Objective To explore the medication rules of Professor Hua Baojin in the treatment of subsolid pulmonary nodules through retrospective analysis and data mining techniques. Methods The prescriptions of patients with subsolid pulmonary nodules who were diagnosed and treated by Professor Hua Baojin at Guang’anmen Hospital of the Chinese Academy of Chinese Medical Sciences from January 1, 2021 to December 31, 2024 were retrospectively collected. Data were imported into the Ancient and Modern Medical Case Cloud Platform for analysis of drug frequency, four natures and five flavors, meridian tropism, drug association, and hierarchical clustering. Results A total of 455 prescriptions were included, containing 205 kinds of traditional Chinese medicines, with a total frequency of 12048 times. Fifty-seven commonly used drugs were screened out, among which drugs with high frequencies included astragalus membranaceus (raw) and hawthorn fruit (charred). The nature of the drugs was mainly warm, cold, and neutral. The flavor of the drugs was mostly sweet, bitter, and pungent. The meridians they belonged to mainly included the lung, spleen, and liver meridians. Their efficacy was mainly tonifying deficiency, clearing heat, resolving phlegm, and relieving cough and asthma. Association analysis obtained 19 pairs of drug combinations, 21 groups of three-drug combinations, and four groups of four-drug combinations. Hierarchical clustering obtained 10 groups of drug combinations. Conclusion On the basis of the core pathogenesis of subsolid pulmonary nodule, Professor Hua applies the theory of regulating qi and detoxifying; regulating the qi of the liver, spleen, and lung; and detoxifying the toxins of phlegm and blood stasis, providing valuable experience for the clinical treatment of SSN.

Objective To explore the clinical information of female patients with pulmonary nodules and the distribution of traditional Chinese medicine (TCM) syndromes and their elements. Methods A cross-sectional study was conducted to collect the basic information, medical history data, image data, and four diagnostic information of female patients with pulmonary nodules. The distribution characteristics of TCM syndromes and their elements in female patients with pulmonary nodules were determined by KMO test, Bartlett spherical test, systematic cluster analysis, chi-square test, and other methods. Results A total of 721 female patients with pulmonary nodules were included in this study. The patients were mainly 45-59 years old, had secondary school education or above, and had a history of oil smoke exposure as clinical characteristics. The pulmonary nodules were mainly 6-10 mm in size and appeared as multiple and ground glass nodules. The clinical symptoms were mainly fatigue, emotional irritability, and shortness of breath. The main syndromes of disease location were the spleen, liver, and lung; and the main syndromes of disease were phlegm, dampness, and qi deficiency. The main complex syndromes were spleen deficiency and dampness, liver stagnation, and qi/yin deficiency. Conclusion Middle age, high education, and multiple small ground glass nodules are the clinical characteristics of female patients with pulmonary nodules. Exposure to oil smoke is an important cause of the occurrence of female pulmonary nodules. During treatment, attention should be paid to strengthening the spleen, removing dampness, soothing the liver, regulating and tonifying qi, and nourishing yin.

Acute postoperative pain and postoperative sleep disturbances are both major challenges in perioperative management,and they interact with each other.Acute pain can interfere with postoperative sleep,and sleep disturbances can lead to hyperalgesia and aggravate postoperative pain.At present,the in-teraction mechanism between the two is not clear,and there is also a lack of unified standards for prevention and control strategies.Therefore,this article reviews the research status of the definition,harmful effect,in-teraction mechanism,prevention,and management strategies of acute postoperative pain and postoperative sleep disturbances.We hope to provide valuable reference for the prevention and treatment of perioperative complications.

