Based on cancer collateral theory， this paper proposes toxin-stasis accumulation in collaterals and yin deficiency with toxin hyperactivity as the core pathogenesis of postoperative recurrence of triple-negative breast cancer. Impaired qi transformation in collateral and depletion of yin interact， contributing to toxin-stasis binding， inadequate collateral nourishment， and unrestrained yang activity. The temporal dimension emphasizes yin deficiency with toxin hyperactivity and early reactivation of latent toxin； the spatial dimension emphasizes toxin-stasis accumulation and dissemination through collaterals. Treatment follows the principle of regulating qi and resolving collaterals. Before recurrence， emphasis is placed on nourishing collaterals to restrain latent toxin； after recurrence， on resolving binding while protecting collaterals. Herbal combinations are further tailored to disorders of qi， blood， and fluid collaterals and to the sites of dissemination， integrating treatment according to recurrence status and affected collateral systems. These theoretical propositions are intended to inform clinical reasoning and require clinical validation.

Objective:To investigate the changes of T lymphocyte subsets in patients with stage Ⅰ and Ⅱ cervical cancer after surgery and their relationship with postoperative lymph node metastasis according to the International Federation of Gynecology and Obstetrics (FIGO) stage (2014) .Methods:A total of 192 patients with FIGO stage ⅠA, ⅠB1, ⅠB2 and ⅡA1 who received radical cervical cancer resection and pelvic lymph node dissection in People's Hospital of Yuechi County of Sichuan Province and West China Guang'an Hospital of Sichuan University from November 2018 to November 2020 were selected for this study. According to FIGO stage, patients were divided into stage Ⅰ group ( n=85) and stage Ⅱ group ( n=107) . The dynamic changes of T lymphocytes subsets in patients with different FIGO stages were compared before and after surgery. Repeated measurement of variance was used to analyze the levels of T lymphocytes subsets in patients of different stages during treatment. Logistic regression was used to analyze the influencing factors of postoperative lymph node metastasis in patients with cervical cancer. Multivariate logistic regression was used to analyze the relationship between T lymphocytes subsets and postoperative lymph node metastasis. Receiver operator characteristic (ROC) curve was used to analyze the predictive efficacy of T lymphocytes level in postoperative lymph node metastasis. Results:The postoperative lymph node metastasis rate in stage Ⅱ patients [32.71% (35/107) ] was higher than that in stage Ⅰ patients [14.12% (12/85) ], with a statistically significant difference ( χ2=8.86, P=0.003) . Compared with the stage Ⅱ group, the levels of CD3 +, CD4 + T lymphocytes and CD4 +/CD8 + ratio were significantly higher in the stage Ⅰ group 1 day before surgery (all P<0.001) , and the level of CD8 + T lymphocytes was significantly lower ( P<0.001) . The levels of CD3 +, CD4 +, CD8 + T lymphocytes and the ratio of CD4 +/CD8 + showed dynamic changes at different stages after surgery. On 1, 7 and 30 days after surgery, the levels of CD3 +, CD4 + T lymphocytes and the ratio of CD4 +/CD8 + in stage Ⅰ group were higher than those in stage Ⅱ group (all P<0.001) , CD8 + T cell levels were lower than those in stage Ⅱ group (all P<0.001) . There were statistically significant differences in T lymphocytes subsets CD3 +, CD4 +, CD8 + and CD4 +/CD8 + time effect, intergroup effect and interaction effect between the two groups (all P<0.001) . Univariate analysis showed that the pathological type ( OR=1.85, 95% CI: 1.14-2.33, P=0.015) , differentiation degree ( OR=1.93, 95% CI: 1.18-2.67, P=0.024) , depth of myometrial invasion ( OR=2.08, 95% CI: 