As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

Background Pneumoconiosis remains a critical occupational disease in China. As a major industrial province, Hebei historically faced severe challenges regarding this condition. The 1986 national epidemiological survey ranked Hebei sixth in reported pneumoconiosis cases nationwide. Objective To analyze 76 years of pneumoconiosis data (1949–2024) in Hebei Province to provide evidence-based support for prevention and control strategies. Methods Occupational pneumoconiosis cases diagnosed in Hebei from 1949 to 2024 were included. Five-year intervals were used to analyze incidence composition, dust exposure duration, age at first diagnosis, and age at death. A hybrid model, integrating autoregressive integrated moving average (ARIMA) with generalized regression neural network (GRNN), was employed to predict case numbers for the 2025−2030 period. Results A total of 36107 cases of pneumoconiosis were recorded (2.10% female) in Hebei from 1949 to 2024. Stages I, II, and III accounted for 77.35%, 16.45%, and 6.20%, respectively. Silicosis (55.60%), coal workers’ pneumoconiosis (27.24%), and pottery workers’ pneumoconiosis (8.88%) were the predominant types. Observed trends included a shortened dust exposure duration [silicosis: (12.78±7.063) years in 2020–2024] and an increasing age at first diagnosis [(54.01±7.499) years in 2020–2024]. The case-fatality rate was 14.84%, with a rising age at death [(82.26±9.632) years in 2015–2019]. Three incidence peaks (1963, 1984, and 2014) correlated with national policies and industrialization phases. The number of pneumoconiosis cases showed a decreasing trend from 2015 to 2024. Chengde and Tangshan were identified as current high-risk areas. The ARIMA-GRNN model projected annual cases between 416 and 429 during 2025–2030. Conclusion In the past decade，the number of pneumoconiosis cases in Hebei Province had shown a decreasing trend, it is projected to plateau with no significant decline over the next five years. Furthermore, challenges such as the proportion of silicosis remaining high and shortened dust exposure duration remain severe. It is recommended to focus on key regions like Chengde (ore mining) and Tangshan (ceramics industry). A comprehensive strategy integrating stricter regulation, technological controls, model innovation, and targeted interventions should be implemented to achieve a further substantial reduction in pneumoconiosis incidence.

Background Pneumoconiosis remains a critical occupational disease in China. As a major industrial province, Hebei historically faced severe challenges regarding this condition. The 1986 national epidemiological survey ranked Hebei sixth in reported pneumoconiosis cases nationwide. Objective To analyze 76 years of pneumoconiosis data (1949–2024) in Hebei Province to provide evidence-based support for prevention and control strategies. Methods Occupational pneumoconiosis cases diagnosed in Hebei from 1949 to 2024 were included. Five-year intervals were used to analyze incidence composition, dust exposure duration, age at first diagnosis, and age at death. A hybrid model, integrating autoregressive integrated moving average (ARIMA) with generalized regression neural network (GRNN), was employed to predict case numbers for the 2025−2030 period. Results A total of 36107 cases of pneumoconiosis were recorded (2.10% female) in Hebei from 1949 to 2024. Stages I, II, and III accounted for 77.35%, 16.45%, and 6.20%, respectively. Silicosis (55.60%), coal workers’ pneumoconiosis (27.24%), and pottery workers’ pneumoconiosis (8.88%) were the predominant types. Observed trends included a shortened dust exposure duration [silicosis: (12.78±7.063) years in 2020–2024] and an increasing age at first diagnosis [(54.01±7.499) years in 2020–2024]. The case-fatality rate was 14.84%, with a rising age at death [(82.26±9.632) years in 2015–2019]. Three incidence peaks (1963, 1984, and 2014) correlated with national policies and industrialization phases. The number of pneumoconiosis cases showed a decreasing trend from 2015 to 2024. Chengde and Tangshan were identified as current high-risk areas. The ARIMA-GRNN model projected annual cases between 416 and 429 during 2025–2030. Conclusion In the past decade，the number of pneumoconiosis cases in Hebei Province had shown a decreasing trend, it is projected to plateau with no significant decline over the next five years. Furthermore, challenges such as the proportion of silicosis remaining high and shortened dust exposure duration remain severe. It is recommended to focus on key regions like Chengde (ore mining) and Tangshan (ceramics industry). A comprehensive strategy integrating stricter regulation, technological controls, model innovation, and targeted interventions should be implemented to achieve a further substantial reduction in pneumoconiosis incidence.

