As people’s attention to health continues to increase, the market demand for traditional Chinese medicine (TCM) is growing steadily. The quality and safety of Chinese medicinal materials have attracted unprecedented social attention. In particular, the issue of exogenous harmful residue pollution in TCM has become a hot topic of concern for both regulatory authorities and society. The Chinese Pharmacopoeia 2025 Edition further refines the detection methods and limit standards for exogenous harmful residues in TCM. This not only reflects China’s high-level emphasis on the quality and safety of TCM but also demonstrates the continuous progress made by China in the field of TCM safety supervision. Basis on this study, by systematically reviewing the development history of the detection standards for exogenous harmful residues in TCM and analyzing the revisions and updates of these detection standards in the Chinese Pharmacopoeia 2025 Edition, deeply explores the key points of the changes in the monitoring standards for exogenous harmful residues in TCM in the Chinese Pharmacopoeia 2025 Edition. Moreover, it interprets the future development directions of the detection of exogenous residues in TCM, aiming to provide a reference for the formulation of TCM safety supervision policies.

Objective:To design a virtual simulation tutorial system for bone traction nursing of the lower limbs, and to investigate its application effect.Methods:Based on clinical cases, a 3D model was established for the fractured lower limb using the virtual simulation technique. The design of the model considered the position and mechanical relationship between bone traction and fracture ends, as well as the assessment and intervention of the condition after bone traction, and such factors were taken as the core elements of simulation design. Virtual experiments were conducted for the four scenarios of pre-hospital first aid, triage in the hospital, bone traction operation, and postoperative nursing. Such experiments were conducted among junior nursing undergraduates, and examination results and student satisfaction survey were used to evaluate the application effect of the experiments.Results:The teaching software consisted of four training modules, i.e., theoretical knowledge learning of fractures, preparation before bone traction operation, methods and principles of bone traction operation, and observation of conditions after bone traction. The final score of experiments was (90.99±0.58) points among the students, and the degree of satisfaction with the experimental system and the teaching model was 87.85% (441/502) and 63.35% (318/502), respectively.Conclusions:The virtual simulation experiments for bone traction nursing of the lower limbs are scientific, professional, and interesting and have a relatively high degree of satisfaction among students, and therefore, they can be applied in the education of nursing students and the continuing education of nurses.

Objective:To investigate the effect of Qingjin Huazhuo Decoction combined with conventional western medicine on blood hypercoagulability in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of phlegm-heat stasis lung syndrome.Methods:Randomized controlled trial. According to random number table method, allocation of cases in the observation and control groups. From April 2021 to March 2022, 66 hospitalized patients with AECOPD of phlegm-heat stasis and lung syndrome were randomly divided into control group ( n=32) and study group ( n=34). The control group was treated with conventional western medicine. The study group was treated with Qingjin Huazhuo Decoction on the basis of the control group. Both groups were treated for 7 days. Plasma thrombomodulin (TM), thrombin-antithrombin complex (TAT), tissue plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC), plasmin-antiplasmin complex (PIC), prothrombin time (PT), partial thromboplastin time (APTT) and D-dimer levels were measured by automatic immunoassay analyzer; serum TNF-α levels were measured by ELISA and CRP levels were measured by immunoturbidimetry. Adverse reactions and acute thrombotic events during treatment were recorded. Results:During the treatment period, 4 of 66 patients had hemolysis, 2 were mistakenly included in the withdrawal study, 28 in the final control group and 32 in the study group were included for the analyses. After treatment, plasma t-PAIC [(6.19±1.93) μg/L vs. (7.42±2.71) μg/L, t=2.04] level in study group was significantly lower than that of the control group ( P<0.05), and the serum TNF-α [(71.15±25.25) ng/L vs. (122.60±98.76) ng/L, t=2.42] level was significantly lower than that of the control group ( P<0.05), plasma PT [(11.98±0.74) s vs. (11.55±0.77) s, t=-2.19] was significantly longer than that of the control group ( P<0.05). No thrombotic events occurred during hospitalization in the study group, and 1 case of acute myocardial infarction occurred in the control group. Conclusion:Qingjin Huazhuo Decoction combined with conventional western medicine therapy can improve the blood hypercoagulability of AECOPD patients with phlegm-heat stasis lung syndrome.

