As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

Objective To analyze the research hotspots and frontier trends in the field of physical therapy for Parkinson's disease(PD)from 2014 to 2023.Methods Relevant literatures published from January,2014 to December,2023 were retrieved from the Web of Science Core Collection.CiteSpace 6.3.R1 was used to conduct bibliometric analysis,generating visual maps of coun-tries,institutions,keyword co-occurrence,burst terms,timelines and clustering,and they were summarized based on both visual results and literature content.Results A total of 400 articles were included.The United States had the highest publication volume,followed by China,Italy and Brazil,and the international collaboration was relatively active.Major contributing institutions included Northwestern University,Rush University,Karolinska Institutet and Universidade de S?o Paulo.Keyword co-oc-currence analysis showed that researches mainly focused on interventions such as exercise,postural control,aero-bic exercise and transcranial direct current stimulation.Burst detection analysis showed that keywords with high attention in recent years included motor symptoms,executive function,resistance training and noninvasive brain stimulation.The timeline map indicated a shift in research themes from early focus on electrical stimulation to in-tegrated interventions involving both motor and cognitive functions.Conclusion Over the past decade,researches on physical therapy for PD has shown steady growth,with increasing diver-sity in intervention strategies.There is a clear trend toward multidimensional integration and interdisciplinary col-laboration.Future studies should strengthen interventions targeting non-motor symptoms and promote the clinical application of new rehabilitation technologies.

Objective:To analyze the effects of vitamin D supplementation therapy on the levels of serum total immunoglobulin E (IgE) and specific IgE (sIgE), as well as T lymphocyte subsets in children with atopic dermatitis (AD).Methods:A retrospective study was conducted. A total of 103 children with AD who visited the Dermatology Department of Xi'an Children's Hospital from January 2023 to December 2024 were selected as the research subjects. They were divided into an observation group 52 cases and a control group 51 cases according to the treatment methods. Children in both the control group and the observation group received treatment with levocetirizine oral solution, and the observation group additionally received oral treatment with vitamin D drops. The general clinical data and clinical efficacy were compared between the two groups of children. The characteristics and differences of serum IgE (total IgE, sIgE of inhaled allergens, sIgE of ingested allergens) and T lymphocyte subsets [regulatory T lymphocyte (Treg cell), helper T lymphocyte 17 (Th17 cell), Th17 cell/Treg cell] before and after treatment were evaluated. The Pearson correlation coefficient was used to test the correlations among the observed indicators.Results:After treatment, the total effective rate in the observation group was higher than that in the control group: 92.3% (48/52) vs. 78.4% (40/51), with a statistically significant difference ( P<0.05). After treatment, the levels of serum total IgE, sIgE of inhaled allergens and sIgE of ingested allergens in the observation group were lower than those in the control group: (174.93 ± 18.78) kU/L vs. (194.04 ± 19.87) kU/L, (93.07 ± 17.52) kU/L vs. (101.38 ± 19.80) kU/L, (74.21 ± 16.11) kU/L vs. (86.20 ± 14.72) kU/L, with statistically significant differences ( P<0.05). After treatment, the Treg cell in the observation group was higher than that in the control group: (5.46 ± 0.41)% vs. (4.42 ± 0.24)%, while the Th17 cell and Th17 cell/Treg cell were both lower than those in the control group: (1.78 ± 0.30)% vs. (2.26 ± 0.25)%, 0.33 ± 0.06 vs. 0.51 ± 0.06, and the differences were statistically significant ( P< 0.05). Among all the enrolled children, after treatment, the total IgE ( r = - 0.48, P<0.001), sIgE of inhaled allergens ( r = -0.24, P = 0.016) and sIgE of ingested allergens ( r = - 0.32, P = 0.001) were negatively correlated with the Treg cell. The total IgE ( r = 0.38 and 0.50, P<0.001) and sIgE of ingested allergens ( r = 0.24 and 0.32, P = 0.013 and 0.001) were positively correlated with the Th17 cell and the Th17 cell/Treg cell. Conclusions:Vitamin D supplementation therapy can effectively reduce total IgE and sIgE levels in children with AD. Concurrently, it can ameliorate the Th17 cell/Treg cell imbalance, ultimately leading to improved treatment outcomes and prognosis for these children.

