ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

Diabetic kidney disease （DKD）， a prevalent microvascular complication of diabetes mellitus， is characterized by intricate pathophysiological mechanisms and persistent clinical management challenges. Historically， glomerular injury has been regarded as the central pathological hallmark of DKD， with research predominantly focusing on hyperfiltration， glomerular basement membrane thickening， and podocyte dysfunction. Emerging evidence， however， underscores the renal tubule-not merely as a passive bystander but as an early initiator and pivotal driver-in DKD pathogenesis. Hyperglycemia， metabolic dysregulation， and chronic low-grade inflammation induce tubular epithelial cell injury at early disease stages. Such injury disrupts tubuloglomerular feedback， thereby elevating intraglomerular pressure and sustaining hyperfiltration. Concurrently， injured tubular cells secrete pro-inflammatory cytokines and profibrotic factors， promoting epithelia-mesenchymal transition， interstitial hypoxia， and progressive tubulointerstitial fibrosis that ultimately culminate in irreversible decline of renal function. This "tubule-first" paradigm represents a fundamental shift from the classical glomerulocentric model and redefines the conceptual framework of DKD progression. Traditional Chinese medicine（TCM）， with its inherent advantages of multi-component synergy， multi-target engagement， and systemic homeostatic regulation， has demonstrated compelling renoprotective effect， particularly in preserving tubular integrity and function， mitigating tubular cellular stress， and indirectly alleviating glomerular hemodynamic burden. Accumulating preclinical and clinical evidence supports the efficacy of numerous single herbs and standardized formulae of TCM in attenuating tubulointerstitial injury and slowing down DKD progression. This review systematically delineates the sequential pathogenic cascade-from initial tubular insult to secondary glomerular deterioration-and critically evaluates the mechanism basis and translational potential of TCM-based interventions targeting tubular resilience. We aim to provide a refined pathophysiological rationale and actionable insights for optimizing clinical strategies and accelerating the development of novel therapeutics for DKD.

Diabetic kidney disease （DKD）， a prevalent microvascular complication of diabetes mellitus， is characterized by intricate pathophysiological mechanisms and persistent clinical management challenges. Historically， glomerular injury has been regarded as the central pathological hallmark of DKD， with research predominantly focusing on hyperfiltration， glomerular basement membrane thickening， and podocyte dysfunction. Emerging evidence， however， underscores the renal tubule-not merely as a passive bystander but as an early initiator and pivotal driver-in DKD pathogenesis. Hyperglycemia， metabolic dysregulation， and chronic low-grade inflammation induce tubular epithelial cell injury at early disease stages. Such injury disrupts tubuloglomerular feedback， thereby elevating intraglomerular pressure and sustaining hyperfiltration. Concurrently， injured tubular cells secrete pro-inflammatory cytokines and profibrotic factors， promoting epithelia-mesenchymal transition， interstitial hypoxia， and progressive tubulointerstitial fibrosis that ultimately culminate in irreversible decline of renal function. This "tubule-first" paradigm represents a fundamental shift from the classical glomerulocentric model and redefines the conceptual framework of DKD progression. Traditional Chinese medicine（TCM）， with its inherent advantages of multi-component synergy， multi-target engagement， and systemic homeostatic regulation， has demonstrated compelling renoprotective effect， particularly in preserving tubular integrity and function， mitigating tubular cellular stress， and indirectly alleviating glomerular hemodynamic burden. Accumulating preclinical and clinical evidence supports the efficacy of numerous single herbs and standardized formulae of TCM in attenuating tubulointerstitial injury and slowing down DKD progression. This review systematically delineates the sequential pathogenic cascade-from initial tubular insult to secondary glomerular deterioration-and critically evaluates the mechanism basis and translational potential of TCM-based interventions targeting tubular resilience. We aim to provide a refined pathophysiological rationale and actionable insights for optimizing clinical strategies and accelerating the development of novel therapeutics for DKD.

