This study analyzed and reported the basic information and clinical evidence of Chinese patent medicines for digestive system diseases in children in a scoping review manner. Based on the drug instructions, the basic information of Chinese patent medicines for digestive system diseases in children was obtained by searching the three lists of national medicines. At the same time, the relevant clinical literatures from the first day of establishment to March 7, 2022 were obtained from Chinese and English databases. According to the screening criteria, 39 Chinese patent medicines were included, involving 8 dosage forms. Eight Chinese medicines including Crataegi Fructus, Poria, Citri Reticulatae Pericarpium, Hordei Fructus Germinatus, Arecae Semen, Massa Medicata Fermentata, Dioscoreae Rhizoma, and Atractylodis Macrocephalae Rhizoma were frequently used, and the main effects were invigorating spleen, checking diarrhea, promoting digestion, clearing heat, and harmonizing stomach. The indications for Chinese patent medicines were mainly diarrhea, anorexia, food accumulation, dyspepsia, and rotavirus enteritis in children. Among all drug instructions, only 4 mentioned adverse reactions and 6 mentioned contraindications. Ninety-two clinical studies were included ultimately, including 84 randomized controlled studies, 2 systematic reviews/Meta-analysis, 1 retrospective study, and 5 case series. The literatures only covered 21 kinds of Chinese patent medicines, with the most studies related to Xingpi Yanger Granules, accounting for 32.6% of the total literature volume. The sample size in the literatures was mainly focused on 51-200 cases, and 51-100 cases were selected by the most literatures, accounting for 34.45%. The interventions of the experimental group were mainly Chinese patent medicines or Chinese patent medicines combined with western medicines. The literatures with treatment course of 0-7 d accounted for the largest proportion(51.10%). The effective rate and symptom improvement time were used as the indexes to evaluate the results. The main adverse reactions were vomiting, constipation, nausea, rash, cold, diarrhea, redness of the skin around the umbilicus, or red itchy skin. The analysis of this study found that Chinese patent medicines have good curative effect and research prospects in the treatment of digestive system diseases in children. However, most clinical evidence has problems, such as limited indexes to evaluate the results, lack of traditional Chinese medicine characteristics, uneven quantity and low quality of Chinese patent medicine literatures, and insufficient specification of instructions. In the future, high-quality clinical studies on this field should be actively carried out, and economic studies and clinical comprehensive evaluation of Chinese patent medicines should be strengthened to explore the characteristics and advantages of its treatment, so as to provide decision-making basis for finding the accurate clinical positioning and promoting the rational clinical application of Chinese patent medicines for treating digestive system diseases in children.
Child ; China ; Diarrhea/drug therapy* ; Digestive System Diseases/drug therapy* ; Drugs, Chinese Herbal/adverse effects* ; Humans ; Medicine, Chinese Traditional ; Nonprescription Drugs/adverse effects* ; Retrospective Studies

Climate change has been referred to as one of the greatest threats to human health, with reports citing likely increases in extreme meteorological events. In this study, we estimated the relationships between temperature and outpatients at a major hospital in Qingdao, China, during 2015-2017, and assessed the morbidity burden. The results showed that both low and high temperatures were associated with an increased risk of outpatient visits. High temperatures were responsible for more morbidity than low temperatures, with an attributed fraction (AF) of 16.86%. Most temperature-related burdens were attributed to moderate cold and hot temperatures, with AFs of 5.99% and 14.44%, respectively, with the young (0-17) and male showing greater susceptibility. The results suggest that governments should implement intervention measures to reduce the adverse effects of non-optimal temperatures on public health-especially in vulnerable groups.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ambulatory Care/statistics & numerical data* ; Cardiovascular Diseases/therapy* ; Child ; Child, Preschool ; China/epidemiology* ; Cold Temperature/adverse effects* ; Cost of Illness ; Digestive System Diseases/therapy* ; Facilities and Services Utilization/statistics & numerical data* ; Female ; Hot Temperature/adverse effects* ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Poisson Distribution ; Respiratory Tract Diseases/therapy* ; Risk Factors ; Young Adult

