Shengma Gegentang is one of the classic formulas in the Catalogue of Ancient Classic Prescriptions （Second Batch）. This study reviewed ancient and modern literature and used literature tracing and bibliometric methods to analyze the historical evolution， efficacy， indications， dosage decoctions， and modern clinical disease spectrum of Shengma Gegentang. The results indicated that the earliest record of Shengma Gegentang can be found in the Taiping Huimin Heji Jufang of the Song dynasty， but its origin can be traced back to the Shaoyao Siwu Jiejitang in the Beiji Qianjin Yaofang of the Tang dynasty. The composition dosage of Shengma Gegentang is 413 g of Cimicifugae Rhizoma， 619.5 g of Puerariae Lobatae Radix， 413 g of Paeoniae Radix Alba， and 413 g of Glycyrrhizae Radix et Rhizoma， which are ground into coarse powder. Each dose is 12.39 g， and the amount of water added is 300 mL. 100 mL of solution is decocted and taken at the right time. The four drugs in the formula play the role of relieving exterior syndrome， penetrating pathogenic factors， and detoxicating together. Its indications are widely involved in internal medicine， pediatrics， surgery， ophthalmology and otorhinolaryngology， obstetrics and gynecology， sexually transmitted diseases， and other diseases， such as measles， sores， acne， spots， surgical gangrene， red eyes， toothache， chancre， and fetal poison. The epidemic diseases treated by Shengma Gegentang are complicated， including rash， pox， macula， numbness， summer diarrhea， dysentery， sha disease， febrile symptoms， spring warmth， winter warmth， and cold pestilence. At the same time， it is a plague prevention formula. Although Shengma Gegentang has a wide range of indications， it cannot be separated from the pathogenic mechanism of evil Qi blocking the muscle surface and heat in the lungs and stomach. The modern clinical disease spectrum of Shengma Gegentang involves the ophthalmology and otorhinolaryngology system， nervous system， pediatric-related diseases and syndromes， skin system， hepatobiliary system， and digestive system. It plays a key role in the treatment of epidemic diseases such as measles， chronic hepatitis B， dysentery， and tetanus.

Objective:To study the clinical application of jejunal feeding tube (J-tube) for early enteral nutrition after surgical treatment of upper digestive tract malformation in newborns.Methods:From January 2019 to December 2021, newborns with upper digestive tract malformation received stage Ⅰ small bowel resection and anastomosis in our hospital were enrolled in this prospective randomized controlled study. According to different types of postoperative nutritional support, these patients were randomly assigned into J-tube group and control group using block randomization method. The J-tube group were given enteral nutrition vis J-tube within 48-72 h after surgery and the control group were given oral feeding after the recovery of gastrointestinal function. Calories and proteins intake, growth indicators, duration of hospital stay and parenteral nutrition, time needed for full oral feeding and complications were compared between the two groups.Results:A total of 24 patients were in J-tube group and 28 in controlled group. No significant differences existed on the general status between the two groups ( P>0.05). The average daily intake of calories and proteins in j-tube group in the first week after surgery were significantly higher than control group [(108.7±8.3) kcal/(kg·d) vs. (97.9±7.0) kcal/(kg·d), (3.4±0.3) g/(kg·d) vs. (3.1±0.2) g/(kg·d)] ( P<0.05). No significant differences existed in the average daily intake of calories and proteins during the second postoperative week between the two groups ( P>0.05). Compared with control group,J-tube group showed increased growth velocity in head circumference and weight over time ( P<0.05), while the trend over time in length growth was not significant ( P>0.05). No significant differences existed in the duration of hospital stay and parenteral nutrition, time needed for full oral feeding and complications between the two groups ( P>0.05). Conclusions:Enteral nutrition via J-tube 48-72 h after surgery is safe and feasible in the postoperative nutritional management of newborns with upper digestive tract malformation. This strategy may promote physical growth after surgery without increasing the incidences of complications.

