Objective:To explore the effects of traditional Chinese medicine nursing protocols for type 2 diabetes mellitus on the level of frailty and self-management in patients with type 2 diabetes mellitus, so as to provide new ideas for intervention of diabetic frailty and improvement of self-management.Methods:From January 2021 to June 2021, the 100 patients with type 2 diabetes mellitus in the department of Endocrinology of the First Affiliated Hospital of Anhui University of Chinese Medicine were treated with the traditional Chinese medicine nursing protocols for type 2 diabetes mellitus issued by the State Administration of Traditional Chinese Medicine using the quasi experimental research method. General information questionnaire, Tilburg Frailty Indicator(TFI), Summary of Diabetes Self-Care Activities (SDSCA), Chinese-Diabetes Management Self-Efficacy Scale(C-DMSES) and the effect evaluation scale of traditional Chinese medicine nursing protocols for diabetes mellitus (type 2 diabetes mellitus) were investigated on 1 to 2 days after admission, at discharge, 3 months after discharge and were analyzed by t test, analysis of variance, SNK test. Results:The TFI scores of patients were (4.90 ± 2.44), (3.89 ± 1.99), (3.43 ± 2.22) points, the SDSCA scores were (41.31 ± 14.30), (57.90 ± 12.73), (52.33 ± 12.71) points, the C-DMSES scores were (128.99 ± 32.18), (154.69 ± 25.43), (141.27 ± 27.86) points, the effect scores of traditional Chinese medicine nursing protocols for type 2 diabetes mellitus were (13.40 ± 6.02), (6.98 ± 5.04), (5.01 ± 3.96) points at 1-2 days after admission, discharge, and 3 months after discharge, there were statistically significant differences among different time periods ( F values were 11.14-72.50, all P<0.05). The fasting blood glucose and 2-hour postprandial blood glucose of patients were (9.28 ± 3.51), (7.16 ± 1.66), (7.24 ± 1.76) mmol/L and (14.93 ± 4.22), (10.28 ± 4.83), (10.30 ± 2.25) mmol/L at 1-2 days after admission, discharge and 3 months after discharge, and the differences were statistically significant ( F = 21.02, 37.55, both P<0.05). Conclusions:The implementation of traditional Chinese medicine nursing protocols for type 2 diabetes mellitus can delay the degree of frailty of type 2 diabetes mellitus, improve the level of self-management of patients, help patients control blood glucose, with good traditional Chinese medicine nursing effect, worthy of clinical application.

Objective:To confirm the efficacy and safety of cinepazide maleate injection in acute ischemic stroke patients with obvious motor function deficit.Methods:This study is a subgroup analysis of multi-center, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial. A total 812 patients of acute ischemic stroke with obvious limb motor deficit [motor function of limbs score in National Institutes of Health Stroke Scale (NIHSS) ≥4] were enrolled in this subgroup analysis. Patients received either cinepazide maleate injection or placebo. The treatment period was 14 days and follow-up was 90 days. The efficacy endpoints included the proportions of patients with a modified Rankin Scale (mRS) score ≤2, mRS score ≤1 and Barthel Index <95 on day 90. Safety was evaluated by recording all adverse events, monitoring vital signs, laboratory parameters and electrocardiogram.Results:A total of 732 patients were involved in the final efficacy analysis (361 in cinepazide maleate group and 371 in control group). The baseline limb motor function score of NIHSS was 5.23±1.43 in the cinepazide maleate group whereas 5.20±1.36 in the control group. Logistic regression analysis showed that following treatment for 90 days, the proportion of patients with a mRS score ≤2 was significantly higher in the cinepazide maleate group than in the control group [56.0% (202/361) vs 44.2% (164/371), OR=0.60, 95% CI 0.44-0.82, P=0.002]. The proportion of patients with a mRS score ≤1 was higher in the cinepazide maleate group than in the control group [43.3% (139/361) vs 35.2% (118/371), OR=0.69, 95% CI 0.50-0.97, P=0.031]. The proportion of patients with a Barthel Index <95 on day 90 was significantly lower in the cinepazide maleate group than in the control group [45.2% (145/361) vs 55.2% (185/371), OR=0.64, 95% CI 0.46-0.88, P=0.007]. During the treatment and follow-up period, the incidence of the most common adverse events in the cinepazide maleate group was 50.4% (199/395). Constipation and abnormal liver function were more common, but there were no statistically significant differences between the two groups. Conclusion:Cinepazide maleate injection is superior to placebo in improving neurological function and activities of daily living, reducing disability, and promoting functional recovery and safe in patients with acute ischemic stroke with obvious limb motor deficit.

