Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly (version 2023) / 中华创伤杂志

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

Study on the mechanism of Polygoni Cuspidati Rhizoma in the treatment of rheumatoid arthritis based on network pharmacology and molecular docking / 国际中医中药杂志

Objective:To explore the molecular mechanism of Polygoni Cuspidati Rhizoma in the treatment of rheumatoid arthritis (RA). Methods:TCMSP database was uesed to screen the active ingredients of Polygoni Cuspidati Rhizoma and predict related targets. The therapeutic targets for RA were predicted by GeneCards database. By collecting the intersection of the rapeutic targets of Polygoni Cuspidati Rhizoma and RA, the therapeutic targets of Polygoni Cuspidati Rhizoma for the treatment of RA were obtained. Then Cytoscape 3.7.2 was used to construct a "drug-active ingredient-target-disease" network diagram. The therapeutic targets of Polygoni Cuspidati Rhizoma for treating RA were imported into the STRING database for protein-protein interaction analysis. The core targets of Polygoni Cuspidati Rhizoma for the treatment of RA were screened out by R language. And the DAVID online database and R language were used to perform GO molecular function enrichment analysis and KEGG pathway enrichment analysis. At last, Autodock Vina software was used for molecular docking of active ingredients and the top five targets. Results:The active ingredients of Polygoni Cuspidati Rhizoma were screened and corresponding to 203 targets. 4 424 target genes related to RA were retrieved in GeneCards database, and 139 targets of Polygoni Cuspidati Rhizoma intervening RA were obtained after intersection. Protein interaction analysis suggested that AKT1, TP53, JUN, MAPK1, RELA were the core targets. GO enrichment analysis on common targets obtained 35 molecular functions including ATP binding, zinc ion binding, and transcription factor activity, etc. KEGG enrichment analysis obtained a total of 117 signaling pathways related to Polygoni Cuspidati Rhizoma for RA, including the PI3K-Akt signaling pathway, the TNF signaling pathway, and pathways related to in cancer. Molecular docking showed that the active ingredients were better docked with AKT1, TP53, JUN, MAPK1 and RELA, and physciondiglucoside had a good binding ability with JUN. Conclusion:Based on network pharmacology and molecular docking, the mechanism of Polygoni Cuspidati Rhizoma in the treatment of RA is discussed, which provides a reference for pharmacological experiment and drug developmen of new herbal medicine.

Status of diagnosis and management of acute appendicitis in 2017: a national multi-center retrospective study / 中华胃肠外科杂志

OBJECTIVE@#To analyze the current status of diagnosis and management of acute appendicitis (AA) in China.@*METHODS@#Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary.@*RESULTS@#A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001).@*CONCLUSIONS@#The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.

The opportunities and challenges of public traditional Chinese medicine hospitals under the comprehensive reform of medical separation in Beijing / 国际中医中药杂志

With the implementation of the comprehensive reform of medical separation in Beijing at April 8 of 2017, more than 3600 medical institutions in the city were involved, including the public hospital of traditional Chinese medicine. ThisIt was an opportunity of public hospitals of traditional Chinese medicine, and it also showed several challenges. This paper analyzed the situation separation of medicine and drug, the opportunity and challenge to put forward reasonable countermeasure and suggestion for the public hospital of traditional Chinese medicine.

Challenges and countermeasures of new media dissemination in Chinese medicine culture / 国际中医中药杂志

At present, there are many problems in the dissemination of new media of Chinese medicine culture, such as "bad communicators", "unsound dissemination of content, serious commercialization" and "less targeted communication". The reasons underlying may be related to the beginning of the new media dissemination of Chinese medicine culture, the imperfect auditing and supervision mechanism and inadequate related research. Therefore, it is necessary to strengthen the access management of communicators, strengthen the management of communication content audit, build TCM knowledge base, strengthen industry regulation, and strengthen audience research and analysis, so as to promote its sustainable development.

Practice and reflection of Chinese medicine hospital participation in trusteeship: taking Beijing Shunyi district traditional Chinese medicine hospital as an example / 国际中医中药杂志

The combination of field surveys and field interviews were conducted in Beijing Shunyi district Traditional Chinese medicine (TCM) hospital to investigate the work situation and find the effectiveness and the existing problems of the hospital after accepting the unified management, technical support, talent support, teaching and scientific research support from a 3As hospital. After trusteeship, the business volume of Shunyi District TCM hospital has increased,the level of scientific research and education have improved,and the service capacity of traditional Chinese medicine has been enhanced. But it is necessary to coordinate trusteeship funds, clear responsibility and power, strengthen the construction of hospital informatization, unified the use of hospital preparations and to improve the hospital trusteeship model.

To explore the medical cooperation between Beijing and Hebei area of traditional Chinese medicine hospitals under the background of integration of the Beijing-Tianjin-Hebei / 国际中医中药杂志

To explore the patterns and ideas of medical cooperation between Beijing and Hebei Chinese Medicine hospitals under the background of the integration of Beijing-Tianjin-Hebei regions. By searching the 2015 China statistical yearbook for health, a survey was conducted among doctors and patients in a Hebei hospital, which is cooperate with the Beijing hospital. We found that Beijing-Tianjin regional medical resources were imbalanced, and Hebei medical resources were insufficient, and patients and doctors were satisfied with the cooperation. There are still some difficulties in Chinese medicine hospital of Beijing and Tianjin cooperation, and many departments need to work together to promote Beijing-Tianjin-Hebei rational allocation of medical resources.

Analysis on medicare reimbursement of traditional Chinese medicine therapies in the selected traditional Chinese medicine hospitals among national public hospital reform projects / 国际中医中药杂志

Objective To find out the general status about the traditional Chinese medicine therapies that were included into medicare among the selected hospitals in the country's public hospital reform project, and to investigate the reasons for those not included and make recommendations.Methods Collecting relevant information through questionnaires, experts interviews and discussions.Results There are still some TCM therapies not included into the range of reimbursement.Most Of them are external treatment of traditional Chinese medicine, acupuncture, massage, special treatments of traditional Chinese medicine and comprehensive therapies of TCM.Conclusions The establishment of negotiations department about medicare in the field of traditional Chinese medicine was needed.Medicare should be in favor of TCM therapies, and traditional Chinese medicine hospitals should strengthen training of personnel and hiring.At the same time, a reasonable increase of the proportion of TCM experts involved in the making health insurance directory was needed.

Clinical trial of treatment of laryngeal cancer by recombinant adenovirus p53 combined with chemotherapy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the effectiveness of recombinant adenovirus p53 injection (rAd2p53) combined with cisplatin plus 5-fluorouracil regimen in treating laryngeal carcinoma.@*METHOD@#Tumour animal models were established in the back of mice with Hep-2 cell line. Recombinant adenovirus p53 injection (rAd2p53) were transduced to tumor-bearing mouse by direct intratumoral injection combine with cisplatin plus 5-fluorouracil ivgtt. The control group 1 was given recombinant adenovirus p53 injection (rAd2p53) simplex. The control group 2 was administered with cisplatin plus 5-fluorouracil ivgtt simplex. Then compare the diameters of pro-treatment with that of post-treatment and test group with controls.@*RESULT@#Tumor growth was significantly inhibited following combined rAd2p53 gene therapy with cisplatin plus 5-fluorouracil chemotherapy compared to single rAd2p53 gene therapy and cisplatin plus 5-fluorouracil chemotherapy controls.@*CONCLUSION@#Local injection of rAd2p53 combined with cisplatin plus 5-fluorouracil chemotherapy is a promising treatment to laryngeal cancer.