ObjectiveTo observe the clinical efficacy and safety of Tianmeng Lingjiao Formula（天礞羚角方， TLF） as an adjunctive therapy for paroxysmal atrial fibrillation （PAF） with phlegm-heat harassing the interior syndrome. MethodsNinety patients with PAF and phlegm-heat harassing the interior syndrome were enrolled and randomly assigned in a 2∶1 ratio to test group （60 cases） and control group （30 cases）. The control group received conventional western medicine， while the test group received TLF in addition to the conventional treatment， with one dose administered daily. The treatment course for both groups was 4 weeks. The efficacy of traditional Chinese medicine （TCM） syndrome and the rate of atrial fibrillation （AF） conversion were compared between groups. Assessments included AF burden， frequency and duration of AF episodes， TCM syndrome scores， and European Heart Rhythm Association （EHRA） AF symptom classification before and after treatment. Safety indicators such as blood routine， urine routine， stool routine， liver function， kidney function， and electrolytes were also monitored. Adverse events were recorded. ResultsA total of 82 patients completed the study （54 in the test group and 28 in the control group）. After treatment， AF burden， the frequency and duration of AF episodes， and TCM syndrome scores were significantly reduced in both groups， and the test group showed lower indicators than the control group （P＜0.01 or P＜0.05）. The AF conversion rate was 25.93% （14/54） in the test group， significantly higher than 3.57% （1/28） in the control group （P＜0.05）. The total effective rate for TCM syndrome efficacy was 83.33% （45/54） in the test group， which was significantly higher than 67.86% （19/28） in the control group （P＜0.05）. After treatment， the EHRA atrial fibrillation symptom severity in the test group showed significant improvement， and the improvement in atrial fibrillation symptoms was superior to that in the control group （P＜0.01or P＜0.05）. No significant abnormalities were observed in safety indicators， and no adverse events occurred during the trial. ConclusionTLF as an adjunctive therapy can reduce AF burden， enhance the conversion rate of AF， decrease the frequency and duration of episodes， and improve clinical symptoms in patients with paroxysmal atrial fibrillation presenting with phlegm-heat harassing the interior syndrome， with a favorable safety profile.

Objective:To compare postoperative inflammatory markers and surgical outcomes between open reduction and internal fixation versus double reverse traction closed reduction and percutaneous internal fixation for tibial plateau fractures.Methods:A retrospective analysis was conducted of the data of 229 patients with tibial plateau fracture who had been admitted to Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University from January 2023 to December 2023. There were 155 males and 74 females with an age of (48.7±10.9) years. According to the surgical methods, the patients were divided into 2 groups. A conventional group of 87 cases were treated by open reduction and internal fixation while a minimally invasive group of 142 cases treated with double reverse traction closed reduction and percutaneous internal fixation. The 2 groups were compared in terms of hematological indexes [white blood cell count (WBC), neutrophil count (NEUT), lymphocyte count (LYM), monocyte count (Mono), platelet count (PLT), and albumin (ALB)] and composite inflammatory indexes [neutrophil to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), systemic inflammatory response index (SIRI)] before operation and on the first day after operation, intraoperative blood loss, operation time, fracture healing time, Hospital for Special Surgery (HSS) knee score and incidence of thrombosis.Results:There were no significant differences in baseline characteristics or treatment variables between the 2 groups, indicating comparability ( P > 0.05). All the 229 patients were followed up for (16.5±2.8) months. In each group, comparisons between preoperation and postoperation showed that LYM and ALB significantly decreased while WBC, NEUT, Mono, PLT, NLR, PLR, SII and SIRI significantly increased on the first day after operation ( P < 0.05). Preoperatively, there were no significant differences between the 2 groups in terms of hematological or composite inflammatory indexes ( P > 0.05). On the first day after operation, there was no significant difference in WBC, NEUT, LYM, ALB or NLR between the 2 groups ( P > 0.05), but Mono, PLT, PLR, SII and SIRI in the minimally invasive group were significantly lower than those in the conventional group ( P < 0.05). The intraoperative blood loss, operation time, fracture healing time, HSS knee score and incidence of thrombosis in the minimally invasive group were significantly better than those in the conventional group ( P < 0.05). Conclusion:In the treatment of tibial plateau fractures, compared with conventional open reduction and internal fixation, double reverse traction closed reduction and percutaneous internal fixation shows obvious advantages in reducing inflammatory indicators and leads to better surgical outcomes.

