Research progress of Charles Bonnet syndrome / 国际眼科杂志(Guoji Yanke Zazhi)

Charles Bonnet syndrome(CBS)refers to hallucinations resulting from visual pathway damage in individuals without neuropsychiatric disorders. CBS patients typically have insight into the unreality of their hallucinations, and the disorder may be episodic, periodic, or chronic. The condition's prevalence varies from 0.4% to 30% due to the absence of agreed diagnostic criteria for CBS and some patients' reluctance to acknowledge hallucinations. Massive studies have demonstrated an association between CBS and ocular diseases, such as age-related macular degeneration and glaucoma. Additionally, there have been reports of CBS occurring after ophthalmic surgery or medication. Therefore, clinicians should be vigilant in diagnosing CBS promptly and reassuring patients. There is a lack of literature on CBS in ophthalmology, and further research is needed to explore its pathogenesis and diagnostic and therapeutic options. This article reviews some of the studies related to CBS in recent years.

Research progress on the diagnosis and treatment of pediatric malocclusion combined with obstructive sleep apnea-hypopnea syndrome / 口腔疾病防治

@#Pediatric malocclusion is common in dentistry. Some children with malocclusion combined with obstructive sleep apnea-hypopnea syndrome (OSAHS) often fail to receive appropriate treatment due to a lack of multidisciplinary diagnosis and treatment. It can cause abnormal ventilation during sleep, affecting the central nervous system and cardiovascular development and even causing neurological and behavioral problems. Pediatric OSAHS is caused by the narrowing of the upper respiratory tract, characterized by specific facial bone characteristics and neuromuscular factors and correlated with malocclusion. Due to its diverse clinical manifestations and etiology, the diagnosis and treatment of pediatric OSAHS require an interdisciplinary, personalized, and specialized approach. Questionnaires and physical examinations can be used for preliminary screening. Moreover, children's stomatology and otorhinolaryngology examinations are the basis for disease diagnosis. Polysomnography (PSG) is currently the direct diagnostic method. There are various treatment methods for OSAHS in children, and for OSAHS caused by adenoid tonsil hypertrophy, adenoidectomy and tonsillectomy are the main treatments. Othodontic treatment including mandibular advancement and rapid maxillary expansion et al is also effective for OSAHS in children with malocclusion. Currently, there is limited research on the correlation between childhood malocclusion and OSAHS, and multidisciplinary combination therapy may improve the cure rate, but there is a lack of sufficient evidence. In the future, the pathogenesis of OSAHS should be further elucidated, and research on multidisciplinary combination therapy should be promoted to achieve early intervention and treatment for potential and existing patients.

Diagnosis and treatment pathway of neoadjuvant immunotherapy for esophageal cancer in Henan province / 中国胸心血管外科临床杂志

@#Esophageal cancer is a highly prevalent tumor species in Henan province, which brings heavy medical burden to families and society. Surgical treatment plays a dominant role in the treatment of non-advanced esophageal cancer. However, cancer cells in esophageal cancer lesions are highly invasive, postoperative recurrence and metastasis rates are pretty high. More effective systemic and comprehensive treatment is urgently needed to improve the prognosis. We invited 52 doctors in esophageal surgery, oncology, pathology, imaging, and radiation therapy of 32 hospitals at all levels in Henan province, to repeatedly negotiate and fully discuss in combination with evidence and clinical practice experience. Finally, “diagnosis and treatment pathway of neoadjuvant immunotherapy for esophageal cancer in Henan province” was formulated. In this treatment pathway, seven recommendations were proposed from seven perspectives including target population, patient evaluation, protocol selection, surgical timing, postoperative management, organ preservation, and general principles to offer reference for medical personnel related to esophageal cancer surgery.

