Objective To explore the effect of remote ischemic conditioning(RIC)combined with binaural beat music(BBM)train-ing in patients with cognitive dysfunction after cerebral infarction.Methods From June,2024 to January,2025,200 patients with cognitive dysfunction after cerebral infarction in the Affil-iated Hospital of North China University of Science and Technology were randomly divided into control group(n=50),RIC group(n=50),BBM group(n=50)and combined group(n=50).All the groups received stan-dardized routine training,RIC group received RIC,BBM group received BBM,and the combined group received RIC+BBM,for 14 days.They were assessed with Montreal Cognitive Assessment(MoCA)and Stroke-Specific Quality of Life Scale(SS-QOL)at baseline,day 14,and day 90.Results Two cases in the control group,four in RIC group,three in BBM group and three in the combined group dropped out.For MoCA scores,the inter-group effect,intra-group effect and interaction effect were all significant(F>13.463,P<0.001).After intervention,on both day 14 and day 90,the score of MoCA was higher in each in-tervention group than in the control group(P<0.05),and was higher in the combined group than in both BBM and RIC groups(P<0.05);and on day 90,it was higher in RIC group than in BBM group(P<0.05).For SS-QOL,the score increased with time in all the groups(χ2>75.182,P<0.001).After intervention,there was signif-icant difference at each time point among four groups(H>18.260,P<0.001).On day 14 and day 90,the score of SS-QOL was higher in the combined group than in the control and BBM groups(|Z|>3.149,P<0.05);on day 90,the score was higher in RIC group than in the control group(|Z|=3.590,P<0.05),and it was higher in the combined group than in RIC group(|Z|=3.186,P<0.05).Conclusion RIC,BBM and their combination all improved cognitive function after cerebral infarction.RIC was superior to BBM,and the combined intervention yielded the greatest benefit.Both RIC and the combined intervention im-proved quality of life,with the combined approach being the most effective.

Immune thrombocytopenia(ITP)is an autoimmune disease characterized primarily by bleeding and fatigue.ITP-related fatigue can substantially affect health-related quality of life and has been recognized as a treatment indication in the latest guidelines.However,its pathogenesis remains unclear,and targeted therapies are lacking.This paper explores the theoretical foundation of the"excessive fire consuming healthy qi"theory,linking two key conceptual pairs:"excessive fire"with inflammation and"healthy qi consumption"with mitochondrial dysfunction.Chronic inflammation leads to continuous"qi consumption"and damage to mitochondrial structure and function,ultimately resulting in symptoms of qi deficiency such as tiredness and fatigue.The imbalance between qi and fire,leading to imbalance of yin and yang,is the primary pathogenesis of ITP-related fatigue,with the disease mainly affecting the spleen.Considering the etiology and pathogenesis of ITP,and relative equilibrium of yin-yang,the therapeutic approach of invigorating spleen and benefiting qi to promote the production of blood serves as a core treatment strategy.Previous research has demonstrated the clinical efficacy of Jianpi Yiqi Shexue Formula,consisting of milkvetch root,tangshen,Indian bread,largehead atractylodes rhizome,India madder root,and ass hide glue in treating patients with ITP-related fatigue.Designed to invigorate the spleen and regulate qi and blood,this formula aligns with the pathogenesis of ITP-related fatigue characterized by deficiency of spleen qi and stomach qi.The formula also modulates the expression levels of key proteins and genes involved in mitochondrial energy metabolism and alleviates the immune dysfunction.These findings highlight the potential for further research into the mechanism of ITP-related fatigue,particularly by using inflammation-mediated mitochondrial energy metabolism as a promising entry point.

