Objective To explore the preoperative diagnostic value of multi slice spiral CT post-process-ing technology for intralobar pulmonary sequestration.Methods A total of 54 patients with abnormal arterial blood supply admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were included retrospectively as the study subjects,including 43 patients with intralobar pulmonary isolation(study group)and 11 patients with normal inferior pulmonary lobe(control group).All patients underwent preoperative multi-slice spiral CT chest plain scan and enhanced scan.Four CT post-processing techniques(MPR,CPR,MIP,and VR)were used to reconstruct the images.The location of abnormal body artery blood supply,other changes in the lungs,and characteristics of blood supply arteries and reflux veins in two groups of patients were analyzed and recorded.Kappa consistency test was used to evaluate the consistency of the re-sults of two physicians' readings.Spearman correlation test was used to evaluate the correlation between the diagnostic results of four post-processing techniques.ROC curve and Delong test were used to evaluate their independent and combined diagnostic efficacy for intrapulmonary sequestration.Results The Kappa test con-sistency coefficient of the two physicians' reading results was r=0.872,P＜0.05.The Spearman test correla-tion coefficients between the diagnostic results of the four post-processing techniques were 0.876(MPR and CPR),0.849(MPR and MIP),0.876(MPR and VR),0.738(CPR and MIP),1.000(CPR and VR),and 0.738(MIP and VR),respectively,with P＜0.05.The AUC values for independent diagnosis of MPR,CPR,MIP,and VR were 0.66,0.58,0.70,and 0.53,respectively.The sensitivities were 95.35％,69.77％,76.74％,and 69.77％,respectively.The specificities were 36.36％,45.45％,63.64％,and 36.36％,respectively.The Youden indexes were 0.32,0.15,0.40,and 0.06,respectively.The accuracies were 88.37％,83.72％,90.70％and 83.72％,respectively.The AUC value,sensitivity,specificity,Youden index,and accuracy of joint diagno-sis were 0.78,83.72％,72.73％,0.56,and 95.35％,respectively.Conclusion The combined application of CTA,MPR,VR,and MIP post-processing techniques has the best diagnostic efficacy for intralayer pulmonary sequestration and can be used for precise preoperative evaluation in clinical practice.

Objective:To explore the application effect of Kaitianmen point massage on pain, faligue, anxiety and depression in patients with rheumatoid arthritis.Methods:This study was a randomized controlled study, a total of 80 patients with rheumatoid arthritis who were admitted to Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine from May to November 2023 were selected as the research objects. The control group was given routine treatment and nursing, and the experimental group was given Kaitianmen acupoint massage on the basis of routine treatment and nursing. The differences in pain score, fatigue score, anxiety and depression score before and after intervention were compared between the two groups.Results:In the final, there were 37 cases in the experimental group and 36 cases in the control group completed the study. Before intervention, there was no statistically significant difference in pain scores, fatigue scores, anxiety and depression scores between the two groups (all P>0.05). After four weeks of intervention, the pain score of the experimental group was (2.06 ± 0.35), and that of the control group was (3.72 ± 0.59), the difference was statistically significant ( t=14.57, P<0.05). After four weeks of intervention, the fatigue score of the experimental group was (20.11 ± 8.03), and that of the control group was (25.02 ± 8.32), the difference was statistically significant ( t=2.55, P<0.05). After four weeks of intervention, the anxiety score of the experimental group was (48.33 ± 6.13), which was significantly different from (53.99 ± 4.91) of the control group ( t=4.35, P<0.05), and the depression score of the experimental group was (49.99 ± 6.33), compared with the (54.86 ± 4.83) of control group, the difference was statistically significant ( t=3.69, P<0.05). Conclusions:Kaitianmen acupoint massage can relieve limb pain, fatigue, anxiety and depression in patients with rheumatoid arthritis, which is worthy of clinical promotion.

