ObjectiveTo establish the fingerprint of seven commercially available Yangyin Qingfei preparations， to quantitatively analyze the index components， to evaluate their quality uniformity with multivariate statistical analysis， and to explore the quality differences among different dosage forms. MethodA total of 33 batches of commercially available 7 kinds of Yangyin Qingfei preparations were analyzed by high performance liquid chromatography（HPLC）， the fingerprints were established and the common peaks were identified. Paeoniflorin， verbascoside， harpagoside， glycyrrhizic acid and paeonol were selected as the indicators of quality attributes to quantitatively analyze 33 batches of preparations. Based on the administration methods of Yangyin Qingfei preparations， the daily intake was calculated and the radar charts were poltted， and cluster analysis and principal component analysis were used to explore the quality differences of 7 kinds of Yangyin Qingfei preparations and the quality uniformity among different batches of the same dosage form. ResultThe similarity of fingerprints of 7 dosage forms was 0.248-0.956， suggesting that there were significant differences among different dosage forms of Yangyin Qingfei preparations， and a total of 15 common peaks were calibrated， of which peak 7， peak 8， peak 11， peak 13 and peak 15 were paeoniflorin， verbascoside， harpagoside， glycyrrhizic acid and paeonol， respectively. The radar plots showed that the average total daily intake of large honeyed pills and water honeyed pills was the highest， and the uniformity of pill components was better. The quality of 33 batches of samples was divided into poor quality and high quality by cluster analysis. Principal component analysis showed that the uniformity and dosage form of different dosage forms were significantly different， the oral liquid had the best quality homogeneity with the minimum dispersion. And the content of paeonol in different dosage forms was significantly different， which was the key component of quality control of Yangyin Qingfei preparations. ConclusionYangyin Qingfei large honeyed pills and water honeyed pills show high content and good uniformity， which are relatively preferred dosage forms. Different preparation processes have a great influence on the content of paeonol， and its quality control should be emphasized during production. This study provides a scientific method for the comparison of product quality of different dosage forms of traditional Chinese medicine prescriptions， which is helpful for the development of preferred dosage forms of different prescriptions， and provides a reference for efficient use of medication in the clinical practice.

Objective:To explore expression and prognostic value of oncostatin M(OSM)in endometrial cancer and to analyze relationship between OSM expression and immune cell infiltration in endometrial cancer tissues.Methods:OSM expression in pan-can-cer was analyzed by TIMER database,OSM expression in endometrial cancer and normal tissues was compared,and survival analysis for patients with different OSM expression was performed;relationship between OSM expression and immune cell infiltration was analyzed by TIMER and TISIDB,and ssGSEA algorithm was used to calculate difference in abundance of immune cell infiltration in samples with different OSM expression;GSEA software was applied to perform enrichment analysis;clinical tissue samples were collected for validation.Results:OSM expression was higher in endometrial cancer tissues than that in normal endometrial tissues(P=4.1e-28),and endometrial cancer patients with high OSM expression had prolonged recurrence-free survival(RFS)(P=0.004 8).OSM expression was positively correlated with abundance of immune cell infiltration and genetic markers of immune cells(P<0.05).OSM was mainly enriched in immune-related signaling pathways.OSM expression was higher in endometrial cancer tissues than normal and atypical hyperplastic tissues(P=0.016 9).Proportions of immune cell markers CD4,CD8,and CD68 were increased in tumor tissues with high OSM expression(all P<0.05),which were positively correlated with OSM expression.Conclusion:OSM is highly expressed in endometrial cancer tissues and correlated with prognosis;OSM expression is positively correlated with immune cell infiltration level and can be used as a biomarker for immunotherapy and prognosis.

