In December 2025， American Gastroenterological Association released the expert review of clinical practice update on the management of ascites， volume overload， and hyponatremia in cirrhosis. The expert review proposes 13 best practice recommendations based on available evidence. This article gives an excerpt of the main recommendations from the expert review.

Objective To explore the current situation,hot spots and trends of clinical research on the treatment of carotid atherosclerosis(CAS)with traditional Chinese medicine.Methods Search CNKI,Wanfang,VIP,Web of Science core collection database related literature,using Python 3.9.6 cleaning data,using CiteSpace and VOSviewer for visual analysis of authors,institutions,keywords,etc.Results 910 Chinese literatures and 5 English literatures were included.The most published authors were Wang Changyin and Yin Chunping,and the institution was Handan Hospital of Traditional Chinese Medicine,Hebei Province.The cooperation between institutions was independent and regional.Research focus on:phlegm stasis interjunction,dyslipidemia,inflammatory factors,vascular endothelial function,nerve function defect,Banxia Baizhu Tianma decoction,coronary heart disease and so on;The treatment of CAS from"interjunction of phlegm and blood stasis"will continue to become a research hotspot in this field.Conclusion The clinical research of traditional Chinese medicine in the treatment of CAS should be closely combined with the observation of curative effect and the revelation of mechanism,and the law of traditional Chinese medicine in the treatment of CAS should be explored.In the future,the treatment of CAS should focus on the treatment of"phlegm and blood stasis",and the pathogenesis principle of"phlegm and blood stasis",the efficacy and mechanism of resolving phlegm and removing blood stasis in the treatment of CAS should be systematically and deeply explored.

Objective To investigate the oral health status of second-grade primary school students in Suzhou,provide baseline data for evaluating Suzhou's"Bright Eyes and Healthy Teeth"public health project,and offer reference for formulating oral health policies for students in Suzhou.Methods A multi-stage,stratified,random sampling method was used to select 1 640 second-grade primary school students from 10 districts(county-level cities)across Suzhou.The oral health survey of primary school students in Suzhou was designedbased on WHO"Basic Methods for Oral Health Surveys"(5th edition).A survey on the students' oral health status was con-ducted.Results The caries prevalence,mean DMFT(Decayed,Missing,Filled Teeth),and caries filling rate for primary teeth among second-grade students in Suzhou were 80.73％,4.25,and 24.48％,respectively.For permanent teeth,the caries prevalence,mean DMFT(Decayed,Missing,Filled Teeth),and caries filling rate were 30.30％,0.62,and 16.96％,respectively.Specifically,the caries prevalence,mean DMFT,and filling rate for the first permanent molar were 29.88％,0.59,and 16.94％,respectively.The pit and fissure sealing rate for the first permanent molar was 13.74％.Additionally,the detection rate for gingival bleeding was 58.05％,and for dental calculus,49.15％.Conclusion The oral health status of second-grade primary school students in Suzhou is concerning.The caries prevalence rate for both primary and permanent teeth is high,while the filling rate is relatively low.Prior to the implementation of oral health programs,the pit and fissure sealing rate for the first permanent molars was low,with significant differ-ences observed between urban and rural areas,as well as among different districts(or county-level cities).

Cardiovascular nursing research focuses on solving practical nursing problems, and nursing practice is continuously improved based on nursing research. This article provides an overview of the development of cardiovascular nursing research, summarizes and generalizes the current research status and future research hotspots in cardiovascular nursing according to the Fuwai Subject Headings, aiming to provide references for nursing staff.

Objective To investigate the oral health status of second-grade primary school students in Suzhou,provide baseline data for evaluating Suzhou's"Bright Eyes and Healthy Teeth"public health project,and offer reference for formulating oral health policies for students in Suzhou.Methods A multi-stage,stratified,random sampling method was used to select 1 640 second-grade primary school students from 10 districts(county-level cities)across Suzhou.The oral health survey of primary school students in Suzhou was designedbased on WHO"Basic Methods for Oral Health Surveys"(5th edition).A survey on the students' oral health status was con-ducted.Results The caries prevalence,mean DMFT(Decayed,Missing,Filled Teeth),and caries filling rate for primary teeth among second-grade students in Suzhou were 80.73％,4.25,and 24.48％,respectively.For permanent teeth,the caries prevalence,mean DMFT(Decayed,Missing,Filled Teeth),and caries filling rate were 30.30％,0.62,and 16.96％,respectively.Specifically,the caries prevalence,mean DMFT,and filling rate for the first permanent molar were 29.88％,0.59,and 16.94％,respectively.The pit and fissure sealing rate for the first permanent molar was 13.74％.Additionally,the detection rate for gingival bleeding was 58.05％,and for dental calculus,49.15％.Conclusion The oral health status of second-grade primary school students in Suzhou is concerning.The caries prevalence rate for both primary and permanent teeth is high,while the filling rate is relatively low.Prior to the implementation of oral health programs,the pit and fissure sealing rate for the first permanent molars was low,with significant differ-ences observed between urban and rural areas,as well as among different districts(or county-level cities).