Objectives:To explore the relationship between carboxymethyl lysine (CML) and type 2 diabetes (T2DM) with myopenia, so as to provide some clinical reference for clinical prevention and early intervention of myopenia.Methods:A case-control study was conducted, selecting 142 T2DM patients admitted to the Endocrinology Department of the Affiliated Hospital of North China University of Science and Technology from November 2022 to November 2023. According to the diagnostic criteria of the 2019 consensus of experts on the diagnosis and treatment of sarcopenia, the patients were divided into a case group (T2DM with sarcopenia, 58 cases) and a control group (T2DM without sarcopenia, 84 cases). Collect and compare general information, serological data, and body composition data of two groups of patients. Two independent sample t-test is used for inter group comparison of metric data that conforms to normal distribution; Non parametric tests are used for inter group comparisons of non normally distributed quantitative data; The comparison of count data between groups is conducted using χ2 test. Multivariate logistic regression analysis was used to analyze the relationship between carboxymethyl lysine and type 2 diabetes with myopenia. Draw receiver operating characteristic (ROC) curves and analyze the efficacy of carboxymethyllysine in diagnosing T2DM with muscle atrophy. Results:Univariate analysis showed the BMI ((21.59±3.04) kg/m 2), FINS (4.49 (1.85,9.03) U/L), and FCP ((1.45±0.96) mg/L) levels of the patients in the case group were lower than those in the control group(27.32±3.74) kg/m 2, 6.91 (3.74, 11.99) U/L, (2.64±1.23) mg/L), while age, ((64.67±6.75) years old) of disease duration(12.16±6.69) years, and CML (5.70±2.14 μg/L) were higher than those in the control group ((62.23±7.33) years old, (8.70±8.01) years, (2.38±0.73) μg/L), and the differences were statistically significant (Statistical values were t=9.66, Z=2.86, t=6.46, t=2.02, t=2.70, t=13.17; P values were <0.001, 0.004, <0.001, 0.046, 0.008, <0.001). Multifactorial binary logistic regression analysis showed that CML ( OR(95%CI):3.242 (1.933-5.437)) and BMI ( OR(95%CI):0.636 (0.505-0.801)) were associated with T2DM combined with sarcopenia (all P<0.001). The results of the ROC curve showed that the area under the curve (AUC) of CML was 0.934, and the corresponding optimal cut-off value was 3.038 μg/L. The diagnostic efficacy of CML for the diagnosis of T2DM combined with myasthenia gravis was high, and the diagnostic results were in good agreement with the actual results. Conclusions:Carboxymethyl lysine is associated with T2DM combined with muscle atrophy. CML has a high diagnostic efficacy in diagnosing T2DM combined with muscle atrophy, and it has certain practical value in diagnosing T2DM combined with muscle atrophy.

Objective To summarize the best evidence of early rehabilitation management of hand function in patients with hand burn,and provide basis for medical personnel to carry out early rehabilitation management of hand burn.Methods According to the 5S model,all evidence on early rehabilitation management of hand function in patients with hand burns was retrieved from databases and websites including UpToDate,BMJ Best Practice,NICE,RNAO,GIN,and so on.The retrieved evidence included clinical decisions,guidelines,evidence summaries,expert consensuses,systematic reviews,Meta analysis.The search period of the summary of best evidence,expert concensus and guidelines are from the establishment of the database to December 20,2024,and the search period of the systematic reviews is from January 1,2019 to December 20,2024.Quality evaluation of literature,evidence extraction and summary were conducted.The evidence was graded according to JBI evidence pre-grading system 2014.Results Totally 17 pieces of the literature were included,including 1 clinical decision,4 guidelines,6 evidence summaries,3 expert consensus articles,and 3 systematic reviews.Totally pieces of best evidence were summarized,including 7 aspects of assessment,hand positioning,treatment of edema,dressing,use of orthotics,joint mobility training,and health education.Conclusion This study summarized the best evidence of early rehabilitation management of hand function in patients with hand burn,and provided evidence-based evidence for clinical rehabilitation management plan.According to the clinical situation,the medical staff can apply the evidence to clinical practice,so as to improve the hand function and quality of life of patients.

Objective To systematically evaluate the quality of Fengshiding capsules,to analyze existing problems based on national drug sampling and testing,and to offer references and suggestions for improving quality control and regulatory supervision of this product.Methods A total of 136 batches of Fengshiding capsules were subjected to standard quality tests and exploratory analyses.HPLC was used to establish the content determination of Angelica dahurica,Cynanchum paniculatum,and Glycyrrhizae Radix,as well as the limit test for anabasine in the preparation.Additionally,an UPLC method was also employed to establish the characteristic chromatogram of Fengshiding capsules.A screening method for artificial pigments was developed,and UPLC-MS/MS was used to detect the illegal addition of chemical drugs in Fengshiding capsules.Results All 136 batches of samples passed inspection according to the current quality standards.However,based on exploratory study evaluations,the content determination results of Cynanchum paniculatum,Angelica dahurica,and Glycyrrhiza Radix were below the proposed limits.The limit test for anabasine did not exceed the proposed threshold.Furthermore,the characteristic chromatograms revealed missing peaks in several samples,and some batches contained artificial pigments and residues of acetaminophen.Conclusions The overall quality of Fengshiding capsules is rated as"average"based on national drug sampling and testing.To enhance product quality,it is recommended to improve quality standards,ensure the use of high-quality raw herbal materials,promote stronger internal oversight by manufacturers,and intensify regulatory supervision.