Objectives:To explore the impact of intensive lipid-lowering strategy on short-term prognosis of acute coronary syndrome(ACS)patients with multi-vessel disease. Methods:A total of 136 ACS patients with multi-vessel disease who received coronary stenting at Zhongnan Hospital of Wuhan University from August 2019 to November 2020 were enrolled in this study.Patients were divided into intensive lipid-lowering group(control low density lipoprotein cholesterol[LDL-C]below 1.0 mmol/L within 3 months,and continuously meet the standards within 12 months,n=69)or standard lipid-lowering group(gradually control LDL-C below 1.4 mmol/L within one year,n=67).The total cholesterol(TC),triglycerides(TG),LDL-C,high-density lipoprotein cholesterol(HDL-C),and lipoprotein(a)(Lp[a])data were collected.Incidence of major adverse cardiovascular events(MACE,including cardiac death,myocardial infarction,target vessel revascularization and stroke)were observed during 12 months of follow up. Results:The baseline data of the intensive lipid-lowering group and the standard lipid-lowering group were consistent before intervention.At the timeline of enrollment,there was no statistically significant difference in the blood lipid profiles(including TC,TG,LDL-C,HDL-C)between the two groups.After 3-months,patients in the intensive lipid-lowering group experienced significantly lower TC,TG,LDL-C and Lp(a)compared with baseline values(all P<0.05),while HDL-C remained unchanged(P>0.05).The standard lipid-lowering group showed a significant decrease in TC and LDL-C compared with baseline values(both P<0.05).The TC and LDL-C levels were significantly lower in the intensive lipid-lowering group than in the standard lipid-lowering group at 3/6/12 months follow up after discharge(all P<0.01).At 12 months follow-up,Kaplan-Meier survival analysis showed that the incidence of MACE was significantly lower in the intensive lipid-lowering group than in the standard lipid-lowering group(2.90%vs.14.93%,χ2=6.090,P=0.014).Multiple Cox regression analysis revealed that the intensive lipid-lowering strategy significantly reduced the risk of MACE compared with the standard lipid-lowering strategy(HR=0.177,95%CI:0.037-0.838,P=0.029). Conclusions:Our data show that intensive lipid-lowering strategy may probably reduce the incidence of short-term MACE in ASC patients with multi-vessel disease.Large-scale prospective multi-center studies are needed to further validate these results.

Objective:To design a Visual TFT-based SF 6 gas measurement system. Methods:Based on Visual TFT, an SF 6 gas measurement system is designed, including system hardware design and system software design. The system hardware mainly includes gas sensors, a Visual TFT display, a signal processing circuit, and a power supply circuit. The system software mainly includes data acquisition, data display, SF 6 monitoring system, and alarm program. The Visual TFT display is controlled by Keil code to display other parameters such as gas flow rate, concentration, and waveform, and calculate the error (? E). The measurement system extracts the gas flow rate and concentration data through the waveform graph and gets the change curve of functional residual gas volume (FRC) data. Results:The proposed Visual TFT-based SF 6 gas measurement system can detect SF 6 with an arithmetic mean value of concentration ? E of 8.906%, which is less than 10% of full scale and meets the design requirements. Conclusions:The Visual TFT-based SF 6 gas measurement system can monitor the concentration of SF 6 gas in real-time, which helps to control the release of SF 6 gas and reduce the impact of inert gas emission on the human body under test. At the same time, the system has an intuitive display interface and alarm function, which helps healthcare workers diagnose and treat lung and respiratory diseases more conveniently and quickly, and improves the efficiency and safety of healthcare workers.

ICU acute respiratory distress syndrome has a high morbidity and mortality rate, and these patients usually need mechanical ventilation to maintain their respiratory function during treatment. However, improper setting of mechanical ventilation parameters may lead to ventilator-induced lung injury (VILI). In order to effectively prevent the occurrence of VILI, ARDSnet recommends the use of a protective ventilation strategy with low tidal volume and limited airway plateau pressure. However, from the perspective of ventilator energy transfer, VILI is actually the result of a combination of respiratory parameters such as tidal volume, airway pressure, and respiratory rate. The mechanical power well reflects the combined effect of the above parameters and is increasingly becoming a hot topic in clinical research. In this review paper, the definitions of mechanical energy and mechanical power were introduced, and the calculation methods of mechanical power under different respiratory modes are summarized. Moreover, the clinical studies related to mechanical power and VILI and further exploration of the safety threshold of mechanical power are reviewed. It is expected to provide new ideas for the future clinical development of personalized mechanical ventilation strategies and the effective prevention of VILI.

Abstract Child abuse is a global public health problem, which has emerged as a neglected yet pressing issue in global development. Early and accurate identification of abuse at a lower-age group is of great significance for treatment, which might reduce the risk of re-maltreatment and promote children s physical and mental health development. Therefore, by reviewing the clinical characteristics, risk factors and existing abuse identification and screening tools of child abuse, the study aims at providing basic evidence for the development of child abuse risk identification tools and the establishment of child maltreatment system in China, so as to take timely intervention measures to prevent adverse outcomes or reduce their severity.

