ObjectiveTo develop a full-process data platform of renal rehabilitation, diagnosis and quality control information. MethodsA hierarchical architectural design was proposed, adhering to clinical pathway models and standardized data protocols. The platform comprehensively covered assessment, intervention, follow-up and quality control for maintenance hemodialysis (MHD) patients. By integrating multidisciplinary resources and standardizing rehabilitation workflows, it delivered standardized and intelligent rehabilitation services. ResultsThe platform achieved standardized and intelligent management of rehabilitation services, effectively improved the physiological function, psychological state and quality of life convenience for MHD patients, while significantly reduced the economic and care burden on patients' families and society. ConclusionThe rehabilitation service model based on a full-process data platform may provide scientific and systematic support for MHD patients.

ObjectiveTo evaluate the clinical efficacy and safety of Xiaozhen Formula （消疹方） in preventing skin toxicity induced by epidermal growth factor receptor inhibitors （EGFRIs） in patients with EGFR-mutant non-small cell lung cancer （NSCLC）. MethodsA randomized， double-blind， placebo-controlled， multicenter clinical study was conducted. A total of 120 patients with EGFR-mutant NSCLC from seven centers were enrolled and randomly assigned to a treatment group （60 cases） or a control group （60 cases）. On the basis of EGFRI-targeted therapy， patients in the treatment group received Xiaozhen Formula granules， whereas those in the control group received Xiaozhen Formula placebo granules， both at 10 g twice daily for 4 consecutive weeks. The primary outcomes were the grading of skin toxicity evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events （NCI-CTCAE） version 5.0 and the incidence of rash. Secondary outcomes included the time to onset and time to resolution of the highest-grade rash， the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 （EORTC QLQ-C30） scores， the Hospital Anxiety and Depression Scale （HADS） scores， and disease control rate， together with safety assessments. ResultsBased on the full analysis set （FAS）， the incidence of skin toxicity in the treatment group was 18.33% （11/60）， significantly lower than 45.00% （27/60） in the control group （P＜0.01）， with the highest severity of skin toxicity in both groups was grade 2. Among patients who developed rash， the resolution rate in the treatment group was 90.91% （10/11）， higher than that 33.33% （9/27） in the control group. The median time to resolution was 15 days （95%CI： 8-17 days） in the treatment group and it was not reached in the control group； the distribution of time to resolution differed significantly between groups （P＜0.001）. After treatment， the treatment group had higher EORTC QLQ-C30 functional scale and global health status/quality-of-life scores， and lower symptom scale， single-item scores， as well as HADS-A， and HADS-D scores than the control group （P＜0.05）. In the FAS analysis， the disease control rate （DCR） was 85.0% （51/60） in the treatment group， lower than 100.0% （60/60） in the control group （P=0.003）， whereas no significant between-group difference was observed in the per-protocol set （PPS） analysis （P=0.464）. The incidence of adverse events did not differ significantly between the two groups （P＞0.05）， and no definite safety signals related to the investigational drug were observed. ConclusionXiaozhen Formula can reduce the incidence of EGFRI-induced skin toxicity， and improve the outcome of rash regression， the patients' quality of life and psychological status in EGFR-mutant NSCLC patients.

Objective: To assess parental expectations for the development of children with autism spectrum disorder (ASD) and identify factors associated with these expectations, so as to provide references for improving rehabilitation outcomes and long term development in children with ASD. Methods: From June 2024 to January 2026, a total of 877 children with ASD and their parents were recruited from 27 rehabilitation institutions in Hefei. The children had been diagnosed by chief physicians at tertiary level hospitals. Demographic characteristics and data on parental expectations were collected by the Parental Expectations Questionnaire. Differences in parental expectations between groups were assessed using the Mann-Whitney U- test and Kruskal-Wallis H-test, and associated factors were examined using quantile regression. Results: The mean item score for overall parental expectations among parents of children with ASD was (4.55±0.47), and scores for all dimensions were higher than those among parents of typically developing children ( t =11.11-31.14, all P <0.01). Child age, school enrollment, and maternal personality were associated with daily living expectation scores, learning and special talents and strengths expectation scores, and special talents and strengths expectation scores, respectively ( H =6.16-8.18, all P <0.05). Parents of preterm children had higher expectations for social interaction, physical and mental well being, and daily living than parents of non-preterm children ( Z =-2.56, -2.48, -2.39, all P <0.05). Multivariate quantile regression analysis showed that children’s age was associated with the expected level of self care ability; school enrollment status was associated with the expected level of learning and specialty strengths; maternal personality was associated with the expected levels of social competence, physical and mental health, self care ability, and specialty strengths; parental age was associated with the expected levels of physical and mental health and specialty strengths; and parental educational attainment was associated with the expected level of self care ability ( β =-0.36-0.41, all P <0.05). Conclusion Parents of children with ASD in Hefei generally have high expectations for their children s development across the domains of learning, daily living, social interaction, and physical and mental well being.