Objective:To observe the clinical effect of the Yiqi Yangxue Shengsui Formula in the prevention and treatment of adverse bleeding events caused by platinum-based dual drugs combined with bevacizumab chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). Methods:A prospective, single-center, randomized controlled trial design was adopted. The research subjects were patients with stage Ⅲb-Ⅳb non-squamous NSCLC who were hospitalized at Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from December 2022 to March 2024. Patients who met the inclusion criteria were randomly assigned to the experimental group and the control group in a 1∶1 ratio. The control group received a platinum-based doublet regimen [pemetrexed disodium for injection+cisplatin/carboplatin, or paclitaxel protein-bound for injection+cisplatin/carboplatin] combined with bevacizumab for 4 courses of treatment; the experimental group was treated with the same regimen plus the traditional Chinese medicine Yiqi Yangxue Shengsui Formula, nourishing blood and generating bone marrow. The primary observation index was the incidence and grade of adverse bleeding events during the 4 courses of treatment. The secondary observation indices were the occurrence time and duration of bleeding, the grade of the lowest platelet count during treatment, the platelet count grade at the time of bleeding, and coagulation function indicators. Results:A total of 77 patients were included, with 39 in the experimental group and 38 in the control group. Among them, 29 were male (37.7%) and 48 were female (62.3%); 35 were aged 65 years or older and 42 were younger than 65 years. There were no statistically significant differences between the 2 groups in terms of gender, age, lung cancer stage, pathological type, and chemotherapy drug selection ( P> 0.05). The incidence of adverse bleeding events in the experimental group was significantly lower than that in the control group [17.9%(7/39) vs. 39.5%(15/38), P=0.037]. There was no statistically significant difference in the grading of adverse bleeding events between the 2 groups ( P>0.05). The duration of bleeding in the experimental group was shorter than that in the control group [(2.57±1.13) days vs. (5.67±1.80) days, P<0.001]. The minimum platelet count classification during the treatment period, and the platelet count classification at the time of bleeding in the experimental group were both better than those in the control group ( P<0.05). The prothrombin time and international normalized ratio when bleeding occurred in the experimental group were both lower than those in the control group [(10.96±0.39) s vs. (11.49±0.50) s and 0.97±0.04 vs. 1.02±0.06, P<0.05]. There were no statistically significant differences between the 2 groups of patients in terms of activated partial thromboplastin time, fibrinogen degradation products and D-dimer ( P>0.05). Conclusion:The Yiqi Yangxue Shengsui formula can effectively prevent and treat bleeding adverse events related to platinum-based dual-drug chemotherapy combined with bevacizumab in patients with advanced NSCLC. The mechanism may be related to the increase of platelet count and the improvement of exogenous coagulation function indicators.