Research on Patients’ Trust Risk Points and Promotion Path from the Perspective of Online Health Community / 中国医学伦理学

Online health community is a new medical treatment mode combining the Internet and medical treatment. Patients can get medical services through the network. However, it cannot be ignored that patients’ trust will be affected by the uncertainty of online medical information, the unsafe factors of patients’ private information, the insufficient standardization of the diagnosis and treatment process, and other issue in the process of using this new medical treatment mode. By taking measures such as improving the information quality in online health community, enhancing patients’ cognitive ability of health information, perfecting privacy protection measures in online health community, advancing patients’ participation in online health community and ensuring the standardization of diagnosis and treatment process, patients’ trust can be improved.

The Development and Current Status in the Diagnosis and Management of Tuberous Sclerosis Complex Associated with Renal Angiomyolipoma in China / 罕见病研究

Tuberous sclerosis complex(TSC) is a rare autosomal dominant genetic disorder caused by mutations in the TSC1 or TSC2 genes. The disease can cause multiple organ lesions. The most common renal lesions are renal angiomyolipoma(RAML). In recent years, China has made progresss in the understanding of TSC-RAML, so that the standardization of the diagnosis and management of TSC-RAML have improved. Efforts have been taken in the studies of the pathogenesis and treatment of TSC-RAML. This article reviews the diagnosis, therapy, and research development of TSC-RAML in China.

Advances in research on application of bacteria combined with nanotechnology for tumor diagnosis and treatment / 中国生物制品学杂志

@#Cancer diagnosis and treatment has always been a hot spot in clinical and basic scientific research. In recent years,scientists have developed a large number of tumor diagnosis and treatment methods based on bacteria combined with nanotechnology. Compared with pure bacterial diagnosis and treatment,bacterial diagnosis and treatment combined with nanotechnology can produce multiple synergistic effects,thereby improving the efficacy of tumor diagnosis and treatment.The characteristics of bacteria such as environmental sensitivity,tropism,motility and hypoxia growth combined organically with nanotechnology can increase the solubility of insoluble drugs,promote drug lysosomal escape,and avoid phagocytosis and clearance of the reticuloendothelial system to construct a new type of bacterial micro/nano diagnosis and treatment platform,thereby achieving the precise tumor diagnosis and controlled drug release. This paper reviewed the research progress of bacteria combined with nanotechnology for tumor diagnosis and treatment in recent years and the challenges and possible solutions,so as to provide reference for promoting the rapid development of tumor diagnosis and treatment research.

Analysis of the diagnosis and treatment experience and etiological characteristics of 119 cases of primary canaliculitis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the clinical features, diagnosis and treatment experience and the distribution characteristics of pathogenic microorganisms of primary canaliculitis, and provide reference for its diagnosis and treatment. METHODS: Retrospective clinical study. A total of 119 cases(120 eyes)diagnosed as primary canaliculitis in the department of ophthalmology of Wuxi No.2 People's Hospital from June 2019 to February 2023 were included. The treatment methods were mainly divided into conservative treatment(removing canaliculus stones through lacrimal punctum combined with injecting antibiotic eye ointment into the tube)and surgical treatment. The inspection methods of pathogenic microorganisms included secretion smear microscopy and microbial culture.RESULTS: Primary canaliculitis was more common in middle-aged and older female, mainly manifested by long-term red eye and increased secretion; however, the majority was not accompanied by tearing. Totally, 118 cases(99.2%)had monocular disease, while 63 cases(63 eyes; 52.5%)had inferior lacrimal canaliculus disease. Laboratory examination: Among 119 cases(120 eyes), 4 cases(4 eyes)did not undergo laboratory examination, and the other 115 cases(116 eyes)were as follows: Gram staining microscopy of secretion smear showed that Actinomyces were detected in 102 cases(103 eyes; 88.8%), while no fungus was detected; Microbial culture: 85 cases(86 eyes; 74.1%)were positive for bacterial culture. A total of 111 bacterial strains were cultured, which contained 26 types of bacteria. Among them, 32 strains were aerobic(28.8%); 26 strains were anaerobic(23.4%); and 53 strains were facultative anaerobic(47.7%). The most common bacteria were streptococcus(20 strains), staphylococcus(13 strains), Propionibacterium(10 strains), and capnocytophaga(10 strains). Only 4 cases(4 eyes; 3.4%)of microbial cultures were positive for Actinomyces. Fungus was negative in all microbial cultures. Treatment: Of the 119 cases(120 eyes), 114 cases(115 eyes; 95.8%)were cured by conservative treatment of removing lacrimal canaliculus stones through lacrimal punctum and intracanalicular ointment infiltration(IOI), while 5 cases(5 eyes)were not effective in conservative treatment; however, all of them were cured after surgical treatment, and the cure rate for primary canaliculitis was 100.0%.CONCLUSION: The incidence of primary canaliculitis is low, and it is prevalent in middle-aged and older female. Single lacrimal canaliculus is more common, which could be missed and misdiagnosed in clinic. Actinomyces is the major pathogen observed mostly in mixed infections, with heterogeneous strains, mainly anaerobic or facultative anaerobic bacteria. Streptococcus and Staphylococcus are the most common whereas fungal canaliculitis is rare. The cure rate of primary canaliculitis is high after diagnosis, and IOI method is recommended as the initial treatment of canaliculitis.

Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine：Fibromyalgia Syndrome / 中国实验方剂学杂志

Fibromyalgia syndrome （FMS） is a refractory， chronic non-articular rheumatic disease characterized by widespread pain throughout the body， for which there are no satisfactory therapeutic drugs or options. There are rich Chinese medical therapies， and some non-drug therapies， such as acupuncture， Tai Chi， and Ba-Duan-Jin， have shown satisfactory efficacy and safety and definite advantages of simultaneously adjusting mind and body. FMS is taken as a disease responding specifically to traditional Chinese medicine （TCM） by the National Administration of Traditional Chinese Medicine in 2018. In order to clarify the research progress in FMS and the clinical advantages of TCM/integrated Chinese and Western medicine， the China Academy of Chinese Medicine organized a seminar for nearly 20 experts in Chinese and Western medicine， including rheumatology， psychology， acupuncture and moxibustion， and encephalopathy， with the topic of difficulties in clinical diagnosis and treatment of FMS and advantages of TCM and Western medicine. The recommendations were reached on the difficulties in early diagnosis and solutions of FMS， mitigation of common non-specific symptoms， preferential analgesic therapy， TCM pathogenesis and treatment advantages， and direction of treatment with integrated Chinese and Western medicine. FMS is currently facing the triple dilemma of low early correct diagnosis， poor patient participation， and unsatisfactory benefit from pure Western medicine treatment. To solve the above problems， this paper suggests that rheumatologists should serve as the main diagnostic force of this disease， and they should improve patient participation in treatment decision-making， implement exercise therapy， and fully utilize the holistic and multidimensional features of TCM， which is effective in alleviating pain， improving mood， and decreasing adverse events. In addition， it is suggested that FMS treatment should rely on both TCM and Western medicine and adopt multidisciplinary joint treatment， which is expected to improve the standard of diagnosis and treatment of FMS in China.

A new way of analyzing tooth movement using universal coordinate system geometry single point superposition in a 3D model

ABSTRACT Introduction: Superposing 3D models is an imminent need. However, current methods rely on marking multiple points on the maxilla and mandible, which could increase point marking and overlapping errors. Objective: This study aimed at developing a method for superimposing 3D models of the maxillary and mandibular arches with Autodesk Inventor® engineering software, using a single universal coordinate system (UCS) point superposition. Methods: A total of 104 STL (stereolithography) models of the maxillary and mandibular arches exported from My iTero® platform were retrospectively selected, in which T0 and T1 were the initial and refinement periods, respectively (n=26 per group). The X, Y, and Z coordinates associated with a single point in each arch were inserted into the models with SlicerCMF® software for model orientation. The arch models with UCS registration were transferred to Autodesk Inventor® for superimposition and to measure tooth movements performed during Invisalign® treatment. Arch expansion, intrusion and rotation were analyzed by two examiners. The statistics were performed using intraclass correlation coefficients (ICC), Dahlberg's formula, and t-test (p<0.05). Results: A reliable method of superimposing 3D digital models using a single UCS point in the maxilla and mandible was developed. ICC showed excellent intra- and inter-examiner correlation (ICC>0.90). A systematic error was not found concerning linear and angular measurements (<1mm and <1.5°, respectively). Digital dental movements could be analyzed, including arch expansion, dental intrusion, and tooth rotation. Conclusions: The developed method was proven reliable and reproducible for superimposing 3D models of the maxillary and mandibular arches by using UCS system.

