ObjectiveChinese patent medicines for cardiovascular and cerebrovascular diseases are diverse and complex in their efficacy. The traditional classification method based on efficacy categories has certain limitations and cannot meet the clinical needs for individualized drug selection and variety comparison. This article， based on the formulation compatibility analysis technology of "Tangye Jingfa Tu"， clarifies the composition and efficacy characteristics of common Chinese patent medicines used for cardiovascular and cerebrovascular diseases， providing support for the precise selection of these medicines. MethodsFifty-six representative Chinese patent medicines， covering all the efficacy subcategories of "stasis-resolving agents" in the National Basic Medical Insurance， Work Injury Insurance， and Maternity Insurance Drug Catalogue （2023） （more than 50% of the total）， were selected for the study. Within the knowledge system of "Tangye Jingfa Tu"， the compatibility structure of herbal flavors and the proportion structure of herbal quantities for each Chinese patent medicine were determined. The correlation between these structures and the efficacy categories was analyzed to identify the similarities and differences among the selected Chinese patent medicines. Additionally， the efficacy was reclassified and compared according to the theoretical framework of tonifying and purging methods of five Zang organs in the "Tangye Jingfa Tu". ResultsThe representative Chinese patent medicines included in the analysis were Shexiang Baoxin pills， Danshen tablets， Qili Qiangxin capsules， Breviscapine tablets， etc.， covering all the efficacy subcategories of "stasis-resolving agents". Among the 56 representative Chinese patent medicines， salty flavor was the most common （48）， followed by pungent （33）， and sweet （26）. According to the dominant herbal flavor， salty flavor was the most common （37）， followed by pungent （9）， and sour （5）. According to the dominant herbal quantity， salty flavor was the most common （27）， followed by sour （7）， and pungent （5）. Furthermore， Chinese patent medicines with different efficacy subtypes showed different flavor characteristics. For example， most Qi-invigorating and blood-activating agents contained sweet drugs for tonifying the spleen （9/10）， most Qi-moving and blood-activating agents contained pungent drugs for tonifying the liver （7/8）， and all kidney-invigorating and blood-activating agents contained bitter drugs for tonifying the kidneys （6/6）. However， the efficacy classification of individual medicines did not always align with the compatibility characteristics of their formulas， as seen with Dengyin Naotong capsules. ConclusionThe formulations of Chinese patent medicines for cardiovascular and cerebrovascular diseases predominantly feature salty， sour， and pungent flavors， which largely conform to the therapeutic principles of "nourishing the heart with salt and soothing the heart with sour" and the liver-heart， heart-spleen mother-child treatment relationship shown in the "Tangye Jingfa Tu". Using the "Tangye Jingfa Tu" framework to conduct research on the structure and efficacy characteristics of Chinese patent medicines is objective and effective.