1.26-2.59, P=0.012) , tumor morphology ( OR=2.17, 95% CI: 1.57-2.63, P=0.009) , parametrial invasion ( OR=1.95, 95% CI: 1.43-2.76, P=0.036) and lymphovascular space invasion ( OR=2.03, 95% CI: 1.28-2.57, P=0.021) were the influencing factors for postoperative lymph node metastasis in patients with FIGO stage Ⅰ and Ⅱ cervical cancer. Multivariate analysis showed that the degree of differentiation ( OR=1.75, 95% CI: 1.08-2.03, P=0.015) , depth of myometrial invasion ( OR=2.30, 95% CI: 1.43-2.84, P=0.021) , parametrial invasion ( OR=2.50, 95% CI: 1.76-2.97, P=0.018) and lymphovascular space invasion ( OR=1.96, 95% CI: 1.03-2.51, P=0.033) were independent factors for postoperative lymph node metastasis in patients with FIGO stage Ⅰ and Ⅱ cervical cancer. Multivariate logistic regression analysis showed that the levels of CD3 +, CD4 +, CD8 + T cells and the ratio of CD4 +/CD8 + in patients with stage Ⅰ and stage Ⅱ cervical cancer 1 day before surgery were independent influencing factors for postoperative lymph node metastasis (all P<0.05) . ROC curve analysis showed that the areas under the curve of CD3 +, CD4 +, CD8 + T lymphocytes levels and the ratio of CD4 +/CD8 + in stage Ⅰ patients 1 day before surgery for predicting postoperative lymph node metastasis were 0.86, 0.82, 0.83, 0.89, respectively, and those in stage Ⅱ patients were 0.90, 0.93, 0.87, 0.95, respectively. CD4 +/CD8 + ratio was significantly more effective in predicting postoperative lymph node metastasis than other indexes (all P<0.001) . Conclusions:The levels of CD3 +, CD4 + T lymphocytes, and the CD4 +/CD8 + ratio in patients with FIGO stage Ⅰ and Ⅱ cervical cancer are significantly higher in 1-30 days after surgery than before, while the level of CD8 + T lymphocytes is significantly lower than before. There is a significant correlation between T lymphocytes subsets and lymph node metastasis after surgery. In addition, low differentiation, depth of myometrial invasion ≥1/2, parametrial invasion, and lymphovascular space invasion are independent risk factors for postoperative lymph node metastasis.

Objective To explore the traditional Chinese medicine(TCM)syndrome character-istics and medication patterns of cerebral small vessel disease(CSVD)using data mining techniques.Methods Clinical research literature on TCM treatment of CSVD,published from the establishment of the database to September 1,2024,was retrieved from the China National Knowledge Infrastructure(CNKI),Wanfang,and VIP databases.Analyses were conducted on syndromes,drug frequencies,properties,flavors,and meridian tropisms.Data mining was performed using R4.4.1 software to ex-plore associations,correlations,and clustering of TCM herbs,aiming to elucidate medication patterns in CSVD treatment.Results A total of 60 prescription formulas for treating CSVD were screened,involving 142 TCM herbs with a total usage frequency of 1,312 times.The top five most frequently used herbs were Chuanxiong,Danggui,Dilong,Huangqi,and Chishao.Herb properties were pre-dominantly warm and cold;flavors were mainly pungent,bitter,and sweet;and meridian tropisms were primarily to the liver,spleen,and heart meridians.Twenty-nine strong association rules were identified,and association analysis revealed core herbal combinations centered around Chuanxiong,Chishao,and Danggui.Clustering analysis yielded five herbal combinations.Conclusion CSVD is characterized by a deficiency in essence and excess in superficiality.Treatment should focus on tonify-ing deficiencies and eliminating excesses,combining both tonification and purgation methods.Medication patterns predominantly involve herbs for promoting blood circulation and removing blood stasis,often combined with herbs for nourishing the kidney and marrow,calming the liver and suppressing wind,and awakening the mind and opening the orifices.

