Pharmaceutical excipients, as an indispensable part of drug preparation, play crucial roles as drug carriers, improving drug release, ensuring drug stability, and enhancing patient compliance. Traditional Chinese Medicine (TCM) boasts a rich developmental history. With the modernization of technology, the deep integration of pharmacy, chemistry, and materials science has provided broader opportunities for innovative research in TCM. Simultaneously, the demand for high-quality excipients has become increasingly critical.This paper aims to review current research and applications of excipients in TCM preparations, including pre-mixed and co-processed excipients, modified excipients, and the unification of drugs and excipients, such as flavoring agents, fillers, penetration enhancers, and delivery systems. A meticulous synthesis and analysis of existing research aims to provide a reference for selecting excipients in TCM preparations, stimulate innovation in excipient development for TCM, and advocate for the development of personalized excipients.

Objective:To analyze the clinical features of anti-neurofascin-155 (NF155) antibody positive autoimmune nodopathy in children.Methods:This was a case series study. A total of 6 children who were diagnosed accurately as anti-NF155 antibody positive autoimmune nodopathy by cell immunofluorescence assay at the Children′s Hospital of Fudan University from January 2020 to December 2023 were collected. This study retrospectively analyzed 6 pediatric children′s clinical manifestations, laboratory and electrophysiological examination results, and treatment outcomes.Results:Among 6 children with anti-NF155 antibody positive autoimmune nodopathy, there were 4 boys and 2 girls. The onset age of 6 children ranged from 3 years and 8 months to 12 years. All 6 children had extremity weakness (more severe in the distal and the lower extremities than in the upper extremities), 5 children had sensory deficits such as numbness or pain in the extremities, 4 children had tremors and ataxia, 3 children had cranial nerve involvement. Among the 6 children, 4 children had protein-cell separation in cerebrospinal fluid examinations. Among the 6 children, 1 child had central nervous system demyelination, the brain magnetic resonance imaging showed multiple abnormal signals in the bilateral cerebral hemispheres. Four children showed motor and sensory nerve damage in electrophysiological examination, and 2 children only showed motor nerve damage. Three children showed myelin and axonal damage, and 3 children only showed axonal damage. Among the 6 children, 5 children were treated with intravenous immunoglobulin and steroids. Among them, 2 children underwent plasma exchange due to poor efficacy, and subsequently, rituximab was added. There was 1 child changed the treatment with olfatomumab since the symptoms did not significantly improve after using rituximab. After treatment for 4-15 months, 2 children had no clinical symptoms, 1 child had improvement in clinical symptoms, 2 children had no significant improvement in clinical symptoms, and 1 child who did not receive the immunotherapy had no significant change in clinical symptoms.Conclusions:Anti-NF155 antibody positive autoimmune nodopathy in children presents with varying degrees of clinical manifestations. It is mainly characterized by extremity weakness, numbness and pain, often accompanied bytremorsand ataxia. Some pediatric patients may also have central nervous system demyelination. Cerebrospinal fluid and electrophysiological examination are important auxiliary examination methods. If steroid therapy is not effective, plasma exchange and rituximab treatment should be used as soon as possible.

Patients in the intensive care unit (ICU) often need to have various catheters placed on their bodies due to their severe condition. In order to prevent the occurrence of unplanned extubation, patients' hands should be restrained appropriately. The current restraint gloves used in clinical practice have problems such as improper restraint, easy falling off of oxygen saturation monitoring probes, and pressure injury of hands. Therefore, department of critical care medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine designed a wrist restraint glove suitable for restless patients, and obtained the national utility model patent (ZL 2020 2 1612453.7). The device is composed of restraint gloves and restraint rings, which can not only restrain patients, but also continuously monitor the changes of blood oxygen saturation in patients with restfulness. This device is convenient to use, low cost, comfortable to wear, and can prevent the occurrence of device-related pressure injuries, which is suitable for clinical application.
Humans ; Wrist ; Intensive Care Units ; Critical Care ; Hand ; Upper Extremity ; Restraint, Physical