Objective:To compare postoperative inflammatory markers and surgical outcomes between open reduction and internal fixation versus double reverse traction closed reduction and percutaneous internal fixation for tibial plateau fractures.Methods:A retrospective analysis was conducted of the data of 229 patients with tibial plateau fracture who had been admitted to Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University from January 2023 to December 2023. There were 155 males and 74 females with an age of (48.7±10.9) years. According to the surgical methods, the patients were divided into 2 groups. A conventional group of 87 cases were treated by open reduction and internal fixation while a minimally invasive group of 142 cases treated with double reverse traction closed reduction and percutaneous internal fixation. The 2 groups were compared in terms of hematological indexes [white blood cell count (WBC), neutrophil count (NEUT), lymphocyte count (LYM), monocyte count (Mono), platelet count (PLT), and albumin (ALB)] and composite inflammatory indexes [neutrophil to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), systemic inflammatory response index (SIRI)] before operation and on the first day after operation, intraoperative blood loss, operation time, fracture healing time, Hospital for Special Surgery (HSS) knee score and incidence of thrombosis.Results:There were no significant differences in baseline characteristics or treatment variables between the 2 groups, indicating comparability ( P > 0.05). All the 229 patients were followed up for (16.5±2.8) months. In each group, comparisons between preoperation and postoperation showed that LYM and ALB significantly decreased while WBC, NEUT, Mono, PLT, NLR, PLR, SII and SIRI significantly increased on the first day after operation ( P < 0.05). Preoperatively, there were no significant differences between the 2 groups in terms of hematological or composite inflammatory indexes ( P > 0.05). On the first day after operation, there was no significant difference in WBC, NEUT, LYM, ALB or NLR between the 2 groups ( P > 0.05), but Mono, PLT, PLR, SII and SIRI in the minimally invasive group were significantly lower than those in the conventional group ( P < 0.05). The intraoperative blood loss, operation time, fracture healing time, HSS knee score and incidence of thrombosis in the minimally invasive group were significantly better than those in the conventional group ( P < 0.05). Conclusion:In the treatment of tibial plateau fractures, compared with conventional open reduction and internal fixation, double reverse traction closed reduction and percutaneous internal fixation shows obvious advantages in reducing inflammatory indicators and leads to better surgical outcomes.

Background and objective The pathological types of lung ground glass nodules(GGNs)show great significance to the clinical treatment.This study was aimed to predict pathological types of GGNs based on computed tomog-raphy(CT)quantitative parameters.Methods 389 GGNs confirmed by postoperative pathology were selected,including 138 cases of precursor glandular lesions[atypical adenomatous hyperplasia(AAH)and adenocarcinoma in situ(AIS)],109 cases of microinvasive adenocarcinoma(MIA)and 142 cases of invasive adenocarcinoma(IAC).The morphological characteristics of nodules were evaluated subjectively by radiologist,as well as artificial intelligence(AI).Results In the subjective CT signs,the maximum diameter of nodule and the frequency of spiculation,lobulation and pleural traction increased from AAH+AIS,MIA to IAC.In the AI quantitative parameters,parameters related to size and CT value,proportion of solid component,energy and entropy increased from AAH+AIS,MIA to IAC.There was no significant difference between AI quantitative parameters and the subjective CT signs for distinguishing the pathological types of GGNs.Conclusion AI quantitative parameters were valu-able in distinguishing the pathological types of GGNs.

Objective To discuss the application of the"rotating guidewire and correcting the filter recovery hook direction technique"("rotation-correction loop technique"for short),a technique invented by the authors in clinical practice,in the retrieval of complex inferior vena cava filter(IVCF),and to discuss its technical skills and advantages.Methods The clinical data of 417 patients carrying an IVCF,who were admitted to the Department of Vascular Surgery of Second Hospital of Shanxi Medical University of China to retrieve IVCF between January 2022 and December 2022,were retrospectively analyzed.Taking the time spent on the retrieval of IVCF and the intraoperative radiation dose as the evaluation indicators,the advantages and disadvantages of the standard filter retrieval technique,the"rotation-correction loop technique"and the other loop-assisted techniques were compared.Results Both the intraoperative radiation dose and the time spent on the retrieval of IVCF using"rotation-correction loop technique"were remarkably lower than those of other loop-assisted techniques(P＜0.000 1).Conclusion For the retrieval of complex IVCF,especially for the IVCF which is heavily tilted and/or its recovered hook is attached to the vascular wall,the use of"rotation-correction loop technique"can shorten the time spent on the the retrieval of IVCF and reduce the intraoperative radiation dose.This technique carries high safety and practicability,the device is simple and it can be manipulated by single physician,which is conducive to clinical application and promotion.(J Intervent Radiol,2024,33:289-294)