Objective To longitudinally analyze the changes in perioperative nutritional indicators in elderly patients with spontaneous intracerebral hemorrhage(ICH)and their correlation with the score of modified Rankin scale(mRS)score.Methods A total of 295 elderly ICH patients ad-mitted to the neurosurgery intensive care unit of North China University of Science and Technolo-gy Affiliated Hospital from June 2022 to November 2024 were consecutively enrolled in this study.The levels of relevant nutritional indicators were measured before(T1),and in 1(T2),3(T3),5(T4)and 7 d(T5)after surgery.According to the mRS score in 90 d after onset of the disease,they were divided into a good prognosis group(mRS score≤ 2,114 cases)and a poor prognosis group(mRS score≥3,181 cases).The general data and levels of nutritional indicators at above time points were compared between the two groups.Binary logistic regression analysis was applied to study the relationship between the perioperative nutritional indicator levels and the prognosis in elderly patients with spontaneous ICH.Results The poor prognosis group had significantly higher SBP,larger proportions of stroke history,hemorrhage in the brainstem and midline dis-placement,and increased NIHSS score than the good prognosis group(P＜0.05,P＜0.01).Obvi-ously lower BMI(56.48±9.54 kg vs 66.62±8.12 kg),decreased serum levels of albumin[40.24(39.10,41.16)g/L vs 43.30(40.65,45.50)g/L],prealbumin[203.00(164.00,261.00)mg/L vs 229.00(180.00,282.00)mg/L]and TC[4.68(4.11,5.39)mmol/L vs 4.91(4.47,5.66)mmol/L],reduced lymphocyte count[1.58(0.95,2.03)× 109/L vs 1.77(1.99,1.91)× 109/L],and reduced GCS[7.00(5.00,10.00)vs 9.00(7.00,13.00)]and Barthel[55.00(43.00,64.00)vs 61.00(52.00,69.00)]scores at admission were observed in the poor prognosis group than the good prognosis group(all P＜0.01).At all different time points,the poor prognosis group also got notably higher Controlling Nutritional Status(CONUT)scores(reaching the highest levels at 3 d after opera-tion),and lower Prognostic Nutritional Index(PNI)score and Geriatric Nutritional Risk Index(GNRI)score(both declining the lowest levels at same time)when compared with the poor prog-nosis group(all P＜0.01).Binary logistic regression analysis showed that COUNT scores,PNI scores and GNRI scores before(T1)and at 1(T2),3(T3),5(T4)and 7 d(T5)after operation were independent risk factors for 90-day poor prognosis in elderly patients with spontaneous ICH.Conclusion The fluctuations of 3 nutritional indicators at different time points in the periopera-tive period are closely associated with the 90-day prognosis of elderly ICH patients.Monitoring the changes in the nutritional indicators can quickly and conveniently predict the prognosis of the pa-tients,which has high clinical application value.

Objective To investigate the quality of life status in patients with type 2 diabetes mellitus and its influencing factors,understand their demands for continuous nursing services,analyze the correlation,and provide a reference for formulating and implementing continuous nursing plans for diabetes in the later stage.Methods From May to December 2024,a cross-sectional survey was conducted among 294 patients with type 2 diabetes mellitus in this hospital by using the Self-Rating Anxiety Scale(SAS),the Diabetes Pa-tient-Specific Quality of Life Scale(DSQL),and the Questionnaire on the Need for Continuous Care.Results The SAS score of patients with type 2 diabetes was 45.76±7.45,DSQL score was 54.68±10.99,and the score of continuous care needs was 32.98±5.79.The quality of life of patients with type 2 diabetes mellitus is mainly influenced by factors such as age,family type,educational level,average monthly family in-come,duration of diabetes,blood glucose control,dietary compliance,intensity of physical exercise,and diabet-ic complications.The quality of life of patients with type 2 diabetes mellitus was positively correlated with need for continuous care(P<0.05).Conclusion The quality of life of patients with type 2 diabetes mellitus is influenced by multiple factors and is related to the need for continuous care.Professional continuous care plans can be formulated and implemented based on the needs of patients with type 2 diabetes mellitus.