Objective To establish an ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)method for the detection of 34 prohibited and restricted pesticide residues in Atractylodes,and 21 batches of commercially available Atractylodes were detected to preliminarily investigate the pesticide residues in commercial Atractylodes.Methods The samples were extracted with pure acetonitrile,the extracts were purified by Waters-HLB 3cc(60 mg)solid phase extraction column,separated by Waters-C18 column,0.1%formic acid water(containing 10 mmol/L ammonium formate)and acetonitrile were used as mobile phases(gradient elution),and quantitatively analyzed by external standard method in multi-reaction monitoring positive ion mode according to the retention time.Results The linear relationship of each component was good in their respective concentration ranges,the correlation coefficients were all greater than 0.998 0.The limits of detection were within 0.8-4.0 μg/kg,and the limits of quantification were within 2.0-10.0 μg/kg.The average recovery rate was 74.1%-97.4%,and RSD was 0.6%-6.4%(n=9).Seven pesticide residues were found in 13 batches of 21 Atractylodes macrocephalus samples.Conclusion This method is simple to operate,accurate in quantification,has high recovery rate and good repeatability,and is suitable for the detection of multiple residues of prohibited and restricted pesticides in Atractylodes.

Objective : To explore the method of intraperitoneal injection of allogenic fecal filtrate to establish the rat model of moderate and severe sepsis． Methods: The preparation method of allogeneic fecal filtrate was determined．Allogeneic fecal filtrate of different concentrations (0. 5，1，2 g / kg) was injected intraperitoneally to observe the general situation，survival time and severe degree of sepsis of rats. After determining the optimal concentration，the success rate of the model，serum inflammatory factors，serum concentration of D-lactic acid ( D-LA) and serum intestinal fatty acid binding protein (I-FABP) ，lung function changes，lung，liver and kidney tissue injury were further observed. Results: After intraperitoneal injection of allogenic fecal filtrate for 24 h，the rats of 1 g / kg group presented fever，tachypnea and hypotension，the survival rate was 83. 3% at 24 h and 16. 7% at 48 h， 2 g / kg group rats all died within 24 h，the dose of 1 g / kg was determined for subsequent experiments．Injected fecal filtrate for 24 h，the success rate of the sepsis model was 77. 8% . The levels of interleukin-6 ( IL-6) ，tumor necrosis factor-α ( TNF-α) ，D-LA and I-FABP in serum significantly increased． There were severe edema and bleeding in lung tissue，Pulmonary function appeared respiratory dysfunction，included functional residual capacity (FRC) ，quasi static compliance ( Cdyn) ，forced expiratory volume for the first 100 milliseconds(FEV100) ，peak expiratory flow (PEF) decreased，airway resistance (RI) ，inspiratory capacity (IC) increased．Liver and kidney tissues also showed varying degrees of edema and inflammatory cell infiltration，the levels of alanine aminotransferase (ALT) ，aspartate aminotransferase (AST) ，blood urea nitrogen (BUN) and creatinine ( Cr) in serum significantly increased． Conclusion Intraperitoneal injection of allogenic fecal filtrate ( 1 g / kg) can produce a relative typical septic model in rats.

OBJECTIVE To build a standardized simulation teaching system for resident pharmacists and evaluate its effects， and to provide reference for improving the competency of resident pharmacists. METHODS The established simulation teaching system for pharmacy residents’ standardized training in the study included revising the simulation teaching syllabus， setting up simulation teaching courses， implementing the teaching method through “six types of simulations”， applying objective structured clinical examination （OSCE） for assessment， building a simulation teaching team and strengthening the simulation teaching management. The effect evaluation was perfermed with mixed research method， and qualitative and quantitative research methods were used to collect and analyze data and information. RESULTS ＆＆CONCLUSIONS Compared with the traditional teaching system， the passing rate of graduation examination （71.4% vs. 100%） and the score of after-department examination （[ 76.2±7.8） vs. （90.4±4.9）] under the simulation teaching mode were higher； through questionnaire surveys and qualitative interviews， we found that resident pharmacists who went through simulation teaching gave positive feedback on the role and impact of this system. The simulation teaching system can be used with good generalizability for the standardized training of resident pharmacists， and can provide strong basis and support for the high-quality development of hospital pharmacy.

