As an exclusive Miao medicine of Honwing Pharma （Guizhou） Co. Ltd.， Yifei Zhike capsules are both a prescription drug and an over-the-counter （OTC） drug. Its main ingredients include Ranunculus ternatus and Panax notoginseng. With the effects of nourishing Yin and moistening the lungs， as well as relieving cough and reducing phlegm， Yifei Zhike capsules are often used in the treatment of acute and chronic bronchitis， pulmonary tuberculosis， and other diseases. However， there is insufficient understanding of their efficacy， suitable syndromes， and safety in clinical practice， with a lack of relevant expert consensus on clinical application. To standardize their clinical application， 30 experts from the fields of respiratory medicine， pharmacy， and evidence-based medicine were invited to develop an Expert Consensus on the Clinical Application of Yifei Zhike Capsules （Consensus for short） through evidence-based medicine methods. The Consensus clarified the syndrome characteristics， disease stages， dosages， treatment courses， combined medication， and other norms in the treatment of acute/chronic bronchitis and pulmonary tuberculosis and could be applicable to clinical physicians and pharmacists in medical and health institutions at all levels. In disease diagnosis， it provided diagnostic criteria for traditional Chinese medicine and Western medicine and clarified that the suitable traditional Chinese medicine syndrome was the syndrome of Qi-Yin deficiency with intermingled phlegm-blood stasis. Clinical studies have confirmed that Yifei Zhike capsules combined with standard anti-tuberculosis therapy can effectively improve the symptoms of pulmonary tuberculosis patients， increase the sputum smear conversion rate， and promote the absorption of lesions. When treating acute cough caused by respiratory tract infections， Yifei Zhike capsules can increase the markedly effective rate and the seven-day disappearance rate of cough symptoms. Meanwhile， recommendations for specific usage， dosages， and treatment courses were given for different diseases， and it was pointed out that long-term medication required key monitoring of adverse reactions. In safety， the adverse reactions of Yifei Zhike capsules involved multiple aspects such as the digestive system and allergic reactions， and pregnant women and women during menstruation were prohibited from using it. In addition， modern research has shown that Yifei Zhike capsules have an adjuvant therapeutic effect on tuberculous pleurisy and may be effective for inflammatory and benign pulmonary nodules. However， further research should be conducted on the toxicological safety of long-term medication. The formulation of the Consensus provides a scientific basis for the rational clinical application of Yifei Zhike capsules， which helps to improve clinical efficacy and reduce medication risks.

As an exclusive Miao medicine of Honwing Pharma （Guizhou） Co. Ltd.， Yifei Zhike capsules are both a prescription drug and an over-the-counter （OTC） drug. Its main ingredients include Ranunculus ternatus and Panax notoginseng. With the effects of nourishing Yin and moistening the lungs， as well as relieving cough and reducing phlegm， Yifei Zhike capsules are often used in the treatment of acute and chronic bronchitis， pulmonary tuberculosis， and other diseases. However， there is insufficient understanding of their efficacy， suitable syndromes， and safety in clinical practice， with a lack of relevant expert consensus on clinical application. To standardize their clinical application， 30 experts from the fields of respiratory medicine， pharmacy， and evidence-based medicine were invited to develop an Expert Consensus on the Clinical Application of Yifei Zhike Capsules （Consensus for short） through evidence-based medicine methods. The Consensus clarified the syndrome characteristics， disease stages， dosages， treatment courses， combined medication， and other norms in the treatment of acute/chronic bronchitis and pulmonary tuberculosis and could be applicable to clinical physicians and pharmacists in medical and health institutions at all levels. In disease diagnosis， it provided diagnostic criteria for traditional Chinese medicine and Western medicine and clarified that the suitable traditional Chinese medicine syndrome was the syndrome of Qi-Yin deficiency with intermingled phlegm-blood stasis. Clinical studies have confirmed that Yifei Zhike capsules combined with standard anti-tuberculosis therapy can effectively improve the symptoms of pulmonary tuberculosis patients， increase the sputum smear conversion rate， and promote the absorption of lesions. When treating acute cough caused by respiratory tract infections， Yifei Zhike capsules can increase the markedly effective rate and the seven-day disappearance rate of cough symptoms. Meanwhile， recommendations for specific usage， dosages， and treatment courses were given for different diseases， and it was pointed out that long-term medication required key monitoring of adverse reactions. In safety， the adverse reactions of Yifei Zhike capsules involved multiple aspects such as the digestive system and allergic reactions， and pregnant women and women during menstruation were prohibited from using it. In addition， modern research has shown that Yifei Zhike capsules have an adjuvant therapeutic effect on tuberculous pleurisy and may be effective for inflammatory and benign pulmonary nodules. However， further research should be conducted on the toxicological safety of long-term medication. The formulation of the Consensus provides a scientific basis for the rational clinical application of Yifei Zhike capsules， which helps to improve clinical efficacy and reduce medication risks.

