Traditional Chinese medicine(TCM) capable of clearing heat and removing toxin is most commonly used in clinical practice and has the effect of removing fire-heat and toxin. Studies have shown that most of the Ilex plants have the effect of clearing heat and removing toxin, among which the varieties of I. cornuta, I. pubescens, I. rotunda, I. latifolia, and I. chinensis are most widely used. These plants generally contain triterpenoids and their glycosides, alkaloids, flavonoids, phenylpropanoids, and other chemical components, especially pentacyclic triterpenoids. According to their skeletons, pentacyclic triterpenoids can be divided into the oleanane type, the ursane type, the lupinane type, etc. Among them, ursane-type components are the most abundant, and 136 species have been found so far. These components have been proved to have pharmacological effects such as anti-inflammatory, anti-tumor, hypolipidemic, anti-thrombosis, cardiomyocyte-protective, antibacterial, and hepatoprotective effects. Therefore, this paper systematically reviews the domestic and foreign literature on Ilex plants with a focus on the research progress on pentacyclic triterpenoids and their pharmacological activities, aiming to provide reference for the development of TCM resources with the effect of clearing heat and removing toxin.
Ilex/chemistry* ; Plants, Medicinal/chemistry* ; Pentacyclic Triterpenes/pharmacology* ; Medicine, Chinese Traditional ; Drugs, Chinese Herbal/pharmacology* ; Humans ; Animals

[This corrects the article DOI: 10.1016/j.apsb.2022.03.002.].

Objective:To investigate the influencing factors of adverse reactions of reconstructive flaps after postoperative precision radiation therapy for head and neck tumors.Methods:Medical records of 46 patients who underwent radiotherapy after flap reconstruction for head and neck tumors in the Affiliated Hospital of Inner Mongolia Medical University between January 2016 and October 2022 were retrospectively analyzed. The overall survival (OS), local regional control (LRC) and dosimetric parameters after radiotherapy were analyzed. The adverse reactions mainly including radiation dermatitis and flap necrosis at 3 and 6 months after radiotherapy, flap atrophy, flap fibrosis, dysphagia and chewing dysfunction at 12 and 24 months after radiotherapy were recorded. Adverse reactions were graded using the common terminology criteria for adverse events (CTCAE) version 5.0. Quantitative data were analyzed by one-way analysis of variance or rank-sum test. Qualitative data were analyzed by chi-square test or Fisher's exact test. Multivariate analysis of influencing factors of adverse reactions was performed using binary logistic stepwise regression.Results:All 46 patients were aged 57.6 years on average. The median follow-up time was 65 months (12-100 months). After the follow-up, 22 patients died, 6 recurred, and 7 had distant metastases. The 5-year OS rate was 48% and 5-year LRC rate was 69%. The incidence of radiation dermatitis was decreased over time after the end of radiotherapy: 80% (37/46) and 65% (30/46) at 3 months and 6 months after radiotherapy, respectively. The incidence of grade 3 radiation dermatitis was 11% (5/46) and 0 at 3 and 6 months after radiotherapy, respectively. The incidence of grade 2 flap necrosis was 4% (2/46) at 3 months after radiotherapy. At 12 months after radiotherapy, the incidence of flap atrophy and fibrosis was 83% (38/46) and 67% (31/46) , and the incidence of grade 3 flap atrophy and fibrosis was equally 4% (2/46) , respectively. All patients had dysphagia and chewing dysfunction at 12 months after radiotherapy. At 24 months after radiotherapy, 83% (38/46) and 61% (28/46) of patients still had dysphagia and chewing dysfunction. Multivariate regression analysis showed that irradiated flap volume, total radiotherapy dose, pharyngeal constrictor D mean and pharyngeal constrictor V 60 Gy, the interval between surgery and radiotherapy, gender and age were the independent influencing factors of adverse reactions of reconstructive flaps after precision radiation therapy for head and neck tumors. Conclusions:For patients undergoing flap reconstruction for head and neck tumors, under the premise of ensuring tumor control, the dose to normal tissue and flap blood supply area should be strictly limited, the irradiated volume should be reduced, and the interval between surgery and radiotherapy should be shortened (≤6 weeks) to reduce the risk of adverse reactions. Hypo-fractionated radiotherapy plan should be formulated or the total radiotherapy dose should be appropriately adjusted for elderly patients to reduce long-term complications.

