Puerariae Lobatae Radix and Puerariae Thomsonii Radix are the dried roots of Pueraria lobata and Pueraria thomsonii of the Leguminosae family， respectively. Since their separate inclusion in the 2005 edition of Pharmacopoeia of the People's Republic of China， the two herbs have been individually recorded. Although they share the same functions and indications， the required content of puerarin differs by a factor of up to eightfold between them. The current quality standard relies solely on a single indicator， puerarin， which fails to reflect the correlation between chemical constituents and core therapeutic effects. This has resulted in prominent issues of mixed use in clinical practice and production， thereby constraining the high-quality development of the industry. Modern research has demonstrated that Puerariae Lobatae Radix contains a comprehensive range and higher content of isoflavonoid constituents， while Puerariae Thomsonii Radix is rich in starch and polysaccharides. Puerariae Lobatae Radix exhibits stronger effects in antipyresis， cardiovascular and cerebrovascular protection， and central analgesia， while Puerariae Thomsonii Radix demonstrates greater advantages in anti-inflammation， hypoglycemia， and peripheral analgesia. Based on this， the chemical material bases of Puerariae Lobatae Radix and Puerariae Thomsonii Radix at both the macromolecule and micromolecule levels were systematically reviewed and compared. The pharmacodynamic material bases and mechanisms of action underlying their three core therapeutic effects， namely "relieving exterior syndrome and clearing heat"， "promoting fluid production to quench thirst"， and "dredging channels and activating collaterals"， were summarized. The most highly correlated common metabolic pathway shared by both herbs for these three therapeutic effects is the arachidonic acid metabolic pathway， and their common core target is prostaglandin-endoperoxide synthase 2 （PTGS2）. This review provided clinical application recommendations based on the therapeutic differences between the two herbs， elucidated the scientific connotation of their "same origin but different effects"， and， grounded in the quality marker （Q-Marker）， proposed the concept of efficacy-related Q-Marker based on "substance-efficacy-syndrome" association， as well as a novel strategy for efficacy-oriented quality evaluation. Preliminary screening of quality markers associated with different therapeutic effects was also conducted. This study aims to provide critical scientific evidence for the precise clinical application of Puerariae Lobatae Radix and Puerariae Thomsonii Radix， the improvement of quality standards， and the high-quality development of the industry.

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

Objective To investigate the status of perceived uncertainty in the process of re-pregnancy in patients with recurrent abortion,and to systematically explore the influencing factors based on the health ecology model,to inform a reduction in the level of perceived uncertainty about their re-pregnancy and improve their quality of life.Methods A convenience sampling method was used to investigate 260 patients with recurrent spontaneous abortion during re-pregnancy from 2 reproductive clinics of a tertiary A hospital in Suzhou,from December 2023 to June 2024,and they were investigated by a self-designed general data questionnaire,Intolerance of Uncertainty Scale-12,Generalized Anxiety Disorder Scale and Simple Coping Style Questionnaire.The single factor analysis and multiple linear regression methods were used to analyze the influences factors of perceived uncertainty in patients with recurrent spontaneous abortion during re-pregnancy.Results A total of 256 valid questionnaires were collected,with a recovery rate of 98.5％.The score of intolerance of uncertainty in patients with recurrent spontaneous abortion during re-pregnancy was(35.18±9.23).Multiple linear regression analysis found that average monthly family income,residence,history with assisted reproductive therapy,anxiety and coping were the factors influencing the feeling of perceived uncertainty in patients with recurrent spontaneous abortion during re-pregnancy(P＜0.05).Conclusion The level of perceived uncertainty in patients with recurrent spontaneous abortion during re-pregnancy is at a medium level.Medical workers should pay attention to the early identification of the perceived uncertainty in patients,enhance the psychological support for patients,and improve their mental health.

OBJECTIVE To explore the clinical characteristics of patients with hematologic tumors combined with Fusarium infection and analyze the prevention and control measures.METHODS Six patients with hematologic neo-plasms combined with Fusarium infection diagnosed at the First Medical Center of the People's Liberation Army General Hospital from Apr.2019 to Dec.2023 were selected as research objects.Through retrospective analysis of patients' clinical data,the clinical manifestations,diagnosis,treatment and prevention strategies of Fusarium in-fection in hematologic neoplasms were analyzed.RESULTS All six patients with hematologic neoplasms combined with Fusarium infection were neutropenic or deficient patients,with main symptoms including moderate fever,painful skin nodules,rash,skin broken and crusted,and scrotal swelling and pain.Patients with severe neutrophil deficiency were susceptible to blood-borne Fusobacterium infections.Four patients had a markedly elevated G-test and Fusorium was first detected by microbiome metagenomic next-generation sequencing(mNGS)in blood,earli-er than traditional pathogenic culture methods.Five patients had Fusarium detected in urine or stool cultures.All six patients received empirical antibacterial and antifungal treatments,but the fungal infection treatment effects were poor.Treatment was adjusted according to the pathogenetic findings,mainly using a combination regimen based on liposomal amphotericin B or posaconazole tablets,with three patients cured and three death.Two pa-tients were from the same ward with a sixteen-day interval.Although no evidence of infection transmission was found,there was still a risk of cross-infection in patients with hematological malignancies and severe immunodefi-ciency.Measures for the prevention and control of hospital-acquired infections were implemented for patients with Fusarium infection and the ward.CONCLUSIONS The clinical manifestations of patients with hematological tumors combined with Fusarium infection are complex and varied with high mortality rates.MNGS testing is valuable in the early diagnosis of Fusarium infection,and it is necessary to explore new treatment options and hospital-ac-quired infectious disease prevention and control measures to improve the prognosis.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

This article discusses the important role and practical experience of Guangxi Zhuang Autonomous Region as a bridgehead between China and the Association of Southeast Asian Nations (ASEAN) in the joint prevention and control of cross-border infectious diseases between China and Vietnam. The cross-border transmission of infectious diseases has been effectively managed in Guangxi Zhuang Autonomous Region through a package of strategies, including government leadership, construction of the joint prevention and control mechanism, establishment of dialogue platforms, collaboration of scientific researches, and personnel exchange and training; however, there are still challenges. Further deepening of collaboration is required to meet future needs for infectious disease prevention and control.

