Objective To explore the immediate and short-term effects of Shexiang Tongxin Dripping Pill in the intervention of coronary slow flow(CSF).Methods Through Interactive Web Response System,Sixty-four patients with CSF from Dongzhimen Hospital,Beijing University of Chinese Medicine were divided into a Shexiang Tongxin Dripping Pill group(32 patients)and a placebo group(32 patients)in a 1∶1 ratio in a randomized,double-blind,placebo-controlled trial.After sublingual administration of four capsules of Shexiang Tongxin Dripping Pill or the placebo,coronary angiography was repeated,and the corrected TIMI frame count(CTFC)and microcirculatory resistance index(caIMR)were measured to evaluate immediate blood flow velocity.After taking Shexiang Tongxin Dripping Pill or the placebo for 12 weeks,the short-term efficacy was evaluated using traditional Chinese medicine(TCM)syndrome,blood stasis syndrome,and Seattle Angina Questionnaire(SAQ)scores.Results The CTFC and caIMR were lower after administration in the Shexiang Tongxin Dripping Pill group(P＜0.05)than in the placebo group,and the differences in pre-and post-administration values between the two groups were significant(P＜0.01).Intragroup comparisons showed that the CTFC and caIMR in the Shexiang Tongxin Dripping Pill group were lower after administration than before administration(P＜0.01).After 12 weeks of treatment,the blood stasis and TCM syndrome scores in the Shexiang Tongxin Dripping Pill group were lower than those in the placebo group,whereas the SAQ score was higher than that in the placebo group(P＜0.01).Intragroup comparisons indicated that the blood stasis syndrome score in the Shexiang Tongxin Dripping Pill group was lower after treatment than before treatment,whereas the TCM syndrome score in both groups was lower and the SAQ score was higher after treatment than before treatment(P＜0.01).Conclusion Shexiang Tongxin Dripping Pill improve the immediate blood flow velocity of CSF,enhance the quality of life of patients,reduce the TCM syndrome and blood stasis syndrome scores,and have good safety.

OBJECTIVE To explore the implementation and standardized management of infection control core ele-ments in grass-roots medical institutions within county-level medical communities.METHODS From Mar.2024 to Apr.2024,the current status of implementation of infection control core elements in the grass-roots medical institu-tions within county-level medical communities was investigated by means of questionnaire survey and qualita-tive interview,and the implementation strategies were further explored.RESULTS The infection management or-ganizational system and functions of the two county-level medical institutions within the county medical communi-ties were completed,there is no independent hospital infection management department in the primary medical in-stitutions.The infection management personnel in the 16 grass-roots medical institutions were part-time person-nel,the personnel with the educational background below junior college accounted for 84.21％,the personnel with the professional background of nursing accounted for 100.00％,the personnel with less than 5 years of working experience accounted for 78.95％,none of them had an on-the-job training certificate.The monitoring programs of the county-level medical institutions within the county medical communities were completed,there was no infec-tion management monitoring information platform in the grass-roots medical institutions.The infection cases,hand hygiene,environmental health and occupational exposures were monitored by people.The grass-roots medi-cal institutions had the highest requirements for various professional trainings and increase of training contents of prevention and control of public health infectious diseases(100.00％).The county-level medical institutions had inadequate capabilities of professional examination of medical equipment replacement and construction of medi-cal architecture.CONCLUSION It is necessary for the country and local levels of governments to attach great importance to the implementation of the infection control core elements in the grass-roots medical institutions within the county-lev-el medical communities,establish the county-level regional information platform,formulate the corresponding surveil-lance indexes and homogenized management systems,complete the cultivation of talents,and offer financial support.

OBJECTIVE To explore the implementation and standardized management of infection control core ele-ments in grass-roots medical institutions within county-level medical communities.METHODS From Mar.2024 to Apr.2024,the current status of implementation of infection control core elements in the grass-roots medical institu-tions within county-level medical communities was investigated by means of questionnaire survey and qualita-tive interview,and the implementation strategies were further explored.RESULTS The infection management or-ganizational system and functions of the two county-level medical institutions within the county medical communi-ties were completed,there is no independent hospital infection management department in the primary medical in-stitutions.The infection management personnel in the 16 grass-roots medical institutions were part-time person-nel,the personnel with the educational background below junior college accounted for 84.21％,the personnel with the professional background of nursing accounted for 100.00％,the personnel with less than 5 years of working experience accounted for 78.95％,none of them had an on-the-job training certificate.The monitoring programs of the county-level medical institutions within the county medical communities were completed,there was no infec-tion management monitoring information platform in the grass-roots medical institutions.The infection cases,hand hygiene,environmental health and occupational exposures were monitored by people.The grass-roots medi-cal institutions had the highest requirements for various professional trainings and increase of training contents of prevention and control of public health infectious diseases(100.00％).The county-level medical institutions had inadequate capabilities of professional examination of medical equipment replacement and construction of medi-cal architecture.CONCLUSION It is necessary for the country and local levels of governments to attach great importance to the implementation of the infection control core elements in the grass-roots medical institutions within the county-lev-el medical communities,establish the county-level regional information platform,formulate the corresponding surveil-lance indexes and homogenized management systems,complete the cultivation of talents,and offer financial support.

