Objective:To evaluate the efficacy and safety of Qingxuan Zhike granules in improving cough symptoms and shortening the course of influenza (wind-heat invading lung) in children.Methods:In this multicenter, randomized, controlled clinical trial, a total of 240 outpatient influenza patients from 7 hospitals, including the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, from April 2023 to December 2023 were collected.The subjects were randomly divided into the control group and the experimental group via SAS software using the block randomization method.The differences between two groups were compared with t test, corrected t test and χ2 test.Subjects in the control group were given Oseltamivir phosphate granules, orally, twice a day (weight ≤15 kg, 30 mg/time; weight >15-23 kg, 45 mg/time; weight >23-40 kg, 60 mg/time; weight >40 kg, 75 mg/time; age≥13 years, 75 mg/time).In addition to Oseltamivir phosphate granules, subjects in the experimental group were also given Qingxuan Zhike granules, orally, 3 times a day (1-3 years old, 1/2 bag each time; >3-6 years old, 3/4 bag each time; >6-14 years old, 1 bag each time).After 5 days of treatment, the medication was suspended for 2 days.The effect of cough, antipyretic effect, clinical recovery rate, clinical recovery time, Canadian Acute Respiratory Illness and Flu Scale (CARIFS) score, traditional Chinese medicine (TCM) syndrome effect, complication rate, and adverse reactions were evaluated between the two groups. Results:Finally, 232 cases were included in the study, including 115 cases in the experimental group and 117 cases in the control group.Before and after treatment, there were no significant difference in CARIFS cough score between the experimental group and the control group (all P>0.05).After treatment, the change in CARIFS cough score in the experimental group [(-1.00±0.91) scores]was significantly higher than that in the control group [(-0.75±0.98) scores] ( t=-1.995, P=0.047).After treatment, the change in TCM syndrome cough score in the experimental group [(-1.69±1.51) scores] was significantly higher than that in the control group [(-0.97±1.63) scores] ( t′=-0.035, P=0.001).The time of complete regression of fever in the experimental group [(44.82±22.72) h] was shorter than that in the control group [(51.35±27.07) h], and the difference between the two groups was statistically significant ( t=-1.966, P=0.050).The fever score showed that the area under the curve between the CARIFS symptom fever score and time in the experimental group was 4.40±2.42, while that in the control group was 5.12±2.44, and the difference between the two groups was statistically significant ( t=-2.252, P=0.025).The clinical recovery rate was 93.91%(108/115) in the experimental group and 92.31%(108/117) in the control group, and there was no significant difference between the two groups ( χ2=0.233, P>0.05).The clinical recovery time in the experimental group [(2.93±1.21) d] was shorter than that in the control group [(3.29±1.15) d], and the difference between the two groups was statistically significant ( t=-2.279, P=0.024).After treatment, there was a significant difference in TCM syndrome score variation between the experimental group [(-12.00±4.13) scores] and the control group [(-10.85±4.31) scores] ( t′=-2.067, P=0.040).No complication occurred in both groups, and there was no significant difference in the incidence of adverse events between the two groups ( χ2=1.299, P>0.05). Conclusions:Qingxuan Zhike granules combined with Oseltamivir phosphate can effectively improve the cough symptoms associated with influenza in children, shorten the time and course of fever, and improve the TCM syndrome score; thus, they are safe in clinical application.

Objective To investigate the intervention efficacy of best possible self (BPS)on the mental health of new recruits (including state optimism and pessimism,perceived stress and subjective well-being).Methods A non-randomized controlled trial was conducted on 212 new recruits subjected with cluster sampling from an army unit in a training base for new recruits in September 2023.Based on their organizational structure,they were divided into a study group (n=100,receiving BPS intervention 15 min/d,for 2 consecutive weeks)and a control group[n=112,typical day (TD)intervention,15 min/d,same period].Future Expectancy Scale (FEX),Chinese Perceived Stress Scale (CPSS),Positive and Negative Affect Scale (PANAS ) and Satisfaction with Life Scale (SWLS ) were used to measure the 2 groups of participants at T0 (baseline),T1 (end of the first week of intervention),T2 (end of the second week of intervention)and T3 (1 week after the end of intervention)in order to evaluate the intervention efficacy on above mentioned mental health indicators.Results There were no significant differences in demographic and baseline psychological variables listed above between the 2 groups.However,as the training progressed,obvious differences were observed in the training effects on state pessimism,perceived stress and subjective well-being (including affective and cognitive well-being)between them.When compared with the baseline data (T0),the study group had notably reduced state pessimism (P<0.01)and elevated affective (P<0.001) and cognitive well-being (P<0.001)during T1 and T3,and decreased perceived stress at T1 (P<0.05)and T3 (P<0.001).However,no such changes of above indicators were observed in the control group before and after training.Conclusion A 2-week BPS intervention can effectively reduce state pessimism and perceived stress,promote subjective well-being,and improve mental health in new recruits during new recruit training.

