The prescription of Qidong Yixin oral liquid is derived from the experience of national medical master Ren Jixue in treating viral myocarditis （VMC）. It has the functions of tonifying Qi， nourishing the heart，calming the mind， and relieving palpitations. It is used to treat VMC and angina pectoris of coronary heart disease caused by deficiency of both Qi and Yin. However，the understanding of its efficacy evidence， advantageous aspects， dosage and administration， and medication safety remains insufficient in clinical practice. Therefore，the development of the Expert Consensus on the Clinical Application of Qidong Yixin Oral Liquid （hereinafter referred to as consensus） was initiated. Consensus strictly followed the process and methods of the expert consensus on the clinical application of Chinese patent medicines of the China Association of Chinese Medicine，successively completing multiple tasks such as the consensus project initiation，determination of clinical problems，evidence search and evaluation，formation of recommendation opinions and consensus suggestions，solicitation of opinions，peer review， submission for review and release， and so on. Consensus formed a total of 10 recommendation opinions and 12 consensus suggestions，clarifying the clinical positioning，efficacy advantages，syndrome differentiation，dosage and administration，combination therapy，timing of medication，adverse reactions，contraindications， and precautions of Qidong Yixin oral liquid，indicating that it has good clinical advantages and safety in the treatment of VMC and angina pectoris of coronary heart disease，providing norms and references for physicians to safely and rationally apply Qidong Yixin oral liquid. Consensus was reviewed and approved for release by the Standardization Office of the China Association of Chinese Medicine on December 23， 2024. Standard number：GSCACM-376-2024.

AIM:To evaluate the optimal timing of preoperative intravitreal anti vascular endothelial growth factor(VEGF)therapy in proliferative diabetic retinopathy(PDR)using intraoperative fluorescein angiography(IOFA).METHODS:A retrospective case series study was conducted on patients who underwent vitrectomy for PDR with vitreous hemorrhage(VH)at Sichuan Provincial People's Hospital from January 2023 to February 2025. Patients were divided into three groups according to the interval between intravitreal conbercept injection and surgery: Group A(3 d before surgery), Group B(7 d before surgery), and Group C(14 d before surgery). IOFA was used to assess the number and size of retinal neovascularization(NV). Additional data were collected including preoperative best corrected visual acuity(BCVA), vitreous hemorrhage grading, operative time, frequency of intraoperative endodiathermy, duration of high perfusion pressure, vitreoretinal adhesion grade, postoperative BCVA, and central macular thickness(CMT). Multidimensional analyses were performed.RESULTS:This study enrolled a total of 91 patients(94 eyes)with PDR accompanied by vitreous hemorrhage. Among them, Group A consisted of 31 patients(31 eyes; 18 males, 13 females; mean age 53.26±12.38 y), Group B consisted of 34 patients(37 eyes; 21 males, 13 females; mean age 51.61±14.16 y), and Group C consisted of 26 patients(26 eyes; 18 males, 8 females; mean age 51.00±12.02 y), with baseline characteristics comparable among the three groups(all P>0.05). Comparative analysis of NV visualized via IOFA revealed that both the number and size of NVs were significantly lower in Groups B and C than in Group A(all P<0.0167), while no statistically significant differences were observed between Groups B and C(both P>0.05). No significant differences were found among the three groups regarding other intraoperative parameters, including operation time, frequency of electrocoagulation application, duration of high perfusion pressure, or grading of vitreoretinal adhesion(all P>0.05).CONCLUSION:IOFA confirms that preoperative anti-VEGF therapy administered 7 or 14 d before surgery is more effective than a 3 d interval in suppressing retinal NV activity in PDR patients.

