In this paper， by referring to ancient and modern literature， the textual research of Cnidii Fructus has been conducted to clarify the name， origin， distribution of production areas， quality specification， nature and flavour， efficacy， harvesting and processing， compatibility taboo and others， so as to provide reference and basis for the development and utilization of the relevant famous classical formulas. After textual research， it can be verified that Cnidii Fructus was first published in Sheng Nong's Herbal Classic， the materia medica of all dynasties was named Shechuangzi， and there are also aliases such as Shesu， Shemi， and Qiangmi. The main source for generations was the dried ripe fruit of Cnidium monnieri， and ancient and modern consistent. From the Eastern Han dynasty to Tang dynasty， the origin of Cnidii Fructus was Zibo， Shandong province. During the Five dynasties， it expanded to Yangzhou in Jiangsu province and Xiangyang in Hubei province， the Song dynasty added Shangqiu in Henan province， and it was considered that Yangzhou， Xiangyang and Shangqiu were its genuine producing areas. It was more widely distributed in Ming and Qing dynasties. After the founding of the People's Republic of China， the origin is clearly distributed throughout the country. For its quality evaluation， generally full grain， gray yellow color， strong aroma is the best. The harvesting period in the past dynasties was mostly the fifth lunar month， and the fruit was collected to remove impurities and dry. The mainstream processing in producing area of the past dynasties was net selection of raw products， mixing and steaming with the juice of Rehmanniae Radix and stir-frying were the mainstream processing methods in the past， there were also stir-frying with honey， stir-frying with salt and rice wine， immersing and steaming with rice wine and other methods. In recent times， it has been used in raw products as medicine. Sheng Nong's Herbal Classic recorded Cnidii Fructus was bitter， Supplementary Records of Famous Physicians recorded its acrid for the first time. It was recorded in the Ming dynasty that its nature was warm， acted on the kidney meridian， and had small toxicity. After the founding of the People's Republic of China， most of the literature classified it as a medicine to attack poison， kill insects and relieve itching with the functions of dispelling pathogenic wind and removing dampness， destroying parasites and elieving itching， warming kidney and activating Yang. Clinical contraindications are mainly contraindicated for people with damp-heat from the lower-jiao or kidney heat. Based on the textual research， it is suggested that when developing the famous classical formulas containing Cnidii Fructus， the source shall be the dried ripe fruit of C. monnieri， and then it shall be processed according to the original formulas. If there is no requirement for processing in the formulas， the raw products can be taken into medicine.

Objective:To explore the application value of P1 response threshold of cortical auditory evoked potential（CAEP） in evaluating the rehabilitation effect of cochlear implant in young children. Methods:Thirty-three young children after cochlear implantation were divided into groups according to hearing age: Group A（hearing age 1-<2 years old） 10 people; Group B（hearing age 2-<3 years old） 13 people; Group C（hearing age 3-<4 years old） 10 people. The subjective assessment was carried out using the assessment tool for hearing-impaired children- "Criteria and Methods for assessing Auditory and language ability of hearing-impaired children" and objective electrophysiological examination was carried out using CAEP to evaluate the rehabilitation effect. SPSS 25.0 software was used for statistical analysis. Results:The results of subjective assessment of auditory ability and language ability in each group showed an increasing trend with the increase of auditory age. In this study, the P1 response threshold of CAEP in CI implanted children had a significant positive correlation with the 2 kHz hearing threshold after intervention, and the P1 response threshold of CAEP was negatively correlated with many items in subjective auditory ability and language ability assessment. Conclusion:The P1 response threshold of CAEP has a stable correlation with the results of speech audiometry, which can effectively and objectively evaluate the postoperative rehabilitation effect of young children with cochlear implantation.
Humans ; Child, Preschool ; Infant ; Male ; Female ; Evoked Potentials, Auditory ; Cochlear Implantation/rehabilitation* ; Cochlear Implants ; Auditory Threshold

