ObjectiveThis study employed the scoping review method to systematically retrieve and analyze the basic information and clinical research evidence of expensive Chinese patent medicines （CPMs）， aiming to provide a basis for future related research and clinical applications. MethodsEight Chinese and English databases were systematically searched for the clinical research evidence on expensive CPMs. ResultsEleven expensive CPMs （Angong Niuhuang Wan， Jufang Zhibao Wan， Suhexiang Wan， Pien Tze Huang， Niuhuang Qingxin Wan， Qinggong Shoutao Wan， Compound Realgar Natural Indigo Tablets， Xihuang Wan， Dingkun Wan， Babao Wan， and Guilingji Capsules） were selected. A total of 365 related studies were included in this review， comprising 331 clinical studies （of which 291 were randomized controlled trials）， 30 systematic reviews and Meta-analyses， 3 expert consensus， and 1 rapid health technology assessment. Among the 11 CPMs， 2（Angong Niuhuang Wan and Jufang Zhibao Wan） had a daily price over 500 yuan. The famous and precious Chinese medicinal materials involved included Moschus （frequency of 7）， Bovisc Alculus （7）， and Borneol （5）. The dosage forms included pills， capsules， oral liquid， tablets， and lozenges. The diseases treated by these CPMs mainly included malignant tumors， cerebrovascular diseases， gynecological diseases， and hepatobiliary system diseases. The sample sizes of the clinical studies were mainly concentrated within the range of 51-100 cases， and the main control form was CPM + basic Western medicine treatment vs. basic Western medicine treatment. The 331 clinical studies reported a total of 44 adverse events occurred， of which 36 were determined to be adverse reactions. ConclusionThe scarcity of raw materials leads to the high prices of expensive CPMs. The difficulty of conducting clinical research and the critical and severe cases treated lead to a lack of clinical research evidence with large sample sizes. The uneven distribution of existing studies， incomplete information on medicine package， and non-standard clinical research designs remain to be addressed in the future.

POEMS syndrome is a rare condition associated with plasma cell disorders， and it often involves multiple systems and has diverse clinical manifestations. This article reports two cases of POEMS syndrome with hepatosplenomegaly as the initial manifestation. During the course of the disease， the patients presented with lower limb weakness， hepatosplenomegaly， lymph node enlargement， ascites， hypothyroidism， positive M protein， and skin hyperpigmentation， and ¹⁸F-FDG PET-CT imaging revealed bone lesions mainly characterized by osteolytic changes and plasma cell tumors. There was an increase in the serum level of vascular endothelial growth factor. The patients were finally diagnosed with POEMS syndrome， and the symptoms were relieved after immunomodulatory treatment.

Purpose: This research observed the efficacy and safety of soft tissue expansion combined with recombinant human epidermal growth factor (rhEGF) in repairing second-degree scald scars. Methods: This study conducted a prospective, single-blind, randomized controlled trial. Eighty-four patients with deep second-degree scald scars were evenly divided into the control and observation groups. The control group was treated with soft tissue expansion, and the observation group was additionally treated with rhEGF. The skin expansion and wound healing times were compared. The changes in wound exudate and inflammation around the wound were observed after first-stage surgery. The hydroxyproline (OHP) and collagen I/III ratios were compared during the second stage of surgery.The complications and repair effects during treatment were evaluated. Results: The observation group exhibited lower expansion time, immediate retraction rate, and wound healing time, higher skin expansion rate, higher wound exudate score and inflammation score, higher OHP, lower collagen I/III, lower complication rate, and higher total effective rate than the control group (all P < 0.05). Conclusion Skin soft tissue expansion combined with rhEGF is more effective in repairing second-degree scald scars, which can effectively increase skin expansion area and reduce wound infection and complications.

Purpose: This research observed the efficacy and safety of soft tissue expansion combined with recombinant human epidermal growth factor (rhEGF) in repairing second-degree scald scars. Methods: This study conducted a prospective, single-blind, randomized controlled trial. Eighty-four patients with deep second-degree scald scars were evenly divided into the control and observation groups. The control group was treated with soft tissue expansion, and the observation group was additionally treated with rhEGF. The skin expansion and wound healing times were compared. The changes in wound exudate and inflammation around the wound were observed after first-stage surgery. The hydroxyproline (OHP) and collagen I/III ratios were compared during the second stage of surgery.The complications and repair effects during treatment were evaluated. Results: The observation group exhibited lower expansion time, immediate retraction rate, and wound healing time, higher skin expansion rate, higher wound exudate score and inflammation score, higher OHP, lower collagen I/III, lower complication rate, and higher total effective rate than the control group (all P < 0.05). Conclusion Skin soft tissue expansion combined with rhEGF is more effective in repairing second-degree scald scars, which can effectively increase skin expansion area and reduce wound infection and complications.