Objective To explore the effectiveness of an integrated laparoscopic simulation training course (best essential surgical technique training, BEST) in enhancing laparoscopic peritoneal suturing techniques in surgical residents.Methods As an integrated two-stage program, the BEST course applied basic laparoscopic training system with simple molds in phase Ⅰ training, and then adopted advanced laparoscopic training system, 3D Laparoscope and ex-vivo animal models in phase Ⅱ training. The laparoscopic suturing techniques were practiced in phase Ⅱ training. From August 2021 to July 2024, surgical residents in the second year of the national standardized training program were divided into pilot and control groups based on whether they had undergone the BEST course. Two cases of laparoscopic peritoneal suture were performed by the surgical residents under supervision in the department of gastrointestinal surgery. The operative time, quality of suture, and independent completion rate were compared between the two groups.Results A total of 33 surgical residents (19 in pilot group and 14 in control group) were included in this study, and a total of 66 cases of laparoscopic peritoneal suture were performed (38 in pilot group and 28 in control group). The operative time was significantly shorter in pilot group than that in control group (15.7 min vs. 17.5 min, P=0.025). The quality of suture was significantly better in pilot group compared to control group (P=0.023). In pilot group, all peritoneal sutures were performed by residents independently, whereas in control group, 3 cases (10.7%) were assisted by the supervisor, and the independent completion rate was different significantly (P=0.039).Conclusions The BEST course can help improve surgical residents′ laparoscopic peritoneal suturing techniques and could be promoted in the national standardized training program for surgical residents.

Objective:To investigate the affection of high mobility group nucleosome-binding protein 5(HMGN5) gene in the hepatocellular cancer tissue and HepG2 cell and its function in the growth of HepG2 cell.Methods:70 Patients with hepatocellular carcinoma who under-went surgical resection and were confirmed by postoperative pathology in Sunshine Union Hospital of Weifang City from January 2017 to June 2020 were selected. Their clinical and pathological data, surgical resection of liver cancer tissue and adjacent normal liver tissue were collected, their survival time were also recorded. The contents of HMGN5 protein in the hepatocellular cancer tissues and adjacent normal liver tissues of 70 patients were detected by immunohistochemistry. Compare the expression of HMGN5 protein in liver cancer tissue and normal liver tissue and the positive expression rate of HMGN5 protein in liver cancer tissues of hepatocellular carcinoma patients with different clinical characteristics, to analyze the relationship between HMGN5 expression and prognosis of patients with hepatocellular carcinoma.The mRNA contents of HMGN5 gene in HepG2 cells and HL-7702 cells were determined by quantitative real time polymerase chain reaction(qRT-PCR) method. After transfectHepG2 cells with HMGN5 shRNA, the proliferation ability of HepG2 cells were evaluated by cell proliferation assay and the cell apoptosis was analyzed by flow cytometry. Measurement data with normal distribution were expressed as ±s, two independent samples t test was used for comparison between groups. Counting data was expressed as n(%), χ2 test was used for comparison between groups. Survival analysis of patients was performed by Kaplan-Meier method. Results:Immunohistochemical tests showed that HMGN5 staining is strong in liver cancer tissue, but weak in normal liver tissue. HMGN5 protein expression was positive in 48 of 70 patients with hepatocellular carcinoma. The positive expression rate of HMGN5 protein in hepatocellular carcinoma tissues of patients with pathological grade 3+4 and clinical stage Ⅲ+Ⅳ was higher than that of patients with grade 1+2 and stage Ⅰ+Ⅱ, respectively. There was no significant difference in cumulative survival rate between HMGN5 positive expression group and HMGN5 negative expression group ( χ2=3.81, P=0.051). The results of qRT-PCR showed that the expression level of HMGN5 mRNA in hepatoma HepG2 cells was higher than that in normal liver HL-7702 cells [(4.51±0.45) vs (1.35±0.27), the difference was statistically significant ( t=10.43, P=<0.001). After 24, 48 and 72h of the HMGN5 gene was knockout, the survival rate of HepG2 hepatoma cells was lower than that of HL-7702 hepatoma cells (all P<0.05) and the apoptosis rate of hepatoma HepG2 cells was higher than that of liver HL-7702 cells [(18.63±1.76)%vs(1.81±0.21)%] ,the difference was statistically significant ( t=16.44, P<0.001). Conclusions:HMGN5 genes and proteins are highly expressed in the hepatocellular cancer tissues and HepG2 cells. HMGN5 gene plays an important role in the growth of hepatocellular cancer and can be used as a potential target of treatment for hepatocellular cancer.

