The blood-brain barrier （BBB） is a physical and biochemical barrier that precisely regulates brain homeostasis and plays a central role in controlling the transport of endogenous and exogenous drugs and related metabolites across the blood-brain interface. These functions of the BBB are mediated by its major components， including brain microvascular endothelial cells （BMECs）， tight junction protein complexes， and influx and efflux transporter proteins. One of the pathological features of ischemic stroke （IS） is BBB disruption， which plays an important role in the development of post-stroke brain injury and subsequent neurological dysfunction. Therefore， given the increasing incidence of IS， there is an urgent need to develop new therapeutic strategies to prevent BBB dysfunction and thereby protect injured brain tissue after IS. This study describes the pathological mechanisms by which BMEC injury after IS leads to BBB dysfunction and elucidates the association between BMECs and IS， including the regulation of apoptosis， autophagy， inflammatory responses， oxidative stress， neurotoxic effects， and cerebral edema. In addition， this article summarizes Chinese herbal medicines that may prevent and treat IS by targeting BMECs. These include monomeric compounds and single herbs such as flavonoids， glycosides， phenols， phthalides， terpenoids， and Styrax. Traditional Chinese medicine （TCM） compound formulas and preparations include oral formulations such as Buyang Huanwu decoction， Sailuotong， Naoxintong capsules， Dandeng Tongnao capsules， and Shexiang Tongxin dropping pills， as well as injectable preparations such as Tongluo Jiunao injection， Xingnaojing injection， Danshen polyphenolic acid for injection， Yiqi Fumai injection， and Shuxuetong injection. This study aims to explore the protective effects of TCM against IS through targeted regulation of BMEC function， providing new insights into the mechanisms of IS and endovascular therapeutic strategies.

Purpose: The aim of this study was to investigate the feasibility of an intelligent handheld ultrasound (US) device for assisting non-expert general practitioners (GPs) in detecting carotid plaques (CPs) in community populations. Methods: This prospective parallel controlled trial recruited 111 consecutive community residents. All of them underwent examinations by non-expert GPs and specialist doctors using handheld US devices (setting A, setting B, and setting C). The results of setting C with specialist doctors were considered the gold standard. Carotid intima-media thickness (CIMT) and the features of CPs were measured and recorded. The diagnostic performance of GPs in distinguishing CPs was evaluated using a receiver operating characteristic curve. Inter-observer agreement was compared using the intragroup correlation coefficient (ICC). Questionnaires were completed to evaluate clinical benefits. Results: Among the 111 community residents, 80, 96, and 112 CPs were detected in settings A, B, and C, respectively. Setting B exhibited better diagnostic performance than setting A for detecting CPs (area under the curve, 0.856 vs. 0.749; P<0.01). Setting B had better consistency with setting C than setting A in CIMT measurement and the assessment of CPs (ICC, 0.731 to 0.923). Moreover, measurements in setting B required less time than the other two settings (44.59 seconds vs. 108.87 seconds vs. 126.13 seconds, both P<0.01). Conclusion Using an intelligent handheld US device, GPs can perform CP screening and achieve a diagnostic capability comparable to that of specialist doctors.

Objective To analyze the CT manifestations of high altitude pulmonary edema(HAPE)to provide radiological evidence for its early and accurate diagnosis.Methods Totally 200 HAPE patients clinically confirmed at some hospital from April 2021 to April 2024 were enrolled into a study group,and 56 individuals undergoing health examinations at the hospital's physical examination center between January and June 2023 were included into a control group.Examinations were carried out with a United Imaging uCT528 40-slice spiral CT scanner.The patients in the study group were observed in terms of HAPE staging,the extent of pulmonary involvement,CT manifestations of different stages including location,distribution,density and morphology of pulmonary lesion.The diameters of the main pulmonary arteries and ascending aortas of the subjects in the two groups were measured,and the ratios of the two diameters were calculated.SPSS 25.0 software was used for statistical analysis.Results In the study group,there were 26 cases(13.0%)at early stage,105 ones at progression stage(52.5%),32 ones at critical outbreak stage(16.0%)and 37 ones at resolution and absorption stage(18.5%),and there were 35.5%with unilateral lung involvement and 64.5%with bilateral involvement.At early stage,HAPE chest CT manifestations included increased and thickened bilateral bronchovascular bundles,widened main pulmonary artery lumen and faint ground-glass opacity in lungs;at progression stage,HAPE chest CT manifestations revealed multiple cloud-like or patchy areas of increased density within lungs;at critical outbreak stage,CT scanning indicated diffuse patchy opacities and consolidation in lungs,white lung-like changes could be found in some severe cases,and bronchial air signs were shown within affected segments in some ones with severer signs in the right lung than in the left lung;at resolution and absorption stage the CT manifestations were similar to those at early stage,with lesions completely resolving after treatment.The study group had the diameters of the main pulmonary arteries greater while the diameters of the ascending aortas less than those of the control group,and the ratios of the diameters of the two diameters in the study group were higher than those in the control group,with the differences being statistically significant(all P<0.05).Conclusion Chest CT is an important examination method for the early diagnosis of HAPE and clarification of its clinical staging,which directly reflects the pulmonary pathological changes in HAPE patients and helps doctors fully understand the disease progression.

