ObjectiveTo observe the short-term and long-term efficacy of traditional Chinese medicine （TCM） surgical operations in treating mixed hemorrhoids. MethodsA multi-center retrospective cohort study was conducted， collecting clinical data from 17，831 mixed hemorrhoid surgery patients in 8 top-tier TCM hospitals in Jiangsu Province. Standardized and structured datasets were obtained through artificial intelligence models. Patients who underwent western surgical treatment were categorized into the western surgery group （11,646 cases）， and those receiving TCM surgical operations were categorized into the TCM surgery group （6185 cases）. Propensity score matching （1∶1 matching） was used to balance baseline data between groups. The primary outcome was the one-year recurrence rate， and secondary outcomes included the main symptoms （rectal bleeding， degree of prolapse） and secondary symptoms （anal distension， anal edema， wound secretion and exudation， anal stenosis， residual skin tags， perianal itching， and anal pain） measured on days 7， 28， and 60 after discharge. ResultsAfter matching， 2194 patients were included in each group. Symptom scores showed that at 28 days after discharge， the TCM surgical group had superior improvement in rectal bleeding ［OR=5.786， 95%CI （3.092，10.827）］， degree of prolapse ［OR=4.510， 95%CI （1.649，12.333）］， and anal edema ［OR=3.188， 95%CI （1.295，7.845）］ compared to the western surgical group. At 60 days post-discharge， the TCM group still showed advantages in improving rectal bleeding ［OR=5.237， 95%CI （1.077，25.464）］ and anal pain ［OR=11.697， 95%CI （1.186，115.336）］ （P＜0.05）. Long-term follow-up showed that the one-year recurrence rate in the TCM surgery group was 1.1% （8/726）， while that in the western surgery group was 2.3% （10/444）， with no statistically significant difference between the two groups （P＞0.05）. ConclusionBased on real-world data， TCM surgical treatment for mixed hemorrhoids shows significant short-term symptom improvement， particularly in terms of hemostasis， reducing swelling， and alleviating prolapse of anal masses.

ObjectiveTo construct a risk prediction model for frequent acute exacerbations of chronic obstructive pulmonary disease （COPD） under disease-syndrome combination， thus providing decision support for precise clinical intervention. MethodsA total of 2 029 patients with acute exacerbations of COPD admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2020 to August 2024 were retrospectively included. These patients were classified into groups of frequent acute exacerbations （≥2 times/year） and infrequent acute exacerbations （<2 times/year） according to the hospitalization times per year. Risk factors were screened by LASSO regression combined with logistic regression， and a nomogram model was constructed. The model performance was assessed based on the area under the curve （AUC）， calibration curves， and decision curve analysis （DCA）. ResultsThe differences in baseline characteristics between the frequent acute exacerbations group （1 196 cases） and infrequent acute exacerbations group （833 cases） were not statistically significant. LASSO regression combined with multivariate logistic regression screened the following independent risk factors： body mass index （BMI）， hospitalization days， number of smoking years， place of residence， use of noninvasive ventilators， oxygen-demanding therapy， liver cirrhosis， use of systemic glucocorticosteroids， and traditional Chinese medicine syndrome （phlegm and stasis obstructing the lung）. The nomogram model showed good discrimination and calibration in both the training set （AUC=0.748） and validation set （AUC=0.774）. ConclusionThe risk prediction model for frequent acute exacerbations of COPD， integrating traditional Chinese medicine syndrome， constructed in this study has high accuracy. It can provide a scientific basis for early clinical identification of high-risk patients and individualized intervention.

