ObjectiveTo evaluate the efficacy and possible mechanism of Wei's Huoxue Tongluo Formula （韦氏活血通络方，WHTF） in treating atrophic-stage non-arteritic anterior ischemic optic neuropathy （NAION） with qi deficiency and blood stasis. MethodsA total of 82 atrophic-stage NAION patients with qi deficiency and blood stasis were randomly divided into a treatment group and a control group， with 41 cases in each group. The treatment group was given oral administration of WHTF twice a day plus acupoint injection of distilled water 2 ml at Taiyang （EX-HN5） once daily， while the control group received injection of compound anisodine injection 2 ml at Taiyang （EX-HN5） once daily and oral administration of WHTF placebo twice a day. Both groups received treatment for a course of 14 days. The best-corrected visual acuity （BCVA）， optic disc perfusion density （PD）， flux index （FI）， macular superficial PD， vascular density （VD）， and traditional Chinese medicine （TCM） syndrome scores were compared between groups before treatment and on day 7 and day 14 of treatment. Additionally， mean defect （MD） and mean sensitivity （MS） of visual fields were measured before treatment and on day 14， along with safety evaluation. ResultsAfter treatment， both groups showed significant improvement in BCVA， visual field MD and MS， and TCM syndrome scores （P＜0.05 or P＜0.01）. On day 14 of treatment， the TCM syndrome score in the treatment group was significantly lower than that in the control group （P＜0.05）. There was no significant improvement in optic disc PD and FI， and macular superficial PD and VD after treatment in either group （P＞0.05） except that on day 7 the macular superficial foveal PD in the control group was significantly better than that in the treatment group （P＜0.05）. During the treatment period， no serious adverse events occurred in either group. ConclusionWHTF can improve the visual function indicators including visual acuity and visual field， as well as TCM syndrome scores in atrophic-stage NAION patients with qi deficiency and blood stasis. It shows clinical safety， although it does not appear to have a significant effect on optic disc or macular blood flow.

ObjectiveTo evaluate the impact of stroke on diaphragmatic function by ultrasound. MethodsFrom April, 2024 to June, 2025, 40 stroke patients (stroke group) were recruited in Xuanwu Hospital Capital Medical University. Additionally, 40 sex- and age-matched healthy subjects (control group) were recruited without directional selection. Diaphragmatic excursion and diaphragmatic thickness during quiet breathing and deep breathing were assessed using ultrasound in both groups, and the diaphragmatic thickening fraction was calculated. The stroke group was further divided into two subgroups according to disease course: ≤ 30 days group and > 30 days group, for subgroup analysis. ResultsDuring both quiet and deep breathing, diaphragmatic excursion on the affected side in the stroke group was smaller than that on the unaffected side and in the control group (P < 0.05). During quiet breathing, diaphragmatic thickening fraction on the affected side in the stroke group was smaller than that on the unaffected side and in the control group (P < 0.05), while the diaphragmatic thickening fraction on the unaffected side was significantly smaller than that in the control group (P < 0.01). During deep breathing, the bilateral diaphragmatic thickening fraction in the stroke group was significantly smaller than that in the control group (P < 0.001), and the bilateral end-inspiratory diaphragmatic thickness was significantly smaller than that in the control group (P < 0.001). During quiet breathing, diaphragmatic excursion in both the ≤ 30 d group and the > 30 d group was smaller than that in the control group (P < 0.05); during deep breathing, diaphragmatic excursion in the ≤ 30 d group was smaller than that in the control group (P < 0.05). In both quiet breathing and deep breathing, the diaphragmatic thickening fraction in the ≤ 30 d group and the >30 d group were lower than those in the control group (P < 0.05). During deep breathing, end-inspiratory diaphragmatic thickness in both the ≤ 30 d group and the > 30 d group was significantly smaller than that in the control group (P < 0.01). ConclusionUltrasound can effectively identify the impact of stroke on patients' diaphragmatic function. In stroke patients, both diaphragmatic excursion and contractile performance are reduced on the affected side, while contractile performance is also reduced on the unaffected side.