Objective:To explore the role of using laboratory critical values for active monitoring of serious adverse drug reactions (SADRs) in pharmacovigilance.Methods:Xingtai Central Hospital was used as a sentinel hospital. The reports containing critical value in blood routine, blood biochemistry, blood gas analysis, and coagulation function from July 2022 to December 2022 were collected by the laboratory information system in the hospital. The electronic medical records of patients involved in the reports were reviewed, and the correlation between therapeutic drugs and the critical values was evaluated. The critical values related to adverse drug reactions (ADRs) and SADRs, and the suspicious drugs were analyzed by descriptive statistics. The occurrence of ADRs and SADRs in outpatients/emergency patients and hospitalized patients were compared.Results:A total of 1 597 reports containing critical values were included in the analysis. In these reports, 174 (10.90%) were judged to be related to ADRs, of which 68 (39.1%) were related to SADRs. The proportion of reports containing critical values in the Inpatient Department was significantly higher than that in the Outpatient/Emergency Department [0.39% (1 114/288 541) vs. 0.16% (483/307 176), P<0.001]; the proportion of reports related to ADR in all laboratory reports of the Outpatient/Emergency Department was significantly higher than that of the Inpatient Department [14.29% (69/483) vs. 9.43% (105/1 114), P=0.004]; the proportion of reports involving SADRs in those involving ADRs [31.88% (22/69) vs. 43.81% (46/105)] and that in all reports [4.55% (22/483) vs. 4.13% (46/1 114)] both were similar between Outpatient/Emergency Department and Inpatient Department, and the differences were not statistically significant (all P>0.05). Six-eight reports of SADR involved 80 critical values, and the top 3 were leukopenia (mainly involving anticancer drugs), coagulation dysfunction (mainly involving anticoagulants) and electrolyte disorder (mainly involving antihypertensive drugs), some of which were induced by medication errors or improper drug use. Conclusions:Reporting laboratory critical values can effectively do some help in implement of active monitoring of SADRs in blood cells, blood biochemistry and coagulation function caused by drugs, which is conducive to the timely detection of SADRs in outpatient/emergency and hospitalized patients, as well as serious adverse events caused by medication errors and inappropriate treatments.

AIM: To study the protective effect of fenofibrate on diabetic retinal neurodegeneration and observe its effect on miR-26a-5p and its target gene PTEN in the retinal of diabetic mice.METHODS: Diabetic mice models were established and they were gavaged by fenofibrate. H& E staining and transmission electron microscopy were used to observe the impairments of retinal neurons. Real-time PCR was used to examine the expression of miR-26a-5p, and Western blotting was employed to measure the expression of phosphatase and tensin homologue(PTEN)in the retina of diabetic mice. The expression level of nuclear factor-κB(NF-κB), interleukin-1β(IL-1β)and the morphology of neural tissues were observed.RESULTS: When compared with the diabetic mice, fenofibrate significantly attenuated the damage to retinal ganglion cells and the atrophy of retinal nerve fiber layer. While the level of miR-26a-5p was increased and the levels of PTEN and inflammatory mediators were significantly decreased in the retina of fenofibrate treated diabetic mice, with significant statistical significance(P<0.05).CONCLUSIONS: Fenofibrate protects against diabetic retinal neurodegeneration by upregulating miR-26a-5p and inhibiting PTEN, attenuating the inflammatory response and alleviating retinal cell injury.

Objective To investigate the effects of microRNA-26a-5p(miR-26a-5p)on high glucose-induced retina Müller activation and apoptosis by regulating PTEN/PI3K/Akt signaling pathway,and the potential mechanism of diabetic retinal neurodegeneration.Methods Various concentrations of high glucose were added into rMC-1 culture.CCK-8 and flow cytometry was used to examine cell proliferation and apoptosis respectively.The regulatory effects of miR-26a-5p on the expressions of PTEN,PI3K and Akt were observed by real-time PCR;the expression levels of IL-1β and IL-6 in Müller cells were examined by ELISA.The data were processed by Graphpad 8.0 software.Results Müller cells grew actively in high-glucose stimulation culture.Compared with the control group,the activity of Müller cells stimulated by 50 mmol/L glucose increased gradually at 12 h and 24 h,but decreased at 48 h after stimulation,when Müller cells apoptosis increased.The difference between the groups was statistically significant(P＜0.05).The expression of miRNA-26a-5p decreased,that of PTEN increased,and those of PI3K and Akt decreased.Meanwhile,IL-1β and IL-6 levels were significantly increased in Müller cells.miR-26a-5p over-expression alleviated injuries to high glucose stimulated retinal Müller cells by inhibiting PTEN,which upregulated the expression of PI3K/Akt and downregulation of IL-1β and IL-6(P＜0.01).Conclusion Upregulating miR-26a-5p protects Müller cells against apoptosis,probably through regulation of PTEN/PI3K/Akt and affecting the production of inflammatory factors.