Diabetes,a metabolic disease stemming from impaired or defective insulin secretion,ranks among the most severe chronic illnesses globally.While several approved drugs exist for its treatment,they often come with multiple side effects.Therefore,there is a pressing need for safe and effective anti-diabetic medications.Traditional Chinese medicine has recognized Lycium barbarum(LB;goji berry)plant,commonly known as"wolfberry fruit"in China,for over 2,000 years.Natural compounds derived from LB show promise in reducing diabetes levels.Although research on the impact of LB on diabetes is still limited,our review aims to explore the potential of LB in reducing the risk of diabetes and examine the underlying mechanisms involved.LB can modulate diabetes through various pathways,such as inhibitingα-amylase and α-glucosidase activities,promoting β-cell proliferation,stimulating insulin secretion,inhibiting glucagon secretion,improving insulin resistance and glucose tolerance,and enhancing anti-oxidant and anti-inflammatory activities.Additionally,LB improves gut flora and immunomodulation,further aiding diabetes management.These findings highlight the potential clinical utility of LB in managing diabetes and its complications within the framework of evidence-based modern medicine.

Objective To explore the impact of deep learning image reconstruction(DLIR)algorithms on image quality of chest CT,detection rate of lung nodule and reproducibility of lung nodule radiomics feature data compared with adaptive statistical iterative reconstruction V(ASIR-V)algorithms.Methods Seventy-five patients with 211 lung nodules who underwent both ultra-low-dose CT(ULD-CT)and standard-dose CT(SDCT)were prospectively enrolled.ULD-CT images were reconstructed using different algorithms,namely high-level DLIR(DLIR-H),medium-level DLIR(DLIR-M)and 50％ASIR-V(50％ASIR-V),while SDCT images were reconstructed by 50％ASIR-V.Image noise was represented by the standard deviation(SD)of lung parenchyma CT values within identical ROI in both ULD-CT and SDCT images,and signal-to-noise ratio(SNR)were calculated.The detection rate of lung nodule were obtained and compared among different images.Radiomics features of lung nodules in chest 50％ASIR-V SDCT and each ULD-CT were extracted based on automatic segmentation methods,and intra-class correlation coefficients(ICC)of each ULD-CT and 50％ASIR-V SDCT were calculated respectively,and then compared among different ULD-CT algorithms.Results Compared with SDCT images reconstructed with 50％ASIR-V algorithm,all ULD-CT images reconstructed by different algorithms showed higher SD and lower SNR(all P＜0.05).ULD-CT images reconstructed by DLIR-H,DLIR-M and 50％ASIR-V exhibited progressively increasing SD and decreasing SNR(all adjusted P＜0.05).Taken 50％ASIR-V SDCT images as standards,ULD-CT by DLIR-H,DLIR-M and 50％ASIR-V each detected 207 lung nodules(207/211,98.10％),respectively.In chest ULD-CT images,the reproducibility with 50％ASIR-V SDCT for texture feature data of lung nodules on ULD-CT reconstructed by 50％ASIR-V algorithm was lower than that by DLIR-H and DLIR-M(both adjusted P＜0.05),while no significant difference was found between the latter two with 50％ASIR-V SDCT(adjusted P＞0.05).The first order and shape feature data of lung nodules on ULD-CT reconstructed by all 3 algorithms showed good reproducibility with 50％ASIR-V SDCT(median ICC＞0.75),and no significant difference was detected among them(all P＞0.05).Conclusion Compared with 50％ASIR-V ULD-CT,both DLIR-H and DLIR-M ULD-CT could significantly reduce image noise and improve image quality,as well as maintain reproducibility of radiomics features in lung nodules in a certain degree,especially DLIR-H.