Objective To investigate cortical morphological changes and structural covariance network(SCN)topological features in patients with visuospatial neglect(VSN)after stroke.Methods A retrospective analysis was conducted on acute stroke patients admitted consecutively to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University,from December 2023 to February 2025.General and clinical data were collected and compared,including age,sex,stroke type(hemorrhagic or ischemic),and time from stroke onset to first brain MRI.All patients were assessed for VSN using the line bisection task,line cancellation test,and star cancellation test.Patients with VSN were assigned to the VSN group,and those without VSN to the non-VSN group.Brain MRI was used to collect patients' brain structural images.T1-weighted MRI data were processed using Freesurfer for whole-brain segmentation.Based on the Desikan-Killiany atlas,the cortex was parcellated into 68 regions per hemisphere,total intracranial volume and cortical parameters were extracted,including cortical area(CA),mean cortical curvature(CC),cortical thickness(CT),and cortical volume(CV).A region-specific asymmetry index(AI)was calculated for cortical parameters of each brain regions using(left-right)/(left+right)to assess cortical lateralization.Analyze the SCN of each cortical parameters through covariance matrix to reflect covariation pattern of each brain region's structural morphological alternations.SCN were constructed separately for each cortical parameter based on inter-regional Pearson correlation coefficients(absolute values),with intracranial volume,age,and sex controlled via linear regression.The resulting 68×68 SCN matrices were transformed into binary networks across a sparsity range of 0.1 to 0.4(in 0.01 steps),and graph theoretical analysis were performed.Permutation tests were used to compare the global and local graph theoretical metrics of cortical SCN under each cortical parameters with different sparsity.Global metrics included clustering coefficient,path length,small-worldness parameters(normalized clustering coefficient[Gamma],normalized path length[Lambda],and small-world index[Sigma]),global efficiency,and average local efficiency.Local metrics included nodal degree,betweenness centrality,and nodal efficiency.Results(1)A total of 109 acute stroke patients were included(81 males,28 females,aged 30-80 years,mean[64±9]years),with 54 in the VSN group and 55 in the non-VSN group.No significant differences were found in age,sex,stroke type,or time from stroke onset to MRI between two groups(all P＞0.05).(2)Comparison of cortical features(of different brain regions)between two groups showed significantly larger CA in the right insular surface area in the VSN group(2 466.50[2 143.75,2 662.50]mm2 vs.2 128.00[1 961.00,2 479.00)]mm2,P=0.037).No significant differences were observed in other regions or metrics(all P＞0.05).The VSN group has significantly lower AI values for CT in the right isthmus cingulate gyrus(-0.01[-0.05,0.03]vs.0.02[-0.01,0.06],P=0.028)and postcentral gyrus(-0.02[-0.04,0.00]vs.0.00[-0.02,0.02],P=0.026).No significant AI differences were observed in other regions or metrics(all P＞0.05).(3)For global network metrics:in the CA-based VSN,compared with the non-VSN group,Sigma values were significantly higher in the VSN group across multiple sparsity thresholds and at the average sparsity level(P＜0.01).In the CT-based SCN,Lambda values were significantly higher in the VSN group at most sparsity thresholds and at the average level(P=0.004).In the CC-based SCN,clustering coefficient and average local efficiency were significantly lower in the VSN group across most sparsity thresholds and average sparsity(P＜0.01).No significant differences were found in global metrics within the CV-based SCN.(4)For local metrics:in the CV-based SCN,compared with the non-VSN group,the VSN group showed significantly lower nodal efficiency in the left inferior temporal gyrus at most sparsity thresholds and at the average level(0.35[0.29,0.50]vs.0.65[0.51,0.72],P＜0.01).No significant differences in local metrics were observed in other SCN between the two groups.Conclusions Patients with VSN exhibit abnormal cortical morphology and SCN topology,characterized by reduced overall integration efficiency and weakened local connectivity,alongside enhanced small-worldness and possible compensatory reorganization.The conclusions of this study require further validation in multicenter,large-scale,prospective studies.

