Objective To study and evaluate the MRI findings and their diagnostic value for breast carcinoma.Methods Preoperative contrast-enhanced MR imaging and mammography were performed in 12 patients who underwent surgery and were histopathologically proved with breast carcinoma.MR imaging findings were compared with clearly mammography.Results Twenty-one breast lesions in 12 cases were detected with MR imaging.Seventeen of the twenty-one lesions were detected with mammography.Contrast-enhanced MR imaging was superior to mammography to demonstrate lesions in these dense breasts.It could clearly indicate the extension of posterior breast carcinoma into the pectoralis major muscle and the metastases of parasternal lymphatic node,while it was difficult to evaluate with mammography.The "rim enhancement sign" might be valuable to diagnose breast carcinoma.Conclusion The sensitivity and accuracy of MR imaging is superior to that of mammography.Contrast-enhanced imaging of the breast is helpful not only in early diagnosis of breast carcinoma but also in staging breast carcinoma and planning therapy.

Objective To study therapeutic efficacy of Aredia in treating malignant metastatic bone tumors. Method 60～ 90 mg Aredia was administrated iv in 31 cases with malignant metastatic tumors,once each week. Results Pain in 12 cases was significantly relieved.14 cases acquired relif.Total effective rate was 83.9% .Activity ability was improved by 80.6% .No apparent toxicological and adverse effects as well as fever and cold symptoms were observed.Conclusion Aredia is a kind of ideal drugs for treatment of pain caused by malignant metastatic bone tumors.It is convenient in use and could be endured by patients.

Objective To assess the value of magnetic resonance imaging for acute pancreatitis.Methods 77 patients of acute pancreatitis were examined with holding breath MRI sequence.Transverse scan:2D Flash T 1WI/T 1W+FS,TSE T 2WI+FS or HASTE+FS,Trufisp.Coronals scan:2D Flash T 1W+FS.MRCP was used in 34 patients.2D Flash dynamic contrast enhanced were used in 77 patients.Results 59 cases of acute edematous pancreatitis showed swelling and low signal intensity on T 1WI and higher signal intensity on T 2WI.Excepted the above findings,18 cases of hemorrhagic necrosis pancreatitis alos showed the higher signal intensity on T 1WI and peripancreatic exudative hydrops.Conclusion MRI is a reliable method for demonstrating acute pancreatitis.

BACKGROUNDTo investigate the efficacy of combined hyperfractionated radiation therapy (HFX RT) plus accelerated HFX RT and concomitant chemotherapy (CHT) in stage IIIA or IIIB non-small-cell lung cancer (NSCLC) compared with HFX RT alone.

METHODSFrom August 1998 to December 2001, 56 patients with NSCLC were randomized into the following groups: HFX RT alone group (group I, n=28), HFX RT with 1.2 Gy twice daily to a total dose of 45.6 Gy, followed by accelerated HFX RT with 1.6 Gy twice daily, the total planned radiation dose was 68.0 Gy in tumour; HFX RT/CHT concomitant group (group II, n=28), same RT with CHT consisting of 20 mg/m² of cisplatin (DDP) on days 1 to 3 and 50 mg/m² of etoposide (VP 16) on days 1 to 3, repeated every two weeks during the RT course.

RESULTSThe overall response rate was 78.6% in group II, including 10 patients with complete response and 12 with partial response; 39.3% in group I, including 11 patients with partial response. Group II had a higher overall response rate compared to Group I (P=0.003). The median survival time was 16 months for group II, 13 months for group I. There was a significant difference in the median survival time between two groups (P= 0.000 3 ). Group II (57.1%) had a lower distant metastasis rate compared with group I (85.7%) (P= 0.018 ). Patients in group II showed a higher incidence of acute and/or late high-grade toxicity (hematologic toxicity, esophagitis, late lung toxicity) compared with group I patients, but no significant difference was observed between the two groups.

CONCLUSIONSThe HFX RT plus accelerated HFX RT and concomitant PDD/VP-16 CHT is tolerable and substantially increases the response rate and prolongs survival in IIIA/IIIB NSCLC patients.

