OBJECTIVE To investigate the effects of safflower polysaccharide （SPS） on ischemic stroke （IS） in rats by regulating the growth arrest-specific protein 6 （Gas6）/Axl receptor tyrosine kinase （Axl） signaling pathway. METHODS The modified suture-occluded method was employed to establish a rat model of middle cerebral artery occlusion （MCAO） for IS. The rats were then randomly divided into the model （Model） group， SPS low- and high-dose （SPS-L， SPS-H， 50 and 100 mg/kg） groups， and integrated traditional Chinese and Western medicine （SPS-H+Nim， SPS 100 mg/kg+Nim 15 mg/kg） group， with 10 rats in each group. Another 10 rats were selected as the sham operation （Sham） group. Rats in each group were administered corresponding doses of medication or an equal volume of normal saline intragastrically， with continuous intervention for 14 days. The neurological function of rats in each group was evaluated 24 hours after drug administration. The morphological changes in hippocampal tissue were observed. The contents of interleukin-6 （IL-6）， IL-1β， and tumor necrosis factor-α （TNF-α） in serum， the percentage of cerebral infarction area， the neuronal apoptosis rate， as well as the contents of malondialdehyde （MDA）， superoxide dismutase （SOD）， and brain-derived neurotrophic factor （BDNF） in hippocampal tissue， and the relative protein expression levels of Gas6， phosphorylated Axl （p-Axl）， Axl， B-cell lymphoma-2 （Bcl-2）， and Bcl-2 associated X protein （Bax） were measured. RESULTS Compared with Model group， the neurological function of rats in SPS-L group， SPS-H group and SPS-H+Nim group improved significantly， while serum contents of IL-6， TNF-α， and IL-1β， the percentage of cerebral infarction area， the apoptotic rate of neurons as well as MDA content and relative protein expression of p-Axl and Bax were decreased significantly （ P ＜0.05 or P ＜0.01）. The contents of SOD and BDNF， as well as the relative protein expression of Gas6， Axl， and Bcl-2 in hippocampal tissue， were significantly increased （ P ＜0.05 or P ＜0.01）， and the ischemic injury in hippocampal tissue imp roved to varying degrees. CONCLUSIONS SPS can reduce neuroinflammation， oxidative stress， and neuronal apoptosis in IS rats， alleviate nerve injury， and improve neurological function， which may be achieved by activating the Gas6/Axl signaling pathway.

Respiratory syncytial virus (RSV) represents the leading viral pathogen causing acute lower respiratory infections in children under five years worldwide. Preterm infants, due to their immature immune systems and pulmonary development, along with frequent comorbidities such as bronchopulmonary dysplasia, constitute a high-risk population for RSV infections. Globally, RSV infections in preterm infants impose substantial burdens across clinical, economic, and long-term health dimensions. Current prevention and treatment options remain limited, primarily relying on supportive care as no specific antiviral drugs are available, while preventive strategies encompass general measures and specific interventions including monoclonal antibodies and RSV vaccines. This review synthesizes recent advances in understanding RSV susceptibility, disease burden, and prevention strategies in preterm infants, aiming to enhance awareness and provide references for managing RSV infections in this vulnerable population.

Objective:To evaluate the clinical value of peripheral blood monocyte subset analysis in the diagnosis and treatment of chronic myelomonocytic leukemia (CMML) .Method:We retrospectively enrolled 51 patients newly diagnosed with CMML at Guangdong Provincial People's Hospital between June 1, 2020, and December 31, 2024, according to the WHO 2022 diagnostic criteria. Twenty-three patients with other myeloid neoplasms (excluding CMML) and peripheral monocytosis (absolute count ≥0.5×10 9/L and percentage ≥10%) were included as the control group. All patients underwent bone marrow aspiration for examinations including bone marrow smears, biopsies, cytogenetics, and gene mutation analysis to establish a definitive diagnosis. Concurrently, flow cytometry was used to determine the proportions of peripheral blood monocyte subsets: classical (MO1, CD14 +CD16 -) , intermediate (MO2, CD14 +CD16 +) , and non-classical (MO3, CD14 lowCD16 +) . Differences between the groups were compared, and diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves. Result:Among the 51 CMML patients, the proportion of the peripheral blood MO1 subset was significantly higher than that in patients with other myeloid neoplasms ( P=0.027) , whereas there were no significant differences in the MO2 and MO3 subsets (all P>0.05) . Further analysis revealed that 43 (84.31%) of the CMML patients met the WHO diagnostic threshold for the MO1 subset (≥94%) , while the remaining 8 patients did not; 46 patients (90.20%) had MO3 subset proportions below the threshold proposed by Hudson (≤1.13%) , while the remaining 5 patients were above this threshold. In-depth analysis showed that among the 8 patients who did not meet the WHO criteria, 7 were experiencing inflammation. Similarly, all 5 patients who did not meet the Hudson criteria were in an inflammatory state. Subsequent ROC curve analysis of this cohort identified a cut-off value for the MO1 subset of 97.55% [Area Under the Curve (AUC) =0.661, P=0.027], which aligns with the WHO criteria. Conclusion:Peripheral blood monocyte subset analysis, particularly MO1 subset analysis, can effectively assist in CMML diagnosis, but exclusion of inflammatory conditions is required.

