Chaihu Guizhi Ganjiangtang was first recorded in the Treatise on Cold Damage （Shang Han Lun）. This prescription is composed of Bupleuri Radix， Scutellariae Radix， Cinnamomi Ramulus， Zingiberis Rhizoma， Trichosanthis Radix， Ostreae Concha， and Glycyrrhizae Radix et Rhizoma. It has the effects of soothing Lesser Yang， warming the spleen， and stimulating the generation of body fluid. It is mainly used to treat digestive tract diseases such as chronic cholecystitis （CC）， irritable bowel syndrome， and non-alcoholic fatty liver disease. Dyspepsia caused by CC presents a variety of gastrointestinal symptoms such as abdominal pain， poor appetite， postprandial fullness， aversion to greasy food， soft stool， and bitter mouth， being a type of biliary dyspepsia. In modern medicine， dyspepsia caused by CC is mainly managed by medical treatment and surgical treatment. Internal medicine mainly focuses on reducing inflammation， promoting the function of gallbladder， resolving stones， alleviating spasms， and relieving the pain for CC， demonstrating definite short-term efficacy but suffering from single effects， high recurrence rate， and poor compliance. Although surgical treatment can cure cholecystitis， it is accompanied by the increased incidence of adverse events such as abdominal pain， diarrhea， and dyspepsia. Modern clinical studies have confirmed that Chaihu Guizhi Ganjiangtang can significantly alleviate the symptoms such as abdominal pain and dyspepsia of CC patients. Pharmacological studies have found that Chaihu Guizhi Ganjiangtang mainly contains active ingredients such as Bupleuri Radix saponins， baicalin， cinnamaldehyde， gingerol， Trichosanthis Radix polysaccharide， Ostreae Concha polysaccharide， and Glycyrrhizae Radix et Rhizoma total flavonoids. Chaihu Guizhi Ganjiangtang can ameliorate the symptoms of dyspepsia caused by CC by inhibiting inflammatory responses， improving gallbladder contraction and gastrointestinal motility， regulating the bile acid-intestinal flora axis and the brain-gut axis， and modulating blood lipids through multiple targets. By reviewing the previous literature， this article summarizes the research progress in the treatment of dyspepsia caused by CC with Chaihu Guizhi Ganjiangtang and its main active ingredients as well as the pathogenesis of this disease and puts forward the shortcomings and improvement strategies for the current research. The review aims to provide a reference for the further research on Chaihu Guizhi Ganjiangtang in the treatment of dyspepsia caused by CC.

Objective:To analyze the accuracy of nine estimation methods for umbilical venous catheterization (UVC) insertion depth in neonates.Methods:This prospective study enrolled neonates who underwent successful UVC placement in the Department of Neonatology at Gansu Provincial Women and Child Healthcare Hospital between September 2023 and October 2024. The standard catheter tip position was defined as the junction of the inferior vena cava and right atrium, with a deviation of ≤0.5 cm considered accurate. Patients were stratified by birth weight (BW) into three groups: <1 500 g, 1 500- 2 499 g, and ≥2 500 g. The actual UVC depth was compared with depths estimated using nine methods: Shukla formula, modified Shukla formula, JSS formula, BW formula, Tambasco formula, modified Tambasco formula, Dunn's nomogram, body surface measurement, and ultrasonographic measurement. Accuracy was evaluated using nonparametric tests and Bland-Altman agreement analysis.Results:The study included 111 neonates: 41 (36.9%) in the <1 500 g group, 55 (49.6%) in the 1 500-2 499 g group, and 15 (13.5%) in the ≥2 500 g group. In the <1 500 g group, accuracy rates ranged from 24% to 56%, with body surface measurement showing the highest accuracy (56%); the mean difference from actual depth was－0.073 cm, with 95% limits of agreement (LOA) of－1.764 to 1.618 cm. In the 1 500-2 499 g group, accuracy rate ranged from 15% to 51%, with the modified Tambasco formula being most accurate (51%); the mean difference was 0.113 cm (95%LOA:－1.558-1.783 cm). In the ≥2 500 g group, accuracy rate ranged from 0/15 to 10/15, with Dunn's nomogram being most accurate (10/15); the mean difference was－0.120 cm (95%LOA:－1.380-1.140 cm).Conclusions:The accuracy of the nine UVC depth estimation methods varied across different BW groups and among methods within the same group. Selection of an estimation method should be tailored to the neonate's birth weight.