Objective To investigate the thalamus and thalamic subnucleus volume changes in patients with trigeminal neuralgia(TN)and to preliminarily investigate whether there is a pain processing lateralization advantage in the thalamus.Methods The three-dimensional T1WI images of 56 TN patients and 56 matched healthy controls(HC)were collected,and thalamus and thalamic subnucleus volumes were extracted by automated segmentation via a region of interest(ROI)-based morphological analysis method.Results There was no significant difference in the whole thalamus volume between TN and HC groups.Compared with HC,the bilateral ventral lateral(VL)of the thalamus were significantly smaller in patients with right-sided trigeminal neuralgia(RTN),and no significant thalamic subnucleus volume changes were found in patients with left-sided trigeminal neuralgia(LTN).After mirror-flipping the whole-brain images of the LTN,it was found that the volume of ipsilateral thalamic VL of TN group was significantly reduced than that of HC group.The volume of ipsilateral mediodorsal lateral parvocellular(MD1)of TN group was significantly smaller than that of HC group.There was no significant difference in the volume of ipsilateral and contralateral thalamic subnucleus.Conclusion The thalamic subnucleus are exclusively reduced in volume in patients with TN,and there is no significant change in whole thalamus volume,suggesting no lateralization advantage for pain processing.

Objective:To synthesize hydroxyapatite/poly (lactic-co-glycolic acid)(HA/PLGA) composites by substituting calcium ions in HA with Cu and Gd ions, characterize their physicochemical properties, and evaluate their feasibility for orbital bone defect repair.Methods:Different ratios of Cu-, Gd-, and Cu/Gd-substituted HA nanoparticles (Cu@HA, Gd@HA and Cu/Gd@HA) were synthesized via hydrothermal synthesis using copper nitrate, gadolinium nitrate, calcium chloride, and ammonium hydrogen phosphate.HA/PLGA, Cu@HA/PLGA, Gd@HA/PLGA, and Cu/Gd@HA/PLGA composites were prepared.HA/PLGA was prepared by co-preparing different ratios of nanoparticles with PLGA via phase inversion and solvent evaporation.The nanoparticles and composites were characterized using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), inductively coupled plasma (ICP), environmental scanning electron microscope (ESEM) and micro-computed tomography (Micro-CT). Composite homogeneity was assessed by elemental analysis and the contact angle was measured to evaluate hydrophilicity.Imaging capability of composites was assessed by magnetic resonance imaging (MRI) and T1-weighted.CCK-8 method was used to detect the cytotoxicity of nanoparticles and their extract.Orbital bone defects model was established in 20 rats, which were randomly divided into 4 groups, and implanted with respective composites.Eight weeks after transplantation, the implants were evaluated using Micro-CT and MRI, and osteogenesis, collagen distribution and biocompatibility were assessed by hematoxylin-eosin staining, Masson, and Sirius red staining.All animal experiments complied with the regulations of the Laboratory Animal Ethics Committee of Dalian Medical University and were approved (No.AEE23104).Results:XRD and ESEM results showed that co-doping with Cu/Gd induced less HA lattice distortion than single doping.FT-IR results showed that the nanoparticles doped with Cu and Gd ions were consistent with the HA infrared absorption spectrum.ICP results revealed a higher Ca content in 0.5Cu/Gd@HA and 0.5Cu@HA samples than in 0.5Gd@HA sample.There was a statistically significant overall difference in contact angles among different groups of composites ( F=5.040, P<0.05), among which the 0.5Cu/Gd@HA/PLGA composite exhibited the smallest contact angle and the best hydrophilicity.There was no statistically significant difference in porosity among different groups of composites ( F=0.004, P>0.05). MRI results showed that Gd-doped composites displayed enhanced development and that the signal intensity of the 0.5Gd@HA/PLGA group was the highest.Micro-CT scanning results showed that the composition of the composite material doped with Cu and Gd was better than that of the pure HA/PLGA group, indicating that the metal ions Cu and Gd could promote bone growth.CCK-8 results showed that the nanoparticles and their extracts had no obvious cytotoxic effects.Eight weeks after modelling, Micro-CT showed that the 0.5Cu/Gd@HA/PLGA material degraded well in vivo and the staining results of bone tissue sections in the bone defect area suggested that tissues around the implanted material and rat organs in different groups did not show biological toxicity.In addition, the Gd-doped composites showed good magnetic imaging characteristics when implanted in animals. Conclusions:Cu/Gd@HA/PLGA composites exhibit favorable physicochemical properties, biosafety, osteogenic potential, and MRI contrast and have good clinical application prospects for orbital bone repair.