A series of treatment and nursing measures were given to a patient with very early-onset inflammatory bowel disease with anal fistula who underwent umbilical cord blood stem cell transplantation complicated with perianal infection, including being alert to the postoperative infection after stem cell transplantation; timely assessment of nutritional status and nutritional support; and multi-modal whole process psychological care. After 32d of careful treatment and care, the patient safely passed the "zero phase" of leukocytes, and the umbilical cord blood stem cell transplantation was successful, and the patient was successfully transferred to the general ward. For patients with combined anal fistula undergoing umbilical cord blood stem cell transplantation, accurate assessment and observation of the patient's condition can effectively control the occurrence and development of infection during the leukocyte-deficient phase and ensure the smooth progress of umbilical cord blood stem cell transplantation.

Objective To develop a nomogram diagnostic model to differentiate peripheral small cell lung cancer(PSCLC)from peripheral lung adenocarcinoma(PADC)using clinical and multi spiral computed tomography features.Methods A retrospective analysis was conducted on the CT characteristics and clinical presentations of 50 PSCLC and 100 PADC.Univariate and multivariate logistic regression analyses were employed to identify significant features.A nomogram was constructed to quantify the influencing factors.The efficacy and clinical applicability of the model were assessed using the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results Smoking,neuron-specific enolase(NSE),smooth margin,spindle/branching shape,and lymphadenopathy were independent risk factors for PSCLC(P＜0.05),whereas rough margin and lobulation sign were independent risk factors for PADC(P＜0.05).The nomogram model demonstrated high diagnostic efficacy,and the calibration curve exhibited a good degree of calibration(Brier=0.079).The DCA indicated that the nomogram model possesses substantial clinical utility.Conclusion The nomogram model developed based on six indicators,including smoking,NSE≥17 ng/mL,margin characteristics,spindle/branching shape,lobulation sign,and lymphadenopathy can well distinguish PSCLC from PADC.

Objective To analyze the composition and distribution characteristics of death causes among elderly inpa-tients in a municipal hospital based on Diagnosis-Related Groups(DRG).This analysis aims to provide data support for the treat-ment and management of diseases in elderly patients and for the development of related disciplines,ultimately aiming to reduce the mortality rate of elderly patients.Methods A total of 1 811 death cases of elderly inpatients(aged≥60 years)were extrac-ted from the medical record management system and DRG operation analysis system of a prefecture-level tertiary hospital between January 1,2022,and December 31,2024.Information from the inpatient medical records'front page and DRG grouping data were matched.A retrospective analysis was conducted on 1,587 cases with hospitalization durations of 60 days orless included in DRG groups using Excel 2021.Results Elderly inpatients accounted for more than 80% of the total deaths.The deaths were mainly caused by three major categories:respiratory diseases and dysfunctions(35.03%),circulatory system diseases and dys-functions(25.27%),and nervous system diseases and dysfunctions(14.43%).The internal medicine treatment group had the highest number of deaths,followed by the surgical operation group,and then the non-operating room operation group.Among eld-erly deceased patients,83.68% had complications or comorbidities,with 85.47% having severe complications or comorbidities,mainly in patients aged 70 and above.Conclusion Elderly patients are the primary population group at risk of death.Based on the disease characteristics of elderly deceased patients in different age groups,hospitals should focus on strengthening the devel-opment of geriatrics departments,advance disciplinary technologies,and enhance patient satisfaction to provide comprehensive and personalized diagnosis and treatment,thereby supporting healthy aging.