Objective:To explore the influence of expander injection port placement on complications of retroauricular soft tissue expander implantation and put forward the corresponding treatment countermeasures.Methods:Data of the patients with congenital microtia or acquired ear defects who were treated in the Department of Plastic Surgery of Sun Yat-sen Memorial Hospital from January 2016 to August 2022 were retrospectively analyzed. All patients underwent ear reconstruction with skin expansion. According to the placement of the expander injection port in the operation, all patients were divided into the group of internal expander injection port (referred to as the internal group) and the group of external expander injection port (referred to as the external group). After the operation, patients of these two groups underwent skin expansion. The general information of the local region and the occurrence of related complications were observed in both groups. Chi-square test was used for statistical analysis.Results:A total of 51 patients were included in this study, including 42 males and 9 females, with an average age of 13.1 years from 5 years old to 43 years old. There were 19 cases of left side, 31 cases of right side, 1 case of both sides. There were 21 cases in the internal group and 30 cases in the external group. There were 19 patients in total who suffered complications such as hematoma, infection, ischemic necrosis of the flap, expander exposure and expander damage. Complications occurred in 6 cases in the internal group, i. e., hematoma in 3 cases and expander exposure in 3 cases. And complications occurred in 13 patients in the external group, including hematoma in 5 cases, infection in 2 cases, expander damage in 1 case, hematoma combined infection in 2 cases, infection combined expander exposure in 1 case, ischemic necrosis of the flap combined expander exposure in 1 case and hematoma combined ischemic necrosis of the flap and expander exposure in 1 case. Patients with all the above-mentioned complications received the second-stage auricle reconstruction surgery on schedule or ahead of schedule after treatment of the complications, and the postoperative effect was good. The incidence of infection was higher in the external group[28.57%(6/21)vs.43.33%(13/30)], and there were significant differences in the incidence of infection between the two groups ( χ2=3.88, P<0.05), but no significant differences in hematoma ( χ2=1.12, P>0.05), ischemic necrosis of the flap ( χ2=1.46, P>0.05), expander exposure ( χ2=0.22, P>0.05) or expander damage ( χ2=0.71, P>0.05). Conclusion:External expander injection port can increase the incidence of postoperative infection. The expander injection port placement does not significantly influence on the incidence of complications such as hematoma, ischemic necrosis of the flap, expander exposure and expander damage. However, the characteristics of these complications in the two kinds of injection port placement are different, and there are some differences in their treatment countermeasures.

Objective:To investigate the efficacy and safety of dermal anchoring method combined with low energy electron beam irradiation in the removal of chest wall keloids.Methods:Clinical data of patients with medium and large-sized chest wall keloids treated in Plastic Surgery Department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from May 2015 to May 2021 were analyzed retrospectively. The keloid was completely removed from the superficial fascia layer, and a small patch of scar dermis tissue was retained in the center of the keloid. When the cutting edge was sutured, the above-mentioned dermis tissue was anchored to achieve tension reduction. Then low energy electron beam irradiation treatment was carried out within 24 h after surgery, with an irradiation range of 5-10 mm from the incision edge and a subcutaneous depth of 2 cm. The lesions were irradiated for 3 times, with a 24 h interval between each exposure. The total irradiation dose was 20 Gy. The width, severity of hyperplasia (expressed in height), and recurrence of keloids at 3, 6, and 12 months after surgery were recorded. Patient satisfaction was evaluated one year after surgery (with a total score of 10 points, 0-3 points of dissatisfaction, 4-7 points of general satisfaction, 8-10 points of great satisfaction), and the incidence of radiation complications was observed. SPSS 25.0 software was used for statistical analysis of the data, with measurement data represented by Mean±SD. Repeated measurement analysis of variance was conducted for the same variable at different periods, and counting data was represented by %. χ2 test was used for group comparison. P<0.05 indicated the difference with statistical significance. Results:A total of 39 patients with 39 scars were included. There were 15 males and 24 females, aged (30.9±9.5) years. The preoperative scar width was (43±5) mm (rang 38-48 mm), and the scar volume was 20.0 mm×38.0 mm×7.5 mm-80.0 mm×48.0 mm×1.6 mm. After the surgery, the wound showed a mild protrusion with minimal exudation, and the wound was dry and clean after irradiation. The scar width at 3, 6, and 12 months after surgery was (1.3±0.5), (1.8±0.5), and (2.9±0.5) mm, respectively, with statistically significant difference ( P<0.01); the severity of scar hyperplasia was (0.9±0.3), (1.3±0.3), and (1.8±0.3) mm, with statistically significant difference ( P<0.01); the recurrence rates of keloids were 12.8% (5 cases), 23.1% (9 cases), and 25.6% (10 cases), respectively, with no statistically significant difference ( P>0.05). The patient satisfaction score at 1 year after surgery was 2-10, average of 7. There were 4 cases (10%) of dissatisfaction, 10 cases (26%) of general satisfaction, 25 cases (64%) of great satisfaction. No radiotherapy complications occurred. Conclusion:Dermal anchoring method combined with low energy electron beam irradiation can achieve good therapeutic effects in the removal of chest wall keloids. The recurrence rate of keloids is low, and patient satisfaction is high.