OBJECTIVES: In recent years, the incidence and detection rate of pancreatic cystic lesions (PCLs) have increased significantly. Endoscopic ultrasound (EUS) plays an indispensable role in the diagnosis and differential diagnosis of PCLs. However, evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration (EUS-FNA) and fine-needle biopsy (FNB) remains limited. This study aims to compare the diagnostic yield, adequacy of tissue acquisition, and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice. METHODS: A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021. The diagnostic yield, tissue acquisition adequacy, and incidence of adverse events were compared between the 2 groups. RESULTS: A total of 90 patients with PCLs were included (52 in the FNA group and 38 in the FNB group). The diagnostic yield was similar between the FNA and FNB groups (94.2% vs 94.7%, P>0.05). The adequacy of tissue acquisition was 71.2% in the FNA group and 81.6% in the FNB group (P>0.05). No statistically significant difference was observed in the incidence of adverse events between the 2 groups (P>0.05). CONCLUSIONS Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs, with excellent safety profiles. Both methods are safe and effective diagnostic tools for evaluating PCLs.
Humans ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects* ; Retrospective Studies ; Female ; Male ; Pancreatic Cyst/diagnostic imaging* ; Middle Aged ; Biopsy, Fine-Needle/adverse effects* ; Aged ; Pancreatic Neoplasms/diagnosis* ; Adult ; Endosonography/methods* ; Pancreas/pathology* ; Diagnosis, Differential

Objective To investigate the situation of unconformity of positive and reverse ABO blood typ-ing between outpatient and inpatient patients in the hospital,and explore the reasons for unconformity of posi-tive and reverse ABO blood typing detected by microcolumn gel method.Methods A retrospective analysis was conducted on the medical records of totally 425 patients with ABO blood type mismatch who underwent ORTHO VISION Max testing in the hospital from August 2023 to December 2024.Comprehensive analysis was conducted using various methods including the saline tube method,irregular antibody screening,increas-ing plasma volume,4 ℃ enhancement test,absorption elution,and gene sequencing,etc.Results Among 128 192 cases of ABO blood type tests,425 cases showed unconformity of positive and reverse ABO blood typ-ing,accounting for 0.33％.The causes were as follows:antibody weakening in 316 cases(74.35％),bone mar-row transplantation in 40 cases(9.41％),interference from irregular antibodies in 34 cases(8.00％),antigen weakening in 13 cases(3.06％),subgroups in 10 cases(2.35％),cold agglutinins in 6 cases(1.41％),inter-ference from irregular and autoantibodies in 4 cases(0.94％),auto-sensitization of red blood cells in 1 case(0.24％),and other reasons in 1 case(0.24％).Among 316 cases with antibody weakening,239 cases(75.63％)involved type A(anti-B weakening),61 cases(19.30％)involved type B(anti-A weakening),8 ca-ses(2.53％)involved type O(anti-A weakening),6 cases(1.91％)involved type O(anti-B weakening),and 2 cases(0.63％)involved type O(both anti-A and anti-B weakening).In patients with antibody weakening,the disease distribution was mainly cardiovascular disease in 127 cases(40.19％),a history of tumors in 67 ca-ses(21.20％),kidney diseases in 11 cases(3.48％),and orthopedic diseases in 10 cases(3.16％).Conclusion The main reason for the unconformity of positive and reverse ABO blood typing in the hospital is the weakening of the antibodies,especially the predominance of type A(anti-B weakening).Weakened anti-bodies are predominantly in the distribution of cardiovascular disease.For subtype-induced disturbances,a comprehensive analysis combining serology and gene sequencing is recommended.For disease-induced uncon-formity of positive and reverse ABO blood typing,monitoring the patients should be strengthened.

OBJECTIVE: To compare the effectiveness and advantages of the double reverse traction reduction versus open reduction internal fixation for treating complex tibial plateau fractures. METHODS: A clinical data of 25 patients with Schatzker type Ⅴ or Ⅵ tibial plateau fractures, who met the selection criteria and were admitted between January 2019 and January 2023, was retrospectively analyzed. Thirteen patients underwent double reverse traction reduction and internal fixation (double reverse traction group), while 12 patients underwent open reduction and internal fixation (traditional open group). There was no significant difference in the baseline data (age, gender, injury mechanism, Schatzker classification, interval between injury and operation) between the two groups ( P>0.05). The effectiveness were evaluated and compared between the two groups, included operation time, intraoperative blood loss, incision length, hospital stay, full weight-bearing time, complications, fracture healing, Rasmussen radiological score (reduction quality), knee Hospital for Special Surgery (HSS) score, and knee flexion/extension range of motion. RESULTS: The double reverse traction group demonstrated significantly superior outcomes in operation time, intraoperative blood loss, hospital stay, incision length, and time to full weight-bearing ( P<0.05). Two patients in traditional open group developed incisional complications, while the double reverse traction group had no complication. There was no significant difference in the incidence of complication between the two groups ( P>0.05). All patients were followed up 24-36 months (mean, 30 months), with no significant difference in follow-up duration between groups ( P>0.05). Fractures healed in both groups with no significant difference in healing time ( P>0.05). At 6 months after operation, Rasmussen radiological scores and grading showed no significant difference between the two groups ( P>0.05); the double reverse traction group had significantly higher HSS scores compared to the traditional open group ( P<0.05). At 12 months after operation, knee flexion/extension range of motion were significantly greater in the double reverse traction group than in the traditional open group ( P<0.05). CONCLUSION Double reverse traction reduction offers advantages over traditional open reduction, including shorter operation time, reduced blood loss, minimized soft tissue trauma, and improved joint functional recovery. It is a safe and reliable method for complex tibial plateau fractures.
Humans ; Tibial Fractures/surgery* ; Fracture Fixation, Internal/methods* ; Male ; Female ; Traction/methods* ; Retrospective Studies ; Middle Aged ; Adult ; Open Fracture Reduction/methods* ; Treatment Outcome ; Range of Motion, Articular ; Fracture Healing ; Operative Time ; Length of Stay ; Blood Loss, Surgical ; Aged ; Tibial Plateau Fractures