Objective To investigate the application of chromosome microarray analysis(CMA)in prenatal diagnosis of 18q deletion syndrome and to analyze the genotype-phenotype correlation of 18q deletion syndrome.Methods Prenatal diagnosis of three fetuses with 18q deletion syndrome was conducted through amniotic fluid karyotype analysis and CMA.Results Karyotype analysis results of the three fetuses were 46,XY,del(18)(q22);46,XY,-18,+mar;and 46,XX,del(18)(q21.2),respectively.The results of CMA showed that Case 1 had a deletion of 10.0 Mb in the 18q22.2q23 region,Case 2 had a deletion of 5.5 Mb in the 18p11.32p11.31 region and a deletion of 20.9 Mb in the 18q21.32q23 region,and Case 3 had a deletion of 24.1 Mb in the 18q21.2q23 region.Therefore,all the three fetuses had 18q deletion syndrome.Conclusion As a molecular diagnostic technique,CMA can accurately detect the location and size of pathogenic chromosome copy number,and identify the pathogenic genes.It can provide useful evidence for prenatal diagnosis and genetic counseling of 18q deletion syndrome.

Objective To analyze the clinical application of the Donabedian-based structure-process-result three-dimensional quality evaluation model for the prevention of stress injury in bone tumor surgery.Methods A total of 284 patients with bone tumor who were admitted to The Second Affiliated Hospital of Naval Medical University from January 2022 to December 2023 were enrolled and assigned to two groups according to the random number table.The control group received routine nursing.In the observation group,the Donabedian-based structure-process-result three-dimensional quality evaluation model was applied to prevent the stress injury in bone tumor surgery.The indexes of the two groups were compared and analyzed.Results Before intervention,there was no significant difference in scores between the two groups(P>0.05).After intervention,the scores of stress injury behavior,skill and knowledge in the observation group were higher than those in the control group(P<0.05).The incidence of stress injury in the observation group was lower than that in the control group(P<0.05).There was significant difference in nursing satisfaction between the two groups(P<0.05).Conclusion Donabedian-based structure-process-result three-dimensional quality evaluation model can not only enhance the self-care ability of the patients undergoing bone tumor surgery,but also prevent stress injury,thus improving patient satisfaction.

Objective To explore the efficacy of the self-formulated Zhuzhang Formula in trea-ting the spleen deficiency with dysfunction of transportation syndrome of idiopathic short stature(ISS)and its effects on the growth rate,disease-related indicators,and bone metabolism indicators in affect-ed children.Methods A total of 80 children with ISS were enrolled as study subjects.They were randomly assigned to control group and observation group using random number table method,with 40 cases in each group.The control group received conventional western medicine treatment,while the observation group was administered self-formulated Zhuzhang Formula in addition to the treatment of the control group.Comparisons were made between the two groups in terms of clinical efficacy,TCM syndrome scores,growth parameters(monthly average height increment,annual growth rate),levels of disease-related indicators[serum insulin-like growth factor-1(IGF-1),bone morphogenetic pro-tein-2(BMP-2),insulin-like growth factor binding protein-3(IGFBP-3)],levels of bone metabo-lism indicators[bone alkaline phosphatase(BAP),type Ⅰ procollagen N-terminal propeptide(PⅠNP),type Ⅰ collagen cross-linked C-terminal telopeptide(β-CTX)],and the incidence of adverse reac-tions.Results The overall effective rate in the observation group was 97.50％,which was significantly higher than the 80.00％ in the control group(P＜0.05).After 3 and 6 months of intervention,the scores for symptoms such as short stature,sallow complexion,loss of appetite,weak voice and shortness of breath,limb weakness,and loose stools,as well as the total TCM syndrome scores,were lower in the observation group than those in the control group,with statistically significant differences(P＜0.05).After 6 months of intervention,the monthly average height increment and annual growth rate were higher in the observation group than those in the control group,and the differences were statistically significant(P＜0.05).After 3 and 6 months of intervention,the levels of IGF-1,BMP-2,IGFBP-3,BAP,and PⅠNP were higher in the observation group than those in the control group,while the level of β-CTX was lower,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion The self-formulated Zhuchang Formula demon-strates remarkable efficacy in treating the spleen deficiency with dysfunction of transportation syndrome of ISS.It can alleviate clinical symptoms by regulating the levels of IGF-1,BMP-2,IGFBP-3,and bone metabolism indicators,thereby promoting the growth and development of affected children,and exhibits high safety.

