Purpose: To characterize the patterns of demographic data, dermatologic diagnosis, and disposition regarding pediatric dermatological presentations in an emergency department (ED) at Armadale Health Service, a secondary outer metropolitan hospital in Perth, Western Australia. Methods: Retrospective cross-sectional study auditing pediatric dermatological presentations to the ED from December 2022 through November 2023. We analyzed the age group, sex, dermatologic diagnosis, Australasian Triage Scale, ED length of stay, and disposition. The age group comprised infants, preschoolers, schoolers, and adolescents. The diagnosis included anaphylaxis and angioneurotic edema (AAE), allergy-related and urticarial dermatitis (AUD), eczema and other dermatitis (EOD), infective dermatoses, and not elsewhere classified. Results: Of the 540 pediatric patients who presented to the ED with a dermatological complaint, 44.4% were girls with a median age of 4.5 years (interquartile range, 1.5-9.3) and a hospitalization rate of 7.6%. The dermatologic diagnoses consisted of AUD (34.3%), infective dermatoses (29.3%), EOD (23.3%), AAE (8.5%), and not elsewhere classified (4.6%). Most patients were triaged as an Australasian Triage Scale category 3-4, with a median ED length of stay of 2.3 hours (1.5-3.5 hours). Pairwise comparisons showed differences in the diagnoses between infants and preschoolers and between schoolers and adolescents for EOD and infective dermatoses (P < 0.001). The hospitalized patients showed a higher proportion of AAE, EOD, and infective dermatoses than those discharged (P < 0.001). Patients with AUD were hospitalized less (odds ratio, 0.06; 95% confidence interval, 0.12-0.30; compared with AAE). No dermatological emergencies, such as Stevens-Johnson syndrome, were identified. Conclusion Our findings underscore regional differences and support global efforts to reduce non-life-threatening pediatric dermatological presentations to the ED. This study may contribute to the ongoing discourse on effectively managing such presentations in EDs.

This study applied the grading of recommendations assessment, development and evaluation(GRADE) system and the integrated evidence chain-based effectiveness evaluation of traditional Chinese medicine(Eff-iEC) to evaluate the evidence for 12 commonly used Chinese patent medicines for the treatment of osteoporosis, which are frequently recommended in guidelines or expert consensuses. The results showed that Xianling Gubao Capsules/Tablets were rated as C(low-level evidence) according to the GRADE system, and as BA~+B~+(intermediate evidence) according to the Eff-iEC system. Jintiange Capsules were rated as C(low-level evidence) by the GRADE system, and as AA~+B(high-level evidence) by the Eff-iEC system. Gushukang Granules/Capsules were rated as C(low-level evidence) by GRADE system, and as BA~+B~+(intermediate evidence) by Eff-iEC system. Zuogui Pills were rated as C(low-level evidence) by GRADE system, and as AA~(++)B~+(high-level evidence) by Eff-iEC system. Qianggu Capsules were rated as D(extremely low-level evidence) by GRADE system, and as AA~+B~+(high-level evidence) by Eff-iEC system. Zhuanggu Zhitong Capsules were rated as D(extremely low-level evidence) by GRADE system, and as BA~+B(intermediate evidence) by Eff-iEC system. Jingui Shenqi Pills were rated as D(extremely low-level evidence) by GRADE system, and as AA~+B(high-level evidence) by Eff-iEC system. Quanduzhong Capsules were rated as D(extremely low-level evidence) by GRADE system, and as AD~+B~+(low-level evidence) by Eff-iEC system. Epimedium Total Flavones Capsules were rated as D(extremely low-level evidence) by GRADE system, and as AAB~+(high-level evidence) by Eff-iEC system. Yougui Pills were rated as D(extremely low-level evidence) by GRADE system, and as AA~(++)B~(+ )(high-level evidence) by Eff-iEC system. Qigu Capsules were rated as D(extremely low-level evidence) by GRADE system, and as BB~+B(intermediate evidence) by Eff-iEC system. Liuwei Dihuang Pills were rated as C(low-level evidence) by GRADE system, and as AA~(++)B~+(high-level evidence) by Eff-iEC system. Overall, the Eff-iEC system provides a more comprehensive assessment of the effectiveness evidence for traditional Chinese medicine(TCM) than the GRADE system. However, it still has certain limitations that hinder its wider promotion and application. In terms of clinical evidence evaluation, both the Eff-iEC and GRADE systems reflect that the current clinical research quality on Chinese patent medicines for the treatment of osteoporosis is generally low. High-quality clinical trials are still needed in the future to further validate clinical efficacy.
Drugs, Chinese Herbal/therapeutic use* ; Osteoporosis/drug therapy* ; Humans ; Nonprescription Drugs/therapeutic use* ; Evidence-Based Medicine ; Medicine, Chinese Traditional