A quantitative method for the analysis of the multi-component contents in Marsdenia tenacissimae was established, and the quality differences were evaluated by principal component analysis (PCA), orthogonal partial least squares-discriminant analysis (OPLS-DA), factor analysis (FA) and weighted technique for order preference by similarity to ideal solution (TOPSIS) method. The contents of chlorogenic acid, cryptochlorogenic acid, sinapic acid, tenacigenoside A, tenacissoside G, tenacissoside I, tenacissoside H, drevogenin A, betulinic acid and lupeol were determined by HPLC wavelength switching method. At the same time, the contents of alcohol-soluble extract and total ash were detected. PCA, OPLS-DA and FA methods were used to identify the origin of M. tenacissimae from different producing areas. According to the OPLS-DA model, the index weight was determined to construct the weighted TOPSIS evaluation model. The qualities of M. tenacissimae from different producing areas were analyzed by model scoring results. The contents of 12 indexes in 18 batches of M. tenacissimae varied to different degrees, and the repeatability and accuracy of the test method were satisfactory. PCA analysis divided 18 batches of M. tenacissimae into three categories. OPLS-DA identified five main potential quality markers, including tenacissoside A, tenacissoside I, lupeol, tenacissoside H and chlorogenic acid. The evaluation results of FA and weighted TOPSIS method were consistent, which showed that the quality of M. tenacissimae from Yunnan and Guizhou was better. The established multi-component quantitative analysis method is accurate and reliable, the chemometrics model has strong predictive ability, and the evaluation results of FA and weighted TOPSIS method are scientific and objective. The combination of the four methods can clearly determine the qualities of M. tenacissimae from different producing areas.

ObjectiveTo investigate the physical fitness status and associated factors among preschool children aged 3 to 6 years in Tongzhou District of Beijing, and to provide evidence for promoting physical development in this population. MethodsBased on the 2020 National Physical Fitness Surveillance data for Tongzhou District of Beijing, a total of 416 children were included for standardized physical tests, including morphological, physiological, and fitness indicators, and questionnaire surveys. Independent sample t-tests and ANOVA were used to compare differences in physical indicators across groups, while multivariate linear regression models were applied to analyze influencing factors. ResultsThe comprehensive fitness score of children aged 3 to 6 years old in Tongzhou District of Beijing was (79.98±6.97) points, with an overall physical fitness pass rate of 99.52%. The proportions of excellent, good, and pass grades were 37.50%, 39.90%, and 22.12%, respectively. The average heights for the 3-years-old, 4-years-old, 5-years-old, and 6-years-old groups in Tongzhou District were (102.13±4.24) cm, (107.92±4.66) cm, (115.43±4.70) cm, and (119.16±4.33) cm, respectively. The corresponding average body weights were (16.63±2.46) kg, (18.66±2.54) kg, (21.60±4.02) kg, and (23.46±4.64) kg, respectively. Among children aged 3 to 6 years, the average BMI was (15.95±1.79) kg‧m^-2, body fat percentage was (21.92±4.77)%, resting pulse rate was (95.24±9.70) beats per minute, grip strength was (5.74±2.07) kg, standing long jump distance was (78.12±19.95) cm, sit-and-reach flexibility was (12.25±4.65) cm, continuous two-foot jump time was (6.29±2.55) seconds, 15-meter obstacle shuttle run time was (7.94±1.30) seconds, and balance beam walking time was (5.11±2.25) seconds. Multiple linear regression analyses showed that higher composite fitness scores were significantly positively associated with female gender (b=1.72, 95%CI: 0.42-3.01), aged 4 years old and above (b=2.97, 95%CI: 1.35-4.59), mixed feeding (b=4.16, 95%CI: 1.60-6.72) or breastfeeding (b=3.23, 95%CI: 0.36-6.10) during infancy, taller paternal (b=0.16, 95%CI: 0.02-0.30) and maternal (b=0.25, 95%CI: 0.11-0.39) height (all P<0.05). ConclusionThe physical fitness of children aged 3 to 6 years in Tongzhou District of Beijing is generally favorable, with gender, age, feeding patterns, and genetic factors identified as key correlating factors. Comprehensive strategies are recommended to improve early childhood physical health.

