Based on the concept of "blood exhaustion" from The Inner Canon of Yellow Emperor （《黄帝内经》）， a three-stage syndrome differentiation and treatment strategy for cancer-related anorexia-cachexia syndrome is proposeed. In the cancer-induced anorexia stage， the pathogenesis is characterized by cancer consuming the spleen and stomach， leading to stagnation of transportation and transformation in the middle jiao （焦）. Treatment should focus on strengthening the spleen， promoting appetite， dispersing accumulation， and aiding digestion， with modified Zisheng Pills （资生丸） in Extensive Notes on Medicine from Xian Xing Studio （《先醒斋医学广笔记》） or Zisheng Decoction （资生汤） in Records of Chinese Medicine with Reference to Western Medicine （《医学衷中参西录》）. In the pre-cachectic stage of malnutrition， the pathogenesis involves insufficient nourishment of blood and qi with essence depletion hindering production. Treatment should focus on nourishing blood and harmonizing ying （营）， warming yang and supplementing qi， and modified Huangqi Jianzhong Decoction （黄芪建中汤） can be used. In the cachectic stage， the pathogenesis involves blood deficiency and essence exhaustion， with blood stasis obstructing the collaterals. The therapeutic approach should focus on tonifying deficiency and replenishing essence， unblocking collaterals， and removing stasis， and modified Buzhong Yiqi Decoction （补中益气汤） and Zuo Gui Beverage （左归饮） are suggested.

Objective To understand the epidemiological characteristics and trends of postoperative pneumonia(POP)in tertiary general hospitals in Jiangsu Province,and provide theoretical basis for carrying out targeted pre-vention and control measures.Methods Surgery patients from 22 tertiary general hospitals in 12 cities in north,central,and south of Jiangsu Province from January 1,2022 to December 31,2023 were chosen as studied subjects,occurrence of POP was analyzed and compared.Results A total of 848 274 surgical procedures were performed in 22 hospitals,and 3 606 cases of POP occurred,with an incidence of 0.43％.The incidence in 2023 was 0.37％,which was lower than that in 2022(0.49％),with statistically significant difference(P＜0.001).The top three de-partments with high incidence of POP were neurosurgery(6.71％),cardiothoracic surgery(2.91％),and general surgery(0.77％).Among hospitals of different grades,the incidence of POP in tertiary first-class hospitals was 0.44％,which was higher than that in other tertiary hospitals(0.37％).There was no statistically significant difference in the incidence of POP between municipal and district/county hospitals(P＞0.05).The incidence of POP in hospitals with a bed:infection control full-time staff ratio＜200∶1 was lower than that in hospitals with the ratio ≥200∶1(0.39％vs 0.47％,P＜0.001),while the incidence of POP in hospitals with a proportion ≥30％of full-time staff being doctors was higher than that in hospitals with a proportion＜30％(0.45％vs 0.36％,P＜0.001).The incidence of POP in male patients was higher than that in female patients(0.62％vs 0.26％,P＜0.001).The incidence of POP in elderly patients aged≥65 was higher than that in patients aged＜65(0.73％vs 0.26％,P＜0.001).A total of 2 667 strains of infectious pathogens were detected,with the top three being Acine-tobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa,accounting for 28.95％,22.72％,and 15.45％,respectively.The detection rates of carbapenem-resistant Acinetobacter baumannii(CRAB),carba-penem-resistant Klebsiella pneumoniae(CRKP),and carbapenem-resistant Pseudomonas aeruginosa(CRPA)were 60.75％,21.45％,and 32.28％,respectively.The detection rate of CRKP decreased in 2023 compared with 2022,with statistically significant difference(P＜0.05).Conclusion The overall incidence of POP in tertiary general hos-pitals in Jiangsu Province is relatively low,but there are significant differences among different hospitals.There-fore,perioperative prevention and control measures should be carried out based on the epidemiological characteristics of patients.

