Objective:To establish a quality control method for the standard decoction of Polygoni Avicularis Herba.Methods:Totally 12 batches of decoction pieces from different origins were collected, the standard decoction was prepared and the quality evaluation method was established, the content of index components in the decoction pieces and the standard decoction was determined with HPLC, the index components, solution pH and other parameters were calculated, and the similarity analysis was carried out against the fingerprints.Results:The total content of myricetin in 12 batches of decoction pieces was >0.12%, and the content of myricetin in the standard decoction was >0.03%, which met the standard of the 2020 edition of the Chinese Pharmacopoeia. The pH value was 5.1-5.5, the transfer rate of myricetin components ranged from 50.0%-106.3%, and the fingerprint study showed that there were 7 common peaks. The similarity analysis results indicated that the standard decoction of 12 batches of decoction pieces of Polygoni Avicularis Herba had good consistency.Conclusion:The preparation process is stable and feasible in line with the traditional decoction preparation method, and can be used for the research and quality evaluation of the standard decoction.

Objective:To investigate the clinicopathological and genetic features of confined placental mosaicism (CPM) and its effect on fetal intrauterine growth.Methods:Fourteen CPM cases of Haidian Maternal and Children Health Hospital were collected from May 2018 to March 2022. Clinicopathological examination on placental specimens and molecular genetic analysis were performed.Results:The age of the parturient women ranged from 27 to 34 years, with an average age of (30.0±3.54) years. The gestational weeks ranged from 35 +1 to 41 +2 weeks. There were 4 premature births and 10 term births, among which 6 were female and 8 were male fetuses. Nine cases (9/14) had adverse pregnancy outcomes, including 7 cases of fetal growth restriction. The weight of CPM placenta decreased, with 6 cases below the 10th percentile of weight standards and 5 cases between the 10th and 25th percentile. All 14 CPM placental specimens showed morphological changes of perfusion dysfunction to varying degrees, with mainly placental-maternal vascular malperfusion followed by placental-fetal vascular malperfusion. The mosaic chromosomes in different CPM cases varied, with 16-trisomy/monosomy mosaicism being the most common followed by 7-trisomy and 21-trisomy/monosomy mosaicism. The mosaic proportion was unequal in different parts of the same CPM placenta, with the mosaic proportion of umbilical cord, fetal membranes, fetal surface, maternal surface, and edge ranging from 1% to 70%. Conclusions:The mosaic chromosomes in different CPM cases vary, and the mosaic proportion is unequal in different parts of the same CPM placenta. The pathological morphology is mainly manifested as perfusion dysfunction, which can lead to adverse pregnancy outcomes such as fetal growth restriction and preterm birth.

The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

Objective To investigate the infection sites,pathogen distribution and risk factors of nosocomial infection after craniocerebral surgery.Methods This is a case-control study.Eighty patients with a mean age of(63.2±8.2)years who developed hospital acquired infections after craniocerebral treatment at Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to December 2021 were assigned to infection group.Eighty patients with a mean age of(61.7±7.8)years who underwent craniocerebral surgery during the same period but did not develop hospital acquired infections were allocated to control group.The medical records and laboratory examination data of the patients were reviewed.Infection sites and pathogen characteristics in patients with hospital acquired infections after craniocerebral surgery were analyzed.Univariate and multivariate analyses were used to explore the risk factors for hospital acquired infections after craniocerebral surgery.Results The respiratory system was mainly infected in the 80 patients with hospital acquired infection after craniocerebral surgery(58.75%),followed by urinary system(22.50%).The main pathogenic bacteria in patients with respiratory system,urinary system and nervous system infections were Gram-negative bacteria.Gram-negative and Gram-positive bacteria in patients with blood system infection accounted for 50%,respectively.There was no significant difference in the composition of pathogenic bacteria among patients with infections in different parts of the body(P>0.05).In 51 patients with Gram-negative bacterial infections,the main pathogenic bacteria were Escherichia coli(26.25%)and Acinetobacter baumannii(15.00%).In 29 patients with Gram-positive bacterial infections,the main pathogenic bacteria were Staphylococcus aureus(16.25%)and Enterococcus faecalis(11.25%).Logistic regression model showed that non class Ⅰ incision,external ventricular drainage,cerebrospinal fluid leakage,non-prophylactic use of antibiotics before surgery,and indwelling catheter were independent risk factors for infection related complications in patients undergoing craniocerebral surgery(all P<0.05).Conclusion The respiratory system and urinary system are mainly involved in patients with nosocomial infection after craniocerebral surgery.The main pathogenic bacteria are Gram-negative bacteria.Non class Ⅰ incisions,external ventricular drainage,leakage of cerebrospinal fluid,non-prophylactic use of antibiotics before surgery,and indwelling catheter may increase the risk of postoperative infection.