Aim To investigate the protective effects of methyl rosmarinate(MR)on myocardial injury in-duced by high-altitude hypoxia and explore its underly-ing mechanisms.Methods BALB/c mice were ran-domly divided into a control group,a model group,and low-,medium-,and high-dose MR groups(25,50,and 75 mg·kg-1,respectively).Except for the control group,all other groups were exposed to a hypobaric hypoxia chamber and administered MR via intraperitoneal injection daily for three days.After the experiment,myocardial tissues were collected for he-matoxylin and eosin(HE)staining to observe morpho-logical changes.Levels of malondialdehyde(MDA),glutathione(GSH),and superoxide dismutase(SOD)were measured to evaluate the anti-myocardial injury activity of MR.Network pharmacology was employed to predict drug-disease interaction targets,construct a protein-protein interaction(PPI)network,and identify core targets.Functional enrichment analysis was car-ried out using Gene Ontology(GO)and Kyoto Ency-clopedia of Genes and Genomes(KEGG)pathways.Molecular docking was used to verify the binding affini-ty of MR to core targets,and Western blot was conduc-ted to detect the expression of related proteins.Results MR significantly alleviated myocardial injury caused by high-altitude hypoxia.Network pharmacology analy-sis identified EGFR,Bcl-2,STAT3,MMP9,ESR1,and MTOR as key targets.Molecular docking con-firmed strong binding between MR and these core tar-gets.Western blot results demonstrated that MR im-proved myocardial injury by regulating the expression of STAT3,Bax,and Bcl-2 proteins.Conclusion MR may exert its protective effects on high-altitude hypoxi-a-induced myocardial injury through a multi-target mechanism.

Objective To analyse the clinical efficacy and safety of acupuncture combined with intermittent catheterisation in treating postoperative urinary retention after radical surgery for cervical cancer,and provide reference for the clinical treatment of postoperative urinary retention.Methods A retrospective analysis was conducted based on the clinical data of patients who underwent radical hysterectomy for cervical cancer at Obstetrics and Gynecology Hospital,Fudan University,from Sept 2019 to Dec 2021 and subsequently developed urinary retention.The patients were treated with a combination of acupuncture and intermittent catheterization.We observed residual urine volume,duration of acupuncture treatment,and urinary tract infection status to evaluate the effectiveness and safety of the acupuncture combined with intermittent catheterization regimen.We examined the relationship between treatment duration and various factors such as age,pathological type,surgical-pathological staging,surgical method,pre-treatment catheter indwelling time,pre-treatment residual urine volume,presence or absence of postoperative radiotherapy and chemotherapy,pre-existing urinary tract infection,and whether ureteral stenting was performed,in order to analyze the factors affecting the treatment duration.Results A total of 156 patients were reviewed.After treatment,132 cases had a post-treatment residual urine volume<100 mL,7 cases had a volume of 100-200 mL,and 15 cases had a volume>200 mL.Two cases still had great difficulty in urination after treatment,resulting in an overall effectiveness rate of 89.1%.No significant adverse events occurred in the patients.The treatment duration ranged from 2 to 17 days,with an average treatment time of 6.2 days.The treatment duration was a correlated with the preoperative indwelling catheter duration,residual urine volume and postoperative radiotherapy.Conclusion Acupuncture combined with intermittent catheterisation in treating urinary retention after radical surgery for cervical cancer has good efficacy,short treatment time and no obvious adverse effects,and can be an option for treating postoperative urinary retention.