In this paper， by referring to ancient and modern literature， the textual research of Kochiae Fructus has been conducted to clarify the name， origin， distribution of production areas， quality specification， taste and efficacy， harvesting time， processing and compatibility taboo， so as to provide reference and basis for the development and utilization of related famous classical formulas. According to the investigation， it can be seen that Difuzi was first published in Sheng Nong's Herbal Classic， and has been used as the official name throughout history. It is also known by other names such as Dimai， Dikui， and Luozhou. The mainstream source of Difuzi in materia medica throughout history is the dried ripe fruit of Kochia scoparia， which is consistent throughout history. In the Han dynasty， it was recorded that Kochiae Fructus was produced in Jingzhou（Hubei province）， while modern literature records its distribution throughout the country， so it does not have obvious geoherbalism. The harvesting period of Kochiae Fructus is mostly in the late autumn， and the quality is best when it is full， gray green in color， and no impurities. There are two processing methods for its origin：from the Southern and Northern dynasties to the Ming dynasty， it was dried in the shade， and after the founding of the People's Republic of China， it was dried in the sun. There are few records about the processing of Kochiae Fructus， and its clinical application is mostly based on raw products as medicine. The seedlings are harvested in February of the lunar calendar， and the leaves are taken in April and May， processing in the place of origin is shade drying， the processing methods include burning ash and frying frost， pounding juice and wine soaking. For internal use， it is mostly decocted or mashed， while for external use， it is mostly washed with decoction or taken in a soup bath. Throughout history， it has been recorded that Kochiae Fructus is bitter and cold， and is mainly used for treating bladder fever. After the founding of the People's Republic of China， most of the literature classified it as damp-clearing medicine. Since the 1985 edition of Chinese Pharmacopoeia， it has been recorded that Kochiae Fructus has a pungent and bitter taste， and a cold nature. Returning to the kidney and bladder meridians with functions of clearing heat and dampness， dispelling wind and relieving itching. The clinical contraindications are mainly prohibited for those with deficiency and no dampness and heat. Throughout history， it has been recorded that the taste of the seedlings and leaves is bitter and cold for treatment of dysentery. Since modern times， it has been used to regulate the liver， spleen and large intestine meridians， with functions such as clearing heat and detoxifying， and diuresis. Based on the textual research， it is recommended to use the dried ripe fruit of K. scoparia when developing the famous classical formulas containing Kochiae Fructus， and processing shall be carried out according to the original processing requirements. If the original formula does not specify the processing requirements， the raw products is taken into medicine.

Objective: To investigate the coexistence of comorbidity of myopia, overweight/obesity and depressive symptoms among middle school students in Quzhou and its associated factors, so as to provide evidence for integrated prevention and control of common multiple health issues in students. Methods: From September to November 2023, a total of 5 867 middle school students from 6 counties (cities and districts) in Quzhou City were selected by stratified random cluster sampling. Physical and visual examinations were conducted, and the Center for Epidemiological Studies - Depression Scale (CES-D) along with a questionnaire on health status and influencing factors were completed. Multivariate Logistic regression was used to analyze the related factors of coexistence of myopia, overweight/obesity, and depressive symptoms among middle school students, and a nomogram model was constructed based on the results. Results: A total of 161 middle school students in Quzhou City were identified as having comorbid myopia, overweight/ obesity and depressive symptoms, with a detection rate of 2.74%. The results of multivariate Logistic regression analysis showed that the coexistence of myopia, overweight/obesity and depressive symptoms increased among middle school students with older age ( OR =1.11), a greater number unhealthy dietary behaviors (1,2,≥3; OR =2.40, 2.70, 4.63), insufficient sleep( OR =1.78) and alcohol consumption ( OR =2.11)(all P <0.05). Compared with no homework after class, those whose homework duration after class was 1 to < 2 hour had a lower risk of comorbidity of myopia, overweight/obesity and depressive symptoms ( OR =0.53, P <0.05). The results of the nomogram model showed that the AUC (95% CI ) was 0.71 (0.67-0.74). Conclusions The coexistence of myopia, overweight/obesity and depressive symptoms among middle school students in Quzhou City is related to age, sleeping, alcohol consumption, poor dietary behavior and the duration of after school homework. The nomogram model can assist in the early screening and intervention of multiple health issues among students.