OBJECTIVE: To find the pathogenies and risk factors related to surgical intensive care unit (SICU) readmission for patients who underwent hepatobiliary-pancreatic surgery, and to develop a predictive model for determining patients who are likely to be readmitted to SICU. METHODS: The patients who admitted to SICU of the Affiliated Hospital of Qingdao University from January 2013 to August 2018; who first stayed in SICU after hepatobiliary-pancreatic surgery; who were assessed and discharged from SICU by surgeons and SICU physicians after treatment, and then transferred to SICU again because of the change of their condition were enrolled. The unintended return to SICU within 3 days and 7 days were recorded. Patients who returned to SICU within 7 days were studied for the pathogenies, risk factors and predictive model of returning to SICU, and non-returning patients were enrolled according to 1:1 as the controls. A total of 43 indicators were divided into five categories, including general clinical data, medical history, surgical indicators before first admission of SICU, length of first SICU stay, and other indicators on the day of first discharge from the SICU. Logistic regression was used to screen the risk factors associated with SICU readmission, then the Nomogram diagram was drawn by using the R 3.4.1 software for predicting SICU readmission, and the classification performance of Nomogram was evaluated by self-help sampling test. RESULTS: Of the 763 patients discharged from the SICU, 2.10% (16/763) of them were readmitted within 3 days and 3.28% (25/763) were readmitted within 7 days to the SICU unexpectedly. The pathogenies of SICU readmission within 7 days included infection [56.00% (14/25)], heart failure [16.00% (4/25)], infarction [12.00% (3/25)], bleeding [12.00% (3/25)], and sutures splitting [4.00% (1/25)]. The pathogenies of SICU readmission within 3 days included infection [56.25% (9/16)], heart failure [18.75% (3/16)], infarction [12.50% (2/16)], and bleeding [12.50% (2/16)]. Nomogram analysis showed that the risk factors associated with unplanned SICU readmission were length of first SICU stay, history of hypertension, and activity of daily living (ADL) score, white blood cell count (WBC), arterial partial pressure of oxygen (PaO₂), prothrombin time (PT), fibrinogen (FIB) on the day of first SICU discharge. Self-help sampling test was carried out on the Nomogram map, and the results showed that the coherence index (C-index) was 0.962 [95% confidence interval (95%CI) = 0.869-1.057]. The classification performance of the model was good. CONCLUSIONS The common pathogenies of SICU readmission for patients who underwent hepatobiliary-pancreatic surgery were infection, heart failure, infarction and bleeding. Risk factors of readmission after SICU discharge included the length of first SICU stay, history of hypertension, and ADL score, WBC, PaO₂, PT, FIB on the day of first SICU discharge. The model consisted of above risk factors showed a good performance in predicting the probability of readmission after SICU discharge for patients who underwent hepatobiliary-pancreatic surgery.
Biliary Tract Diseases/surgery* ; Digestive System Surgical Procedures/adverse effects* ; Humans ; Intensive Care Units ; Liver Diseases/surgery* ; Models, Statistical ; Pancreatic Diseases/surgery* ; Patient Readmission/statistics & numerical data* ; Postoperative Complications/therapy* ; Risk Factors

Duodenal injury is a serious abdominal organ injury. Duodenal fistula is one of the most serious complications in gastrointestinal surgery, which is concerned for its critical status, difficulty in treatment and high mortality. Thoracic and abdominal compound closed injury and a small part of open injury are common causes of duodenal injury. Iatrogenic or traumatic injury, malnutrition, cancer, tuberculosis, Crohn's disease etc. are common causes of duodenal fistula, however, there has been still lacking of ideal diagnosis and treatment by now. The primary treatment strategy of duodenal fistula is to determine the cause of disease and its key point is prevention, including perioperative parenteral and enteral nutrition support, improvement of hypoproteinemia actively, avoidance of stump ischemia by excessive separate duodenum intraoperatively, performance of appropriate duodenum stump suture to ensure the stump blood supply, and avoidance of postoperative input loop obstruction, postoperative stump bleeding or hematoma etc. Once duodenal fistula occurs, a simple and reasonable operation can be selected and performed after fluid prohibition, parenteral and enteral nutrition, acid suppression, enzyme inhibition, anti-infective treatment and maintaining water salt electrolyte and acid-base balance. Double tube method, duodenal decompression and peritoneal drainage can reduce duodenal fistula-related complications, and then reduce the mortality, which can save the lives of patients.
Abdominal Injuries ; complications ; Anti-Infective Agents ; therapeutic use ; Decompression, Surgical ; Digestive System Surgical Procedures ; adverse effects ; methods ; Drainage ; Duodenal Diseases ; diagnosis ; etiology ; prevention & control ; therapy ; Duodenum ; blood supply ; injuries ; surgery ; Enteral Nutrition ; Humans ; Hypoproteinemia ; therapy ; Intestinal Fistula ; diagnosis ; etiology ; prevention & control ; therapy ; Ischemia ; prevention & control ; Nutritional Support ; Parenteral Nutrition ; Postoperative Complications ; prevention & control ; therapy ; Suture Techniques ; Thoracic Injuries ; complications

Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system. A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases, i.e. PubMed, Excerpt Medica Database, China Biology Medicine disc and China National Knowledge Infrastructure. However, no relevant study on the subjects of interest was identified. Therefore, drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine, we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial. Further, we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders. Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research. The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.
Digestive System Diseases ; diagnosis ; therapy ; Evidence-Based Medicine ; Humans ; Medical Records ; Medicine, Chinese Traditional ; Narration ; Physicians

The incidence of inflammatory bowel disease in China is rising on a yearly basis, followed by an increased number of patients who require surgery and those who suffer from maneuver postoperative complications. Surgical treatment is important in the management of patients with inflammatory bowel diseases. Management and prevention of postoperative complications is also a key factor to the success of surgical treatment if it is not more important than the surgical procedure itself. In this article, the most recent literatures in this field will be reviewed combined with our own clinical experiences. The types, risk factors, preoperative prevention strategies as well as postoperative management of surgical complications of patients with inflammatory bowel disease will be discussed.
China ; Digestive System Surgical Procedures ; adverse effects ; Humans ; Incidence ; Inflammatory Bowel Diseases ; surgery ; Postoperative Complications ; prevention & control ; therapy ; Risk Factors

