Objective:To evaluate the efficacy and safety of Xiao′er Huangjin Zhike Granules in the treatment of cough caused by acute bronchitis in children, which is defined in TCM terms as a syndrome of phlegm-heat obstructing the lung.Methods:This was a block-randomized, double-blind, placebo-controlled, multicenter clinical trial.From January 2022 to September 2023, 359 children aged 3 to 7 years old diagnosed as acute bronchitis (lung-obstructing phlegm-heat syndrome) were enrolled from 21 participating hospitals and randomly assigned to the experimental group and placebo group in a 3︰1 ratio, and respectively treated with Xiao′er Huangjin Zhike Granules and its matching placebo.Cough resolution/general resolution rate after 7 days of treatment was used as the primary efficacy outcome for both groups.Results:(1)On the seventh day of treatment, the rate of cough disappearance/basically disappearance in the experimental group and placebo group were 73.95% and 57.61% retrospectively, which had statistically significance ( P=0.001).(2)After 7 days of treatment, the median duration of cough disappearance/basic disappearance were 5 days and 6 days in the two groups , with a statistically significant difference ( P=0.006).The area under the curve of cough symptom severity time was 7.20 ± 3.79 in the experimental group and 8.20±4.42 in the placebo group.The difference between the two groups was statistically significant ( P=0.039).(3) After 7 days of treatment, the difference between TCM syndrome score and baseline was -16.0 (-20.0, -15.0) points in the experimental group and -15.0 (-18.0, -12.0) points in the placebo group, with significant difference between the two groups ( P=0.004).In the experimental group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 49.04%, 28.35%, 16.48% and 6.13% severally; and in the placebo group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 38.04%, 26.09%, 29.35%, and 6.52% separately, which had statistically significant ( P=0.014).(4) There was no significant difference in the incidence of adverse events or adverse reactions during the trial between both groups.Moreover, while adverse reactions in the form of vomiting and diarrhea were occasionally reported, no serious drug-related adverse event or adverse reaction was reported.(5)The tested drug provided good treatment compliance, showing no statistically significant difference from the placebo in terms of compliance rate. Conclusions:Based on the above findings, it can be concluded that Xiao′er Huangjin Zhike Granules provides good safety, efficacy, and treatment compliance in the treatment of cough caused by acute bronchitis, and lung-obstructing phlegm-heat syndrome, in children.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.

Objective:To dynamically monitor the pediatric sequential organ failure assessment(pSOFA) score of children in PICU at different time points, and to evaluate the predictive value of pSOFA score for the prognosis of children with sepsis.Methods:A multicenter prospective observational study was conducted to collect the data of children with sepsis admitted to the PICU of four children′s hospitals in Shanghai from December 2018 to December 2019(Children′s Hospital of Fudan University, Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Children′s Hospital Affiliated to Shanghai Jiaotong University School of Medicine, and Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine). We collected their pSOFA scores on the 1st, 3rd, and 7th day after sepsis diagnosis and the highest score.The patients were divided into survival group and death group according to the clinical outcomes at the time of leaving PICU.The clinical characteristics of two groups were compared.Receiver operating characteristic(ROC) curve were used to assess the resolution of the pSOFA score.Logistic regression was used to analyze the relationship between pSOFA score and sepsis mortality.Results:A total of 170 cases diagnosed sepsis were included, with a median age of 32.5(11.5, 83.2) months, and a median length of stay in PICU of 10(6, 21) days.Forty-two died and 128 survived.The medians of the 1st, 3rd, 7th day and the highest pSOFA score of the children in death group[10(7, 12) points, 9(5, 10) points, 7(4, 10) points, 11(7, 12) points, respectively] were higher than those in survival group[4(2, 8) points, 3(1, 6) points, 2(0, 5) points, 6(3, 8) points, respectively]( P<0.05). The area under the ROC curve of the pSOFA score predicting death on day 1 after sepsis diagnosis was greater than that on days 3, 7 and the highest pSOFA score[0.84(95% CI 0.79-0.91) vs.0.80(95% CI 0.71-0.89), 0.77(95% CI 0.65-0.89), 0.83(95% CI 0.77-0.90)], but the difference was not statistically significant( χ2=1.660, P=0.646). The pSOFA score on the first day of diagnosis had the best cut-off value of >6 points for predicting the risk of death from sepsis, with a sensitivity of 97.6% and a specificity of 53.9%.Logistic regression analysis of pSOFA score and childhood sepsis death showed that the OR values corresponding to the 1st, 3rd, 7th day of diagnosis and the highest pSOFA score were 1.58(95% CI 1.350-1.840), 1.39(95% CI 1.218-1.595), 1.38(95% CI 1.184-1.617) and 1.55(95% CI 1.333-1.800), respectively(all P<0.05). The 1-point increase in pSOFA score on the first day of diagnosis of sepsis was associated with a 58% increase in the hazard ratio for death, and each 1-point increase in the highest pSOFA score was associated with a 55% increase in the hazard ratio for death. Conclusion:The 1st, 3rd, 7th day of sepsis diagnosis and the highest pSOFA score could better predict the mortality risk of sepsis in children.Dynamic monitoring of the pSOFA score at different time points has a certain clinical value in predicting the progression and prognosis of children with sepsis.