Objective:To explore emergency nurses' experiences and feelings about nursing interruption events and measures to avoid or reduce work interruption events, so as to provide references for emergency nursing managers to strengthen the management of nursing interruption events.Methods:Using methods of descriptive qualitative research and purposive sampling, a total of 12 nurses from 3 nursing units in Emergency Department of a ClassⅢ Grade A hospital in Chengdu were selected for semi-structured interviews from August to September 2019. The obtained interview data were analyzed by thematic analysis.Results:Through thematic analysis, the extracted themes included the source of the interruption events, the nurses' current affairs at the time of occurrence, effects and coping strategies.Conclusions:The occurrence of emergency nursing interruption events has more adverse effects on emergency nurses. Nursing managers should take various measures from multiple perspectives to reduce the occurrence of nursing interruption events and avoid adverse nursing events to ensure patient safety.

Objective    To investigate the effect of artificial colloid on coagulation function in pediatric patients weighing less than 5 kg with congenital heart disease during cardiopulmonary bypass in congenital heart disease surgery by using artificial colloid instead of human serum albumin. Methods    A total of 65 pediatric patients with weight less than 5 kg who underwent congenital heart disease surgery in our hospital from September 2016 to December 2017 were included in the study. They were randomly divided into two groups: an artificial colloid group (the experimental group, n=33) and a human serum albumin combined artificial colloid group (the control group, n=32). Perioperative hemoglobin concentration (Hb), blood products and hemostatic drugs used, postoperative coagulation function index and pleural fluid volume 24 hours after surgery were monitored. Results    There was no significant difference in perioperative Hb and chest tube drainage between the two groups. The platelet utilization rate in the experimental group was significantly lower than that in the control group (P<0.05). No significant difference was found in the dosage of other blood products and hemostatic drugs between the two groups during the perioperative period. There was no significant difference in coagulation parameters between the two groups before and after surgery (P>0.05). Conclusion    The use of artificial colloid as colloid priming solution during cardiopulmonary bypass has no adverse effect on coagulation function in pediatric patients weighting less than 5 kg with congenital heart disease.

Objective : To explore the correlation between air pollution and outpatient visits,and to provide evidence for health risk assessment of air pollutants and intervention. Methods : The data of air pollutants and outpatient visits in 2016 in Zhoushan Hospital were collected,and the outpatient volume on the days when the concentration of air pollutants reached and exceeded the standard were compared. Spearman rank correlation analysis was used to explore the relationship between outpatient volume and the concentration of air pollutants. Results : In 2016,the median（inter-quartile range）of daily outpatient volume in Zhoushan Hospital was 3 304（1 638）person-times. O3,PM2.5 and PM10 were the primary air pollutants in Zhoushan in 2016. The average daily outpatient volume of internal medicine,circulatory system,other diseases and all when the air was polluted at light level or above were higher than those when the air quality was good（P< 0.05）. CO concentration was positively correlated with the average daily outpatient volume of respiratory system and circulatory system（P< 0.05）,was negatively correlated with the average daily outpatient volume of all（P< 0.05）. O3-8 h concentration was positively correlated with the average daily outpatient volume of internal medicine,other diseases and all（P< 0.05）,and was negatively correlated with the average daily outpatient volume of respiratory system and pediatrics（P< 0.05）. SO2 concentration was negatively correlated with the average daily outpatient volume of respiratory system,skin and subcutaneous tissue（P< 0.05）. The concentration of NO2,PM10 and PM2.5 were positively correlated with the average daily outpatient volume of respiratory system and pediatrics（P< 0.05）. Conclusion The main air pollutants in Zhoushan were O3,PM2.5 and PM10. When they exceed the limits,the outpatient volume would increase.

OBJECTIVES: To investigate the genetic causes of hearing loss with enlarged vestibular aqueduct (EVA) in two children from unrelated two Chinese families. METHODS: Sanger sequencing of all coding exons in SLC26A4 (encoding Pendrin protein) was performed on the two patients, their sibling and parents respectively. To predict and visualize the potential functional outcome of the novel variant, model building, structure analysis, and in silico analysis were further conducted. RESULTS: The results showed that the proband from family I harbored a compound heterozygote of SLC26A4 c.1174A>T (p.N392Y) mutation and c.1181delTCT (p.F394del) variant in exon 10, potentially altering Pendrin protein structure. In family II, the proband was identified in compound heterozygosity with a known mutation of c.919-2A>G in the splice site of intron 7 and a novel mutation of c.1023insC in exon 9, which results in a frameshift and translational termination, consequently leading to truncated Pendrin protein. Sequence homology analysis indicated that all the mutations localized at high conservation sites, which emphasized the significance of these mutations on Pendrin spatial organization and function. CONCLUSION: In summary, this study revealed two compound heterozygous mutations (c.1174A>T/c.1181delTCT; c.919- 2A>G/c.1023insC) in Pendrin protein, which might account for the deafness of the two probands clinically diagnosed with EVA. Thus this study contributes to improve understanding of the causes of hearing loss associated with EVA and develop a more scientific screening strategy for deafness.
Asian Continental Ancestry Group ; Child ; Clinical Coding ; Computer Simulation ; Deafness ; Exons ; Extravehicular Activity ; Frameshift Mutation ; Hearing Loss ; Heterozygote ; Humans ; Introns ; Mass Screening ; Parents ; Sequence Homology ; Siblings ; Vestibular Aqueduct