The compilation instructions for the Expert Consensus on Clinical Application of Yifei Zhike Capsules systematically expound the development background， methodological framework， and core achievements of this consensus. In view of the problems existing in the clinical application of Yifei Zhike Capsules， such as insufficient efficacy evidence and lack of standardized syndrome differentiation， the Institute of Basic Research in Clinical Medicine， China Academy of Chinese Medical Sciences took the lead and collaborated with 21 tertiary grade-A hospitals and research institutions across China to form a multidisciplinary expert group （comprising 30 experts in clinical medicine， pharmacy， and methodology）. The compilation work was carried out in strict accordance with the World Health Organization （WHO） guidelines， the GB/T 1.1-2020 standard， and the writing specifications for the explanatory notes of expert consensus on clinical application of Chinese patent medicines. Through systematic literature retrieval （including 32 studies， with 24 clinical studies）， Grading of Recommendations Assessment， Development and Evaluations （GRADE）-based evidence grading， and multiple rounds of discussions using the nominal group method （25 experts voted to determine 17 clinical questions）， 5 evidence-based recommendations and 11 expert consensus suggestions were formed. It is clarified that this medicine （Yifei Zhike Capsules） is applicable to the treatment of expectoration/hemoptysis in acute and chronic bronchitis and the adjuvant treatment of pulmonary tuberculosis. It is recommended that it can be used alone or in combination with anti-tuberculosis drugs. The safety evaluation shows that this medicine mainly induces the following adverse reactions： mild gastrointestinal reactions （such as nausea and abdominal pain） and rashes. The contraindicated populations include pregnant women and women during menstruation. The compilation process of the consensus underwent three rounds of expert letter reviews， two rounds of peer reviews， and quality control assessments to ensure methodological rigor and clinical applicability. In addition， through policy alignment， academic promotion， and a dynamic revision mechanism， the standardization of clinical application was promoted， providing a demonstration for the evidence-based transformation of characteristic therapies of Miao medicine.

Objective:To improve and optimize the modified surgical strategies for patents with Simon Ⅰ and Simon Ⅱ type of gynecomastia, based on their magnetic resonance imaging (MRI) features.Methods:Clinical data of 190 patients aged 12 to 56 years (mean age 26.7±8.6) with gynecomastia who underwent modified surgeries in the Department of Plastic Surgery of Peking Union Medical College Hospital from January 2017 to January 2023 were retrospectively analyzed. The study measured breast MRI images of 44 male patients to calculate the area ratio of the glands on the transverse plane via nipple. This provided insight into the physiological structure and the tissue distribution of gynecomastia for improving the modified surgical strategies. All 190 patients were treated with enhanced liposuction and " Pull-Through and Bottom-Up" techniques. The duration of operation, amount of liposuction and amount of glandular resection, postoperative complications were recorded, and postoperative satisfaction was investigated by questionnaire surveys.Results:MRI images of the 87-side male breast showed that the average area ratio of the glands on the transverse plane via nipple was (10.9±12.5) %. The most prevalent subtype of gynecomastia was branch pattern, accounting for 46.0%. The median surgical duration of 190 patients was 95 (65-210) minutes, the median liposuction volume was 300 (50-1 400) ml, and the median glandular removal was 19.9 (1.5-157.0) g. Eighty-eight patients (46.3%) went through followed up for more than 6 months post-posterative with an overall satisfaction score of 4.68±0.53. Postoperative complications occurred in 19 sides (5.1%), and the reoperation rate was 1.3%.Conclusions:The MRI imaging of gynecomastia shows that the component of patients′ breasts are mainly fat, with a small amount of glandular tissue and the dominant subtype is branch pattern. Enhanced liposuction combined with " Pull-Through and Bottom-Up" stab incision technique can be an effective treatment for Simon grades Ⅰ and Ⅱ gynecomastia. The method results in high patient satisfaction with fewer postoperative complications.