Objective:To assess iodine nutritional status and the prevalence of thyroid dysfunction in Kunming, Yunnan Province, along with correlation and risk factors between thyroid dysfunction and urinary iodine levels.Methods:This cross-sectional study was conducted from January 2014 to July 2016 using a multi-stage, stratified cluster sampling method. A total of 2 650 residents of Kunming, Yunnan Province, who met the inclusion criteria were selected. Data on participants′ demographics, physical measurements, and laboratory tests were collected through questionnaire and clinical assessments which led to 1 463 subjects in the final analysis considering missing data. Statistical analysis were performed using SPSS 26.0, while R Studio was used to model the nonlinear relationship between urinary iodine levels and the risk of thyroid dysfunction.Results:(1) Among 2 650 subjects, 755(28.5%) were diagnosed with thyroid dysfunction, with incidence rates of clinical hyperthyroidism(0.83%), subclinical hyperthyroidism(0.38%), clinical hypothyroidism(1.36%), subclinical hypothyroidism(17.66%), and isolated thyroid antibody positive(13.85%). The median urinary iodine concentration was 177.49(123.59, 251.85) μg/L, indicating adequate iodine nutritional. (2)Among the 1 463 subjects analyzed, significant differences in urinary iodine were found between healthy individual group and abnormal TSH group or abnormal TSH group and thyroid antibody positive group( H=-83.437, P=0.003; H=107.489, P=0.003). Logistic regression revealed that rural residents had a lower risk of thyroid dysfunction than urban residents( OR=0.429, 95% CI 0.256-0.717, P=0.001). Risk of thyroid disease increased with age, and TSH, thyroid peroxidase antibody(TPOAb), thyroglobulin antibody(TgAb), and urinary iodine levels were identified as significant risk factors, with a U-shaped relationship between urinary iodine levels and thyroid dysfunction. Conclusions:The prevalence of thyroid dysfunction in Kunming is comparable to the national average. The relationship between urinary iodine concentration and thyroid dysfunction follows a U-shaped curve. Factors including region, age, TSH, TPOAb, TgAb, and urinary iodine concentration are associated with thyroid dysfunction.

Objective:To analyze the clinical characteristics and cytokines expression characteristics in infants with mild and severe respiratory syncytial virus (RSV) infection.Methods:From May 2023 to December 2023, plasma samples and clinical information were collected from 16 infants with RSV infection and 14 control infants. Cytek Aurora flow cytometry (Cytek, America) and Enzyme linked immunosorbent assay (ELISA) were used to detect the expression levels of 25 cytokines after mild and severe RSV infection.Results:Cough and nasal obstruction were the main clinical manifestations in infants with mild RSV infection, accompanied by polypnea, wheezing and other symptoms. The main symptoms of severe RSV infection were cough and rales, accompanied by fever and polypnea. In comparison with the control group, the expression levels of IL-2, IL-4, IL-5, IL-6, IL-9, IL-13, IL-22, TNF-α, IFN-α, IFN-β, MIP-1β, I-TAC, ENA-78, GROα, Eotaxin, and MCP-1 in the RSV infection group all exhibited an upregulation trend. Both IP-10 and MIP-3α demonstrated a downward trend in the RSV infection group; however, there was no statistically significant difference ( P>0.05). The levels of IL-10, IFN-γ, MIP-1α, and IL-8 in the RSV infection group were significantly higher than those in the control group, whereas the levels of MIG, TARC, and RANTES in the RSV infection group were significantly lower than those in the control group ( P<0.05). The levels of IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-22, IFN-β, IFN-γ, TNF-α, IL-8, I-TAC, MIP-1β, Eotaxin, and MCP-1 in the mild RSV infection group were significantly higher than those in the severe RSV infection group ( P>0.05). Among these, the levels of MIG, RANTES, TARC, MIP-3α, and ENA-78 in the mild infection group were all lower than those in the severe infection group. The expressions of ENA-78 and MIP-1α in the severe infection group were significantly higher than those in the mild infection group and also higher than those in the control group. There was no significant difference in IP-10 and GROα between the mild and severe RSV infection groups ( P>0.05). Conclusions:The differences in clinical features and cytokines between infants with mild and severe RSV infection provide important data support for the prevention and treatment of RSV infection in infants.