Objective:To explore the evaluation and relationship of hepatitis B virus(HBV)surface antigen(HBsAg)in clinical laboratory in different detection systems,further scientifically and reasonably to explain the test results for serving clinical practices.Methods:During the period from June 2021 to July 2022,100 425 specimens of patients with screened,suspected and confirmed HBV infections were collected from the clinical departments(mainly infectious hepatology)of Nanyang Central Hospital.Detection methodology included quantitative(electrochemiluminescence and chemiluminescence),qualitative(gold standard),semi-quantita-tive(ELISA),and highly sensitive HBV-DNA(RT-PCR)methods,and then analyzed the strengths and weaknesses and closeness be-tween each methodology.The relationship between the two Roche HBsAg detection systems was analyzed by correlation analysis.The HBsAg efficacy analysis was validated using Cut/Off value setting and detection limit,which in turn analyzed the distribution of false-positive and false-negative reporting models.Results:Detection results for low-and medium-concentration HBsAg showed a correla-tion between the electrochemical luminescence semi-quantitative method and ELISA method.ELISA method still had advantages in terms of sensitivity and specificity when detecting HBsAg,and there were no significant differences compared to domestic and interna-tional HBsAg quantitative detection systems.Performance validation conducted in accordance with the CNAS-GL038 document showed that the minimum detection limit for HBsAg calculated using the ELISA method in this laboratory was 0.1 U/ml.When the ROC curve Cut/Off value was set to 0.105,the area under the curve was the largest(AUC=0.986).Based on Roche's semi-quantitative electroche-miluminescence detection and patient medical history,in the common reporting model for hepatitis B five-item detection using ELISA method,HBsAg false positives occurred most frequently when HBsAg was positive alone,and HBsAg occurred most frequently in the false positive range when the OD value was less than 0.5.In ELISA method for detecting HBsAg,as the OD value increased from 0.01 to 0.10,the number of false-negative results also increased.Roche Elecsys HBsAg Ⅱ Quant Ⅱ and Elecsys HBsAg Ⅱ testing systems exhibited good linearity under certain conditions,with a ratio of approximately 1/0.18.In Elecsys HBsAg Ⅱ Quant Ⅱ detection sys-tem,the test results of HBsAg samples diluted 400 times were highly consistent with the original test results with a coefficient of deter-mination R2=0.993 8.Conclusion:There was a certain relationship between various detection systems of HBsAg at a suitable concen-tration.The detection of HBsAg by ELISA can meet the needs of clinical detection.

Objective:To explore the evaluation and relationship of hepatitis B virus(HBV)surface antigen(HBsAg)in clinical laboratory in different detection systems,further scientifically and reasonably to explain the test results for serving clinical practices.Methods:During the period from June 2021 to July 2022,100 425 specimens of patients with screened,suspected and confirmed HBV infections were collected from the clinical departments(mainly infectious hepatology)of Nanyang Central Hospital.Detection methodology included quantitative(electrochemiluminescence and chemiluminescence),qualitative(gold standard),semi-quantita-tive(ELISA),and highly sensitive HBV-DNA(RT-PCR)methods,and then analyzed the strengths and weaknesses and closeness be-tween each methodology.The relationship between the two Roche HBsAg detection systems was analyzed by correlation analysis.The HBsAg efficacy analysis was validated using Cut/Off value setting and detection limit,which in turn analyzed the distribution of false-positive and false-negative reporting models.Results:Detection results for low-and medium-concentration HBsAg showed a correla-tion between the electrochemical luminescence semi-quantitative method and ELISA method.ELISA method still had advantages in terms of sensitivity and specificity when detecting HBsAg,and there were no significant differences compared to domestic and interna-tional HBsAg quantitative detection systems.Performance validation conducted in accordance with the CNAS-GL038 document showed that the minimum detection limit for HBsAg calculated using the ELISA method in this laboratory was 0.1 U/ml.When the ROC curve Cut/Off value was set to 0.105,the area under the curve was the largest(AUC=0.986).Based on Roche's semi-quantitative electroche-miluminescence detection and patient medical history,in the common reporting model for hepatitis B five-item detection using ELISA method,HBsAg false positives occurred most frequently when HBsAg was positive alone,and HBsAg occurred most frequently in the false positive range when the OD value was less than 0.5.In ELISA method for detecting HBsAg,as the OD value increased from 0.01 to 0.10,the number of false-negative results also increased.Roche Elecsys HBsAg Ⅱ Quant Ⅱ and Elecsys HBsAg Ⅱ testing systems exhibited good linearity under certain conditions,with a ratio of approximately 1/0.18.In Elecsys HBsAg Ⅱ Quant Ⅱ detection sys-tem,the test results of HBsAg samples diluted 400 times were highly consistent with the original test results with a coefficient of deter-mination R2=0.993 8.Conclusion:There was a certain relationship between various detection systems of HBsAg at a suitable concen-tration.The detection of HBsAg by ELISA can meet the needs of clinical detection.