【Objective】 To investigate the efficacy of negative pressure suction and topical testosterone cream in the treatment of simple micropenis in school-aged obese children and the effects on blood lipids and serum sex hormones. 【Methods】 A total of 79 children aged 7 to 14 (10.50±1.62) years treated and followed up during Nov.2020 and Jul.2022 were involved. The patients were randomly enrolled in the negative pressure suction group (n=39) and the topical testosterone cream group (n=40). The negative pressure suction group was treated with negative pressure suction for 30 min/time, 1 time/day, for 30 d. The topical testosterone cream group was treated with topical testosterone cream applied to the scrotum of the penis 2 times/day for 30d. The transverse and longitudinal diameter of the glans, penile flaccidity, retraction length, serum sex hormones and blood lipids were measured before and after treatment. 【Results】 In both groups, penile flaccidity, retracted length and transverse and longitudinal diameter of the glans were significantly greater at 30 days of treatment and 2 months of follow-up than those before treatment (P<0.01). The increase in penile flaccidity, retraction length and transverse and longitudinal diameter of glans at 30 days of treatment and 2 months of follow-up were greater in the topical testosterone cream group than in the negative pressure suction group (P<0.01). There were no significant differences in the blood lipids and sex hormones in the negative pressure suction group before treatment and at 30 days of treatment and 2 months of follow-up (P>0.025). In the topical testosterone cream group, at 30 days of treatment, there were significant differences in serum total cholesterol (CHOL), apolipoprotein B (Apo B), apolipoprotein A1 (Apo A1), high-density lipoprotein (HDL), low-density lipoprotein (LDL), sex hormone binding protein (SBG), estradiol (E2) and testosterone (TES) compared to those before treatment; at 2 months of follow-up, the differences in Apo A1, HDL, TES and DHS were still significant (P<0.025). 【Conclusion】 Both topical testosterone cream and negative pressure suction have significant efficacy in the treatment of micropenis in school-aged obese children, while topical testosterone cream has some side effects and retraction may occur after treatment. Negative pressure suction is safe and easy to operate, without side effects and retraction, and can be promoted for the treatment of micropenis in obese children.