Objective:To explore the structural relationship between WMSDs in the upper limbs and various risk factors in the occupational population in China, based on a large sample epidemiological survey and structural equation analysis, and to establish a structural equation model, so as to lay a foundation for the prevention and control of such diseases.Methods:The Chinese version of the Musculoskeletal Disorders Electronic Questionnaire was used to conduct a nationwide survey on the prevalence of WMSDs in the upper extremity. Six factors related to WMSDs in the upper extremity were extracted by the classification standard of adverse ergonomic factors and their source and confirmatory factor analysis, including work organization, work type, upper extremity work posture, individual factors, upper extremity fatigue and upper extremity WMSDs. The structural equation analysis was carried out and the structural equation model was established.Results:The incidence of WMSDs and fatigue in the upper limbs was 24.44% and 43.76%, respectively. The adjusted structural equation model fitting indicators were generally up to the standard (GFI=1.000, AGFI=1.000, RMSEA=0.043, NFI=0.808, TLI=0.784) . The four exogenous latent variables of work organization, work type, upper limb work posture and individual factors were correlated. There was a strong positive correlation between job type and upper limb work posture ( r=0.865) , a moderate positive correlation between work organization and job type and upper limb work posture ( r=0.570, 0.490) , and a weak negative correlation between individual factors and the other three exogenous latent variables. Upper limb work posture and individual factors had direct effects on upper limb WMSDs, and the effect coefficients were 0.10 and 0.06, respectively. Upper limb fatigue played a mediating role between work organization, work type, upper limb work posture and upper limb WMSDs. The effect coefficient was 0.46, and the composition ratios of indirect effects were 100.0%, 100.0%, and 38.3%, respectively. The direct path effect of upper limb work posture, individual factors and upper limb WMSDs was weaker than the mediating path through upper limb fatigue. Conclusion:When carrying out the prevention and control of upper limbWMSDs, it is necessary to comprehensively consider the pathogenesis path of upper limb muscle fatigue and upper limb WMSDs caused by work organization, work type, and upper limb work posture, so as to provide theoretical reference for improving the prevention and control level of such diseases.

Objective To investigate the impacts of epidural anesthesia with ropivacaine combined with dezocine on lower limb motor nerve block and maternal and infant outcomes in primipara undergoing painless delivery.Methods A total of 159 primiparas who delivered in Nanjing Jiangbei Hospital were selected as the research objects,and divided into the blank group(53 cases),the ropivacaine group(53 cases)and the combined group(53 cases)by the random number table method.Parturients in the blank group were given natural delivery mode,parturients in the ropivacaine group were given ropivacaine epidural anesthesia,and parturients in the combined group were given dezocine anesthesia on the basis of ropivacaine.Analgesic effect at different time points,time of the first,second and third stage of labor,pressing times of analgesic pump,lower limbs motor nerve block,maternal and infant outcomes,and adverse reactions of parturients were compared among the three groups.Results At 10 minutes after analgesia,60 minutes after analgesia,when the cervix was fully dilated and when the fetus was delivered,the VAS scores of the parturients in the ropivacaine group and the combined group were lower than those in the blank group(P<0.05),and the VAS scores of the parturients in the combined group were significantly lower than those in the ropivacaine group(P<0.05).There was no significant difference in the time of the first,second or third stage of labor of parturients among the three groups(P>0.05);The pressing times of analgesic pump of parturients in the combined group was significantly less than that in the ropivacaine group(P<0.05).There was no statistically significant difference in terms of low limb motor nerve block after painless labor of parturients among the three groups(P>0.05).There were no statistically significant differences in the perineal incision rate or the Apgar scores of newborns at 1 minute and 5 minutes after birth among the three groups(P>0.05).The usage rate of forceps and the rate of conversion to cesarean section in the combined group were significantly lower than those in the ropivacaine group and the blank group(P<0.05).There was no statistically significant difference in the incidence of total adverse reactions among the blank group,the ropivacaine group and the combined group(P>0.05).Conclusion The combination of ropivacaine and dezocine for epidural anesthesia has a better analgesic effect on primiparas with painless delivery,has a smaller impact on lower limb motor nerve block in parturients,and can achieve better maternal and infant outcomes.

Xanthine oxidase (XO) is an important therapeutic target for the treatment of hyperuricemia and gout. Based on the previously identified potent XO inhibitor 1, seventeen oxadiazoles and their ring-opening analogues were designed and synthesized via the bioisostere replacement strategy. Among them, compounds 2l, 2n, and 3b showed obvious XO inhibitory activity at the concentration of 10 μmol·L^-1, and compound 3b exhibited an IC₅₀ value of 1.45 μmol·L^-1.