Objective:To investigate the role of mechanosensor Yes-associated protein 1 (YAP1) in urothelial cells in inducing bladder dysfunction in a partial bladder outlet obstruction (pBOO) model.Methods:Ten female C57BL/6 mice were included in this study and randomly divided into pBOO and sham groups based on body weight using a stratified pairing method, with 5 mice in each group. The pBOO group underwent proximal urethral ligation surgery, while the sham group underwent a sham operation. Two weeks after surgery, the urinary pattern was analyzed using the urine spot test. The significant increase in urine spot numbers indicated the successful establishment of the pBOO model. The mice were then sacrificed, and bladder tissues were weighed and stained with hematoxylin and eosin (HE) to observe morphological changes. The bladder urothelial layer was further isolated, and total cell proteins were extracted to detect the expression levels of YAP1 protein using Western blotting. Mouse immortalized bladder urothelial cells were divided into three experimental groups: the negative control (NC) group, which was treated with YAP1-NC lentivirus; the overexpression (OE) group, which was treated with YAP1-OE lentivirus to induce YAP1 protein overexpression; and the verteporfin treatment (VP) group, which was treated with verteporfin on the basis of the OE group. Real-time quantitative PCR and Western blotting were used to verify the transcription and expression levels of YAP1 protein, the co-transcriptional activator TEAD4 protein, and the phosphorylated protein DRP1-616 (at serine 616) of dynamin-related protein 1 (DRP1). An ATP detection kit was used to measure the ATP release concentration in the NC, OE, and VP groups. The interaction between YAP1 and TEAD4 was investigated using co-immunoprecipitation, and the expression of the mitochondrial marker translocase of the outer mitochondrial membrane 20 (Tom20) was observed using immunofluorescence staining.Results:The results of the urine spot test showed that the number of urine spots on the filter paper in the pBOO group was higher than that in the sham group within 6 hours [(283.0±9.1) spots vs. (3.7±0.3) spots, P<0.01], and the urine spots were scattered. The bladder wet weight in the pBOO group was significantly higher than that in the sham group [(105.70±6.84) mg vs. (22.33±1.20) mg, P<0.01]. Histological observations revealed reduced bladder mucosal folds and increased detrusor muscle thickness in the pBOO group. The expression of YAP1 protein in the bladder urothelial cells of the pBOO group was significantly upregulated compared to the sham group [(1.26±0.08) vs. (0.50±0.04), P<0.01]. In vitro experiments showed that compared to the NC group, the OE group had significantly increased expression of DRP1-616 [(0.94±0.05) vs. (0.33±0.01), P<0.01] and higher ATP release concentration [(24.45±0.16) μmol/mg vs. (19.67±0.42) μmol/mg, P<0.01]. In contrast, the VP group had significantly decreased expression of DRP1-616 [(0.29±0.04) vs. (0.94±0.05), P<0.01] and lower ATP release concentration [(10.55±0.01) μmol/mg vs. (24.45±0.16) μmol/mg, P<0.01] compared to the OE group. Co-immunoprecipitation experiments using YAP1 and TEAD4 antibodies showed that YAP1 and TEAD4 proteins could interact and form a transcriptional complex to regulate ATP release. Immunofluorescence staining revealed increased expression of Tom20 in the OE group compared to the NC group [(104.20±3.28) vs. (74.51±3.87), P<0.01]. Conclusions:In the pBOO-induced bladder dysfunction model, YAP1 is highly expressed in urothelial cells. YAP1 forms a transcriptional complex with TEAD4 to regulate ATP release by promoting mitochondrial fission via DRP1-616 expression, which is a key mechanism underlying pBOO-induced bladder dysfunction.