Objective To compare the differences between swept-source optical coherence tomography angiography(SS-OCTA)and ultra-wide-field fluorescein angiography(UWFA)in detecting non-perfusion areas(NPs)in patients with diabetic retinopathy(DR),to evaluate the accuracy of SS-OCTA in predicting NPs outside its visible range,and to explore the distribution patterns of NPs.Methods A retrospective analysis was made on 69 DR patients(88 eyes)who under-went both UWFA and SS-OCTA examinations at the Ophthalmology Department of Sichuan Provincial People's Hospital from December 2022 to September 2024.Manual NP labeling was conducted to compare the detection rate of NPs between the two imaging techniques.The distribution patterns of NPs and the accuracy of SS-OCTA for predicting NPs outside its visible range were also analyzed.Results In a scanning area of 20 mm x 24 mm,the overall NP detection rate by SS-OCTA was 47.40％,with UWFA taken as the standard.The NP detection rate by SS-OCTA was 51.56％in the superotemporal quad-rant,58.35％in the inferotemporal quadrant,45.50％in the superonasal quadrant,and 43.17％in the inferonasal quad-rant.Most NPs occurred in the inferonasal quadrant,accounting for 41.71％of the total NP.The accuracy of SS-OCTA in predicting NPs was 75.00％in the superonasal quadrant and 78.41％in the inferonasal quadrant.The ischemic indices(ISI)of the two imaging techniques were highly positively correlated(r2=0.74).Conclusion Although SS-OCTA can-not yet fully replace UWFA for NP detection in DR patients due to a small visible range,it is still an effective tool to assess retinal ischemia.SS-OCTA has the ability to predict NPs outside its visible range in its scanning range.The inferonasal quadrant is the region where NPs occur most frequently in DR patients,so it is suggested that special attention should be paid to this region in early diagnosis and follow-up periods.

Objective To investigate the mechanisms by which paeoniflorin improves tissue and cell damage caused by diabetic retinopathy(DR)through the hypoxia-induced factor-1α(HIF-1α)pathway.Methods Thirty rats were ran-domly divided into a control group(10 normal rats),a DR group(10 diabetic model rats)and a paeoniflorin group(10 dia-betic model rats given 80 mg·kg-1 paeoniflorin by gavage).Rat retinal microvascular endothelial cells(rRMECs)were di-vided into a control group(cultured with 5 mmol·L-1 glucose),a high glucose group(cultured with 30 mmol·L-1 glu-cose)and a paeoniflorin group(cultured with 30 mmol·L-1 glucose and 20 mol·L-1 paeoniflorin).The three groups of cells were all cultured for 24 h.Fasting blood glucose was measured by a glucose meter.Hematoxylin and eosin(HE)stai-ning was used to detect the retinal histopathological structure.The levels of HIF-1α and vascular endothelial growth factor(VEGF)proteins and mRNAs in retinal tissues and rRMECs were detected by Western blotting and real time quantitative polymerase chain reaction(RT-qPCR).The proliferative ability of rRMECs was detected by the EdU kit.The serum levels of total cholesterol(TC),triglyceride(TG),low density cholesterol(LDL-C),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in retinal tissues and rRMECs were detected by kits.The activity and invasive ability of rRMECs were measured by CCK-8 and Transwell assay,respectively.The levels of HIF-1α and VEGF proteins in rRMECs were detected by immunofluorescence staining.Results Compared with those in the DR group,the fasting blood glucose,TC,TG and LDL-C levels in the paeoniflorin group were significantly decreased(all P＜0.05).The retinal tissue was loose with an un-clear boundary in the DR group,compared with that in the control group.The retinal tissue in the paeoniflorin group was less loose with a clearer boundary than that in the DR group.The levels of HIF-1α and VEGF proteins and mRNAs,TNF-αand IL-6 in retinal tissues of the DR group were significantly higher than those of the control group(all P＜0.05).The lev-els of HIF-1α and VEGF proteins and mRNAs,TNF-α and IL-6 in retinal tissues of the paeoniflorin group were significantly lower than those in the DR group(all P＜0.05).The activity,proliferation and invasive abilities of rRMECs in the high glu-cose group were higher than those in the control group(all P＜0.05).Compared with those in the high glucose group,rRMECs in the paeoniflorin group showed decreased cell activity,proliferation and invasive abilities(all P＜0.05).The lev-els of HIF-1α and VEGF proteins and mRNAs,TNF-α and IL-6 in the rRMECs of the high glucose group were higher than those of the control group(all P＜0.05).The levels of HIF-1α and VEGF proteins and mRNAs,TNF-α and IL-6 in the rRMECs of the paeoniflorin group were lower than those of the high glucose group(all P＜0.05).Conclusion Paeoni-florin can down-regulate the HIF-1α/VEGF pathway to improve the inflammatory injury of the retinal tissue and inhibit rRMEC activity,proliferation and invasive abilities in DR rats,thereby preventing angiogenesis and reducing the incidence of DR.