Objective To evaluate the clinical significance of improving the goal attainment rate by management of timely feedback of hypertension patients, which is carried out by using existing communication network. Methods Totally 423 hypertension patients who were hospitalized for treatment in Daping Hospital from Jan. 2012 to Jan 2013, the random numbers table was used to randomize the patients into 2 groups: control group (212 cases) and experiment group (211cases), the conventional treatment was used in control group. Besides the conventional treatment measures, the modern way of communication and network information platform was used by patients who timely feed back the blood pressure changing, and implement the cognitive treatment of hypertension at the same time in the experiment group. The Chi square test was used to compare the patient's medication compliance, the attainment rate and so on , the t test was used to compare the blood pressure in two groups of patients after the intervention. Results At the end of the intervention, the difference of heavy salt diet (reduced to 16.59%), regularly drinking (reduced to 13.74%), heavy sugar diet (reduced to 10.43%), abnormal blood lipid (reduced to 19.91%), smoking (reduced to 27.96%), the number of people who have a stable mood (up to 91.47%), body mass index (reduced to 29.38%) and exercise at ordinary times (reduced to 36.02%) were statistically significant (P< 0.05). Hypertension patients compliance increased significantly, of which the medical behavior of 84.83%, compared with 13.21%in the control group, there was statistically significant difference (χ 2=8.54,P< 0.05). And the awareness, treatment, success rate of blood pressure control were 94.79%, 84.36%, 82.94% in experimental group and 50.94%, 40.09%, 27.83% in control group, and the differences were statistically significant (P<0.05). Conclusion Use of the existing information interaction platform in order to strengthen the management of the blood pressure of hypertension patients and related cognitive behavioral intervention, the control of risk factors and treatment compliance have improved significantly. The remote interaction platform used to patients with hypertension management improve the attainment rate of high blood pressure.

Objective To analyze the clinical features of pulmonary embolism(PE) after urologic surgery in order to provide the theory base for preventing pulmonary embolism Methods CNKI database was used to look for our subjects who were with PE after urologic surgery from January 2005 to December 2011.Ten cases were selected.Three related patients simultaneously in Xuancheng Central Hospital were also recruited as our subjects.The information of diagnosis and treatment information and clinical features were collected.Results Among the 13 patients,3 were women and 10 were men with confirmed PE.Their age ranged from 48 to 79 years old and the average was 61.Among the 13 patients,2 conducted routine surgery,and the other 11 conducted mini-invasion operation.The 13 patients underwent PE from 2 to 18 days after urologic surgery and 7 patients (53.85％) died of PE.Conclusion No specificity of clinical feature for PE was found to contribute to cure rate.Early diagnosis and prevention of PE are important,and anticoagulant treatment and immediate thrombolytic are critical.

To investigate the safety, feasibility and effectiveness of transrectal high-intensity focused ultrasound (HIFU) in the ablation of canine prostate, 20 dogs were divided randomly into 5 groups.Sixteen canine prostates were treated with the third-generation transrectal HIFU device (Sonablate-500 TM). Transrectal ultrasound images of the prostate and prostatic urethra were observed preoperatively and postoperatively. Serial study was performed 30 min, 30 days, 60 days and 180 days after the therapy. The rectum, periprostatic tissues, and prostate were excised en bloc and the tissues were fixed for gross and histological analysis. Our results showed that the average maximal diameter of prostatic urethra was 0.59±0.11 cm before the operation and 2.57±0.98 cm 60 days after the operation. The volume of prostate was 6.5±3.12 cm3 before the treatment while the volume was 4.13±0.23 cm3 60 days after the treatment and the differences were statistically significant (P＜0.05).Histologically, there was a clear demarcation between the necrotic area of the treated tissues and the unaffected surrounding tissues. All the necrotic tissues in the targeted zone broke off and the prostatic urethra became cavitary 60 days later. The more frequent complications were urinary retention and frequency and hematuria. No rectal injury occurred during the treatment. It is concluded that the third-generation transrectal HIFU is capable of destroying prostatic tissue, substantially increasing the width of the prostatic urethra without causing injury to the adjacent tissues. The risk of postoperative complications associated with HIFU was low. HIFU may become a safe, effective and minimally invasive alternative for the treatment of prostatic diseases..