Purpose To analyze the sonographic features of incarcerated gravid uterus and evaluate the diagnostic value of ultrasonography.Materials and Methods Clinical data of eight patients diagnosed with incarcerated gravid uterus at Sichuan Provincial Maternity and Child Health Care Hospital from January 2018 to December 2023 were retrospectively analyzed.Clinical manifestations,sonographic characteristics,management approaches and pregnancy outcomes were evaluated.Results Among the eight confirmed cases,seven presented with initial symptoms of dysuria and urinary retention,while one reported irregular lower abdominal pain.Ultrasonography consistently demonstrated:retroverted and retroflexed uterine position with the uterine body posterior to the cervix.Elongated cervix(range:4.0-8.6 cm)displaced anteriorly.Overdistended,elongated and superiorly displaced bladder in seven cases.Management included successful manual reduction via knee-chest position after catheterization in seven patients.One patient was managed conservatively with close monitoring and delivered by cesarean section at term.All eight patients achieved successful term deliveries with favorable maternal and neonatal outcomes.Conclusion Prenatal ultrasonography plays a crucial role in diagnosing and managing incarcerated gravid uterus.Early recognition of characteristic sonographic features facilitates prompt diagnosis and intervention,thereby mitigating risks of adverse pregnancy outcomes.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To understand the epidemiological characteristics and trends of postoperative pneumonia(POP)in tertiary general hospitals in Jiangsu Province,and provide theoretical basis for carrying out targeted pre-vention and control measures.Methods Surgery patients from 22 tertiary general hospitals in 12 cities in north,central,and south of Jiangsu Province from January 1,2022 to December 31,2023 were chosen as studied subjects,occurrence of POP was analyzed and compared.Results A total of 848 274 surgical procedures were performed in 22 hospitals,and 3 606 cases of POP occurred,with an incidence of 0.43％.The incidence in 2023 was 0.37％,which was lower than that in 2022(0.49％),with statistically significant difference(P＜0.001).The top three de-partments with high incidence of POP were neurosurgery(6.71％),cardiothoracic surgery(2.91％),and general surgery(0.77％).Among hospitals of different grades,the incidence of POP in tertiary first-class hospitals was 0.44％,which was higher than that in other tertiary hospitals(0.37％).There was no statistically significant difference in the incidence of POP between municipal and district/county hospitals(P＞0.05).The incidence of POP in hospitals with a bed:infection control full-time staff ratio＜200∶1 was lower than that in hospitals with the ratio ≥200∶1(0.39％vs 0.47％,P＜0.001),while the incidence of POP in hospitals with a proportion ≥30％of full-time staff being doctors was higher than that in hospitals with a proportion＜30％(0.45％vs 0.36％,P＜0.001).The incidence of POP in male patients was higher than that in female patients(0.62％vs 0.26％,P＜0.001).The incidence of POP in elderly patients aged≥65 was higher than that in patients aged＜65(0.73％vs 0.26％,P＜0.001).A total of 2 667 strains of infectious pathogens were detected,with the top three being Acine-tobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa,accounting for 28.95％,22.72％,and 15.45％,respectively.The detection rates of carbapenem-resistant Acinetobacter baumannii(CRAB),carba-penem-resistant Klebsiella pneumoniae(CRKP),and carbapenem-resistant Pseudomonas aeruginosa(CRPA)were 60.75％,21.45％,and 32.28％,respectively.The detection rate of CRKP decreased in 2023 compared with 2022,with statistically significant difference(P＜0.05).Conclusion The overall incidence of POP in tertiary general hos-pitals in Jiangsu Province is relatively low,but there are significant differences among different hospitals.There-fore,perioperative prevention and control measures should be carried out based on the epidemiological characteristics of patients.

OBJECTIVE To establish HPLC fingerprints of three drying processes(Atmospheric pressure drying,Decompression drying,Freeze-drying)of Danggui Buxue granules,and combine them with antioxidant tests to determine the optimal drying process and main active components of Danggui Buxue granules.METHODS The fingerprints of multiple batches of Danggui Buxue granules were established by HPLC;the"Fingerprint Similarity Evaluation System of Traditional Chinese Medicine Chromatogram"was used to evaluate the similarity;Hierarchical Cluster Analysis(HCA)and Principal Component Analysis(PCA)were used to characterize the different drying processes of Danggui Buxue granules;evaluate the antioxidant activity of Danggui Buxue granules in different drying processes using 1,1-diphenyl-2-picrylhydrazy(DPPH)and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)diammonium salt(ABTS)free radical scavenging method;the spectrum-effect relationship between Danggui Buxue granules fingerprint and antioxi-dant activity was analyzed by grey correlation degree and Pearson,Spearman,Kendall's tau-b correlation analysis methods.RE-SULTS The results of fingerprint showed that there were 16 common peaks in 30 batches of Danggui Buxue granules,and 6 of them were identified by comparison.The results of Cluster Analysis and Principal Component Analysis showed that 30 batches of Danggui buxue granules were divided into 3 categories,and the difference between the groups of atmospheric pressure drying was the least.The results of oxidation test showed that different drying processes of Danggui Buxue granules had good antioxidant activity,and the atmos-pheric pressure drying had the lowest IC50 and the strongest antioxidant activity.Finally,combining the results of gray correlation anal-ysis and correlation analysis,the compounds F2,F10,F13(calycosin),F15(formononetin),F16 might be important characteristic peaks reflecting the antioxidant activity of Danggui Buxue granules.CONCLUSION Compared with other drying processes,atmos-pheric pressure drying has higher batch consistency and stronger antioxidant activity,and can be used as the preferred drying process for Danggui Buxue granules,and components 2,10,13,15 and 16 are the main active ingredients for Danggui Buxue granules to exert antioxidant effects.

