Endoscopic thoracic sympathicotomy/sympathotomy (ETS) is the first-line treatment for palmar hyperhidrosis with best minimally invasive effect. In recent years, with the widespread development of ETS in the treatment of palmar hyperhidrosis, many medical centers list ETS surgery as the day surgery. Nevertheless, there is no expert consensus on medical quality control of day surgery for ETS yet. Therefore, the Chinese Medical Doctor Association Thoracic Surgeons Branch Hyperhidrosis Subcommittee, Sympathetic Neurosurgery Expert Committee of WU Jieping Medical Foundation, and Fujian Provincial Strait Medical and Health Exchange Association Hyperhidrosis Special Committee organized domestic experts to conduct repeated consultations and sufficient discussions based on domestic and foreign literatures, to formulate the "Chinese expert consensus on ETS optimization and surgical quality control of day surgery for palmar hyperhidrosis". It aims to provide a reference for the clinical diagnosis and treatment of palmar hyperhidrosis for thoracic surgery colleagues in our country, to enhance their management level and work efficiency, and ultimately to achieve standardized quality control.

Objective:To observe the effect of early electroacupuncture intervention on the expression of TARDNA bind-ing protein 43(TDP-43)and HMGB1/RhoA signaling pathway in the cerebral cortex of amyotrophic lateral sclerosis(ALS)mice,and to explore the potential mechanism of early electroacupuncture intervention in im-proving motor function in ALS mice. Method:SOD1G93A gene phenotype mice were randomly divided into model group(SOD1G93A),acupuncture in-tervention group(EA),riluzole group(Riluzole),and SOD1G93A negative mice in the same litter were blank control group(Control),with 15 mice in each group.The electroacupuncture group was given acupuncture of Baihui point,bilateral Tianzhu point,bilateral Tianshu point,5 times/7 days,7 days for a course of treat-ment,a total of 4 courses of treatment.The riluzole group was treated with riluzole 30 mg/(kg·d)by gavage,once a day,five times a week for two weeks.The motor function of mice in each group was evaluated by hind limb functional neurological score and rotarod fatigue test,and the rate of TDP-43 positive cells in cere-bral cortex was observed by immunofluorescence.The relative expression of Iba-1,HMGB1 or RhoA protein in cerebral cortex was detected by Western Blot.The levels of serum TNF-α and MCP-1 were detected by Elisa.The morphological changes of cerebral cortical neurons were observed by transmission electron microscopy. Result:Compared with the control group,the rotarod latency time was decreased and the neurological score was increased in the model group(P＜0.01).The contents of serum MCP-1 and TNF-α,the expression of Iba-1,HMGB1 and RhoA protein in cerebral cortex and the rate of TDP-43 positive cells were increased in the model group(P＜0.01).Compared with the model group,the rotarod latency time of the electroacupuncture group and the riluzole group increased and the neurological score decreased(P＜0.01,P＜0.05),the serum MCP-1,TNF-α content and the cerebral cortex Iba-1,HMGB1,RhoA protein expression and TDP-43 positive cell rate decreased(P＜0.01,P＜0.05).The results of electron microscopy showed that the structure of cortical neurons in the control group was normal,and the nerve cells in the model group exhibited obvious pathologi-cal changes.The damage of nerve cells in the electroacupuncture group and the riluzole group was reduced,the structure was relatively complete,and some normal organelles were detected. Conclusion:Electroacupuncture intervention can improve the motor function of ALS model mice.The mecha-nism may be related to the inhibition of HMGBl/RhoA signaling pathway and the reduction of microglia-in-duced neuroinflammation,and it is speculated that it has a positive effect on the reduction of ALS pathologi-cal substrate TDP-43 deposition.

The nursing experience of a severe crusted scabies patient with multiple underlying diseases based on the multidisciplinary treatment(MDT)mode was reported.To avoid the nosocomial scabies outbreaks and promote disease control,the key points of nursing included:precise treatment and care for underlying diseases based on MDT model;application of 20％sulfur ointment to smear whole body skin to kill scabies mites and strict contact isolation;respiratory support and airway management to improve respiratory failure;alleviation of itching and pain to enhance patient comfort;quantitative assessment of mental state and sleep condition,implementation of psychological nursing to improve sleep quality;to implement individualized nutrition,blood glucose management,pulmonary rehabilitation program and targeted follow-up guidance.After 28 days of meticulous care,the patient's condition was stable with controlled scabies and gradually alleviated severe itching.Sleep quality was improved,and no scabies transmission occurred in the hospital.The patient was transferred to the community hospital for further rehabilitation.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

ObjectiveTo analyze the pharmacodynamic material basis of Hippophae Folium in the treatment of hyperlipidemia by network pharmacology and experimental verification. MethodThe hyperlipidemic HepG2 cell model induced by oleic and palmitic acid （molar ratio 2∶1） was established. The optimal concentration of Hippophae Folium containing serum was determined by cell counting kit （CCK）-8 method. The cells were intervened by the medicated serum， and oil red O staining was used to determine the success of the model. The contents of total cholesterol （TC） and triglyceride （TG） were determined by enzyme-linked immunosorbent assay （ELISA）. The possible mechanism of action was analyzed by network pharmacology， and molecular docking was performed to detect the binding ability of the potential targets. ResultCCK-8 assay showed that 10% medicated serum was the optimal concentration for cell growth. Oil red O staining proved that the hyperlipidemic cell model induced by oleic and palmitic acid has been built. After treatment with medicated serum， the contents of TG and TC decreased， indicating that Hippophae Folium had a good therapeutic effect on hyperlipidemia. Network pharmacology revealed that the core targets of Hippophae Folium in the treatment of hyperlipidemia were albumin （ALB）， peroxisome proliferative activated receptor γ （PPARγ） and matrix metalloprotein（MMP）-9， involving 755 biological processes， 73 molecular functions and 3 cellular components. By Kyoto Encyclopedia of Genes and Genomes（KEGG） analysis， it was found PPAR， hypoxia inducible factor（HIF）-1， AMP-activated protein kinase（AMPK） and other signal pathways were involved in the treatment of hyperlipidemia by Hippophae Folium. ConclusionHippophae Folium containing serum （10%） could reduce lipid accumulation and intracellular TG and TC levels in hyperlipidemic cell model， and its mechanism of action might be realized by activating PPAR signal pathway.