Objective:The genotoxicity risk of graphene artificial nerve sheath conduit was systematically evaluated to provide scientific evidence for their clinical safety and to establish methodological references for the genotoxicity assessment of nanomaterial medical devices.Methods:The potential effects of graphene artificial nerve sheath conduit on genetic and chromosomal endpoints were analyzed by integrating bacterial reverse mutation assays,in vitro chromosome aberration assays,mouse lymphoma cell TK gene mutation tests,and mammalian erythrocyte Pig-a gene mutation assays.Results:In the bacterial reverse mutation assay,all plates showed good background growth.There was no significant difference in the average number of revertant colonies between the test group and the negative control group,with a ratio around 1.0.In the in vitro chromosome aberration assay,the chromosomal aberration rate in the test group was less than 5％,showing no significant increase compared to the negative control group.In the mouse lymphoma cell TK gene mutation assay,the mutation frequency in the test group was less than twice that of the negative control group,with no significant difference.In the mammalian erythrocyte Pig-a gene mutation assay,the mutation frequencies of erythrocytes and reticulocytes in the test group were both less than 3× 10-6,showing no significant difference compared to the negative control group.Conclusions:Graphene artificial nerve sheath conduit exhibited no detectable genotoxicity under the tested conditions,the research results can provide reference and guidance for the genotoxicity evaluation of nanomaterial medical devices.

BACKGROUND:The asymmetrical biomechanical environment of adolescent idiopathic scoliosis can lead to further wedge deformation of the vertebral body,which may affect cardiopulmonary function and compress nerves in severe cases.Adolescent idiopathic scoliosis with different degrees of scoliosis should be treated with exercise,bracing,and surgery.However,the mechanical mechanism of selecting an orthopedic approach remains unclear due to the individual variability of patients.OBJECTIVE:To investigate the biomechanical mechanism of different orthopedic modalities for the treatment of adolescent idiopathic scoliosis to provide a basis for clinical selection of treatment modalities based on the spine model of adolescent idiopathic scoliosis patients.METHODS:Based on the CT images of an adolescent idiopathic scoliosis patient,a scoliosis model(C7-L5)was reconstructed in Mimics software in three dimensions,and lateral thrust force was applied at the T8/T9 thorax and vertical distraction force was applied over the C7 vertebra with the magnitude of 20,40,60,80,100,and 120 N.The intervertebral disc stress and vertebral displacement in concave and convex sides,and Cobb angle of the spine were analyzed under two orthopedic modalities.RESULTS AND CONCLUSION:(1)With lateral thrust,there was no significant change in the C7T1-T7T8 intervertebral disc.The concave and convex stress of T7T8-L4L5 segment decreased first and then increased with the increase of lateral thrust force.The correction effect of lateral thrust on the segment near T8T9 was obvious and weakened with the extension of the segment to the cephalic and caudal ends.At 120 N of lateral thrust,the thoracic Cobb angle changed from 53.2° to 32.5° and the lumbar Cobb angle changed from 50.2° to 43.9°.(2)With the vertical distraction,the thoracic intervertebral disc stresses first decreased and then increased,and all the lumbar disc stresses decreased.The C7 displacement was the most obvious,and the correction effect gradually diminished with the segment extended to the caudal end.At a vertical distraction force of 120 N,the thoracic Cobb angle changed from 53.2° to 39.4° and the lumbar Cobb angle changed from 50.2° to 47.6°.(3)It is concluded that both orthopedic modalities provide improvement in the degree of scoliosis,with the thoracic correction being greater than the lumbar correction.Also,the asymmetric stress distribution on the concave and convex sides is improved,which contributes to normal bone growth.A vertical distraction approach is appropriate for larger Cobb angles,and a lateral thrust approach is appropriate for smaller Cobb angles.The results of this study help to understand the mechanism of spinal orthosis and provide a theoretical basis for the choice of orthopedic approach.