Objective To investigate the influencing factors associated with early neurological deterioration(END)in patients with minor acute ischemic stroke(mAIS),develop a clinical prediction model for END,and identify independent risk factors for 90-day neurological functional outcomes after stroke.Methods mAIS patients admitted consecutively to the Department of Neurology,Yijishan Hospital of Wannan Medical College(the First Affiliated Hospital of Wannan Medical College),from July 2023 to July 2024 were retrospectively collected.A minor ischemic stroke was defined as acute ischemic stroke with a National Institutes of Health stroke scale(NIHSS)score≤5 on admission.Baseline,clinical,and imaging data of all mAIS patients were collected and recorded,including demographic information(age,sex),past medical history(hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease,atrial fibrillation),smoking history,alcohol consumption,baseline blood pressure,pre-onset modified Rankin scale(mRS),NIHSS scores at admission and during hospitalization(24 hours,48 hours,72 hours after admission),motor component subscore of the NIHSS scores,NIHSS scores at discharge,trial of Org 10172 in acute stroke treatment(TOAST)classification,laboratory indicators(fasting blood glucose,hemoglobin A1c[HbA1c],total cholesterol,triglycerides,high-density lipoprotein,low-density lipoprotein),clinical treatment information(intravenous thrombolysis,mono antiplatelet therapy,dual antiplatelet therapy,anticoagulation therapy)and length of stay.The status of stenosis and occlusion in the culprit vessel were assessed based on imaging results.Mild-to-moderate stenosis was defined as a stenosis rate of 0％to 69％,severe stenosis as a stenosis rate of 70％to 99％,and occlusion as complete interruption of the supplying artery.END was defined as an increase in NIHSS score of ≥2 points from baseline within 72 hours after admission,combined with an increase of at least 1 point in the motor score compared to the score at admission.Prognosis was assessed via telephone follow-ups at 90-day after onset using mRS score,with an mRS score ≤ 2 indicating a favorable outcome and an mRS score＞2 indicating a poor outcome.Variables with P＜0.05 in the univariate analysis were incorporated into multivariate Logistic regression analysis to identify the independent risk factors for END in mAIS patients.A nomogram model was constructed,and calibration curves along with decision curve analysis were plotted to evaluate the model's goodness-of-fit and clinical utility.Univariate and multivariate Logistic regression analyses were performed to identify factors associated with poor 90-day functional outcome after mAIS.Results(1)A total of 826 patients were included,aged 33-94 years,with a median age of 67(57,76)years.There were 571 males and 255 females.The NIHSS score at admission ranged from 0 to 5,with a median NIHSS score at admission of 3(2,4).The NIHSS motor subscore at admission ranged from 0 to 5,with a median baseline NIHSS motor score of 2(0,2).Among them,119 patients(14.4％)were in the END group and 707 patients(85.6％)were included in the non-END group.At 90days after stroke,744 patients(90.1％)had a favorable outcome,while 82 patients(9.9％)had a poor outcome.(2)Univariate analysis showed that there were statistically significant differences between the END group and the non-END group in terms of HbA1c,fasting blood glucose,baseline NIHSS score,baseline NIHSS motor subscore,history of alcohol consumption,diabetes mellitus,culprit vessel stenosis and occlusion,and TOAST classification(all P＜0.05).Statistically significant differences were observed between the favorable outcome group and the poor outcome group in HbA1c,fasting blood glucose,incidence of END,baseline NIHSS score,discharge NIHSS score,culprit vessel stenosis and occlusion,TOAST classification,and history of alcohol consumption(all P＜0.05).(3)Multivariate Logistic regression analysis indicated that mAIS patients with severe stenosis of the culprit vessel(OR,5.88,95％CI2.32-14.91,P＜0.01),occlusion of the culprit vessel(OR,5.74,95％CI 2.25-14.62,P＜0.01),history of alcohol consumption(OR,5.59,95％CI3.41-9.17,P＜0.01),elevated HbA1c(OR,1.67,95％CI 1.35-2.08,P＜0.01),and higher baseline NIHSS motor score(OR,1.43,95％CI 1.08-1.89,P=0.012)had an increased risk of END.A higher discharge NIHSS score(OR,2.59,95％CI 1.89-3.57,P＜0.01)and the occurrence of END(OR,18.42,95％CI 5.13-66.18,P＜0.01)were associated with poor 90-day functional outcome after mAIS.(4)The nomogram model constructed based on independent risk factors of END in mAIS patients demonstrated an AUC of 0.78(95％CI 0.73-0.83)for predicting END,with a sensitivity of 0.8 and a specificity of 0.7.The model showed good calibration,and the Hosmer-Lemeshow test indicated good agreement between predicted and observed values(P=0.333).Decision curve analysis revealed that the model provided a high net benefit across a range of high-risk thresholds(0.1-0.7),suggesting its potential clinical utility.Conclusions Severe stenosis of the culprit vessel,occlusion of the culprit vessel,glycated hemoglobin levels,baseline NIHSS motor subscale scores,and history of alcohol consumption are independent risk factors for END in patients with mAIS.The nomogram model constructed based on these factors demonstrated good predictive performance.END and NIHSS scores at discharge are independent predictors of poor 90-day outcomes in patients with mAIS.