Objective To analyze the preferences of elderly cancer patients for internet hospital diagnosis and treatment services,providing a reference for the sustainable development of internet hospitals.Methods This study was based on the method of discrete choice experiments.By combining literature review and expert consultation,10 relevant attributes affecting the choice of internet hospitals by elderly cancer patients were determined.Through KANO questionnaires,6 key attributes were se-lected to form the final DCE questionnaire,consisting of 11 choice sets and 1"quality control"set.Using the convenience sam-pling method,elderly cancer patients visiting a certain tertiary hospital in Tianjin were selected to collect 318 valid question-naires.The obtained data were analyzed using mixed Logit regression.Results Patients visiting a certain specialized cancer hos-pital in Tianjin tend to prefer hospitals with a grade of Grade Ⅲ-A(β=0.661 6,P＜0.05)and those offering out-of-hospital rehabilitation guidance for cancer patients(β=0.559 9,P＜0.05).The page operation process(β=0.352 2,P＜0.05)and the accessibility mode for the elderly(β=0.357 5,P＜0.05)are the attributes with lower attention.In the subgroup analysis,for patients of different genders and different family incomes,hospital grade and out-of-hospital rehabilitation guidance for cancer patients remain the most influential factors,but male patients pay more attention to the page operation process(β=0.378 3,P＜0.05)and the accessibility mode for the elderly(β=0.373 7,P＜0.05),while female patients pay more attention to the cover-age of medical insurance reimbursement(β=0.435 9,P＜0.05),which has a greater impact than that of male patients(β=0.394 7,P＜0.05);patients with a monthly per capita income of less than 5 000 yuan pay more attention to the coverage of medical insurance reimbursement(β=0.423 0,P＜0.05)and the self-appointment check function(β=0.467 0,P＜0.05);while patients with a monthly per capita income of more than 5 000 yuan pay more attention to the page operation process(β=0.364 7,P＜0.05)and the accessibility mode for the elderly(β=0.359 1,P＜0.05).Conclusion Hospitals should en-hance elderly patients' awareness and trust in internet hospitals by providing comprehensive health education and support,simpli-fying operational processes,strengthening age-friendly design,and highlighting medical insurance coverage to address the diverse needs across genders and income levels.

Objective To analyze the effects of national centralized volume-based procurement(CVBP)on hospitaliza-tion expenses of patients undergoing artificial joint replacement under the Diagnosis-Related Group(DRG)payment model in a public hospital,and to provide evidence for advancing reforms in high-value medical consumables and healthcare payment sys-tems.Methods Data from patients undergoing artificial joint replacement in a tertiary public hospital in 2022 were collected.Statistical analysis was used to assess the surplus and deficit of DRG year-end settlements for these cases.By comparing cost com-positions across different medical insurance types,differences in total inpatient medical expenses,out-of-pocket payments,per-sonal medical insurance account expenditures,and pooled fund reimbursements were evaluated before and after CVBP implemen-tation.Results Following CVBP implementation,the sample hospital demonstrated significant improvements in reducing medical costs,alleviating patient financial burdens,and optimizing medical insurance fund utilization.Under the DRG payment model,operational performance remained stable.Post-CVBP,total hospitalization expenses,patient out-of-pocket payments,and pooled fund reimbursements all decreased significantly(P＜0.001).Conclusion The practice of centralized procurement of artificial joints can be extended to other high-value medical consumables,continuously promoting the reform of the medical and health sys-tem,and ultimately achieving mutually beneficial and sustainable development among healthcare providers,insurers,and patients.

Objective:To study the development status and characteristics of the Traditional Chinese Medicine(TCM)service capacity of primary medical institutions(referred as primary)in Beijing.Methods:The case-base aggregation method was used to analyze the total amount,distribution,and development changes of total TCM costs in primary healthcare institutions in Beijing.Results:From 2019 to 2023,the average annual growth rate of the TCM costs of primary healthcare institutions in Beijing was 10.09％,and the proportion in total TCM costs increased from 16.01％to 18.19％.The average annual growth rate of the TCM costs of community health service centers(stations)was 11.78％,but there were negative growths in outpatient departments,clinics,and village clinics.The proportion of the primary TCM costs in its health costs increased from 29.16％to 32.56％.The average annual growth rate of income from primary herbal medicines and processed Chinese medicines were 16.75％and 10.13％.Conclusion:The primary TCM undertaking has developed steadily,and Beijing should continue to guide high-quality TCM resources to sink.Multiple measures should be taken to promote the development of TCM in outpatient departments,clinics,and village clinics.The coordination between prices and medical insurance reimbursement and payment methods should be strengthened.Supervision over the quality and use of Chinese medicine should be strengthened,and the technical service capabilities of primary TCM should be enhanced.

