As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

Parkinson's disease （PD） is a common neurodegenerative disorder characterized by motor impairments， with its pathological mechanisms involving multiple processes such as the degeneration of dopaminergic neurons and the abnormal aggregation of α-synuclein. Current Western medical treatments face challenges including diminished long-term efficacy and motor complications. In recent years， Traditional Chinese Medicine （TCM） has demonstrated advantages in the prevention and treatment of PD through its systematic regulatory capabilities， featuring multi-component， multi-target， and multi-pathway approaches.This article systematically reviews the roles of seven key signaling pathways-NF-κB， AMPK/mTOR， PI3K/Akt， MAPKs， Nrf2/ARE， Wnt/β-catenin， and BDNF/TrkB-in the pathological process of PD and the regulatory mechanisms of TCM. Research indicates that active ingredients of Chinese herbs and compound formulations can synergistically modulate these pathways， exerting comprehensive effects in inhibiting neuroinflammation， alleviating oxidative stress， promoting autophagy to clear abnormal proteins， and enhancing neurotrophic support. These signaling pathways form a complex regulatory network through crosstalk among key nodal molecules， constituting an intricate regulatory system in PD pathology. The multi-target intervention characteristics of TCM align well with this network-based regulatory requirement， achieving integrated anti-inflammatory， antioxidant， autophagy-regulating， and neurorestorative effects through synergistic multi-pathway modulation. This article systematically outlines the mechanisms of TCM in the coordinated regulation of multiple pathways， providing a theoretical basis for elucidating the pathological process of PD and the intervention mechanisms of TCM， while also offering new perspectives and directions for modern research on TCM in the prevention and treatment of PD.

Aim To construct and analyze the genotype of G protein-coupled receptor kinase 2(GRK2)conditional knockout mice in synoviocytes,and to provide an animal model for stud-ying the function of GRK2 in synoviocytes.Methods Grk2flox/+mice were bred to generate Grk2flox/flox mice,Grk2flox/flox mice were bred to Col1a1-iCre+mice,Grk2flox/+Col1a1-iCre+mice were bred to Grk2flox/flox mice.Grk2flox/flox Col1a1-iCre+mice were ob-tained as target mice.DNA was extracted and amplified by PCR to identify the genotype.Western blot was used to verify the effect of Grk2 knockout in synovium,liver and kidney tissues.HE staining was used to detect the effects of Grk2 conditional knockout in synovial cells on ankle synovium,liver and kidney tissues.Multiple immunofluorescence was used to detect GRK2 expression in synovial cells.Results The results of gene iden-tification showed that Grk2flox/flox Col1a1-iCre+mice had both Flox and Col1a1-iCre genotypes.Western blot results showed that GRK2 expression decreased in synovial tissues of Grk2flox/flox Col1a1-iCre+mice,but there was no significant change in the expression of GRK2 in liver and kidney tissues.HE staining showed that Grk2flox/flox Col1a1-iCre+mice had no significant pathological changes in the ankle synovium,liver and kidney.The results of multiple immunofluorescence showed that GRK2 expression in synovial cells of Grk2flox/flox Col1a1-iCre+mice de-creased.Conclusion Grk2 conditional knockout mice in syno-viocytes are successfully constructed and identified,which pro-vides an animal model for further study of the role of GRK2 in synovial-related diseases.

OBJECTIVE To investigate the serotypes and antimicrobial resistance rate of clinically isolated Salmonel-la in a children's hospital in Suzhou,and to provide reference for the treatment of salmonellosis.METHOD Totally 177 strains of Salmonella isolated from Children's Hospital of Wujiang District from Jan.2021 to Dec.2023 were collected,and the results of serotypes and drug sensitivity of Salmonella were analyzed.RESULTS The male to fe-male isolation rate of Salmonella was 1.39∶1,with a median age of children infection at 1.3(0.8,2.3)years.The highest number of Salmonella strains were isolated in the month of Jun.,followed by Jul.,Aug.,Sep.,Oct.and May,collectively accounting for 82.49％of all isolates.Acute gastroenteritis was manifested in 142 cases(80.22％),with respiratory tract infections in 38 cases(21.47％)and septicemia in 7 cases(3.95％).The differ-ence in detection rates across the three years was not statistically significant(P=0.806).Salmonella Typhimuri-um was the predominant serotype,representing 54.24％of all isolates.The antimicrobial drug with the highest rate of resistance in Salmonella was ampicillin(71.35％,122/171),followed by sulfamethoxazole/metronidazole(43.60％,75/172),and ampicillin/sulbactam(30.23％,52/172),and no imipenem resistant strains were found.29.07％(50/172)of strains showed multidrug resistance.CONCLUSIONS Boys under three years of age are sus-ceptible to Salmonella infections in summer and fall in this region,with Salmonella Typhimurium being the pre-dominant serotype.Clinical attention should be paid to the characteristics of Salmonella infection and drug resist-ance,as well as the early diagnosis and rational use of antimicrobial drugs.

