ObjectiveTo explore the listed varieties and prescription characteristics of Chinese patent medicines for stroke in China， explore the medication rules of Chinese medicine for stroke， and provide guidance for further clinical research and development of Chinese patent medicines. MethodsExcel 2021 and the Ancient and Modern Medical Record Cloud Platform （V2.3.5） were used to systematically mine and analyze the varieties and prescriptions of Chinese patent medicines for stroke in China. ResultsA total of 244 Chinese patent medicines （two for different dosage forms of the same prescription）， 1 736 approval documents for Chinese patent medicines， 792 manufacturers， and 83 varieties of protected Chinese patent medicines were finally included in the database. The top three dosage forms were capsules （75）， pills （53）， and tablets （42）. There were 28 Chinese patent medicines for stroke in the National Essential Drug Catalogue （2018）， 129 in the National Essential Medical Insurance， Industrial Injury Insurance and Maternity Insurance Drug Catalogue （2023）， and 4 in the National Non-prescription Drug Catalogue. Among the 138 prescriptions screened out， Chinese patent medicines mainly treated stroke patients with the syndrome of Qi deficiency and blood stasis. The top three most frequent medicinal herbs were Chuanxiong Rhizoma （63）， Pheretima （47）， and Salviae Miltiorrhizae Radix et Rhizoma （47）. The medicinal herbs used were mainly warm， pungent， with the meridian tropism to the liver meridian. The correlation analysis showed that the herb pair with the highest support was Astragali Radix-Chuanxiong Rhizoma， and that with the highest confidence was Carthami Flos-Chuanxiong Rhizoma. Five herb combinations were identified based on the cluster analysis. ConclusionThe Chinese patent medicines for stroke mainly treat patients with the syndrome of Qi deficiency and blood stasis. The medicinal herbs used in the prescriptions mainly have the functions of activating blood and resolving stasis， extinguishing wind and stopping convulsions. Drug compatibility usually focuses on activating blood and resolving stasis， as well as expelling phlegm and opening orifices. This review of the varieties and prescription characteristics of Chinese patent medicines for stroke helps optimize clinical decision-making， guide drug research and development， promote medical research and scientific progress， and provide more effective support and guarantee for the treatment of stroke patients.

Objective:To study the clinical value of enhanced recovery after surgery(ERAS) strategy combined with early intestinal fluid reinfusion among neonates receiving jejunostomy due to intestinal obstruction.Methods:From December 2018 to December 2022, neonates with intestinal obstruction receiving jejunostomy in the Department of Neonatal Surgery of our hospital were prospectively enrolled. They were randomly assigned into ERAS group and traditional treatment (TT) group after surgery. The ERAS group was treated with ERAS strategy plus early intestinal fluid reinfusion. The TT group was treated with conventional gastrointestinal decompression, analgesia as needed and enteric fluid reinfusion according to the amount of defecation. The postoperative parenteral nutrition (PN) duration (T pn), central venous catheter (CVC) duration (T cvc), daily weight gain, duration of postoperative hospital stay (T hos), complications and readmission rate within 30 days were compared between the two groups. Results:A total of 22 cases were included in the ERAS group and 20 cases were in the TT group. T pn [(22.6±9.4) d vs. (30.7±11.3) d], T cvc [(5.9±0.8) d vs. (9.9±2.1) d] and T hos [(26.8±9.8) d vs. (33.8±11.5) d] in the ERAS group were significantly shorter than the TT group ( P<0.05). No significant difference existed in daily weight gain between the two groups ( P>0.05). The incidence of postoperative gastrointestinal mucosal bleeding in the ERAS group was significantly lower than the TT group (13.6% vs. 45.0%)( P<0.05). No significant differences existed in the following items between the two groups: feeding intolerance, PN-associated cholestasis, CVC-related bloodstream infection, intestinal fluid reinfusion-related complications, premature closure of fistula and readmission rate within 30 days (all P>0.05). Conclusions:The application of ERAS strategy plus early intestinal fluid reinfusion in neonates with enterostomy is safe and feasible, which can reduce the postoperative durations of PN, CVC and hospital stay and accelerate the recovery.