Objective To explore the pioneering symptoms of the gastrointestinal symptom cluster and their influencing factors in gastric cancer patients with chemotherapy.Methods Based on the hospital's management system for scientific research data,463 gastric cancer patients with chemothera-py were surveyed through multicenter collaboration by the corresponding module of the MD Anderson Symptom Inventory(MDASI),the Chinese Medicine Constitution Classification and Identification Standard,and the Chinese Medicine SyndromeIdentification Standard for Gastric Cancer.IBM SPSS Statistic 22.0 and IBM SPSS Modeler 18.0 were used for data analysis.Results The first occurrence of dry mouth in the gastrointestinal symptom cluster of gastric cancer patients with chemotherapy was(22.99±10.70)hours after chemotherapy.The support,confidence,and lift for the association be-tween dry mouth and decreased appetite were 62.2％,94.8％and 1.52,respectively;for dry mouth and nausea,the numerical values were 62.2％,89.6％and 1.44;for dry mouth and vomiting,the numerical values were 62.2％,79.5％and 1.28.The results of one-way ANOVA and multivariate linear regression analysis showed that alcohol consumption,syndrome of stomach heat injuring yin,and phlegm-dampness constitution were independent influencing factors for dry mouth in gastric cancer patients with chemotherapy(P＜0.05).Conclusion Dry mouth,as a pioneering symptom of the gastroin-testinal symptom cluster,is of great significance in clinical assessment and management.Improved assessment of dry mouth can provide a basis for the construction of subsequent risk prediction model,the formulation of targeted interventions,and the enhancement of symptom management efficiency.

Objective:To assess common errors in head and neck CT angiography (CTA) image reports using four types of large language models (LLM), namely GPT-4, DeepSeek, ERNIE Bot and SparkDesk, and to assess the feasibility of using existing LLMs to support quality control of radiology reports in Chinese.Methods:The study was a cross-sectional study. Totally 1 000 head and neck CTA image reports were randomly selected using the simple random sampling method from Xuanwu Hospital, Capital Medical University in 2023, including 500 primary reports and 500 finalized reports. Two radiologists collaboratively identified six types of errors in the reports: description errors, writing errors, left-right confusion errors, diagnostic omissions, logical sequence errors, and other errors. The overall quality of the reports was assessed using a 5-point Likert scale. Subsequently, GPT-4, DeepSeek, ERNIE Bot and SparkDesk models were employed to detect the same six types of errors in the imaging reports and to provide overall scoring. The results from manual review were considered the gold standard for calculating F1 score to evaluate model performance. Intra-class correlation coefficients ( ICC) were used to assess the consistency between manual scores and the overall scores from the four LLMs. Results:In the primary imaging reports, the proportions of manually detected errors were as follows: descriptive errors 2.6% (13/500), writing errors 0.6% (3/500), left-right confusion errors 0, diagnostic omissions 6.4% (32/500), logical sequence errors 5.2% (26/500), and other errors 0. In the finalized imaging reports, the proportions of errors across the six categories were 0.2% (1/500), 0, 0, 0, 0, and 0.2% (1/500), respectively. For error detection in the primary imaging reports, the F1 scores of GPT-4 for the six error types were 0.992, 0.997, 0.997, 0.967, 0.980, and 0.992, respectively. DeepSeek achieved F1 scores of 0.980, 0.955, 0.981, 0.920, 0.995, and 0.960; ERNIE Bot scored 0.982, 0.990, 1.000, 0.956, 0.976, and 0.999; and SparkDesk achieved 0.985, 0.995, 1.000, 0.961, 0.982, and 1.000. In the detection of errors in finalized imaging reports, GPT-4′s F1 scores were 0.994, 0.995, 0.998, 0.973, 0.989, and 0.993; DeepSeek scored 0.968, 0.965, 0.985, 0.971, 0.991, and 0.983; ERNIE Bot achieved 0.996, 0.992, 1.000, 0.983, 0.999, and 0.997; and SparkDesk achieved 0.999, 0.999, 1.000, 1.000, 1.000, and 0.999. The consistency between GPT-4, DeepSeek, and SparkDesk models and human ratings was moderate, with ICC values of 0.514, 0.560, and 0.515 respectively (all P0.001); in contrast, the overall score of ERNIE Bot showed poor consistency with human ratings, with an ICC of 0.221 ( P0.001). Conclusion:LLMs demonstrate high accuracy in detecting errors in head and neck CTA imaging reports. The overall scoring of report quality shows moderate consistency with manual assessments, indicating a certain feasibility for automated quality control in reporting.