Ulcerative colitis (UC) is a chronic non-specific intestinal inflammatory disease. Whether surgical treatment should be taken is a difficult and focus decision of clinical practice. Studies have shown that severe complications, combined with severe infection, poor laboratory indices, and ineffective medical treatment are the evaluation elements of UC surgery. This article reviewed the advances in study on high risk factors of surgery with UC.

The authors attempted to use information technology in hierarchical management on clinician′s surgical authority. By means of a hierarchical surgery catalogue database, clinicians′ surgical authority is subject to by-level IT-based approval, and such authorities as clinician′s surgical medical advice, application for surgery, and approval of special surgeries are regulated. Thanks to multi-dimensional objective data, clinicians′surgical competence is subject to a dynamic evaluation, hierarchical authorization and reauthorization. These measures further standardize the behavior of the surgeons, and rule out unauthorized operations, thus improving fine management of surgeries and ensuring patient safety.

Objective: To modify traditional prognostic model for patients with ER/PR+, HER2- breast cancer to meet the actual requirements in current clinical practice. Methods: 335 patients with ER/PR+, HER2- breast cancer, who were admitted in Department of Breast Surgery, Shanghai Huangpu Center Hospital from January 2009 to December 2009, were enrolled in this study. 97 variables were incorporated into the model, using SCAD variable selection method, after fully considering whether covariates existing a log-linear relationship, reasonable determination of the cut-off value of the covariates in non-logarithmic linear relationship (piecewise linear relationship) and collinear and interaction, then we set up a new Cox regression prognostic model for traditional ER/PR+, HER2-type breast cancer patients with traditional immunohistochemical indicators, and further establish its nomogram model. On this basis, a nomogram of the survival probability of 1-, 3-, and 5- years after surgery was established; The discrimination and calibration of model were compared to evaluate the predictive ability of the model. Results: The Cox regression model shows that the prognosis of patients are associated with the histologic grade, lymph node metastasis, Ki67, PR and age etc. Among them, the histologic grade and lymph node metastasis have log-linear relationship with prognosis; Ki67, PR and age have non-log-linear relationship with prognosis and the reasonable cut-off values are Ki67(60%)，PR（20%）and age（55 years old） . Area under the receiver operating characteristic (ROC) curve（AUC）of this Cox model for 1-, 3- and 5- year survival after surgery are all above 0.85, indicating high discrimination. The Grønnesby-Borgan goodness-of-fit test statistics of this model is 1.37 with P>0.05, indicating good calibration. Conclusion: The modified nomogram.could accurately, directly and effectively predict the survival probability of patients, which may exert good guidance for the clinical practice for patients with breast cancer.

Objective To explore the association of nocturnal serum cortisol levels with diabetic microvascular complications in overweight or obese patients with type 2 diabetes mellitus. Methods Serum cortisol levels of 316 overweight or obese type 2 diabetic patients were tested at midnight by the method of chemiluminescence. Diabetic microvascular complications were compared among various groups according to nocturnal serum cortisol levels. All the patients with nocturnal serum cortisol level > 50 nmol/L were asked to undergo overnight low-dose dexamethasone suppression test to rule out the possibility of subclincal Cushing's syndrome. The incidences of diabetic nephropathy ( DN ) , diabetic retinopathy ( DR ) , and diabetic peripheral neuropathy ( DPN ) were examined in all the patients. Results (1)The incidence of DN was gradually increased from 13.3％to 27.7％and 44.2％in patients with low, medium, and high cortisol level groups, showing a statistical difference among 3 groups ( P<0.05) . The incidences of DR in medium and high cortisol level groups were higher than that in low cortisol level group (40.6％and 47.7％vs 22.7％, both P<0.01). The incidence of DPN in high cortisol level group was higher as compared with low cortisol level group (60.5％ vs 38.7％, P<0.01). (2) Nocturnal serum cortisol level in patients with diabetic microvascular complications was higher than that in patients without complications [ (136.87 ± 105.78 vs 97.55 ± 93.48) nmol/L, P<0.01]. Nocturnal serum cortisol level in patients with multiple diabetic microvascular complications was higher than that in patients with single diabetic microvascular complication [ (151.66±114.54vs117.69±90.26)nmol/L,P<0.05].(3)Singlefactorlogisticregressionanalysisshowedthat higher nocturnal serum cortisol level was a risk factor for diabetic microvascular complications in addition to female, age, longer diabetic duration, higher fasting plasma glucose ( FPG ) . Multivariate logistic regression analysis showed that higher nocturnal serum cortisol level was still a risk factor for diabetic microvascular complications after adjusted by diabetic duration, FPG, HbA1C, and the use of insulin (P=0.013). Conclusion Nocturnal serum cortisol level seems to be a risk factor for diabetic microvascular complications in overweight or obese patients with type 2 diabetes mellitus.