To explore the status of two-week illness in primary and secondary students and to provide the basis for rationally distributing heath resources in primary and secondary schools.
 Methods: Stratified cluster sampling method was used to select 6 744 primary and secondary students aged from 9.0-16.9 years, and the name or symptoms of two-week illness, frequencies, medical expenses and days of sick leave were surveyed by using the self-made questionnaires.
 Results: Respiratory system disease (73.6%) and digestive system diseases (13.2%) were the major two-week illness. When they were ill, 58.9% students went to hospital, 39.9% took medicine by themselves, and 1.2% received non-treatment. The two-week morbidity, sick frequencies, average medical expenses per time and days of sick leave were 12.6%, (1.34±0.81) times, 10.0 yuan, and (0.39±0.98) days, respectively. The two-week sick frequencies, average medical expenses per time and days of sick leave among primary or secondary students were (1.37±0.87) or (1.26±0.69) times, 12.0 or 9.0 yuan, and (0.44±1.14) or (0.30±0.55) days, respectively. There was a positive correlation between two week sick frequencies and medical fees per time, or days of sick leave (r=0.301, r=0.275 for primary students, respectively, P<0.01; r=0.334, r=0.290 for secondary students, respectively, P<0.01). The positive correlation between medical fees per time and days of sick leave was also found (r=0.312, r=0.343 for primary students and secondary students, respectively, P<0.01).
 Conclusion: Characteristics of two-week illness among primary and secondary students possess common symptoms, frequent, low medical expenses per time. The frequencies, medical expenses and days of sick leave in primary students were increased compared with that in secondary students.
Adolescent ; Child ; Digestive System Diseases ; epidemiology ; therapy ; Fees, Medical ; statistics & numerical data ; Female ; Humans ; Male ; Respiratory Tract Diseases ; epidemiology ; therapy ; Schools ; Sick Leave ; statistics & numerical data ; Students ; Surveys and Questionnaires

BACKGROUND/AIMS: In pediatrics, endoscopic examination has become a common procedure for evaluation of gastrointestinal presentations. However, there are limited data on pediatric endoscopy in Korea. The aim of this study was to analyze the current status and clinical impacts of endoscopic examination in children and adolescents. METHODS: We retrospectively reviewed the medical records of outpatients who visited the tertiary hospital. Patients under 18 years of age who underwent endoscopy were included. Endoscopic findings were classified as specific and normal based on gross findings. Specific endoscopic findings were reflux esophagitis, peptic ulcers, and Mallory-Weiss tear. Other findings included acute gastritis classified according to the updated Sydney system. RESULTS: In 722 of 330,350 patients (0.2%), endoscopic examination (554 esophagogastroduodenoscopies [EGDs], 121 colonoscopies, 47 sigmoidoscopies) was performed between January 2008 and January 2013. In EGD, abdominal pain was the most frequent presentation (64.1%). The most common diagnosis was gastritis (53.2%), followed by reflux esophagitis. The frequency of peptic ulcer disease was 12.8%. Frequent symptoms leading to colonoscopic examination were abdominal pain, diarrhea, and hematochezia. In colonoscopy, a negative result was more likely in children younger than 7 years old. After the procedure, the diagnostic yield of EGD and colonoscopy was 88.1% and 45.8%, respectively, and the rate of change in management was 67.1%. CONCLUSIONS: In pediatrics, endoscopic examination was useful for the choice of therapeutic strategy and it would be a standard method for evaluation of gastrointestinal presentation.
Abdominal Pain ; Adolescent ; Child ; Child, Preschool ; *Endoscopy, Digestive System ; Esophagitis, Peptic/diagnosis/drug therapy ; Female ; Gastritis/diagnosis/drug therapy ; Gastrointestinal Hemorrhage/diagnosis ; Histamine H2 Antagonists/therapeutic use ; Humans ; Infant ; Infant, Newborn ; Inflammatory Bowel Diseases/diagnosis ; Male ; Peptic Ulcer/diagnosis/drug therapy ; Proton Pump Inhibitors/therapeutic use ; Republic of Korea ; Retrospective Studies ; Tertiary Care Centers

Congresses as Topic ; Digestive System Diseases ; diagnosis ; therapy ; Humans ; Integrative Medicine

Liver dysfunction by various reasons can cause metabolic disorders of a variety of nutrients and malnutrition, while malnutrition affects the recovery of liver function. Clinically patients undergoing gastrointestinal surgery are often accompanied with malnutrition, and these patients with liver dysfunction are easy to develop nutrient metabolic disorders. Therefore, improving the nutritional status of patients with liver dysfunction can improve the success rate of surgery and postoperative recovery. This article reviews the nutritional support in patients with liver dysfunction undergoing gastrointestinal surgery.
Digestive System Surgical Procedures ; Gastrointestinal Diseases ; surgery ; Humans ; Liver Diseases ; physiopathology ; therapy ; Nutritional Status ; Nutritional Support ; Postoperative Care ; Postoperative Period ; Preoperative Care