Objective:To explore the clinical efficacy of retzius-sparing robot-assisted laparoscopic radical prostatectomy with retrograde release of the neurovascular bundle.Methods:From January 2021 to January 2022, the clinical data of 113 patients with retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RARP) was retrospectively analyzed. The ages of the optimized group and the standard group were (67.5±6.4) years and (67.7±6.1) years, and the body mass index (BMI) was (25.0±3.2) kg/m 2 and (24.9±3.1) kg/m 2, respectively. The prostate volume was (42.8±15.4) ml and (41.0±17.9) ml, the preoperative PSA was (13.5±13.1) ng/ml and (11.9±16.0) ng/ml, and the preoperative IIEF-5 score was (15.0±4.0) and (14.8±4.2) points, respectively. Gleason scores were (7.2±0.8) points and (7.1±0.9) points, respectively, with no statistical significance ( P>0.05). The clinical stages of cT 2 and cT 3 were 35 and 40 cases in the optimized group and 16 and 22 cases in the standard group, respectively. There were 5 and 11 cases of preoperative neoadjuvant therapy, respectively, with no statistical significance ( P>0.05). The optimized RS-RARP is the blunt dissection of the denonvilliers fascia and forward to the apex of prostate, and retrograde release of the NVB. The operation time, intraoperative blood loss, drainage tube retention time, days of hospital stay, positive rate of pathological margin and incidence of complications were compared. The recovery of urinary continence was evaluated at 2 weeks after the catheter was removed, and the postoperative IIEF-5 score and PSA were followed up at 1 month after the surgery. Immediate urinary continence was defined as the use of 1 pad on the day of radical prostatectomy. Follow-up intervals were no more than 3 months. The log-rank test compared urinary incontinence rates between the two modalities. Results:All 113 cases of surgery were completed, and median follow-up was 16 months. The operation time was (79.7±26.6) min and (149.8±40.1) min, and the intraoperative blood loss was (54.9±24.7) ml and (110.0±83.2) ml, respectively, and the difference was statistically significant ( P<0.01). The retention time of postoperative drainage tube was (5.3±2.1) d and (5.5±2.1) d in the optimal group and the standard group, and the days of hospital stay was (7.6±2.1) d and (8.5±2.3) d, respectively. The positive rate of postoperative pathological margin was 19.6% (10/51) and 24.2% (15/62), respectively. There was no significant difference ( P>0.05). immediate urinary continence was 86.3% (44/51) and 69.4% (43/62) in the optimized group and the standard group, respectively, and the difference was statistically significant ( P=0.033). Postoperative IIEF-5 scores were (13.2±3.3) and (11.0±4.3), respectively, and the difference was statistically significant ( P=0.012). Kaplan-Meier analysis showed that the risk of urinary incontinence was lower in the optimized group ( P=0.02). Conclusions:The optimized RS-RARP might shorten the operation time, reduce intraoperative bleeding, and help the recovery of urinary continence and sexual function to a great extent.

Objective To evaluate the relative safety of different ventilation methods regarding mortality and rates of complication,on neonatal respiratory distress syndrome (NRDS).Methods Network Meta-analysis was used to collect data on randomized controlled trials of pulmonary ventilation strategies in preterm infants with a mean gestational age of less than 32 weeks.Diagnostic criteria on NRDS were published in the PubMed,Cochrane,Web of Science,EBSCO,and Springer Link databases from January 1986 to June 2018.Revman 5.3 software was used to evaluate the quality of studies,based on the Cochrane quality assessment tool.Data were analyzed by Bayesian and frequency methods,using both Win BUGS 1.4.3 and STATA 13.0 software.Safety of different ventilation strategies for NRDS mortality and complications would include intraventficular hemorrhage (IVH),patent ductus arteriosus (PDA) and retinopathy of prematurity (ROP) and were evaluated.Counted data was displayed by OR and 95％CI.Results A total of 31 RCTs were included in this paper,including 5 827 preterm infants and 11 ventilation strategies.There were no statistically significant differences appearing in 11 ventilation strategies on mortality,PDA or ROE IVH results were reported in 28 studies.Compared with nasal intermittent positive pressure ventilation (NIPPV),both high-frequency oscillation ventilation (HFOV) (OR=3.33,95％ CI:1.08-16.67,P＜0.05) and synchronized intermittent mechanical ventilation (SIMV) (OR=8.22,95％CI:1.25-29.44,P＜0.05) schemes seemed to have increased the risk of IVH in preterm infants with NRDS.NIPPV appeared the optimal ventilation strategy in the rankings of cumulative probability.Results on clustering showed that NIPPV was probably the best ventilation strategy for children with NRDS after considering the orders of IVH,PDA and ROP on mortality,respectively.However,HFOV,IMV,and SIMV did not seem to be the ideal ventilated strategies.Conclusions Most of the clinical decision makers might prefer using NIPPV in the treatment of children with NRDS through mechanical ventilation systems to reduce both the incidence and death caused by IVH,PDA and ROP.It was not recommended to use HFOV,SIMV and IMV in treating NRDS with gestational less than 32 weeks.We suggested that larger numbers of multi-center RCTs ba carried out to make the above conclusions more convincing.