Objectives:To explore the relationship between carboxymethyl lysine (CML) and type 2 diabetes (T2DM) with myopenia, so as to provide some clinical reference for clinical prevention and early intervention of myopenia.Methods:A case-control study was conducted, selecting 142 T2DM patients admitted to the Endocrinology Department of the Affiliated Hospital of North China University of Science and Technology from November 2022 to November 2023. According to the diagnostic criteria of the 2019 consensus of experts on the diagnosis and treatment of sarcopenia, the patients were divided into a case group (T2DM with sarcopenia, 58 cases) and a control group (T2DM without sarcopenia, 84 cases). Collect and compare general information, serological data, and body composition data of two groups of patients. Two independent sample t-test is used for inter group comparison of metric data that conforms to normal distribution; Non parametric tests are used for inter group comparisons of non normally distributed quantitative data; The comparison of count data between groups is conducted using χ2 test. Multivariate logistic regression analysis was used to analyze the relationship between carboxymethyl lysine and type 2 diabetes with myopenia. Draw receiver operating characteristic (ROC) curves and analyze the efficacy of carboxymethyllysine in diagnosing T2DM with muscle atrophy. Results:Univariate analysis showed the BMI ((21.59±3.04) kg/m 2), FINS (4.49 (1.85,9.03) U/L), and FCP ((1.45±0.96) mg/L) levels of the patients in the case group were lower than those in the control group(27.32±3.74) kg/m 2, 6.91 (3.74, 11.99) U/L, (2.64±1.23) mg/L), while age, ((64.67±6.75) years old) of disease duration(12.16±6.69) years, and CML (5.70±2.14 μg/L) were higher than those in the control group ((62.23±7.33) years old, (8.70±8.01) years, (2.38±0.73) μg/L), and the differences were statistically significant (Statistical values were t=9.66, Z=2.86, t=6.46, t=2.02, t=2.70, t=13.17; P values were <0.001, 0.004, <0.001, 0.046, 0.008, <0.001). Multifactorial binary logistic regression analysis showed that CML ( OR(95%CI):3.242 (1.933-5.437)) and BMI ( OR(95%CI):0.636 (0.505-0.801)) were associated with T2DM combined with sarcopenia (all P<0.001). The results of the ROC curve showed that the area under the curve (AUC) of CML was 0.934, and the corresponding optimal cut-off value was 3.038 μg/L. The diagnostic efficacy of CML for the diagnosis of T2DM combined with myasthenia gravis was high, and the diagnostic results were in good agreement with the actual results. Conclusions:Carboxymethyl lysine is associated with T2DM combined with muscle atrophy. CML has a high diagnostic efficacy in diagnosing T2DM combined with muscle atrophy, and it has certain practical value in diagnosing T2DM combined with muscle atrophy.

Objective:To observe the clinical effect of the Yiqi Yangxue Shengsui Formula in the prevention and treatment of adverse bleeding events caused by platinum-based dual drugs combined with bevacizumab chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). Methods:A prospective, single-center, randomized controlled trial design was adopted. The research subjects were patients with stage Ⅲb-Ⅳb non-squamous NSCLC who were hospitalized at Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from December 2022 to March 2024. Patients who met the inclusion criteria were randomly assigned to the experimental group and the control group in a 1∶1 ratio. The control group received a platinum-based doublet regimen [pemetrexed disodium for injection+cisplatin/carboplatin, or paclitaxel protein-bound for injection+cisplatin/carboplatin] combined with bevacizumab for 4 courses of treatment; the experimental group was treated with the same regimen plus the traditional Chinese medicine Yiqi Yangxue Shengsui Formula, nourishing blood and generating bone marrow. The primary observation index was the incidence and grade of adverse bleeding events during the 4 courses of treatment. The secondary observation indices were the occurrence time and duration of bleeding, the grade of the lowest platelet count during treatment, the platelet count grade at the time of bleeding, and coagulation function indicators. Results:A total of 77 patients were included, with 39 in the experimental group and 38 in the control group. Among them, 29 were male (37.7%) and 48 were female (62.3%); 35 were aged 65 years or older and 42 were younger than 65 years. There were no statistically significant differences between the 2 groups in terms of gender, age, lung cancer stage, pathological type, and chemotherapy drug selection ( P> 0.05). The incidence of adverse bleeding events in the experimental group was significantly lower than that in the control group [17.9%(7/39) vs. 39.5%(15/38), P=0.037]. There was no statistically significant difference in the grading of adverse bleeding events between the 2 groups ( P>0.05). The duration of bleeding in the experimental group was shorter than that in the control group [(2.57±1.13) days vs. (5.67±1.80) days, P<0.001]. The minimum platelet count classification during the treatment period, and the platelet count classification at the time of bleeding in the experimental group were both better than those in the control group ( P<0.05). The prothrombin time and international normalized ratio when bleeding occurred in the experimental group were both lower than those in the control group [(10.96±0.39) s vs. (11.49±0.50) s and 0.97±0.04 vs. 1.02±0.06, P<0.05]. There were no statistically significant differences between the 2 groups of patients in terms of activated partial thromboplastin time, fibrinogen degradation products and D-dimer ( P>0.05). Conclusion:The Yiqi Yangxue Shengsui formula can effectively prevent and treat bleeding adverse events related to platinum-based dual-drug chemotherapy combined with bevacizumab in patients with advanced NSCLC. The mechanism may be related to the increase of platelet count and the improvement of exogenous coagulation function indicators.

