Irritable bowel syndrome （IBS） is a functional bowel disorder characterized primarily by abdominal pain and altered defecation habits. In recent years， traditional Chinese medicine （TCM） has made progress in multiple aspects of IBS research and treatment， including syndrome distribution， development of TCM formulas， clinical efficacy evaluation， external therapies， and psychosocial regulation. However， it still faces challenges such as over-reliance on symptomatic manifestations rather than biomarkers for diagnostic criteria， and the lack of high-quality evidence-based data supporting the efficacy of TCM formulas in treating IBS. This paper proposed that TCM diagnosis and treatment of IBS should adhere to the strategy of integrating the holistic concept with syndrome differentiation and treatment， combining TCM external therapies such as acupuncture， moxibustion and acupoint application）， and emphasizing individualized diagnosis and treatment for psychosomatic abnormalities. Future research should integrate multi-omics technologies， artificial intelligence and other methods to deepen the understanding of the pathogenesis of IBS and the mechanisms of TCM formulas， so as to promote the standardization and internationalization of TCM in the diagnosis and treatment of IBS.

With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.

ObjectiveTo investigate the potential mechanism of action of the Qufeng Tongqiao Cough-relieving Decoction （祛风通窍止咳方， QTCD） in the treatment of upper airway cough syndrome （UACS）. MethodsTwenty-four guinea pigs were randomly divided into blank group， model group， traditional Chinese medicine （TCM） group， and inhibitor group， with six guinea pigs in each group. Except for the blank group， guinea pigs were sensitized with ovalbumin and aluminum hydroxide via intraperitoneal injection， followed by ovalbumin nasal drops combined with smoke exposure to establish the UACS model. After modeling， the TCM group was administered QTCD 0.9 g/（100 g·d） by gavage， the inhibitor group received the transient receptor potential vanilloid receptor 4 （TRPV4） inhibitor GSK2193874 1 mmol/L， 5 min by nebulisation， and the blank group and model group were given 2 ml/（100 g·d） normal saline by gavage once daily. After 7 days of treatment， a cough provocation test was performed using 0.4 mol/L citric acid. The levels of IgE in serum and inflammatory cytokines， including interleukin-6 （IL-6）， interleukin-8 （IL-8） in serum， bronchoalveolar lavage fluid （BALF）， and nasal lavage fluid （NLF） were detected by enzyme-linked immunosorbent assay （ELISA）. Histopathological changes in lung and nasal mucosal tissues were observed by hematoxylin-eosin （HE） staining. Immunohistochemistry was used to detect the protein levels of TRPV4， substance P （SP）， and calcitonin gene-related peptide （CGRP） in lung and nasal mucosal tissues. Real-time polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of TRPV4， SP， and CGRP in lung tissues. ResultsHE staining showed significant structural damage and infiltration of inflammatory cells in the lung and nasal mucosal tissues in the model group， while the TCM group and inhibitor group showed improved pathological changes. Compared with the blank group， the model group showed increased cough frequency， serum IgE level， and IL-6 and IL-8 levels in serum， BALF， and NLF. The protein levels of TRPV4， SP， and CGRP in lung and nasal mucosal tissues and their mRNA expression were elevated （P＜0.05 or P＜0.01）. Compared with the model group， the TCM group and inhibitor group showed reduced cough frequency， serum IgE level， and TRPV4 and SP mRNA expression in lung tissues. The TCM group showed reduced IL-6 and IL-8 levels in serum， BALF， and NLF， and reduced TRPV4 and CGRP protein levels in lung and nasal mucosal tissues. The inhibitor group showed reduced IL-6 and IL-8 levels in serum， BALF， and NLF， reduced IL-6 in BALF， reduced IL-8 in NLF， and decreased TRPV4， SP， and CGRP protein levels in lung tissues and SP and CGRP protein levels in nasal mucosal tissues （P＜0.05 or P＜0.01）. Compared with the TCM group， the inhibitor group had increased serum IgE， IL-6， and IL-8 levels， increased IL-6 level in BALF， and increased IL-8 levle in NLF， but decreased SP protein level in lung tissues and increased TRPV4 and SP mRNA expression in lung tissues （P＜0.01）. ConclusionQTCD effectively reduces cough frequency in the UACS guinea pig model. Its mechanism may involve inhibiting the activation of the TRPV4 pathway， improving airway neurogenic inflammation， alleviating inflammatory responses， and reducing cough hypersensitivity.