Triatoma rubrofasciata is currently the most widely distributed species of Triatoma worldwide, and it is also widespread in southern China. T. rubrofasciata has been proven to transmit Trypanosoma cruzi, and is one of vectors transmitting Chagas disease, which poses a potential risk for transmission of imported Chagas disease in China. Findings from latest studies have shown that T. rubrofasciata naturally infects T. lewisi, T. conorhini, and T. rangeli, which undoubtedly increases significant risks of and challenges to trypanosomiasis control in China. This article briefly describes the species of T. rubrofasciata-transmitted trypanosomes, and summarizes the epidemiological characteristics of trypanosomiasis, so as to provide insights into T. rubrofasciata-transmitted trypanosomiasis surveillance and control, and prevention of trypanosomiasis development and transmission in China.

Background: Adrenocortical hormones, particularly 11-oxygenated androgens, are pivotal in female reproductive health and fertility. Standardized detection kits and population-specific reference intervals are lacking in China, hindering related clinical applications. Methods: A HPLC-tandem mass spectrometry (HPLC-MS/MS) pipeline was developed, rigorously validated, and applied to simultaneously quantify corticosterone, cortisone, cortisol, 18-OH cortisol, androstenedione (A4), 11β-hydroxyandrostenedione (11-OH A4), dehydroepiandrosterone, and dehydroepiandrosterone sulfate in serum samples from 455 reproductive-aged women (18–45 yrs) in Guangxi, China. Age-dependent concentration trends were analyzed, and reference intervals stratified by age (2.5th to 97.5th percentiles) were established. Correlations with body-composition metrics, ethnicity, and the menstrual cycle were investigated. Results: The HPLC-MS/MS method demonstrated high precision (intra- and inter-assay CVs < 15%), accuracy, and sensitivity. All eight hormones exhibited significant age-related declines (P < 0.001 for seven hormones; P = 0.001 for 11-OH A4). Notably, 11-OH A4 levels were significantly lower in the 35–45-yr (3.05 nmol/L) and 25–34-yr (3.09 nmol/L) age groups than in the 18–24-yr (3.57 nmol/L) age group, whereas no significant difference was observed between the 35–45-yr and 25–34-yr age groups. Weak negative correlations were observed between the body mass index and corticosterone and cortisone levels, whereas ethnicity and the menstrual cycle showed no significant associations with hormone levels. Conclusions We developed an HPLC-MS/MS-based method for simultaneously quantifying eight adrenocortical hormones, including 11-OH A4, and defined age-specific reference intervals for reproductive-aged Chinese women. These findings advance the clinical utility of adrenocortical hormones in diagnosing and managing reproductive disorders.

Objective To analyze changes in sleep,mood state,and brain function in healthy populations living in near-sea-level environments before and after exposure to high-altitude environment,and to explore the correlations between regional brain functional changes and variations in sleep and mood states.Methods A total of 45 healthy volunteers were enrolled.The participants came from regions of near-sea-level altitudes and were exposed to the high-altitude environment for a short period of time.The Pittsburgh Sleep Quality Index(PSQI),Zung Self-Rating Depression Scale(SDS),Patient Health Questionnaire-9(PHQ-9),Zung Self-Rating Anxiety Scale(SAS),and Generalized Anxiety Disorder-7(GAD-7)were administered to assess sleep quality as well as depressive and anxiety symptoms at 4 time points—prior to high-altitude exposure,immediately after exposure,one month after returning to low-altitude regions,and three months after returning to low-altitude regions.Resting-state functional magnetic resonance imaging(rs-fMRI)data were collected before and after high-altitude exposure,and regional brain functional parameters,including the amplitude of low-frequency fluctuations(ALFF)and functional connectivity strength,were analyzed.Statistical analyses were performed,including a linear mixed-effects model to evaluate longitudinal changes in scale scores,paired-sample t-tests to compare brain function differences before and after exposure,and Pearson correlation analyses to examine the relationship between brain functional changes and alterations in sleep and mood states.Results Compared with the pre-exposure findings,the participants exhibited significantly increased PSQI scores(8.89±4.41 vs.5.08±2.69,P<0.05)and PHQ-9 scores(3.60±4.19 vs.1.54±2.30,P<0.05)immediately after high-altitude exposure.One month after returning to the low-altitude environment,both sleep and depression scores decreased relative to the findings immediately after exposure(PSQI:3.88±2.13 vs.8.89±4.41,P<0.05;PHQ-9:1.50±2.25 vs.3.60±4.19,P<0.05)and showed no statistically significant difference compared with the pre-exposure findings(P>0.05).Three months after returning to near-sea-level environment,sleep,depression,and anxiety scores were all reduced compared with the findings immediately after exposure(PSQI:3.76±2.31 vs.8.89±4.41,P<0.05;PHQ-9:1.24±2.13 vs.3.60±4.19,P<0.05;SAS:23.84±5.93 vs.27.93±7.05,P<0.05),also showing no significant difference compared with the pre-exposure levels(P>0.05).Brain function analysis revealed that,relative to the pre-exposure levels,ALFF in the bilateral superior temporal gyrus,insula,and dorsolateral prefrontal cortex(DLPFC)increased after high-altitude exposure(P<0.05),and that functional connectivity strength in the DLPFC was also elevated(P<0.05).Furthermore,changes in DLPFC functional connectivity strength were positively correlated with changes in sleep and mood scores(P<0.05).Conclusion High-altitude exposure has a significant impact on the sleep,mood states,and brain function of populations from near-sea-level regions,and DLPFC,in particular,is closely associated with changes in sleep and mood states.The findings of this study provide a theoretical basis for health management and intervention strategies in high-altitude environments.