Objective:To evaluate the effect of toric collamer lens (TICL) rotation on myopia combined with astigmatism correction after V4c TICL implantation using standardized vector analysis.Methods:An observational case series study was performed.A total of 152 patients (268 eyes) who underwent V4c TICL implantation for the correction of myopia and myopic astigmatism were enrolled at Henan Eye Hospital from January to December 2021.The preoperative spherical diopter, cylindrical diopter, and spherical equivalent (SE) were -15.00 to -3.25 D, -5.00 to -0.50 D, -16.50 to -3.88 D, respectively.Postoperative TICL vault and axis were measured by anterior segment optical coherence tomography, and postoperative TICL rotation was calculated.Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical diopter, cylindrical diopter, SE, and target astigmatism vector were recorded before and 1 month after surgery.The effectiveness index, safety index, surgically induced astigmatism vector (SIA), margin of error (ME), absolute value of the difference vector |DV|, correction index (CI), and achievement index (IS) were calculated based on the subjective refraction results 1 month after surgery and the cylindrical axis of the V4c TICL.Vector analysis parameters was compared among patients with different preoperative astigmatism, intraoperative TICL fixation, postoperative TICL rotation, and postoperative vault.The correlation between postoperative TICL rotation and TICL fixed angle deviation, postoperative vault, visual acuity and refraction, and vector analysis parameters were evaluated.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2021[13]).Written informed consent was obtained from each subject.Results:At 1 month postoperatively, the mean safety and efficacy indices were 1.27 and 1.29, respectively.There was no statistically significant difference between the predicted SE of (-0.11±0.13)D and the postoperative SE of (-0.07±0.52)D ( t=-0.994, P=0.321).UCVA, BCVA and cylinder diopter in the operative eyes were all improved after surgery compared to before surgery and the differences were statistically significant ( t=17.854, 5.446, -25.634; all P<0.001).The rotation of V4c TICL was 0° to 25°, with a mean of (5.41±4.35)°, which was positively correlated with the V4c TICL fixed angle deviation ( rs=0.461, P<0.001), negatively correlated with postoperative cylindrical diopter and positively correlated with postoperative UCVA, |DV| and SIA ( r=-0.360, 0.191, 0.205, 0.142; all P<0.05).Vector analysis between groups showed that vault, SIA and |DV| were higher and CI and IS were lower in low astigmatism group than in high astigmatism group ( Z=-3.017, -13.569, -2.793, -2.761, -4.779; all P<0.05).V4c TICL rotation and |DV| were lower in low fixation angle difference group than in high fixation angle difference group ( Z=-7.865, -2.080; both P<0.05).Preoperative cylindrical diopter, intraoperative V4c TICL fixed angle deviation, SIA and |DV| were lower in low rotation group than in high rotation group ( Z=-2.104, -4.578, -2.456, -2.090; all P<0.05).There were no statistically significant differences in the TICL rotation or in each vector between patients with different vault after the surgery (all P>0.05). Conclusions:V4c TICL implantation can achieve good results for the correction of myopia and myopic astigmatism.There is a slight difference between the fixation axis and the target axis of V4c TICL, which affects the rotation of V4c TICL and |DV|.Postoperative V4c TICL rotation is related to TICL fixed angle deviation, postoperative UCVA, SIA, |DV| and postoperative cylindrical diopter.Postoperative vault has no significant effect on TICL rotation and differences in each vector.