Objective:To investigate the blood pressure change in patients with acute ischemic stroke (AIS) and hypertension treated with cinepazide maleate injection.Methods:This was a subgroup analysis of post-marketing clinical confirmation study of cinepazide maleate injection for acute ischemic stroke: a randomized, double-blinded, multicenter, placebo-parallel controlled trial, which conducted in China from August 2016 to February 2019. Eligible patients fulfilled the inclusive criteria of acute anterior circulation ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores of 7-25. The primary endpoints were mean blood pressure of AIS patients treated with cinepazide maleate or control, which were assessed during the treatment period (14 days), and the proportion of the patients with normal blood pressure was analyzed after the treatment period. Furthermore, a subgroup analysis was performed to investigate a possible effect of the history of hypertension on outcomes.Results:This analysis included 809 patients with hypertension. There was no significant difference in patients blood pressure and the proportion of patients with normal blood pressure (60.5% vs. 59.0%, P>0.05) between cinepazide maleate group and control group. Conclusion:Administration of cinepazide maleate injection does not affect the management of clinical blood pressure in patients with AIS.

Rheumatic diseases, a typical kind of autoimmune disease, are often treated with glucocorticoids, immunosuppressants, biological agents, and small-molecule targeted drugs, which often leads to immune dysfunction in patients and increases the risk of activation of latent tuberculosis infection. To regulate the screening, diagnosis, and prophylactic treatment of latent tuberculosis infection in patients with rheumatic diseases, reduce the risk of developing active tuberculosis and improve the prognosis, Peking University Shenzhen Hospital, Shenzhen Third People′s Hospital and Peking Union Medical College Hospital jointly organized domestic experts in the field of rheumatology and tuberculosis to establish the expert consensus on the diagnosis and treatment of latent tuberculosis infection in patients with rheumatic diseases. This consensus focuses on epidemiology, the importance of screening, screening methods, and prophylactic anti-tuberculosis treatment strategies for latent tuberculosis infection combined with rheumatic diseases.

ObjectiveTo explore the characteristics of eye collaterals of patients with hepatic Wilson's disease （WD） and intervention effect of Gandouling （GDL） based on digital diagnosis information on eyes， in order to provide references for the clinical efficacy of GDL in the treatment of patients with hepatic WD. MethodEighty-two patients with hepatic WD （WD group） and 68 healthy volunteers （normal control group， NC） were enrolled. Eye images of all subjects were collected by the ophthalmoscope， followed by digital extraction of eye collateral characteristics. Differences in main eye collateral characteristics between the WD group and the NC group were analyzed. Pearson correlation test was used to analyze the eye collateral characteristics， serological indexes of liver damage ［alanine aminotransferase （ALT），aspartate transaminase （AST），and albumin （ALB）］， and Child-Pugh score in patients with hepatic WD. The 82 patients with hepatic WD were divided into a treatment group （42 cases） and a control group （40 cases）. All patients were treated with sodium 2，3-dimercapto-1-propane sulfonate （DMPS）， while those in the treatment group received additional GDL Tablets. One course of treatment contained eight days， and the treatment lasted six courses. The effects of GDL intervention on the levels of ALT，AST， and ALB，as well as the eye collateral characteristics score and Child-Pugh score were evaluated. Result① Compared with the NC group，the WD group had higher scores of "Qiu" （P<0.05） and "Xuemai" （P<0.05），which are the characteristics of eye collaterals. ② The levels of ALT and AST， and Child-Pugh score in patients with hepatic WD were positively correlated with the scores of "Qiu" and "vessel"，while the ALB level was negatively correlated with the "bulge" and "Xuemai" scores. ③ Compared with the conditions before treatment，the serum ALT and AST levels，Child-Pugh score，and the "Qiu" and " Xuemai " scores of the two groups were reduced （P<0.01），and the ALB levels were increased （P<0.01）. ④ Compared with the control group after treatment，the treatment group showed improved levels of ALT and ALB and the scores of "Qiu" and "Xuemai" （P<0.05）and better Child-Pugh score （P<0.01）. There was no significant difference in AST between the two groups. ConclusionCompared with healthy people，hepatic WD patients showed higher scores of "Qiu" and "Xuemai"， indicating that patients with hepatic WD were mainly characterized by dampness and heat，and the scores of "Qiu" and "Xuemai" were positively correlated with the severity of liver damage. Meanwhile，copper-expelling therapy combined with GDL can significantly improve the liver function of WD patients and improve the clinical efficacy.