Objective To analyze the CT manifestations of high altitude pulmonary edema(HAPE)to provide radiological evidence for its early and accurate diagnosis.Methods Totally 200 HAPE patients clinically confirmed at some hospital from April 2021 to April 2024 were enrolled into a study group,and 56 individuals undergoing health examinations at the hospital's physical examination center between January and June 2023 were included into a control group.Examinations were carried out with a United Imaging uCT528 40-slice spiral CT scanner.The patients in the study group were observed in terms of HAPE staging,the extent of pulmonary involvement,CT manifestations of different stages including location,distribution,density and morphology of pulmonary lesion.The diameters of the main pulmonary arteries and ascending aortas of the subjects in the two groups were measured,and the ratios of the two diameters were calculated.SPSS 25.0 software was used for statistical analysis.Results In the study group,there were 26 cases(13.0%)at early stage,105 ones at progression stage(52.5%),32 ones at critical outbreak stage(16.0%)and 37 ones at resolution and absorption stage(18.5%),and there were 35.5%with unilateral lung involvement and 64.5%with bilateral involvement.At early stage,HAPE chest CT manifestations included increased and thickened bilateral bronchovascular bundles,widened main pulmonary artery lumen and faint ground-glass opacity in lungs;at progression stage,HAPE chest CT manifestations revealed multiple cloud-like or patchy areas of increased density within lungs;at critical outbreak stage,CT scanning indicated diffuse patchy opacities and consolidation in lungs,white lung-like changes could be found in some severe cases,and bronchial air signs were shown within affected segments in some ones with severer signs in the right lung than in the left lung;at resolution and absorption stage the CT manifestations were similar to those at early stage,with lesions completely resolving after treatment.The study group had the diameters of the main pulmonary arteries greater while the diameters of the ascending aortas less than those of the control group,and the ratios of the diameters of the two diameters in the study group were higher than those in the control group,with the differences being statistically significant(all P<0.05).Conclusion Chest CT is an important examination method for the early diagnosis of HAPE and clarification of its clinical staging,which directly reflects the pulmonary pathological changes in HAPE patients and helps doctors fully understand the disease progression.

AIM To investigate the effects of Yiqi Juanbi Formula on chondrocyte pyroptosis in rat models of collagen-induced arthritis(CIA).METHODS Fifty rats were subcutaneously injected at the tail base with an emulsion containing equal volumes of bovine type Ⅱ collagen and incomplete Freund's adjuvant(IFA)to establish the CIA models.These rats were then randomly assigned to the model group,the methotrexate group(0.35 mg/kg),and the low-dose,medium-dose,and high-dose Yiqi Juanbi Formula groups(9.4,18.7,37.4 g/kg),in contrast to the ten intact rats serving in the normal control group.Following four weeks of intragastric administration,the rats had their general conditions observed;their joint swelling and arthritis indices measured;their ankle joint pathology assessed by HE staining;their serum levels of IL-1β,IL-18 and TNF-ɑ detected by ELISA;their mRNA expressions of NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ in ankle cartilage quantified by RT-qPCR;their protein expressions of NF-κB,NLRP3 and Caspase-1 in ankle cartilage analyzed by Western blot;and their NLRP3 and GSDMD positive expressions in ankle cartilage examined by immunohistochemistry.RESULTS Compared to the control group,the model group showed significantly increased joint swelling and arthritis indices(P＜0.01);elevated serum levels of IL-1 β,IL-18 and TNF-ɑ(P＜0.01);pathological changes including cartilage surface defects,reduced cell count,altered cellular morphology,irregular cell arrangement,and significant inflammatory cell infiltration in synovial tissue;upregulated mRNA expressions of NF-κB,NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ(P＜0.01)and increased protein expressions of NF-κB,NLRP3 and Caspase-1(P＜0.01)in ankle cartilage;enhanced positive expressions of NLRP3 and GSDMD in ankle cartilage(P＜0.01).Compared to the model group,the groups intervened with methotrexate or medium-or high-dose Yiqi Juanbi Formula exhibited reduced joint swelling and arthritis indices(P＜0.01);alleviated pathological damage in ankle joints;decreased serum levels of IL-1β,IL-18 and TNF-ɑ(P＜0.01);downregulated mRNA expressions of NF-κB,NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ(P＜0.05,P＜0.01),and reduced protein expressions of NF-κB,NLRP3 and Caspase-1(P＜0.05,P＜0.01)in ankle cartilage;and diminished positive expressions of NLRP3 and GSDMD in ankle cartilage(P＜0.01).CONCLUSION Yiqi Juanbi Formula alleviates inflammation in CIA rats,potentially by inhibiting the activation of the NF-κB/NLRP3/Caspase-1 signaling pathway,thereby suppressing chondrocyte pyroptosis.