Purpose: To characterize the patterns of demographic data, dermatologic diagnosis, and disposition regarding pediatric dermatological presentations in an emergency department (ED) at Armadale Health Service, a secondary outer metropolitan hospital in Perth, Western Australia. Methods: Retrospective cross-sectional study auditing pediatric dermatological presentations to the ED from December 2022 through November 2023. We analyzed the age group, sex, dermatologic diagnosis, Australasian Triage Scale, ED length of stay, and disposition. The age group comprised infants, preschoolers, schoolers, and adolescents. The diagnosis included anaphylaxis and angioneurotic edema (AAE), allergy-related and urticarial dermatitis (AUD), eczema and other dermatitis (EOD), infective dermatoses, and not elsewhere classified. Results: Of the 540 pediatric patients who presented to the ED with a dermatological complaint, 44.4% were girls with a median age of 4.5 years (interquartile range, 1.5-9.3) and a hospitalization rate of 7.6%. The dermatologic diagnoses consisted of AUD (34.3%), infective dermatoses (29.3%), EOD (23.3%), AAE (8.5%), and not elsewhere classified (4.6%). Most patients were triaged as an Australasian Triage Scale category 3-4, with a median ED length of stay of 2.3 hours (1.5-3.5 hours). Pairwise comparisons showed differences in the diagnoses between infants and preschoolers and between schoolers and adolescents for EOD and infective dermatoses (P < 0.001). The hospitalized patients showed a higher proportion of AAE, EOD, and infective dermatoses than those discharged (P < 0.001). Patients with AUD were hospitalized less (odds ratio, 0.06; 95% confidence interval, 0.12-0.30; compared with AAE). No dermatological emergencies, such as Stevens-Johnson syndrome, were identified. Conclusion Our findings underscore regional differences and support global efforts to reduce non-life-threatening pediatric dermatological presentations to the ED. This study may contribute to the ongoing discourse on effectively managing such presentations in EDs.

Purpose: To characterize the patterns of demographic data, dermatologic diagnosis, and disposition regarding pediatric dermatological presentations in an emergency department (ED) at Armadale Health Service, a secondary outer metropolitan hospital in Perth, Western Australia. Methods: Retrospective cross-sectional study auditing pediatric dermatological presentations to the ED from December 2022 through November 2023. We analyzed the age group, sex, dermatologic diagnosis, Australasian Triage Scale, ED length of stay, and disposition. The age group comprised infants, preschoolers, schoolers, and adolescents. The diagnosis included anaphylaxis and angioneurotic edema (AAE), allergy-related and urticarial dermatitis (AUD), eczema and other dermatitis (EOD), infective dermatoses, and not elsewhere classified. Results: Of the 540 pediatric patients who presented to the ED with a dermatological complaint, 44.4% were girls with a median age of 4.5 years (interquartile range, 1.5-9.3) and a hospitalization rate of 7.6%. The dermatologic diagnoses consisted of AUD (34.3%), infective dermatoses (29.3%), EOD (23.3%), AAE (8.5%), and not elsewhere classified (4.6%). Most patients were triaged as an Australasian Triage Scale category 3-4, with a median ED length of stay of 2.3 hours (1.5-3.5 hours). Pairwise comparisons showed differences in the diagnoses between infants and preschoolers and between schoolers and adolescents for EOD and infective dermatoses (P < 0.001). The hospitalized patients showed a higher proportion of AAE, EOD, and infective dermatoses than those discharged (P < 0.001). Patients with AUD were hospitalized less (odds ratio, 0.06; 95% confidence interval, 0.12-0.30; compared with AAE). No dermatological emergencies, such as Stevens-Johnson syndrome, were identified. Conclusion Our findings underscore regional differences and support global efforts to reduce non-life-threatening pediatric dermatological presentations to the ED. This study may contribute to the ongoing discourse on effectively managing such presentations in EDs.