Objective To analyze the the differences in the use of medical consumables of single diseases,so as to provide ideas for the supervision of the rational use of medical consumables.Methods The case information of the patients discharged from some hospital in Hunan Province who underwent artificial femoral head replacement for femoral neck fracture,transurethral plasma electrosurgery for prostatic hyperplasia and percutaneous nephrolithotripsy for renal calculi from January 1,2022 to December 31,2023 were selected.Based on the results of the normality test,difference analyses were carried out over the consumption ratios of inpatients undergoing different procedures at different time periods and the consumption ratios treated by different physicians,and the percentile method was used to determine the recommended range for the consumption ratio based on the difference analysis results.SPSS 26.0 software was used for statistical analysis.Results The inpatients undergoing artificial femoral head replacement for femoral neck fracture at different periods had no significant difference in the consumption ratio(P>0.05);the inpatients going through transurethral plasma electrosurgery for prostatic hyperplasia had the consumption ratio in 2023 decreased by 5.22%when compared with that in 2022,with the difference being statistically significant(P<0.05);the inpatients undergoing percutaneous nephrolithotripsy for renal calculi had the consumption ratio at 2023 increased by 6.49%when compared with that at 2022,with the difference being statistically significant(P<0.05).There were no strong correlations between physician and inpatient consumption ratios for the three single-diseases(P<0.05),while the consumption ratios by different physicians for each single disease had differences.There were respectively 50%,40%and 50%of the physicians implementing artificial femoral head replacement for femoral neck fracture,transurethral plasma electrosurgery for prostatic hyperplasia and percutaneous nephrolithotripsy for renal calculi had the average consumption ratios higher than the average annual consumption ratios for the single diseases.The recommended ranges of the consumption ratio was[51.16%,63.89%]for artificial femoral head replacement for femoral neck fracture,[8.76%,10.77%]for transurethral plasma electrosurgery for prostatic hyperplasia and[26.40%,32.80%]for percutaneous nephrolithotripsy for renal calculi.Conclusion Under the premise of ensuring the quality of medical care,medical consumables can be scientifically and rationally supervised by setting a reasonable range,seizing the"vital few"and implementing joint management and control to reduce the consumption ratio.[Chinese Medical Equipment Journal,2025,46(7):87-91]

Objective:To develop evaluation indicators for care ability of caregivers in home-based palliative care based on the Farran caregiver skills model.Methods:Based on the Farran caregiver skills model, a preliminary evaluation index system was constructed through theoretical analysis, literature review, and semi-structured interviews. From July to October 2024, experts in the field were selected to conduct expert consultations, revise and improve the index system, and determine the weight of the indicators through the analytic hierarchy process.Results:A total of two rounds of expert consultations were conducted. The effective response rates for the first and second rounds of expert consultation questionnaires were 90.00% (18/20) and 100.00% (18/18), respectively. In the two rounds of expert consultations, 15 experts (83.33%) and 3 experts (16.67%) respectively proposed revision suggestions. In the two rounds of consultation, the expert authority coefficients were 0.931 and 0.936, respectively, and the Kendall coefficient of concordance were 0.152~0.283、0.183~0.269 ( P<0.05). The final evaluation indicators for care ability of caregivers in home-based palliative care included four first-level indicators, 12 second-level indicators, and 45 third-level indicators. Conclusions:The evaluation indicators for care ability of caregivers in home-based palliative care developed are highly scientific and reliable, and can provide a reference for the evaluation of family caregiver care ability and the formulation of training programs.