Immune thrombocytopenia(ITP)is an autoimmune disease characterized primarily by bleeding and fatigue.ITP-related fatigue can substantially affect health-related quality of life and has been recognized as a treatment indication in the latest guidelines.However,its pathogenesis remains unclear,and targeted therapies are lacking.This paper explores the theoretical foundation of the"excessive fire consuming healthy qi"theory,linking two key conceptual pairs:"excessive fire"with inflammation and"healthy qi consumption"with mitochondrial dysfunction.Chronic inflammation leads to continuous"qi consumption"and damage to mitochondrial structure and function,ultimately resulting in symptoms of qi deficiency such as tiredness and fatigue.The imbalance between qi and fire,leading to imbalance of yin and yang,is the primary pathogenesis of ITP-related fatigue,with the disease mainly affecting the spleen.Considering the etiology and pathogenesis of ITP,and relative equilibrium of yin-yang,the therapeutic approach of invigorating spleen and benefiting qi to promote the production of blood serves as a core treatment strategy.Previous research has demonstrated the clinical efficacy of Jianpi Yiqi Shexue Formula,consisting of milkvetch root,tangshen,Indian bread,largehead atractylodes rhizome,India madder root,and ass hide glue in treating patients with ITP-related fatigue.Designed to invigorate the spleen and regulate qi and blood,this formula aligns with the pathogenesis of ITP-related fatigue characterized by deficiency of spleen qi and stomach qi.The formula also modulates the expression levels of key proteins and genes involved in mitochondrial energy metabolism and alleviates the immune dysfunction.These findings highlight the potential for further research into the mechanism of ITP-related fatigue,particularly by using inflammation-mediated mitochondrial energy metabolism as a promising entry point.

Objective To explore the effect of remote ischemic conditioning(RIC)combined with binaural beat music(BBM)train-ing in patients with cognitive dysfunction after cerebral infarction.Methods From June,2024 to January,2025,200 patients with cognitive dysfunction after cerebral infarction in the Affil-iated Hospital of North China University of Science and Technology were randomly divided into control group(n=50),RIC group(n=50),BBM group(n=50)and combined group(n=50).All the groups received stan-dardized routine training,RIC group received RIC,BBM group received BBM,and the combined group received RIC+BBM,for 14 days.They were assessed with Montreal Cognitive Assessment(MoCA)and Stroke-Specific Quality of Life Scale(SS-QOL)at baseline,day 14,and day 90.Results Two cases in the control group,four in RIC group,three in BBM group and three in the combined group dropped out.For MoCA scores,the inter-group effect,intra-group effect and interaction effect were all significant(F>13.463,P<0.001).After intervention,on both day 14 and day 90,the score of MoCA was higher in each in-tervention group than in the control group(P<0.05),and was higher in the combined group than in both BBM and RIC groups(P<0.05);and on day 90,it was higher in RIC group than in BBM group(P<0.05).For SS-QOL,the score increased with time in all the groups(χ2>75.182,P<0.001).After intervention,there was signif-icant difference at each time point among four groups(H>18.260,P<0.001).On day 14 and day 90,the score of SS-QOL was higher in the combined group than in the control and BBM groups(|Z|>3.149,P<0.05);on day 90,the score was higher in RIC group than in the control group(|Z|=3.590,P<0.05),and it was higher in the combined group than in RIC group(|Z|=3.186,P<0.05).Conclusion RIC,BBM and their combination all improved cognitive function after cerebral infarction.RIC was superior to BBM,and the combined intervention yielded the greatest benefit.Both RIC and the combined intervention im-proved quality of life,with the combined approach being the most effective.

Objective To investigate and analyze the construction and management status of drug clinical trial institu-tions in Jiangxi Province,and to provide a reference for institutions' standardized management and development.Methods The registered drug clinical trial institutions in Jiangxi Province were selected as the research objects in the"Drug and Medical De-vice Clinical Trial Institution Filing Management Information System",and the public data were retrieved.Questionnaires were sent to the registered medical institutions as"Questionnaire Star"to collect the questionnaire data.The data on the construction and management of drug clinical trial institutions were analyzed descriptively from multiple dimensions.Results By December 2023,52 drug clinical trial institutions and one vaccine clinical trial institution had been registered in Jiangxi Province.The organ-ization and management structure,personnel composition,hardware,and software of the registration institutions met the basic re-quirements for conducting drug clinical trials.In recent years,the number of drug clinical trial record institutions and the number of projects to undertake has increased year by year,and the management ability and comprehensive strength of clinical trial institu-tions have been continuously enhanced,and there is still a big gap compared with the developed areas of the pharmaceutical in-dustry.Conclusion There is unbalanced regional development,uneven ability of different institutions to undertake projects,a low level of clinical trial information management,and the comprehensive ability of clinical trials needs to be improved in Jiangxi Province.