Objective:To explore the influence of expander injection port placement on complications of retroauricular soft tissue expander implantation and put forward the corresponding treatment countermeasures.Methods:Data of the patients with congenital microtia or acquired ear defects who were treated in the Department of Plastic Surgery of Sun Yat-sen Memorial Hospital from January 2016 to August 2022 were retrospectively analyzed. All patients underwent ear reconstruction with skin expansion. According to the placement of the expander injection port in the operation, all patients were divided into the group of internal expander injection port (referred to as the internal group) and the group of external expander injection port (referred to as the external group). After the operation, patients of these two groups underwent skin expansion. The general information of the local region and the occurrence of related complications were observed in both groups. Chi-square test was used for statistical analysis.Results:A total of 51 patients were included in this study, including 42 males and 9 females, with an average age of 13.1 years from 5 years old to 43 years old. There were 19 cases of left side, 31 cases of right side, 1 case of both sides. There were 21 cases in the internal group and 30 cases in the external group. There were 19 patients in total who suffered complications such as hematoma, infection, ischemic necrosis of the flap, expander exposure and expander damage. Complications occurred in 6 cases in the internal group, i. e., hematoma in 3 cases and expander exposure in 3 cases. And complications occurred in 13 patients in the external group, including hematoma in 5 cases, infection in 2 cases, expander damage in 1 case, hematoma combined infection in 2 cases, infection combined expander exposure in 1 case, ischemic necrosis of the flap combined expander exposure in 1 case and hematoma combined ischemic necrosis of the flap and expander exposure in 1 case. Patients with all the above-mentioned complications received the second-stage auricle reconstruction surgery on schedule or ahead of schedule after treatment of the complications, and the postoperative effect was good. The incidence of infection was higher in the external group[28.57%(6/21)vs.43.33%(13/30)], and there were significant differences in the incidence of infection between the two groups ( χ2=3.88, P<0.05), but no significant differences in hematoma ( χ2=1.12, P>0.05), ischemic necrosis of the flap ( χ2=1.46, P>0.05), expander exposure ( χ2=0.22, P>0.05) or expander damage ( χ2=0.71, P>0.05). Conclusion:External expander injection port can increase the incidence of postoperative infection. The expander injection port placement does not significantly influence on the incidence of complications such as hematoma, ischemic necrosis of the flap, expander exposure and expander damage. However, the characteristics of these complications in the two kinds of injection port placement are different, and there are some differences in their treatment countermeasures.

Objective:To investigate the efficacy and safety of dermal anchoring method combined with low energy electron beam irradiation in the removal of chest wall keloids.Methods:Clinical data of patients with medium and large-sized chest wall keloids treated in Plastic Surgery Department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from May 2015 to May 2021 were analyzed retrospectively. The keloid was completely removed from the superficial fascia layer, and a small patch of scar dermis tissue was retained in the center of the keloid. When the cutting edge was sutured, the above-mentioned dermis tissue was anchored to achieve tension reduction. Then low energy electron beam irradiation treatment was carried out within 24 h after surgery, with an irradiation range of 5-10 mm from the incision edge and a subcutaneous depth of 2 cm. The lesions were irradiated for 3 times, with a 24 h interval between each exposure. The total irradiation dose was 20 Gy. The width, severity of hyperplasia (expressed in height), and recurrence of keloids at 3, 6, and 12 months after surgery were recorded. Patient satisfaction was evaluated one year after surgery (with a total score of 10 points, 0-3 points of dissatisfaction, 4-7 points of general satisfaction, 8-10 points of great satisfaction), and the incidence of radiation complications was observed. SPSS 25.0 software was used for statistical analysis of the data, with measurement data represented by Mean±SD. Repeated measurement analysis of variance was conducted for the same variable at different periods, and counting data was represented by %. χ2 test was used for group comparison. P<0.05 indicated the difference with statistical significance. Results:A total of 39 patients with 39 scars were included. There were 15 males and 24 females, aged (30.9±9.5) years. The preoperative scar width was (43±5) mm (rang 38-48 mm), and the scar volume was 20.0 mm×38.0 mm×7.5 mm-80.0 mm×48.0 mm×1.6 mm. After the surgery, the wound showed a mild protrusion with minimal exudation, and the wound was dry and clean after irradiation. The scar width at 3, 6, and 12 months after surgery was (1.3±0.5), (1.8±0.5), and (2.9±0.5) mm, respectively, with statistically significant difference ( P<0.01); the severity of scar hyperplasia was (0.9±0.3), (1.3±0.3), and (1.8±0.3) mm, with statistically significant difference ( P<0.01); the recurrence rates of keloids were 12.8% (5 cases), 23.1% (9 cases), and 25.6% (10 cases), respectively, with no statistically significant difference ( P>0.05). The patient satisfaction score at 1 year after surgery was 2-10, average of 7. There were 4 cases (10%) of dissatisfaction, 10 cases (26%) of general satisfaction, 25 cases (64%) of great satisfaction. No radiotherapy complications occurred. Conclusion:Dermal anchoring method combined with low energy electron beam irradiation can achieve good therapeutic effects in the removal of chest wall keloids. The recurrence rate of keloids is low, and patient satisfaction is high.