Objective To investigate the inhibitory effect of aspirin on liver metastasis of colon cancer in mice and the possible mechanism.Methods A total of 32 BALB/C mice were injected with CT26 colorectal cancer cells to establish colon cancer liver metastatic model,with 3 mice dead,15 mice in control group and 14 mice in experimental group.The control group was given saline 0.2 mL/d,the experimental group were given aspirin 30 mg/kg.The liver weight and the number of metastatic tumors were calculated after 30 days of intervention.HE and CD31 staining was performed by immunohistochemistry to observe the metastasis and angiogenesis.The protein expression of VEGF and cox-2 were analyzed by Western blot.Results The average liver weight and number of liver metastases nodules in the experimental group were significantly lower than those in the control group(P<0.05).Pathological examination showed that the experimental group of mice the number of liver cells and liver tumor angiogenesis were significantly less than the control group(P<0.05).Western blot showed that the expression of VEGF and cox-2 of CT26 cells were down-regulated after treated with aspirin.Conclusion Aspirin can down regulate the protein expression of VEGF and cox-2 protein to inhibit liver metastasis of colon tumor proliferation and angiogenesis,thereby inhibiting metastasis of colon cancer cells,for therapeutic purposes.

Objective To develop a newly designed guide and evaluate its clinic application prospect in treatment of patella fracture. Methods In our mechanical experiment, we carried out the tensile test of the two generation drilling guides by biomechanics machine and then analyzed the difference in their deformation. In the corpse experiment , we transversed fractures at the equator of the patella obtained from 10 fresh cadaver speci-mens. They were divided into 2 groups randomly: a test group and a control group. The second-generation of the aiming guide was used for the test group but not for the control group during the experiment. Then we evaluated its clinic application in the treatment of patella fracture. Results In the mechanical experiment, the displace-ment of the first generation guide was significantly larger than that of the newly one. The accuracy in the place-ment of k-wires by the second generation guide was significantly higher than by the first generation guide (P <0.05). Conclusions The drilling guide is reasonable in design and convenient in use. Moreover, it can improve the accuracy and quality of insertion of tension-band wiring of patellar fractures. The second-generation one is better and thus it is worth clinically spreading.

Objective To develop a new designed Kirschner wires guider for patellar fracture,and to evaluate its clinic outcomes.Methods From October 2010 to November 2015,totally 72 patients with patellar fracture were detected for this study.Divided them into 3 groups, named as the second-generation guider group,the first-generation guider group and the control group.And then evaluated the clinic outcomes in treatment of patellar fracture of the 3 groups.Results The surgery time,accuracy of placement needle position of the second-generation guider group were better than the other two groups with significant statistical differences (P <0.01).And the clinic outcomes of the first-generation guider group were better than the control group,and the differences were statistically significant (P <0.05).Conclusion The second-generation Kirschner wires guider is reasonable in design and convenient for use.Moreover,it can improve the accuracy and quality of surgery,reduce the operation time,and enhance the clinical effects.

Objective To explore an effective way for medical students and young surgeons learning operative approach .Methods A total of 50 medical students and young surgeons in our hospital were detected for this study .They were randomly divided into the BOOK class (group A) and the 3D computer class (group B) to learn the course of anthropotomy.After learning each section, they were examined to-gether on fresh corpse , and the examined results of the two groups were compared and assessed .Results In the general surgery examina-tions, there was no difference in the examined results with no statistically significant difference (P>0.05).But in the orthopedics examina-tions, the difference of intra-group comparison both in group A and group B were of statistical significance (P<0.05), and the results of group B were better than group A with statistically significant difference (P<0.05).Conclusion For the general surgical approach learn-ing, both of the two methods could achieve good effect .For the orthopedics surgical approach learning ,it can receive better results through computer software ,but it still cannot achieve the ideal effect ,which indicates that the teaching through fresh corpse could not be replaced yet .

Objective To test the biomechanical properties and evaluate the feasibility of the new developed external fixator system,so as to provide reliable theoretical basis for further clinical research.Methods The tibia of 10 fresh male cadaver were made into fracture model.In order to fix the fracture of tibia,experimental group were treated with the new developed external fixator system and the control group were treated with the Hoffman 2 external fixator which was used in clinic commonly.Then axial compression and horizontal torsion test were made on tibia fracture model.The test results were recorded and statistically analyzed.Results There was no statistical difference on the aspect of the ability to resist axial compression and horizontal torsion between the experimental group and the control group(P >0.05). The new developed external fixator system could meet the criterion in clinical application.Conclusion The new developed external fixation system can meet the requirement of biomechanics on fixing the fracture of bone,and it can greatly simplify and diversify the clinical applica-tion of external fixation device.