ObjectiveTo observe the clinical efficacy and safety of Tangning Tongluo tablets in the treatment of nonproliferative diabetic retinopathy （DR）. MethodsFourteen research centers participated in this study， which spanned a time interval from September 2021 to May 2023. A total of 240 patients with nonproliferative DR were included and randomly assigned into an observation group （120 cases） and a control group （120 cases）. The observation group was treated with Tangning Tongluo tablets， and the control group with calcium dobesilate capsules. Both groups were treated for 24 consecutive weeks. The vision， DR progression rate， retinal microhemangioma， hemorrhage area， exudation area， glycosylated hemoglobin （HbA1c） level， and TCM syndrome score were assessed before and after treatment， and the safety was observed. ResultsThe vision changed in both groups after treatment （P<0.05）， and the observation group showed higher best corrected visual acuity （BCVA） than the control group （P<0.05）. The DR progression was slow with similar rates in the two groups. The fundus hemorrhage area and exudation area did not change significantly after treatment in both groups， while the observation group outperformed the control group in reducing the fundus hemorrhage area and exudation area. There was no significant difference in the number of microhemangiomas between the two groups before treatment. After treatment， the number of microhemangiomas decreased in both the observation group （Z=-1.437， P<0.05） and the control group （Z=-2.238， P<0.05）， and it showed no significant difference between the two groups. As the treatment time prolonged， the number of microhemangiomas gradually decreased in both groups. There was no significant difference in the HbA1c level between the two groups before treatment. After treatment， the decline in the HbA1c level showed no significant difference between the two groups. The TCM syndrome score did not have a statistically significant difference between the two groups before treatment. After treatment， neither the TCM syndrome score nor the response rate had significant difference between the two groups. With the extension of the treatment time， both groups showed amelioration of TCM syndrome compared with the baseline. ConclusionTangning Tongluo tablets are safe and effective in the treatment of nonproliferative DR， being capable of improving vision and reducing hemorrhage and exudation in the fundus.

Traditional Chinese Medicine (TCM), as a treasure of the Chinese nation, plays a significant role in maintaining public health. In 2019, the Central Committee of the Communist Party of China and the State Council proposed for the first time the establishment of a TCM registration and evaluation evidence system that integrates TCM theory, "personal experience" and clinical trials (referred to as the "Three-in-One" System) to promote the inheritance and innovation of TCM. Subsequently, the National Medical Products Administration issued several guiding principles to advance the improvement and implementation of this system. Owing to the complexity of its implementation, there are still differing understandings within the TCM industry regarding the positioning of the "Three-in-One" Registration and Evaluation Evidence System, as well as the connotation and value orientation of the "personal experience." To address this, Academician WANG Qi, President of the TCM Association, China International Exchange and Promotion Association for Medical and Healthcare and TCM master, led a group of academicians, TCM masters, TCM pharmacology experts and clinical TCM experts to convene a "Seminar on Promoting the Implementation of the ′Three-in-One′ Registration and Evaluation Evidence System for Chinese Medicinals." Through extensive discussions, an expert consensus was formed, clarifying the different roles of the TCM theory, "personal experience" and clinical trials within the system. It was further emphasized that the "personal experience" is the core of this system, and its data should be derived from clinical practice scenarios. In the future, the improvement of this system will require collaborative efforts across multiple fields to promote the high-quality development of the Chinese medicinal industry.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Objective:To study influence of cardiac rehabilitation exercise combined nutritional intervention on pa-tients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods:A total of 100 AMI patients treated in our hospital were randomly and equally divided into routine nursing group and combined intervention group(received cardiac rehabilitation exercise combined nutritional intervention mode based on routine nursing group)according to random number table method.Both groups were intervened for two months.General clinical data,anaerobic threshold(AT),maximal oxygen uptake(VO2peak),LVEF,6min walking distance(6MWD),scores of China questionnaire of quality of life in patients with cardiovascular diseases(CQQC)and gen-eral self-efficacy scale(GSES)before and after intervention and incidence rate of cardiovascular adverse events within three months were compared between two groups.Results:Compared with routine nursing group,after inter-vention,there were significant rise in AT[(10.14±2.81)ml·kg-1·min-1 vs.(14.85±3.80)ml·kg-1· min-1],VO2peak[(1.23±0.40)ml·kg-1·min-1 vs.(2.44±0.46)ml·kg-1·min-1],LVEF[(48.96± 3.73)％vs.(55.98±4.31)％],6MWD[(300.72±33.71)m vs.(340.47±31.86)m],scores of CQQC[(53.59 ±6.28)scores vs.(72.93±7.15)scores]and GSES[(21.21±2.39)scores vs.(32.28±5.44)scores]in com-bined intervention group(P=0.001 all).Incidence rate of cardiovascular adverse events in combine intervention group within three months was significantly lower than that of routine nursing group(10.0％vs.48.0％,P=0.001).Conclusion:Cardiac rehabilitation exercise combined nutritional intervention can observably improve quality of life,cardiopulmonary function,enhance self-efficacy and reduce incidence rate of adverse cardiovascular events in patients with acute myocardial infarction after percutaneous coronary intervention.