To evaluate the safety and efficacy of transrectal high-intensity focused ultrasound (HIFU) in the treatment of benign prostatic hyperplasia (BPH), serial studies were conducted in 150 BPH pa- tients before and 30 min, 1, 2, 6 and 12 month(s) after Sonablate-500TM HIFU treatment. A sili- con-coated indwelling 16F latex catheter was placed during the determination of the therapy zone. Preoperative and postoperative evaluations were made by using the international prostate symptom score (IPSS), quality of life (QOL), uroflowmetric findings and transrectal ultrasound, and incidence of complications. The cystourethrography was done in 23 patients within 1 year postoperatively. The results showed that after HIFU treatment, IPSS and QOL scores were significantly decreased at 1, 2, 6 and 12 month(s) (P<0.01). Maximum urine flow rate (6.0 to 17.2 mL/s, P<0.01), PVR (75.0 to 30.3,P<0.01) and prostatic volume (65.0 to 38.1 mL, P<0.05) were significantly improved 12 months after the operation. Recurrent urinary retention (n=2) and urethrorectal fistula (n=1) occurred at the 15th postoperative day. The duration of the HIFU prostate ablation was 25-90 rain. The mean time for an indwelling catheter was 3-19 days. These data demonstrate that treatment of BPH with Sonab- late-500TM HIFU is safe and effective.

To investigate the safety, feasibility and effectiveness of transrectal high-intensity focused ultrasound (HIFU) in the ablation of canine prostate, 20 dogs were divided randomly into 5 groups. Sixteen canine prostates were treated with the third-generation transrectal HIFU device (Sonablate-500). Transrectal ultrasound images of the prostate and prostatic urethra were observed preoperatively and postoperatively. Serial study was performed 30 min, 30 days, 60 days and 180 days after the therapy. The rectum, periprostatic tissues, and prostate were excised en bloc and the tissues were fixed for gross and histological analysis. Our results showed that the average maximal diameter of prostatic urethra was 0.59+/-0.11 cm before the operation and 2.57+/-0.98 cm 60 days after the operation. The volume of prostate was 6.5+/-3.12 cm(3) before the treatment while the volume was 4.13+/-0.23 cm(3) 60 days after the treatment and the differences were statistically significant (P<0.05). Histologically, there was a clear demarcation between the necrotic area of the treated tissues and the unaffected surrounding tissues. All the necrotic tissues in the targeted zone broke off and the prostatic urethra became cavitary 60 days later. The more frequent complications were urinary retention and frequency and hematuria. No rectal injury occurred during the treatment. It is concluded that the third-generation transrectal HIFU is capable of destroying prostatic tissue, substantially increasing the width of the prostatic urethra without causing injury to the adjacent tissues. The risk of postoperative complications associated with HIFU was low. HIFU may become a safe, effective and minimally invasive alternative for the treatment of prostatic diseases.

The paper analyzes the current status of and problems in the development of non-government medical institutions in Shanghai, the advantages non-government medical institutions possess and the difficulties they face in the process of development. It advances the development orientation of non-government medical institutions, arguing that it is imperative to create circumstances and conditions for fair competition, formulate perfect supporting policies, and lead non-government medical institutions to the integration of their own development with the reform and development of the medical and health cause of the country. It argues, on the other hand, that non-government medical institutions must stress simultaneously the accumulation and the operation of capital so as to have a niche in the fierce competitions of the medical market.

Objective To study the clinic characters of patients with latent autoimmune diabetes in adults (LADA). Methods We evaluated the prevalence of acute and chronic complications in the LADA patients with serum antibodies to glutamic acid decarboxylase (GADA) or to islet cell cytoplasmic antigens (ICA). The prevalence of acute and chronic complications were further compared with that in patients with acute onset type 1 or type 2 diabetes. Results The mean age, BMI, fasting and postprandial C peptide levels of the LADA patients were higher than those of type 1 diabetes and lower than those of type 2 diabetes. Of the LADA patients, 29.3% had ketosis. Although the frequency of repeated attack of ketosis in the LADA patients was similar to that in type 1 diabetes, the duration from diabetic onset to first ketosis in the LADA patients was much longer. The prevalence of retinopathy in the LADA patients was 19.5%, which was similar to that in type 1 diabetes. The prevalence of cataract in the LADA patients was 48.8%, which was similar to that in type 2 diabetes. Less LADA patients had microalbuminuria, compared with the other groups. There was no difference in the prevalence of overt nephropathy, neuropathy and hyperlipidemia among the three groups. The prevalence of coronary heart disease in the LADA patients was similar to that in type 2 diabetes. The prevalence of hypertension in the LADA patients was higher than that in type 1 but lower than that in type 2 diabetes. Conclusion The clinic characters as well as acute and chronic complications in LADA patients are different from those in type 1 and type 2 diabetes.