ObjectiveChinese patent medicines for cardiovascular and cerebrovascular diseases are diverse and complex in their efficacy. The traditional classification method based on efficacy categories has certain limitations and cannot meet the clinical needs for individualized drug selection and variety comparison. This article， based on the formulation compatibility analysis technology of "Tangye Jingfa Tu"， clarifies the composition and efficacy characteristics of common Chinese patent medicines used for cardiovascular and cerebrovascular diseases， providing support for the precise selection of these medicines. MethodsFifty-six representative Chinese patent medicines， covering all the efficacy subcategories of "stasis-resolving agents" in the National Basic Medical Insurance， Work Injury Insurance， and Maternity Insurance Drug Catalogue （2023） （more than 50% of the total）， were selected for the study. Within the knowledge system of "Tangye Jingfa Tu"， the compatibility structure of herbal flavors and the proportion structure of herbal quantities for each Chinese patent medicine were determined. The correlation between these structures and the efficacy categories was analyzed to identify the similarities and differences among the selected Chinese patent medicines. Additionally， the efficacy was reclassified and compared according to the theoretical framework of tonifying and purging methods of five Zang organs in the "Tangye Jingfa Tu". ResultsThe representative Chinese patent medicines included in the analysis were Shexiang Baoxin pills， Danshen tablets， Qili Qiangxin capsules， Breviscapine tablets， etc.， covering all the efficacy subcategories of "stasis-resolving agents". Among the 56 representative Chinese patent medicines， salty flavor was the most common （48）， followed by pungent （33）， and sweet （26）. According to the dominant herbal flavor， salty flavor was the most common （37）， followed by pungent （9）， and sour （5）. According to the dominant herbal quantity， salty flavor was the most common （27）， followed by sour （7）， and pungent （5）. Furthermore， Chinese patent medicines with different efficacy subtypes showed different flavor characteristics. For example， most Qi-invigorating and blood-activating agents contained sweet drugs for tonifying the spleen （9/10）， most Qi-moving and blood-activating agents contained pungent drugs for tonifying the liver （7/8）， and all kidney-invigorating and blood-activating agents contained bitter drugs for tonifying the kidneys （6/6）. However， the efficacy classification of individual medicines did not always align with the compatibility characteristics of their formulas， as seen with Dengyin Naotong capsules. ConclusionThe formulations of Chinese patent medicines for cardiovascular and cerebrovascular diseases predominantly feature salty， sour， and pungent flavors， which largely conform to the therapeutic principles of "nourishing the heart with salt and soothing the heart with sour" and the liver-heart， heart-spleen mother-child treatment relationship shown in the "Tangye Jingfa Tu". Using the "Tangye Jingfa Tu" framework to conduct research on the structure and efficacy characteristics of Chinese patent medicines is objective and effective.

Objective:To investigate the expression of EIF3B and its role in the development of laryngeal carcinoma. Methods:Immunohistochemistry, cell culture, cell transfection, qRT-PCR, Western Blot and other techniques were used to determine the expression difference of EIF3B in laryngeal cancer and adjacent tissues, and analyze the relationship between EIF3B and the size and TNM stage of laryngeal cancer. By constructing a laryngeal carcinoma cell model with EIF3B knocked down, the cell function was studied, and the regulatory effect of EIF3B on laryngeal carcinoma cells was proved in vitro. Finally, the effect of EIF3B on laryngeal carcinoma growth in vivo was studied by subcutaneous xenograft tumor model in nude mice. Results:The signal intensity of EIF3B in laryngeal carcinoma tissues was significantly stronger than that in adjacent tissues, and the expression level of EIF3B was positively correlated with patient age, TNM stage, lymph node metastasis, tumor size and clinical stage. Knocking down EIF3B can significantly inhibit the proliferation, migration and aggregation of cancer cells, and promote apoptosis. In vivo experiments with nude mice also showed that down-regulating EIF3B expression could inhibit tumor formation in vivo. Conclusion:The expression of EIF3B in laryngeal cancer is significantly increased, and it is closely related to the pathological characteristics of laryngeal cancer, which can be used as a diagnostic index of laryngeal cancer. In terms of function, EIF3B knockdown can inhibit the proliferation, migration and tumor formation of laryngeal cancer cells in vitro and in vivo, and may become a candidate target for targeted therapy of laryngeal cancer in the future.
Laryngeal Neoplasms/pathology* ; Humans ; Eukaryotic Initiation Factor-3/metabolism* ; Animals ; Mice, Nude ; Mice ; Cell Line, Tumor ; Cell Proliferation ; Apoptosis ; Cell Movement ; Neoplasm Staging ; Male ; Transfection ; Female ; Middle Aged ; Gene Expression Regulation, Neoplastic

