Objective To compare the benefits and drawbacks of primary patch expansion versus pericardial tube right ventricular-pulmonary artery connection in patients diagnosed with pulmonary atresia with ventricular septal defect (PA/VSD). Methods A retrospective study was conducted on patients diagnosed with PA/VSD who underwent primary right ventricular-pulmonary artery connection surgery at our center between 2010 and 2020. Patients were categorized into two groups based on the type of right ventricular-pulmonary artery connection: a pericardial tube group and a patch expansion group. Clinical data and imaging findings were compared between the two groups. Results A total of 51 patients were included in the study, comprising 31 males and 20 females, with a median age of 12.57 (4.57, 49.67) months. The pericardial tube group included 19 patients with a median age of 17.17 (7.33, 49.67) months, while the patch expansion group consisted of 32 patients with a median age of 8.58 (3.57, 52.72) months. In both groups, the diameter of pulmonary artery, McGoon index, and Nakata index significantly increased after treatment (P<0.001). However, the pericardial tube group exhibited a longer extracorporeal circulation time (P<0.001). The reoperation rate was notably high, with 74.51% of patients requiring further surgical intervention, including 26 (81.25%) patients in the patch expansion group and 12 (63.16%) patients in the pericardial tube group. No statistical differences were observed in long-term cure rates or mortality between the two groups (P＞0.005). Conclusion In patients with PA/VSD, both patch expansion and pericardial tube right ventricular-pulmonary artery connection serve as effective initial palliative treatment strategies that promote pulmonary vessel development and provide a favorable foundation for subsequent radical operations. However, compared to the pericardial tube approach, the patch expansion technique is simpler to perform and preserves some intrinsic potential for pulmonary artery development, making it the preferred procedure.

AIM To evaluate the quality of Beidougen Formula Granules.METHODS Fifteen batches of standard decoctions and three batches of formula granules were prepared,after which paste rate and contents,transfer rates of magnoflorine,daurisoline,dauricine were determined.HPLC specific chromatograms were established,and cluster analysis was adopted in chemical pattern recognition.RESULTS For three batches of formula granules,the paste rates were 15.1%-16.6%,the contents of magnoflorine,daurisoline,dauricine were 18.93-19.39,9.42-9.60,6.79-6.85 mg/g with the transfer rates of 34.42%-35.25%,43.81%-44.65%,27.27%-27.51%from decoction pieces to formula granules,respectively,and there were seven characteristic peaks in the specific chromatograms with the similarities of more than 0.95,which demonstrated good consistence with those of standard decoctions and accorded with related limit requirements.Fifteen batches of standard decoctions were clustered into two types,and the medicinal materials produced from Jilin,Hebei,Shangdong could be used for the preparation of formula granules.CONCLUSION This reasonable and reliable method can provide references for the quality control and clinical application of Beidougen Formula Granules.