OBJECTIVE:To compare in vitro percutaneous permeation characteristics of glycyrrhizic acid in 6 kinds of glycyrrhetate creams,and to provide reference for further development and utilization. METHODS:Modified Franz diffusion cell and isolated rat skin were adopted for in vitro percutaneous permeation test. 24 h accumulative permeation of glycyrrhizic acid in 6 kinds of glycyrrhetate creams(monoammonium glycyrrhizinate,diammonium glycyrrhizinate,monopotassium glycyrrhizinate, dipotassium glycyrrhizate,trisodium glycyrrhizinate,disodium glycyrrhetate)were determined by HPLC. The permeation characteristics of 6 kinds of glycyrrhetate creams were evaluated by calculating percutaneous absorption rate. RESULTS:24 h accumulative permeation of 6 kinds of glycyrrhetate in rat skin in descending order was as follows:trisodium glycyrrhizinate (23.933 μ g/cm2)>dipotassium glycyrrhizinate(22.952 μ g/cm2)>disodium glycyrrhizinate(15.424 μ g/cm2)>monopotassium glycyrrhizinate(10.703 μg/cm2)>diammonium glycyrrhizinate(9.557 μg/cm2)>monoammonium glycyrrhizinate(1.621 μg/cm2). The percutaneous permeation rate in descending order was as follows as trisodium glycyrrhizinate [1.010 2 μ g/(cm2·h)]>dipotassium glycyrrhizinate [0.974 5 μg/(cm2·h)]>disodium glycyrrhizinate [0.641 2 μg/(cm2·h)]>diammonium glycyrrhizinate [0.399 9 μg/(cm2·h)]>monopotassium glycyrrhizinate[0.362 8 μg/(cm2·h)]>monoammonium glycyrrhizinate[0.072 6 μg/(cm2·h)]. CONCLUSIONS:The permeation rate of trisodium glycyrrhizinate is the highest among 6 kinds of glycyrrhetate creams in vitro.

Objective:To develop the methods for the determination of calcined calamine and borneol in Jinniu ophthalmic remedy. Methods:The content of zinc oxide in calcined calamine was determined by an EDTA coordination titration method. A DB-WAX capillary column (30 m ×0.32 mm,0.5 μm) was used with an FID as the detector and ethylacetate as the solvent to determine the content of borneol. The column temperature was 150 ℃, the injection port temperature was 180 ℃, the detector temperature was 200 ℃, the split ratio was 5 :1,and the flow rate was 1 ml·min-1. Results:The recovery of zinc oxide was 101.5% with the RSD was 1.2%(n = 9). The linear range of borneol was 0.1-5.0 μg(r = 0.999 9). The recovery of borneol was 98.18% with the RSD was 0.8%(n = 9). The content of zinc oxide and borneol in the samples was 0.38-0.59 g·g-1and 0.13-0.21 g·g-1,respectively. Conclusion:The method is simple and accurate with high reproducibility and promising stability, which can be used for the quality control of Jinniu ophthalmic remedy.

Objective To investigate the knowledge,attitude and practice (KAP) status quo of the primary caregivers on cardiopulmonary resuscitation (CPR) in the patients with high risk of sudden cardiac death (SCD).Methods The convenience sampling method was used to extract 139 primary caregivers of the inpatients with high risk of SCD in the cardiology department of our hospital from January to June 2015.The self-designed questionnaire was adopted to perform the KAP status quo investigation on CPR and the influence factors were analyzed.Results The scoring rate of knowledge,attitude and practice about CPR in the primary caregivers were 36.85%,64.26% and 29.24%,respectively;the cultural level,residence place,health status,training experience,first-aid experience and sick time of the patients were the influence factors of KAP on CPR (P<0.05).Conclusion The KAP status quo of CPR among primary caregivers are poor.It is necessary to strengthen CPR training in primary caregivers and improve their KAP level.