ObjectiveTo explore the status and influencing factors of electric bicycle （e-bike）-related traffic injury in Songjiang District of Shanghai， and to provide reference for prevention and control of the injury. MethodsA self-designed questionnaire was used to investigate the community residents over 16 years old who rode e-bike in Songjiang Western Industrial Zone. The survey included general demographic characteristics， physical and psychological conditions， e-bike use， accidents and injuries. Descriptive analysis， chi-square test and Fisher's exact probability method were used to explore the influencing factors of traffic injury by e-bike in Songjiang District. Results1 030 questionnaires were distributed and 1 013 valid questionnaires were recovered. The effective rate of the questionnaire was 98.35%. From June 2020 to May 2021， the incidence of e-bike traffic accidents in Songjiang Western Industrial Zone was 17.47% and the incidence of injuries was 12.64%. The difference between e-bike accident group and non accident group was statistically significant （P<0.05） in the following factors： gender， registered residence， educational level， sleeping time， fatigue， violation of traffic regulations including speed limit 25 km‧h^-1 and crossing of red traffic lights， riding after alcohol drinking， riding speed higher than 30 km‧h^-1， riding on the phone， wearing headset， turning without prompting signal， riding on the lane of motor vehicles，and e-bike life. The top three injured body parts were limb pelvis （48.10%）， body surface （27.85%） and head （13.92%）. The nature of injury was mainly contusion / abrasion （82.03%）， followed by fracture （17.19%）. ConclusionThe incidence of e-bike traffic accidents in Songjiang District is high. We should strengthen the traffic safety education of e-bike riders， strengthen the road traffic control， and reduce the occurrence of e-bike road traffic accidents in Songjiang District.

Ventilator associated pneumonia(VAP)is one of the major source of nosocomial infection in PICU, of which the pathogenesis remains unclear.Recent metataxonomic and metagenomic technologies, from 16S ribosomal RNA to whole genome sequencing, have revealed that healthy lungs harbor a dynamic ecosystem of bacteria and dysbiosis of the respiratory microbiome involved in the pathogenesis and progression of VAP.Recent studies have illustrated that the imbalance of species diversity and abundance of lung microbiome might be the underlying cause of VAP through regulating local mucosal immune response.These methods offer the potential to better interrogate the relationship between an intubated individual′s respiratory microbiota and the underlying disease process to provide important insights into the pathogenesis of VAP, optimizing disease surveillance and multi-drug resistant microbes detection.

Objective:To understand the effect of organ donation surgery on the mental health of nurses in operating room, and to explore the intervention effects.Methods:From Jan.2015 to Dec. 2018, 60 operating room nurses in our hospital participating in organ donation surgery were selected for investigation of mental health, and were intervened by group psychological training, positive psychological intervention, improving shift arrangement system and financial support. The SCL-90 scale and DAP-R scale were used to evaluate before and after intervention.Results:The mean scores of somatization, interpersonal sensitivity, depression, anxiety, terror, paranoia and psychoticism in SCL-90 scale of 60 operating room nurses were (2.07±0.63) , (2.07±0.69) , (1.88±0.62) , (1.71±0.57) , (1.78±0.67) , (1.71±0.68) , (1.73±0.60) before intervention respectively, which were significantly higher than the Chinese norm ( P<0.01) and those[ (1.64±0.60) , (1.46±0.57) , (1.53±0.62) , (1.48±0.60) , (1.28±0.50) , (1.45±0.56) , (1.43±0.52) ] after intervention were lower than before ( P<0.01) . Before and after the intervention, the scores of DAP-R scale tended to be death fear dimension and acceptance dimension, the proportion of the death fear dimension was 16.7% (10/60) and 6.7% (4/60) , respectively, and the approaching acceptance dimension was 83.3% (50/60) and 93.3% (56/60) . The proportion of the nurses with scores of SCL-90 scale ≥160 after the intervention was significantly lower than that before the intervention (χ 2=5.82, P<0.05) . Conclusion:The mental health of nurses in the operating room participating in organ donation surgery is lower; After intervention, the investigated nurses present improved mental health and positively emotional attitude towards death.

