Yigongsan， derived from QIAN Yi’s Key to Therapeutics of Children’s Diseases in the Song Dynasty， is a classic pediatric prescription that is included in the Catalogue of Ancient Classic Prescriptions （the Second Batch of Pediatrics） released by the National Administration of Traditional Chinese Medicine in 2022. This paper verifies and analyzes the historical origin， composition， dosage， processing， decoction method and efficacy of Yigongsan by systematically combing ancient books and modern documents. As a result， Yigongsan is composed of five herbs： Panax ginseng， Poria cocos， Atractylodes macrocephala， Citrus reticulata and Glycyrrhiza uralensis， of which P. cocos should be peeled， A. macrocephala is fried with soil， G. uralensis is roasted with honey while P. ginseng and C. reticulata are raw products. According to the dosage of ancient and modern times， each medicinal herb must be ground into fine powder， 1.6 g for each， added with 300 mL of water， 5 pieces of Zingiber officinale， and 2 Ziziphus jujuba， decocted together to 210 mL， and taken before meals. In ancient books， Yigongsan is used to treat vomiting， diarrhea， spleen and stomach deficiency， chest and abdominal distension， and lack of appetite， etc. Modern research showed that Yigongsan could also be used in the diseases of immune system， respiratory system， blood system， etc.， involving infantile anorexia， asthma， anemia， tumors and so on.

Objective To explore the early prediction value of related test indicators for non-biliary acute pancreatitis and the influence of interaction of related test indicators on non-biliary acute pancreatitis.Methods A total of 280 patients with the first onset of non-biliary acute pancreatitis who were hospitalized in Jinshan Hospital of Fudan University from July 2019 to July 2023 were divided into mild group and severe group.The severe group included moderately severe and severe patients.Clinical data,tests and examination indicators of first-attack inpa-tients within 48 hours after admission were collected.Through logistics regression analysis,early detection indica-tors related to the severity of non-biliary acute pancreatitis were explored,and the influence of their interaction was studied.Results Single-factor analysis showed that albumin(ALB),thyroxine(T4),serum free triiodothyronine,albumin(ALB),Thyroxine(T4)in both groups.FT3),thyroid stimulating hormone(TSH),serum triglyceride(TG),calcium(Ca)and other indicators were statistically significant(P<0.05);Through multi-factor logistics regression analysis,it was found that the OR values of T4,FT3,TSH,CA and other detection indicators were all less than 1(P<0.05);After controlling for gender,age,history of hypertension,history of diabetes and other factors,the interaction between TG and HbA1c was analyzed,the aOR was 1.500 when only HbA1c was increased(P>0.05),the aOR was 4.488 when only TG was increased(P<0.05),and the aOR was 5.084 when TG and HbA1c were increased simultaneously(P<0.05).Conclusion ALB,T4,FT3,TSH,CA were protective factors of non-biliary AP,and could be used as predictive indicators of the severity of non-biliary acute pancreatitis.Inter-action of HbA1c with TG increases the risk of progression to severe non-biliary acute pancreatitis.

