Objective To investigate the clinical efficacy of Shangke Huangshui medicated gauze in the treatment of small-area deep second-degree burn wounds with fire-heat injuring fluid type.Methods Sixty patients who were diagnosed as small-area deep second-degree burn wounds of fire-heat injuring fluid type in Foshan Hospital of Traditional Chinese Medicine from January 2024 to July 2024,were selected as the research objects.The patients were randomly divided into trial group and control group by random number table method,with 30 cases in each group.The trial group was treated with external application of Shangke Huangshui medicated gauze,and the control group was treated with external application of Silver Sulfadiazine Cream.The treatment lasted for 21 days,and then the patients were followed up for 7 days.The changes of Visual Analogue Scale(VAS)score of wound pain,and serum levels of C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the two groups were observed before and after treatment.The wound healing rate,wound healing time,bacterial infection of the wound,and adverse reactions were compared between the two groups.Results(1)During the treatment,there was no fell-off case in the trial group while there was one patient falling off from the control group.Eventually,a total of 59 patients were included in the statistical analysis,including 30 in the trial group and 29 in the control group.(2)On day 14 and 21 of treatment,the wound healing rates of the two groups were significantly higher than those on day 7 of treatment(P＜0.05),and wound healing rates in the trial group on the day 14 and 21 of treatment were significantly superior to those of the control group(P＜0.05).(3)The time for the complete healing of wound in the trial group was(22.07±2.30)days,which was significantly shorter than that of the control group[(27.07±4.10)days],and the difference was statistically significant(P＜0.05).(4)After 7,14 and 21 days of treatment,the VAS scores of wound pain in the two groups were lowered compared with those before treatment(P＜0.05),and the VAS scores in the trial group were significantly lower than those in the control group(P＜0.05).(5)On day 7 of treatment,the levels of serum CRP,IL-6 and TNF-α in the two groups were lowered compared with those before treatment(P＜0.05),and the levels in the trial group were significantly lower than those in the control group(P＜0.05).(6)On day 7 of treatment,the positive rate of bacterial culture for wound discharge in the trial group was 6.67%(2/30),which was significantly lower than 27.59%(8/29)in the control group,and the difference was statistically significant(P＜0.05).(7)There were no serious adverse events or adverse reactions occurring in the two groups during the trial.Conclusion Shangke Huangshui medicated gauze can accelerate the healing of burn wounds,shorten the wound healing time,reduce the wound infection rate and the level of serum inflammatory factors,and has fewer adverse reactions with high safety.