Objective:To investigate the clinical characteristics of children with Chikungunya fever.Methods:This retrospective cohort study analyzed clinical data of 91 children with Chikungunya fever at the Department of Pediatrics, Foshan women and Children Hospital between July 2025 and August 2025. The patients were divided into four groups based on onset-age: 0-<1 year, 1-<3 years, 3-<6 years, and 6-14 years. One-way ANOVA and chi-square tests were used to compare the clinical features of children with Chikungunya fever at different ages.Results:Among the 91 children with chikungunya fever, 55 were male and 36 were female, with an onset age of 6 (2, 11) years, age groups comprised 0-<1 year (10 cases), 1-<3 years (13 cases), 3-<6 years (17 cases) and 6-14 years (51 cases). Fever occurred in 87 cases (96%), with 50 cases (57%) had high fever. Skin rash was observed in 89 cases (98%), and 60 cases (67%) had a generalized rash. Joint pain was reported in 57 cases (63%), among which 35 cases (61%) had pain in two or more locations, with the knee involved in 21 cases (37%), the ankle in 15 cases (26%), and the wrist in 6 cases (11%).The knee was the most commonly affected joint 21 cases (37%), followed by the ankle 15 cases (26%) and wrist 6 cases (10%). Joint ultrasound was performed in 31 cases (34%), all showed joint effusion, including 8 cases (26%) without complaints of joint pain. The incidence of high fever was significantly lower in the 3-<6 years and 6-14 years groups compared to the 0-<1 year group (both P<0.05). The 6-14 years group also had a lower incidence of high fever than the 1-<3 years group ( P<0.05). The 1-<3 years group had longer duration of fever than the 3-<6 years and 6-14 years groups (both P<0.05). The incidence of joint pain was higher in the 3-<6 years and 6-14 years groups compared to the 1-<3 years group (both P<0.05), and higher in the 6-14 years group than in the 3-<6 years group ( P=0.007). Among all 91 children, 22 cases (24%) had abnormal liver function, 49 cases (54%) showed elevated lactate dehydrogenase (LDH), and 2 cases (2%) had elevated creatine kinase. The proportions of elevated aspartate aminotransferase (AST) and LDH were higher in the 0-<1 year and 1-<3 years groups compared to the 3-<6 years and 6-14 years groups (all P<0.05). Conclusions:The clinical characteristics of children with Chikungunya fever vary among children of different ages. Children in the 0-<3 years are more prone to high fever with longer duration and generalized maculopapular rash, while the children in the 6-14 years have have a higher proportion of joint pain, and joint ultrasound revealed effusion in all examined children. AST and LDH levels are elevated in the 0-<3 years groups.

Adipose tissue is a critical energy reservoir in animals and humans, with multifaceted roles in endocrine regulation, immune response, and providing mechanical protection. Based on anatomical location and functional characteristics, adipose tissue can be categorized into distinct types, including white adipose tissue (WAT), brown adipose tissue (BAT), beige adipose tissue, and pink adipose tissue. Traditionally, adipose tissue research has centered on its morphological and functional properties as a whole. However, with the advent of single-cell transcriptomics, a new level of complexity in adipose tissue has been unveiled, showing that even under identical conditions, cells of the same type may exhibit significant variation in morphology, structure, function, and gene expression——phenomena collectively referred to as cellular heterogeneity. Single-cell transcriptomics, including techniques like single-cell RNA sequencing (scRNA-seq) and single-nucleus RNA sequencing (snRNA-seq), enables in-depth analysis of the diversity and heterogeneity of adipocytes at the single-cell level. This high-resolution approach has not only deepened our understanding of adipocyte functionality but also facilitated the discovery of previously unidentified cell types and gene expression patterns that may play key roles in adipose tissue function. This review delves into the latest advances in the application of single-cell transcriptomics in elucidating the heterogeneity and diversity within adipose tissue, highlighting how these findings have redefined the understanding of cell subpopulations within different adipose depots. Moreover, the review explores how single-cell transcriptomic technologies have enabled the study of cellular communication pathways and differentiation trajectories among adipose cell subgroups. By mapping these interactions and differentiation processes, researchers gain insights into how distinct cellular subpopulations coordinate within adipose tissues, which is crucial for maintaining tissue homeostasis and function. Understanding these mechanisms is essential, as dysregulation in adipose cell interactions and differentiation underlies a range of metabolic disorders, including obesity and diabetes mellitus type 2. Furthermore, single-cell transcriptomics holds promising implications for identifying therapeutic targets; by pinpointing specific cell types and gene pathways involved in adipose tissue dysfunction, these technologies pave the way for developing targeted interventions aimed at modulating specific adipose subpopulations. In summary, this review provides a comprehensive analysis of the role of single-cell transcriptomic technologies in uncovering the heterogeneity and functional diversity of adipose tissues.