Objective To evaluate the effect of relaxation training combined with basic psychological intervention on attention deficit factor score in children with attention deficit hyperactivity disorder.Methods A total of 320 children with attention deficit hyperactivity disorder were enrolled in Anhui Children's Hospital affiliated to Anhui Medical University from April 2022 to April 2024.The children were divided into 2 groups by random number table method with 160 cases in each.The control group received basic psychological intervention and the observation group received relaxation training combined with psychological intervention.Attention deficit factor score,hyperac-tivity factor score,oppositional defiant factor score,Weiss Functional Deficit Scale(parent version)score and satis-faction were compared between the two groups.Results The Pittsburgh Sleep Quality Index(PSQI)score of the observation group was higher(17.35±1.42)than that of the control group(P＜0.05).The scores of Attention Defi-cit Hyperactivity Disorder Rating Scale-Parent Version(SNAP-Ⅳ)in observation group were lower than those in control group(P＜0.05),including attention deficit factor(14.25±1.58),hyperactivity factor(12.01±1.33)and oppositional defiant factor(9.79±1.27).There was no difference in Weiss functional deficit Scale(parent version)between the two groups before intervention,and Weiss functional deficit scale(parent version)score of the obser-vation group was higher than that of the control group after intervention(P＜0.05).The satisfaction of observation group was higher than that of control group(P＜0.05).Conclusions The effect of relaxation training combined with psychological intervention is obvious in children with attention deficit hyperactivity disorder,and the symptoms of attention deficit are significantly improved.