Objective To investigate the mammographic imaging features of breast cancer and its correlation with microvascular density(MVD).Methods A total of 86 patients with breast cancer confirmed by surgical pathology in Xinjiang Production and Construction Corps 7th Division Hospital from January 2019 to December 2022 were selected as the research objects.According to the modified Bloom Richard-son scoring system,the breast cancer patients were classified into histological grade Ⅰ(n=22),grade Ⅱ(n=25)and grade Ⅲ(n=39).All patients underwent preoperative mammographic imaging examination.Immunohistochemistry staining was performed and MVD count was conducted after operation.Spearman rank correlation was used to analyze the correlation between MVD of breast cancer with different histo-logical grades and mammographic imaging features.Results The microvascular positive expression rate of breast cancer lesions was 100%,the MVD counts per visual field were 14～276 vessels,with an average of(72.58±16.37)vessels,of which the MVD counts of patients with histological grade Ⅰ to Ⅱ were 14 to 175 vessels,with an average of(42.10±13.51)vessels;the MVD counts of patients with histological grade Ⅲ was 22～276 vessels,with an average of(93.82±22.17)vessels.The MVD counts of patients with histological grade Ⅲ was signifi-cantly higher than that of patients with histological grade Ⅰ to Ⅱ,with statistically significant difference(t=19.627,P<0.001).The incidences of irregular margin,spicular sign,axillary lymph node metastasis and fine particle calcification in patients with histological gradeⅢ were higher than those in patients with histological grade Ⅰ to Ⅱ,with statistically significant difference(P<0.05).The MVD counts of breast cancer patients with irregular margin,spicular sign,axillary lymph node metastasis and fine particle calcification were higher than those of patients with smooth margin and without spicular sign,axillary lymph node metastasis or fine particle calcification,which was positively correlated with histological grades(P<0.05).Conclusion Some mammographic imaging features of breast cancer can reflect tumor angiogenesis to a certain extent,which can provide important reference for the treatment and prognosis of the disease,with certain clinical value.

Objective To investigate the mammographic imaging features of breast cancer and its correlation with microvascular density(MVD).Methods A total of 86 patients with breast cancer confirmed by surgical pathology in Xinjiang Production and Construction Corps 7th Division Hospital from January 2019 to December 2022 were selected as the research objects.According to the modified Bloom Richard-son scoring system,the breast cancer patients were classified into histological grade Ⅰ(n=22),grade Ⅱ(n=25)and grade Ⅲ(n=39).All patients underwent preoperative mammographic imaging examination.Immunohistochemistry staining was performed and MVD count was conducted after operation.Spearman rank correlation was used to analyze the correlation between MVD of breast cancer with different histo-logical grades and mammographic imaging features.Results The microvascular positive expression rate of breast cancer lesions was 100%,the MVD counts per visual field were 14～276 vessels,with an average of(72.58±16.37)vessels,of which the MVD counts of patients with histological grade Ⅰ to Ⅱ were 14 to 175 vessels,with an average of(42.10±13.51)vessels;the MVD counts of patients with histological grade Ⅲ was 22～276 vessels,with an average of(93.82±22.17)vessels.The MVD counts of patients with histological grade Ⅲ was signifi-cantly higher than that of patients with histological grade Ⅰ to Ⅱ,with statistically significant difference(t=19.627,P<0.001).The incidences of irregular margin,spicular sign,axillary lymph node metastasis and fine particle calcification in patients with histological gradeⅢ were higher than those in patients with histological grade Ⅰ to Ⅱ,with statistically significant difference(P<0.05).The MVD counts of breast cancer patients with irregular margin,spicular sign,axillary lymph node metastasis and fine particle calcification were higher than those of patients with smooth margin and without spicular sign,axillary lymph node metastasis or fine particle calcification,which was positively correlated with histological grades(P<0.05).Conclusion Some mammographic imaging features of breast cancer can reflect tumor angiogenesis to a certain extent,which can provide important reference for the treatment and prognosis of the disease,with certain clinical value.