Objective To investigate effects of α7 nicotinic acetylcholine receptor(α7nAChR)agonist PNU-282987 on intestinal injury and mitochondrial autophagy in sepsis mice.Methods A total of 30 male C57BL/6J mice were divided into control group,sepsis group and PNU-282987 group,10 mice each group.In PNU-282987 group,1mg/kg PNU-282987 was injected intraperitoneally 1h before and 2h after modeling,respectively.Intestinal tissue were taken back 24h after modeling,and pathological changes were observed by hematoxylin-eosin staining and Chiu's score were made.Mitochondrial autophagy were observed by uranium acetate-lead citrate double staining,and α7nAChR,autophagy marker protein microtubule-associated protein 1 light chain(LC)3-Ⅱ/LC3-Ⅰ and Beclin-1,and mitochondrial autophagy-related protein PTEN-induced kinase(PINK)1 were detected by Western blot.Serum and ileum tissues were taken to detect interleukin(IL)-1β,IL-6,IL-10.Results Comparison of Beclin-1,LC3-Ⅱ/LC3-Ⅰ,PINK 1 and Parkin in the mice ileum tissues among three groups,model group were higher than control group,and PNU-282987 group were higher than model group,the difference were statistically significant(P＜0.05).Comparison of mice in Chiu's score among three groups,model group was higher than control group,and PNU-282987 group was lower than model group,the difference were significant(P＜0.05).PNU-282987 group α7nAChR level in the mice ileal tissue was higher than model group,the difference was significant(P＜0.05).Conclusion α7nAChR agonist PNU-282987 improves intestinal injury in sepsis mice,activation of mitochondrial autophagy and reduction of inflammation in ileum may be the related molecular mechanism.

This paper combs through the current situation and influencing factors of the application of action research in nursing undergraduate teaching reform, and puts forward its problems and suggestions, with a view to providing reference for nursing educators in China to carry out nursing undergraduate teaching action research.

Objective:To explore the experiences of nursing undergraduates with the blended teaching model in midwifery courses.Methods:This qualitative study employed purposive sampling to select 17 nursing undergraduates from the 2021 cohort who participated in the "Midwifery Theory and Skills 2" course in December 2023. Face-to-face semi-structured interviews were conducted, and the data were analyzed using Colaizzi's seven-step method.Results:Three main themes and eight subthemes were identified. First, the blended teaching model enhanced professional knowledge and skills in midwifery: online resources expanded professional knowledge; online demonstration videos improved operational skills; offline group collaboration strengthened communication skills. Second, it developed professional awareness and emotions in midwifery: systematic course learning enhanced professional identity; offline role-playing cultivated emotional perception; clinical experience sharing by teachers fostered a sense of responsibility in midwifery. Third, it optimized blended teaching resources: the user experience on online platforms was improved, and offline classroom settings were better designed.Conclusions:The blended teaching model aids in enhancing students' comprehensive knowledge and skills in midwifery and fosters professional emotions related to the field. It is recommended to further optimize blended teaching resources to improve the effectiveness of this teaching model in midwifery courses.