ObjectiveThis study aims to develop a prediction model for the compatibility of Chinese medicinal pairs based on Graph Convolutional Networks （GCN）， named HC-GCN. The model integrates the properties of herbs with modern pharmacological mechanisms to predict pairs with specific therapeutic effects. It serves as a demonstration by applying the model to predict and validate the efficacy of blood-activating herb pairs. MethodsThe training dataset for herb pair prediction was constructed by systematically collecting commonly used herb pairs along with their characteristic data， including Qi， flavor， meridian tropism， and target genes. Integrating traditional characteristics of herb with modern bioinformatics， we developed an efficacy-oriented herb pair compatibility prediction model （HC-GCN） using graph convolutional networks （GCN）. This model leverages machine learning to capture the complex relationships in herb pair compatibility， weighted by efficacy features. The performance of the HC-GCN model was evaluated using accuracy （ACC）， recall， precision， F1 score （F1）， and area under the ROC curve （AUC）. Its predictive effectiveness was then compared to five other machine learning models： eXtreme Gradient Boosting （XGBoost）， logistic regression （LR）， Naive Bayes， K-nearest neighbor （KNN）， and support vector machine （SVM）. ResultsUsing herb pairs with blood-activating effects as a demonstration， a prediction model was constructed based on a foundational dataset of 46 blood-activating herb pairs， incorporating their Qi， flavor， meridian tropism， and target gene characteristics. The HC-GCN model outperforms other commonly used machine learning models in key performance metrics， including ACC， recall， precision， F1 score， and AUC. Through the predictive analysis of the HC-GCN model， 60 herb pairs with blood-activating effects were successfully identified. Among of these potential herb pairs， 44 include at least one herb with blood-activating effects. ConclusionIn this study， we established an efficacy-oriented compatibility prediction model for herb pairs based on GCN by integrating the unique characteristics of traditional herbs with modern pharmacological mechanisms. This model demonstrated high predictive performance， offering a novel approach for the intelligent screening and optimization of traditional Chinese medicine prescriptions， as well as their clinical applications.

Objective:To evaluate the feasibility of using the domestic ArcherQA system for fast and simplified independent verification of CyberKnife (CK) stereotactic radiotherapy (SRT) plans.Methods:SRT plans of 57 patients treated with CK at Tianjin Medical University Cancer Institute and Hospital from August 2021 to August 2022 were retrospectively analyzed, including 15 intracranial, 30 pulmonary, and 12 abdominal tumors cases. Point-dose and planar-dose verifications were performed using an ionization chamber and radiochromic films embedded in a homogeneous phantom, and the results were compared with those calculated by the treatment planning system (TPS). The localization CT images and corresponding SRT plans were imported into the ArcherQA system for independent dose verification and analysis. The correlation between ArcherQA results and phantom measurements was analyzed, with comparisons of target mean dose differences and γ pass rates.Results:Phantom measurement results showed, the measured point-dose differences for intracranial, lung, and abdominal plans were -0.94% ± 3.22%, 1.92% ± 2.05%, and 2.12% ± 0.77%, respectively. The mean dose differences in target dose calculation between ArcherQA and TPS: intracranial in the gross tumor volume (GTV) regions were 0.34% ± 2.21%, lung tumor GTV were -2.47% ± 2.46%, and abdominal tumor GTV were 0.80% ± 2.61%, respectively. Among them, the abdominal GTV region showed the highest correlation between ArcherQA and measured results ( r=0.78). The average two-dimensional γ pass rates (2 mm/2%, threshold=10%) measured using phantom films were 95.92% ± 2.35% for intracranial, 95.70% ± 2.74% for lung, and 96.74% ± 3.41% for abdominal tumors plans, respectively. The three-dimensional ArcherQA results showed comparable γ pass rates (1 mm/2%, threshold=10%) for lung and abdominal GTV and PTV regions, with similar medians and data dispersion to film measurements. Conclusions:The ArcherQA system enables rapid and efficient independent dose verification of CK SRT plans without the need for additional hardware. The verification results show good correlation with phantom measurements, supporting its potential as an auxiliary quality assurance tool in clinical CK SRT implementation.