RESUMO Introdução: A sobreposição de modelos 3D é uma necessidade iminente. No entanto, os métodos atuais dependem da marcação de múltiplos pontos na maxila e na mandíbula, o que pode aumentar a incorporação de erros no processo de sobreposição. Objetivo: O objetivo desse estudo foi desenvolver um método para sobrepor modelos 3D das arcadas superior e inferior utilizando o software de engenharia Autodesk Inventor®, por meio da marcação de um único ponto em cada arcada, usando o sistema de coordenadas universal (UCS). Métodos: No total, 104 modelos STL das arcadas superior e inferior exportados da plataforma My iTero® foram selecionados retrospectivamente, onde T0 foi o período inicial e T1, o de refinamento (n=26 por grupo). As coordenadas X, Y e Z associadas a um único ponto em cada arcada foram inseridas nos modelos usando o software SlicerCMF®. Os modelos com os pontos UCS demarcados foram transferidos para o software Autodesk Inventor® para realizar a sobreposição e medir os movimentos dentários realizados durante o tratamento com Invisalign®. Os movimentos de expansão, intrusão e rotação foram analisados por dois examinadores. A análise estatística foi realizada usando os coeficientes de correlação intra-classe (ICC), fórmula de Dahlberg e teste t (p<0,05). Resultados: Foi desenvolvido um método confiável de sobreposição de modelos digitais 3D usando um único ponto UCS na maxila e mandíbula. O ICC apresentou excelente correlação intra e inter-avaliadores (ICC>0,90). Não foi encontrado erro sistemático nas medidas lineares e angulares (<1mm e <1,5°, respectivamente). Os movimentos dentários puderam ser analisados por meio do método proposto, incluindo expansão da arcada, intrusão e rotação dentária. Conclusão: O método desenvolvido provou ser confiável e reprodutível para sobreposição de modelos 3D das arcadas superior e inferior usando o sistema UCS com marcação de ponto único.

Success factors for evidence-based healthcare practice adoption

Background: Evidence-based health policies are widely acknowledged as being essential for attaining ongoing improvements in health outcomes. This study represents a theoretical model to test and identify to identify the key drivers for adopting evidence-based healthcare practice (EBHP). Objectives: The goal of this study was to investigate the critical success factors for the adoption of evidence-based healthcare at a South African public hospital. Methods: Medical healthcare professionals were surveyed using a questionnaire developed by the researcher. The results were analysed with SPSS 23 and AMOS. A hypothetical model based on updated (D&M) IS Success Model, Technology, Organization and Environment framework (TOE) as well as Technology Acceptance Model (TAM) was developed and analysed using structural equation modelling (SEM). Results: The findings of this study indicate that EHR is crucial and the main construct influencing the adoption of EBHP. The findings of this study indicated a positive relationship between the construct electronic health records (EHR) with medical error reduction (MER), information quality (IQ) and knowledge quality (KQ), all showed a strong positive correlation towards the adoption of EBHP. Conclusions: Better coordination of patient care (BCP) typically results in lower health care costs. The results also show that using EBHP improves the accuracy of disease diagnosis and treatment, which lowers the burden of disease. Contribution: The developed framework will help healthcare systems that are strapped for money, particularly in developing countries.