Objective To explore the effects of combined exposure to bisphenol A (BPA) and high-fat diet on liver lipid metabolism and hepatocyte senescence in mice, and to elucidate the potential mechanisms of the onset and development of non-alcoholic fatty liver disease (NAFLD). Methods Specific pathogen free C57BL/6J mice were randomly divided into six groups, with 10 mice with equal numbers of each sex in each group. The mice in the control group and the simple BPA group were fed with regular diet, while others four groups of mice were fed with high-fat diet. At the same time, the mice in the simple BPA group were intragastric administered with BPA at a dose of 50 μg/kg body weight, while the mice in the low-, medium- and high-dose BPA+high-fat groups were intragastric administered with BPA at doses of 5, 50 and 500 μg/kg body weight respectively. The mice in the control group and the high-fat group were intragastric administered with the same volume of corn oil once per day for 90 consecutive days. Liver tissues were subjected to hematoxylin-eosin (HE) and Oil Red O staining. Liver coefficients and lipid-stained area ratios were calculated. Serum level of total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, and the activities of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined using an automatic biochemical analyzer. The hepatic tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-10 levels were quantified by enzyme-linked immunosorbent assay. The relative expression of cholesterol regulatory element binding protein 1 (SREBP1), CCAAT enhancer binding protein α, P16, and phosphorylated histone H2AX (γ-H2AX) in liver tissues was detected using Western blotting. The interaction effect of the combined exposure to BPA and high-fat diet was observed based on the result of mice in the control group, the simple high-fat group, the simple BPA group, and the medium-dose BPA group+high-fat group (the combined exposure group) using a 2×2 factorial design. The results of mice in the simple high-fat group and the low-, medium-, and high-dose BPA+high-fat groups were used to observe the effect of BPA exposure dose under high-fat diet conditions. Results i) The interactive effect of combined exposure to BPA and high fat. The HE and Oil Red O staining results indicated that the combined exposure to BPA and high-fat diet successfully established NAFLD in mice. The interactive effect of combined exposure to BPA and high-fat diet on serum ALT activity and the relative expression of P16 in the liver tissue of female mice, as well as the serum ALT and AST activities and the relative expression of SREBP1 in the liver tissue of male mice was significant (all P<0.05). Specifically, the serum ALT activity of male mice in the combined exposure group was higher than that in the simple high-fat group (P<0.05), while the ALT activity in the serum of female mice in the combined exposure group was lower than that in the simple BPA group (P<0.05). The relative expression of SREBP1 protein in the liver tissue of male mice in the combined exposure group was higher than that in the control group, the simple high-fat group, and the simple BPA group (all P<0.05). For the other indicators, there were no significant differences in the interactive effect of combined exposure to BPA and high-fat diet (all P>0.05). ii) Dose effects of BPA exposure. The HE and Oil Red O staining result showed that the degree of vacuolar steatosis in the liver of female and male mice of medium- and high-dose BPA + high-fat groups was aggravated, and the range of inflammatory cell infiltration was expanded when compared with same-sex mice in the simple high-fat group. The serum ALT activity and the fat stained area ratio, as well as the relative expression of P16 in liver tissue of female mice in high-dose BPA + high-fat group increased (all P<0.05), while the level of IL-10 in liver tissue decreased (P<0.05), compared with the female mice in simple high-fat group. The serum ALT activity, the TNF-α level in liver tissue, and the relative expression of SREBP1, P16 and γ-H2AX proteins in liver tissue of male mice in high-dose BPA + high-fat group increased (all P<0.05), while the IL-6 level in liver tissue decreased (P<0.05), compared with the male mice in simple high-fat group. For the female or male mice in the low- and medium-dose BPA + high-fat groups, only some of the above indicators showed significant changes (all P<0.05). Conclusion The combined exposure to BPA and high-fat diet has a synergistic effect on the onset and development of NAFLD. The mechanism may be related to inducing cellular senescence and modulation of lipid synthesis pathways, thereby affecting liver steatosis. The exposure dose of BPA may affect the synergistic effect.

Objective To propose a novel method based on three-dimensional depthwise separable convolution network(3D DSN)for the separation of PET images with dual tracers of 18F-FDG and 18F-FAPI.Methods A total of 120 pairs of 18F-FDG and 18F-FAPI PET images of the same patient scanned separately at different time points were collected,and the dual-tracer PET image was generated through simulation.After the image registration of PET images of two tracers for ensuring spatial position matching,the registered PET images were forward-projected to generate sinogram data,and the sinogram data of two tracers were accumulated to obtain mixed sinogram data.Subsequently,the dual-tracer PET image was reconstructed using maximum likelihood expectation maximization and input into a 3D DSN based network for image separation,thereby obtaining PET images of two single tracers.Results Compared with 3D CNN method,the proposed method increased the structure similarity index measure(SSIM)of the separated 18F-FDG images to the real 18F-FDG images by 0.87%,increased the peak signal-to-noise ratio(PSNR)by 11.8%,and reduced the normalized root mean square error(NRMSE)by 52%.The SSIM of the separated 18F-FAPI images to the real 18F-FAPI images increased by 1.1%,PSNR increased by 17.0%,and NRMSE decreased by 51%.Conclusion The proposed method can be effectively applied to simultaneous PET imaging with dual PET tracers,reducing the number of scans and costs in time and money,and providing clinical doctors more accurate and abundant diagnostic information.