Objective:To understand the current status of financial management in public hospitals of Anhui Province and provide a basis for strengthening financial management and promoting high-quality development in public hospitals.Methods:Stratified and random sampling methods were used to select 100 public hospitals as sample hospitals.A self-designed questionnaire was used to conduct a questionnaire survey on the current status of financial management.Results:The overall financial management level of public hospitals in Anhui Province needs to be further improved.The main problems are that the functions of the chief accountant need to be fully exerted,the structure of financial personnel is uneven,the coverage and depth of budget management are insufficient,cost accounting is relatively rough,the operation management system is not sound,the construction of internal control emphasizes form over substance,and the informatization construction needs to be advanced urgently.Conclusion:In response to the existing problems,efforts can be made from fully exerting the functions of the chief accountant,optimizing the talent team,promoting the refinement of budget and cost management,deeply carrying out operation management,improving internal control,and making up for the shortcomings of informatization,to adapt to the new situation and policy requirements of the medical industry's development.

Objective To retrieve,evaluate and summarise the best evidence for exercise management in patients with chronic non-specific low back pain,and to provide an evidence-based knowledges for healthcare professionals in clinical practice.Methods According to"6S"model systematic searches on BMJ Best Practice,UpToDate,Joanna Briggs Institute evidence-based Healthcare Centre Database,Cochrane library,World Health Organization,National Institute for Health and Care Excellence,Registered Nurses'Association of Ontario,Guideline International Network,Canadian Medical Association Clinical Practice Guidelines Infobase,Scottish Intercollegiate Guidelines Network,New Zealand Guidelines Group,Agency for Healthcare Research and Quality,Medlive,the North American Spine Society,Chinese Association for the Study of Pain,American Society of Pain and Neuroscience,PubMed,CINAHL,Embase,Web of Science,China National Knowledge Infrastructure,Wanfang Data,VIP,SinoMed in exercise management for patients with chronic nonspecific low back pain,expert consensus,systematic reviews,clinical decisions and evidence summaries were conducted,with a search timeframe of the inception of databases to 29 th February 2024.Two graduate nursing students trained in systematic evidence-based methodology independently conducted literature quality assessment,evidence review and extraction using literature quality assessment tools such as the JBI Centre for Evidence-Based Healthcare,and consolidated the evidence after discussion by the evidence-based research team.Results A total of 15 papers were included in the literature,including 5 guidelines,3 expert consensus,1 systematic review,4 evidence summaries and 2 clinical decisions,and 31 pieces of evidence were summarised,including 6 aspects of exercise assessment,the type,frequency and intensity of exercise,precautions and health awareness.Conclusion This study summarises the best evidence for exercise management in patients with chronic nonspecific low back pain,and provides an evidence-based knowledges for the care of patients in hospital,community or at home.

Objective:To understand the current status of financial management in public hospitals of Anhui Province and provide a basis for strengthening financial management and promoting high-quality development in public hospitals.Methods:Stratified and random sampling methods were used to select 100 public hospitals as sample hospitals.A self-designed questionnaire was used to conduct a questionnaire survey on the current status of financial management.Results:The overall financial management level of public hospitals in Anhui Province needs to be further improved.The main problems are that the functions of the chief accountant need to be fully exerted,the structure of financial personnel is uneven,the coverage and depth of budget management are insufficient,cost accounting is relatively rough,the operation management system is not sound,the construction of internal control emphasizes form over substance,and the informatization construction needs to be advanced urgently.Conclusion:In response to the existing problems,efforts can be made from fully exerting the functions of the chief accountant,optimizing the talent team,promoting the refinement of budget and cost management,deeply carrying out operation management,improving internal control,and making up for the shortcomings of informatization,to adapt to the new situation and policy requirements of the medical industry's development.

