Objective:To explore the research status, hotspots, and directions in traditional Chinese medicine treatment for postoperative gastrointestinal dysfunction both domestically and internationally.Methods:The bibliometric software CiteSpace 5.7.R5 was used to visually analyze literature published on the China National Knowledge Infrastructure and Web of Science core collection from establishment until 2022, and to draw the knowledge graph of authors, research institutions, and keywords.Results:After screening by two researchers, a total of 1 012 Chinese articles and 111 English articles were included. The analysis of annual publication volume showed that this field was showing an upward trend both domestically and internationally. The co-occurrence analysis of authors displayed that Hu Kaiwen and Jingwen Yang had the highest number of publications. Institutional co-occurrence analysis indicated that there were relatively few mature and influential teams formed domestically and internationally, and research institutions had limited cross-regional cooperation. Keyword clustering analysis revealed that the research hotspots mainly focused on integrated traditional Chinese and Western medicine nursing, clinical research, and traditional Chinese medicine external treatment methods.Conclusions:The research on the treatment of postoperative gastrointestinal dysfunction with traditional Chinese medicine is mainly concentrated in China, but there are few closely cooperating and stable research teams. Research in this field is still in its developmental stage both domestically and internationally, close cooperation between multiple institutions and authors is needed to form influential teams to conduct in-depth research on the mechanisms and principles of this field, making significant contributions to its development.

[Objective]To analyse and summarize Professor CHEN Mingxian's clinical experience in the treatment of gastric cancer by"tonifying the spleen and stomach,removing stasis poison,clearing cancer poison".[Methods]Through clinical learning and medical case analysis,this paper elucidates Professor CHEN's understanding of the etiology and pathogenesis of gastric cancer,gives examples of the treatment of gastric cancer,and attaches two cases.[Results]Professor CHEN thinks weakness of the spleen and stomach is a prerequisite for the occurrence of gastric cancer,which runs through the occurrence and development of gastric cancer.Stasis coagulation is the key link for the transformation of precancerous lesions into gastric cancer,and the residual cancer poison is the main pathogenesis of the recurrence and metastasis of gastric cancer.In the treatment,the three methods of"tonifying the spleen and stomach,removing stasis poison and clearing cancer poison"are established,and the flexible fusion application with the syndrome reflects the concept of"always strengthening the body resistance,not forgetting to attack evil and combining prevention and treatment".Two cases of gastric cancer with emaciation after surgery were treated by tonifying the spleen to produce muscle and eliminate distention,removing blood stasis and detoxifying cancer,but each had its own emphasis on strengthening the body resistance and eliminating evil.After treatment,all the cases were stable,and no recurrence and metastasis were observed during follow-up period.[Conclusion]Professor CHEN treats gastric cancer by"tonifying the spleen and stomach,removing stasis poison and clearing cancer poison",which has good curative effect and certain clinical practical value.

Objective: To investigate the incidence and trend of short-term outcomes among preterm infants born <34 weeks' gestation. Methods: A secondary analysis of data from the standardized database established by a multicenter cluster-randomized controlled study "reduction of infection in neonatal intensive care units (NICU) using the evidence-based practice for improving quality (REIN-EPIQ) study". This study was conducted in 25 tertiary NICU. A total of 27 192 infants with gestational age <34 weeks at birth and admitted to NICU within the first 7 days of life from May 2015 to April 2018 were enrolled. Infants with severe congenital malformation were excluded. Descriptive analyses were used to describe the mortality and major morbidities of preterm infants by gestational age groups and different admission year groups. Cochran-Armitage test and Jonckheere-Terpstra test were used to analyze the trend of incidences of mortality and morbidities in 3 study-years. Multiple Logistic regression model was constructed to analyze the differences of outcomes in 3 study-years adjusting for confounders. Results: A total of 27 192 preterm infants were enrolled with gestational age of (31.3±2.0) weeks at birth and weight of (1 617±415) g at birth. Overall, 9.5% (2 594/27 192) of infants were discharged against medical advice, and the overall mortality rate was 10.7% (2 907/27 192). Mortality for infants who received complete care was 4.7% (1 147/24 598), and mortality or any major morbidity was 26.2% (6 452/24 598). The incidences of moderate to severe bronchopulmonary dysplasia, sepsis, severe intraventricular hemorrhage or periventricular leukomalacia, proven necrotizing enterocolitis, and severe retinopathy of prematurity were 16.0% (4 342/27 192), 11.9% (3 225/27 192), 6.8% (1 641/24 206), 3.6% (939/25 762) and 1.5% (214/13 868), respectively. There was a decreasing of the overall mortality (P<0.001) during the 3 years. Also, the incidences for sepsis and severe retinopathy of prematurity both decreased (both P<0.001). However, there were no significant differences in the major morbidity in preterm infants who received complete care during the 3-year study period (P=0.230). After adjusting for confounders, infants admitted during the third study year showed significantly lower risk of overall mortality (adjust OR=0.62, 95%CI 0.55-0.69, P<0.001), mortality or major morbidity, moderate to severe bronchopulmonary dysplasia, sepsis and severe retinopathy of prematurity, compared to those admitted in the first study year (all P<0.05). Conclusions: From 2015 to 2018, the mortality and major morbidities among preterm infants in Chinese NICU decreased, but there is still space for further efforts. Further targeted quality improvement is needed to improve the overall outcome of preterm infants.
Bronchopulmonary Dysplasia/epidemiology* ; Gestational Age ; Humans ; Infant ; Infant Mortality/trends* ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases/epidemiology* ; Patient Discharge ; Retinopathy of Prematurity/epidemiology* ; Sepsis/epidemiology*