Objective:To analyze the selection pattern of auricular acupressure points based on association rules and entropy clustering of complex systems for the treatment of diabetes mellitus combined with insomnia.Methods:The relevant studies on auricular acupressure in the treatment of diabetes mellitus complicated with insomnia were searched by computer from CNKI, Wanfang Database, VIP and China Biomedical Medicine Disc. The search period was from the establishment of the databases to January 2023. Excel 2019 was used to establish the auricular prescription database, and the traditional Chinese medicine inheritance platform was used for data analysis.Results:Finally, 81 articles were included, involving 27 auricular points. The high frequency syndrome types of diabetes combined with insomnia were heart-spleen deficiency, liver stagnation and fire, heart and gallbladder qi deficiency and phlegm-heat internal disturbance. The high frequency auricular points were shen men, subcortical, sympathetic, etc. Eight groups of auricular point combination were obtained, which were composed of the combination of shen men, heart, subcortical and sympathetic, and 14 rules of strongly associated auricular point combinations were obtained. A total of 15 core groups containing 3 auricular points were extracted. Five new auricular points were developed, including heart, forehead, temporal, kidney; heart, anterior pituitary, deep sleep point, insomnia; liver, anterior pituitary, brain point, stomach, spleen; frontal, endocrine, sympathetic, mouth; stomach, spleen, pancreas and gallbladder, liver, kidney and gallbladder.Conclusions:The compatibility rule, core combination and new prescription of auricular points found in this study can provide new ideas and inspiration for nurses to use auricular acupressure in the treatment of diabetes mellitus complicated with insomnia in the future.

Objective To evaluate the quality of hypoglycemia fear assessment tools for adults,so as to provide references for the selection of high-quality research tools.Methods PubMed,Embase,Web of Science,CNKI,VIP,Wanfang,CBM were retrieved to collect the literature on the measurement properties of hypoglycemic fear.There were 2 researchers who screened the literature and extracted data,independently.Based on the consensus-based standards for the selection of health measurement instruments(COSMIN)guideline,the methodological and measure-ment properties quality of the included assessment tools were evaluated by the COSMIN risk of bias checklist and quality criteria.Results A total of 17 studies involving 6 hypoglycemia fear assessment tools for adults were included,none of which reported cross-cultural validity,measurement error,and responsiveness.All assessment tools were recommended by grade B.Conclusion The 15-item Fear of Hypoglycemia Scale(FH-15)has the most comprehensive measurement properties in its evaluation,and can be provisionally recommended for use,but it needs further testing.

Objective:To evaluate the effect of preemptive analgesia with ibuprofen on postoperative pain following single posterior tooth implantation, aiming to provide a clinical reference for its application.Methods:A multicenter, randomized, double-blind, placebo-controlled parallel-group trial was conducted. A total of 82 participants were included in the trial, meeting the eligibility criteria from April 2022 to April 2024 at the Capital Medical University School of Stomatology (40 cases), Beijing TianTan Hospital, Capital Medical University (22 cases), Beijing Chao-Yang Hospital, Capital Medical University (20 cases). Participants were randomly assigned in a 1∶1 ratio to either the ibuprofen group or the control group, with each group comprising 41 individuals. Participants in the ibuprofen group received 300 mg of sustained-release ibuprofen capsules orally 15 min before surgery, while the control group received a placebo. Both groups received the same postoperative analgesic regimen for 3 days. Pain scores were assessed using the numerical rating scale at 30 min, 4 h, 6 h, 8 h, 24 h, 48 h, and 72 h postoperatively, and the additional use of analgesic medication was recorded from days 4 to 6 postoperatively.Results:A total of 82 participants were initially enrolled in the study, with 7 dropouts (4 from the control group and 3 from the ibuprofen group), resulting in 75 participants (37 in the control group and 38 in the ibuprofen group) completing the trial. There were no reports of adverse events such as nausea or vomiting among the participants. The ibuprofen group exhibited significantly lower pain scores at 4 h, 6 h and 8 h [1.0 (0.0, 2.0), 1.0 (0.0, 2.0), 1.5 (0.0, 3.0) ] postoperatively compared to the control group 4 h, 6 h and 8 h [2.0 (1.0, 3.0), 3.0 (1.5, 4.0), 2.0 (1.0, 4.0)] ( Z=-1.99, P=0.047; Z=-3.01, P=0.003; Z=-2.10, P=0.036). The proportions of patients requiring additional analgesic medication between days 4 and 6 post-surgery were 18.4% (7/38) in the ibuprofen group and 27.0% (10/37) in the control group, with no significant difference (χ 2=0.79, P=0.373). The median additional medication usage postoperatively was [0.0 (0.0, 0.0) pills] in the ibuprofen group and [0.0 (0.0, 1.0) pills] in the control group, with no significant difference ( Z=-0.78, P=0.439). Conclusions:Preemptive analgesia with ibuprofen effectively reduces postoperative pain following tooth implantation, representing a safe and effective perioperative pain management strategy.

