ObjectiveTo evaluate the immediate effectiveness and safety of four intranasal acupuncture methods based on different intranasal localizations of Neiyingxiang （EX-HN 9） for improving nasal ventilation in patients with allergic rhinitis （AR）. MethodsA total of 120 patients with AR were randomly divided into four groups with 30 cases in each group， the agger nasi group， the inferior turbinate-alar junction group， the inferior turbinate top group， and the nasal septum group. All patients received one 20-minute session of intranasal acupuncture. The agger nasi group received acupuncture at the agger nasi site， the inferior turbinate-alar junction group at the junction of the inferior turbinate and alar cartilage， the inferior turbinate top group at the top of the inferior turbinate directly facing the nostril， and the nasal septum group at Little's area of the nasal septum. Before acupuncture and within 5 min after treatment， the assessments and measurements were performed including nasal obstruction symptom evaluation （NOSE） scale used to evaluate the severity of nasal obstruction before and after acupuncture， a nasal resistance/nasal flow analyzer applied to detect nasal airway resistance （NAR） and nasal respiration volume （NS）， the visual analogue scale （VAS） adopted to assess pain intensity. The incidence of nasal bleeding and other adverse events were recorded， and patients' willingness to receive repeat treatment was statistically analyzed. ResultsCompared with baseline within group， all four groups showed decreased NOSE scores and NAR as well as elevated NS after treatment （all P＜0.05）. Compared with the agger nasi group and the inferior turbinate-alar junction group， the inferior turbinate top group had higher NOSE scores and lower NS； the nasal septum group presented higher NOSE scores and NAR alongside lower NS （P＜0.05）. The nasal septum group yielded significantly higher VAS scores than the other three groups （P＜0.05）， with 11 cases （36.67%） of massive nasal bleeding observed， while no severe nasal hemorrhage occurred in the remaining groups. The proportions of patients willing to receive repeated intranasal acupuncture treatment were 70.00% （21/30） in the agger nasi group， 76.67% （23/30） in the inferior turbinate-alar junction group， 43.33% （13/30） in the inferior turbinate top group， and 3.33% （1/30） in the nasal septum group， respectively， with statistical significant difference among groups （χ² = 39.91， P＜0.001）. ConclusionAll four intranasal acupuncture methods can immediately improve nasal ventilation in patients with AR. The agger nasi group and inferior turbinate-alar cartilage junction group achieved superior therapeutic improvement compared with the inferior turbinate top group and nasal septum group， accompanied by better safety and higher patient acceptability.

ObjectiveTo evaluate the immediate effectiveness and safety of four intranasal acupuncture methods based on different intranasal localizations of Neiyingxiang （EX-HN 9） for improving nasal ventilation in patients with allergic rhinitis （AR）. MethodsA total of 120 patients with AR were randomly divided into four groups with 30 cases in each group， the agger nasi group， the inferior turbinate-alar junction group， the inferior turbinate top group， and the nasal septum group. All patients received one 20-minute session of intranasal acupuncture. The agger nasi group received acupuncture at the agger nasi site， the inferior turbinate-alar junction group at the junction of the inferior turbinate and alar cartilage， the inferior turbinate top group at the top of the inferior turbinate directly facing the nostril， and the nasal septum group at Little's area of the nasal septum. Before acupuncture and within 5 min after treatment， the assessments and measurements were performed including nasal obstruction symptom evaluation （NOSE） scale used to evaluate the severity of nasal obstruction before and after acupuncture， a nasal resistance/nasal flow analyzer applied to detect nasal airway resistance （NAR） and nasal respiration volume （NS）， the visual analogue scale （VAS） adopted to assess pain intensity. The incidence of nasal bleeding and other adverse events were recorded， and patients' willingness to receive repeat treatment was statistically analyzed. ResultsCompared with baseline within group， all four groups showed decreased NOSE scores and NAR as well as elevated NS after treatment （all P＜0.05）. Compared with the agger nasi group and the inferior turbinate-alar junction group， the inferior turbinate top group had higher NOSE scores and lower NS； the nasal septum group presented higher NOSE scores and NAR alongside lower NS （P＜0.05）. The nasal septum group yielded significantly higher VAS scores than the other three groups （P＜0.05）， with 11 cases （36.67%） of massive nasal bleeding observed， while no severe nasal hemorrhage occurred in the remaining groups. The proportions of patients willing to receive repeated intranasal acupuncture treatment were 70.00% （21/30） in the agger nasi group， 76.67% （23/30） in the inferior turbinate-alar junction group， 43.33% （13/30） in the inferior turbinate top group， and 3.33% （1/30） in the nasal septum group， respectively， with statistical significant difference among groups （χ² = 39.91， P＜0.001）. ConclusionAll four intranasal acupuncture methods can immediately improve nasal ventilation in patients with AR. The agger nasi group and inferior turbinate-alar cartilage junction group achieved superior therapeutic improvement compared with the inferior turbinate top group and nasal septum group， accompanied by better safety and higher patient acceptability.

Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

Given the escalating number of cancer patients and the consequent rise in demand for radiation therapy in China, there is an urgent need to establish and improve a talent cultivation system for radiation dosimetrists. The United States, with an early-established cultivation system for radiation dosimetrists, boasts relatively mature and comprehensive systems of academic education and qualification certification. This study summarized and analyzed the educational and certification patterns for radiation dosimetrists in the United States based on public data from relevant institutions, related literature, and interviews with American radiation dosimetrists. Meanwhile, this study delved into and assessed the shortcomings in China′s radiation dosimetry education, examination, certification, and career advancement pathways. Furthermore, this study offered suggestions and recommendations for constructing a novel pattern tailored to the cultivation of radiation dosimetrists in China, in order to facilitate the high-quality development of the medical dosimetry discipline.

ObjectiveTo investigate the possible mechanism of Shenfuhuang Formula （参附黄配方） in prevention and treatment of epsis-associated encephalopathy from the perspective of brain genomics. MethodsC57BL/6 mice were randomly divided into sham surgery group， sepsis group， and Shenfuhuang group， with 20 mice in each group. The sepsis group and Shenfuhuang group were induced to develop sepsis by cecal ligation and puncture （CLP） procedure. At 4 hours after modelling， Shenfuhuang group were gavaged with 2.5 g/（kg·d） of Shenfuhuang Formula， 0.5 ml each time， at 12 hours intervals， for a total of 4 times after modelling. Sepsis group and sham surgery group were given 0.5 ml of purified water orally. At 48 hours after modeling， the transcriptome sequencing was used to explore the differential gene expression in the effects of Shenfuhuang Formula on the brain regions of septic mice， and real-time PCR and ELISA were later used to further validate the differential gene and proteins expression. ResultsA total of 4605 genes were differentially expressed in Shenfuhuang group compared with sepsis group， of which 2353 genes were up-regulated and 2252 genes were down-regulated. According to the results of previous publications， six key genes were screened， including serine/threonine-protein kinase （Nek1）， myelin-associated glycoprotein （Mag）， endothelial cell-specific tyrosine kinase receptor （Tek）， a disintegrin and metalloproteinase with thrombospondin motifs 20 （Adamts20）， lymphocyte antigen 86 （Ly86）， and E3 ubiquitin-protein ligase （Traip）. Further genetic and protein validation revealed that， compared to the sham surgery group， the mRNA levels and corresponding protein levels of Nek1， Mag， Tek， Adamts20， Ly86， and Traip in the brain tissue of septic mice significantly reduced （P＜0.05）. In comparison to the sepsis group， Shenfuhuang group showed significantly increased mRNA levels and corresponding protein levels of Nek1， Mag， Tek， Adamts20， Ly86， and Traip （P＜0.05）. ConclusionThe potential therapeutic targets of Shenfuhuang Formula for treating sepsis-associated encephalopathy may be related to the Nek1， Mag， Tek， Adamts20， Ly86， and Traip genes and their encoded proteins.