Objective:To explore the effects of prenatal dexamethasone (DEX), postnatal pulmonary surfactant (PS) and respiratory support on the lung fluid clearance in premature rabbits at gestational age (GA) of 25-28 d (full term: 31 d) and their relationship with dynamic compliance of respiratory system (Cdyn), pulmonary morphology and other parameters.Methods:In our previous publications, premature rabbits were divided into four groups according to the intervention strategy: control group, PS-only group, DEX-only group and DEX+PS group in which data of several parameters including wet-to-dry lung weight ratio (W/D), Cdyn and volume density of alveoli (Vv) were retrieved and the lung tissue sections were scanned to recalculate the ratio of perivascular sheath to vascular sectional area (S/V) and lung injury scores-edema (LIS-E). W/D, LIS-E, S/V and Vv were adjusted for birth weight (BW) (divided by BW, represented as W/D/BW, LIS-E/BW, S/V/BW and Vv/BW) and mean Cdyn (Cdyn-m) was adopted. Based on the grouping of previous studies, the intervention groups in this study were divided as DEX group and non-DEX group, and PS group and non-PS group to analyze the influence of DEX and PS on the above parameters. Two independent samples t-test, one-way analysis of variance, LSD test, Kruskal-Wallis H test, Mann-Whitney U test and Pearson correlation analysis were used for statistical analysis. Results:A total of 196 newborn rabbits receiving mechanical ventilation after birth were included in this study. (1) Effects of DEX: compared with the non-DEX group, the DEX group showed increased W/D/BW (489±69 vs 421±113, t=－2.09), LIS-E/BW (188±57 vs 138±55, t=－2.61) and Vv/BW (20.1±4.9 vs 14.2±4.7, t=－3.60), but decreased S/V (0.33±0.23 vs 0.51±0.25, t=2.23) and S/V/W/D (0.05±0.03 vs 0.07±0.04, t=2.22) at 25 d of gestation; at 26 d of gestation, W/D/BW (472±76 vs 303±44, t=－8.75), LIS-E/BW (189±63 vs 106±36, t=－5.23), Cdyn-m [(0.16±0.07) vs (0.05±0.03) ml/(kg?cmH 2O), 1 cmH 2O=0.098 kPa; t=－7.29] and Vv/BW increased (22.4±5.0 vs 12.2±3.8, t=－7.46), while S/V (0.23±0.19 vs 0.62±0.38, t=4.10), S/V/BW (15.7±12.4 vs 25.7±17.3, t=2.20), S/V/W/D (0.03±0.03 vs 0.08±0.05, t=3.92) and propensity scores decreased [(12.5±1.2) vs (15.1±1.2) scores, t=7.00]; at 27 d of gestation, Cdyn-m increased [(0.23±0.12) vs (0.16±0.07) ml/(kg?cmH 2O), t=－2.43], but S/V (0.32±0.23 vs 0.57±0.39, t=2.57) and S/V/W/D decreased (0.05±0.04 vs 0.09±0.06, t=2.55); at 28 d of gestation, W/D/BW (270±64 vs 162±33, t=－8.09), LIS-E/BW (72±32 vs 35±20, t=－5.17), S/V (0.90±0.60 vs 0.59±0.48, t=－2.81), S/V/BW (34.0±23.6 vs 15.2±12.7, t=－3.77) and Vv/BW increased (16.9±4.3 vs 9.2±2.9, t=－8.04); the differences were all statistically significant (all P<0.05). (2) Effects of PS: compared with the non-PS group, the PS group had decreased LIS-E/BW at 25, 26 and 27 d of gestation, increased Cdyn-m and Vv/BW at 25 and 27 d of gestation and higher propensity scores at 25 d of gestation (all P<0.05). (3) The correlation between gestational age and each index: gestational age was positively correlated with S/V ( r=0.31, P<0.05), but negatively correlated with W/D/BW and LIS-E/BW ( r=－0.73 and－0.63, both P<0.05). Conclusions:The pharmacological action of prenatal DEX on lung fluid clearance is mainly confined to preterm rabbits at the GA of 28 d which is supported by mechanical ventilation. Prenatal treatment with DEX and/or postnatal PS can improve the early respiratory function in preterm rabbits between GA of 25-27 d, but had no substantial impact on lung fluid clearance. The GA-related lung maturation appears to play a crucial role, in comparison with medications, in lung fluid clearance.