Objective To investigate the effects of HIF1A-AS1 on the proliferation and apoptosis of gastric cancer cells lines BGC-823 and MKN28 and its possible mechanism.Methods The expression of HIF1A-AS1 in gastric cancer tissues was analyzed by bioinformatics.H1F1A-AS1 over expression and silenced BGC-823 and MKN28 cell strains were constructed.HIF1A-AS1 expression was detected by real-time PCR,cell proliferation was detected by CCK-8 assay,and apoptosis was detected by flow cytometry.Western blot was used to detect the expression of HIF1A protein in cytoplasm and nucleus and cellular immunofluorescence was used to detect HIF1A protein into nucleus.Results Models of BGC-823 and MKN28 gastric cancer cells with HIF1A-AS1 over-expression and silence were successfully constructed.HIF1A-AS1 over-expression decreased cell proliferation(P＜0.05),while HIF1A-AS1 over-expression significantly increased cell proliferation(P＜0.05).HIF1A-AS1 silencing significantly increased the apoptosis(P＜0.05),and HIF1A-AS1-over expression significantly decreased the apoptosis(P＜0.05).HIF1A-AS1 silencing inhibited the nucleation of HIF1A protein and over-expression promoted the nucleation of HIF1A pro-tein.HIF1A-AS1 silencing significantly decreased the expression of HIF1A cytoplasmic protein(P＜0.05)and over-expression of HIF1A-AS1 significantly increased the expression of HIF1A cytoplasm protein(P＜0.05).HIF1A-AS1 silencing significantly decreased the expression of HIF1A nuclear protein(P＜0.05)while HIF1A-AS1 over-expression significantly increased the expression of HIF1A nuclear protein(P＜0.05).Conclusions HIF1A-AS1 may promote the proliferation and inhibit apoptosis of BGC-823 and MKN28 gastric cancer cells by regulating the expression of parental gene HIF1A.

Objective To investigate the intervention effects of a progressive upper limb exercise rehabilitation program based on the multi-process action control theory on upper limb function,rehabilitation compliance,and quality of life in patients with permanent pacemaker implantation(PPI).Methods A total of 130 patients scheduled for PPI from March to August 2024 were selected using a convenience sampling method.Among them,65 patients admitted from June to August were assigned to the experimental group,and 65 patients admitted from March to May formed the control group.The experimental group received the progressive upper limb exercise program in addition to routine care,while the control group received routine care only.The intervention lasted for 3 months.The differences were compared between the 2 groups in terms of primary outcome measures,including the Shoulder Pain and Disability Index(SPADI)and grip strength.The secondary outcome measures were the Quality of Life Instrument for Chinese Patients with Pacemaker(QLICPP),hospital stay and incidence of complications.Results A total of 122 patients(62 in the experimental group and 60 in the control group)completed this study.Repeated-measures analysis of variance showed significant interaction effects between time and group for the total SPADI score and its pain and disability dimensions,as well as for the physical function,psychological function,and total score of QLICPP(P＜0.001).Simple effects analysis indicated that the experimental group had better grip strength than the control group at l month postoperatively,and lower SPADI scores and total score than the control group at 1 and 3 months postoperatively.At 1 month postoperatively,the total QLICPP score and each dimension of the experimental group were higher than those of the control group(P＜0.05).There were no significant differences between the 2 groups in the incidence of complications and length of hospital stay(P＞0.05).Conclusion The progressive upper limb exercise rehabilitation program developed in this study effectively addressed the issue of low rehabilitation compliance in PPI patients,improved their upper limb function and quality of life,and it was safe.It provides a feasible and effective new pathway for the rehabilitation of PPI patients.