Objective To explore the value of contrast agent injection protocol based on individualized iodine delivery rate(IDR)applicated in enhanced spectral CT scanning of colorectal cancer.Methods Totally 131 colorectal cancer patients were prospectively collected and randomly divided into conventional group(group A,n=64,contrast agents were injected with routine method)and individualized group(group B,n=67,contrast agents were injected with individualized IDR method).Whole abdominal energy spectrum CT scanning was performed,and 70 keV images at arterial and venous phases(A70 keV)of group A and 40-70 keV images(interval 10 keV)at arterial and venous phases(B40-70 keV)of group B were reconstructed,and iodine-based material maps were reconstructed.Subjective and objective evaluation on quality of enhanced images were performed,lesions'normalized iodine concentration(NIC)were calculated,and the above indexes were compared between groups.Results Iodine intake in group B was lower than that in group A(P＜0.001).The subjective scores of B60 keV images at both arterial and venous phases were the highest,which were not different from those of A70 keV images(both P＞0.05).CT values,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of superior mesenteric artery(SMA)and abdominal aorta on arterial B40-60 keV images were higher than those in arterial A70 keV images(all P＜0.05).CT values,SNR and CNR of superior mesenteric vein(SMV)on venous B40-50 keV,as well as CT values and CNR of SMV on venous B60 keV images were all higher than those on venous A70 keV images(all P＜0.05).No significant difference of lesions'NIC in arterial and venous phases was detected between groups(both P＞0.05).Conclusion Injection of contrast agents based on IDR combined with 60 keV single energy image for enhanced energy spectrum CT scanning of colorectal cancer could reduce the amount of contrast agents while do not affect imaging quality.

Objective To investigate the effects of Bushen Zhuanggu decoction on total N-terminal propeptide of type Ⅰprocollagen(t-PINP)and β-C-terminal telopeptide of type Ⅰ collagen(β-CTX)in patients with knee osteoarthritis(KOA).Methods A total of 120 patients with liver-kidney deficiency KOA treated in Linping District Hospital of Traditional Chinese Medicine from June 2021 to April 2024 were selected and divided into study group and control group according to random number table method,with 60 cases in each group.The patients of control group was given oral treatment with etocoxib and omeprazole,and patients of study group was given oral treatment of Bushen Zhuanggu decoction on the basis of control group.Both groups were treated for one month.The clinical efficacy,TCM syndrome scores,serum t-PINP and β-CTX leves,t-PINP/β-CTX,Western Ontario and Mcmaster Universities osteoarthritis index(WOMAC)scores and adverse reactions during treatment were compared between two groups.Results The total effective rate in study group was significantly higher than that in control group(x2=4.5 13,P=0.034).After treatment,the TCM syndrome scores,serum t-PINP and β-CTX levels and WOMAC scores in two groups were significantly lower than before treatment,and t-PINP/β-CTX were significantly higher than before treatment(P＜0.05).The TCM syndrome scores,serum t-PINP and β-CTX levels and WOMAC scores in study group were significantly lower than those in control group,and t-PINP/β-CTX was significantly higher than that in control group(P＜0.05).There was no significant difference in incidence of adverse reactions between two groups(x2=0.686,P=0.408).Conclusion Bushen Zhuanggu decoction can improve the clinical efficacy of KOA patients with liver-kidney deficiency,relieve clinical symptoms and pain,increase t-PINP/β-CTX,and reduce the incidence of adverse reactions.