ObjectiveTo explore the clinical characteristics and risk factors for 30-day mortality in hospitalized patients with bloodstream infections (BSI) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). MethodsData were obtained retrospectively from the electronic medical records of inpatients at a tertiary A-grade hospital in Shanghai from January 2016 to December 2023. The collected variables included age, gender, department, surgical treatment, empirical antibiotic therapy, Pitt Bacteremia score (PBS), Charlson comorbidity index (CCI), INCREMENT-CPE score (ICS), length of hospital stay, the time from CRKP-BSI to discharge and, etc. The follow-up period ended upon discharge, with the follow-up outcomes defined as in-hospital mortality or discharge. The endpoint was defined as death within 30 days (including day 30) caused by CRKP-BSI or infection-related complications. Patients who survived within 30 days after CRKP-BSI were classified into the survival group, while those who died within 30 days were classified into the death group. Independent risk factors for 30-day mortality in patients with CRKP-BSI were analyzed using univariate and multivariate Cox regression analysis. ResultsA total of 71 hospitalized patients with CRKP-BSI, comprising 51 males and 20 females, with an average age of (65.12±18.25) years, were included during the study period. The M (P₂₅, P₇₅) of hospital stay were 37.00 (24.00, 56.00) days, and M (P₂₅, P₇₅) of the duration from CRKP-BSI to discharge or death were 18.00 (7.00, 35.00) days. There were 20 deaths (28.17%) in the death group and 51 survivors (71.83%) in the survival group. The results of multivariate Cox regression analysis showed that the ICS as an independent risk factor for 30-day mortality in CRKP-BSI patients (HR=1.379, 95%CI: 1.137‒1.671, P=0.001). Each 1-point increase in the ICS was associated with a 37.9% increase in the risk of mortality. ConclusionThe ICS is found to be a risk factor for 30-day mortality in patients with CRKP-BSI, which may facilitate the prediction for the risk of 30-day mortality and thereby support clinical decision-making for patients with CRKP-BSI.

Purpose: This research observed the efficacy and safety of soft tissue expansion combined with recombinant human epidermal growth factor (rhEGF) in repairing second-degree scald scars. Methods: This study conducted a prospective, single-blind, randomized controlled trial. Eighty-four patients with deep second-degree scald scars were evenly divided into the control and observation groups. The control group was treated with soft tissue expansion, and the observation group was additionally treated with rhEGF. The skin expansion and wound healing times were compared. The changes in wound exudate and inflammation around the wound were observed after first-stage surgery. The hydroxyproline (OHP) and collagen I/III ratios were compared during the second stage of surgery.The complications and repair effects during treatment were evaluated. Results: The observation group exhibited lower expansion time, immediate retraction rate, and wound healing time, higher skin expansion rate, higher wound exudate score and inflammation score, higher OHP, lower collagen I/III, lower complication rate, and higher total effective rate than the control group (all P < 0.05). Conclusion Skin soft tissue expansion combined with rhEGF is more effective in repairing second-degree scald scars, which can effectively increase skin expansion area and reduce wound infection and complications.

Chaihu Guizhi Ganjiangtang （CGG）is a classic prescription in the Treatise on Cold Damage，which has the effects of clearing and relieving stagnation heat in Shaoyang，warming and dissolving water drink，and relieving the pivot mechanism. It is a classic prescription for treating spleen deficiency and liver depression and stopping internal stagnation caused by water drink. The formula is exquisite and well-matched and is often modified and used by ancient and modern medical practitioners to treat various miscellaneous diseases of internal and external medicine，with significant therapeutic effects. In recent years，with the rapid development of modern pharmacology，research on the micro mechanism of CGG has been continuously developed and deepened，providing new ideas for the treatment of diseases with CGG. Therefore，the authors systematically searched databases such as China National Knowledge Infrastructure，Wanfang Data Knowledge Service Platform，VIP Database， and PubMed for literature on the clinical application and pharmacological mechanism of CGG published by Chinese and foreign scholars in recent years. This article summarized the literature from two aspects：the modern clinical application and mechanism of action of CGG and elaborated on the diseases treated by CGG in modern literature，involving digestive system，respiratory system，nervous system，endocrine system，circulatory system，urinary system，gynecology，as well as its application in reducing the side effects of radiotherapy and chemotherapy， gynecology， dermatology， ophthalmology， and orthopedics. At the same time，the mechanism of CGG in treating diseases may be related to anti-inflammatory，anti-oxidative stress， regulation of immunity， anti-fibrosis， anti-tumor， improvement of gastrointestinal flora and motility， protection of liver tissue， reduction of blood lipids and blood sugar， and regulation of hormone levels.