Endometriosis is a common estrogen-dependent disease in women of childbearing age,often leading to chronic pelvic pain,infertility,ovarian cancer,and other serious complications,and jeopardizing the health of women.The pathogenesis of endometriosis is complex and involves the alteration of multiple signaling pathways mediated by hormones,immunity,genetics,and the environment,and their interactions.Wnt/β-catenin signaling is involved in the regulation of embryonic development and tissue homeostasis,and it has recently been implicated in the pathogenesis of endometriosis via multiple pathways.This review considers the biological characteristics of the Wnt/β-catenin signaling pathway and summarizes the main mechanisms and signaling pathways involved in the pathogenesis of endometriosis,as well as the curr-ent research status of the regulation of this signaling pathway by traditional Chinese medicine for the treatment of endometriosis.We aim to clarify how the Wnt/β-catenin signaling pathway affects the development of endometriosis,and suggest that future studies should focus on exploring its potential role as an indicator for the clinical prediction and early diagnosis of endometriosis,thus providing theoretical support for the early diagnosis of this condition and the development of targeted drugs.

Objective:This multicenter retrospective study aimed to analyze the clinicopathological features of duodenal adenocarcinoma (DA) and identify prognostic factors for postoperative survival.Methods:Demographic characteristics, clinicopathological features, treatment outcomes and survival of DA patients undergoing surgical treatment at 18 Chinese medical centers from January 2012 to December 2023 were retrospectively analyzed.Results:Among the 2 056 DA patients included, 46.8% (963) had extra-ampullary DA (EA-DA), and 53.2% (1 093) had peri-ampullary DA (PA-DA). The 1-, 3-, and 5-year overall survival (OS) rates for patients who underwent radical surgery were 93.2%, 71.0%, and 57.2%, respectively. The median overall survival was 76 months, and the median progression-free survival (PFS) was 65 months. No differences in survival were observed between the laparotomy group and minimally invasive surgery (MIS) group either before or after propensity score matching (OS: 76 vs. 75 months before PSM, P=0.986; OS: 75 vs. 75 months after PSM, P=0.602). Furthermore, there were no significant differences between-group in operation time and postoperative complications ( P＞0.05). The MIS group experienced less intraoperative blood loss and shorter hospital stays. The multivariate Cox regression analysis revealed that advanced age ( HR=1.43,95% CI:1.18-1.73), elevated carbohydrate antigen 19-9 levels ( HR=1.24,95% CI:1.02-1.51), perineural invasion ( HR=1.44,95% CI:1.14-1.81), vascular invasion ( HR=1.35,95% CI:1.07-1.71), advanced T stage (T3-4 vs. T1-2: HR=1.86,95% CI:1.49-2.31), regional lymph node metastasis ( HR=1.93,95% CI:1.58-2.36), preoperative biliary drainage ( HR=1.26,95% CI:1.04-1.53), intraoperative blood loss ( HR=1.34,95% CI:1.11-1.62), clinically significant postoperative pancreatic fistulas ( HR=1.53,95% CI:1.12-2.09), and postoperative hemorrhage ( HR=1.62,95% CI:1.14-2.29) were independent risk factors for poor prognosis after surgery (all P＜0.05). Conclusions:Radical surgery is associated with favorable overall survival among DA patients, and no difference in survival is observed between EA-DA and PA-DA patients. MIS is a reliable alternative for DA treatment.

To investigate the in vitro inhibitory mechanism of Nymphaea candida total flavonoids(NCTF)against Staphylococcus aureus(S.aureus)and its safety in mice,this study first deter-mined the antibacterial effect of NCTF on the clinically isolated strain S.aureus-C1.Subsequently,the inhibitory mechanism of NCTF on S.aureus-C1 was explored by measuring its effects on bac-terial growth curves,microstructure,intracellular AKP and LDH levels,and biofilm formation.Safety evaluation included determination of LD50 and MDT in mice,as well as analysis of serum biochemical parameters,organ indices,and histopathological observations.Results showed that NCTF effectively inhibited S.aureus-C1 proliferation,with an inhibition zone diameter of(18.98±0.67)mm and a MIC of 6.25 g/L.A concentration of 2×MIC nearly completely suppressed bacte-rial growth.Scanning electron microscopy revealed structural damage to bacterial cells,including collapse and shrinkage.AKP and LDH assays indicated significantly increased AKP activity(P＜0.05)and decreased intracellular LDH activity(P＜0.05)in the supernatant of drug-treated groups,demonstrating NCTF-induced disruption of cell walls and membranes leading to leakage of AKP and LDH.Crystal violet staining of biofilms showed significant inhibition rates of(43.77±9.16)％and(61.71±9.82)％at 2 × MIC and 4 × MIC concentrations,respectively(P＜0.05).Safe-ty assessments indicated low toxicity of NCTF in mice,with transient effects that returned to nor-mal levels within a short period.These findings demonstrate that NCTF exhibits potent antibacte-rial activity against S.aureus-C1 by damaging bacterial cell structures,increasing cell wall/mem-brane permeability,reducing biofilm formation,and displaying low toxicity.This study provides scientific evidence for clinical drug screening against bovine mastitis and the development of Nym-phaea candida resources.