Objective To investigate the effectiveness of the curriculum design and teaching mode reform in Health Statistics through the assessment by postgraduate students so as to enhance the teaching performance of the course.Methods A questionnaire survey was conducted among the postgraduate students of grade 2023 at a certain medical university.The survey covered such aspects as students'mastery and application of the course learning content,their evaluation and satisfaction with the course,etc.Descriptive approaches were employed to analyze and summarize the data.Results Students achieved a good command of theoretical knowledge and its application.They highly evaluated the teacher,the course content and its practicality,demonstrated a strong interest in learning,expressed a high level of satisfaction with the course,and manifested a strong willingness to continue studying the course.The learning of the course met the expectations of the students.The final exam scores in the later stage of curriculum reform(78.60±10.58)was higher than that before the reform(75.78±7.97,P<0.05);the excellent rate after the reform was 53.6%,which was higher than the 33.5%before the reform(P<0.05).Conclusion The construction of a course system that integrates knowledge,skills the mixed teaching mode of case-based teaching and the combination of theory and statistical software package operation are beneficial for enhancing postgraduate students'learning and application of the course in health statistics.It also strengthens the design and training of course application aspects for students in clinical medicine and dental medicine disciplines.

Objective To explore the roles of the mechanoreceptor Yes-associated protein 1(YAP1)and piezo type mechanosensitive ion channel component 2(PIEZO2)in mechanotransduction in mouse bladder urothelial cells.Methods Mouse bladder urothelial cells were subjected to mechanical stretching using the FX-6000T cell stretching system and treated with the YAP1-specific inhibitor verteporfin(VP).The expressions of PIEZO2,YAP1 and connective tissue growth factor(CTGF)at the mRNA and protein levels,as well as changes in cellular adenosine triphosphatase(ATP)concentration,were detected using reverse transcription quantitative PCR(RT-qPCR)and Western blotting(WB).Results After stretching stimulation,under the fluorescence microscope,it was observed that the diameter length of the stretched cells were longer than that before stretching,and the difference was statistically significant(P＜0.05).The expressions of YAP1,PIEZO2 and CTGF at the mRNA and protein levels were increased in the stretched group compared to those of the non-stretched group(P＜0.05).VP effectively reduced the expressions of YAP1,PIEZO2 and CTGF at the mRNA and protein levels after stretching stimulation(P＜0.05).Stretching stimulation significantly increased the intracellular ATP concentration,while VP was able to inhibit the increase in ATP concentration,with a statistically significant difference(P＜0.000 1).Conclusion Stretching stimulation increased the expressions of YAP1 and PIEZO2 in bladder urothelial cells and promoted the release of ATP;verteporfin inhibited the increase in YAP1 activity and the overexpression of PIEZO2 caused by stretching,thereby reducing the release of ATP.It is suggested that mouse bladder urothelial cells may primarily sense mechanical signals through the YAP1-PIEZO2-ATP pathway.

Objective To evaluate and summarise the best evidence on non-pharmacological preventive measures for lower limb lymphedema in patients with gynecologic malignancy so as to provide an evidence-based guidance for prevention of lower limb lymphedema.Methods Systematic searches were conducted from inception to 31th January,2024 on databases of UpToDate,BMJ Best Practice,the National Institute for Health and Care Excellence(NICE),the Oncology Nursing Society(ONS),Guidelines International Network(GIN),China Guideline Clearinghouse,Medlive,National Comprehensive Cancer Network(NCCN),Registered Nurses Association of Ontario(RNAO),American Society of Clinical Oncology(ASCO),European Society for Medical Oncology(ESMO),Cancer Australia(CA),National Lymphedema Network(NLN),Scottish Intercollegiate Guidelines Network(SIGN),Lymphedema Support Network(LSN),International Society of Lymphology(ISL),International Society of Nurses in Cancer Care,Lymphedema Association of Ontario,Lymphoedema United,Cochrane Library,Web of Science,PubMed,Scopus,OVID,Embase,CINAHL,VIP,Wangfang Data,CNKI and SinoMed for the relevant evidence in non-pharmacological preventive measures for lower limb lymphedema in patients with gynecological malignancy.Two researchers evaluated the quality of clinical decisions,expert consensus,systematic reviews and randomised controlled trials,while four investigators assessed the quality of the guidelines.Another two researchers performed data extraction and evidence summary.Results A total of 17 articles were included,comprising two clinical decisions,two guidelines,two systematic reviews,seven expert consensuses,one evidence summary,three randomised controlled trials.A total of 32 pieces of evidence were summarised across eight dimensions:prevention timing,evaluation element,general self-care,skin care,manual lymphatic drainage,compression therapy,exercise and health education.Conclusion This study provides an evidence-based guidance for prevention of lower limb lymphedema in patients with gynecological malignancy.Healthcare professionals should apply the best evidences based on the conditions,preferences,resource allocation,and other factors of the patients,to reduce limb lymphedema and improve the quality of life of the patients.