Objective This study aims to investigate the current status of burnout among anesthesi-ology residents,and to explore its influencing factors and potential interventions.Methods A total of 2 651 practicing anesthesiology residents from 218 hospitals nationwide were included in this study.Demographic characteristics,occupational features,and psychological resilience scores(Connor-Davidson resilience scale)were collected using a questionnaire distributed electronically.The Maslach burnout inventory-human service survey(MBI-HSS)was used to assess burnout.A comparison between groups with and without occu-pational burnout was conducted.Multiple logistic regression analysis was used to identify risk factors for burnout among anesthesiology residents.Results Out of the expected 2 651 questionnaires,1 990 valid responses were received(response rate 77.7%).The prevalence of burnout among the residents was 53.4%(1 063/1 990).Compared with residents without occupational burnout,those with burnout had a signifi-cantly higher proportion of females,working in tertiary hospitals,unmarried individuals,frequency of en-countering challenging patients,participating in on-call duty,and research tasks,and had a significantly lon-ger weekly working hours(P＜0.05).Multivariate logistic regression analysis indicated that female(OR = 1.58,95%CI 1.28-1.97,P＜0.01),longer working hours(OR = 1.62,95%CI 1.45-1.81,P＜0.01),and higher frequency of encountering challenging patients(OR = 1.11,95%CI 1.11-1.40,P＜0.01)were risk factors for occupational burnout.High levels of psychological resilience was protective factor against burnout(OR = 0.86,95%CI 0.84-0.88,P＜0.01).Conclusion The occurrence of burnout among anesthesiology residents is high.It is crucial to focus on and design practical preventive measures to en-hance psychological resilience,ensuring healthy physical and mental development of the resident community.

Objective To investigate the levels of serum CXC-chemokine ligand 16(CXCL16)and anti-neu-trophil cytoplasmic antibody(ANCA)in patients with allergic rhinitis and their clinical diagnostic value.Meth-ods A total of 84 patients with allergic rhinitis(allergic rhinitis group)treated in the hospital from January to December 2022 were selected as the study objects,and were divided into mild group(44 cases)and moderate and severe group(40 cases)according to the severity of their disease.Another 80 healthy subjects who had physical examination in the same period were selected as the control group.The levels of CXCL16 and ANCA in serum were determined by enzyme-linked immunosorbent assay.The correlation between serum CXCL16 and ANCA levels and inflammatory factors[interleukin(IL)-4,IL-9,IL-13]and immunoglobulin E(IgE)was analyzed by Pearson.The value of serum CXCL16 and ANCA levels in the diagnosis of moderate and severe allergic rhinitis was evaluated by receiver operating characteristic(ROC)curve.Results Compared with con-trol group,the levels of IL-4,IL-9,IL-13 and IgE in allergic rhinitis group were significantly increased,and the difference was statistically significant(P＜0.05).Compared with control group,serum CXCL16 and ANCA levels in allergic rhinitis group were significantly increased,and the differences were statistically significant(P＜0.05).The area under the curve(AUC)of serum CXCL16 and ANCA in patients with allergic rhinitis was 0.897 and 0.844,respectively.The AUC of combined diagnosis was 0.959,both of which were better than that of individual diagnosis(Z=2.164,3.474,P＜0.05),and the specificity was 93.75％.The sensitivity was 89.29％.The levels of serum CXCL16 and ANCA in patients with allergic rhinitis increased with the se-verity of the disease(P＜0.05).Pearson correlation analysis showed that serum CXCL16 and ANCA levels were positively correlated with IL-4,IL-9,IL-13 and IgE in patients with allergic rhinitis(P＜0.05).ROC curve analysis results showed that the AUC of the patients diagnosed with moderate and severe allergic rhini-tis by serum CXCL16 and ANCA was 0.862 and 0.832,respectively,and the AUC of the combined diagnosis of CXCL16 and ANCA was 0.949,both of which were better than those diagnosed separately(Z=1.981,2.378,P＜0.05),and the specificity was 90.91％.The sensitivity was 90.00％.Conclusion The levels of se-rum CXCL16 and ANCA in patients with allergic rhinitis increased significantly,and increased with the severi-ty of the patients'disease,both of which have certain value in the clinical diagnosis of allergic rhinitis.