ATP-binding cassette (ABC) transporters are the largest transporter families in human bodies; they are widely distributed and have complex functions. ABC transporters can mediate the translocation of various substrates on the cell membrane. This paper summarizes the structure, classification, function and action mechanism of ABC transporters and the research progress of ABC transporters in AD in recent years, and discusses the future research direction for preventing and treating AD in this field to provide new ideas and references for the prevention and treatment of AD.

In recent years, although the quantity of organ donation after citizen's death has been constantly increased, a large number of patients with end-stage renal diseases are waiting for kidney transplantation every year. The imbalance between donor and recipient is still one of the main problems affecting kidney transplantation in clinical practice. Therefore, it is of clinical significance to accurately evaluate the quality of donor kidney and fully utilize the expanded criteria donor kidney. Contrast-enhanced ultrasound has been gradually applied in the detection of multiple solid organs due to its safety, portability, real-time detection, quantification and other characteristics, and it also has promising application prospect in the evaluation of donor kidney quality. In this article, the advantages and limitations of current evaluation methods for donor kidney and current status and advantages of contrast-enhanced ultrasound in donor kidney evaluation were reviewed, and the application prospect of contrast-enhanced ultrasound in the evaluation of donor kidney quality was discussed, aiming to increase the methods and enhance the accuracy for donor kidney evaluation, and provide reference for rational use of expanded criteria donor kidney.

Objective:To evaluate the value of the crescent sign for predicting the invasiveness of lung adenocarcinoma presenting as pure ground-glass nodule (pGGN).Methods:The clinical, pathological and imaging data of 316 patients (320 pGGNs) confirmed lung adenocarcinoma by surgery and pathology from July 2013 to June 2018 in the First Affiliated Hospital of Wenzhou Medical University were retrospectively analyzed. All pGGNs were divided into preinvasive group (148 pGGNs) and invasive group (172 pGGNs) according to histopathology. Logistic regression analysis was used to determine the risk factors for invasiveness of pGGN, and the ROC curve analysis was performed on each risk factor.Results:Crescent sign was found in 24 cases (16.2%) in the preinvasive group and 49 (28.5%) in the invasive group, and the difference between the two groups was statistically significant (χ2=6.804 ,P=0.009).There were statistically significant differences in patient′s age, lesion size, shape, lobulation sign, and vascular stretch sign between the two groups ( P<0.05). The ROC curve showed that with the lesion size 10.5 mm as the optimal cut off value, the sensitivity for differential diagnosis of preinvasive and invasive lesions was 65.7%, the specificity was 61.5%, and the area under the curve was 0.666. Logistic regression analysis showed that maximum diameter of the lesion ≥10.5 mm, irregular shape, crescent sign and vascular stretch were independent risk factors of invasiveness of pGGN, and the OR value (95%CI) were 3.192 (1.981-5.144), 3.672 (1.545-8.725), 1.972 (1.104-3.521), and 2.026 (1.087-3.777), respectively. A logistic model was established based on the above four independent risk factors, and the area under curve was 0.711 (95%CI 0.655-0.768). Conclusion:Crescent sign can effectively reflect the invasiveness of pGGN. Maximum diameter of the lesion ≥10.5 mm, irregular shape, crescent sign and vascular stretch sign are independent risk factors of invasiveness of pGGN.