Objective:Exploring the clinical effects of silicone silver ion foam dressing in managing scalp donor site wounds in burn patients.Methods:A retrospective analysis was conducted on the clinical data of burn patients admitted to the 940th Hospital of Joint Logistics Support Force of PLA from January 2020 to January 2023. Patients underwent intraoperative harvesting of split-thickness skin grafting to repair deep burn wounds, with the denuded scalp area covered by either silicone silver ion foam dressing (Group A) or petrolatum gauze (Group B). Comparison of the following 5 parameters between the two groups: (1) Postoperative wound healing time. (2) Initial dressing change pain score was assessed using the numeric rating scale (NRS). 0 points indicated no pain, 1-3 points indicated mild pain, 4-6 points indicated moderate pain, and 7-10 points indicated severe pain. (3) Number of dressing changes. (4) Secondary trauma score, with a total score ranging from 1 to 3, where a higher score indicates more severe trauma. (5) Proportion of wounds healed to grade A (number of grade A healed cases/total number of cases in each group×100%). Depending on the data type, between-group comparisons were performed using t-test, Wilcoxon rank-sum test, or chi-square test. P<0.05 was considered a statistically significant difference. Results:A total of 60 patients, with 30 in each Group A and Group B, were included in the study. Group A was comprised of 18 males and 12 females, with an average age of (29.4±16.6) years. The burn area was (21.43±5.66)% of the total body surface area (TBSA), and the area of skin taken from the scalp was (1.80±0.61)% of TBSA. Group B was comprised of 20 males and 10 females, with an average age of (30.2±16.2) years. The burn area was (21.37±5.67)% of TBSA, and the area of skin taken from the scalp was (1.78±0.63)% of TBSA. No statistically significant differences were observed in gender distribution, age, burn area, and scalp area between the two groups( P>0.05). The wound healing time in the denuded scalp area was shorter in Group A than in Group B [(5.97±0.41) days vs. (6.93±0.58) days, t=-7.40, P<0.001]. The initial NRS pain score during dressing change was lower in Group A than in Group B [3.0 (2.0, 4.0) points vs. 5.5 (4.0, 6.0) points, Z=-4.82, P<0.001]. Group A had fewer frequency of dressing changes compared to Group B [2 (2, 2) vs. 4 (3, 5), Z=-6.64, P<0.001]. The secondary injury score was lower in Group A than in Group B [1 (1, 1) points vs. 3 (3, 3) points, Z=-7.08, P<0.001]. The proportion of grade A healing was 96.7% (29/30) in Group A and 90.0% (27/30) in Group B, with no statistically significant difference between the two groups ( χ2=0.27, P=0.605). Conclusion:The application of silicone silver ion foam dressing to cover the denuded scalp area of burn patients significantly improves therapeutic efficacy compared to petrolatum gauze. It can shorten wound healing time, reduce the frequency of dressing changes, alleviate pain, minimize the occurrence of secondary injuries, and enhance patient comfort.