Implications of occlusal plane in diagnosis and treatment of malocclusion / 浙江大学学报·医学版

Occlusal plane (OP) is one of the essential factors affecting craniofacial morphology and function. The OP not only assists in diagnosing malocclusion but also serves as an important reference for making treatment plans. Patients with different types of malocclusions have different forms of OP. Compared with patients with standard skeletal facial type, the occlusal plane of patients with skeletal class Ⅱ and high angle is steeper, while that of patients with skeletal class Ⅲ and low angle is more even. In orthodontic treatment, adjusting and controlling the OP can promote the normal growth and development of the mandible in most patients with malocclusion during the early stage of growth, while causing favorable rotation of the mandible in some adults with mild-to-moderate malocclusion. For moderate-to-severe malocclusion, the OP rotation by orthodontic-orthognathic treatment can achieve better long-term stability. This article reviews the evolution of the definition of OP and its implications for diagnosing and the guiding treatment of malocclusion.

Expert recommendations on homogenization management of the diagnosis and treatment of rare diseases in children / 中国当代儿科杂志

Rare diseases in children are characterized by low prevalence, complex pathogenesis, variety, and difficulty in the diagnosis and treatment. With the development of medical services, progress has been made in the diagnosis and treatment of rare diseases. However, due to asymmetric allocation of medical resources at different levels, there are still many shortcomings in the establishment and promotion of the homogenized management system of rare disease diagnosis and treatment. In order to further standardize the homogenized management of rare diseases in children, achieve early and accurate diagnosis and treatment, and improve the quality of life of the children, the Rare Disease Diagnosis and Treatment Center of Tianjin Children's Hospital (Tianjin University Children's Hospital) invited relevant experts in the field to develop recommendations for the management model of homogenized diagnosis and treatment of rare diseases in children from the aspects of information construction, hierarchical diagnosis and treatment, personnel training, scientific popularization, and multi-participation. The recommendations provide reference for the regional homogenization of clinical diagnosis and treatment management system for children with rare diseases.

Research progress of the diagnosis and treatment of anterior shoulder instability / 中国修复重建外科杂志

The shoulder joint is the most prone to dislocation in the whole body, and more than 95% of them are anterior dislocation. Improper treatment after the initial dislocation is easy to lead to recurrent anterior dislocation or anterior shoulder instability, and the outcomes following conservative treatment is poor. Anterior shoulder instability can damage the soft tissue structure and bone structure that maintain the stability of shoulder joint, among which bone structure is the most important factor affecting the stability of shoulder joint. Diagnosis should be combined with medical history, physical examination, and auxiliary examination. Currently, three-dimensional CT is the most commonly used auxiliary examination means. However, various bone defect measurement and preoperative evaluation methods based on three-dimensional CT and the glenoid track theory have their own advantages and disadvantages, and there is still a lack of gold standard. Currently, the mainstream treatment methods mainly include Bankart procedure, coracoid process transposition, glenoid reconstruction with free bone graft, Bankart combined with Remplissage procedure, and subscapular tendon binding tamponade, etc. Each of these procedures has its own advantages and disadvantages. For the diagnosis and treatment of anterior shoulder instability, there are still too many unknown, further research and exploration need to be studied.

Diagnosis and treatment of 4 cases imported severe malaria and COVID-19 co-infection / 中国热带医学

