioperative peripheral venous pathway chain management scheme on the basis of the control group. A total of 528 patients were included, including 5 cases of detachment due to patient change of treatment plan, 5 cases of detachment due to temporary cancellation of operation, and 3 cases of detachment without relevant data collected by puncture inspection during hospitalization. Finally, 515 patients were included, including 247 cases in the control group and 268 cases in the observation group. A total of 589 indwelling needles were indwelled in the observation group and 474 indwelling needles in the control group. The indwelling needle site, indwelling needle model, re-catheterization rate, indwelling time, failure rate of indwelling needles, venipuncture consumables costs and nursing costs were compared between the two groups.Results:The number of indwelling needles in the medial forearm vein and lateral forearm vein in the observation group was more than that in the control group, and the differences were statistically significant ( P<0.01) . The number of indwelling 20 G indwelling needles in the observation group was more than that in the control group, and the number of indwelling 18 G indwelling needles in the observation group was less than that in the control group, and the differences were statistically significant ( P<0.01) . The failure rate of indwelling needle, re-catheterization rate, venipuncture consumables costs and nursing costs in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.01) . Conclusions:The perioperative peripheral venous access chain management scheme can effectively reduce the failure rate andre-catheterization rate of indwelling needles in surgical patients, reduce related costs, and improve the quality of peripheral venous care.