Objective:To explore the application effect of dexmedetomidine combined with ciprofol general anesthesia in laparoscopic radical resection of ovarian cancer.Methods:A total of 120 patients who underwent laparoscopic radical resection of ovarian cancer at the Hengshui Second People′s Hospital, Hebei Province from January 2021 to January 2023 were selected as the research objects. They were divided into the control group and the observation group by random number table method, with 60 cases in each group. Both groups underwent surgery under general anesthesia: the control group was given ciprofol, while the observation group was given dexmedetomidine combined with ciprofol. Postoperative recovery, changes in hemodynamics and vital signs, levels of stress indicators, and the occurrence of adverse reactions were compared between the two groups.Results:Compared with the control group, the observation group had fewer presses on the analgesic pump, shorter first flatus time and awakening time, lower Visual Analogue Scale (VAS) score at 1 hour after surgery, and higher Ramsay sedation score (all P<0.05). There were no statistically significant differences in heart rate (HR), mean arterial pressure (MAP), and bispectral index (BIS) between the two groups before induction (T 0) (all P>0.05); MAP at skin incision (T 1), 30 minutes after skin incision (T 2), and after extubation (T 3) in both groups were higher than those at T 0, while HR were lower than those at T 0 (all P<0.05); HR and MAP at T 1, T 2, and T 3 in the observation group were significantly lower than those in the control group (all P<0.05), but there was no statistically significant difference in BIS between the two groups at each time point (all P>0.05). There were no statistically significant differences in serum cortisol (COR) and adrenocorticotropic hormone (ACTH) levels between the two groups at T 0 (all P>0.05); serum COR and ACTH levels at T 3 and 1 hour after surgery (T 4) in both groups were higher than those at T 0 (all P<0.05), and the levels of serum COR and ACTH at T 3 and T 4 in the observation group were lower than those in the control group (all P<0.05). In the control group, there were 3 cases of hypotension, 7 cases of nausea and vomiting, and 1 case of respiratory depression; in the observation group, there were 2 cases of hypotension and 3 cases of nausea and vomiting. No serious adverse reactions occurred in either group, and the total incidence of adverse reactions in the observation group was lower than that in the control group (χ 2=3.354, P<0.05). Conclusions:Dexmedetomidine combined with ciprofol general anesthesia can promote postoperative recovery of patients undergoing laparoscopic radical resection of ovarian cancer, effectively stabilize hemodynamics, and reduce stress response and adverse reactions.

Objective:To develop and validate clinical predictive models for identifying poor short-term response to recombinant human growth hormone(rhGH) treatment in children with short stature.Methods:A retrospective analysis was conducted on 118 children diagnosed with growth hormone deficiency or idiopathic short stature who were treated at the First Affiliated Hospital of Zhengzhou University and two other hospitals between January 1, 2020, and January 1, 2024. A poor response to rhGH was defined as a height increase of less than 0.2 standard deviation score(SDS) after 6 months of rhGH treatment. LASSO regression was used to identify predictive variables from baseline and follow-up data. Two logistic regression models were conducted: Model A(incorporating baseline variables only) and model B(incorporating both baseline and follow-up variables), and nomograms were created for visualization. External data and internal resampling were used for dual validation of the models, and their performance was compared.Results:A total of 118 children with short stature were included. Six baseline predictive variables(diagnosis, initial height SDS, bone age, bone age-chronological age difference, rhGH dose, and gender) and one follow-up variable(height SDS after 3 months of rhGH treatment) were identified. Area under the curve values for Model A and Model B were 0.753(95% CI 0.696-0.811) and 0.930(95% CI 0.891-0.975), respectively. Calibration curves, decision curve analysis, and other evaluation metrics demonstrated good discrimination and clinical utility for both models. Model B, incorporating the 3-month follow-up variable, showed superior predictive performance compared to Model A. Conclusions:The clinical prediction models developed in this study(Model A and Model B) are practical and reliable tools for quantitatively, conveniently, and intuitively identifying children with short stature at risk of poor response to rhGH treatment.

Objective To investigate the status of management of iodinated contrast media(ICM)extravasation in Henan Province,as well as nurses' knowledge and influencing factors,in order to provide a basis for optimizing management strategies.Methods A self-designed questionnaire was applied,employing convenience sampling,to survey nursing administrators and nurses in the radiology departments of 55 tertiary hospitals across 16 regions of Henan Province,from December 2024 to January 2025.Multiple linear regression analysis was conducted to explore the factors influencing nurses' knowledge.Results A total of 55 nursing administrators and 64 nurses participated,with a valid questionnaire response rate of 100％.The survey results reveal that only 5.45％of radiology depart-ments utilized high-pressure central venous catheters,and 32.73％employed vascular visualization techniques.When setting the high-pressure injection speed for ICM,only 54.55％of radiology departments required an assessment of the type and model of intravenous access.Additionally,only 9.09％of radiology departments mandated an observa-tion for 2 to 4 hours following ICM extravasation.Furthermore,only 50.91％of radiology departments had estab-lished an information system for ICM use.The nurses' knowledge score regarding the prevention and management of ICM extravasation was(90.00±17.59),influenced by years of experience in radiology and professional titles(P＜0.05).Conclusion The prevention and management measures for ICM in radiology departments in Henan Province need further improvement.Nursing administrators should optimize management strategies,improve relevant training systems,and continuously enhance nurses' knowledge and practical abilities.