By consulting ancient and modern literature， the herbal textual research of Farfarae Flos has been conducted to verify the name， origin， producing area， quality evaluation， harvesting and processing methods， so as to provide reference for the development and utilization of the famous classical formulas containing Farfarae Flos. According to the research， the results showed that Farfarae Flos was first described as a medicinal material by the name of Kuandonghua in Shennong Bencaojing（《神农本草经》）， and the name was used and justified by later generations. The main origin was the folwer buds of Tussilago farfara， in addition， the flower buds of Petasites japonicus were used as medicine in ancient times. The ancient harvesting time of Farfarae Flos was mostly in the twelfth month of the lunar calendar， and the modern harvesting time is in December or before the ground freeze when the flower buds have not been excavated. Hebei， Gansu， Shaanxi are the authentic producing areas with the good quality products. Since modern times， its quality is summarized as big， fat， purple-red color， no pedicel is better. Processing method from soaking with licorice water in the Northern and Southern dynasties to stir-frying with honey water followed by micro-fire in the Ming dynasty， and gradually evolved to the modern mainstream processing method of honey processing. Based on the research results， it is suggested that the dried flower buds of T. farfara， a Compositae plant， should be selected for the development of famous classical formulas containing Farfarae Flos， and the corresponding processed products should be selected according to the specific processing requirements of the formulas， and raw products are recommended for medicinal use without indicating processing requirements.

By reviewing the ancient and modern literature， the name， origin， scientific name evolution， place of origin， quality， harvesting， processing， efficacy and toxicity of Asteris Radix et Rhizoma（ARR） were systematically sorted out， so as to provide reference for the development and utilization of the relevant famous classical formulas. According to textual research， ARR was first contained in Shennong Bencaojing， all generations are Ziwan for its proper name， and there are still aliases such as Ziyuan， Ziqian and Xiaobianer. Its mainstream origin in successive generations was Aster tataricus， and there are also Ligularia fischeri and others in local area of use. The medicinal parts of ARR are root and rhizome， but in modern times， the rhizome is mostly used for propagation and cultivation， so some of ARR medicinal materials only have the root without the rhizome. The earliest recorded ancient origin of ARR was now Fangxian（Hubei）， Zhengding and Handan（Heibei）， then the range of production areas gradually expanded， the mainstream production areas from the Song dynasty to the Ming and Qing dynasties included Hebei， Jiangsu， Anhui， Henan and other places， since modern times， two major producing areas have been formed in Anguo， Hebei province and Bozhou， Anhui province. From the quality evaluation， it is clear that from ancient times， flexible roots and purple color are the best. The ancient harvesting was mainly in lunar February or March， and then dried in the shade， and the modern harvesting is mostly in spring and autumn， and the roots are braided into pigtails and then dried in the sun or dried in the sun after 1-2 d. The ancient and modern processing method of ARR are basically the same， mainly honey processing， there are still methods of frying， steaming， vinegar sizzling， etc. Based on the results， it is recommended that the dried roots and rhizomes of A. tataricus should be used in clinical and the development of related famous classical formulas， and those whose original formulas specify the processing requirements can be processed according to the relevant requirements， while whose processing requirements are not specified should be used in the form of raw products.

Postoperative pain seriously affects the recovery process of patients, resulting in prolonged hospital stay and increased care costs. Appropriate application of patient-controlled analgesia devices can effectively relieve perioperative acute pain. In 1994 patient-controlled analgesia began to be used in Peking Union Medical College Hospital, and the Acute Pain Service Working Group was established in 2004. With the cooperation of anesthesiologists and specialist nurses, the group jointly has implemented the whole process and standardized management based on patient-controlled analgesia, and constantly improved and innovated working methods, laying a solid foundation for the development of postoperative pain management. This paper systematically reviews and summarizes the work from the aspects of clinical focus, nursing management experience, promotion and dissemination of pain treatment concepts, and development of acute pain service model under the new situation, with the hope of providing valuable reference for comprehensively strengthening pain management in the process of diagnosis and treatment, and enhancing patients' satisfaction with perioperative analgesia services.