To further investigate the molecular genetic characteristics of enzomatic nasal tumor vi-rus of goats(ENTV-2)in Yunnan Province,this study measured and analyzed the entire genome of ENTV-2 in Yunnan Province.The results showed that the complete genome sequence of the EN-TV-2 YN2023 strain(GenBank accession number:PP682590.1)was successfully obtained.The YN2023 strain has a total length of 7 307 bp and a typical structure of 5'-M5-gag-pro-pol-env-M3-3'.Whole genome sequence homology analysis showed that the nucleotide homology between YN2023 strain and 41 reference strains ranges from 85.3％to 95.5％.The whole genome evolution-ary tree indicates that the YN2023 strain is closely related to the prevalent strains in China,with certain genetic diversity and geographical clustering.The analysis of the gag gene evolutionary tree shows that the gag gene cluster of YN2023 strain is on a branch of the ENTV-2 gag gene,and YN2023 is clustered on the same small branch as enENTV-FJ1 and GDQY2017 strains,with the closest genetic relationship.The env gene evolutionary tree shows that YN2023 is on the same branch as GDQY2017,GDZJ2022,ENTV-2CHN1-6,ENTV-FJ1,and ENTV-FJ3,and is also on the same branch as GDQY2017,indicating a close genetic relationship.Recombination analysis showed that the YN2023 strain underwent a potential recombination event between breakpoint positions 6378-7478 bp,with the Chinese Chongqing strain enENTV-CQ1(OR669623.1)as the primary parent and the Chinese Sichuan strain BH(MT254062.1)as the secondary parent.This study enriches the genomic information of the ENTV-2 strain in Yunnan Province and provides data sup-port for the genetic variation of ENTV-2 in Yunnan Province.

OBJECTIVE The non-volatile and volatile chemical components in Yin-Qiao-Qing-Re Tablets were analyzed sepa-rately using ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS)and Gas Chromatography Mass Spectrometry(GC-MS).METHODS The non-volatile components were analyzed using a Waters ACQUITY UPLC BEH C18 column(2.1 mm×100 mm,1.7 μm),with a mobile phase consisting of 0.1％formic acid aqueous solution(A)and acetonitrile(B)for gradient elution,a flow rate of 0.35 mL·min-1,an injection volume of 5 μL,and a column temperature of 30 ℃;the volatile components were analyzed using an Agilent SH-I-5MS column(5％Phenyl Methyl Silox,30 m×250 μm,0.25 μm);the procedure was temperature-programmed,with an injection volume of 1 μL,a split ratio of 10∶1,a flow rate of 1.0 mL·min-1,and an inlet temperature of 200 ℃.RESULTS A total of 134 non-volatile chemical components and 23 volatile components were analyzed and identified from Yin-Qiao-Qing-Re Tablets,among which 49 compounds were confirmed through comparison with reference stand-ards.The non-volatile components mainly include 27 flavonoids,21 organic acids,15 lignans,14 iridoids,12 phenylethanoid glyco-sides,11 saponins,10 alkaloids,5 terpenes,4 amino acids,3 phenylpropanoids,3 nucleosides,3 xanthones,3 phenolic glycosides,2 chromones and 1 carbohydrate.The volatile components mainly include 11 monoterpenes,5 alcohols and phenols,3 alkenes,2 ke-tones,1 ester,and 1 hydrocarbon.CONCLUSION This study rapidly identifies the chemical components of Yin-Qiao-Qing-Re Tablets,laying a preliminary foundation for research on the pharmacodynamic substances of Yin-Qiao-Qing-Re Tablets and the im-provement of quality control standards.