In the context of the complex and ever-changing spectrum of diseases, the traditional Chinese medicine compatibility of prescription and drugs is no longer able to fully meet the needs of clinical diagnosis and treatment. Therefore, this article is based on the diagnosis and treatment model of the combination of disease, syndrome, and symptom, combined with the development achievements of Western medicine, and explores the principles of formulating traditional prescriptions based on the combination of chief, deputy, assistant, and envoy. This article proposes a formulation principle of composing prescriptions with the diagnosis of syndrome as the chief, the diagnosis of disease as the deputy, the treatment of symptoms as the assistant, and the harmonization of medicine as the envoy. This forms a treatment plan with the core link of syndrome differentiation and treatment, disease differentiation and treatment, symptomatic treatment, detoxification, and efficacy enhancement. The purpose of this article is to address the current clinical challenges such as an increasing disease spectrum and the complexity of syndrome patterns and symptom clusters. It aims to provide new insights into traditional Chinese medicine clinical treatment plans and herbal formulation strategies, with the ultimate goal of improving the clinical effectiveness of traditional Chinese medicine.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Inhibition of human cytochrome P450 (CYP) can lead to drug-drug interactions, resulting in serious adverse reactions.It is therefore crucial to accurately predict the inhibitory power of a given compound against a particular CYP isoform.This study compared 11 machine learning methods and 2 deep learning models based on different molecular representations.The experimental results showed that the CatBoost machine learning model based on RDKit_2d+Morgan outperformed other models in terms of accuracy and Mathews coefficient, and even outperformed previously published models.Moreover, the experimental results also showed that the CatBoost model not only had superior performance, but also consumed less computational resources.Finally, this study combined the top 3 performing models as co_model, which slightly outperformed the CatBoost model alone in terms of performance.

Objective To analyze the epidemiological characteristics of an outbreak of carbapenem resistant Klebsiella pneumoniae(CRKP)hospital infection in the neonatal intensive care unit(NICU),and to explore possible causes of the outbreak.Methods Case analysis,epidemiological studies and environmental detection methods were used to investigate the detection of CRKP in the NICU of a hospital from March 11,2022 to May 3,2022,and the causes and corresponding prevention and control measures were analyzed.Results This CRKP outbreak in the NICU occurred in two phases.The first phase was from March 11,2022,to March 30,2022,during which 3 people contracted CRKP hospital infections.The second phase was from April 13,2022,to May 3,2022,during which 4 people contracted CRKP hospital infections.The source of the hospital infection outbreak was patient No.1.All 13 CRKP cases showed sensitivity only to amikacin and tigecycline,with intermediate sensitivity to levofloxacin,and high resistance to other antibiotics.All 13 CRKP cases carried resistant genes for metalloenzymes.After the outbreak,the ward environment was sampled three times,with 35 samples taken in total,and 14 of them tested positive for CRKP.After strict environmental cleaning,disinfection,and multiple control measures,no new hospital infection cases similar to this outbreak were detected after May 13,2022.Conclusion The outbreak of NICU hospital infections may be due to the contamination of the ward environment,medical equipment,and inadequate hand hygiene of medical staff,leading to its spread.Therefore,strict cleaning and disinfection of the environmental surfaces,strengthening hand hygiene of medical staff,and implementing multiple measures can effectively control hospital infections of CRKP.

To systematically evaluate the effects of metformin on tumors in experimental animal models of different types of cancer. Pubmed, Embase, Cochrane, and Web of Science databases were searched for studies on metformin used in various experimental animal tumor models from 2008 to 2022. Meta-analysis was performed using STATA 16.0 software after screening literature extraction data and methodological quality evaluation by inclusion and exclusion criteria. A total of 24 studies with 1108 model animals were included. Meta-analysis results showed that this study used meta-analysis for quantitative synthesis of study results and found that tumor model animals of different species showed different degrees of reduction in tumor volume, weight, and number after metformin intervention.

Objective:To evaluate the medium-term clinical and hemodynamic outcomes of percutaneous pulmonary valve implantation (PPVI) using a domestic Venus-P self-expanding valve in the treatment of severe pulmonary regurgitation after Tetralogy of Fallot (TOF).Methods:Retrospective study.From December 2017 to December 2020, 13 TOF patients with (17.8±4.7) years old and (50.2±12.3) kg underwent PPVI using the Venus-P self-expanding valve in the Department of Children′s Heart Center, Zhengzhou University People′s Hospital were recruited.The mean valve size was (31.9±3.1) mm.All patients received the transannular patch surgery and developed severe pulmonary regurgitation.After PPVI, 13 patients were followed up for at least 12 months.The operation-related complications, improvement of valve and heart function and the durability and reintervention of the Venus-P self-expanding valve were analyzed.The right ventricular end-diastolic volume index (RVEDVi) before and after operation was compared by the paired t-test, and the New York Heart Association (NYHA) class was compared by the paired Wilcoxon signed rank sum test. Results:PPVI was successfully performed in all 13 patients without death.At 6 months post-PPVI, cardiac magnetic resonance imaging findings showed that RVEDVi was significantly reduced[(145.7±9.6) mL/m 2vs.(100.2±12.2) mL/m 2, P<0.05], and the NYHA class was significantly improved ( P<0.05). One patient presented moderate pulmonary valve regurgitation at 12 months postoperatively.No vegetation was found on echocardiography, and blood culture was negative in this case.Six patients did not have postoperative pulmonary valve regurgitation, and the remaining presented mild or less pulmonary regurgitation.One patient had sudden ventricular tachycardia on the 6 th day postoperatively, which was converted to sinus rhythm after synchronous electrocardiography.Only one case underwent appendectomy 7 months after operation due to acute appendicitis, and the remaining did not require valve-related reintervention after implantation.During the follow-up for (22.8±8.0) months, no patients had perivalve leakage, stent migration and rupture.Complications like embolization and coronary artery compression were not reported. Conclusions:PPVI using the Venus-P self-expanding valve is safe and effective in patients with severe pulmonary valve regurgitation after TOF surgery, showing an acceptable medium-term follow-up outcome.Studies with a large sample size and long follow-up period are still needed to validate our findings.