Pain management, listed as the fifth vital sign, has gained increasing attention from clinicians. Conventional analgesics have limited duration, leading to intense monitor and frequent dosing during the early phase in order to prevent the progression of chronic pain. Thus, prolonging the duration of analgesics has become one focus of the pain research. Several strategies, such as adding adjuvants, producing derivatives, and applying extended-release carriers, make it possible for super long-acting analgesics to come into reality. This review briefly introduces the strategies and development of the super long-acting analgesics, including the successful translation and commercialization of the present products of super long-acting analgesics. It also summarizes the application and translation of extended-release drug carriers, providing invaluable reference for the future research on the field of super long-acting analgesics.

  Objective  To explore the mechanism of Wnt5a on keratinocyte involved in the peripheral sensitization of complex regional pain syndrome type-Ⅰ (CRPS-Ⅰ) by regulating the expression of MMP9, and search for potential therapeutic strategies.  Methods  Cultured HaCaT cells were treated with oxygen glucose deprivation/re-oxygenation (OGD/R). The early stage of mitochondrial damage and membrane potential changes after OGD/R and the effects of Box5 (Wnt5a inhibitor) at different concentrations (20 μmol/L, 40 μmol/L) on MMP9 were explored. Adult male Sprague-Dawley rats were divided into Control group(n=8), CPIP group (n=8), Box5 (20) group (n=8) and Box5 (40) group (n=8). The rat chronic post-ischemia pain (CPIP) model was established to mimic the pathophysiological process of CRPS-Ⅰ. Box5 (20) group and Box5 (40) group were treated with intraplantar injection of 20 μmol/L and 40 μmol/L Box5 100 μL, respectively. The changes of mechanical withdrawal threshold and thermal withdrawal latency were measured within two weeks, and the skin inflammatory infiltration and keratosis were observed by HE staining. The expression of MMP9 was observed by immunofluorescence, and the levels of IL-1β and TNF-α in dorsal root ganglion of different groups were detected by ELISA.  Results  Vitro experiment: After OGD/R treatment, the mitochondrial atrophy was observed in OGD/R group under transmission electron microscope and the average fluorescence intensity of MMP9 was found to increase significantly (P<0.001). Compared with Control group, the mitochondrial membrane potential in OGD/R group decreased significantly by JC-1 detection (P=0.027). Compared with OGD/R group, only Box5 (40) group had a statistically significant increase in mitochondrial membrane potential (P=0.046). Animal experiment: Behavioral tests showed that the mechanical pain threshold and thermal pain threshold of CPIP group were significantly decreased at each time point (D1, D2, D4, D10, D14) (all P<0.05). HE staining indicated that there was a large-scale infiltration of inflammatory cell in the dermis and excessive keratosis in the epidermis, and the thickness of stratum granulosum and stratum spinosum increased significantly (P < 0.001). Immunofluorescence analysis showed that the expression of MMP9 in CPIP group was significantly increased (P<0.001). Compared with CPIP group, the fluorescence intensity of MMP9 in Box5 (20) group (P=0.002) and Box5 (40) group (P<0.001) were significantly decreased. ELISA results showed that the concentrations of IL-1β (P=0.048) and TNF-α (P=0.002) in CPIP group were significantly increased. Compared with CPIP group, the concentrations of IL-1β (P=0.047) and TNF-α (P=0.047) were significantly decreased in Box5 (40) group.  Conclusions  Peripheral ischemia reperfusion injury leads to overexpression of MMP9 on keratinocytes, resulting in CRPS-Ⅰ peripheral sensitization. Targeted inhibition of Wnt5a/MMP9 pathway can reverse pain behavior in rat model of CPIP, thus providing a strategy for clinical treatment of chronic pain.