Objective To investigate the contamination status of five foodborne pathogens (Salmonella, Listeria monocytogenes, Campylobacter jejuni, Yersinia enterocolitica, and Escherichia coli) in four categories of poultry and meat products sold in Jinan City, and to grasp the serotype, molecular typing features, and antibiotics resistance of isolated Salmonella, providing a reference for preventing foodborne disease outbreaks. Methods According to the "National Food Contaminants and Harmful Factors Risk Monitoring Work Manual", five types of foodborne pathogens were isolated from 132 samples of four categories of poultry and meat products sold in Jinan City from 2021 to 2022, and serotyping was performed using hemagglutination, and molecular typing was performed using pulse field gel electrophoresis (PFGE), while the drug sensitivity of isolates was tested by broth microdilution method. Results Pathogenic bacteria were detected in all four categories of poultry and meat products, with a positive sample detection rate of 53%. A total of 96 strains of pathogenic bacteria were detected from 132 samples, with a total detection rate of 72.7%. The highest detection rate of pathogenic bacteria was in raw poultry meat (93.3%). Among the isolates from raw poultry meat, Salmonella enteritidis was the predominant serotype, and Salmonella rissen was the predominant serotype in isolates from raw livestock meat. The similarity of 46 Salmonella strains ranged from 49.0% to 100.0%, with a total of 35 serotypes. Among them, the similarity of 36 strains was above 85.0%, accounting for 78.3% of the total. The strains isolated from raw poultry meat and livestock meat did not show clustering distribution in the dendrogram, and the isolates were resistant to a variety of antibiotics. Conclusions There is a serious pathogen contamination and food safety risk in raw poultry meat, raw livestock meat, and processed meat products in Jinan. The Salmonella isolates exhibit severe drug resistance, highlighting the need for relevant authorities to conduct risk assessment and implement reasonable risk control measures and drug resistance control measures.

Objective:To explore the role of using laboratory critical values for active monitoring of serious adverse drug reactions (SADRs) in pharmacovigilance.Methods:Xingtai Central Hospital was used as a sentinel hospital. The reports containing critical value in blood routine, blood biochemistry, blood gas analysis, and coagulation function from July 2022 to December 2022 were collected by the laboratory information system in the hospital. The electronic medical records of patients involved in the reports were reviewed, and the correlation between therapeutic drugs and the critical values was evaluated. The critical values related to adverse drug reactions (ADRs) and SADRs, and the suspicious drugs were analyzed by descriptive statistics. The occurrence of ADRs and SADRs in outpatients/emergency patients and hospitalized patients were compared.Results:A total of 1 597 reports containing critical values were included in the analysis. In these reports, 174 (10.90%) were judged to be related to ADRs, of which 68 (39.1%) were related to SADRs. The proportion of reports containing critical values in the Inpatient Department was significantly higher than that in the Outpatient/Emergency Department [0.39% (1 114/288 541) vs. 0.16% (483/307 176), P<0.001]; the proportion of reports related to ADR in all laboratory reports of the Outpatient/Emergency Department was significantly higher than that of the Inpatient Department [14.29% (69/483) vs. 9.43% (105/1 114), P=0.004]; the proportion of reports involving SADRs in those involving ADRs [31.88% (22/69) vs. 43.81% (46/105)] and that in all reports [4.55% (22/483) vs. 4.13% (46/1 114)] both were similar between Outpatient/Emergency Department and Inpatient Department, and the differences were not statistically significant (all P>0.05). Six-eight reports of SADR involved 80 critical values, and the top 3 were leukopenia (mainly involving anticancer drugs), coagulation dysfunction (mainly involving anticoagulants) and electrolyte disorder (mainly involving antihypertensive drugs), some of which were induced by medication errors or improper drug use. Conclusions:Reporting laboratory critical values can effectively do some help in implement of active monitoring of SADRs in blood cells, blood biochemistry and coagulation function caused by drugs, which is conducive to the timely detection of SADRs in outpatient/emergency and hospitalized patients, as well as serious adverse events caused by medication errors and inappropriate treatments.