Objective:To analyze the correlation between metabolic syndrome indexes and thyroid nodules in individuals receiving health examinations.Methods:It′s a retrospective cohort study. A total of 2 678 individuals who received health examinations in the Health Management Center of the First Hospital of Shanxi Medical University for four consecutive years and met the admission criteria were selected as the research objects. According to the metabolic syndrome index data of health examination, according to the different duration of metabolic syndrome during the observation period, the group-based trajectory model, Bayesian information criterion and average posterior grouping probability were used to determine the best trajectory groups, and the objects were divided into three different metabolic syndrome index trajectory groups: normal, abnormal and recovery group. During the physical examination in 2022 and 2023, the detection of thyroid nodules in each group was followed up, and the difference of detection rate of thyroid nodules in different metabolic syndrome trajectory groups was compared by Log-rank test, and the correlation between different metabolic syndrome index change trajectories and thyroid nodules was analyzed by logistic regression model.Results:The cumulative detection rate of thyroid nodules in normal group, abnormal group and recovery group was 18.8% (77/410), 27.5% (327/1 190) and 24.7% (266/1 078), respectively ( χ2=19.482, P<0.001). In model 4, after adjusting for age, gender, smoking, drinking, staying up late, insomnia, physical activity, family history and other confounding factors, the risk of thyroid nodules in abnormal group and recovery group was still 2.011 times (95% CI: 1.457-2.776) and 2.006 times (95% CI: 1.389-2.897) of that in normal group. Conclusion:There is a positive correlation between metabolic syndrome index and thyroid nodules in individuals receiving health examinations, and metabolic syndrome index can be used as a predictive index of thyroid nodules.

Objective:To investigate influence of different phantoms on the results of quality control for the images of cone beam computed tomography(CBCT)for breast on the basis of quality control for breast CBCT.Methods:Five different manufacturers'phantoms were selected,and they were placed at the position of testing breast in clinical examination to conduct position for phantom according to the method of the national health industry standard WS 818-2023.The analysis focused on the differences of evaluation results of using different phantoms for image quality on the basis of a series of parameters included uniformity,resolution of high contrast,resolution of low contrast,and CT value of water in scanning images of different phantoms.Data collection and image reconstruction were performed respectively by using commonly clinical procedures.Corresponding module images were selected from the reconstructed images of standard breast phantom.The common layer thickness and projection method of the system were set to record and analyze data.Results:The image uniformity of measured results of the five phantoms were respectively 42.37±2.01,-5.83±0.15,3.76±0.15,2.16±0.06,3.60±0.10.The differences of the image uniformities among the five phantoms were statistically significant(F=1310.02,P<0.001),and the differences of the CT values of the measured water among the five phantoms were statistically significant(F=9 846.46,P<0.001).The differences in the resolution of low contrast among them were also statistically significant(F=27.50,P<0.001).However,the results of the resolution of high contrast were stability,and there was no significant difference in that among the five phantoms.Conclusion:The measured results of quality control of different phantoms are different.