Primary palmar hyperhidrosis (PPH) is a pathologic condition of excessive sweating on hands that has adverse impacts on patients' social activity, professional life, and psychological state. Endoscopic thoracic sympathicotomy (ETS) is by far the treatment choice for PPH with the most stable and durable curative effects, but special attention should be given to the side effects of the surgery, especially compensatory hyperhidrosis (CH). This consensus is the second version of the Chinese Expert Consensus on the Surgical Treatment of PPH by the China Expert Committee on Palmar Hyperhidrosis (CECPH), which was published 10 years ago. This consensus emphasizes the need for special attention and careful assessment of the patients’ feelings, as well as their emotional and mental state, and emphasizes that distress due to palmar sweating and the desire for treatment are prerequisites for diagnosis. It also provides a more nuanced delineation of CH and reviews all new attempts to prevent and treat this side effect. New evidence of the epidemiology, pathogenesis of PPH, and indications for surgery were also assessed or recommended.

This guideline systematically reviewed and summarized the 20 years' clinical and basic research experience of minimally invasive treatment of palmar hyperhidrosis (PH) in China, and discussed the hot and difficult issues of minimally invasive treatment of PH. We have formed a new consensus of PH in terms of its definition, clinical manifestations, diagnostic criteria and classification, surgical indications and contraindications, surgical procedures and management of complications, especially in the area of postoperative compensatory hyperhidrosis (CH). This guideline confirmed that endoscopic thoracic sympathicotomy (ETS) was the most effective treatment for PH and that CH was the most common side effect. In order to reduce the incidence of CH, eliminate patient's distress and improve patient's satisfaction, the guideline emphasized that the keys to prevent CH were to pay attention to pre-operative interview, communicate with patients, select patients carefully, avoid the enlargement of operative indication and optimize operative procedure. This guideline also introduced the advantages and disadvantages of various methods to reduce the incidence of CH. We provided this authoritative guidance document in order to avoid the surgical risk, strengthen the perioperative management and improve the sugery effect.

OBJECTIVE: To establish the optimum extraction technique and high performance liquid chromatographic (HPLC) method to simultaneously quantify nine compounds of gallic acid, hydroxy-paeoniflorin, catechin, albiflorin, paeoniflorin, pentagalloylglucose, benzoic acid, benzoylpaeoniflorin and paeonol in . METHODS: Linear gradient elution was applied using water containing 0.1%phosphoric acid and acetonitrile as the mobile phase with a flow rate of 0.8 mL/min, column temperature of 30℃ and wavelength of 230 nm. The method of ultrasound extraction was used. Methanol and ethanol were used as extraction solvents, and three factors and three levels of orthogonal experiments was designed using L (3 ) table to investigate the effects of solvent concentration, ratio of liquid to material and extraction time on the total content of nine components of . RESULTS: HPLC method was verified to have high specificity, sensitivity and accuracy through methodological validation, and it could be used for simultaneous quantitative analysis of nine components of . The results showed that the optimum extraction technology of nine components of was using 70%ethanol as extraction solvent, ratio of liquid to material was 200 mL/g and ultrasound extraction time was 30 min. CONCLUSIONS HPLC method for the simultaneous determination of nine components of is established, and the optimum extraction technology is confirmed.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Paeonia

Important/potential value of macrolides has been proved in the management of chronic respiratory diseases by increasing basic and clinical trials.Through three face-to-face discussions,10 experts examined important data and drafted this consensus related to macrolides:(1) mechanism of nonantiinfective effects;(2) clinical use in chronic respiratory diseases;(3) cautions of long-term use.The mechanism out of non-antiinfective effects includes anti-inflammatory effect,modifying airway secretion,immune-regulation related to antibacterial effect,corticoid saving effect and anti-viral effect.The efficacy of long-term use of low-dose macrolides is definitely confirmed in diffuse panbronchiolitis,chronic rhinosinusitis.It is considerably used in bronchiectasia,cystic fibrosis,severe asthma and chronic obstructive pulmonary disease.Further studies should be conducted in cryptogenic organizing pneumonia and respiratory viral infection.It should be paid attention to its possible adverse effects (including drug interactions,cardiac toxicity,ototoxicity and disturbance of intestinal flora) and drug resistance in long-term use.A Chinese consensus for non-antiinfective effects and clinical use of macrolides is developed for the first time,which aims to expand their rational use and the further research.

According to the phenomenon that the curriculum of psychological health education for college students is theoretical,lack of experience and the teaching form is single,this research attempts to private a blended teaching which is based on the small private online course (SPOC) and experiential teaching.The content of mental health is divided into theoretical knowledge and experience knowledge.And the theoretical knowledge is taught through online teaching in the form of massive open online courses (MOOC),while the experiential knowledge is taught by pure experiential teaching in the classroom.The study has summed up 3 stages of learning mode:learning before class,teaching experience and reflection after class.This changes the single classroom theory teaching to students experience learning.Besides,formative evaluation is used as assessment methods,which has enhanced the effectiveness of the course and at the same time,it has also promoted the improvement of teachers' teaching level effectively.