Objective To retrieve,evaluate and summarise the best evidence for exercise management in patients with chronic non-specific low back pain,and to provide an evidence-based knowledges for healthcare professionals in clinical practice.Methods According to"6S"model systematic searches on BMJ Best Practice,UpToDate,Joanna Briggs Institute evidence-based Healthcare Centre Database,Cochrane library,World Health Organization,National Institute for Health and Care Excellence,Registered Nurses'Association of Ontario,Guideline International Network,Canadian Medical Association Clinical Practice Guidelines Infobase,Scottish Intercollegiate Guidelines Network,New Zealand Guidelines Group,Agency for Healthcare Research and Quality,Medlive,the North American Spine Society,Chinese Association for the Study of Pain,American Society of Pain and Neuroscience,PubMed,CINAHL,Embase,Web of Science,China National Knowledge Infrastructure,Wanfang Data,VIP,SinoMed in exercise management for patients with chronic nonspecific low back pain,expert consensus,systematic reviews,clinical decisions and evidence summaries were conducted,with a search timeframe of the inception of databases to 29 th February 2024.Two graduate nursing students trained in systematic evidence-based methodology independently conducted literature quality assessment,evidence review and extraction using literature quality assessment tools such as the JBI Centre for Evidence-Based Healthcare,and consolidated the evidence after discussion by the evidence-based research team.Results A total of 15 papers were included in the literature,including 5 guidelines,3 expert consensus,1 systematic review,4 evidence summaries and 2 clinical decisions,and 31 pieces of evidence were summarised,including 6 aspects of exercise assessment,the type,frequency and intensity of exercise,precautions and health awareness.Conclusion This study summarises the best evidence for exercise management in patients with chronic nonspecific low back pain,and provides an evidence-based knowledges for the care of patients in hospital,community or at home.

Background and purpose:Rectal cancer occurs on the inner wall of the rectum,and metastasis-associated in colon cancer 1(MACC1)can promote drug resistance in colon cancer cells.This study aimed to investigate the effect of MACC1 on oxaliplatin resistance in rectal cancer and its mechanism.Methods:Biosignal analysis of MACC1 and TCF7 expressions in rectal cancer tissues and signaling pathways enriched for MACC1 were carried out.The expressions of MACC1 and TCF7 in rectal cancer cells and rectal cancer oxaliplatin-resistant cells were detected by real-time fluorescence quantitative polymerase chain reaction(RTFQ-PCR),cell viability was detected by cell counting kit-8(CCK-8),and cell proliferation was detected by cell colony formation assay.ECAR values,lactate production and glucose consumption were detected by Seahorse Biosciences XF96.Western blot was used to detect the expressions of glycolysis-related proteins.Dual luciferase reporter gene and ChIP were used to validate the regulatory relationship between MACC1 and TCF7.Normality test and homogeneity of variance analysis was performed on the data of each group by GraphPad Prism 8.0.If it conformed to normal distribution,one-way ANOVA or t-test would be used for inter group comparison,otherwise the comparison between groups would be conducted using Wilcoxon rank sum test.Using a two-sided test,P＜0.05 was considered statistically significant.Results:MACC1 and TCF7 expressions were upregulated in rectal cancer,and knockdown of MACC1 significantly inhibited the viability of rectal cancer drug-resistant cells and the IC50 values of different concentrations of oxaliplatin treatments,as well as reduced the proliferation ability of rectal cancer oxaliplatin-resistant cells.Overexpression of MACC1 was able to promote the proliferation and glycolytic capacity of rectal cancer cells.Further studies revealed that the transcription factor TCF7 existed in the upper reaches of MACC1.Besides,this study analyzed the data from Cancer Genome Atlas Program(TCGA),and the result showed that knockdown of TCF7 was able to attenuate the promotional effect of overexpression of MACC1 on the glycolytic capacity and oxaliplatin resistance of rectal cancer cells.Conclusion:This study demonstrated that the TCF7/MACC1 axis could promote aerobic glycolysis and thus oxaliplatin resistance in rectal cancer cells.The findings suggest that targeting the TCF7/MACC1 axis or inhibiting the aerobic glycolysis pathway may be a novel therapeutic approach to inhibit oxaliplatin resistance in rectal cancer.