Objective To analyze the multimodal ultrasound imaging characteristics in patients with different molecular subtypes of breast cancer.Methods The medical records of 85 patients with breast cancer were retrospectively collected and classified into 12 cases of Luminal A,35 cases of Lu-minal B,21 cases of HER2,and 17 cases of triple-negative breast cancer based on immunohisto-chemical results.All patients underwent conventional ultrasound,color Doppler ultrasound,ultra-sound elastography,and contrast-enhanced ultrasound.The relationship between multimodal ultra-sound characteristics and breast cancer molecular subtypes and their diagnostic value were analyzed.Results Conventional ultrasound and color Doppler ultrasound results showed statistically significant differences in the margin characteristics of breast cancer lesions among the four molecular subtypes(P＜0.05).Ultrasound elastography results revealed that the maximum elastic modulus(Emax)lev-els of HER2 and triple-negative subtypes were higher than those of Luminal A and Luminal B,respec-tively.The ratios of elastic modulus to normal tissue(Eratio)for Luminal B,HER2,and triple-nega-tive subtypes were higher than that of Luminal A,and the Eratio level of Luminal Bwas lower than that of HER2(P＜0.05).Contrast-enhanced ultrasound results showed statistically significant differences in enhancement levels,perfusion defects,and peak intensity(IMAX),time to peak(TTP),and augmentation time(AT)among the four molecular subtypes of breast cancer lesions(P＜0.05).Multivariate Logistic regression analysis showed that margin characteristics,Emax,Emin,Emean,Eratio,IMAX,TTP,and AT were independent influencing factors for breast cancer molecular subtypes(P＜0.05).Receiver operating characteristic curve analysis showed that the area under the curve and sensitivity of multimodal ultrasound imaging characteristics(combined indicators)for diagnosing breast cancer molecular subtypes were significantly greater than those of individual indicators(P＜0.05).Conclusion There are differences in two-dimensional ultrasound,color Doppler ultra-sound,ultrasound elastography,and contrast-enhanced ultrasound results among different molecular-subtypes of breast cancer.Multimodal ultrasound imaging characteristics have high diagnostic value for breast cancer molecular subtypes.

Objective To investigate the effects of penehyclidine hydrochloride(PHC)admin-istered at different time points on neurological function and the blood-brain barrier(BBB)in rat model of severe intracerebral hemorrhage(ICH),and to preliminarily explore its potential mechanism of action based on the growth arrest-specific protein 6(GAS6)/receptor tyrosine kinase(Axl)signaling pathway.Methods ICH model rats were established via intracerebral injection of a collagenase type Ⅳ solu-tion.The model rats were randomly divided into sham operation group(intracerebral injection of an equal volume of saline),model group(intracerebral injection of 0.4 μL of collagenase type Ⅳ solu-tion),24 h drug administration group(intracerebral injection of 0.4 μL of collagenase type Ⅳ solu-tion combined with intraperitoneal injection of 2 mg/kg PHC 24 h after successful model establish-ment),6 h drug administration group(intracerebral injection of 0.4 μL of collagenase type Ⅳ solu-tion combined with intraperitoneal injection of 2 mg/kg PHC 6 h after successful model establish-ment),pre-drug administration group(intraperitoneal injection of 2 mg/kg PHC before modeling combined with intracerebral injection of 0.4 μL of collagenase type Ⅳ solution),and pathway in-hibitor group(intraperitoneal injection of 2 mg/kg PHC before modeling combined with intracerebral injection of 0.4 μL of collagenase type Ⅳ solution and intraperitoneal injection of 75 mg/kg R428,a GAS6/Axl signaling pathway inhibitor,after successful model establishment).The degree of neu-rological impairment in rats was assessed after successful model establishment and at the end of treat-ment;brain tissue water content in rats was calculated;brain tissue damage and Evans blue(EB)content in rats were evaluated using hematoxylin-eosin(HE)and EB staining methods;western blot was used to detect the expression levels of Claudin-5,zonula occludens-1(ZO-1),Occludin,ma-trix metalloproteinase-9(MMP-9),and proteins related to the GAS6/Axl signaling pathway in brain tissue.Results HE staining revealed that compared with the sham operation group,the model group exhibited irregular arrangement of brain tissue cells,a large number of necrotic cells,and sig-nificant infiltration of inflammatory cells;compared with the model group,the 24 h drug administra-tion,6 h drug administration,pre-drug administration,and pathway inhibitor groups showed more orderly brain tissue cells,reduced cell gaps,and decreased infiltration of inflammatory cells;com-pared with the 24 h drug administration group,the 6 h drug administration,pre-drug administration,and pathway inhibitor groups exhibited more intact brain tissue cell structures,reduced cell gaps,and decreased infiltration of inflammatory cells;compared with the pre-drug administration group,the 6 h drug administration and pathway inhibitor groups showed slight swelling of brain tissue cells and a small amount of inflammatory cell infiltration.Compared with the sham operation group,the model group had increased neurological function scores,brain tissue water content,EB content in brain tissue,and MMP-9 protein levels,along with decreased levels of ZO-1,Occludin,Claudin-5 proteins,and GAS6 and p-Axl protein expression;compared with the model group,the 24 h drug administration,6 h drug administration,pre-drugadministration,and pathway inhibitor groups had decreased neurological function scores,brain tissue water content,EB content in brain tissue,and MMP-9 protein levels,along with increased levels of ZO-1,Occludin,Claudin-5 proteins,and GAS6 and p-Axl protein levels in brain tissue;compared with the 24 h drug administration group,the 6 h drug administration,pre-drug administration,and pathway inhibitor groups had decreased neurological function scores,brain tissue water content,EB content in brain tissue,and MMP-9 protein levels,along with increased levels of ZO-1,Occludin,Claudin-5 proteins,and GAS6 and p-Axl protein expression;compared with the pre-drug administration group,the 6 h drug administra-tion and pathway inhibitor groups had increased neurological function scores,brain tissue water con-tent,EB content in brain tissue,and MMP-9 protein levels,along with decreased levels of ZO-1,Occludin,Claudin-5 proteins,and GAS6 and p-Axl protein expression in brain tissue;the between-group differences mentioned above were statistically significant(P＜0.05).Conclusion Early ad-ministration of PHC can improve neurological function and the BBB in ICH rats by reducing brain tissue damage and brain edema,and its mechanism may be related to the activation of the GAS6/Axl signaling pathway.