Objective To explore the application effects of the structured intervention model on the protective restriction in psychiatric inpatients.Methods The study investigated 91 8 psychiatric inpatients hospitalized from January 201 3 to December 201 4.The participants were randomly divided into the intervention group (n =469 )and the control group (n =449 ).The patients of intervention group received protective restriction based on the structured intervention model.A standard risk assessment was applied before and after the restriction.The patients of control group received the routine protective restriction.The protection rate, protection duration,and day-night protection time were compared between the two groups.Results The protection rate was 1 5.4% (71 /469)for the intervention group,which was lower than the rate of 20.49%(92 /449)for the control group (P <0.05 ).The difference of day-night protection was also statistically significant between the two arms (P <0.05).Conclusions The application of structured intervention model on the clinical practice can effectively reduce the protection rate and protection duration in psychiatric inpatients.

Objective To investigate the protective effect and mechanism of apigenin on the liver of hyperlipidemic mice based on metabolomics methods.Methods C57BL/6 mice were randomly divided into four groups including blank,model,fenofibrate(26.0 mg·kg-1),and apigenin(12.5 mg·kg-1)groups,with six mice in each group.Each group was treated with corresponding drug by gavage once a day for five days.On the third day of administration,the mouse model of acute hyperlipidemia was induced by a single intramuscular injection of Triton WR-1339(5 mL·kg-1)at a concentration of 0.12 g·mL-1.Biochemical indexes such as TC and TG in mice serum were measured by using a fully automatic microplate reader.HE staining was used to observe pathological changes in liver tissue.UPLC-Q-TOF-MS/MS technology was applied to analyze liver tissue samples.Differential metabolites were screened by using multivariate statistical analysis methods such as PCA,PLS-DA,and OPLS-DA.Then we ran the mass spectrometry information of these metabolites through online databases including HMDB,METLIN and KEGG,as well as combined with relevant literature to obtain the potential differential metabolites.The identified potential differential compounds were imported into the MetaboAnalyst platform for metabolic pathway analysis.Results Compared with the blank group,TC and TG levels in mice serum of model group increased obviously(P＜0.01).Irregular arrangement of liver cells,fat vacuoles and infiltration of inflammatory cells were found.Compared with the model group,TC and TG levels in mice serum of apigenin group decreased(P＞0.05).Fatty lesions in liver tissue were significantly improved,and fat vacuoles and inflammatory cell infiltration were significantly reduced.A total of 35 differential metabolites were screened.Twenty-six differential metabolites showed callback trend after apigenin treatment.Eight metabolic pathways were obviously affected,among which pantothenate and CoA biosynthesis,as well as arachidonic acid metabolism are two main metabolic pathways(P＜0.05).Conclusion Apigenin exhibits a certain protective effect on liver of hyperlipidemic mice,and its mechanism may be related to regulating liver inflammatory response and lipid metabolism-related pathways.

With the rapid development of the interdisciplinary area of artificial intelligence and medicine, large language model (LLM) has been widely used in the fields such as diagnosis and treatment, medicine, and healthcare. LLM has unique advantages in the field of traditional Chinese medicine (TCM), such as high consistency with the "Four Diagnostic Methods", perfect combination of natural language and self-supervised learning in TCM, the ability to adapt to the characteristics TCM formulas, and the assistance in TCM diagnosis and treatment. At present, various LLM models have been developed, including the "Qihuang Ask Big Model" and the Digital Traditional Chinese Medicine Big Model "GLM-130B", but they still face challenges such as value mismatch and medical abuse, increased demand for interpretability, lack of advanced technology, and domestic policy access. This article reviews the evolution of LLM, its unique advantages and applications in the field of TCM, the problems and challenges, and the future development trends, in order to providereference for the further promotion of LLM in traditional medicine.