Objective To investigate the effects of meropenem and amikacin on gut microbiota diversity and composition in a neonatal rat model of necrotizing enterocolitis(NEC).Methods Neonatal SD rats(1～2 d,weighing 5～10 g,both sexes)were subjected to establish a NEC model through artificial formula feeding,hypoxic-cold stress,and lipopolysaccharide(LPS)gavage.The rats were randomly divided into normal control group(Group C,n=12),NEC group(Group N,n=20),meropenem intervention group(Group M,n=20),and amikacin intervention group(Group A,n=20).Following modeling,Group M and Group A received intraperitoneal injections of meropenem(125 mg/kg)or amikacin(468 mg/kg),twice daily for 3 consecutive days.Groups C and N were administered an equal volume of normal saline.At the end of the intervention,colonic contents or fecal samples were collected.The gut microbiota structure was analyzed using 16S rDNA high-throughput sequencing.Bioinformatics analysis was performed using the QIIME2 platform.Alpha diversity was evaluated using Chao1,Shannon,and Simpson indices.Beta diversity was assessed based on Bray-Curtis distance through principal coordinate analysis(PCoA)and non-metric multidimensional scaling(NMDS).Venn and UpSet plots were generated to visualize the composition and overlap of operational taxonomic units(OTUs).Linear discriminant analysis effect size(LEfSe)was applied to identify differentially abundant taxa across groups.Results High-throughput 16S rDNA sequencing showed that the N group had significantly lower 3 indices of α diversity than the C group(P<0.01),that is,a Chao1 index from 230 to 40,a Shannon index from 1.65 to 0.85,and a Simpson index from 0.65 to 0.42.After antibiotic intervention,both the M group and A group obtained obvious increases in the Chao1 index than the N group(P<0.001),with a greater increase observed in the M group than in the A group(P<0.05).However,neither antibiotic group exhibited notable improvements in the Shannon index or Simpson index compared with the N group(P>0.05).Venn and UpSet analyses revealed that the M group had the highest number of unique OTUs(283),while the A group shared the most OTUs(63)with the C group.PCoA and NMDS analyses indicated that the microbial structure of the A group was closer to that of the C group,with better clustering.Taxonomic composition and LEfSe analysis demonstrated that the N group was enriched with potentially pathogenic taxa such as Escherichia coli B2 and Klebsiella under the phylum Proteobacteria,while beneficial bacteria including Lactobacillaceae and Bifidobacteriaceae(phylum Firmicutes)were significantly reduced,indicating severe dysbiosis.In contrast,the A group exhibited a significant increase in beneficial bacteria and a structural tendency toward ecological recovery.The M group,however,was enriched with various conditionally pathogenic and environmentally associated genera,displaying a microbial configuration notably deviating from a healthy state.Conclusion Meropenem and amikacin exhibit differential regulatory effects on the intestinal microbiota in the context of NEC.Amikacin demonstrates superior efficacy in restoring microbial stability and levels of beneficial bacteria,whereas meropenem,although effective for early infection control,warrants caution due to its potential long-term impact on the gut microbiome.

3D printing technology, with a layer-by-layer construction method, enables the fabrication of intricately shaped and customizable bolus. In contrast to traditional preparation methods, 3D printing technology addresses challenges such as poor bolus fit and cumbersome production processes, offering a novel approach to efficient and personalized bolus fabrication. This article discusses the research progress of 3D printing technology in radiotherapy bolus from aspects such as the preparation process, clinical application, and research advancements, combined with the actual printing experience of Department of Radiation Oncology in Chongqing University Cancer Hospital.
Printing, Three-Dimensional ; Humans ; Radiotherapy/methods*