Objective To investigate the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)parameters in evaluating the short-term prognosis of laryngeal cancer patients after postoperative radiotherapy.Methods A case-control study was performed on 127 laryngeal cancer patients admitted to our hospital from January 2021 to December 2023.The patients underwent different tumor treatment followed by radical radiotherapy.According to tumor recurrence or not,they were divided into a recurrence group(n=50)and a non-recurrence group(n=77).DCE-MRI parameters,such as volume transfer constant(Ktrans),rate constant(Kep),and volume fraction of extracellular extravascular space(Ve),and clinical data were compared between the 2 groups.Multivariate logistic regression analysis was used to identify influencing factors for short-term prognosis after radiotherapy.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive efficacy of DCE-MRI parameters,and the area under the curve(AUC)was calculated.Results The recurrence group had significantly larger proportions of positive surgical margins,preoperative maximum lesion diameter≥4 cm,ulcerative lesions,stages N1～N3,and advanced stages Ⅲ～Ⅳ,and obviously higher Ktrans and Kep values but lower Ve valus than the non-recurrence group(P<0.05).Multivariate logistic regression analysis indicated that positive surgical margins,stages N1～N3,Ktrans,and Kep were independent risk factors for short-term prognosis,while Ve was a protective factor(P<0.05).ROC curve analysis showed that the AUC value of combination of Ktrans,Kep and Ve and of above 5 indicators in predicting short-term prognosis of postoperative radiotherapy for laryngeal cancer was 0.920(95%CI:0.858～0.961)and 0.923(95%CI:0.862～0.963),respectively.Though the AUC value of combined 3 parameters was significantly higher than that of the single indicator alone(P<0.05),there was no difference in the value between the combination of 3 parameters and the combined application of the 5 indicators.Conclusion DCE-MRI parameters Ktrans,Kep,and Ve are closely associated with short-term prognosis of postoperative radiotherapy for laryngeal cancer.Their combination has a good predictive efficacy for the short-term prognosis of the patients.

Objective:To explore the technique methods and clinical application value of β-electrode (a plasma needle shape electrode) assisted laparoscopic repair of complex vesicovaginal fistula (VVF).Methods:Clinical data of one patient with complex VVF admitted to Chinese PLA General Hospital in April 2025 was retrospectively analyzed. A 36-year-old female presented with urinary leakage 2 months after hysterectomy. Computed tomography urography excluded ureterovaginal fistula. Cystoscopy revealed a 2 cm fistula on the posterior bladder wall with both ureteral orifices adjacent to the fistula edge. The procedure involved two steps: first, transurethral β-electrode pretreatment was performed to protect the ureteral orifices and create a passage from the bladder to the abdominal cavity. Then, laparoscopic separation, suture closure of the fistula, and omental flap coverage were conducted.Results:Total operation time was 180 min (the time of β- electrode operation was 30 min) with intraoperative estimated blood loss of 50 mL. The catheter was removed 3 weeks postoperatively, and the patient voided well without leakage during 4-month follow-up.Conclusions:β- electrode assisted laparoscopic repair of complex VVF have the advantage of precise manipulation, minimal invasion and rapid recovery. No similar technique have been reported domestically or internationally. This technique provides a new approach for the treatment of complex VVF.

Objective To analyze the research hotspots and frontier trends in the field of physical therapy for Parkinson's disease(PD)from 2014 to 2023.Methods Relevant literatures published from January,2014 to December,2023 were retrieved from the Web of Science Core Collection.CiteSpace 6.3.R1 was used to conduct bibliometric analysis,generating visual maps of coun-tries,institutions,keyword co-occurrence,burst terms,timelines and clustering,and they were summarized based on both visual results and literature content.Results A total of 400 articles were included.The United States had the highest publication volume,followed by China,Italy and Brazil,and the international collaboration was relatively active.Major contributing institutions included Northwestern University,Rush University,Karolinska Institutet and Universidade de S?o Paulo.Keyword co-oc-currence analysis showed that researches mainly focused on interventions such as exercise,postural control,aero-bic exercise and transcranial direct current stimulation.Burst detection analysis showed that keywords with high attention in recent years included motor symptoms,executive function,resistance training and noninvasive brain stimulation.The timeline map indicated a shift in research themes from early focus on electrical stimulation to in-tegrated interventions involving both motor and cognitive functions.Conclusion Over the past decade,researches on physical therapy for PD has shown steady growth,with increasing diver-sity in intervention strategies.There is a clear trend toward multidimensional integration and interdisciplinary col-laboration.Future studies should strengthen interventions targeting non-motor symptoms and promote the clinical application of new rehabilitation technologies.