@#Abstract: To explore the clinical characteristics, diagnosis and treatment of imported severe malaria and COVID-19 co-infection cases, and to provide scientific basis for epidemic prevention and control measures. The epidemiological characteristics, clinical manifestations, laboratory tests, treatment process and prognosis of 4 cases of severe malaria and COVID-19 co-infection with confirmed diagnosis were analyzed retrospectively. Four cases of severe malaria were African returnees of the same batch, male, aged 40-54 years old, with the same journey track. They all had African work and life history and acute onset. The main clinical manifestations were fever (4/4), chills (3/4), chills (3/4), nausea and vomiting (3/4), diarrhea (4/4), fatigue and anorexia (4/4). Two cases had headache and dizziness, confusion, muscle aches, two cases had cough, one cases had sputum, sore throat and runny urine. All 4 cases were confirmed by positive nucleic acid detection of the new coronavirus (2019-nCOV) in throat swabs. Plasmodium falciparum was found by microscopic examination of peripheral blood smears of all patients, and all of them were consistent with high altitude helminthiasis. All cases were accompanied by abnormal liver function and severe hypoproteinemia, two cases were hyperbilirubinemia, three cases were dyslipidemia, three cases were involved in abnormal tertiary hemogram with different degrees of elevation of procalcitonin, two cases were lactic acid poisoning, and one case was hypoglycemia. One case showed viral pneumonia on chest CT. All cases were treated individually according to the different conditions and were discharged after improvement, and were rechecked for 2019-nCOV nucleic acid and microscopic examination of blood smear negative for Plasmodium.During the global COVID-19 epidemic, the emergence of coinfection cases of con-infection of imported malaria parasites and severe acuterespiratory syndrome coronavirus 2 (SARS-CoV-2) makes the clinical diagnosis and treatment more complicated. It is important to establish the awareness of simultaneous prevention and diagnosis of COVID-19 and malaria for local prevention and control and early warning of severe cases, and timely and effective formulation of treatment plan to improve the comprehensive treatment efficiency.

Current situation and analysis of radiological diagnosis and radiotherapy equipment resources in Suzhou, China, 2020 / 中国辐射卫生

Objective To comprehensively analyze and understand the status of medical resources of radiological diagnosis and treatment in Suzhou, China, and to provide a basis for the health administration departments to reasonably plan and allocate medical radiation resources. Methods The radiological diagnosis and treatment institutions were registered on the radiation health information platform of Jiangsu province, and information was entered as required. Results There were totally 793 radiological diagnosis and treatment institutions at all levels in Suzhou, including 22 (6.04%) tertiary institutions. There were 2208 radiological diagnosis and treatment equipment. The number of X-ray diagnosis and treatment equipment per million people in Suzhou was 205.40. However, there was no class A large-scale medical equipment. Conclusion Compared with 2005, the numbers of radiological diagnosis and treatment institutions and equipment in Suzhou increased significantly. However, government departments at all levels should strengthen overall regulation and control to improve the rational allocation of high-tech medical resources.

Investigation and analysis of administrative penalties for radiation diagnosis and treatment in Xuzhou, China, 2018—2021 / 中国辐射卫生

Objective To analyze the administrative penalties for radiation diagnosis and treatment in Xuzhou, China, 2018—2021, investigate the key illegal behaviors in radiation diagnosis and treatment, and provide a basis for effective supervision with targeted measures. Methods A total of 142 cases of administrative penalties were analyzed for the year of the case, the undertaker, the basic information of the subjects, the amount of penalty, and the specific illegal facts. Results From 2018 to 2021, the case number of administrative penalties for radiation diagnosis and treatment in Xuzhou was relatively stable. The cases were mainly undertaken by the municipal health supervision institution, while the number of cases handled by basic-level health supervision institutions was increasing. The administrative penalties were mainly imposed on persons and primary or non-classified medical institutions. Common illegal behaviors included occupational health management of radiation workers and personal protection during medical exposure. Conclusion We should focus on strengthening the publicity and supervision of personal protection in occupational health management and medical exposure, continue to improve the law enforcement ability of basic-level radiation health supervisors, develop a standardized management system for radiation diagnosis and treatment, innovate the supervision mode and radiation hazard notification mode, promote the “Internet + ” informatization supervision, and recommend to improve and revise radiation-related laws and regulations.