Objective:To analyze the clinical characteristics and gene mutations of 4 patients with the male phenotype of 17α-hydroxylase /17, 20-lyase deficiency(17-OHD), in order to improve the recognition and appropriate management of atypical cases.Methods:A retrospective analysis was performed on the clinical features, biochemical findings, and gene mutations of 4 patients with the male phenotype of 17-OHD treated in our hospital between 2018 and 2023.Results:The social gender of all 4 patients with 17-OHD was male. None of the 4 patients had hypertension or hypokalemia, but all had micropenis and gynecomastia. Two patients had adrenal hyperplasia, while adrenal morphology was normal in the other two. One patient had decreased bone mass. There were typical changes in the steroid synthesis-related hormone spectrum: progesterone was significantly elevated in all 4 patients, 17-hydroxyprogesterone was not markedly abnormal, cortisol, dehydroepiandrosterone sulfate(DHEAS) and estradiol levels were low, and testosterone levels were also low.Conclusion:17-OHD is a rare type of congenital adrenal hyperplasia, with the male phenotype being even rarer. Early symptoms are often atypical, resulting in high rates of misdiagnosis and missed diagnosis. Patients without hypertension and hypokalemia are particularly prone to diagnostic confusion. Male patients with unexplained progesterone elevation, poor secondary sexual development, and gynecomastia should undergo timely steroid hormone profiling and genetic testing to avoid misdiagnosis and missed diagnosis.

Objective To explore the current situation,hot spots and trends of clinical research on the treatment of carotid atherosclerosis(CAS)with traditional Chinese medicine.Methods Search CNKI,Wanfang,VIP,Web of Science core collection database related literature,using Python 3.9.6 cleaning data,using CiteSpace and VOSviewer for visual analysis of authors,institutions,keywords,etc.Results 910 Chinese literatures and 5 English literatures were included.The most published authors were Wang Changyin and Yin Chunping,and the institution was Handan Hospital of Traditional Chinese Medicine,Hebei Province.The cooperation between institutions was independent and regional.Research focus on:phlegm stasis interjunction,dyslipidemia,inflammatory factors,vascular endothelial function,nerve function defect,Banxia Baizhu Tianma decoction,coronary heart disease and so on;The treatment of CAS from"interjunction of phlegm and blood stasis"will continue to become a research hotspot in this field.Conclusion The clinical research of traditional Chinese medicine in the treatment of CAS should be closely combined with the observation of curative effect and the revelation of mechanism,and the law of traditional Chinese medicine in the treatment of CAS should be explored.In the future,the treatment of CAS should focus on the treatment of"phlegm and blood stasis",and the pathogenesis principle of"phlegm and blood stasis",the efficacy and mechanism of resolving phlegm and removing blood stasis in the treatment of CAS should be systematically and deeply explored.

Objective To evaluate the effects of Yiqi Huayu Jiedu Decoction combined with chemotherapy on disease-free survival rate and disease-free survival(DFS)of patients with stage Ⅱ and Ⅲ postoperative gastric cancer.Methods Totally 102 patients with stage Ⅱ and Ⅲ postoperative gastric cancer treated by Affiliated Hospital of Nanjing University of Chinese Medicine and Nanjing Drum Tower Hospital were selected.The patients were divided into control group(52 cases)and test group(50 cases)with block random method.The control group received conventional postoperative adjuvant chemotherapy for 4-6 cycles.The test group was treated with Chinese materia medica for 6 months on the basis of chemotherapy.Continue follow-up until the patients had recurrence,metastasis or death.DFS was analyzed by Kaplan-Meier method,and the average DFS of the two groups was estimated.Log Rank test was used to test the significance of differences in survival distribution between groups.Univariate and multivariate analyses of variables affecting prognosis were conducted using the Cox regression model.Adverse reactions of both groups were monitored.Results The recurrence and metastasis rate of the test group was 12.0%(6/50),while that of the control group was 34.6%(18/52),which was lower in the test group than in the control group(P<0.05).The 1-year and 2-year DFS rates and DFS of the control group were 86.5%,72.2%and 25.8 months respectively,while those of the test group were 95.6%,84.1%and 33.9 months respectively,with statistical significance(P=0.012).Cox-regression analysis suggested:The independent factors influencing the disease-free survival time of patients with gastric cancer were the test group(P=0.022),surgical methods of subtotal gastrectomy(P=0.038)and clinical stages Ⅱ(P=0.040).No adverse reactions related to Chinese materia medica were reported in the two groups.Conclusion Yiqi Huayu Jiedu Decoction combined with chemotherapy can improve the 1-year and 2-year DFS rate,prolong DFS,reduce the recurrence and metastasis rate,and improve the prognosis.