Objective:To construct a smart elderly education system that in line with the current situation under the Healthy China strategy and explore the constraints on its institutional implementation,in order to provide a basis for scientifically evaluating the implementation effect of this system.Methods:A questionnaire survey was conducted on 34 experts in related fields.The analytic hierarchy process(AHP)was used to perform quantitative and qualitative analyses on the construction of the smart elderly education system,and the weights of the importance of each scheme were obtained.Results:The constructed model of the smart elderly education system included 5 first-level indicators and 15 second-level indicators.Calculations of the judgment matrix for the 5 first-level indicators showed that the maximum eigenvalue(λmax)=5.071 4,the random consistency index(RI)=1.12,the consistency index(CI)=0.017 8,and the consistency ratio(CR)=0.015 9.With CR＜0.1,the result met the consistency requirement.For the second-level indicators under each first-level indicator,pairwise comparison judgment matrices were constructed.The CR values of all 5 judgment matrices were＜0.1.In summary,all judgment matrices passed the consistency test and were applicable.Among the first-level indicators,the top three by weights were guarantee mechanisms,demand orientation,and implementation effectiveness.Among the second-level indicators,the top three by combined weights were funding support capacity,health literacy improvement rate,and health demand identification mechanism.Conclusions:The indicator evaluation system for the smart elderly education system constructed based on AHP includes core dimensions such as guarantee mechanisms and demand orientation,responding to the key issues of institutional implementation.The selected indicators are both objective and practical,and can serve as reference tools for actual evaluation.

Purpose To analyze the sonographic features of incarcerated gravid uterus and evaluate the diagnostic value of ultrasonography.Materials and Methods Clinical data of eight patients diagnosed with incarcerated gravid uterus at Sichuan Provincial Maternity and Child Health Care Hospital from January 2018 to December 2023 were retrospectively analyzed.Clinical manifestations,sonographic characteristics,management approaches and pregnancy outcomes were evaluated.Results Among the eight confirmed cases,seven presented with initial symptoms of dysuria and urinary retention,while one reported irregular lower abdominal pain.Ultrasonography consistently demonstrated:retroverted and retroflexed uterine position with the uterine body posterior to the cervix.Elongated cervix(range:4.0-8.6 cm)displaced anteriorly.Overdistended,elongated and superiorly displaced bladder in seven cases.Management included successful manual reduction via knee-chest position after catheterization in seven patients.One patient was managed conservatively with close monitoring and delivered by cesarean section at term.All eight patients achieved successful term deliveries with favorable maternal and neonatal outcomes.Conclusion Prenatal ultrasonography plays a crucial role in diagnosing and managing incarcerated gravid uterus.Early recognition of characteristic sonographic features facilitates prompt diagnosis and intervention,thereby mitigating risks of adverse pregnancy outcomes.

OBJECTIVE To establish HPLC fingerprints of three drying processes(Atmospheric pressure drying,Decompression drying,Freeze-drying)of Danggui Buxue granules,and combine them with antioxidant tests to determine the optimal drying process and main active components of Danggui Buxue granules.METHODS The fingerprints of multiple batches of Danggui Buxue granules were established by HPLC;the"Fingerprint Similarity Evaluation System of Traditional Chinese Medicine Chromatogram"was used to evaluate the similarity;Hierarchical Cluster Analysis(HCA)and Principal Component Analysis(PCA)were used to characterize the different drying processes of Danggui Buxue granules;evaluate the antioxidant activity of Danggui Buxue granules in different drying processes using 1,1-diphenyl-2-picrylhydrazy(DPPH)and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)diammonium salt(ABTS)free radical scavenging method;the spectrum-effect relationship between Danggui Buxue granules fingerprint and antioxi-dant activity was analyzed by grey correlation degree and Pearson,Spearman,Kendall's tau-b correlation analysis methods.RE-SULTS The results of fingerprint showed that there were 16 common peaks in 30 batches of Danggui Buxue granules,and 6 of them were identified by comparison.The results of Cluster Analysis and Principal Component Analysis showed that 30 batches of Danggui buxue granules were divided into 3 categories,and the difference between the groups of atmospheric pressure drying was the least.The results of oxidation test showed that different drying processes of Danggui Buxue granules had good antioxidant activity,and the atmos-pheric pressure drying had the lowest IC50 and the strongest antioxidant activity.Finally,combining the results of gray correlation anal-ysis and correlation analysis,the compounds F2,F10,F13(calycosin),F15(formononetin),F16 might be important characteristic peaks reflecting the antioxidant activity of Danggui Buxue granules.CONCLUSION Compared with other drying processes,atmos-pheric pressure drying has higher batch consistency and stronger antioxidant activity,and can be used as the preferred drying process for Danggui Buxue granules,and components 2,10,13,15 and 16 are the main active ingredients for Danggui Buxue granules to exert antioxidant effects.