Objective:To compare the repair effects of three kinds of treatment methods included synovial mesenchymal stem cells(SMSCs),platelet rich plasma(PRP)and the combination of them with knee joint cavity injection on cartilage injury of rabbit.Methods:A total of 24 New Zealand rabbits were selected to establish a cartilage injury model of knee joint by using surgery in knee joint of them.The rabbits with cartilage injury model were divided into four groups using a random number table method,which included blank group,single SMSCs with joint cavity injection group(SMSCs group),PRP with joint cavity injection group(PRP group)and the combination of SMSCs and PRP with joint cavity injection group(SMSCs+PRP group),with 6 rabbits in each group.The synovium of four groups of rabbits were scraped off their joints to conduct in vitro culture of SMSCs,as well as the morphological observation and identification of SMSCs.The venous bloods of rabbits were extracted to prepare PRP by centrifugation.The contents of PRP,platelet and growth factor in blood were compared.The SMSCs and PRP were injected into the knee joint cavity of three groups of rabbits with model.After 2,4 and 6 weeks of injection treatment,the repair statuses of cartilages at defection area of different groups were evaluated according to cartilage repair scoring table of International Association for Cartilage Repair(ICRS).Results:The primary synovial cells of rabbit knee joint synovium were initially round in shape after isolation,but almost all of them were spindle shaped after passage.The positive detection rates of SMSCs surface antigen CD73,CD90 and CD105 of 4 group were respectively 100%,99.22%and 99.99%.The CD45 detection was 0.5%,which indicated that they possessed the property of stem cell.The platelet count of 4 groups showed that the platelet concentration in PRP was approximate 6 times of that in whole blood.The concentrations of platelet derived growth factor(PDGF),transforming growth factor-β(TGF-β)and vascular endothelial growth factor(VEGF)were respectively(569.15±57.48)ng/mL,(633.56±63.90)ng/mL and(1 243.55±106.04)ng/mL in PRP,which were approximately 5 times,6 times and 7 times of that in whole blood,respectively.After 2 weeks of injection treatment for joint cavity,there was no significant statistical difference in the scores of cartilage repair among 4 groups(P>0.05).At 4 and 6 weeks of injection treatment,the morphological and histological score of cartilage repair of the SMSCs+PRP group were significantly higher than those of the blank group,and the differences were significant(t4 week=6.35,9.15,t6 week=8.16,8.60,P<0.05),respectively.Conclusion:The repair effect of SMSCs combined with PRP on cartilage injury of rabbit is significantly better than that of single PRP and single SMSCs,respectively,and all of them are better than those without treatment.SMSCs combined with PRP can significantly improve the effect of self-repair of cartilage injury.

Objective To explore the effects of different acupoints,different target organs,and different interventions on acupoint efficacy based on ACU&MOX-DATA platform;To illustrate and visualize whether the above factors have the characteristics of"specific effect"or"common effect"of acupoint efficacy.Methods The multi-source heterogeneous data were integrated from the original omics data and public omics data.After standardization,differential gene analysis,disease pathology network analysis,and enrichment analysis were performed using Batch Search and Stimulation Mode modules in ACU&MOX-DATA platform under the conditions of different acupoints,different target organs,and different interventions.Results Under the same disease state and the same intervention,there were differences in effects among different acupoints;under the same disease state,the same acupoint and intervention,the responses produced by different target organs were not completely consistent;under the same disease state and acupoint,there were differences in effects among different intervention measures.Conclusion Based on the analysis of ACU&MOX-DATA platform,it is preliminary clear that acupoints,target organs,and interventions are the key factors affecting acupoint efficacy.Meanwhile,the above results have indicated that there are specific or common regulatory characteristics of acupoint efficacy.Applying ACU&MOX-DATA platform to analyze and visualize the critical scientific problems in the field of acupuncture and moxibustion can provide references for deepening acupoint cognition,guiding clinical acupoint selection,and improving clinical efficacy.

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.