To investigate the effectiveness and safety of ultrasound-guided microwave ablation (MWA) in treatment of primary hyperparathyroidism (PHPT). A total of 12 PHPT patients with parathyroid adenoma were treated with MWA in Nanjing University of Chinese Medicine Affiliated Hospital of Integrated Traditional Chinese and Western Medicine from May 2019 to February 2021. The patients were followed up once every 3 months for 3-12 months. Levels of serum parathyroid hormone (PTH), calcium and phosphorus were detected before and 20 min, 4h and 1day after ablation, and during follow-up period. The volume and volume reduction rate of parathyroid lesion were compared before the treatment and at the end of follow-up. The technical and clinical success of MWA were assessed as well. At the end of follow-up, median serum PTH [66.60 (42.21,80.03) ng/L vs.169.90 (89.01,396.50) ng/L] and calcium [2.39 (2.32,2.49) mmol/L vs. 2.75 (2.57,2.96) mmol/L] levels in 12 patients decreased significantly (all P<0.05). A complete response in terms of PTH and calcium levels was achieved in 6 of the 12 patients, while 4 of the patients had slightly elevated PTH levels just above the upper limit of normal reference range, and 2 of the patients remained abnormal PTH and calcium levels. The clinical cure rate was 50%. The volumes of all lesion after ablation were significantly decreased ( P<0.05), with the technical success rate reaching 92.3%. No serious complications were observed. Ultrasound-guided MWA, thus, is safe and effective in the treatment of PHPT.

Objective:To investigate the application value of triangular modal construed for planning approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 10 patients who underwent local laparoscopic resection of liver tumors located in superior part of central liver lobe at the Affiliated Hospital of Qingdao University from January to June 2020 were collected. There were 6 males and 4 females, aged from 41 to 63 years, with a median age of 54 years. Preoperative triangular model was constructed for all patients to plan approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe. Observation indicators: (1) preoperative general situations of patients; (2) surgical situations; (3) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect tumor recurrence and survival of patients up to February 2021. Measurement data with normal distribution were expressed as Mean± SD. Count data were expressed was absolute numbers. Results:(1) Preoperative general situations of patients: hepatocellular carcinoma was found in 7 cases, inthahepatic cholangiocarcinoma was found in 2 cases and ovarian cancer with liver metastasis was found in 1 case. Three cases had tumors located in S4a segment, 2 cases had tumors located in ventral subsegment of S8 segment, 2 cases had tumors located in dorsal subsegment of S8 segment, and 3 cases had tumors across the ventral segment of S4a+S8. The diameter of tumors was (3.4±1.0)cm. (2) Surgical situation: all the 10 patients underwent R 0 resection successfully, with no intraoperative blood transfusion or conversion to open surgery. The operation time of 10 patients was (149±59)minutes, the volume of intraoperative blood loss was (294±163)mL, the minimum surgical margin of specimen was (1.1±0.2)cm. The alanine aminotransferase was (324±151)U/L on the postoperative first day, the aspartic aminotransferase was (401±113)U/L on the postoperative first day, and the duration of postoperative hospital stay was (9±4)days. No bile leakage, hemorr-hage, reoperation or other complications occurred in all patients. (3) Follow-up: 10 patients were followed up for 7?13 months, with a median follow-up time of 11 months. All patients had no margin recurrence or distant metastasis. Conclusion:It is safe and feasible to construct triangular modal for planning approach of local laparoscopic resection of liver tumors located in superior part of central liver lobe.