Humans ; Asthma/diagnosis* ; HMGB1 Protein

OBJECTIVE: To investigate the effect of lateral prone position ventilation in patients with acute respiratory distress syndrome (ARDS). METHODS: A prospective control study was conducted. A total of 75 patients with moderate to severe ARDS admitted to the department of critical care medicine of Jingxian Hospital in Anhui province from January 2020 to December 2022 were selected as the research objects. According to the envelope method, the patients were divided into the lateral prone position ventilation group (38 cases) and the traditional prone position ventilation (PPV) group (37 cases), using lateral prone position ventilation and traditional PPV, respectively. The mechanical ventilation parameters were set according to the ARDS treatment guidelines and lung protective ventilation requirements in both groups, and the time of prone position for the first 3 times was not less than 16 hours per day. General data of patients were recorded, including heart rate (HR), mean arterial pressure (MAP), airway resistance and lung static compliance (Cst) before prone position (T0), 1 hour (T1), 4 hours (T2), 8 hours (T3), and before the end of prone position (T4), oxygenation index (PaO₂/FiO₂) before the first prone position (t0) and 12 hours (t1), 24 hours (t2), 48 hours (t3), and 72 hours (t4) after the intensive care unit (ICU) admission, as well as the incidence of pressure injury (PI) and vomiting, tracheal intubation time, and mechanical ventilation time. Repeated measures analysis of variance was used to compare the effects of different prone positions on patients before and after the prone position. RESULTS: There were no significant differences in age, gender, body mass index (BMI), acute physiology and chronic health evaluation II (APACHE II), underlying diseases, HR, MAP, pH value, PaO₂/FiO₂, blood lactic acid (Lac), arterial blood pressure of carbon dioxide (PaCO₂) and other general information between the two groups. The HR (intergroup effect: F = 0.845, P = 0.361; time effect: F = 1.373, P = 0.247; interaction: F = 0.245, P = 0.894), MAP (intergroup effect: F = 1.519, P = 0.222; time effect: F = 0.169, P = 0.954; interaction: F = 0.449, P = 0.773) and airway resistance (intergroup effect: F = 0.252, P = 0.617; time effect: F = 0.578, P = 0.679; interaction: F = 1.467, P = 0.212) of T0-T4 between two groups showed no significant difference. The Cst of T0-T4 between the two groups showed no significant difference in the intergroup effect (F = 0.311, P = 0.579) and the interaction (F = 0.364, P = 0.834), while the difference in the time effect was statistically significant (F = 120.546, P < 0.001). The PaO₂/FiO₂ of t0-t4 between the two groups showed no significant difference in the intergroup effect (F = 0.104, P = 0.748) and the interaction (F = 0.147, P = 0.964), while the difference in the time effect was statistically significant (F = 17.638, P < 0.001). The group factors and time factors were tested separately, and there were no significant differences in the HR, MAP, airway resistance, Cst, PaO₂/FiO₂ between the two groups at different time points (all P > 0.05). The Cst at T1-T4 and PaO₂/FiO₂ at t1-t4 in the two groups were significantly higher than those at T0/t0 (all P < 0.05). There were no significant differences in the tracheal intubation time [days: 6.75 (5.78, 8.33) vs. 7.00 (6.30, 8.45)] and mechanical ventilation time [days: 8.30 (6.70, 9.20) vs. 7.40 (6.80, 8.75)] between the lateral prone position ventilation group and the traditional PPV group (both P > 0.05). However, the incidences of PI [7.9% (3/38) vs. 27.0% (10/37)] and vomiting [10.5% (4/38) vs. 29.7% (11/37)] in the lateral prone position ventilation group were significantly lower than those in the traditional PPV group (both P < 0.05). CONCLUSIONS Both lateral prone position ventilation and traditional PPV can improve Cst and oxygenation in patients with moderate to severe ARDS. The two types of prone position have little influence on HR, MAP and airway resistance of patients, and there is no difference in the influence on tracheal intubation time and mechanical ventilation time of patients. However, the lateral prone position ventilation mode can reduce the incidence of PI and vomiting, and is worthy of clinical promotion and application.
Humans ; Respiration, Artificial ; Prone Position ; Prospective Studies ; Lung ; Respiratory Distress Syndrome/therapy* ; Respiration ; Vomiting

This paper summarized professor ZHANG Boli's experience in treating stubborn bi （痹） with the herbal pair of Ruxiang （Olibanum）- Moyao （Myrrha）. The basic pathogenesis of stubborn bi is channel and collateral stasis and obstruction. Ruxiang and Moyao are thus used in mutual reinforcement to rectify qi and diffuse bi， activate blood and relieve pain， thereby removing static and obstructed qi and blood， unblocking the obstructed channels and colla-terals， which is especially suitable for stubborn bi caused by channel and collateral obstruction. In clinical practice， the herbal pair of Ruxiang-Moyao is used together with qi-moving and blood-activating medicinals to treat chest bi by expelling stasis and diffusing stagnation， dissipating cold and unblocking vessels. To treat long-term wither and weakness in late stage of stroke， the medicinals of boosting qi and invigorating blood， unblocking channels and venting collaterals can be added to the herbal pair so as to soothe and drain vessels and collaterals， harmonize and regulate qi and blood. Simiao Yongan Decoction （四妙勇安汤） can be integrated in the treatment of vessel bi by moving qi and dissolving stasis， and for the long-term stubborn vessel bi， integrated internal and external treatment is suggested by external use of Ruxiang-Moyao to vent bi with aromatics. Moreover， it is emphasized to use the herbal pair of Ruxiang-Moyao in accordance with indications and cautions.