Medication Analysis of Traditional Chinese Medicine Diagnosis and Treatment Guidelines for Allergic Rhinitis Based on Clinical Efficacy Evaluation / 中国实验方剂学杂志

ObjectiveTo explore the role of efficacy evaluation methods in providing evidence for traditional Chinese medicine （TCM） clinical practice guidelines based on a demonstration study of clinical efficacy evaluation of TCM for allergic rhinitis （AR），aiming to enrich the sources of evidence for guideline development. MethodReal-world data of TCM medication for AR were collected and efficacy evaluation was carried out. SPSS 16.0 software was used to calculate the conformity of clinical syndromes，main prescriptions， and medications to the guidelines. Correlation analysis of efficacy and medications was performed according to guideline conformity to compare the differences in medications between real-world clinical applications and current guidelines. ResultA total of 198 cases were collected and the clinical medications were compared with the relevant guidelines for AR. It was found that the clinical syndrome conformity was above 70%，and in addition to the guideline syndrome，there were also syndromes in six meridians and other mixed syndromes in clinical practice. The guideline conformity of the main prescriptions used in clinical practice showed a positive correlation trend with efficacy. There were some differences between the commonly used drugs in clinical practice and those recommended by the guidelines. For example，for lung Qi deficiency and cold syndrome，drugs such as Angelicae Dahuricae Radix， Magnoliae Flos， and Schisandrae Chinensis Fructus were often used. For kidney Yang deficiency syndrome，drugs such as Atractylodis Macrocephalae Rhizoma and Ostreae Concha were often used. For spleen Qi deficiency and weakness syndrome，drugs such as Poria， Cinnamomi Ramulus， and Magnoliae Flos were used. For lung Qi deficiency and cold syndrome in children，drugs such as Chebulae Fructus， Cicadae Periostracum， Zingiberis Rhizoma， and Ginseng Radix et Rhizoma were used. For lung and spleen Qi deficiency syndrome，drugs such as Dioscoreae Rhizoma， Menthae Haplocalycis Herba， Amomi Fructus， and Zingiberis Rhizoma were used. There were also some differences in the commonly used drugs for adults and children. For example，for lung Qi deficiency and cold syndrome，adults often used Angelicae Dahuricae Radix， Magnoliae Flos， and Tribuli Fructus，while children often used Ginseng Radix et Rhizoma， Paeoniae Radix Alba， and Poria. For lung meridian hidden heat syndrome， adults often used Bupleuri Radix， Asari Radix et Rhizoma， Pinelliae Rhizoma， and Xanthii Fructus， while children often used Houttuyniae Herba， Menthae Haplocalycis Herba， Citri Reticulatae Pericarpium， and Massa Medicata Fermentata. ConclusionEffective medication regimens can be screened out based on efficacy evaluation methods，which can help supplement immediate， objective， and clinically relevant evidence of medication for the development of clinical practice guidelines in TCM from the perspective of clinical effectiveness.