Objective:To investigate the clinical and pathological characteristics, treatment and prognosis of endometriosis (EM)-associated ovarian mesonephric-like adenocarcinoma (MLA).Methods:Clinical and pathological data were collected from nine patients diagnosed with EM-associated ovarian MLA at the Obstetrics and Gynecology Hospital of Fudan University between January 2022 and December 2024. Histological slides were re-reviewed, immunohistochemical examination and molecular testing were performed, and patient follow-up was conducted.Results:(1) Clinical characteristics: the median age of the nine patients was 54 years (range: 38-69 years). All patients presented with a pelvic mass; five cases also reported abdominal pain. Tumor location included five cases in the right ovary, two in the left ovary, and two involving both ovaries. International Federation of Gynecology and Obstetrics (FIGO) staging showed 3 cases at stage Ⅰ, 4 at stage Ⅱ, and 2 at stage Ⅲ. (2) Pathological features: gross examination revealed mixed solid-cystic masses with solid areas appearing gray-white or yellow-brown; the median maximum tumor diameter was 9.0 cm (range: 2.6-13.0 cm). Microscopically, tumors exhibited various architectural patterns, including tubular, glandular, papillary, slit-like, sex cord-like, glomeruloid, and solid structures, with tubular and glandular patterns being most common. Tumor cells demonstrated mild to moderate nuclear atypia. Of the 11 tumor foci in the 9 cases, 8 showed coexistence of MLA with other tumor components, such as endometrioid carcinoma, borderline endometrioid or borderline seromucinous tumors. In 1 case of MLA mixed with a borderline endometrioid tumor, both components exhibited squamous metaplasia. Immunohistochemistry showed variable expression of GATA-binding protein 3, thyroid transcription factor-1, CD 10, and calretinin, with positive rates of 9/11, 8/11, 5/11, and 3/6, respectively. Two tumor foci (2/11) exhibited focal expression of estrogen receptor and progesterone receptor. All cases displayed wild-type p53 expression. Molecular testing via next-generation sequencing in five patients revealed pathogenic mutations in the KRAS gene (5/5), with 3 cases (3/5) harboring additional pathogenic mutations in other genes. (3) Treatment and prognosis: all patients underwent surgery, supplemented by chemotherapy and (or) targeted therapy. Five patients underwent comprehensive staging surgery, four received cytoreductive surgery, and one patient received targeted therapy. The median follow-up duration was 7 months (range: 2-27 months). Three patients (3/9) experienced recurrence, and no deaths were reported during the follow-up period. Conclusions:EM-associated ovarian MLA demonstrates diverse morphological patterns and frequently coexists with other tumor types. Accurate diagnosis relies on an integrated evaluation of histomorphology, immunohistochemistry, and molecular testing. The primary treatment for EM-associated ovarian MLA is surgery, followed by adjuvant chemotherapy. Patients harboring pathogenic KRAS p.G12C mutations may benefit from targeted therapies. Ovarian MLA is an aggressive tumor, prone to recurrence in the short term, and has a poor prognosis.

Objective To systematically evaluate the quality of Fengshiding capsules,to analyze existing problems based on national drug sampling and testing,and to offer references and suggestions for improving quality control and regulatory supervision of this product.Methods A total of 136 batches of Fengshiding capsules were subjected to standard quality tests and exploratory analyses.HPLC was used to establish the content determination of Angelica dahurica,Cynanchum paniculatum,and Glycyrrhizae Radix,as well as the limit test for anabasine in the preparation.Additionally,an UPLC method was also employed to establish the characteristic chromatogram of Fengshiding capsules.A screening method for artificial pigments was developed,and UPLC-MS/MS was used to detect the illegal addition of chemical drugs in Fengshiding capsules.Results All 136 batches of samples passed inspection according to the current quality standards.However,based on exploratory study evaluations,the content determination results of Cynanchum paniculatum,Angelica dahurica,and Glycyrrhiza Radix were below the proposed limits.The limit test for anabasine did not exceed the proposed threshold.Furthermore,the characteristic chromatograms revealed missing peaks in several samples,and some batches contained artificial pigments and residues of acetaminophen.Conclusions The overall quality of Fengshiding capsules is rated as"average"based on national drug sampling and testing.To enhance product quality,it is recommended to improve quality standards,ensure the use of high-quality raw herbal materials,promote stronger internal oversight by manufacturers,and intensify regulatory supervision.