Objective To explore the immediate and short-term effects of Shexiang Tongxin Dripping Pill in the intervention of coronary slow flow(CSF).Methods Through Interactive Web Response System,Sixty-four patients with CSF from Dongzhimen Hospital,Beijing University of Chinese Medicine were divided into a Shexiang Tongxin Dripping Pill group(32 patients)and a placebo group(32 patients)in a 1∶1 ratio in a randomized,double-blind,placebo-controlled trial.After sublingual administration of four capsules of Shexiang Tongxin Dripping Pill or the placebo,coronary angiography was repeated,and the corrected TIMI frame count(CTFC)and microcirculatory resistance index(caIMR)were measured to evaluate immediate blood flow velocity.After taking Shexiang Tongxin Dripping Pill or the placebo for 12 weeks,the short-term efficacy was evaluated using traditional Chinese medicine(TCM)syndrome,blood stasis syndrome,and Seattle Angina Questionnaire(SAQ)scores.Results The CTFC and caIMR were lower after administration in the Shexiang Tongxin Dripping Pill group(P＜0.05)than in the placebo group,and the differences in pre-and post-administration values between the two groups were significant(P＜0.01).Intragroup comparisons showed that the CTFC and caIMR in the Shexiang Tongxin Dripping Pill group were lower after administration than before administration(P＜0.01).After 12 weeks of treatment,the blood stasis and TCM syndrome scores in the Shexiang Tongxin Dripping Pill group were lower than those in the placebo group,whereas the SAQ score was higher than that in the placebo group(P＜0.01).Intragroup comparisons indicated that the blood stasis syndrome score in the Shexiang Tongxin Dripping Pill group was lower after treatment than before treatment,whereas the TCM syndrome score in both groups was lower and the SAQ score was higher after treatment than before treatment(P＜0.01).Conclusion Shexiang Tongxin Dripping Pill improve the immediate blood flow velocity of CSF,enhance the quality of life of patients,reduce the TCM syndrome and blood stasis syndrome scores,and have good safety.

OBJECTIVE：To reevaluate the guidelines/cons ensus，systematic review/Meta-analysis of proton pump inhibitors （PPIs）in the prevention of drug-induced gastrointestinal injury ，and to provide evidence-based reference for its clinical use. METHODS： The relevant guidelines/consensus and systematic review/Meta-analysis literatures at home and abroad were systematically reviewed ，and the re evaluation was carried out from the effectiveness ，safety and economy dimensions to analyze the current situation of clinical use of PPIs in the prevention of drug-induced gastrointestinal injury in adults and children. RESULTS ： A total of 14 clinical guidelines/consensus and 10 systematic review/Meta-analysis literatures of PPIs for the prevention of drug-related gastrointestinal injury at home and abroad were sorted out and included. In terms of effectiveness ，PPIs could prevent various drug-related gastric mucosal damage ，gastrointestinal bleeding and other damage to the digestive tract ，but PPIs had not yet obtained the indication for children in China ；PPIs were widely used in the treatment of children ’s digestive tract diseases ，which belonged to off-label medication. In terms of safety ，the common adverse reactions of PPIs included headache ，gastrointestinal symptoms，etc. There may be risks of kidney disease and fracture during long-term application. In terms of economy ，for some patients with digestive tract and cardiovascular disease risk ，the economic benefit of NSAIDs combined with PPIs were higher ； esomeprazole 20 mg and 40 mg daily were equally effective in preventing ulcer recurrence caused by NSAIDs ，but increasing the dose could not improve the preventive effect. CONCLUSIONS ：The preventive effect of PPIs on drug-induced gastrointestinal injury is supported by evidence-based evidence. It has good safety in adults and has certain economic benefits ；but it belongs to off-label drug use in children in China ，and the safety and economy still need to refer to the results of adult studies. In the future ，a number of multicenter prospective clinical studies based on Chinese pediatric population are still needed to provide more support for the prevention and treatment of drug-induced gastrointestinal injury by PPIs in children.