Xiaoruwan is one of the classic prescriptions included in the Catalogue of Ancient Classic Prescriptions （the Second Batch of Pediatrics） published by the National Administration of Traditional Chinese Medicine（TCM） in 2022 with definite clinical efficacy， but it has not been converted into Chinese patent medicine preparations. The authors collected 173 pieces of data based on ancient literature on Xiaoruwan by the method of bibliometrics and selected 99 pieces of effective data， involving 46 ancient books of TCM. The study analyzed the historical development origin， prescription names， formulation rules， dosage， drug origin， preparation method and usage， indications and functions， and other aspects of Xiaoruwan. The results showed that Xiaoruwan was presumably derived from Ying Hai Miao Jue Lun（《婴孩妙诀论》） written by TANG Minwang， a doctor in the Song Dynasty. In the records of ancient medical books， there are names such as Xiaoshiwan，Yangshi Xiaoruwan， and Kuaige Xiaoshiwan， but they are mainly recorded in the name of Xiaoruwan. The prescription was composed of Cyperi Rhizoma， Amomi Fructus， Citri Reticulatae Pericarpium， Massa Medicata Fermentata， Hordei Fructus Germinatus， and Glycyrrhizae Radix et Rhizoma. In terms of processing method， Cyperi Rhizoma， Massa Medicata Fermentata， and Hordei Fructus Germinatus are fried， Glycyrrhizae Radix et Rhizoma is processed， and raw materials of Amomi Fructus and Citri Reticulatae Pericarpium are used directly. In terms of function， it is effective in warming the middle， improving digestion， stopping vomiting， and digesting milk and food. The main indications include vomiting， diarrhea， night crying， and other diseases caused by milk and food stagnation. The dosage of the most used prescription in the records of ancient books is Cyperi Rhizoma 41.30 g， Amomi Fructus 20.65 g， Citri Reticulatae Pericarpium 20.65 g， Massa Medicata Fermentata 20.65 g， Hordei Fructus Germinatus 20.65 g， and Glycyrrhizae Radix et Rhizoma 20.65 g， which are prepared into pills. In the taking method， it is recommended to take it with warm boiled water or ginger soup after meals. The study summarized the historical evolution of Xiaoruwan and identified the key information， with a view to providing a reference for the modern development and research of Xiaoruwan.

Background: Previous studies have found that patients with gastrointestinal diseases have a higher incidence of headache, while migraine patients are often accompanied by gastrointestinal symptoms. Understanding the relationship between diseases can provide new ideas for the study of its mechanism. Aims: To explore the co-occurrence and related risk factors of gastroesophageal reflux disease (GERD), functional dyspepsia (FD), irritable bowel syndrome (IBS) and migraine without aura (MWoA). Methods: A total of 2 696 adult rural residents in Shaanxi Province were investigated by random stratified sampling. MWoA, GERD, FD and IBS were diagnosed based on ICHD-IIIβ, Montreal classification and Rome , respectively. The prevalence of the single disease and overlapping prevalence of MWoA were calculated. The prevalence rates of GERD, FD and IBS between MWoA group and non-MWoA group were compared, and the disease-related risk factors were analyzed. Results: In this study, a total of 2 423 valid questionnaires were collected. The prevalence rates of GERD, FD and IBS were 12.5%, 15.6% and 6.9%, respectively, and the prevalence rate of MWoA was 8.8%. The prevalence rates of GERD (30.5% vs. 10.7%), FD (37.1% vs. 13.5%) and IBS (27.2% vs. 4.9%) in MWoA group were all higher than those in non-MWoA group (P all < 0.001). Multivariate analysis showed that female, hypertension, chronic motor system diseases were positively correlated with GERD, FD, IBS and MWoA. Conclusions: There is a certain association between GERD, FD, IBS and MWoA.

