ObjectiveTo address the challenges of unstructured classical Chinese expressions， nested entity relationships， and limited annotated data in famous traditional Chinese medicine（TCM） case records， this study proposes a joint relation extraction framework that integrates data augmentation and entity mapping， aiming to support the construction of TCM diagnostic knowledge graphs and clinical pattern mining. MethodsWe developed an annotation structure for entities and their relationships in TCM case texts and applied a data augmentation strategy by incorporating multiple ancient texts to expand the relation extraction dataset. A cascade binary tagging framework for relation triple extraction（CasRel） model for TCM semantics was designed， integrating a pre-trained bidirectional encoder representations from transformers（BERT） layer for classical TCM texts to enhance semantic representation， and using a head entity-relation-tail entity mapping mechanism to address entity nesting and relation overlapping issues. ResultsExperimental results showed that the CasRel model， combining data augmentation and entity mapping， outperformed the pipeline-based Bert-Radical-Lexicon（BRL）-bidirectional long short-term memory（BiLSTM）-Attention model. The overall precision， recall， and F₁-score across 12 relation types reached 65.73%， 64.03%， and 64.87%， which represent improvements of 14.26%， 7.98%， and 11.21% compared to the BRL-BiLSTM-Attention model， respectively. Notably， the F₁-score for tongue syndrome relations increased by 22.68%（69.32%）， and the prescription-syndrome relations performed the best with the F₁-score of 70.10%. ConclusionThe proposed framework significantly improves the semantic representation and complex dependencies in TCM texts， offering a reusable technical framework for structured mining of TCM case records. The constructed knowledge graph can support clinical syndrome differentiation， prescription optimization， and drug compatibility， providing a methodological reference for TCM artificial intelligence research.

BACKGROUND:The extracellular-regulated protein kinase 5(ERK5)signaling protein is essential for the survival of organisms,and resveratrol can promote osteoblast proliferation through various pathways.However,whether resveratrol can regulate osteoblast function through the ERK5 signaling protein needs further verification. OBJECTIVE:To explore the regulatory effect of ERK5 on the proliferation of MC3T3-E1 cells and related secreted proteins,and to further verify whether resveratrol can complete the above process by activating ERK5. METHODS:Mouse MC3T3-E1 preosteoblasts were treated with complete culture medium,XMD8-92(an ERK5 inhibitor),epidermal growth factor(an ERK5 activator),resveratrol alone,XMD8-92+EGF,and resveratrol+XMD8-92,respectively.Western blot assay was used to detect the expression of ERK5 and p-ERK5 proteins,proliferation-related proteins Cyclin D1,CDK4 and PCNA,and osteoblast-secreted proteins osteoprotegerin and receptor activator of nuclear factor-κB ligand in MC3T3-E1 cells of each group.The fluorescence intensity of ERK5,osteoprotegerin and receptor activator of nuclear factor-κB ligand in each group was detected by cell immunofluorescence staining,and cell proliferation was detected by EdU staining,respectively.The appropriate concentration and time of resveratrol intervention in MC3T3-E1 cells were determined by cell morphology observation and cell counting kit-8 assay. RESULTS AND CONCLUSION:The activation of ERK5 signaling protein could effectively promote the proliferation of MC3T3-E1 cells,up-regulate the osteoprotegerin/receptor activator of nuclear factor-κB ligand ratio.The appropriate concentration and time for resveratrol intervention in MC3T3-E1 cells was 5 μmol/L and 24 hours,respectively.Resveratrol could activate ERK5 signaling protein,thereby promoting osteoblast proliferation and up-regulating the osteoprotegerin/RANKL ratio.All these results indicate that resveratrol can promote the proliferation of MC3T3-E1 cells and up-regulate the osteoprotegerin/RANKL ratio by activating the ERK5 signaling protein.