Objective: To investigate the impact of endometriosis on pregnancy and delivery outcomes in patients undergoing single euploid frozen_thawed blastocyst transfer cycles following preimplantation genetic testing. Methods : A retrospective analysis was performed on clinical data from patients undergoing frozen_thawed blastocyst transfer after preimplantation genetic testing at the reproductive center of The First Affiliated Hospital of Anhui Medical University. The endometriosis group comprised 84 treatment cycles. After 1 : 3 propensity score matching , 252 treatment cycles from non_endometriosis patients were included as the control group. General characteristics and clinical outcomes were compared between the two groups. Results: There were no statistically significant differences between the two groups in terms of general characteristics , human chorionic gonadotropin ( HCG) positive rate , cycle clinical pregnancy rate per cycle , early miscarriage rate , preterm birth rate , live birth rate per cycle , cesarean section rate , delivery weeks , cumulative clinical pregnancy rate , and cumulative live birth rate (all P > 0. 05) . Conclusion Endometriosis may not reduce the pregnancy rate and live birth rate in single frozen euploid blastocyst transfer cycles .

Objective To discuss the method of constructing TCM word network and the subsequent optimization method;To solve the problems of natural language processing in the TCM-clinical decision support system using TCM terminology.Methods This study was based on several national standards and terminology dictionaries of TCM,such as Zhong Yi Lin Chuang Zhen Liao Shu Yu Ji Bing Part and Zhong Yi Yao Xue Zhu Ti Ci Biao,supplemented with related corpus on the Internet,and the framework of TCM word network was constructed with ontology as the guide.Word2Vec was used to load pre-trained models for similarity calculation,statistical and rule-based new word discovery,bibliometric analysis,and other methods to add or delete concept words and synonyms such as symptom terms and prescription terms.Results The TCM word network contained 55 semantic types and 13 semantic relationships,more than 110 000 concept words,and more than 300 000 synonyms.In addition to classifying concept words by semantic types,more detailed semantic classification was carried out in the upper and lower tree structures,in which more than 30 000 concept words had superordinate words,and nearly 2 600 concept words had subordinate words.At the same time,a process-based terminology supplementation mechanism,update review mechanism and cleaning mechanism were created.Conclusion TCM word network can not only be applied to the natural language processing process of TCM-clinical decision support system,but also can be applied to the normalization of data and the automatic construction of knowledge graph.