Objective:To analyze the effects of vitamin D supplementation therapy on the levels of serum total immunoglobulin E (IgE) and specific IgE (sIgE), as well as T lymphocyte subsets in children with atopic dermatitis (AD).Methods:A retrospective study was conducted. A total of 103 children with AD who visited the Dermatology Department of Xi'an Children's Hospital from January 2023 to December 2024 were selected as the research subjects. They were divided into an observation group 52 cases and a control group 51 cases according to the treatment methods. Children in both the control group and the observation group received treatment with levocetirizine oral solution, and the observation group additionally received oral treatment with vitamin D drops. The general clinical data and clinical efficacy were compared between the two groups of children. The characteristics and differences of serum IgE (total IgE, sIgE of inhaled allergens, sIgE of ingested allergens) and T lymphocyte subsets [regulatory T lymphocyte (Treg cell), helper T lymphocyte 17 (Th17 cell), Th17 cell/Treg cell] before and after treatment were evaluated. The Pearson correlation coefficient was used to test the correlations among the observed indicators.Results:After treatment, the total effective rate in the observation group was higher than that in the control group: 92.3% (48/52) vs. 78.4% (40/51), with a statistically significant difference ( P<0.05). After treatment, the levels of serum total IgE, sIgE of inhaled allergens and sIgE of ingested allergens in the observation group were lower than those in the control group: (174.93 ± 18.78) kU/L vs. (194.04 ± 19.87) kU/L, (93.07 ± 17.52) kU/L vs. (101.38 ± 19.80) kU/L, (74.21 ± 16.11) kU/L vs. (86.20 ± 14.72) kU/L, with statistically significant differences ( P<0.05). After treatment, the Treg cell in the observation group was higher than that in the control group: (5.46 ± 0.41)% vs. (4.42 ± 0.24)%, while the Th17 cell and Th17 cell/Treg cell were both lower than those in the control group: (1.78 ± 0.30)% vs. (2.26 ± 0.25)%, 0.33 ± 0.06 vs. 0.51 ± 0.06, and the differences were statistically significant ( P< 0.05). Among all the enrolled children, after treatment, the total IgE ( r = - 0.48, P<0.001), sIgE of inhaled allergens ( r = -0.24, P = 0.016) and sIgE of ingested allergens ( r = - 0.32, P = 0.001) were negatively correlated with the Treg cell. The total IgE ( r = 0.38 and 0.50, P<0.001) and sIgE of ingested allergens ( r = 0.24 and 0.32, P = 0.013 and 0.001) were positively correlated with the Th17 cell and the Th17 cell/Treg cell. Conclusions:Vitamin D supplementation therapy can effectively reduce total IgE and sIgE levels in children with AD. Concurrently, it can ameliorate the Th17 cell/Treg cell imbalance, ultimately leading to improved treatment outcomes and prognosis for these children.

Objective:To investigate the affection of high mobility group nucleosome-binding protein 5(HMGN5) gene in the hepatocellular cancer tissue and HepG2 cell and its function in the growth of HepG2 cell.Methods:70 Patients with hepatocellular carcinoma who under-went surgical resection and were confirmed by postoperative pathology in Sunshine Union Hospital of Weifang City from January 2017 to June 2020 were selected. Their clinical and pathological data, surgical resection of liver cancer tissue and adjacent normal liver tissue were collected, their survival time were also recorded. The contents of HMGN5 protein in the hepatocellular cancer tissues and adjacent normal liver tissues of 70 patients were detected by immunohistochemistry. Compare the expression of HMGN5 protein in liver cancer tissue and normal liver tissue and the positive expression rate of HMGN5 protein in liver cancer tissues of hepatocellular carcinoma patients with different clinical characteristics, to analyze the relationship between HMGN5 expression and prognosis of patients with hepatocellular carcinoma.The mRNA contents of HMGN5 gene in HepG2 cells and HL-7702 cells were determined by quantitative real time polymerase chain reaction(qRT-PCR) method. After transfectHepG2 cells with HMGN5 shRNA, the proliferation ability of HepG2 cells were evaluated by cell proliferation assay and the cell apoptosis was analyzed by flow cytometry. Measurement data with normal distribution were expressed as ±s, two independent samples t test was used for comparison between groups. Counting data was expressed as n(%), χ2 test was used for comparison between groups. Survival analysis of patients was performed by Kaplan-Meier method. Results:Immunohistochemical tests showed that HMGN5 staining is strong in liver cancer tissue, but weak in normal liver tissue. HMGN5 protein expression was positive in 48 of 70 patients with hepatocellular carcinoma. The positive expression rate of HMGN5 protein in hepatocellular carcinoma tissues of patients with pathological grade 3+4 and clinical stage Ⅲ+Ⅳ was higher than that of patients with grade 1+2 and stage Ⅰ+Ⅱ, respectively. There was no significant difference in cumulative survival rate between HMGN5 positive expression group and HMGN5 negative expression group ( χ2=3.81, P=0.051). The results of qRT-PCR showed that the expression level of HMGN5 mRNA in hepatoma HepG2 cells was higher than that in normal liver HL-7702 cells [(4.51±0.45) vs (1.35±0.27), the difference was statistically significant ( t=10.43, P=<0.001). After 24, 48 and 72h of the HMGN5 gene was knockout, the survival rate of HepG2 hepatoma cells was lower than that of HL-7702 hepatoma cells (all P<0.05) and the apoptosis rate of hepatoma HepG2 cells was higher than that of liver HL-7702 cells [(18.63±1.76)%vs(1.81±0.21)%] ,the difference was statistically significant ( t=16.44, P<0.001). Conclusions:HMGN5 genes and proteins are highly expressed in the hepatocellular cancer tissues and HepG2 cells. HMGN5 gene plays an important role in the growth of hepatocellular cancer and can be used as a potential target of treatment for hepatocellular cancer.