Objective This study aimed to explore the correlation between abnormal hand features and coronary atherosclerotic heart disease(CHD)to provide clinical data support for digitalized traditional Chinese medicine(TCM)hand diagnosis.Methods A palm key point prediction algorithm was used to automatically capture and collect detailed features of the palm and nails through image analysis and data mining using the hand diagnosis information collection technology based on the NVIDIA Jetson platform and Qt framework.A total of 438 cardiac patients who underwent coronary artery computed tomography angiography(CACTA)in the Department of Cardiology,Dongzhimen Hospital,Beijing University of Chinese Medicine,from December 2023 to April 2024 were included and divided into CHD(148 cases)and non-CHD groups(290 cases)based on the CACTA results.The hand features of the two groups were compared,and abnormal hand features associated with CHD were screened using random forest analysis as well as univariate and multivariate logistic regression analyses.Results Based on the results of univariate logistic regression and random forest analyses,a set of hand-related features associated with CHD were identified and subsequently included in the multivariate logistic regression analysis.These features included the morphology of the thenar eminence,the wrinkles of the thenar eminence,nail shape,nail texture,and the length of the blood vessel in the middle finger.Multivariate logistic regression analysis revealed that hypertrophic thenar eminence[odds ratio(OR):3.049,95%confidence interval(CI):1.430-6.503,P=0.004],presence of wrinkles on the thenar eminence(OR:2.206,95%CI:1.119-4.348,P=0.022),presence of gray-black vertical stripes on the nails(OR:1.981,95%CI:1.173-3.347,P=0.011),uneven nail surface(OR:3.130,95%CI:1.822-5.378,P<0.001),and inward-bending nail surface(OR:5.727,95%CI:1.812-18.102,P=0.003)were positively associated with CHD.In contrast,the blood vessel in the middle finger longer than 1/3 of the phalanx was negatively associated with CHD(OR:0.405,95%CI:0.234-0.702,P=0.001).Conclusion Certain hand features are significantly associated with CHD,providing the valuable clinical data to support for the digitalization of TCM hand diagnosis.

ObjectiveTo establish the self-reported core outcome set （COS） for patients with an example of a community study on heat-sensitive moxibustion for primary hypertension （PH）， to provide a reference for the selection of effectiveness evaluation indicators in community study on heat-sensitive moxibustion. MethodsA systematic literature search was conducted to collect outcomes used in randomized controlled trials and systematic review of heat-sensitive moxibustion for PH （Jan 2021）， and additional outcomes were added through patient and expert questionnaires （Feb 2021） to create a pool of outcome entries. A multidisciplinary expert Delphi survey was conducted to screen outcomes applicable to patient self-reporting （Apr 2021）， and the importance of outcome indicators was rated on a 5-Point Likert Scale. Finally， patient self-reported COS was determined through a consensus conference （June 2021）. ResultsA pool of patient self-reported indicators in the community study of heat-sensitive moxibustion treatment for PH was generated by standardizing and combining the outcome indicators based on the results of the literature search and the questionnaire survey， which consisted of totally 100 measurement tools or contents， excluding 51 indicators or measurement tools required measurement by specialized physicians or hospital equipment， and 49 items were retained to enter the initial list of indicator entries. For the first round of Delphi survey， the mean score for expert familiarity was 0.819， the mean score for basis of judgment was 0.710， and the expert authority coefficient was 0.765， with a total of 21 indicator measurement tools or contents deleted （significance score ≤ 75 or coefficient of variation ＞ 0.25）， 28 retained， and 3 new expert-added indicator entries added. In the second round of Delphi survey， the average score for expert familiarity was 0.859， the average score for basis for judgment was 0.763， and the expert authority coefficient was 0.811， with a total of 11 indicator measurement tools or contents deleted and 20 retained involving 5 domains. Following an expert consensus meeting， 8 outcome indicators were finalized for inclusion in the patient self-reported COS， including 6 indicators of effectiveness evaluation such as quality-of-life scores， blood pressure， traditional Chinese medicine symptom scores， cost-benefit， cardiovascular and cerebrovascular events， and adverse reactions/events， and 2 indicators of factors influencing effectiveness such as sensation of heat-sensitive moxibustion， and adherence. ConclusionIn this study， we initially established a criteria for evaluating the effectiveness in the community study on heat-sensitive moxibustion by constructing patient self-reported COS in the community study on heat-sensitive moxibustion for PH， which can provide a scientific research paradigm for the subsequent development of the community study on heat-sensitive moxibustion.