Allografts ; COVID-19 ; China/epidemiology* ; Disease Outbreaks ; Humans ; Kidney Transplantation/adverse effects* ; SARS-CoV-2

Objective To analyze the distribution status and agglomeration degree of radiological diagnosis and treatment resources in Beijing, and provide references for rationally coordinating the allocation of radiological diagnosis and treatment resources, formulating resource allocation policies, and promoting the stable development and efficient use of radiological diagnosis and treatment resources. Methods Based on the medical radiation protection monitoring data of Beijing medical and health institutions from 2019 to 2020, the current situation of radiological diagnosis and treatment resources is described by the number of radiological diagnosis and treatment resources, the average service volume, and the resource composition, and the distribution of radiological diagnosis and treatment resources in Beijing is evaluated with the aid of the agglomeration degree. Results The number of radiological diagnostic equipment, the number of service personnel, and the number of radiological workers engaged in third-level hospitals is the largest; for the number of service personnel for each type of single equipment, third-level hospitals account for a larger proportion, and radiotherapy and nuclear medicine services are concentrated in third-level hospitals. Human resource pressure and equipment service pressure are relatively high in third-level hospitals. First-level hospitals mainly undertake radiological diagnosis services. There is little difference in the amount of radiological diagnosis services per capita between second-level hospitals and third-level hospitals. Nuclear medicine and radiotherapy in third-level hospitals per capita service volume is significantly higher than that insecond-level hospitals. Radiological diagnosis and radiotherapy resources are concentrated in urban areas to a large extent. Conclusion There are obvious differences in the utilization of radiological diagnosis and treatment resources in different levels of hospitals. There is a significant concentration of radiological diagnosis and treatment resources in various districts. There is a certain degree of unbalanced distribution and inadequate utilization of radiological diagnosis and treatment resources in Beijing.

【Objective】 To analyze the HIV-, HCV- and HBV- NAT yield rate in different areas of Henan province, so as to provide the basis for disease prevention and control as well as the establishment of a unified quality control standard for nucleic acid testing(NAT) in the Henan province. 【Methods】 The number and prevalence of NAT yielding samples with isolated infectious virus, namely HIV, HCV and HBV, in 18 blood stations in Henan province from 2017~2019, as well as the trends were analyzed. The NAT quality of each laboratory and each testing system was analyzed according to the ratio of reactive individual donation(ID) results to reactive minipools(MP). 【Results】 The HBV, HCV and HIV ID-NAT yield numbers in 3 501 251 blood donations were HBV 2 606(74/100 000), HCV 21 (0.63/100 000), and HIV 34(1.00/100 000). The HBV ID-NAT yield rate showed an upward trend in the whole province from 2017 to 2019, while the prevalence of HIV and HCV ID-NAT yield didn′t differ significantly during three years. 5 kinds of NAT detection systems were applied in 18 blood centers. among which Ⅰ, Ⅱ, Ⅳ and Ⅴ were triplex detection systems. 2661 ID-reactive samples were implicated in 5 595 MP-reactive samples, with a resolution rate of 47.56%. The resolution rate of triplex NAT system Ⅰ, Ⅱ, Ⅳ and Ⅳ was 39.63%~47.95%, 40.43%~54.36%, 51.61% and 70.00%~45.45%, respectively. An upward trend in triplex NAT resolution rate was observed in 8 laboratories, i. e.B, D, E, F, I, K, L and Q, and an descending trend in A and C. The NAT system Ⅲ, a ID-NAT system, was used only by laboratory C, presenting a NAT-yield rate of 0.19% (282/145 474) and resolution rate of 46.45% (131/282). 【Conclusion】 The majority of NAT-yield of one infectious virus in Henan province is HBV, presenting annual increasing trend. The quality management of NAT laboratories should be strengthened as the divergence was seen in the performance of different NAT laboratories.

The number of women of childbearing age having overweight or obesity problems keeps increasing globally. Besides diabetes, hypertension and other chronic conditions, these women may develop metabolic disorders of sex hormones, manifested by irregular menstruation, infertility and obstetric complications. Bariatric surgery offers prominent weight loss and improves obesity-related conditions. Women patients also benefit from elevated chances of pregnancy postoperatively. However, the timing of pregnancy for obese women after surgery has impact on the effects of weight loss surgery, pregnancy complications, delivery outcomes and long-term prospects of mother and child. This article reviews the clinical studies on the timing of pregnancies after bariatric surgery, weight loss results, as well as risks and outcomes.