Objective:To explore the in vitro radiation levels and in vivo neutron activation after patients receiving boron neutron capture therapy (BNCT). Methods:Totally 29 BNCT treatments were performed for 21 patients with head and neck and brain cancer using the NeuPex accelerator-based boron neutron capture therapy (AB-BNCT) system in Xiamen Humanity Hospital from October, 2022 to April, 2024. The ambient dose equivalent rate around the patients was measured with an X/gamma dose rate survey meter. The gamma radiation dose rates were measured at 0, 0.5, 1.0, and 2.0 m from the irradiation position, at 0, 0.5, 1.0, and 2.0 m from the opposite side of the irradiation position, and at the navel and the affected knee, respectively. Meanwhile, a portable high-purity germanium gamma spectrometer was used to measure the spectrum of activated nuclides in the bodies of patients who had underwent the treatment, and the types of radionuclides generated by neutron activation during each BNCT treatment were analyzed.Results:The radionuclides 24Na, 38Cl, and 49Ca were mainly produced in the bodies of patients treated with BNCT. 20 minutes after BNCT treatment, the ambient dose equivalent rate at a distance of 1.0 m from the irradiation position was lower than 2.5 μSv/h. Conclusions:The dose delivered to the staff and family members by the patients undergoing BNCT is relatively low, and the resulting radiation risk is low. According to the ALARA principle, it is recommended that certain control actions be taken for patients having received BNCT treatment to minimize the exposure doses of both patients and staff as much as possible.

Objective To develop and validate a nomogram prediction model for residual stone risk after flexible ureteroscopic lithotripsy(FURL)in patients with 2-3 cm renal calculi,so as to provide reference for treatment options.Methods Clinical data of 342 patients with renal calculi measuring 2-3 cm undergoing FURL in our hospital during Jun.2017 and Apr.2024 were retrospectively collected.At a 3∶1 randomization ratio,patients were allocated to the training cohort(n=257)and validation cohort(n=85).Patients in the training cohort were stratified into two subgroups based on postoperative stone-free status:residual stone group(n=63)and stone-free group(n=194).Logistic regression analysis was employed to identify factors influencing stone retention and construct the nomogram prediction model.Bootstrapped resampling was applied to validate the model internally,model performance was assessed with calibration curves,Hosmer-Lemeshow test was used to test the degree of fitting,receiver operating characteristic(ROC)curve was plotted to evaluate the predictive accuracy,and decision curve analysis was used to determine the clinical net benefit.The model's generalization capability was evaluated with 10-fold cross-validation of the training set.Results Multivariate logistic regression revealed that stone size,CT value,lower calyx stones,multiple stones,renal infundibulum length(RIL),and renal infundibulum width(RIW)were independent predictors of residual stones(P＜0.05).The nomogram based on the above mentioned parameters demonstrated excellent discrimination,with Bootstrap-validated concordance indices of 0.876(training cohort)and 0.948(validation cohort).Hosmer-Lemeshow tests showed good calibration in both cohorts(P＞0.05).ROC analysis yielded the area under the curve(AUC)of 0.876 and 0.948 for the training and validation cohorts,respectively.The optimal cutoff value was 0.253,with corresponding sensitivity of 84.13％,specificity of 78.35％,and total score of nomogram of 143.The decision curve analysis showed when the threshold probability of the training cohort and verification cohort was 0-0.81 and 0-0.97,respectively,the nomogram could obtain good clinical net benefit in predicting the risk of residual stones.The average accuracy of 10-fold cross-validation was 0.814,and the average AUC was 0.865.Conclusion The nomogram model effectively predicts residual stone risk following FURL for 2-3 cm renal calculi.It is suggested that patients with a total score of ≤143 may consider undergoing FURL.