Objective:To compare the efficacy of pedicle screw placement between computer navigation guidance and freehand assistance in the surgical treatment of isthmic spondylolysis at the lumbar vertebrae.Methods:A retrospective study was conducted to analyze the 47 patients with bilateral isthmic spondylolysis at the L 5 vertebra who had been treated at Department of Spinal Surgery, The General Hospital of Xinjiang Military Command from January 2020 to April 2023. All were male patients with an age of (24.0±4.3) years. They were divided into a study group (13 cases subjected to pedicle screw placement assisted by computer navigation guidance) and a control group (34 cases subjected to pedicle screw placement assisted freehandedly). The 2 groups were compared in terms of surgical incision length, intraoperative bleeding, screw placement time, postoperative hospital stay, total hospitalization cost, postoperative complications, rate of screw reposition, angle between pedicle screw and upper endplate, angle between bilateral pedicle screws, and placement accuracy; the visual analogue scale (VAS) for pain, Japanese Orthopaedic Association (JOA) score for lumbar spine function, and Oswestry disability index (ODI) were also compared between preoperation, 1-week postoperation, and the last follow-up. Patient satisfaction was assessed according to the modified MacNab criteria, and internal fixation failure and isthmic healing were also evaluated at the last follow-up. Results:There were no statistically significant differences in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The differences were not statistically significant in surgical incision length, intraoperative bleeding, screw placement time, postoperative hospital stay, or postoperative complications ( P>0.05). However, in the study group, the total hospitalization cost was significantly higher than that in the control group, the rate of screw reposition [7.7% (2/26)] significantly lower than that in the study group [26.5% (18/68)], the angle between pedicle screw and upper endplate and the angle between bilateral pedicle screws were both significantly smaller than those in the control group, and the placement accuracy [92.3% (24/26)] was significantly greater than that [70.6% (48/68)] in the control group (all P<0.05). All patients were followed up for 7.0 (5.0, 14.0) months. Patients in both groups showed significant improvements in VAS, JOA score, and ODI at postoperative 1 week and the last follow-up compared with the preoperative values, and the improvements at the last follow-up were significantly larger than those at postoperative 1 week ( P<0.05). According to the modified MacNab criteria at the last follow-up, patient satisfaction was rated as excellent in 10 cases, as good in 2 cases and as moderate in 1 case in the study group while as excellent in 27 cases, as good in 3 cases, as moderate in 3 cases and as poor in 1 case in the control group. In the study group, there were 1 case of internal fixation failure, 1 case of spine cutting-out by titanium cable, and 12 cases of bony healing of the isthmus; in the control group, there were 2 cases of internal fixation failure, 2 cases of spine cutting-out by titanium cable, and 29 cases of bony healing of the isthmus. Conclusions:In the surgical treatment of bilateral isthmic spondylolysis at the L 5 vertebra, computer navigation-guided pedicle screw placement is safe and reliable, showing an advantage of higher accuracy over freehand placement. It deserves clinical promotion due to its satisfactory therapeutic effects.

Objective To develop a prefilled portable intelligent intravenous transfusion pump to facilitate fast and convenient fluid pumping during emergency treatment and casualty transport.Methods The prefilled portable intelligent venous transfusion pump was composed of a driver module,a pump module,a human-machine interface,a prefilled sterile infusion bag and a pump catheter.The driver module adopted integrated design and applied a high-voltage DC-AC converter to driving the piezoelectric pump used as the power source of the pump module;the human-machine interface consisted of several keys for on/off,rate adjustment,switching and confirmation;the prefilled sterile infusion bag was made of medical-grade polypropylene,and the pump catheter was made of medical silicone rubber.Results The transfusion pump developed could be worn on the casualty limb and did not require height difference for intravenous infusion,which enhanced intravenous drug delivery in portability,reliability and intelligence.Conclusion The transfusion pump developed gains advantages in low size,weight and easy operation,and thus is worthy promoting for venous transfusion in battlefield conditions and field emergency environments.[Chinese Medical Equipment Journal,2024,45(5):111-114]

