AIM: To evaluate the risk of drug-related dysphagia in elder people based on the FDA Adverse Event Reporting System (FAERS). METHODS: We collected the reports of dysphagia in elder people (Age≥65) from 2004 quarter 1 through 2022 quarter 2 of FAERS by Open Vigil 2.1 database. The reported odds ratio (ROR) and the proportional reported ratio (PRR) were calculated to detect the adverse reaction signal of drug-induced dysphagia in elder people. Signal generation standard of ROR: number of reports≥3 with the lower limit of 95% confidence interval (CI) of the ROR value>1, PRR≥2 and c

Objective To investigate the anatomical classification of left intrahepatic bile duct (LHD) and the pattern of bile duct reconstruction during pediatric split liver transplantation and their relationship with postoperative biliary complications. Methods Clinical data of 75 pediatric recipients undergoing split liver transplantation were analyzed retrospectively. Before splitting the donor liver, iopromide injection was used for retrograde cholangiography through the common bile duct. According to the patterns of intrahepatic bile ducts in the second, third and fourth segments, the anatomical classification of LHD of the donor liver was determined. The biliary reconstruction regimens for different classification types of LHD were summarized. The incidence and treatment of biliary complications after pediatric split liver transplantation were analyzed. Results Among 75 donor livers, the anatomical classification of LHD included 57 cases (76%) of type Ⅰ, 9 cases (12%) of type Ⅱ, 4 cases (5%) of type Ⅲ and 5 cases (7%) of type Ⅳ LHD, respectively. Among 75 pediatric recipients, 69 cases (53 cases of type Ⅰ, 8 type Ⅱ, 4 type Ⅲ and 4 type Ⅳ) underwent the left hepatic duct-jejunum Roux-en-Y anastomosis, 1 case received common bile duct-jejunum Roux-en-Y anastomosis (type Ⅳ), and 5 cases underwent the left hepatic duct-common bile duct end-to-end anastomosis (4 cases of type Ⅰ and 1 type Ⅱ). Postoperative biliary complications occurred in 6 cases (8%), including 3 cases of biliary anastomotic stenosis, 2 cases of biliary anastomotic leakage and 1 case of bile leakage on the hepatic resection surface. Among 6 recipients, 4 cases were classified as type Ⅰ and 2 cases of type Ⅲ LHD. No significant difference was observed in the incidence of biliary complications between typical type and anatomical variant type of LHD (all P > 0.05). Among 3 recipients with biliary anastomotic stenosis, 2 cases underwent percutaneous transhepatic cholangial and drainage (PTCD) and 1 case repeatedly received biliary-intestinal anastomosis. Two cases of biliary anastomotic leakage underwent PTCD and 1 case of bile leakage on the hepatic resection surface received local drainage. All 6 children survived after treatment. Conclusions Anatomical variation of LHD can be observed in 24% of donor livers, and type Ⅱ accounts for the highest proportion of 12%. Prior to donor liver splitting, routine cholangiography and fine biliary anastomosis may effectively lower the incidence of biliary complications. The incidence of postoperative biliary complications is not significantly associated with the anatomical classification of LHD.

AIM: To measure medication consumption and the prevalence of potentially inappropriate medications (PIMs) during hospitalization and hospital discharge in the geriatric condition of frailty and to provide bases for rational medications use and further deprescribing. METHODS: A clinical data questionnaire, including the basic situation of patients and medications was designed. Charlesson comorbidity index was used to determine the patient's burden and status and the number of medication consumption in the geriatric condition of frailty. The medication consumption was determined by examining Hospital Medication Administration Records. PIMs were defined using STOPPFrail deprescribing criteria and McLeod criteria, whose sensitivity was compared to determine the PIMs independent related factors. RESULTS: This study included 169 patients. The mean age of participants was 83.49±6.73, 42.6% were female. The median number of days spent in hospital was 19 (interquartile range (IQR)12-33). During the first 24 hours of hospitalization, the mean number of individual medications consumed was 9.01 (standard deviation 4.12). Of hospital discharge, the mean number of individual medications consumed was 11.27 (standard deviation 4.57). Over 60% of patients were prescribed at least one PIM at discharge and 7.69% had ≥3 PIMs. Leukotriene antagonists, proton pump inhibitors (PPIs), lipid-lowering medications and diabetic oral agents accounted for major PIMs. Compared with McLeod's criteria, STOPPfrail criteria was a more sensitive tool for 24-hour hospitalization and hospital discharge PIMs screening (t=6.78, P=0.00<0.01; t=10.10, P=0.00<0.01). Full implementation of STOPPFrail recommendations would have resulted in one-in-seven long-term medications being discontinued. CONCLUSION: High levels of medication consumption in the geriatric condition of frailty will result in high burden experienced by patients in the condition of frailty and continued prescribing of futile medications. It is necessary to improve and pay more attention to the safety of medications. The STOPPFrail criteria is highly sensitive, simple and easy to use. Screening for medication consumption in geriatric condition of frailty with STOPPFrail tool will decrease medication burden.

OBJECTIVETo analyze the diseases and effects of the manipulations to promoteby filiform needles, with the help of data mining technique.

METHODSLiterature about different manipulations to promoteby filiform needles in recent 60 years was collected in China National Knowledge Infrastructure(CNKI). Then databases were established to mine the relativities among the diseases, subjects, acupoints selection law,routes and directions of meridianand effects.

RESULTS①Total 489 articles were included. The basic manipulations with the frequency of 630 were on the top. The auxiliary and four methods ofrespectively appeared 70 times. The diseases in the internal medicine were treated with the basic and auxiliary methods of the higher frequencies, 311 and 44 times separately. While the four methods ofwere mostly used in the surgical area, 37 timestotally. ②The diseases treated from high to low by lifting, thrusting and twirling represented retention of urine, sequelae of stroke, pain in waist and lower limbs, of which the effect for retention of urine was better than those of the other two, and the lifting and thrusting method was superior to twirling. ③As for the auxiliary methods, 25 times were found about vibration needling; 18 times, twisting. The highest frequency of 6 times for the vibration needling was on the sequelae of stroke; while 4 times for the twisting, stranguria. ④As to the four methods of,was most frequently applied, and its highest frequency of 18 was onsyndrome.

CONCLUSIONSManipulations to promoteby filiform needles are crucial to achieving the effects of acupuncture. The basic methods are widely used in clinic and have been seen good efficacy. While the auxiliary means assist to promoteto stimulate the body,among which the four methods ofare mainly to smooth the meridians and driveof patients with surgical diseases and take meridian blocking the priority.

Combining with the data based on data mining,to collect the clinical experimental research ralating to thermal moxibustion from June 2010 to March 2015, and extract the representative clinical experimental research of clinical diseases. To summarize advances in clinic study of Thermal Moxibustion in recent five years.