Objective To investigate the predictive value of early fluid balance combined with daily average fluid intake on the prognosis of patients who received hematoma evacuation for spontaneous intracerebral hemorrhage(sICH).Methods This study retrospectively and consecutively enrolled patients who underwent hematoma evacuation for sICH admitted to the Neurosurgical Intensive Care Unit of North China University of Science and Technology Affiliated Hospital between January 2023 and January 2025.Patients'baseline and clinical data were collected,including gender,age,admission vital signs(body temperature,respiratory rate,heart rate,systolic and diastolic blood pressure),medical history(hypertension,diabetes mellitus,coronary heart disease),admission Glasgow coma scale(GCS)score,admission laboratory parameters(including white blood cell count,red blood cell count,platelet count,urine bacterial levels,urine ketones,urine pH,homocysteine),hemorrhage location,hemorrhage volume,time from ictus to surgery,and hematoma evacuation rate(hematoma evacuation rate[％]=[preoperative hematoma volume-postoperative hematoma volume]/preoperative hematoma volume × 100％).Fluid intake,output,balance,daily average intake,and cumulative fluid balance during the early postoperative period(the first to seventh 24-hour periods)were assessed and recorded.Fluid intake comprised the sum of intravenously administered fluids(crystalloids,hypertonic fluids,colloids,blood products,and parenteral nutrition),enteral nutrition(nasogastric feeding solutions and water),and renal replacement therapy fluids.Fluid output comprised the sum of urine volume,vomitus,drainage fluid,and dialysis fluid losses.Fluid balance was defined as the difference between fluid intake and output.Daily average intake was calculated as the average of the fluid intake over the first seven postoperative 24-hour periods.Cumulative fluid balance was the sum of the fluid balances over the first seven postoperative 24-hour periods.Patient outcomes were assessed at 30 days postoperatively.Discharged patients underwent outpatient review or telephone follow-up,while inpatients were evaluated by neurosurgeons.Prognosis was evaluated using the 30-day modified Rankin scale(mRS)score:mRS scores 0-3 were classified as favorable prognosis,and mRS scores 4-6 as poor prognosis.Patients were subsequently divided into favorable prognosis and poor prognosis groups based on mRS scores.Factors with P＜0.05 in univariate comparisons and without collinearity(multicollinearity was defined by:tolerance＜0.1 and variance inflation factor＞10)were included in multivariate Logistic regression analysis to identify independent risk factors for poor 30-day prognosis after hematoma evacuation in sICH patients.Receiver operating characteristic(ROC)curve analysis was employed to evaluate the predictive value of relevant factors for poor 30-day prognosis after hematoma evacuation in sICH patients.Results A total of 320 patients who underwent hematoma evacuation for sICH were enrolled,including 192 males and 128 females,with an age range of 20-91 years(median age 62[53,68]years).Among them,144 patients were assigned to the favorable prognosis group and 176 to the poor prognosis group.The poor prognosis group exhibited significantly higher hemorrhage volume,homocysteine level,fluid intake at the 3rd,5th,6th,and 7th 24-hour periods,fluid balance at the 3rd,5th,6th,and 7th 24-hour periods,daily average intake,and cumulative fluid balance compared to the favorable prognosis group(all P＜0.05).The favorable prognosis group had a significantly higher hematoma evacuation rate,GCS score,proportion of supratentorial hemorrhage and negative urine ketones than the poor prognosis group(all P＜0.05).No significant differences were found in other clinical data(all P＞0.05).Fluid balance over the first seven postoperative 24-hour periods displayed a rise-decline-rise pattern in the poor prognosis group and a rise-decline pattern in the favorable prognosis group.Both groups peaked at the 3rd 24-hour period.Multivariate Logistic regression analysis identified fluid balance at the 3rd 24-hour period(OR,2.013,95％CI 1.386-2.922,P＜0.01)and daily average intake(OR,3.583,95％CI 1.793-7.161,P＜0.01)as independent influencing factors for poor 30-day prognosis after hematoma evacuation in sICH patients.ROC curve analysis revealed that the area under the curve(AUC)for fluid balance at the 3rd 24-hour period and daily average intake in predicting poor 30-day prognosis were 0.699(95％CI 0.642-0.757)and 0.765(95％CI 0.712-0.819),respectively.The combined model of fluid balance at the 3rd 24-hour period and daily average intake achieved an AUC of 0.804(95％CI 0.756-0.853),demonstrating significantly superior predictive performance compared to either variable alone(both P＜0.05).Conclusions The combination of fluid balance at the 3rd 24-hour period and daily average intake demonstrates modest predictive value for poor 30-day prognosis after hematoma evacuation in sICH patients.These findings require validation through multicenter,large-scale,prospective studies.