Objective To analyze the effects of intravenous tirofiban following endovascular treatment on the prognosis of patients with acute anterior circulation large vessel occlusion stroke who did not achieve successful recanalization.Methods This retrospective study included consecutive patients with acute anterior circulation ischemic stroke who underwent endovascular treatment but did not achieve successful recanalization.These patients were retrospectively enrolled from the Department of Neurology at Nanjing Jinling Hospital,Affiliated Hospital of Medical School,Nanjing University,the Second Affiliated Hospital of Soochow University,Wuhan No.1 Hospital,and Yijishan Hospital of Wannan Medical College(the First Affiliated Hospital of Wannan Medical College)between January 2015 and April 2023.Baseline and clinical data were collected including age,sex,medical history(hypertension,diabetes,atrial fibrillation,hyperlipidemia),personal history(smoking and drinking),National Institutes of Health stroke scale(NIHSS)score at admission,trial of Org 10172 in acute stroke treatment(TOAST)classification(large artery atherosclerosis,cardioembolism,or other types),Alberta stroke program early CT score(ASPECTS)on admission,intravenous thrombolysis,onset-to-puncture time(OTP),collateral circulation status(poor collaterals:American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology[ASTIN/SIR]score 0-2;good collateral:ASTIN/SIR score 3-4),procedure duration(from femoral or radial artery puncture to device removal),occlusion site,number of passes for thrombus retrieval,and post-procedural modified thrombolysis in cerebral infarction(mTICI)grade.Patients were divided into a tirofiban group and a non-tirofiban group based on whether they received post-procedural intravenous tirofiban.The primary outcome is a favorable functional outcome at 90-day since onset(modified Rankin scale[mRS]score ≤ 3).Safety outcomes included mortality at 90-day since onset(mRS score 6),any intracranial hemorrhage within 24 h post-procedure,and symptomatic intracranial hemorrhage within 24 h post-procedure.1∶1 propensity score matchings using the nearest neighbor method was performed based on variables with P＜0.05 in the comparison between the tirofiban and non-tirofiban groups.Differences in primary and safety outcomes between the matched groups were compared.Univariate and multivariate Logistic regression analyses were conducted with favorable outcomes at 90 days as the dependent variable to evaluate the effect of intravenous tirofiban administration after endovascular therapy on 90-day prognosis in patients without successful recanalization.Results A total of 356 patients without successful recanalization after endovascular treatment were included,comprising 195 males and 161 females,with a median age of 70(61,78)years(32-92 years).Among them,76 and 280patients were assigned to the tirofiban and non-tirofiban groups,respectively.At 90 days,114 patients had favorable outcomes,while 242 had unfavorable outcomes.(1)Before the 1∶1 propensity score matching,significant differences were observed between the tirofiban and non-tirofiban groups in terms of admission NIHSS score,ASPECTS,good collateral circulation,intravenous thrombolysis,and mTICI grade(all P＜0.05).After 1∶1 propensity score matching,66 matched pairs(132 patients)were obtained.No significant differences in the baseline and clinical characteristics were found between the two groups after matching(all P＞0.05).(2)After 1∶1 matching,a significant difference was observed in the rate of favorable outcomes at 90 days between the two groups(48.5％[32/66]vs.30.3％[20/66],P=0.033)after propensity score matching,while no significant differences were found in 90-day mortality,intracranial hemorrhage within 24h,or symptomatic intracranial hemorrhage within 24h(all P＞0.05).(3)Univariate analysis after 1∶1 matching indicated that age,atrial fibrillation,smoking history,admission NIHSS score,M2 segment middle cerebral artery occlusion,good collateral circulation,number of passes for thrombus retrieval,and tirofiban treatment were factors influencing favorable outcomes at 90 days.Multivariate Logistic regression analysis showed that younger age(aOR,0.942,95％CI 0.906-0.978,P=0.002),lower admission NIHSS score(aOR,0.855,95％CI 0.777-0.941,P=0.001),good collateral circulation(aOR,5.534,95％CI 2.141-14.301,P＜0.01),tirofiban treatment(aOR,2.774,95％CI 1.092-7.046,P=0.032),and M2 segment MCA occlusion(reference:internal carotid artery occlusion;aOR,4.874,95％CI 1.428-16.632,P=0.011)were independent predictors of favorable outcomes at 90 days.Conclusions Intravenous tirofiban administration after endovascular therapy may improve 90-day neurological outcomes in patients with acute anterior circulation large vessel occlusion stroke who did not achieve successful recanalization without increasing the risk of hemorrhage.Further large-scale randomized controlled trials are warranted to validate these findings.