Objective:To investigate the overlapping prevalence and risk factors of gastroesophageal reflux disease (GERD), functional dyspepsia (FD) and irritable bowel syndrome (IBS) among rural adults in Shaanxi Province.Methods:From February 1 to October 31 in 2019, 12 villages in Shaanxi Province were randomly selected for household questionnaire survey through multistage stratified cluster sampling. A total of 2 423 subjects were enrolled, including 1 037 males and 1 386 females, with age of (45.3±16.9) years old. GERD was diagnosed according to the Montreal criteria, FD and IBS were diagnosed according to the Rome Ⅳ criteria. The overlapping prevalence of the three diseases were calculated. The risk factors for the overlapping of GERD, FD and IBS were analyzed. Multivariate logistic regression was used for statistical analysis.Results:Among the 2 423 subjects, 624 cases had GERD (302 cases), FD (377 cases) or IBS (167 cases), of which 30.77% (192/624) patients had overlap of ≥two diseases. The overlap rates of GERD and FD, GERD and IBS, FD and IBS, GERD, FD and IBS were 2.56% (62/2 423), 1.61% (39/2 423), 2.52% (61/2 423) and 1.24% (30/2 423), respectively. The results of Multivariate analysis showed that female and migraine without aura were positively correlated with the overlap of GERD and FD, FD and IBS, and GERD and IBS (odds ratio ( OR)=3.08, 2.68, 3.66, 7.37, 5.91 and 4.46, 95% confidence interval ( CI) 1.35 to 7.01, 1.35 to 5.30, 1.52 to 8.83, 3.97 to 13.69, 1.78 to 19.60 and 2.01 to 9.92; all P<0.05). Heavy drinking (alcohol intake≥50 g/d (male) or≥30 g/d (female)) was positively correlated with the overlap of FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=3.69, 4.20 and 4.91, 95% CI 1.19 to 11.48, 1.01 to 17.50 and 1.23 to 19.52; all P<0.05). Heavy smoking (smoking≥20 cigarettes per day) was positively correlated with the overlap of GERD and FD, FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=3.44, 6.25, 8.27 and 7.04, 95% CI 1.07 to 11.01, 1.60 to 24.44, 1.80 to 38.07 and 1.76 to 28.12; all P<0.05). The educational level of junior or senior high school and age≥60 years old were negatively correlated with the overlap of GERD and FD, FD and IBS, GERD and IBS, and GERD, FD and IBS ( OR=0.47, 0.29, 0.20, 0.05, 0.23, 0.10, 0.37 and 0.16, 95% CI 0.23 to 0.93, 0.09 to 0.95, 0.09 to 0.42, 0.01 to 0.19, 0.09 to 0.60, 0.02 to 0.65, 0.15 to 0.87 and 0.03 to 0.81; all P<0.05). Conclusions:The overlap of GERD, FD and IBS is common and affected by many factors. Female, age≥60 years old, heavy smoking, heavy drinking, low education level and history of migraine without aura are associated with multiple overlaps of GERD, FD and IBS.

Adenosine, as an endogenous purine nucleoside, is widely distributed in various tissues and organs of the body. It binds to adenosine receptors to regulate a variety of important biological processes. Adenosine 2A receptors have a close relationship with the occurrence and development of various clinical diseases. This article reviews the research progress of adenosine 2A receptors in non-alcoholic fatty liver disease, acute immune hepatitis, liver ischemia-reperfusion injury, liver fibrosis, etc., in order to provide new research strategies for the prevention and treatment of these diseases.

Background: Previous studies showed controversial findings for correlation of periodontal disease and cognitive deficits. Methods: We searched systematically for studies pertaining to correlation of periodontal disease and cognitive deficits published between August 1980 and December 2019 on Web of Science and PubMed. We combined the data extracted from the included studies to determine the correlation between periodontal disease and cognitive deficits. Results: Our analysis indicated a higher risk of cognitive deficits in those with moderate to severe periodontal disease when compared to those with mild or no periodontal disease (odds ratio (OR) = 1.38 (95% confidence intervals (CI): 1.28-1.48). Subgroup analysis showed significant correlations in only case-control and cohort studies (case-control studies: OR = 1.49 (95% CI: 1.24-1.80); cohort studies: relative risk (RR) = 1.33 (95% CI: 1.22-1.45)). Subgroup analysis also indicated that moderate to severe periodontal disease was correlated to increased dementia and Alzheimer disease risks, whereas no significant correlation was found between periodontal disease and mild cognitive impairment (dementia: OR/RRs = 1.32 (95% CI: 1.22-1.44); Alzheimer disease: OR/RRs = 1.51 (95% CI: 1.20-1.90); Mild cognitive impairment: OR/RRs = 1.31 (95% CI: 0.89-1.94)). Furthermore, subgroup analysis showed significant correlations between cognitive deficits and tooth loss, periodontitis, whereas no significant correlation was found between deep periodontal pockets and cognitive deficits (tooth loss: OR/RRs = 1.57 (95% CI: 1.39- 1.77); periodontitis: OR/RRs = 1.43 (95% CI: 1.03-2.00); deep periodontal pockets: OR/RRs = 1.24 (95% CI: 0.77-2.00)). Conclusions: This review suggests a significant correlation between periodontal disease and cognitive deficits. Interventional studies for periodontal disease may be beneficial for patients with cognitive deficits