Following the principles of evidence-based medicine,in accordance with the structure and drafting rules of standardized documents,based on literature research,according to the characteristics of chronic cough in children and issues that need to form a consensus,the TCM Guidelines for Diagnosis and Treatment of Chronic Cough in Children was formulated based on the Delphi method,expert discussion meetings,and public solicitation of opinions.The guideline includes scope of application,terms and definitions,eti-ology and diagnosis,auxiliary examination,treatment,prevention and care.The aim is to clarify the optimal treatment plan of Chinese medicine in the diagnosis and treatment of this disease,and to provide guidance for improving the clinical diagnosis and treatment of chronic cough in children with Chinese medicine.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Objective:To explore the levels of regulatory T cells(Tregs)and cytokines IL-35,TGF-β and IL-10 in peripheral blood of hemophilia A(HA)patients with F Ⅷ inhibitor and their clinical significance.Methods:43 HA patients admitted to the Hematology Department of the Affiliated Hospital of North China University of Science and Technology from October 2019 to December 2020 were selected,including 6 cases with F Ⅷ inhibitor and 37 cases without FⅧ inhibitor.In addition,20 healthy males who underwent physical examinations were selected as healthy controls.Flow cytometry was used to detect the levels of CD4+CD25+CD127-Tregs in peripheral blood of the HA patients and healthy controls,and ELISA assay was used to detect the expression levels of IL-35,TGF-β and IL-10 in serum,and their differences between different groups were compared.Results:Compared with the healthy control group,the level of Tregs in HA patients was decreased,and the level of Tregs in the FⅧ inhibitor positive group was the lowest,the difference was statistically significant(P＜0.05).There was no significant difference in the expression level of Tregs in HA patients of different severity levels.The serum IL-35,TGF-β,and IL-10 levels in both FⅧ inhibitor negative and positive groups were significantly lower than those in healthy control group,and those in FⅧ inhibitor positive group were significantly lower than those in FⅧ inhibitor negative group(all P＜0.05).Conclusion:The decrease of Tregs,IL-35,TGF-β,and IL-10 levels in HA patients may be related to the formation of FⅧ inhibitors.

Objective:Exploring the clinical effects of silicone silver ion foam dressing in managing scalp donor site wounds in burn patients.Methods:A retrospective analysis was conducted on the clinical data of burn patients admitted to the 940th Hospital of Joint Logistics Support Force of PLA from January 2020 to January 2023. Patients underwent intraoperative harvesting of split-thickness skin grafting to repair deep burn wounds, with the denuded scalp area covered by either silicone silver ion foam dressing (Group A) or petrolatum gauze (Group B). Comparison of the following 5 parameters between the two groups: (1) Postoperative wound healing time. (2) Initial dressing change pain score was assessed using the numeric rating scale (NRS). 0 points indicated no pain, 1-3 points indicated mild pain, 4-6 points indicated moderate pain, and 7-10 points indicated severe pain. (3) Number of dressing changes. (4) Secondary trauma score, with a total score ranging from 1 to 3, where a higher score indicates more severe trauma. (5) Proportion of wounds healed to grade A (number of grade A healed cases/total number of cases in each group×100%). Depending on the data type, between-group comparisons were performed using t-test, Wilcoxon rank-sum test, or chi-square test. P<0.05 was considered a statistically significant difference. Results:A total of 60 patients, with 30 in each Group A and Group B, were included in the study. Group A was comprised of 18 males and 12 females, with an average age of (29.4±16.6) years. The burn area was (21.43±5.66)% of the total body surface area (TBSA), and the area of skin taken from the scalp was (1.80±0.61)% of TBSA. Group B was comprised of 20 males and 10 females, with an average age of (30.2±16.2) years. The burn area was (21.37±5.67)% of TBSA, and the area of skin taken from the scalp was (1.78±0.63)% of TBSA. No statistically significant differences were observed in gender distribution, age, burn area, and scalp area between the two groups( P>0.05). The wound healing time in the denuded scalp area was shorter in Group A than in Group B [(5.97±0.41) days vs. (6.93±0.58) days, t=-7.40, P<0.001]. The initial NRS pain score during dressing change was lower in Group A than in Group B [3.0 (2.0, 4.0) points vs. 5.5 (4.0, 6.0) points, Z=-4.82, P<0.001]. Group A had fewer frequency of dressing changes compared to Group B [2 (2, 2) vs. 4 (3, 5), Z=-6.64, P<0.001]. The secondary injury score was lower in Group A than in Group B [1 (1, 1) points vs. 3 (3, 3) points, Z=-7.08, P<0.001]. The proportion of grade A healing was 96.7% (29/30) in Group A and 90.0% (27/30) in Group B, with no statistically significant difference between the two groups ( χ2=0.27, P=0.605). Conclusion:The application of silicone silver ion foam dressing to cover the denuded scalp area of burn patients significantly improves therapeutic efficacy compared to petrolatum gauze. It can shorten wound healing time, reduce the frequency of dressing changes, alleviate pain, minimize the occurrence of secondary injuries, and enhance patient comfort.

Curriculum ideological and political is an important measure to realize fundamental task of"cultivating people by virtue".In recent years,our course team has carried out ideological and political education exploration and practice of course of Micro-biology and Immunology based on blended online and offline teaching model.From course objectives,teachers'teaching ability,all aspects of online and offline teaching,ideological and political education is organically integrated into whole process,aiming to culti-vate medical talents with"both ability and morality".