Objective To quantify the setup errors for the different anatomical sites of patients who received intensity-modulated radiotherapy (IMRT) with linear accelerator on-board kilovolt fan beam CT(kV-FBCT) as non-isocenter IGRT and megavolt cone beam CT (MV-CBCT) as isocenter IGRT. Methods A retrospective analysis was performedon 70 patients who underwent radiotherapy, kV-FBCT, and/or MV-CBCT scans after each routine setup prior to IMRT. The average displacement (M), systematic error (Σ), and random error (б) at different treatment sites in the left-right, anterior-posterior, and cranial-caudal directions were calculated according to the individual displacements. The formula 2.5Σ+0.7б was used to estimate the PTV margin in respective direction. For each single patient, the root mean square in three directions was used as 3D displacement. Results A total of 1130 displacements were recorded in the 70 patients. The PTV margin was estimated to be 1.9-3.1 mm in head and neck cancer, 2.8-5.1 mm in thoracic cancer, 4.6-5.1 mm in breast cancer, 3.0-5.5 mm in upper abdominal cancer, and 3.5-6.8 mm in pelvic tumor. For the 3D mean displacements, the head and neck, thoracic, breast, upper abdominal, and pelvic cancer were 2.4±1.0, 4.0±1.6, 4.1±2.0, 4.6±2.1, and 4.6±2.1 mm, respectively. The average 3D displacement obtained by kV-FBCT and MV-CBCT were 4.1 and 3.4 mm, respectively (P=0.212). Conclusion The quantitative setup-error data can be obtained using linear accelerator on-board FBCT, and the non-isocenter IGRT induced set-up error cannot be negligible.

Objective To optimize the manufacture process for Zhibai Anshen oral liquid. Methods The orthogonal designed experiments were conducted to monitor the effects of three factors on the content of mangiferin. The three factors included the amount of water, extraction time and alcohol precipitation concentration. Six month accelerated stability study and twelve month long term stability study were performed. Results Optimum percolation process was boiling the mixture with 10 times of water for 1 hour, followed by deposition with 60% alcohol. Conclusion This optimized process can be used for mass production.

Objective To explore the clinical value of serum interleukin(IL)-33 and its soluble receptor ST2(sST2) level in patients with chronic hepatitis B.Methods A total of 65 cases with chronic hepatitis B were recruited into study group,meanwhile 60 healthy persons were enrolled in the control group from January 2014 to October 2016 in our hospital.IL-33,sST2 and alanine aminotransferase(ALT) were detected and compared in the two groups.Results The level of IL-33,sST2 and ALT were significant higher than those of the control group(t=6.542,7.218,6.324;P<0.05).IL-33 and sST2 levels in chronic hepatitis B patients with abnormal ALT level were significant higher than those with normal ALT(t=16.328,9.874,P<0.05).Conclusion The detection of IL-33 and sST2 in patients with chronic hepatitis B could help to understand the immune status of patients,and provide a theoretical basis for the treatment of chronic hepatitis B.

Objective To study the clinical efficacy of the combination of sephedex and docetaxel used in transcatheter arterial chemoembolization (TACE) for clinical treatment of primary liver cancer.Methods 120 patients with primary liver cancer in our hospital were divided into the experimental group and the control group randomly and equally, the 60 cases in experimental group were treated with sephedex suspensoid (Sephedex, G-50, 300-500 μm) and docetaxel-iodized oil, while other 60 cases in control group were treated with docetaxel-iodized oil suspension liquid.Results The success rate of surgical intubation in the two groups was 100%.After an average follow-up of 12 months, the postoperative tumor diameter of the experimental group was reduced by (4.4±1.4) cm, while that of the control group was (1.8±1.0) cm;The overall response rate was 70% in the experimental group in contrast to 30% in the control group;the alpha fetal protein (AFP) value was decreased by (33.2±15.2) μg/L in the experimental group and (10.4±9.8) μg/L in the control group.Conclusion The combination of sephedex, docetaxel suspensoid and iodized oil shows great potential in TACE treatment of primary liver cancer, from which the treatment effect can be improved significantly.

The paper described the development stages of a hospital performance evaluation scale based on patient experience.An empirical application on 7 856 patients of 26 hospitals in four provinces in the country identified the challenges encountered in the course of its application.These include limits of patients experience,variations on the experience reports incurred by different services experienced by patients,and setting of the patient-inpatient ratio among others.Solutions proposed based on these studies aim at creating a patient experience scale tailored to Chinese patients.