Objective To explore the correlation between depressive symptoms and frailty,in order to provide evidence for prevention and relief of depressive symptoms in elderly inpatients.Methods A cross-sectional survey and comprehensive geriatric assessment(CGA)were conducted with 248 eligible elderly inpatients from December 2015 to February 2017 in our hospital.Depressive symptoms were assessed by the 5-Item Geriatric Depression Scale(GDS-5),and frailty was identified by the frailty phenotype method.Results In all respondents,50 (20.2 ％)patients showed depressive symptoms,93(37.5 ％)patients had pre-frailty and 39 (15.7 ％)patients had frailty.Correlation analysis showed that frailty degree,low grip strength,slow gait speed,low physical activity,fatigue,and weakness were all positively correlated with depressive symptoms in elderly inpatients (r =0.441,0.315,0.426,0.316,0.395 and 0.151,respectively,P ＜ 0.05).Logistic regression analysis showed that patients who had more severe frailty faced a much higher risk of developing depressive symptoms (OR=2.608,P＜0.05).Of the 5 indicators of frailty,slow gait speed and frailty also increased the risk of having depressive symptoms (OR =2.801 and 3.484,P ＜ 0.05).Conclusions Frailty degree,gait speed and fatigue are associated with increased risk of depression in the elderly.Depressive symptoms can be reduced in elderly inpatients with prevention and intervention of pre-frailty and frailty.

Objective To investigate the outcomes of patients with diabetic retinopathy (DR) in Shanghai communities and the influencing factors.Methods From October 2015 to April 2016,533 type 2 diabetic patients with DR were selected by target sampling and cluster random sampling method from six community health service centers in Shanghai.Patients were followed up for 1 year.The demographic information,physical examination,laboratory tests and eye fundus exam results were documented and the DR was graded.The factors associated with the regression of DR were analyzed.Results Total 478 patients,including 280 females (58.6％) and 198 males (41.4％),were followed up for 1 year.The mean age of patients was (64±7) years and the mean disease duration was (8.85±4.20) years.The original DR lesion was remitted in 35 patients with an improvement rate of 7.3％;while the original DR lesion was aggravated in 29 patients with a progression rate of 6.1％.Ordinal logistic regression analysis revealed that age (OR=0.197,95％CI:0.056-0.699),body mass index (BMI) (OR=0.383,95％CI:0.171-0.856),glycosylated hemoglobin (HbAlc) (OR=0.287,95％CI:0.102-0.803),triglycerides (TG) (OR=0.541,95％CI:0.295-0.991),urinary albumin to creatinine ratio (ACR)(OR=0.218,95％CI:0.066-0.720) were associated with DR in type 2 diabetic patients.Conclusion The regression of DR is closely related to age,BMI,glucose,serum lipids and renal function,so it is suggested that lowering BMI,controlling glucose and serum lipids and maintaining normal kidney function are necessary for preventing the progression and promoting the improvement of DR in diabetic patients.

OBJECTIVE: To compare the effects of different anesthetics and blood sampling methods on blood routine test results in experimental animals. METHODS: A total of 42 specific pathogen free( SPF) male Sprague Dawley( SD) rats and 59 SPF male Kunming( KM) mice were randomly divided into 4 groups( control group,ether group,chloral hydrate group and pentobarbital sodium group). Ether group animals were treated with ether inhalation anesthesia; animals in chloral hydrate group and pentobarbital sodium group were injected intraperitoneally with chloral hydrate or pentobarbital sodium. The control group received no anesthesia treatment. Blood samples were collected by different ways: orbital venous plexus,abdominal aorta or eyeball enucleation. White blood cell( WBC) count,red blood cell( RBC) count,platelet(PLT) count,hemoglobin(Hb) level and hematocrit(HCT) in blood samples were analyzed. RESULTS: The RBC count,Hb level and HCT of SD rats in pentobarbital sodium group were significantly lower than those in control group( P <0. 05). The HCT of SD rats in ether group was lower than that in control group( P < 0. 05). The WBC count of orbital venous plexus of KM mice was lower than that taken by eyeball enucleation in control group( P < 0. 05),but the WBC count of orbital venous plexus was higher than that taken by eyeball enucleation in chloral hydrate group( P < 0. 05). The RBC count,Hb level,HCT of KM mice in pentobarbital sodium group were significantly lower than those in control group(P < 0. 05). CONCLUSION: The anesthetic can affect the blood routine test results of experimental animals. Different blood sampling methods have effects on blood routine test results of KM mice.