Objective To explore the application value of Auto-prescription combined with low-dose contrast and adaptive statisti-cal iterative reconstruction-Veo(ASIR-V)algorithm in the computed tomography angiography(CTA)of thoracodorsal artery(TDA).Methods A total of 100 patients who underwent TDA CTA examination were prospectively selected.A tube voltage of 120 kVp and contrast agent of 1.5 mL/kg were used for group A(50 cases),and images were reconstructed with 40％ post-set ASIR-V.The Auto-prescription for tube voltage and contrast agent of 1.2 mL/kg were used for group B(50 cases),while images were reconstruc-ted with 40％,60％,and 80％ post-set ASIR-V,labeled as subgroups B1 to B3.The objective and subjective evaluation results of the images were compared between and within groups.Results Group A had an effective dose(ED)of 2.98(2.65,4.03)mSv,while group B had an ED of 1.92(1.44,3.33)mSv.The iodine intake in group B was lower than that in group A,and the CT value of the axillary artery in group B was significantly higher than that in group A(P＜0.001).With the increased of ASIR-V level in group B,the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the images gradually increased(P＜0.05).In terms of subjec-tive scores on axial images,both subgroups B2 and B3 were superior to group A(P＜0.001);with the increased of ASIR-V level in group B,subjective scores of axial images increased first and then decreased,among which subjective score of subgroup B2 was the highest and the differences were statistically significant(P＜0.001).In terms of subjective scores on three-dimensional image quality,subgroups B1 to B3 were superior to group A(P＜0.001).Conclusion The use of Auto-prescription combined with low-dose con-trast and 60％ ASIR-V can significantly optimize the display of TDA,and reduce the radiation dose and contrast agent dose to a certain extent.

The orthobunyavirus is a major group of mosquito-borne viruses，mainly prevalent in the Americas，Europe，and Africa. It can cause severe human diseases（e.g.，encephalitis，hemorrhagic fever）and livestock abortions. Reverse genetics，as a powerful tool for viral genome research，has been widely applied to study viral gene functions，develop vaccines，and screen antiviral drugs. This review systematically presents the evolutionary history and applications of the reverse genetics system for orthobunyaviruses，providing critical insights into studies on the infection and transmission mechanisms of these viruses，as well as the development of novel vaccines and therapeutic agents.

The orthobunyavirus is a major group of mosquito-borne viruses，mainly prevalent in the Americas，Europe，and Africa. It can cause severe human diseases（e.g.，encephalitis，hemorrhagic fever）and livestock abortions. Reverse genetics，as a powerful tool for viral genome research，has been widely applied to study viral gene functions，develop vaccines，and screen antiviral drugs. This review systematically presents the evolutionary history and applications of the reverse genetics system for orthobunyaviruses，providing critical insights into studies on the infection and transmission mechanisms of these viruses，as well as the development of novel vaccines and therapeutic agents.

Chronic prostatitis,a common condition in andrology,is clinically characterized by a prolonged course,resistance to treatment,and frequent recurrence.In traditional Chinese medicine,it is classified under the categories of"turbid sperm,""overstrain strangury,"and"vaginal pain."Based on the"host-guest interaction-collateral disease"theory,we believe that healthy qi deficiency,latent pathogenic factors,and collateral obstruction are the primary pathological factors of this disease,which run through the entire process of chronic prostatitis occurrence and development.Accordingly,we propose that obstruction of collaterals and apathesia of the semen chamber are the core pathogenesis.The disease progression can be divided into three pathological stages:"deficiency,depression,and blood stasis."Spleen and kidney deficiency and malnutrition of collaterals form the pathological foundation.In the deficiency stage,treatment strategies involve reinforcing qi and nourishing the collaterals,using Fuzheng Yangrong Decoction.During disease progression,dampness and heat invasion,as well as collateral stagnation qi,are key contributors to disease progression.Thus,treatment focuses on clearing heat and dampness,promoting qi flow,and smoothing the collaterals,achieved with a modified Qiantongding Decoction.In the final stage,blood stasis and collateral obstruction dominate,warranting therapeutic strategies aimed at tonifying and removing blood stasis,addressing both the body and the collaterals simultaneously using the modified Guiling Huayu Decoction.Overall,the clinical treatment generally focuses on the concept of function through free flow,combination of unblocking and tonifying.This study provides a novel perspective and reference for clinical differentiation and treatment of chronic prostatitis.