[Objective] To explore the optimal pressure parameters for chyle plasma filtration under low-temperature conditions, and to improve the quality of chyle plasma treatment and filtration efficiency by improving experimental methods. [Methods] The filtration efficiency and filtration time of 30 severe chyle plasma samples under conventional preparation environment pressure and under preparation environment with a controlled filtration membrane pressure difference of 0.5 bar were compared. [Results] The absorbance of severe chyle plasma samples before and after filtration under two different preparation pressures was statistically significant (P<0.05), and both achieved the expected filtration effect. Under the preparation environment of controlling the pressure difference of the filtration membrane to 0.5 bar, the filtration was faster and with better effect, which was statistically significant compared to the conventional preparation environment pressure (P<0.05). [Conclusion] By selecting the optimal pressure parameters for filtering chyle plasma under low-temperature conditions, the efficiency of chyle plasma filtration under low-temperature conditions has been improved, and the practicality and reliability of low-temperature filtration technology have been enhanced.

Objective To analyze the value of heparin-binding protein(HBP)and interleukin-17A(IL-17A)levels in bronchoalveolar lavage fluid in predicting prognosis of elderly patients with se-vere pneumonia.Methods A total of 105 elderly patients with severe pneumonia in the hospital from May 2022 to May 2024 were selected and divided into death group(n=32)and survival group(n=73)based on their survival outcomes within 28 days after admission.The levels of HBP and IL-17A in bronchoalveolar lavage fluid were compared between the two groups;the Logistic regression analysis was conducted to explore the influencing factors for prognosis in elderly patients with severe pneumoni-a;the receiver operating characteristic(ROC)curve was plotted to analyze the predictive efficiencies of HBP and IL-17A in bronchoalveolar lavage fluid for the prognosis of elderly patients with severe pneumonia.Results The levels of HBP and IL-17A in bronchoalveolar lavage fluid in the death group were significantly higher than those in the survival group(P＜0.01).There were significant differ-ences in the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and blood lac-tate(Lac)level between the two groups(P＜0.01).Logistic regression analysis showed that HBP(OR=3.084,95％CI,1.326 to 4.694),IL-17A(OR=4.521,95％CI,2.164 to 7.841),APACHE Ⅱscore(OR=2.039,95％CI,1.069 to 2.859),and Lac(OR=2.627,95％CI,1.168 to 3.058)were influencing factors for the prognosis of elderly patients with severe pneumonia(P＜0.05).When the optimal cut-off values were set at 15.92 ng/mL for HBP and 109.34 pg/mL for IL-17A,the area under the curve(AUC)for the combined prediction of prognosis by HBP and IL-17A in bronchoalveolar lavage fluid was 0.852,with a 95％CI of 0.801 to 0.948.The AUC for the com-bined prediction of prognosis by HBP and IL-17A in bronchoalveolar lavage fluid was significantly higher than that for single tests(Z=2.906,2.416,P=0.007,0.014).Conclusion Increased levels of HBP and IL-17A in bronchoalveolar lavage fluid,decreased APACHE Ⅱ score,and in-creased Lac are influencing factors for the prognosis of elderly patients with severe pneumonia.Com-bined detection of HBP and IL-17A in bronchoalveolar lavage fluid has high sensitivity in predicting the prognosis of elderly patients with severe pneumonia.