Traditional scientific research management suffers from problems such as scattered archives,lack of effective dynamic process supervision for projects,weak data analysis capabilities,and low sharing,making it difficult to meet the unified management of multiple hospital areas in medical groups and the independent management of each branch.The group has devel-oped an intelligent scientific research management system based on artificial big data by constructing the framework and designing the content of various demand modules for scientific research management.This system achieves full coverage management of sci-entific research activities,designing interrelated information data networks for scientific research project process management,a-chievement management,academic(specialized)construction management,postdoctoral management,etc.,realizing informa-tionization and refined management of multiple campuses within the group.Analyze the technological values of each hospital,de-partment,and personnel to provide powerful reference for decision-makers.The information-based scientific research manage-ment system is an important guarantee for hospital groups to intelligently manage and efficiently carry out scientific research work.

Objective:To investigate the current status of fertility concerns among early-stage endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) patients with fertility preservation, and analyze its influencing factors.Methods:Convenience sampling was used to select early-stage EC and AEH patients with fertility preservation at Peking University People's Hospital from January to December 2021 as study subjects. The study subjects were surveyed using the General Information Questionnaire, Chinese version of the Reproductive Concerns after Cancer Scale (RCAC), and Social Support Rating Scale (SSRS). Pearson correlation was employed to examine the relationship between fertility concerns and social support in early-stage EC and AEH patients with fertility preservation. Single-factor analysis and multiple linear regression analysis were used to examine the factors influencing fertility concerns in early-stage EC and AEH patients with fertility preservation.Results:A total of 170 questionnaires were distributed, and 167 valid questionnaires were collected, with a valid response rate of 98.24% (167/170). The RCAC and SSRS scores of 167 early-stage EC and AEH patients with fertility preservation were (56.58±10.58) and (34.22±8.21), respectively. Educational level, disease type and staging, marital status, and social support were statistically significant factors influencing fertility concerns among early-stage EC and AEH patients undergoing fertility preservation ( P<0.05), explaining 32.80% of the total variance. Conclusions:Early-stage EC and AEH patients with fertility preservation exhibit high levels of fertility concerns. Clinical practice should develop individualized psychological intervention programs for patients with high education level, unmarried status, high pathological grading, and lack of social support to improve their physical and mental health.

Objective:To investigate and analyze the thyroid examination results and influencing factors of interventional radiation workers in Tianjin.Methods:In February 2023, A convenient sampling method was used to select the staff engaged in interventional radiation work in an occupational health inspection institution in Tianjin from 2020 to 2022 as the study object. After excluding the incomplete data, 1080 people were included, and 363 medical staff with non-radiological work during the same period were included as the control group. To analyze the individual doses and occupational health examination data of interventional radiation workers, and to analyze the possible influencing factors of thyroid abnormalities.Results:The cumulative dose M ( Q1, Q3) of interventional radiation workers was 1.039 (0.528, 1.905) mSv. The levels of FT 3 and FT 4 in the intervention group were higher than those in the control group, while TSH levels were lower than those in the control group ( Z=4.84、6.03、-5.82, P<0.05). The levels of FT 3 and FT 4 in female interventional radiation workers were lower than those in males, while the levels of TSH were higher than those in males ( Z= -17.54、-6.65、3.61, P<0.05). There were statistically significant differences in FT 3 levels among different ages, differen tradiation exposure years, different initial age of exposure to radiation, and different cumulative doses ( H=47.22、11.33、16.70, Z=-2.48, P<0.05). There were statistically significant differences in thyroid ultrasound abnormalities among different genders, different ages, different initial age of exposure to radiation, and different cumulative doses ( χ2=28.02、61.12、17.87、11.30, P<0.05). The results of logistic regression analysis showed that the influencing factors of FT 3 distributed in the low-level group were female ( OR=10.53, 95% CI: 7.66-14.47, P<0.05), and age 40-49, ≥50 years old ( OR=2.40, 95% CI: 1.12-5.14 OR=3.79, 95% CI: 1.59-9.03, P<0.05). The influencing factors of thyroid ultrasound abnormalities were female ( OR=1.92, 95% CI: 1.48-2.50, P<0.05) and age ≥50 years old ( OR=3.93, 95% CI: 1.91-8.09, P<0.05) . Conclusion:Long term low dose ionizing radiation has a certain effect on FT 3, FT 4 and TSH levels of interventional radiation workers. Gender and increased age are possible influencing factors of the decreased FT 3 levels and thyroid ultrasound abnormalities.