Objective:To evaluate the differences and aesthetic meaning of stable vitiligo treatment in the face and neck region using suction blister transplantation or noncultured autologous suspension of epidermal cells.Methods:Sixty-four stable vitiligo patients (25 males and 39 females with age ranges from 10 to 46 years, average 25 years) in the face and neck region were randomly divided into two groups (32 patients in each group): one group received suction blister transplantation, while other group received noncultured autologous suspension of epidermal cells. Patients′treatment effectiveness, pigmentation and piecing deformity were evaluated in postoperative 3 months and 6 months.Results:In the postoperative 3 months and 6 months, the effectiveness of suction blister transplantation group was 68.75% (22/32) and 90.63% (29/32), respectively, while the effectiveness of noncultured autologous suspension of epidermal cells group was 59.37% (19/32) and 87.50% (28/32), respectively, in which no significant differences were found between two groups ( P>0.05). No obvious pigmentation and piecing deformity were found in noncultured autologous suspension of epidermal cells group, which were much better than the suction blister transplantation group in postoperative 3 months and 6 months. Conclusions:Both suction blister transplantation and noncultured autologous suspension of epidermal cells could bring good treatment effectiveness for patients of stable vitiligo in the face and neck region. Compared with suction blister transplantation, noncultured autologous suspension of epidermal cells could offer better aesthetic appearance.

Good sleep is essential for children′s physical and mental health, growth, and development.Adequate and high-quality sleep positively impacts children′s quality of life, memory, learning, attention, mood, and behavior.Children of different ages have different sleep needs.Children have various sleep problems in different cultures.Therefore, it is significant to guide children to get healthy sleep by popularizing the sleep problems of Chinese children of all ages and in all dimensions.Based on China′s social and cultural background, this paper summarizes the contents related to children′s sleep physiology, good sleep habits, common sleep problems, sleep apnea disorders, hypnagogic sleep, narcolepsy, insomnia, and other issues that interfere with children′s sleep.Chinese sleep experts summarize and interpret the 100 sleep health problems of children that medical workers and parents are most concerned about.To promote children′s sleep health and popularize solutions to sleep problems.

Platycodon grandiflorum (Jacq.) A. DC. is a famous medicinal plant commonly used in East Asia. Triterpene saponins isolated from P. grandiflorum are the main biologically active compounds, among which polygalacin D (PGD) has been reported to be an anti-tumor agent. However, its anti-tumor mechanism against hepatocellular carcinoma is unknown. This study aimed to explore the inhibitory effect of PGD in hepatocellular carcinoma cells and related mechanisms of action. We found that PGD exerted significant inhibitory effect on hepatocellular carcinoma cells through apoptosis and autophagy. Analysis of the expression of apoptosis-related proteins and autophagy-related proteins revealed that this phenomenon was attributed to the mitochondrial apoptosis and mitophagy pathways. Subsequently, using specific inhibitors, we found that apoptosis and autophagy had mutually reinforcing effects. In addition, further analysis of autophagy showed that PGD induced mitophagy by increasing BCL2 interacting protein 3 like (BNIP3L) levels.In vivo experiments demonstrated that PGD significantly inhibited tumor growth and increased the levels of apoptosis and autophagy in tumors. Overall, our findings showed that PGD induced cell death of hepatocellular carcinoma cells primarily through mitochondrial apoptosis and mitophagy pathways. Therefore, PGD can be used as an apoptosis and autophagy agonist in the research and development of antitumor agents.
Humans ; Mitophagy ; Carcinoma, Hepatocellular/pathology* ; Liver Neoplasms/pathology* ; Cell Line ; Autophagy ; Apoptosis ; Membrane Proteins ; Proto-Oncogene Proteins/genetics* ; Tumor Suppressor Proteins/pharmacology*