Objective To propose a novel method based on three-dimensional depthwise separable convolution network(3D DSN)for the separation of PET images with dual tracers of 18F-FDG and 18F-FAPI.Methods A total of 120 pairs of 18F-FDG and 18F-FAPI PET images of the same patient scanned separately at different time points were collected,and the dual-tracer PET image was generated through simulation.After the image registration of PET images of two tracers for ensuring spatial position matching,the registered PET images were forward-projected to generate sinogram data,and the sinogram data of two tracers were accumulated to obtain mixed sinogram data.Subsequently,the dual-tracer PET image was reconstructed using maximum likelihood expectation maximization and input into a 3D DSN based network for image separation,thereby obtaining PET images of two single tracers.Results Compared with 3D CNN method,the proposed method increased the structure similarity index measure(SSIM)of the separated 18F-FDG images to the real 18F-FDG images by 0.87%,increased the peak signal-to-noise ratio(PSNR)by 11.8%,and reduced the normalized root mean square error(NRMSE)by 52%.The SSIM of the separated 18F-FAPI images to the real 18F-FAPI images increased by 1.1%,PSNR increased by 17.0%,and NRMSE decreased by 51%.Conclusion The proposed method can be effectively applied to simultaneous PET imaging with dual PET tracers,reducing the number of scans and costs in time and money,and providing clinical doctors more accurate and abundant diagnostic information.

Objective The prediction of RR intervals in hypertensive patients can help clinicians to analyze and warn patients'heart condition.Methods Using 8 patients'data as samples,the RR intervals of patients were predicted by long short-term memory network(LSTM)and gradient lift tree(XGBoost),and the prediction results of the two models were combined by the inverse variance method to overcome the disadvantage of single model prediction.Results Compared with the single model,the proposed combined model had a different degree of improvement in the prediction of RR intervals in 8 patients.Conclusion LSTM-XGBoost model provides a method for predicting RR intervals in hypertensive patients,which has potential clinical feasibility.

Heart failure refers to a group of clinical syndromes caused by structural or functional abnormalities of the heart that lead to impaired ejection or filling of the ventricles. The traditional Chinese medicine （TCM） theory of cardiac and renal coordination holds that the kidney governs water and plays a key role in maintaining the balance of fluid metabolism. Therefore， the treatment of water retention in heart failure can start from the heart and kidney. The basic pathogenesis of heart failure is kidney deficiency， blood stasis， and water stagnation， and the therapies including dredging the heart and kidneys， warming yang and excreting water， tonifying kidneys and activating blood， and dredging meridians and collaterals. Aquaporins （AQPs）， the key molecular basis of water metabolism， are involved in the pathogenesis of water retention in heart failure together with the arginine vasopressin system （AVP）， renin-angiotensin-aldosterone system （RAAS）， and diuretic resistance. Studies have shown that herbal medicines that regulate the heart and kidney can alleviate water retention in heart failure by targeting AQPs， thereby delaying or even reversing the progression of heart failure. This paper expounds the TCM name and pathogenesis of heart failure from the theory of cardiac and renal coordination， the role of AQPs in the pathogenesis of water retention in heart failure， and the modern connotation of the therapy of tonifying heart and kidney for heart failure， aiming to provide ideas for the prevention and treatment of water retention in heart failure by TCM.

Traditional Chinese medicine (TCM) with a long history in China has demonstrated unique advantages in treating a variety of cardiovascular diseases, with promising prospects. We exemplify the TCM advantages with 3 major cardiovascular diseases: coronary heart disease, hypertension, and chronic heart failure. With both national and international guidelines, consensus, systematic reviews, and randomized controlled trials as evidence, we used the modified Jadad and AMSTAR-1 scales to evaluate the evidence quality and then systematically evaluated the clinical effects and benefits of TCM on cardiovascular diseases, aiming to provide fresh insights into the research methodologies and future development directions for TCM-dominant diseases.