Objective:To investigate the clinical efficacy of tacrolimus combined with Jisheng Shenqi pills and Sijunzi decoction in treating spleen-kidney deficiency type lupus nephritis in patients. Methods:A randomized controlled study was conducted on 82 patients with spleen-kidney deficiency type lupus nephritis admitted to Weinan Central Hospital from January 2019 to December 2023. The patients were divided into a control group ( n = 41) and an observation group ( n = 41) using the coin flip method. The control group was treated with tacrolimus, while the observation group received Jisheng Shenqi pills and Sijunzi decoction in addition to the control group's treatment. All patients were treated for 2 months. The clinical efficacy, traditional Chinese medicine (TCM) syndrome scores, systemic lupus erythematosus disease activity index (SLE-DAI) scores, chronicity index (SLE-CI) scores, renal function (cystatin C, blood urea nitrogen, serum creatinine), high-sensitivity C-reactive protein, transforming growth factor β 1, procalcitonin, silent information regulator 4 (SIRT4) levels, and adverse reactions (gastrointestinal discomfort, dizziness, rash, liver function abnormalities) were compared between the two groups. Results:The total effective rate of clinical treatment in the observation group was significantly higher than that in the control group [95.12% (39/41)] vs. [80.49% (33/41), χ2 = 4.10, P < 0.05). After treatment, the TCM syndrome scores, SLE-DAI scores, and SLE-CI scores in the observation group were (4.24 ± 0.96) points, (9.04 ± 1.40) points, (1.22 ± 0.17) points, respectively, which were significantly lower than those in the control group [(8.13 ± 1.06) points, (12.78 ± 1.82) points, (1.37 ± 0.19) points, t = 17.41, 10.42, 3.76, all P < 0.05]. The levels of cystatin C, blood urea nitrogen, and serum creatinine in the observation group were (1.49 ± 0.42) mg/L, (5.20 ± 1.30) mmol/L, (93.27 ± 5.22) μmol/L, respectively, which were significantly lower than those in the control group [(2.16 ± 0.46) mg/L, (6.26 ± 1.27) mmol/L, (103.29 ± 5.07) μmol/L, t = 6.88, 3.73, 8.81, all P < 0.05]. The levels of high-sensitivity C-reactive protein, transforming growth factor β 1, and procalcitonin in the observation group were (3.24 ± 0.87) mg/L, (32.27 ± 6.57) μg/L, (14.11 ± 2.34) μg/L, respectively, which were significantly lower than those in the control group [(4.48 ± 0.81) mg/L, (40.34 ± 7.52) μg/L, (18.26 ± 2.79) μg/L, t = 6.67, 5.17, 7.29, all P < 0.05], while the level of SIRT4 was significantly higher in the observation group [(0.47 ± 0.06) mg/L] compared with the control group [(0.37 ± 0.04) mg/L, t = 8.87, P < 0.05]. The incidence of adverse reactions in the observation group [4.87% (2/41)] was slightly, but not significantly, lower than that in the control group [14.63% (6/41), χ2 = 2.21, P > =0.05]. Conclusion:Tacrolimus combined with Jisheng Shenqi pills and Sijunzi decoction in treating spleen-kidney deficiency type lupus nephritis can significantly improve clinical efficacy, reduce TCM syndrome scores, SLE-DAI scores, and SLE-CI scores, improve renal function, alleviate inflammation, and has good safety.

Objective:To establish an inductively coupled plasma-mass spectrometry(ICP-MS)method for the simultaneous determination of elemental impurities in fluphenazinedecanoate.Methods:Sample was dissolvedwith-organic solution.With 45Sc,72Ge,115In,125Te,175Lu and 209Bi used as internal standards,an ICP-MS method was developed and established with the following conditions:RF power of 1 550 W,atomizer flow rate of 0.6 L·min-1,argon oxygen mixed auxiliary gas ratio of 30％,sampling depth of 8.0 mm,and S/C temperature of-5 ℃.Results:The linear range of each element was good within the linear range(r＞0.997),the recovery rates at low,medium and high concentrations were 84％-135％,and the limit of detection was less than 0.3 J.Ten batches of samples were tested,trace contents of chromium(Cr),arsenic(As),iridium(Ir)and mercury(Hg)were detected,and the other 20 elements were less than the limit of detection.Conclusion:The method is fast,sensitive,and accurate for screening and the quality control of elemental impurities in fluphenazinedecanoate.