Objective To explore the clinical efficacy,safety and changes in sexual function of 450 nm blue laser vaporization resection of the prostate in the treatment of benign prostatic hyperplasia(BPH).Methods The clinical data of 132 BPH patients treated in Yingsheng Branch of Taian Central Hospital during Jan.and Oct.2023 were retrospectively analyzed.The perioperative related indicators,incidence of complications were recorded.The international prostate symptoms(IPSS)score,maximum urine flow rate(Qmax),post voiding residual(PVR),quality of life score(QoL),prostate-specific antigen(PSA)level,the Chinese index of premature ejaculation score(CIPE)and international erectile function index-5(IIEF-5)score before operation,and 1,3,6,and 12 months after operation were analyze.Results The operation time was(18.37±5.38)min,intraoperative blood loss(6.73±2.57)mL,postoperative hospital stay(4.31±1.54)d,catheter indwelling time(2.45±1.27)d,and bladder irrigation time(19.61±2.45)h.There were significant differences in Qmax,PVR,PSA level,QoL and IPSS before and after operation(P＜0.05).There was no statistically significant difference in IIEF-5 and CIPE before operation and 3,6 and 12 months after operation(P＞0.05).The retrograde ejaculation rate remained 6.25％3,6 and 12 months after operation.Conclusion The 450 nm blue laser vaporization resection of the prostate can relieve lower urinary tract symptoms,preserve the sexual function,and improve patients'quality of life.

Objective To investigate the effect of gender on prognosis after transcatheter patent foramen ovale(PFO)closure in patients with cerebral infarction or transient ischemic attack.Methods A retrospective cohort study was conducted involving patients with cerebral infarction or transient ischemic attack(TIA)who underwent PFO closure at our hospital between January 2013 and December 2023.The patients were grouped by gender,and related data were collected,including age,comorbidities,Risk of Paradoxical Embolism(RoPE)score,laboratory results,findings of transthoracic/transesophageal echocardiography(TTE/TEE),and post-procedural complications,such as device-related thrombosis(DRT),recurrent stroke,bleeding,and atrial fibrillation(AF).Results A total of 112 patients were enrolled,including 59 males and 53 females,at a mean age of 42.47±12.35 years.The females had significantly higher preoperative RoPE score than the males(6.6±1.4 vs 6.0±1.5,P=0.046),and a statistical difference was observed in the distribution of infarction sites between them(Chi-square=10.25,P=0.006),indicating that the males were prone to posterior circulation infarction.Intraoperative transthoracic echocardiography revealed a greater distance from the PFO to the aortic root in the females(9.3±2.4 mm vs 7.6±2.0 mm,P<0.001).During a median follow-up of 4 years,the male group had 1 case of myocardial infarction,1 cerebral hemorrhage,1 paroxysmal AF,2 gingival bleeding episodes,and 1 skin ecchymosis.In the female group,1 case experienced pulmonary embolism,1 paroxysmal atrial fibrillation,3 gingival bleeding episodes,2 skin ecchymoses,2 recurrent cerebral infarctions,and 2 recurrent TIAs.There was no statistical difference in overall adverse events between gender(P=0.291).Although the females had higher rates of recurrent cerebral infarction and TIA,this difference lacked statistical significance(P=0.222).Multivariate Cox regression analysis indicated that after adjusting for various potential confounding factors,such as RoPE score,age,hypertension,coronary heart disease,and other factors,gender was not an independent predictor of composite endpoint events after surgery.Conclusion Gender does not significantly affect overall prognosis after PFO closure in patients with cerebral infarction or TIA.However,females showed a trend toward higher rates of recurrent cerebral infarction and TIA.