Objective To analyze the infection status of Mycoplasma pneumoniae(MP)in the First Affilia-ted Hospital of Shandong First Medical University(the hospital)from 2019 to 2023 and explore the related influencing factors.Methods Basic admission information,test results,and related diagnostic results of 16 465 MP positive patients admitted to the hospital were collected,and the distribution characteristics of the number and disease types of MP positive patients in the hospital were analyzed.Results The positive rate of MP from high to low in the 5 years was in the years of 2021,2019,2020,2022,2023(P＜0.05).The proportion of MP positive cases in outpatient department from high to low was in the years of 2023,2021,2022,2019 and 2020(P＜0.05).Incidence was higher in spring and winter.In 5 years,the positivity rate of MP in respiratory tract infection patients was slightly higher in males than in females,the proportions of males in 2020 and 2022 were higher than those in 2019 and 2021(P＜0.05),and the proportions of males in 2019,2020,and 2022 were higher than that in 2023(P＜0.05).The age groups of MP infected patients were mainly concentrated in ado-lescents and infants under 14 years old.The positive results of patients in the 5 years were mainly distributed in titers of 1∶40,1∶80,and＞1∶160.There was no statistically significant difference in the proportion of positive results with MP total antibody≥1∶160 detected(P＞0.05).The top 5 clinical diagnoses of MP in-fected patients in thed hospital were fever,acute bronchitis,bronchopneumonia,chronic bronchitis,and pneu-monia,and the difference in the proportion of diagnostic results was statistically significant(P＜0.05).Conclu-sion This study clarifies the infection status of MP in the hospital from 2019 to 2023,and analyzes the impact of factors such as season,gender,and age on MP infection,which is of great significance for the prevention and control of respiratory infectious diseases in the hospital.

Objective    To investigate the feasibility and effectiveness of using ultrasound to evaluate the internal mammary artery (IMA) and explore the related factors affecting the quality of IMA. Methods    From July 2020 to January 2021, for patients who underwent coronary artery bypass grafting at the Department of Cardiovascular Surgery, Fuwai Hospital, ultrasound was applied to measure bilateral IMA at the parasternal second intercostal space. There were 62 males and 18 females with an average age of 59.9±8.3 years. The clinical data of the patients were recorded and analyzed. Results    A total of 160 IMA were measured. The IMA was detected in 99.4% (159/160), and the one that was not measured was proved to be occluded by enhanced CT. A total of 157 (98.1%) IMA intima were smooth, 2 (1.3%) were found to have uneven intimal thickening and less smooth, and only 1 (0.6%) was occluded. The intravascular diameter, peak systolic flow rate, peak diastolic flow rate, and blood flow rate of the left second intercostal IMA were 1.9±0.3 mm, 66.8±17.7 cm/s, 6.4 (0.0, 9.7) cm/s, 19.7±9.4 mL/min; and those of the right one were 2.1±0.3 mm, 69.7±18.5 cm/s, 6.0 (0.0, 9.2) cm/s and 22.8±11.5 mL/min, respectively. IMA vessel diameter and blood flow were greater on the right than those on the left side in the same individual (P<0.01). In univariate analysis, sex and body surface area were the factors that influenced the size of the IMA vessel among different individuals, and by linear regression analysis, the size of the IMA vessel was only related to body surface area among different individuals. On univariate analysis, diabetes mellitus was the only factor affecting IMA blood flow, with a mean reduction in blood flow of 18.4% (left) and 21.7% (right) in the diabetic group (P<0.05). Conclusion    Preoperative evaluation of the IMA using ultrasound over the parasternal second intercostal space is easy, noninvasive, and has a high success rate. The internal diameter of the IMA is positively correlated with body surface area, and blood flow is significantly reduced in patients with diabetes.