Objective:To evaluate the efficacy of visualized precise lung expansion for determining the intersegmental plane in thoracoscopic segmentectomy.Methods:Sixty-four American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, regardless of gender, aged 33-77 yr, with body mass index of 16-34 kg/m 2, undergoing elective thoracoscopic segmentectomy under general anesthesia, were included. They were preoperatively reconstructed with 3D CT bronchovascularization to reconstruct the pulmonary vasculature, bronchus, and the virtual intersegmental planes of the lungs. The patients were divided into 2 groups ( n=32 each) using a random number table method: visualized precise lung expansion group (group V) and modified expansion and atrophy group (group E). Group V used visualized precision lung expansion to determine the intersegmental planes, and group E used the modified expansion and atrophy method to determine the intersegmental planes. The intraoperative intersegmental plane determination time, target segmental bronchus identification and treatment time, anesthesia time, operation time, postoperative air leakage, pulmonary atelectasis, fever, occurrence of lung infection, postoperative 24 h drainage volume, drain removal time and hospitalization time were recorded in the two groups. Results:Compared with group E, the intersegmental plane determination time, target segment bronchial identification and treatment time, anesthesia time and operation time were significantly shortened in group V( P<0.05).There were no significant differences between groups in the 24 h postoperative drainage volume, drain removal time, hospitalization time or incidence of postoperative pulmonary complications ( P>0.05). Conclusions:Compared with the modified expansion and atrophy method, visualized precise lung expansion can effectively shorten the intersegmental plane determination time in thoracoscopic segmentectomy.

We present a case of nephrogenic diabetes insipidus secondary to primary Sj?gren′s syndrome. At onset, the patient exhibited a urine output of up to 10 liter per day. Diagnostic evaluation and clinical features confirmed renal diabetes insipidus due to primary Sj?gren′s syndrome. A review of the literature indicates that primary Sj?gren′s syndrome can involve renal manifestations, including renal tubulointerstitial inflammation and impaired renal concentration ability. However, nephrogenic diabetes insipidus with such high urine output is uncommon. Management of this condition requires proactive control of the underlying disease, potassium supplementation, and urine management.

The occurrence of eosinophilic leukemia complicated with cardiogenic embolism and L?ffler endocarditis are relatively rare.Early accurate diagnosis and prompt treatment can improve the its prognosis.When patients have symptoms of neurological impairment accompanied by increased eosinophils,the rare etiological type of cerebral infarction should be actively screened.Further improvements are needed in the examination of bone marrow smears,detection of fusion genes associated with leukemia,screening for L?ffler endocarditis,and identification of intraventricular thrombi.In this case,the main manifestations of eosinophilic leukemia were cardiogenic embolism and L?ffler endocarditis.After active treatment,the symptoms improved,and the eosinophil count returned to normal.This study summarizes the case data of this patient and combines it with a literature review,with the hope of raising clinicians'understanding of this rare disease.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Objective:To investigate factors related to non-variceal upper gastrointestinal bleeding(NVUGIB)in hospitalized elderly patients.Methods:A retrospective study was conducted to collect the medical records of 1 085 elderly patients at the Affiliated Hospital of Qingdao University from January 1, 2018 to January 1, 2019.According to whether NVUGIB occurred during hospitalization, they were divided into the bleeding group(173 cases)and the control group(912 cases). General information(age, sex, smoking and drinking), diseases, medications and laboratory test results for the two groups were compared and analyzed, and factors related to NVUGIB were analyzed via binary Logistic regression.Results:There were significant differences in age, smoking, drinking, peptic ulcer, tumor, coronary heart disease, atrial fibrillation, stroke, helicobacter pylori(HP)infection, acute respiratory failure, use of anti-coagulant, anti-platelet drugs, nonsteroidal anti-inflammatory drugs and glucocorticoids, leukocyte counts, hemoglobin, C-reactive protein, procalcitonin, prothrombin time and international normalized ratio(INR), D-dimer, triglycerides, albumin and glycosylated hemoglobin(all P<0.05). Multivariate Logistic regression analysis showed that history of tumor( OR=1.552, 95% CI: 1.028-2.344), peptic ulcer( OR=4.797, 95% CI: 2.263-10.165), HP infection( OR=7.199, 95% CI: 1.825-28.571), acute respiratory failure( OR=2.977, 95% CI: 1.314-6.757), use of anti-coagulant and anti-platelet drugs( OR=2.715, 95% CI: 1.769-4.167), prolonged INR( OR=21.314, 95% CI: 2.321-195.727), increased leukocyte count( OR=10.370, 95% CI: 6.521-16.493)and hypoproteinemia( OR=1.970, 95% CI: 1.304-2.976)were independent risk factors for NVUGIB in hospitalized elderly patients. Conclusions:For hospitalized elderly patients, attention should be paid to their history of tumor, peptic ulcer, HP infection, acute respiratory failure, prolonged INR, elevated leukocyte counts, hypoalbuminemia and the use of anti-coagulant and anti-platelet drugs.The occurrence of NVUGIB, early evaluation and intervention should be carefully monitored or carried out to reduce its incidence in hospitalized elderly patients.

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.