Objective:To explore the significance of digital orthopedic technology in surgical plan for spinal tumor and the preliminary outcomes of 3D printed vertebral bodies in spinal tumor surgery.Methods:The clinical data of 2 patients were retrospectively analyzed who had had a 3D printed vertebral body implanted at Center of Orthopaedics, Shenzhen Hospital from June 2018 to December 2019. One was a 32-year-old male, diagnosed with cervical neurinoma; the other was a 27-year-old female, diagnosed with giant cell tumor of lumbar bone. 3D virtual reconstruction of tumor and surrounding structures was established via Mimics software for surgical plan. Virtual osteotomy was simulated, their disease models and guide templates were 3D printed, and their metal artificial vertebral bodies were 3D printed after personalized design of the vertebral body diameter, porosity and procedures of reconstruction and fixation. Lesion resection and prosthesis implantation were carried out in accordance with the preoperative plan. After operation, the motor function of cervical or lumbar vertebrae, tumor recurrence, and spinal stability reconstructed were regularly observed.Results:Resections and reconstructions went uneventfully in both cases. The 2 patients were followed up for 21 and 13 months respectively. Their postoperative images showed that their 3D printed vertebral bodies fitted the neighboring vertebral bodies well. The spinal stability was reconstructed without any loosening or periprosthetic osteolysis, and the tumors were removed completely with no recurrence in both cases. Their spinal motor function was satisfactory.Conclusions:Digital orthopedic technology can offer accurate guidance in the treatment of spinal tumors. It is necessary to consider local physiological anatomy in personalized design of a metal vertebral body 3D printed. Clinical application of 3D printed metal vertebral bodies is a new strategy for spinal reconstruction following spinal tumor resection.

Objective:To assess the efficacy and safety of cinepazide maleate injection in the treatment of patients with acute ischemic stroke.Methods:A multicenter, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial, led by Peking Union Medical College Hospital, was conducted in 65 Hospitals in China. The efficacy of cinepazide maleate injection in patients with acute anterior circulation cerebral infarction with onset time of ≤48 hours, 7≤National Institute of Health stroke scale (NIHSS) score ≤25 was assessed from August 2016 to February 2019, using the proportion of modified Rankin scale (mRS) score≤1 and Barthel index (BI) score≤95 on day 14 as efficacy endpoint. The patients were divided into treatment group who were treated with cinepazide maleate injection and control group who were treated with placebo.Results:A total 937 patients were involved in the final efficacy analysis (466 in treatment group and 471 in control group). The proportion of subjects with mRS score≤1 on day 14 after treatment were higher in the treatment group than that in the control group (102/466(21.89%) vs76/471(16.14%)). Logistic regression analysis showed that patients treated with cinepazide maleate were significantly more likely to have a favorable outcome (mRS score≤1) than patients treated with placebo on day 14 ( OR=0.677, 95% CI 0.484-0.948 , P=0.023), and patients treated with cinepazide maleate were more likely to reach independence in activities of daily living (Barthel Index ≥95) than those treated with placebo on day 14 (125/466(26.82%) vs 91/471(19.32%); OR=0.632, 95% CI0.459-0.869, P=0.005). The rate of adverse events was similar between the treatment and control groups. Conclusion:The 14-day treatment with cinepazide maleate injection could reduce the degree of disability whereas did not increase the risk of adverse events.

Acute pancreatitis (AP) is a common abdominal acute inflammatory disorder.Clinical manifestations of AP vary from self-limiting local inflammation to multiple organ failure causing significant mortality.At present,AP treatment methods mainly include non-surgical treatment such as fluid resuscitation and somatostatin,and minimally invasive or open surgical debridement treatment.Either treatment programs,nutritional support treatment is an essential part of them.According to the pathophysiological characteristics of AP onset,many scholars have emphasized that strategic nutritional support therapy is the key to limiting local inflammation,preventing and controlling AP-related complications.This article will provide an overview of the latest advances in nutritional support treatment of AP,including enteral and parenteral nutrition strategies in clinical treatment,and nutritional supplements such as glutamine,omega-3 fatty acids,vitamins and probiotics.