Objective:To investigate the effects of dexmedetomidine (Dex) combined with propofol or cyclopropofol on postoperative stress in laparoscopic ovarian cancer surgery.Methods:A total of 120 ovarian cancer patients who underwent laparoscopic radical resection of ovarian cancer in the Second People′s Hospital of Hengshui from January 2022 to December 2023 were selected and divided into observation group and control group by random number table method, with 60 cases in each group. The control group was given Dex combined with propofol for compound anesthesia, and the observation group was given Dex combined with cyclopropofol for compound anesthesia. The perioperative indicators and intraoperative opioid dosage were compared between the two groups. The heart rate (HR) and mean arterial pressure (MAP) were compared at 3 min after entering the operating room (T 1), intubation (T 2), skin incision (T 3), extubation (T 4) and leaving the operating room (T 5). The Ramsay Sedation Scale (RSS) scores at T 1, T 2, T 3, T 4 and Prince-Henry scores at 2, 6, 12, 24 h after operation were compared. The serum levels of prostin E 2 (PGE 2) and cortisol (Cor) 1 day before operation and 12, 24, 48 h after operation, as well as the incidence of adverse events during treatment were compared between the two groups. Results:The anesthesia recovery time in the observation group was significantly shorter than that in the control group, and the intraoperative dosages of sufentanil and remifentanil were significantly less than those in the control group (all P<0.05). Compared with T 1, there were no significant differences in HR and MAP at T 2, T 3, T 4 in the observation group (all P>0.05); the HR and MAP at T 2, T 3, T 4 in the control group were significantly different from those at T 1 (all P<0.05), and the HR and MAP at T 2, T 3, T 4, T 5 in the observation group were lower than those in the control group (all P<0.05). The RSS scores at T 2, T 3 and T 4 in the observation group were significantly higher than those in the control group (all P<0.05). The Prince-Henry scores at 2, 6, 12, 24 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The serum PGE 2 and Cor levels at 12, 24 and 48 h after operation in the observation group were significantly lower than those in the control group (all P<0.05). The total incidence of postoperative adverse events in the observation group was 18.33%(11/60), lower than 23.33%(14/60) in the control group ( P<0.05). Conclusions:Compared with Dex combined with propofol, Dex combined with cyclopropofol for compound anesthesia can reduce postoperative stress response in laparoscopic ovarian cancer surgery, improve intraoperative sedation and postoperative analgesia, stabilize hemodynamics, and has good safety.

Objective To investigate the status of management of iodinated contrast media(ICM)extravasation in Henan Province,as well as nurses' knowledge and influencing factors,in order to provide a basis for optimizing management strategies.Methods A self-designed questionnaire was applied,employing convenience sampling,to survey nursing administrators and nurses in the radiology departments of 55 tertiary hospitals across 16 regions of Henan Province,from December 2024 to January 2025.Multiple linear regression analysis was conducted to explore the factors influencing nurses' knowledge.Results A total of 55 nursing administrators and 64 nurses participated,with a valid questionnaire response rate of 100％.The survey results reveal that only 5.45％of radiology depart-ments utilized high-pressure central venous catheters,and 32.73％employed vascular visualization techniques.When setting the high-pressure injection speed for ICM,only 54.55％of radiology departments required an assessment of the type and model of intravenous access.Additionally,only 9.09％of radiology departments mandated an observa-tion for 2 to 4 hours following ICM extravasation.Furthermore,only 50.91％of radiology departments had estab-lished an information system for ICM use.The nurses' knowledge score regarding the prevention and management of ICM extravasation was(90.00±17.59),influenced by years of experience in radiology and professional titles(P＜0.05).Conclusion The prevention and management measures for ICM in radiology departments in Henan Province need further improvement.Nursing administrators should optimize management strategies,improve relevant training systems,and continuously enhance nurses' knowledge and practical abilities.