Objective To investigate the effect of varying blood pressure stratification on renal function in the diabetic population.Methods A prospective cohort study was conducted,enrolling 9 489 diabetic patients from a total of 101 510 Kailuan Group employees who underwent health examinations between July 2006 and October 2007.The follow-up period was(8.6±4.0)years.Participants were categorized into four groups based on their baseline blood pressure levels:normal blood pressure(systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg),elevated blood pressure(systolic blood pressure 120-130 mmHg and diastolic blood pressure<80 mmHg),stage 1 hypertension(systolic blood pressure 130-140 mmHg and/or diastolic blood pressure 80-90 mmHg),and stage 2 hypertension(systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg).The incidence density of chronic kidney disease(CKD)was compared among these groups.A multivariate Cox proportional hazards regression model was employed to assess the effects of different blood pressure levels on renal function in diabetic patients,with the stability of the results confirmed using a multivariate time-dependent Cox proportional hazards model.Sensitivity analysis was conducted after excluding cases of cardiovascular disease(CVD)during follow-up,and cases using antihypertensive and antidiabetic medications at baseline.Results(1)At baseline,stage 1 hypertension patients demonstrated statistically significant higher differences with age and body mass index(BMI)compared to normal blood pressure group(P<0.05).(2)By the end of the follow-up,2 294 cases of CKD were identified,including 1 117 cases of estimated glomerular filtration rate(eGFR)decline and 1 575 cases of urinary protein.The incidences density of CKD,eGFR decline and urinary protein for stage 1 hypertension group were 39.4,16.3 and 25.5 per thousand person-years,respectively,all of which were statistically significant different from normal blood pressure group(log-rank test,P<0.01).(3)Multivariate Cox regression analysis revealed that,compared to the normal blood pressure group,stage 1 hypertension was associated with a 29%increased risk of CKD(HR=1.29,95%CI 1.09-1.52)and a 40%increased risk of eGFR decline(HR=1.40,95%CI 1.08-1.80)in diabetic individuals.Conclusion Stage 1 hypertension significantly increases the risk of CKD and eGFR decline in diabetic individuals,with a particularly notable effect on the risk of eGFR decline.

Objective:To analyze the results of unqualified blood screening among blood donors in Shaoxing region.Methods:257 145 blood samples from volunteer blood donors from 2017 to 2021 were tested for HBsAg,HCV,HIV,TP,ALT,HTLV,and NAT.All blood test results were analyzed retrospectively.Results:Over the 5-year period,the average failure rate of the tests for volunteer blood donors was 1.22％.In the descending order from high to low,the positive rates of ALT,HBsAg,NAT,TP,HCV,HIV,HTLV were 0.32％,0.25％,0.20％,0.19％,0.17％,0.07％,and 0.01％respecitively.Of these,HBsAg(x2=65.23),ALT(x2=47.32),and HCV(x2=12.73)were significantly different between different years(P＜0.05),but TP(x2=4.19),HIV(x2=7.58),NAT(x2=7.62),and HTLV(x2=6.75)were no significant differences(P＞0.05).And the positivity rates of HBsAg and HCV was a trend of decreasing.By comparing nucleic acid and enzyme immunoassay positive tests,the two methods were found to complement each other.The age and gender distribution difference of the positive population could help to better ensure safe blood recruitment.Conclusion:It is necessary to strengthen blood testing efforts and continuously pay attention to the changing patterns of positive blood-borne diseases in order to improve blood quality and safety.

Objective:This paper aims to analyze the current status,characteristics,and problems of the policy text of China's chronic disease from the perspective of full-cycle,and provide a reference for subsequent policy optimization.Methods:The author selected 104 policy documents on chronic disease published at the national level from 2009 to 2023,used content analysis method,constructed a two-dimensional analysis framework of"policy tools-full-cycle management",and carried out one-dimensional quantitative analysis and two-dimensional cross-analysis.Results:The application of policy tools is obviously unbalanced,with supply-type policy tools accounting for as much as 63.23％,and demand-type policy tools used the least,only 10.51％.In the dimension of full-cycle management,the proportions of prevention,prevention and treatment,treatment,treatment and rehabilitation,health care,and full-cycle stages are 21.01％,24.58％,28.89％,7.32％,4.69％and 13.51％respectively.It is noteworthy that the proportions of the treatment and rehabilitation,and health care stages are relatively low.All stages of chronic disease health management interact frequently with supply-type policies,and the treatment and rehabilitation,health care and full-cycle stages cross less with demand-type policy tools.Conclusion:It is necessary to adjust the proportion of policy tools,strengthen their internal coordination,improve the top-level design of treatment and rehabilitation and health care,enhance the synergistic interaction between various types of policy tools and full-cycle management,and improve the overall effectiveness of policies.