Objective To investigate the effects of N-acetyl-D-glucosamine(GlcNAc)on acute pancreatitis in rats.Methods Twenty male SD rats were randomly divided into a control group,AP group,low GlcNAc + AP group and high GlcNAc + AP group,with five rats in each group.Acute pancreatitis was induced in AP group,low GlcNAc + AP group and high GlcNAc + AP group by two intraperitoneal injections of 2.5 g/kg L-arginine with a 1 hour interval.Among them,low GlcNAc + AP group and high GlcNAc + AP group were administered 50 and 200 mg/kg GlcNAc,respectively,by intraperitoneal injection at 24 hours before the first intraperitoneal injection of L-arginine.Group control and AP were intraperitoneally injected with the same volume of normal saline.After 24 h,the rats were sacrificed,and serum and pancreatic tissues were collected.Pancreatic tissue morphology was observed by HE staining,and serum levels of amylase(AMY),lipase(LPS),interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),superoxide dismutase(SOD)and malondialdehyde(MDA)were measured by enzyme-linked immunosorbent assay.Protein expression of nuclear factor E2-related factor 2(NRF2),heme oxygenase-1(HO-1),and peroxisome proliferator-activated receptor-γ(PPAR-γ)in pancreatic tissue was detected by Western Blot.Cluster of differentiation(CD)86,CD206 and macrophage markers(F4/80)were detected by immunofluorescence.Expression of CD86 and CD206 in pancreatic tissue was detected by immunohistochemistry.Results(1)Compared with control group,AMY,LPS,IL-1β,IL-6,TNF-α,and MDA levels and pancreatic CD86 expression in AP group were significantly increased(P<0.05),while SOD activity,protein expression levels of NRF2,HO-1,and PPAR-γ,and pancreatic CD206 expression were significantly decreased(P<0.05).(2)Compared with AP group,serum IL-1β,IL-6,TNF-α,MDA,and LPS and the pancreatic CD86 expression in low GlcNAc + AP group were significantly decreased(P<0.05).The PPAR-γ protein level in the pancreas was significantly increased(P<0.05).(3)Compared with AP group,serum AMY,LPS,IL-1β,IL-6,TNF-α,and MDA and pancreatic CD86 expression in high GlcNAc + AP group were significantly decreased(P<0.05),while serum SOD,and NRF2,HO-1,PPAR-γ,and pancreatic CD206 expression were significantly increased(P<0.05).(4)Compared with low GlcNAc + AP group,serum LPS,IL-1β and IL-6 in high GlcNAc + AP group were significantly decreased(P<0.05).Pancreatic expression of HO-1,PPAR-γ,and pancreatic CD206 were significantly increased(P<0.05).Conclusion GlcNAc treatment attenuates acute pancreatitis injury in AP rats,possibly by activating the NRF2/HO-1 signaling pathway to inhibit oxidative stress and promoting M2 macrophage polarization to attenuate pancreatic injury in AP rats.

Objective:To establish a computer-aided design and 3D printing system for precise implantation of micro implant anchorage, and accurately calibrate the position and direction of micro implant implantation.Methods:A retrospective selection was conducted on 15 patients (30 in total) who underwent micro implant implantation surgery from the Department of Stomatology, the Affiliated Hospital of Jiangnan University from November 2019 to November 2021, including 6 males and 9 females, aged (17.1±6.3)years old. The preoperative patient was photographed with cone beam computed tomography (CBCT) and the collected DICOM data format was output. A 3D scan was performed on the patient′s preoperative analysis model to obtain the STL file of the model scan. The CBCT data and model data were fitted and matched using 3Shape Implant Studio software, and the thickness of the guide plate, the amount of undercut compensation, and the size of the key component collar were designed. The 3D printer was used for printing after resizing. Using the assist method to implant micro implants, CBCT was taken postoperatively to compare the preoperative design with the postoperative results.Results:After fitting the postoperative CBCT with the designed CBCT of the micro implant, it was found that the micro implant was consistent with the preoperative design, maintained a safe distance and parallel to the adjacent tooth root, and did not damage the maxillary sinus and other areas. No detachment of the micro implant anchorage was observed 1 or 3 months after surgery. The application of assisted micro implant anchorage 3D guide plate was reliable, with accurate implantation position and direction, and can be implanted in most parts of the oral cavity.Conclusions:The use of computer-aided design and 3D printing system to create an assistive micro implant anchorage 3D guide plate can accurately locate the position and direction of the micro implant, which is worthy of clinical promotion and application.

Objective:To investigate the clinical significance of suction blister transplantation in improving the efficacy of ReCell technique in the treatment of vitiligo.Methods:Patients were divided into three groups, namely, vitiligo patients without history of suction blister therapy, patients with ineffective suction blister therapy and patients with effective suction blister therapy. There were 30 patients in each group. All patients were treated with standard procedure of ReCell technique. The color recovery effect of leukoplakia was observed 3 and 6 months after operation, and the incidence of complications was also observed.Results:The effective rate of color recovery 3 and 6 months after operation were as follow: in patients without history of suction blister group, the effective rate of three months was 53.3%, and that of six months was 63.3%; in patients with ineffective suction blister group, the effective rate was 43.3% in three months and 50.0% in six months, and in patients with effective suction blister group, the effective rate was 76.7% in three months and 90.0% in six months. No obvious complications were observed in the three groups.Conclusions:For the treatment of stable vitiligo with ReCell technique, suction blister method is a simple and effective method for screening patients.