OBJECTIVE: To study the clinical features of children with periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome, a polygenic and multifactorial autoinflammatory disease with unknown pathogenesis. METHODS: A retrospective analysis was performed on the medical data of 13 children with PFAPA syndrome. RESULTS: All 13 children had disease onset within the age of 3 years, with a mean age of onset of (14±10) months. They all had periodic fever, with 8-18 attacks each year. The mean interictal period of fever was (30±5) days. Pharyngitis, cervical adenitis, and aphthous stomatitis were the three cardinal symptoms, with incidence rates of 100% (13/13), 85% (11/13), and 38% (5/13) respectively. There were increases in white blood cells, C-reactive protein, and erythrocyte sedimentation rate during fever. Of all the 13 children, 6 underwent whole exome sequencing and 7 underwent panel gene detection for autoinflammatory disease, and the results showed single heterozygous mutations in the CONCLUSIONS For children with unexplained periodic fever with early onset accompanied by pharyngitis, cervical adenitis, aphthous stomatitis, elevated inflammatory indices, and good response to glucocorticoids, PFAPA syndrome should be considered. This disorder has good prognosis, and early diagnosis can avoid the long-term repeated use of antibiotics.
Child ; Child, Preschool ; Fever/etiology* ; Humans ; Infant ; Lymphadenitis/diagnosis* ; Pharyngitis/drug therapy* ; Pyrin ; Retrospective Studies ; Stomatitis, Aphthous/genetics*

Macular pigment (MP) is composed of lutein, zeaxanthin, and meso-zeaxanthin, which accumulate mainly at the macula. MP has antioxidant function and can filtering blue wave. Measurement of MP is about its optical density, that is, macular pigment optical density (MPOD). This review summarizes the function and clinical use of MP and MPOD. Researches has show that MPOD is related to some ocular disease such as age-related macular degeneration, macular telangiectasia type 2, diabetic retinopathy, Stargardt disease et al. MPOD can be used in the judgment of clinical diagnosis, treatment effect. The specific mechanism of MP metabolism in the retina and in the pathogenesis of the disease, genotype specific nutritional therapy of xanthophyll, the establishment of a database combined with artificial intelligence and the rapid and convenient MP determination are all issues of great contention that need to be resolved.

Objective To explore the clinical characteristics of late-onset ornithine carbamoyltransferase deficiency (OTCD) in order to improve the clinicians' understanding of this disease.Methods The clinical,therapeutic and follow-up data of two patients with late-onset OTCD diagnosed in the Department of Neurology,Qilu Hospital of Shandong University from November 2017 to February 2018 were collected and analyzed.Results Case 1 is a 17-year-old male who was admitted into Qilu Hospital with recurrent dizziness and vomiting for 4 months,sudden mental abnormality and convulsion for 3 days.The liver dysfunction,respiratory alkalosis and hyperammonemia (434 μmol/L) had been found before his admission.His blood ammonia fluctuated obviously from 180 μ mol/L to 2998 μmol/L,though he was given hemodialysis and arginine infusion,and died on the fourth day after admission.Case 2 is a 15-year-old male,complained with recurrent dizziness,vomiting,bluntness and somnolence for 20 days.He was found with hyperammonemia (600 μmol/L) and liver dsyfunction in a local hospital.He was getting better after intravenous administration of arginine and liver protective drugs.After admission,the blood ammonia,liver function and amino acids,acylcarnitine profiling in dried blood spots,and organic acid analysis in urine were normal,and he has not recurred since restriction of protein diet.Brain magnetic resonane imaging of both patients showed cytotoxic edema of bilateral frontal lobe and insular cortex,and their genetic detection both showed c.119G＞A(p.R40H) hemizygous pathogenic mutation of OTC gene inherited from their respective mothers.Conclusion Unexplained hyperammonemia and acute encephalopathy with insular and frontal cortical involvement should be on the alert to the urea cycle disorders,especially OTCD.Early diagnosis and reasonable treatment are the key to changing the prognosis.

Heparin-induced thrombocytopenia (HIT) is a relatively infrequent complication of heparin administration. HIT can cause devastating thrombosis, making it one of the most serious adverse drug reactions encountered in clinical practice. We successfully treated a case of severe HIT presenting with thrombosis and life-threatening bleeding complications with intravenous immunoglobulin (IVIG), platelet transfusion and oral anticoagulant Rivaroxaban. In this case, we considered that IVIG played the most important role by preventing further thrombosis, increasing the platelet count, and ensuring the efficacy of Rivaroxaban. We therefore suggest that IVIG might be the optimal treatment for patients with this urgent condition.
Aged, 80 and over ; Female ; Heparin ; administration & dosage ; adverse effects ; Humans ; Immunoglobulins, Intravenous ; administration & dosage ; Platelet Transfusion ; Rivaroxaban ; administration & dosage ; Thrombocytopenia ; chemically induced ; therapy