Objective To evaluate the clinical utility of the f-wave to QRS complex amplitude ratio(f/R ratio)in intracardiac electrogram(IC-ECG)-guided positioning of peripherally inserted central catheter(PICC)tips in patients with atrial fibrillation(AF),providing evidence to enhance clinical practice.Methods This study employed a conve-nience sampling method to enroll eligible AF patients admitted to a tertiary hospital in Suzhou from July 2023 to July 2024.During PICC placement,IC-ECG was utilized to monitor f-wave and QRS complex amplitude variations.Following successful catheterization,the f/R ratio was measured,and chest X-ray was performed to confirm the catheter tip position.The accuracy of PICC tip positioning across different f/R ratio ranges was analyzed,and the incidence of arrhythmias was recorded.A receiver operating characteristic curve was constructed to assess the diag-nostic performance of the f/R ratio in PICC tip localization.Results A total of 68 AF patients were included,with f/R ratios ranging from 20.63％to 91.24％.PICC tip positioning accuracy varied significantly across different f/R ratio ranges(P=0.006).The area under the ROC curve(AUC)for f/R ratio in PICC tip positioning was 0.784(P=0.009),with a maximum Youden index of 0.567,an optimal diagnostic threshold of 40.00％,a sensitivity of 81.7％,a speci-ficity of 75.0％,a positive predictive value of 96.1％,and a negative predictive value of 35.3％.No arrhythmias other than AF occurred during the procedure.Conclusion The f/R ratio provides reliable and safe guidance for PICC tip positioning in AF patients.An f/R ratio ≥40％is associated with higher accuracy in identifying the optimal catheter tip position.

Objective:To evaluate the safety and efficacy of accelerator-based boron neutron capture therapy (AB-BNCT) in the treatment of recurrent and refractory malignant tumors.Methods:The data of 14 patients admitted to Xiamen Humanity Hospital from September 2022 to April 2023 were prospectively collected, including 7 patients with primary brain malignancies and 7 patients with locally recurrent inoperable head and neck malignancies. All patients received intravenous infusion of boron drug (NBB-001, p-dihydroxyborylphe nylalanine, a patented freeze-dried formulation) at a total nominal dosage of 500 mg/kg (11 patients) or 750 mg/kg (3 patients), and were irradiated with neutrons (operating with NeuPex system). Adverse events after treatment were recorded and assessed. The primary efficacy endpoint was the 90 d objective response rate (ORR), while the secondary endpoints included progression-free survival (PFS) and complete response rate (CRR). Data were compiled and analyzed by SAS 9.4 software. The rate and 95% CI were calculated using Clopper-Pearson method. Results:The median dose delivered to 80% of the target volume (D 80%) was 16.80 GyE (range: 8.93-23.79 GyE). The most common adverse reactions were hyperamylasemia, alopecia, and hyperprolactinemia. Five patients experienced 8 cases of grade 3 or above adverse events, including 1 case of grade 4 acute kidney injury and 7 cases of grade 3 adverse events. All adverse events were recovered after observation or treatment. At 90 d after treatment, the ORR of all patients was 9/14 (64%, 95% CI: 35%-87%), disease control rate (DCR) was 10/14 (71%, 95% CI: 42%-92%), CRR was 2/14 (14%, 95% CI: 2%-42%); and the best overall response during the entire course included an ORR of 10/14 (71% ,95% CI: 42%-92%), DCR of 13/14 (93%, 95% CI: 66%-100%), and CRR of 3/14 (21% ,95% CI: 5%-51%). The 1-year survival rate for head and neck malignancies was 71.4%, and the 2-year survival rate was 42.8%. The 1-year survival rate for recurrent brain malignancies was 42.8%. Conclusion:AB-BNCT demonstrates favorable safety and promising efficacy in treating primary brain malignancies and recurrent/refractory head and neck malignancies, representing a potential therapeutic option.