Objective:To understand the effect of organ donation surgery on the mental health of nurses in operating room, and to explore the intervention effects.Methods:From Jan.2015 to Dec. 2018, 60 operating room nurses in our hospital participating in organ donation surgery were selected for investigation of mental health, and were intervened by group psychological training, positive psychological intervention, improving shift arrangement system and financial support. The SCL-90 scale and DAP-R scale were used to evaluate before and after intervention.Results:The mean scores of somatization, interpersonal sensitivity, depression, anxiety, terror, paranoia and psychoticism in SCL-90 scale of 60 operating room nurses were (2.07±0.63) , (2.07±0.69) , (1.88±0.62) , (1.71±0.57) , (1.78±0.67) , (1.71±0.68) , (1.73±0.60) before intervention respectively, which were significantly higher than the Chinese norm ( P<0.01) and those[ (1.64±0.60) , (1.46±0.57) , (1.53±0.62) , (1.48±0.60) , (1.28±0.50) , (1.45±0.56) , (1.43±0.52) ] after intervention were lower than before ( P<0.01) . Before and after the intervention, the scores of DAP-R scale tended to be death fear dimension and acceptance dimension, the proportion of the death fear dimension was 16.7% (10/60) and 6.7% (4/60) , respectively, and the approaching acceptance dimension was 83.3% (50/60) and 93.3% (56/60) . The proportion of the nurses with scores of SCL-90 scale ≥160 after the intervention was significantly lower than that before the intervention (χ 2=5.82, P<0.05) . Conclusion:The mental health of nurses in the operating room participating in organ donation surgery is lower; After intervention, the investigated nurses present improved mental health and positively emotional attitude towards death.

Objective: To investigate the effects of costunolide (Cos) on the proliferation, apoptosis, migration andinvasion of cholangiocarcinoma RBE cells, and explore its potential mechanism. Methods: The CCK-8, flow cytometry,Annexin V-FITC/PI double staining, Transwell assays were used to examine the influence of Cos on proliferation, cell cycle, apoptosis, migration and invasion of RBE cells after treated with gradient concentrations of Cos. The expressions of M M P 2 and M M P 9 were detected by qRT-PCR, and the expression of PI3K/AKT-associated signal proteins was detected by Western blotting. Results: Cosdose-dependently inhibited proliferation activity of RBE cells( P <0.05 or P <0.01), arrested cell cycle at S and G2/M phases and induced RBE cell apoptosis( P <0.01). Transwell and qRT-PCR results demonstrated that Cos impeded RBE cell migration, invasion, and reduced the transcription of M M P 2 and M M P 9 . Cos inhibited the expressionofp-AKT, Bcl-2, MMP2 and MMP9, the level of Bax. Conclusion: Cos restrained the proliferation, migration and invasion of RBE cells by suppressing PI3K/AKTpathway.

Objective To construct the permanent colostomy patients with rectal cancer in archives information module content. Methods Using expert meeting,semi- structured interview, literature review, Delphi expert consultation method, establish the system of permanent rectal cancer patients file information specific module. Results In two- round consultation authority coefficient was 0.847. Kendall coordination coefficient (Kendall′s W) was 0.195-0.331, the difference had statistical significance (P<0.01); through the expert consultation method to construct the file information module for permanent colostomy patients with rectal cancer, which contained 4 first-level indicators (colostomy patient information module, stoma nursing modules, stoma patients transitional care modules, colostomy patients with network platform module), 11 secondary indicators, 36 third grade indicators. Conclusions This study established file information module content for permanent stoma patients with rectal cancer. It has good scientificity and reliability, and can provide a theoretical basis for the clinical development of a file information system network for transitional care of permanent stoma patients with rectal cancer.

UNLABELLEDObjective To compare the impact of right ventricular apical (RVA) versus right ventricular outflow tract (RVOT) pacing on left ventricular systolic synchronization.

METHODSSixty patients were prospectively recruited and randomized into RVA group (n=30) with the right ventricle leads placed in the RVA and RVOT group (n=30) with right ventricle leads placed in the septum of the RVOT. Speckle tracking imaging was performed with 100% ventricle pacing to measure the differences in the time to maximum left ventricle (LV) radial strain.

RESULTSIn RVA group, the difference in the time to 6-segment maximum LV radial strain after pacing was 105.27 ± 19.74 ms, significantly greater than that in RVOT group (41.65 ± 12.17 ms, P<0.001). The standard difference of time to 6-segment maximum LV radial strain was also significantly greater in RVA group than in RVOT group (42.71 ± 17.63 vs 17.63 ± 5.62 ms, P<0.001).

CONCLUSIONLeft ventricle systolic synchronizaition after RVOT pacing is superior to RVA pacing.