Clinical Efficacy of Chinese Medicine Combined with Indirect Moxibustion Plaster on COVID-19 Patients During Recovery Period Based on COVID-19 Diagnosis and Treatment Protocol（Tenth Edition） / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy of Chinese medicine combined with indirect moxibustion plaster on corona virus disease 2019 （COVID-19） patients during recovery period. MethodNinety patients of COVID-19 during the recovery period were randomly divided into a Chinese medicine group， an indirect moxibustion plaster group， and a combination group，with 30 cases in each group. According to the 10th edition of COVID-19 Diagnosis and Treatment Protocol，patients in the Chinese medicine group received oral Chinese medicine based on syndrome differentiation，one dose per day， twice a day. Patients in the indirect moxibustion plaster group were treated with indirect moxibustion plaster at Zusanli （ST 36）， Pishu （BL 20）， Dazhui （GV 14）， Feishu （BL 13）， Kongzui （LU 6）， and Tiantu （CV 22），once a day，40 min each time. Patients in the combination group were treated with Chinese medicine combined with indirect moxibustion plaster. Treatment lasted two weeks. Before and after treatment，the traditional Chinese medicine （TCM） symptom score，pulmonary computed tomography （CT） score，St. George's Respiratory Questionnaire （SGRQ） score，blood routine indexes ［white blood cell count （WBC），neutrophil count （NEUT），and lymphocyte count （LYM）］， and inflammatory indexes ［C-reactive protein （CRP），serum ferritin， and interleukin-6 （IL-6）］ were observed in the three groups. The clinical efficacy was evaluated. ResultAfter treatment，the scores of TCM symptoms，pulmonary CT， and SGRQ，CRP，IL-6，and ferritin in the three groups decreased（P<0.05），while WBC and LYM increased（P<0.05）， but there was no significant difference in NEUT. The above indexes in the combination group were better than those in the other two groups（P<0.05）. After treatment， the cured and markedly effective rate was 76.7% （23/30） in the combination group， 50.0% （15/30） in the Chinese medicine group， and 46.7% （14/30） in the indirect moxibustion plaster group. The cured and markedly effective rate of the combination group was significantly higher than that of the Chinese medicine group （χ2=4.593， P<0.05） and the indirect moxibustion plaster group （χ2=5.711， P<0.05）. The total effective rate was 96.7 % （29/30） in the combination group， 93.3% （28/30） in the Chinese medicine group， and 86.7% （26/30） in the indirect moxibustion plaster group. The total effective rate of the combination group was higher than that of the Chinese medicine group and the indirect moxibustion plaster group， but the differences were not statistically significant. ConclusionChinese medicine combined with indirect moxibustion plaster can effectively improve the clinical symptoms，promote pulmonary inflammation，blood routine indexes， and inflammatory indexes， and improve the quality of life of COVID-19 patients during the recovery period，which is more advantageous than Chinese medicine alone or indirect moxibustion plaster.

Experience in radiation protection management in the tertiary general hospital / 中国辐射卫生

@#With widespread popularization, the radiological diagnosis and treatment technology has played an increasingly important role in clinical practice. The tertiary general hospital is generally featured as multiple types of radioisotope and radiation equipment, wide involvement of departments and persons, and many ways of use and potential harms of the radiological diagnosis and treatment technology. Radiation protection has become a content that cannot be ignored in hospital management. This article analyzes the radiation protection management structure of the tertiary general hospital - Guangdong Provincial People’s Hospital. The hospital radiation protection management is gradually improved by clarifying the main leading department, refining duties and responsibilities, strengthening multi-departmental communication and cooperation, and sorting out key connection links. A closed loop of refined management is formed through digging and correcting problems and continuously improving the management level and work efficiency. Valid qualifications are ensured to be obtained in time by radiation workers, radioactive drugs, equipment, and the venues to guarantee the radiation safety of radiation workers and patients and to further promote the construction of the Safe Hospital.

An investigation of frequency of radiation services in medical institutions in Hangzhou, China, 2020 / 中国辐射卫生

@#<b>Objective</b> To investigate radiation resources in medical diagnosis and treatment and their use frequency in medical institutions in Hangzhou, China, and to provide a basis for relevant departments to rationally allocate and scientifically supervise the resources. <b>Methods</b> From April 1, 2019 to March 31, 2020, a survey was conducted on the basic information, radiation staff, equipment configuration, and frequency of radiation diagnosis and treatment of all medical institutions in Hangzhou using a questionnaire. <b>Results</b> There were 1001 institutions with radiation services in Hangzhou, with 6714 radiation staff members and 2742 pieces of radiation equipment. The frequency of conventional X-ray diagnosis was 788.43 per 1000 population. The frequency of computed tomography diagnosis was 531.93 per 1000 population. The frequency of mammography and dental photography diagnosis was 246.34 per 1000 population. The frequency of interventional diagnosis and treatment was 10.01 per 1000 population. The frequency of radiotherapy was 2.39 per 1000 population. The frequency of nuclear medicine diagnosis was 8.90 per 1000 population. The frequency of nuclear medicine treatment was 0.99 per 1000 population. <b>Conclusion</b> Medical institutions have developed rapidly in Hangzhou, but with an unbalanced situation. In order to better protect the health of examinees, we recommend relevant departments optimize resource allocation and strengthen supervision on radiation protection in medical institutions.