ObjectiveThe proteome of biological evidence contains rich genetic information, namely single amino acid polymorphisms (SAPs) in protein sequences. However, due to the lack of efficient and convenient analysis tools, the application of SAP in public security still faces many challenges. This paper aims to meet the application requirements of SAP analysis for forensic biological evidence’s proteome data. MethodsThe software is divided into three modules. First, based on a built-in database of common non-synonymous single nucleotide polymorphisms (nsSNPs) and SAPs in East Asian populations, the software integrates and annotates newly identified exonic nsSNPs as SAPs, thereby constructing a customized SAP protein sequence database. It then utilizes a pre-installed search engine—either pFind or MaxQuant—to perform analysis and output SAP typing results, identifying both reference and variant types, along with their corresponding imputed nsSNPs. Finally, SAPTyper compares the proteome-based typing results with the individual’s exome-derived nsSNP profile and outputs the comparison report. ResultsSAPTyper accepts proteomic DDA mass spectrometry raw data (DDA acquisition mode) and exome sequencing results of nsSNPs as input and outputs the report of SAPs result. The pFind and Maxquant search engines were used to test the proteome data of 2 hair shafts of2 individuals, and both obtained SAP results. It was found that the results of the Maxquant search engine were slightly less than those of pFind. This result shows that SAPTyper can achieve SAP fingding function. Moreover, the pFind search engine was used to test the proteome data of 3 hair shafts from 1 European person and 1 African person in the literature. Among the sites fully matched by the literature method, sites detected by SAPTyper are also included; for semi-matching sites, that is, nsSNPs are heterozygous, both literature method and SAPTyper method had the risk of missing detection for one type of the allele. Comparing the analysis results of SAPTyper with the SAP test results reported in the literature, it was found that some imputed nsSNP sites identified by the literature method but not detected by SAPTyper had a MAF of less than 0.1% in East Asian populations, and therefore they were not included in the common nsSNP database of East Asian populations constructed by this software. Since the database construction of this software is based on the genetic variation information of East Asian populations, it is currently unable to effectively identify representative unique common variation sites in European or African populations, but it can still identify SAP sites shared by these populations and East Asian populations. ConclusionAn automated SAP analysis algorithm was developed for East Asian populations, and the software named SAPTyper was developed. This software provides a convenient and efficient analysis tool for the research and application of forensic proteomic SAP and has important application prospects in individual identification and phenotypic inference based on SAP.

This paper aims to contribute to guaranteeing the stable development and enhancing the understanding of ecological agriculture of Chinese materia medica so that the national strategy and industrial demand can be better served. It first introduces current traditional Chinese medicine(TCM)policy and industrial development status from five aspects, including policy guarantee, theoretical support, technological innovation, standardization system, and brand influence. Then, the paper analyzes the development dilemma of TCM agriculture in production and quality increase and ecological environment protection. It also proposes the development goals of ecological agriculture of Chinese materia medica that meet the current industrial development demand, which are reducing chemical fertilizers, pesticides, and carbon emissions, improving quality, increasing efficiency, and protecting ecological environment. In addition, the new development goals are interpreted through case studies. Finally, this paper proposes four development strategies for ecological agriculture of Chinese materia medica: conducting research on the pattern and spatial and temporal variations of nationwide TCM production areas; studying the internal and external ecological memories of medicinal plant growth from the perspectives of genetic variations and environmental adaptation variations and elucidating their contributions to the formation of quality; carrying out selection and breeding of stress-resistant varieties for ecological agriculture of Chinese materia medica, the optimization of key technologies for soil improvement and restoration and green prevention and control against diseases and pests, and the improvement of quality; carrying out research on the quality assurance and value realization of ecological products made from TCM. This research can provide guidance for policy formulation, theoretical development of the discipline, and the enhancement of industrial technology for ecological agriculture of Chinese materia medica.
Agriculture/methods* ; China ; Drugs, Chinese Herbal ; Plants, Medicinal/chemistry* ; Ecosystem ; Materia Medica ; Medicine, Chinese Traditional

Cardiac fibrosis(CF) is a cardiac pathological process characterized by excessive deposition of extracellular matrix(ECM). When the heart is damaged by adverse stimuli, cardiac fibroblasts are activated and secrete a large amount of ECM, leading to changes in cardiac fibrosis, myocardial stiffness, and cardiac function declines and accelerating the development of heart failure. There is a close relationship between heart yin deficiency and cardiac fibrosis, which have similar pathogenic mechanisms. Heart Yin deficiency, characterized by insufficient Yin fluids, causes the heart to lose its nourishing function, which acts as the initiating factor for myocardial dystrophy. The deficiency of body fluids leads to stagnation of blood flow, resulting in blood stasis and water retention. Blood stasis and water retention accumulate in the heart, which aligns with the pathological manifestation of excessive deposition of ECM, as a tangible pathogenic factor. This is an inevitable stage of the disease process. The lingering of blood stasis combined with water retention eventually leads to the generation of heat and toxins, triggering inflammatory responses similar to heat toxins, which continuously stimulate the heart and cause the ultimate outcome of CF. Considering the syndrome of heart Yin deficiency, traditional Chinese medicine capable of nourishing Yin, activating blood, and promoting urination can reduce myocardial cell apoptosis, inhibit fibroblast activation, and lower the inflammation level, showing significant advantages in combating CF.
Humans ; Fibrosis/drug therapy* ; Animals ; Yin Deficiency/metabolism* ; Myocardium/metabolism* ; Medicine, Chinese Traditional ; Drugs, Chinese Herbal/therapeutic use*