Objective To investigate the risk factors of decompression bleeding of CSDH patients after minimally invasive drainage and to construct prediction model to provide more reference for developing more targeted prevention and treatment strategies and improving prognosis.Methods 165 CSDH patients after minimally invasive drainage were retrospectively chosen in the period from January 2019 to January 2023 in our hospital and grouped according to whether decompression bleeding occurred after surgery or not into bleeding group(33 cases)and non-bleeding group(132 cases).The univariate and multivariate method were used to analyze the risk factors of decompression bleeding of CSDH patients after minimally invasive drainage.Construction of risk prediction model for decompression bleeding after CSDH minimally invasive drainage.Results The results of single factor analysis showed that both intracavitary pressure and midline recovery rate of hematoma may be related to decompression bleeding after CSDH minimally invasive drainage(P＜0.05).The results of multifactor analysis(bleeding group=1,non-bleeding group=0)showed that intracavitary pressure and midline recovery speed were independent factors influencing the risk of decompression bleeding after CSDH minimally invasive drainage(P＜0.05).Intracranial pressure,postoperative midline recovery speed and Logistic regression model P value were used to predict decompression bleeding after CSDH minimally invasive drainage.The area under ROC curve was 0.784,0.778 and 0.840,respectively,and the approximate den index was 50.76％,44.70％and 56.82％.Conclusion The incidence of decompression bleeding after CSDH minimally invasive drainage was related to the intracavitary pressure of hematoma and the recovery rate of postoperative midline and the prediction model based on the above factors can guide the identification of high risk groups of early decompression bleeding.

Wubeizi(Galla Chinensis)is a commonly used traditional Chinese medicine in modern clinical practice,which is widely used to treat hemorrhoids,bleeding,mouth ulcers and other diseases.Based on the incopat patent database,the global Galla Chinensis sub-patent search in the past 20 years was conducted,and a total of 8123 related patents were retrieved;Using the basic chart analysis method,the pattern analysis of Galla Chinensis sub-patents was carried out from the aspects of application trend,patent value,technical field,legal status,etc.The analysis results show that the development of Galla Chinensis is in the rapid development stage,Galla Chinensis has in-depth research in the treatment of hemorrhoids,oral ulcers,bleeding,Chinese herbal medicine,Chinese patent medicine and cosmetics are the hot spot of research and development at present,China and South Korea are the main distribution countries of Galla Chinensis patents.The number of Chinese Galla Chinensis patents is large,but the patent quality,value and patent level of the world have a certain gap.In view of the current development trend of Galla Chinensis,there is still a large amount of patent application space in this field.Chinese Galla Chinensis patent applicants can combine their own advantages,development trend and short board to formulate scientific development strategy,thus improving the core competitiveness of Galla Chinensis industry fundamentally.

Malignant insulinoma is a kind of rare and challenging neuroendocrine tumor. It is often accompanied by distant metastasis, among which liver metastasis is most common, and the prognosis is often non-promising. In this paper, we report a case of multiple liver metastases from malignant insulinoma. The patient, a 70-year-old male, was admitted to the hospital due to "episodic consciousness disorder for more than four months." Blood glucose monitoring revealed recurrent hypoglycemia in the early morning, after meals, and at night. Pancreatic perfusion CT and dynamic enhanced MRI of the liver revealed a mass in the uncinate process of the pancreatic head and multiple liver metastases. Percutaneous liver biopsy confirmed the diagnosis of insulinoma. After multidisciplinary discussions, hepatic artery embolization and radiofrequency ablation were performed in stages, in combination with everolimus treatment. Thereafter, the enhanced CT demonstrated that some liver metastases shrank. The patient had regular meals, and the blood sugar gradually increased and remained normal thereafter. This article discusses this case's clinical characteristics and multidisciplinary collaborative diagnosis and treatment, aiming to provide experience for the comprehensive clinical diagnosis and treatment of malignant insulinoma patients.