Objective To explore the value of contrast agent injection protocol based on individualized iodine delivery rate(IDR)applicated in enhanced spectral CT scanning of colorectal cancer.Methods Totally 131 colorectal cancer patients were prospectively collected and randomly divided into conventional group(group A,n=64,contrast agents were injected with routine method)and individualized group(group B,n=67,contrast agents were injected with individualized IDR method).Whole abdominal energy spectrum CT scanning was performed,and 70 keV images at arterial and venous phases(A70 keV)of group A and 40-70 keV images(interval 10 keV)at arterial and venous phases(B40-70 keV)of group B were reconstructed,and iodine-based material maps were reconstructed.Subjective and objective evaluation on quality of enhanced images were performed,lesions'normalized iodine concentration(NIC)were calculated,and the above indexes were compared between groups.Results Iodine intake in group B was lower than that in group A(P＜0.001).The subjective scores of B60 keV images at both arterial and venous phases were the highest,which were not different from those of A70 keV images(both P＞0.05).CT values,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of superior mesenteric artery(SMA)and abdominal aorta on arterial B40-60 keV images were higher than those in arterial A70 keV images(all P＜0.05).CT values,SNR and CNR of superior mesenteric vein(SMV)on venous B40-50 keV,as well as CT values and CNR of SMV on venous B60 keV images were all higher than those on venous A70 keV images(all P＜0.05).No significant difference of lesions'NIC in arterial and venous phases was detected between groups(both P＞0.05).Conclusion Injection of contrast agents based on IDR combined with 60 keV single energy image for enhanced energy spectrum CT scanning of colorectal cancer could reduce the amount of contrast agents while do not affect imaging quality.

Bone marrow suppression is one of the common adverse reactions to radiotherapy and chemotherapy. Anticancer treatments such as radiotherapy and chemotherapy first directly damage the patient′s peripheral blood cells, impairing qi and blood; further, they damage the actively proliferating cell populations in the bone marrow, impairing yin and blood; and then they interfere with hematopoietic stem cells, impairing essence and blood. This process is rapid and intense, consistent with the characteristics of " acute deficiency syndrome" , marked by sudden onset, rapid changes, critical condition, complexity and variability, multiple complications, and poor prognosis. Given this, its diagnosis and treatment should differ from those of general deficiency syndromes. This paper advocates the principles and ideas of diagnosis and treatment such as " preventing first and treating early to prevent changes; supplementing for deficiency and strengthening vital qi to eliminate pathogenic factor; urgent rescue for critical conditions, no time to lose; and comprehensive supplementing throughout the process, with severe cases requiring singular action" . This approach is intended to provide theoretical reference and practical guidance for bone marrow suppression after radiotherapy and chemotherapy.

Premature ejaculation refers to a sexual dysfunction in which men experience a short intravaginal ejaculation latency and a lack of control over ejaculation during sexual activity. The onset of this condition is often accompanied by anxiety and depression, which can seriously affect the quality of the patient′s sexual life and the relationship between partners. Based on the "integration of body and spirit" theory in traditional Chinese medicine, our team believes that this condition is a comorbidity of physical and spiritual factors. We propose that the core pathogenesis of this disease lies in the "loss of form and essence, impairment of spirit, and depression of the mind, "while the primary treatment principle involves "nourishing form and regulating spirit." As a result, a new diagnosis and treatment approach of "four-dimensional integration" is summarized in this study. The disease is treated through the four dimensions of shape, body, spirit, and emotion. Traditional Chinese medicine is used to adjust the shape in cases where the physical form is damaged. For individuals with depression of heart and liver qi, the treatment focuses on soothing the heart and smoothing liver qi, and the modified Wangyou Powder and Xuanzhi Decoction is used. In cases where the heart and kidney function are compromised, the treatment involves nourishing both the heart and kidney while restoring interaction between the heart and the kidney, and modified Jihuo Yansi Elixir is used. To reduce the sensitivity of the glans penis, the patient′s body is washed with a traditional Chinese medicine formula, and a delicate fumigation formula is decocted for external washing. For those who are not in tune with their god, psychological counseling can be used to regulate their spirit and advocate "self-partner" and psychotherapy. If there are issues with intimacy, partners should focus on cooperating during foreplay, sexual intercourse, and post-coital interactions. Overall, the treatment aims to harmonize the body and spirit, addressing both physical and psychological factors through a comprehensive, multi-dimensional approach. This method provides new perspectives and ideas for the clinical diagnosis and treatment of this condition.