Objective To investigate the neuroprotective effect of Tibetan medicine 70 Wei Pearl Pill(RNSP)on 6-hydroxydopamine(6-OHDA)induced Parkinson's disease model rats and its related mechanism.Methods Totally 48 male SD rats were randomly divided into control group,model group,model plus low-dose RNSP group(90 mg/kg),model plus medium-dose RNSP group(180 mg/kg),model plus high-dose RNSP group(360 mg/kg),and model plus madopar group(50 mg/kg),with 8 rats in per group.Except for the control group,the other rats were treated with 6-OHDA single injection into the striatum to establish the PD model.Each group was given intragastric administration after modeling and the control group and model group were given an equal volume of saline once a day for 4 weeks.The rats were subjected to apomorphine-induced rotation,experiments at the 2nd and 4th week after the completion of modeling,and the open field experiment was conducted the next day after the last rotation experiment to observe the animal behavior.After the behavioral experiment,the rats were stained with tyrosine hydroxylase(TH)in the substantia nigra pars compacta by immunohistochemical method and the positive neurons were counted.The protein levels of Bcl-2,BAX,Caspase-3 in substantia nigra and P38,P-P38,ERK,P-ERK,JNK,P-JNK in the striatum were detected by Western blotting.Results Compared with the control group,the rotation frequency and percentage of rotating rats in the model group increased significantly at the 2nd and 4th weeks after modeling;the open field active distance,average speed and times of crossing the grid were significantly decreased;and the rest time was significantly increased.While the number of TH positive neurons in the substantia nigra was significantly decreased,the BAX and Caspase-3 protein levels were increased significantly,Bcl-2 was decreased significantly,the ratios of P-P38/P38,P-JNK/JNK and P-ERK/ERK in the striatum were significantly increased in PD group.Compared with the model group,the rotation frequency and percentage of rotating rats in the low-,medium-and high-dose groups of RNSP had no significant changes after 2 weeks of administration,the rotation frequency in the high-dose group and percentage of rotating rats in the low-and medium-dose RNSP groups significantly decreased after 4 weeks of administration.The open field active distance,average speed,and times of crossing the grid were significantly increased;the rest time was significantly decreased.The number of TH positive neurons in the substantia nigra was significantly increased,the Bax and Caspase-3 protein levels were decreased significantly while the Bcl-2 was significantly increased.The ratios of P-P38/P38,P-JNK/JNK and P-ERK/ERK in the striatum were significantly decreased.Conclusion Tibetan medicine RNSP can improve the motor ability and reduce the loss of DA neurons in PD rats,and its mechanism may be related to inhibiting P38/JNK/ERK signaling pathway and reducing the apoptosis of midbrain neurons.

Objective To construct machine learning models to predict the incidence of linezolid-induced thrombocytopenia(LIT).Methods A total of 198 patients treated with linezolid in a hospital between January 2020 and March 2024 were retrospectively included.Firstly,the patients were divided into LIT and non-LIT groups,and the basic characteristics of the two groups were compared.Then,the variables with significant differences between the two groups were selected as potential risk factors to construct models for predicting LIT,including Logistic regression,decision tree and random forest models,and the prediction performance of the models was evaluated and compared.Results There were 52(26.3％)patients developed LIT during the treatment.The univariate analysis showed significant differences in linezolid trough concentration(Cmin),baseline platelet counts and creatinine clearance,the incidence of cerebrovascular disease,acute respiratory distress syndrome,and abdominal infection in patients with and without LIT.Among the three models built based on these variables,the random forest model has the best predictive performance.The results of variable importance analysis based on random forest model showed that Cmin,baseline platelet count and combined with acute respiratory distress syndrome had higher importance scores.Conclusions The random forest model has high accuracy in predicting the occurrence of LIT,and the risk of LIT is higher in patients with higher levels of linezolid exposure and lower baseline platelets.

Artificial intelligence(AI)has emerged as a cutting-edge technology leading the future and is a key engine for China's development.In the innovation and research of medical devices,AI has provided critical support in the areas of intelligent diagnostic assistance,intelligent therapeutic assis-tance,intelligent monitoring,life support,et al.Ma-chine learning-enabled device software functions(ML-DSFs)have become an essential component of many medical devices.Recently,the United States Food and Drug Administration(FDA)released a draft guidance titled"Marketing Submission Rec-ommendations for a Predetermined Change Con-trol Plan for Artificial Intelligence/Machine Learn-ing(AI/ML)-Enabled Device Software Functions(Draft)."that aimed to provide a forward-looking approach to foster the development of ML medical devices.By supporting iterative updates through modifications,this approach ensures the continu-ous safety and effectiveness of the devices.This guidance represents the latest in regulatory direc-tion and is especially beneficial for enhancing the quality and efficiency of clinical trials for AI prod-ucts.Therefore,we plan to provide a detailed intro-duction and interpretation of the guidance,with the aim of learning from international advanced regulatory concepts and experiences to promote the development of ML-DSFs with more profound international influence.