Aim To study the therapeutic effect of al-licin on senna-induced diarrhea in mice and to explore the underlying mechanism.Methods Forty-eight C57BL/6J mice were randomly divided into six groups:control,model,loperamide positive control group(2 mg·kg-1),allicin low-dose group(6 mg·kg-1),allicin medium-dose group(12 mg·kg-1)and allicin high-dose group(18 mg·kg-1).Except for the con-trol group,the diarrhea model was induced in the other groups by intragastric administration of senna leaf ex-tract.After drug administration,several diarrhea indi-ces were measured:the rate of loose stools,diarrhea index,accumulated frequency of loose stools at differ-ent time points within 5 hours,and small intestine pro-pelling rate.Serum levels of TNF-α and IL-6 were de-tected by ELISA.Serum NO content was determined u-sing the Griess method.The activities of SOD and CAT,as well as MDA content in the ileum and colon,were measured.The pathological changes and the ex-pression of mRNA related to intestinal barrier proteins in the ileum and colon were evaluated using HE stai-ning and RT-qPCR.Results Allicin improved diar-rhea symptoms in mice induced by senna leaf.It re-duced the rate of loose stools,diarrhea index,cumula-tive number of loose stools in five hours,and the intes-tinal propulsion rate.Allicin also protected the intesti-nal mucosa,decreased serum TNF-α and IL-6 levels,and lowered MDA content in the intestines.It in-creased serum NO levels and enhanced SOD and CAT activities in the intestines.Additionally,allicin upreg-ulated the mRNA expression of AQP1,AQP4,and ZO-1 in intestinal tissues.Conclusions Allicin has a significant therapeutic effect on senna-induced diarrhea in mice.The underlying molecular mechanisms may involve anti-inflammatory and antioxidant effects,in-creased NO content,and upregulation of mRNA ex-pression of aquaporins and tight-junction proteins.

Objectives:Recently,domestical developed left ventricular assist devices(LVAD)have been frequently introduced into clinical practice.This study aims to report the anesthesia protocol and perioperative outcomes in Chinese patients receiving LVAD implantation surgery.Methods:This retrospective analysis included patients who underwent LVAD implantation at our center from June 2017 to November 2024.During and after separation from cardiopulmonary bypass,we optimized right heart function through careful adjustments in heart rate,rhythm,preload,myocardial contractility,and afterload.Vasoactive agents were administered as needed,and mechanical ventilation parameters were optimized.We implemented blood conservation strategies and established strict transfusion criteria to minimize allogenic blood transfusions.Results:A total of 100 patients were included in the analysis,with 54.0%classified as Interagency Registry for Mechanically Assisted Circulatory Support(INTERMACS)I or II.Before leaving the operating room,the mean arterial pressure(MAP),mean pulmonary arterial pressure(mPAP),central venous pressure(CVP),lactic acid levels,and urinary output after cardiopulmonary bypass were recorded as(74±7)mmHg,(25±7)mmHg,(7±3)mmHg,(2.3±1.9)mmol/L,and(8.2±5.4)ml/(kg·h),respectively.The transfusion rates for red blood cells and fresh frozen plasma were 20.0%and 28.0%.The in-hospital mortality rate was 3.0%,with a low incidence of severe complications including right heart failure(12%).Left ventricular ejection fraction increased from(23.7±4.8)%preoperatively to(25.3±10.5)%prior to discharge.Conclusions:Patients who received LVAD at our center exhibited low rates of postoperative mortality and complications and significant improvement in left heart function before discharge.

With the continuous improvement of the national management requirements for medical quality and safety,it is particularly important to improve the level of refinement,scientificity,and standardization of medical quality and safety manage-ment.Based on the evaluation criteria of tertiary hospitals,a hospital in Tianjin has constructed a medical quality indicator moni-toring system,which has improved the management efficiency of medical data and assisted the hospital in successfully meeting the evaluation and achieved good results.This paper discusses the system's requirements analysis,construction process,application results,and shares experiences and shortcomings to provide reference for other medical institutions to improve the effectiveness of medical quality and safety management.