Objective     To evaluate the clinical radiological features combined with circulating tumor cells (CTCs) in the diagnosis of invasiveness evaluation of subsolid nodules in lung cancers. Methods     Clinical data of 296 patients from the First Hospital of Lanzhou University between February 2019 and February 2021 were retrospectively included. There were 130 males and 166 females with a median age of 62.00 years. Patients were randomly divided into a training set and an internal validation set with a ratio of 3 : 1 by random number table method. The patients were divided into two groups: a preinvasive lesion group (atypical adenomatoid hyperplasia and adenocarcinoma in situ) and an invasive lesion group (microinvasive adenocarcinoma and invasive adenocarcinoma). Independent risk factors were selected by regression analysis of training set and a Nomogram prediction model was constructed. The accuracy and consistency of the model were verified by the receiver operating characteristic curve and calibration curve respectively. Subgroup analysis was conducted on nodules with different diameters to further verify the performance of the model. Specific performance metrics, including sensitivity, specificity, positive predictive value, negative predictive value and accuracy at the threshold were calculated. Results     Independent risk factors selected by regression analysis for subsolid nodules were age, CTCs level, nodular nature, lobulation and spiculation. The Nomogram prediction mode provided an area under the curve (AUC) of 0.914 (0.872, 0.956), outperforming clinical radiological features model AUC [0.856 (0.794, 0.917), P=0.003] and CTCs AUC [0.750 (0.675, 0.825), P=0.001] in training set. C-index was 0.914, 0.894 and corrected C-index was 0.902, 0.843 in training set and internal validation set, respectively. The AUC of the prediction model in training set was 0.902 (0.848, 0.955), 0.913 (0.860, 0.966) and 0.873 (0.730, 1.000) for nodule diameter of 5-20 mm, 10-20 mm and 21-30 mm, respectively. Conclusion     The prediction model in this study has better diagnostic value, and is more effective in clinical diagnosis of diseases.

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

Objective:To investigate five kinds of tuberculin skin test (TST), tubercle bacillus-antibody(TB-Ab), interferon-γ release assay(IGRA), tubercle bacillus-DNA (TB-DNA) and collection of bacterial centrifugal smears methods, the application value of combined detection in improving the diagnostic efficiency of pneumoconiosis complicated with tuberculosis.Methods:A total of 150 eligible patients with pneumoconiosis from January 2018 to January 2019 in Zhangjiakou Pulmonary Hospital were selected as the research subjects, and all of them underwent TST, TB-Ab, IGRA, TB-DNA and bacterial centrifugal smear detection. Compared the positive rates of five detection methods in pneumoconiosis and its different stages, and compare the proportion of tuberculosis infection and tuberculosis in different stages of pneumoconiosis.Results:Among the 150 patients with pneumoconiosis, 41 cases (27.33%) were with pneumoconiosis complicated with tuberculosis infection, 24 cases (16.00%) with pneumoconiosis complicated with clinically diagnosed pulmonary tuberculosis, 21 cases (14.00%) with pneumoconiosis complicated with confirmed pulmonary tuberculosis, and 45 cases (30.00%) with pneumoconiosis complicated with pulmonary tuberculosis; with the improvement of pneumoconiosis stage, the proportion of pneumoconiosis combined with tuberculosis infection and pulmonary tuberculosis increased significantly ( P<0.05). Compared with TB-Ab, TB-loop-mediated isothermal amplification(LAMP), and interlayered cup collection centrifuge smear method, the overall positive rate of IGRA detection and pneumoconiosis stage Ⅲ were higher ( P<0.05), but there was no significant difference compared with TST detection ( P>0.05). The positive rate of combined detection was higher, but there was no significant difference compared with IGRA detection ( P>0.05). With the increase of pneumoconiosis stage, the positive reaction intensity of TST decreased, and the positive value of TB-Ab and IGRA increased. Conclusions:The combined detection of TST, TB-Ab, IGRA, TB-DNA and bacterial centrifugal smear method can significantly improve the diagnostic efficiency of pneumoconiosis combined with tuberculosis.

Late-onset hypogonadism (LOH) is an age-related testosterone deficiency syndrome. With the increasing aging of society, LOH results in impaired quality of life of middle-aged and elderly men. Although domestic and international guidelines have been issued in recent years, and the management of LOH became more standardized, numerous controversies still remained in the diagnosis of LOH, the benefits of testosterone replacement therapy (TRT) and therapeutic targets. Based on comparison of different guidelines, this review focuses on age cut-off , specific signs and symptoms of LOH, diagnostic cut-off level of testosterone, the advantages and disadvantages of TRT treatment, and non-testosterone therapy.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.