OBJECTIVE： To provide reference for the selection of inhaled corticosteroids （ICS） in clinic. METHODS： A questionnaire survey was conducted among pediatricians from medical institutions of 11 provinces （districts， cities） to analyze the drug selection and reasons， dosage form selection [by comprehensive score （CS）] of 3 kinds of ICS as budesonide （BUD）， beclomethasone （BDP） and fluticasone （FP）， medication compliance and influential factors （by CS）. RESULTS： A total of 200 questionnaires were sent out， and 196 valid questionnaires were collected with effective rate of 98.00％. Pediatric clinicians preferred BUD as a control drug for asthma in children （158 cases， 80.61％）， followed by FP （22 cases， 11.22％） and BDP （2 cases， 1.02％） and the rest had no tendency （14 cases， 7.14％）. Clinicians who chose BUD mainly believed that the drug had better clinical efficacy， and was more recommended by guidelines and experts， more recognized by patients and so on. In addition， of all inhalation equipment for children asthma， pediatric clinicians believed that parents or children were more easier to master atomizer （CS： 4.04）， followed by pressurized metered dose inhalers （pMDI） （with spacer） （CS： 2.75）， pMDI （without spacer） （CS： 1.71）， dry powder inhalers （DPI） （turbuhaler） （CS： 1.46） and DPI （accuhaler） （CS： 1.08）. For the evaluation of patients’ medication compliance， 48 （24.49％）， 88 （44.90％）， 58 （29.59％） pediatricians thought that the actual administration accounted for ＜50％， 50％-74％， 75％-99％ of the medical order dosages， respectively. Only 2 （1.02％） subjects thought that the patients would fully obey. The main factors affecting children’s medication compliance were worrying about side effects of long-term medication （CS： 9.19）， drug withdrawal after improvement （CS： 8.16）， and children’s treatment incompatibility （CS： 7.82）. CONCLUSIONS： Pediatricians tend to choose BUD as drug for asthma control， and atomizer is treated as the easiest inhalation equipment for children. At the same time， pediatricians have low evaluation on the medication compliance of parents and children.

Objective To explore the feasibility of post-marketing active safety surveillance for pediatric medication based on big medical data.Methods A questionnaire on hospital information systems was conducted using cross-sectional study method in 17 children's hospital of Beijing Children's Hospital Group during May to July, 2016.Variables for post-marketing active safety surveillance for pediatric medication was designed in the questionnaire which included 146 questions of six aspects, database features, degree of computerization (including 21 variables), degree of structuring (involving 39 variables), data type, data encoding, degree of linkage on information systems, and data sharing willingness.The data were analyzed using Excel 2007 software.Results The recovery rate of the questionnaire was 100%.There were 17 children's hospitals, of them, 14 hospitals were level 3 A and 3 hospitals were level 3 B, distributed in 17 provinces or regions in China.Data starts from 1999 to 2014 in the different hospitals' information systems with a total of 60 million children's medical records.The 21 variables used to evaluate the degree of computerization computerized in all departments in 10 hospitals and in half of the departments in 2 hospitals.Of the 39 variables used to evaluate the degree of structuring, 10 variables structured in the 17 hospitals, 23 variables structured in the 10-16 hospitals, and 6 variables structured in the 2-6 hospitals.However, there was a big difference in the data types and data coding among the information systems.The data encoding were mostly based on the hospital standard.Four modules of variable information (baseline information, drug exposure,diagnosis information, laboratory test) could be linked by a uniform number in 10 hospitals, partially linked in 7 hospitals.Meanwhile, 12 hospitals have the willing to share the desensitization data to support post-marketing drug safety studies.Conclusions Most children's hospitals in this study have willing and conditions to integrate data of different modules of information systems to form the data chain.It is feasible to monitor actively the post-marketing safety of children's drugs based on the big medical data.However, the medical data need to be further standardized firstly because of the big difference in the data structure and types among the medical systems.