Objective:To investigate influence of different phantoms on the results of quality control for the images of cone beam computed tomography(CBCT)for breast on the basis of quality control for breast CBCT.Methods:Five different manufacturers'phantoms were selected,and they were placed at the position of testing breast in clinical examination to conduct position for phantom according to the method of the national health industry standard WS 818-2023.The analysis focused on the differences of evaluation results of using different phantoms for image quality on the basis of a series of parameters included uniformity,resolution of high contrast,resolution of low contrast,and CT value of water in scanning images of different phantoms.Data collection and image reconstruction were performed respectively by using commonly clinical procedures.Corresponding module images were selected from the reconstructed images of standard breast phantom.The common layer thickness and projection method of the system were set to record and analyze data.Results:The image uniformity of measured results of the five phantoms were respectively 42.37±2.01,-5.83±0.15,3.76±0.15,2.16±0.06,3.60±0.10.The differences of the image uniformities among the five phantoms were statistically significant(F=1310.02,P<0.001),and the differences of the CT values of the measured water among the five phantoms were statistically significant(F=9 846.46,P<0.001).The differences in the resolution of low contrast among them were also statistically significant(F=27.50,P<0.001).However,the results of the resolution of high contrast were stability,and there was no significant difference in that among the five phantoms.Conclusion:The measured results of quality control of different phantoms are different.

Objective:To evaluate the clinical value of peripheral blood monocyte subset analysis in the diagnosis and treatment of chronic myelomonocytic leukemia (CMML) .Method:We retrospectively enrolled 51 patients newly diagnosed with CMML at Guangdong Provincial People's Hospital between June 1, 2020, and December 31, 2024, according to the WHO 2022 diagnostic criteria. Twenty-three patients with other myeloid neoplasms (excluding CMML) and peripheral monocytosis (absolute count ≥0.5×10 9/L and percentage ≥10%) were included as the control group. All patients underwent bone marrow aspiration for examinations including bone marrow smears, biopsies, cytogenetics, and gene mutation analysis to establish a definitive diagnosis. Concurrently, flow cytometry was used to determine the proportions of peripheral blood monocyte subsets: classical (MO1, CD14 +CD16 -) , intermediate (MO2, CD14 +CD16 +) , and non-classical (MO3, CD14 lowCD16 +) . Differences between the groups were compared, and diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves. Result:Among the 51 CMML patients, the proportion of the peripheral blood MO1 subset was significantly higher than that in patients with other myeloid neoplasms ( P=0.027) , whereas there were no significant differences in the MO2 and MO3 subsets (all P>0.05) . Further analysis revealed that 43 (84.31%) of the CMML patients met the WHO diagnostic threshold for the MO1 subset (≥94%) , while the remaining 8 patients did not; 46 patients (90.20%) had MO3 subset proportions below the threshold proposed by Hudson (≤1.13%) , while the remaining 5 patients were above this threshold. In-depth analysis showed that among the 8 patients who did not meet the WHO criteria, 7 were experiencing inflammation. Similarly, all 5 patients who did not meet the Hudson criteria were in an inflammatory state. Subsequent ROC curve analysis of this cohort identified a cut-off value for the MO1 subset of 97.55% [Area Under the Curve (AUC) =0.661, P=0.027], which aligns with the WHO criteria. Conclusion:Peripheral blood monocyte subset analysis, particularly MO1 subset analysis, can effectively assist in CMML diagnosis, but exclusion of inflammatory conditions is required.

Objective:To analyze the correlation between metabolic syndrome indexes and thyroid nodules in individuals receiving health examinations.Methods:It′s a retrospective cohort study. A total of 2 678 individuals who received health examinations in the Health Management Center of the First Hospital of Shanxi Medical University for four consecutive years and met the admission criteria were selected as the research objects. According to the metabolic syndrome index data of health examination, according to the different duration of metabolic syndrome during the observation period, the group-based trajectory model, Bayesian information criterion and average posterior grouping probability were used to determine the best trajectory groups, and the objects were divided into three different metabolic syndrome index trajectory groups: normal, abnormal and recovery group. During the physical examination in 2022 and 2023, the detection of thyroid nodules in each group was followed up, and the difference of detection rate of thyroid nodules in different metabolic syndrome trajectory groups was compared by Log-rank test, and the correlation between different metabolic syndrome index change trajectories and thyroid nodules was analyzed by logistic regression model.Results:The cumulative detection rate of thyroid nodules in normal group, abnormal group and recovery group was 18.8% (77/410), 27.5% (327/1 190) and 24.7% (266/1 078), respectively ( χ2=19.482, P<0.001). In model 4, after adjusting for age, gender, smoking, drinking, staying up late, insomnia, physical activity, family history and other confounding factors, the risk of thyroid nodules in abnormal group and recovery group was still 2.011 times (95% CI: 1.457-2.776) and 2.006 times (95% CI: 1.389-2.897) of that in normal group. Conclusion:There is a positive correlation between metabolic syndrome index and thyroid nodules in individuals receiving health examinations, and metabolic syndrome index can be used as a predictive index of thyroid nodules.