Objective:To synthesize hydroxyapatite/poly (lactic-co-glycolic acid)(HA/PLGA) composites by substituting calcium ions in HA with Cu and Gd ions, characterize their physicochemical properties, and evaluate their feasibility for orbital bone defect repair.Methods:Different ratios of Cu-, Gd-, and Cu/Gd-substituted HA nanoparticles (Cu@HA, Gd@HA and Cu/Gd@HA) were synthesized via hydrothermal synthesis using copper nitrate, gadolinium nitrate, calcium chloride, and ammonium hydrogen phosphate.HA/PLGA, Cu@HA/PLGA, Gd@HA/PLGA, and Cu/Gd@HA/PLGA composites were prepared.HA/PLGA was prepared by co-preparing different ratios of nanoparticles with PLGA via phase inversion and solvent evaporation.The nanoparticles and composites were characterized using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), inductively coupled plasma (ICP), environmental scanning electron microscope (ESEM) and micro-computed tomography (Micro-CT). Composite homogeneity was assessed by elemental analysis and the contact angle was measured to evaluate hydrophilicity.Imaging capability of composites was assessed by magnetic resonance imaging (MRI) and T1-weighted.CCK-8 method was used to detect the cytotoxicity of nanoparticles and their extract.Orbital bone defects model was established in 20 rats, which were randomly divided into 4 groups, and implanted with respective composites.Eight weeks after transplantation, the implants were evaluated using Micro-CT and MRI, and osteogenesis, collagen distribution and biocompatibility were assessed by hematoxylin-eosin staining, Masson, and Sirius red staining.All animal experiments complied with the regulations of the Laboratory Animal Ethics Committee of Dalian Medical University and were approved (No.AEE23104).Results:XRD and ESEM results showed that co-doping with Cu/Gd induced less HA lattice distortion than single doping.FT-IR results showed that the nanoparticles doped with Cu and Gd ions were consistent with the HA infrared absorption spectrum.ICP results revealed a higher Ca content in 0.5Cu/Gd@HA and 0.5Cu@HA samples than in 0.5Gd@HA sample.There was a statistically significant overall difference in contact angles among different groups of composites ( F=5.040, P<0.05), among which the 0.5Cu/Gd@HA/PLGA composite exhibited the smallest contact angle and the best hydrophilicity.There was no statistically significant difference in porosity among different groups of composites ( F=0.004, P>0.05). MRI results showed that Gd-doped composites displayed enhanced development and that the signal intensity of the 0.5Gd@HA/PLGA group was the highest.Micro-CT scanning results showed that the composition of the composite material doped with Cu and Gd was better than that of the pure HA/PLGA group, indicating that the metal ions Cu and Gd could promote bone growth.CCK-8 results showed that the nanoparticles and their extracts had no obvious cytotoxic effects.Eight weeks after modelling, Micro-CT showed that the 0.5Cu/Gd@HA/PLGA material degraded well in vivo and the staining results of bone tissue sections in the bone defect area suggested that tissues around the implanted material and rat organs in different groups did not show biological toxicity.In addition, the Gd-doped composites showed good magnetic imaging characteristics when implanted in animals. Conclusions:Cu/Gd@HA/PLGA composites exhibit favorable physicochemical properties, biosafety, osteogenic potential, and MRI contrast and have good clinical application prospects for orbital bone repair.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.