Objective To observe the clinical efficacy of Shuxuening injection combined with compound coenzyme in the treatment of chronic allograft nephropathy (CAN). Methods A retrospective analysis of 108 patients with chronic allograft nephropathy (CAN) admitted to our hospital from June 2014 to May 2018 were divided into two groups according to different treatments. The 43 cases in the experimental group were given Shuxuening injection combined with compound coenzyme, and the 65 cases in control group were given non-Shu Xuening + compound coenzyme. The original immunization protocol was maintained in both groups. After 4 weeks of treatment, the changes of hemodynamic parameters, clinical efficacy, biochemical parameters, coagulation function and adverse reactions were observed before and after treatment. Results There was no significant difference in baseline data between the two groups before treatment (P> 0.05). After treatment, the peak systolic velocity of the intersegmental artery and cortical arteriole in the experimental group were significantly higher than that the control group (P < 0.05) , and the resistance index was lower than that in the control group (P < 0.05). After treatment, serum creatinine, 24 h urine protein quantitation, urinary microalbumin, total cholesterol and triglycerides were lower than that before treatment (P < 0.05) , and estimated glomerular filtration rate (eGFR) and serum. Albumin increased significantly (P < 0.05) , but the 24 h urine protein quantitation and urinary albumin decreased significantly in the experimental group compared with the control group (P < 0.05). After treatment, the total amount of cholesterol, triglycerides showed no significant difference (P> 0.05). After treatment, the platelet count, fibrinogen and D-dimer of the experimental group were significantly lower than those before treatment (P < 0.05) , and the activated partial thrombin time (APT) was significantly higher than that before treatment (P < 0.05). Significant difference in platelet count, fibrinogen, D-dimer and APTT was found after treatment (P < 0.05). After 4 weeks of treatment, the values of urea nitrogen and serum creatinine were significantly lower than those of the control group (P < 0.05). The recovery of transplanted kidney function in the experimental group was higher than that in the control group (P < 0.05). The experimental group reported 2 cases of fatigue complain and 1 case of dizziness, but no special treatment was given to them and their condition improved after symptomatic treatment; 1 case of mild phlebitis which was cured after given slowed drip rate and local hot compress therapy. The incidence of adverse events was 9.3％ (4/43). The control group reported 2 cases of fatigue complain, 1 case of nausea, 1 case of facial flushing, and all cured with no special treatment was given; 1 case of mild phlebitis, and cured after slowed the i.v. drip rate and ocal hot compress; The adverse events rate was 7.7％ (5/65). No serious adverse reactions occurred during the entire clinical trial. There was no significant difference in the incidence of adverse events between the experimental group and the control group (χ2=0.054, P=0.732). Conclusion Combined with Shuxuening injection and compound coenzyme can improve blood flow of transplanted kidney, reduce proteinuria, reduce blood urea nitrogen and creatinine in patients with CAN after renal transplantation and effectively improve patient's hemodynamic parameters and safety.

Circulating tumor DNA (ctDNA) detection is one of "liquid biopsy"analysis. It has shown promising clinical application in cancer precise medicine due to its noninvasive sampling and real-time observation. Nowadays, ctDNA analysis has been clinically validated and successfully applied in advanced cancer, including selecting personalized treatment, monitoring treatment responses, minimal residual disease and recurrence. Although there has been rapidly increasing interests in ctDNA, its clinical application in cancer precise medicine is still facing few challenges, especially in screening and diagnosing cancer at early stages. Here, the latest progress in the applications and challenges of ctDNA in advancedstage tumor therapy were reviewed to provide references for future studies on ctDNA.

Objective To examine the operation efficiency of hospital clinical departments and explore ways to improve inefficient units from an input-output perspective.Methods We used the data envelopment analysis(DEA) to analyze the panel data in 2013-2017 from 30 clinical departments of a hospital,applying the CCR model and the BCC model.Results The overall operation efficiency of the hospital was as high as 26.32％ of its clinical departments showed the increasing returns to scale.The scale efficiency was found to be high when the bed size in clinical departments ranged from 1 to 20,from 41 to 80,or from 91 to 100.There was an irrationality in fixed assets and staff deployment.Conclusions Size and input of clinical departments should be carefully planned to increase resource utilization efficiency.