Objective To explore the feasibility of post-marketing active safety surveillance for pediatric medication based on big medical data.Methods A questionnaire on hospital information systems was conducted using cross-sectional study method in 17 children's hospital of Beijing Children's Hospital Group during May to July, 2016.Variables for post-marketing active safety surveillance for pediatric medication was designed in the questionnaire which included 146 questions of six aspects, database features, degree of computerization (including 21 variables), degree of structuring (involving 39 variables), data type, data encoding, degree of linkage on information systems, and data sharing willingness.The data were analyzed using Excel 2007 software.Results The recovery rate of the questionnaire was 100%.There were 17 children's hospitals, of them, 14 hospitals were level 3 A and 3 hospitals were level 3 B, distributed in 17 provinces or regions in China.Data starts from 1999 to 2014 in the different hospitals' information systems with a total of 60 million children's medical records.The 21 variables used to evaluate the degree of computerization computerized in all departments in 10 hospitals and in half of the departments in 2 hospitals.Of the 39 variables used to evaluate the degree of structuring, 10 variables structured in the 17 hospitals, 23 variables structured in the 10-16 hospitals, and 6 variables structured in the 2-6 hospitals.However, there was a big difference in the data types and data coding among the information systems.The data encoding were mostly based on the hospital standard.Four modules of variable information (baseline information, drug exposure,diagnosis information, laboratory test) could be linked by a uniform number in 10 hospitals, partially linked in 7 hospitals.Meanwhile, 12 hospitals have the willing to share the desensitization data to support post-marketing drug safety studies.Conclusions Most children's hospitals in this study have willing and conditions to integrate data of different modules of information systems to form the data chain.It is feasible to monitor actively the post-marketing safety of children's drugs based on the big medical data.However, the medical data need to be further standardized firstly because of the big difference in the data structure and types among the medical systems.

Objective To study the role of transforming growth factor-β1 (TGF-β1),connective tissue growth factor (CTGF)and endothelin-1 (ET-1) in myocardial tissues of the mice with myocardial fibrosis induced by coxsachievirus B3 (CVB3) and the effect of Carvedilol intervention for it in acute stage and chronic phase of viral myocarditis.Methods Forty male BALB/c mice were randomly divided into 4 groups (10 cases in each group):control group,model group,Carvedilol acute phase intervention group,the chronic phase intervention group.Mice in model group and Carvedilol intervention groups were inoculated with CVB3 (100TCID50/0.1 mL) by peritoneal injection fortnightly.Mice in control group were given normal saline(NS) instead equivalently.Mice were poured Carvedilol (10 mg/kg per day for 2 weeks) from the second day in acute phase intervention group and from the fourth week in the chronic phase intervention group,while mice of control group and model group were poured with equivalent NS instead.At the end of 6 weeks,mice were sacrificed.Heart weight index (HWI) was determined.The collagen volume fraction (CVF) of left ventricular myocardial tissue were examined after Masson staining.Expressions of ET-1,TGF-β1 and CTGF were detected by enzyme linked immunosorbent assay and immunohistochemistry staining respectively; the mRNA expression was tested by reverse transcription-polymerase chain reaction.Results Compared with the control group,HWI and CVF of model group increased significantly(all P ＜ 0.01),those of the intervention groups decreased than those of the model group(all P ＜ 0.01),and in the acute phase those of the intervention group were significantly lower than those in chronic phase intervention group(all P ＜ 0.05).The expressions of TGF-β1,CTGF,ET-1 and their mRNA in model group were increased significantly than those in the control group(all P ＜0.01),and were decreased in acute and the chronic phase intervention group than those in model group(all P ＜0.01),while those were significantly lower in acute phase intervention group than those in chronic phase intervention group (all P ＜ 0.01).Conclusions TGF-β1,CTGF and ET-1 may be involved in myocardial fibrosis induced by CVB3.Compared with the chronic phase intervention,the acute phase intervention of Carvedilol can reduce myocardial fibrosis more efficiently by down-regulating the excessive expression of inflammatory factors.

s:Objective To investigate the possible role of basic ifbroblast growth factor (bFGF) and transforming growth factorβ1 (TGF-β1) in mice with Coxsackie viral myocarditis and their relationship. Methods Eighty male BALB/c mice, 4 weeks old, were divided randomly into study group (n=40) and control group (n=40). The study group was repeated intraperitoneally injected with Coxasckie viral B3 to establish the model of viral myocarditis, while the control group was injected with virus-free Eagle’s medium in the same period. On the 7th, 14th, 28th and 42th day after the ifrst injection, 8 alive mice selected randomly from each group were sacriifced to examine the myocardial collagen volume fraction (CVF) by Masson dyeing, and to detect the protein and mRNA expression of bFGF and TGF-β1 by RT-PCR and immunohistochemistry. The correlations were analyzed. Results At each time point, the expressions of protein and mRNA of bFGF and TGF-β1 both in study group were signiifcantly higher than those in control group (P<0.01), and gradually increased over time. The expressions of protein and mRNA of bFGF and TGF-β1 were positively correlated with CVF (r=0.86~0.95, all P<0.01). In addition, the expressions of protein and mRNA of bFGF also had positive correlation with the expression of protein and mRNA of TGF-β1 (r=0.94, 0.92, P<0.01). Conclusion bFGF and TGF-β1 may promote the occurrence and development of myocardial ifbrosis in viral myocarditis, which may provide a new target for future treatment of myocardial ifbrosis.