Objective:Using oral iron preparations as the positive control,this study explores the efficacy and safety of intravenous iron isomaltoside in the treatment of moderate postpartum iron deficiency anemia(IDA),as well as the impact of anemia correction on fatigue levels and psychological status among postpartum patients.Methods:Eighty-four patients with moderate iron deficiency anemia during puerperium who were delivered at the Tianjin Medical University General Hospital from April 1,2022,to June 30,2023,were included and randomly as-signed1∶1 to the intravenous group(37cases)or the oraliron group(39cases).Theintravenous group received a one-time infusion of ferric derisomaltose(1000 mg)within 1-3 days after delivery.In the oral group,oral iron(150 mg/day for at least 4 weeks)was administered from postpartum day 1.The improvement effect of anemia and the occurrence of adverse reactions were compared between groups.At the same time,the quality of life assess-ment[Multidimensional Fatigue Inventory(MFI)]and postpartum depression assessment[Edinburgh Postnatal Depression Scale(EPDS)]were self-evaluated by electronic questionnaire,and the degree of fatigue and psy-chological condition were compared.Results:①After treatment,6-8 weeks postpartum follow-up showed that the Hb level(129.1±6.4 g/L vs.119.4±9.6 g/L),Hb growth value(49.8±9.4 g/L vs.39.8±11.8 g/L),and Hb growth percentage(62.7%vs.49.3%)Hb increase≥40 g/L(89.2%vs.53.8%),hematocrit level(34.8%vs.29.4%),mean corpuscular volume(97.6 fl vs.92.5 fl)in the intravenous group were significantly higher than those in the control group(P<0.05).②Comparison within groups:compared with the pre-treatment,the MFI scores of the intravenous group and the oral group were significantly lower after treatment(P<0.05),while the difference between the EPDS scores of the two groups before and after treatment was not statistically significant(P>0.05).Comparison between groups:there was no statistically significant difference in MFI scores and EPDS scores between the two groups before and after treatment(P>0.05).③There were no grade 3 or above adverse events occurred in either group.Conclusions:Intravenous ferric derisomaltose is effective and safe for the treat-ment of postpartum anemia,improving hemoglobin levels more rapidly than oral iron,with similar improvements in fatigue levels and no significant impact on postpartum depression as assessed by EPDS.

This paper interprets the best practice guidelines for Practice Education in Nursing published by the Registered Nurses' Association of Ontario (RNAO), providing a scientific basis and insights for the development and progress of nursing students' practical education in China. The goal is to improve the quality of nursing students' clinical practice and enhance their clinical service capabilities.

Objective To investigate the application of chromosome microarray analysis(CMA)in prenatal diagnosis of 18q deletion syndrome and to analyze the genotype-phenotype correlation of 18q deletion syndrome.Methods Prenatal diagnosis of three fetuses with 18q deletion syndrome was conducted through amniotic fluid karyotype analysis and CMA.Results Karyotype analysis results of the three fetuses were 46,XY,del(18)(q22);46,XY,-18,+mar;and 46,XX,del(18)(q21.2),respectively.The results of CMA showed that Case 1 had a deletion of 10.0 Mb in the 18q22.2q23 region,Case 2 had a deletion of 5.5 Mb in the 18p11.32p11.31 region and a deletion of 20.9 Mb in the 18q21.32q23 region,and Case 3 had a deletion of 24.1 Mb in the 18q21.2q23 region.Therefore,all the three fetuses had 18q deletion syndrome.Conclusion As a molecular diagnostic technique,CMA can accurately detect the location and size of pathogenic chromosome copy number,and identify the pathogenic genes.It can provide useful evidence for prenatal diagnosis and genetic counseling of 18q deletion syndrome.