Objective:To explore the effects of capacity, opportunity, motivation-behavior (COM-B) model-based motivation interview combined with transitional care on self-management ability, health behavior, and social support in stroke patients.Methods:From June 2021 to June 2024, 104 stroke patients admitted to Beijing Anzhen Hospital, Capital Medical University, were selected as study subjects using convenience sampling. Patients were randomly assigned to either the control group or the intervention group, with 52 patients in each group. Control group received routine care, while intervention group received COM-B model based motivation interview combined with transitional care in addition to routine care. Scores of the Exercise of Self-Care Agency Scale (ESCA) , Health Behavior Scale for Stroke Patients (HBS-SP) , 11-item Duke Social Support Index (DUKE-UNK11) , Readiness for Hospital Discharge Scale (RHDs) , and Stroke Specific Quality of Life Scale (SS-QOL) were compared between two groups of patients before and after intervention.Results:After intervention, the ESCA, HBS-SP, DUKE-UNK11, RHDs, and SS-QOL scores of intervention group were higher than those of control group, and the differences were statistically significant ( P<0.05) . Conclusions:COM-B model-based motivation interview combined with transitional care can improve the self-management ability of stroke patients, promote the formation of healthy behaviors, and enhance patients' perception of social support, which is worthy of clinical promotion and application.

Relevant China's literature on the application of brain-computer interface technology in the field of rehabilita-tion of stroke patients was retrieved in the China Knowledge Network database from its establishment to December 31,2024,and CiteSpace visual analysis software was used to analyze the selected literature in terms of trend of annual publica-tion number,author collaboration network,keyword co-occurrences and emergences and to generate a corresponding knowledge map.It's pointed out brain-computer interface technology showed significant application potential for motor function recovery and neurorehabilitation,which had the research hotspots of the cross technologies covering motor imagina-tion,rehabilitation training and virtual reality and the research frontiers of the fusion application of intelligent algorithms of deep learning and pattern recognition.The challenges and future development directions of the field were investigated,and references were provided for promoting the application of brain-computer interface technology to rehabilitation of sroke patients in China.[Chinese Medical Equipment Journal,2025,46(9):65-69]

Objective:To explore the construction of an evaluation model for aortic root anatomy and calcium burden in patients with bicuspid aortic valve (BAV) stenosis before transcatheter aortic valve replacement (TAVR) based on deep learning (DL) algorithms.Methods:A retrospective collection of 362 BAV stenosis patients who underwent TAVR from September 2023 to May 2024 was performed. All patients underwent cardiac CT angiography. The patients were divided into training group ( n=104), internal validation group ( n=206), and external validation group ( n=52). A DL model was trained on the training dataset to assess aortic root anatomy and calcification burden. The evaluation included the segmentation accuracy of the algorithm, the measurement performance of key anatomical structures (i.e., valve leaflets and type-1 and type-2 fusion raphe), and calcification burden, as well as the measurement efficiency. Overall segmentation performance was assessed using the average Dice coefficient (ADC). The fine-scale segmentation quality was validated by the 95th-percentile Hausdorff distance (HD-95) and the average symmetric surface distance (ASSD). The consistency of the measurement results was assessed using the Pearson correlation coefficient and the intraclass correlation coefficient ( ICC) with a two-way mixed model for absolute agreement. In addition, the total time and total mouse movement distance required for manual assessment versus the DL model on the validation datasets were recorded and compared. Results:The algorithm demonstrated excellent segmentation performance on aortic root anatomical targets, achieving outstanding consistency within both internal and external validation datasets (0.955

Objective:To evaluate the efficacy of combined cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) in the management of dysphagia secondary to glossopharyngeal and vagal nerve injury.Methods:This retrospective cohort study collected the clinical data of 18 patients with persistent dysphagia due to glossopharyngeal and vagus nerve injuries, who underwent concurrent cricopharyngeal myotomy (CPM) and autologous fat injection laryngoplasty (AFIL) at the Department of Otolaryngology, Peking Union Medical College Hospital, from January 2017 to December 2024. Pre-and postoperative assessments included electronic flexible laryngoscope, the Chinese version of Swallow Quality-of-Life Questionnaire (CSWAL-QOL), videofluoroscopic swallowing study (VFSS), body weight changes, and nasogastric tube (NGT) removal status with routine follow-up. The comparison of swallowing function before and after surgery was conducted using paired samples t-test and χ2 test. Results:The study cohort comprised 10 male and 8 female patients, with ages ranging from 33 to 70 years (mean±SD: 53.8±10.5). All surgical procedures were completed successfully without complications. During the 6-to 24-month follow-up period, 10 of the 13 patients who were initially nasogastric tube-dependent achieved successful decannulation. Compared with preoperative values, postoperative measurements demonstrated statistically significant improvements across all parameters: mean body weight increased from (56.95±9.14) kg to (59.22±8.72) kg ( t=3.689 , P<0.01), CSWAL-QOL scores improved from 91.89±17.81 to 130.83±25.42 ( t=6.921 , P<0.01), while, both VFSS scales showed marked reductions (VFSS-SWAL: 6.78±1.40 to 3.39±1.61, t=-8.001, P<0.01; PAS: 6.56±1.15 to 2.94±1.26, t=-10.114, P<0.01). Conclusions:Combined CPM and AFIL represents an effective surgical approach for dysphagia following glossopharyngeal and vagal nerve injury, thereby demonstrating significant improvements in both swallowing function and quality of life.