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.

Objective To explore the construction and verification of prediction model for family clustering of Helicobacter pylori(Hp)infection in Henan province.Methods A total of 240 patients with Hp infection from different families in Henan province who underwent physical examination in a hospital from January 2022 to August 2023(modeling group)were selected as the study objects.According to the pathological detec-tion of whether family cluster Hp infection occurred in the families of the subjects,they were divided into the occurrence group(97 cases)and the non-occurrence group(143 cases),and their clinical data were collected.Risk factors were analyzed and a nomogram prediction model was constructed.In addition,110 Hp infected pa-tients from different families in Henan province who underwent physical examination in the hospital from September 2023 to March 2024 were selected as the verification group,and their clinical data were collected to verify the prediction model of the nomogram.Results There were statistically significant differences in the highest level of education,number of people living together,annual household income,use of serving chop-sticks,meal separation,frequency of eating out and the proportion of family members with stomach diseases between the two groups(P＜0.05).Multivariate analysis showed that the highest level of family education,the number of people living together,the annual household income,the use of serving chopsticks,separate meals,the frequency of eating out,and family members with stomach disease were independent risk factors.The area under the curve of the prediction probability of the nomogram prediction model was 0.728(95％CI:0.663-0.793),the sensitivity was 0.701,the specificity was 0.657,and the cutoff value was 0.417.The no-mogram prediction model had a good fit(x2=5.532,P＞0.05).Conclusion The prediction model of family clustering of Hp infection in Henan province can effectively identify high-risk patients,make suggestions for their daily living habits,and reduce the incidence of family clustering of Hp infection,which has high clinical application value.

BACKGROUND:Cartilage defects are one of the major clinical challenges faced by orthopedic surgeons.Tissue engineering is an interdisciplinary approach that combines knowledge of engineering and cell biology to provide new ideas and approaches for the repair of cartilage defects. OBJECTIVE:To prepare a multi-component composite scaffold based on silk fibroin,gelatin,and chitosan to screen for a three-dimensional porous scaffold suitable for cartilage regeneration by evaluating its physicochemical properties and biological performance. METHODS:Four groups of porous scaffolds were prepared by vacuum freeze-drying method using silk fibroin,gelatin and chitosan as the base materials,namely chitosan/gelatin scaffold,silk fibroin/chitosan scaffold,silk fibroin/gelatin scaffold and silk fibroin/chitosan/gelatin scaffold.The suitable cartilage scaffolds were screened by scanning electron microscopy,X-ray diffractometer,porosity,water absorption and swelling rate,biodegradation rate and mechanical property detection.Then cartilage scaffolds were co-cultured with chondrocytes isolated and extracted from patients with osteoarthritis.The feasibility of porous scaffolds for cartilage injury repair was evaluated in vitro by cell adhesion rate assay,cell live-dead staining and cell activity proliferation assay. RESULTS AND CONCLUSION:(1)All four groups of scaffolds had porous structures.The comprehensive physical performance test results showed that the silk fibroin/gelatin/chitosan scaffold was more in line with the requirements of cartilage defect repair.This scaffold had a pore size of(176.00±53.68)μm,the porosity of(80.15±2.57)%,and water absorption and swelling rate of(3 712±358)%.After immersion in PBS containing lysozyme for 28 days in vitro,the biodegradation rate was(46.87±3.25)%,and it had good mechanical properties.(2)Chondrocytes could adhere well on the silk fibroin/gelatin/chitosan scaffold,and the cell adhesion rate increased with time.CCK8 and live/dead cell double staining results showed that silk fibroin/gelatin/chitosan scaffold had good biocompatibility and low cytotoxicity.(3)The results showed that silk fibroin/gelatin/chitosan scaffold had a highly hydrated 3D structure,suitable pore size and porosity,good biodegradability and superior mechanical properties,which can provide a good reticular skeleton and microenvironment for nutrient transport and chondrocyte attachment and proliferation.

Objective:To investigate the risk factors of urethrovesical anastomotic leakage after laparoscopic radical prostatectomy.Methods:The clinical data of 292 patients who underwent laparoscopic radical prostatectomy in the Tenth People's Hospital Affiliated to Tongji University from January to December 2021 were retrospectively analyzed. According to whether there was anastomotic leakage, the patients were divided into leakage group (27 cases) and non-leakage group (265 cases). There were no significant differences in age [(71.5±6.5) years vs. (70.2±6.4) years], body mass index [(24.5±3.6) kg/m 2 vs. (24.2±3.0) kg/m 2], prostate volume[40(27.3, 63.2)ml vs. 38(28.1, 56.2)ml], Gleason score, clinical stage, and risk classification between the leakage group and the non-leakage group ( P>0.05), but the total prostate-specific antigen in the leakage group was significantly higher than that in the non-leakage group[20.0 (9.6, 79.0) ng/ml vs. 13.7 (8.5, 25.0) ng/ml, P=0.049]. Propensity score matching (PSM) was used to match the above indicators between the leakage group and the non-leakage group as 1∶1, so that the baseline of the two groups was balanced. The perioperative indicators of the matched two groups of patients were compared and analyzed. Statistically significant indicators were selected and included in univariate and multivariate logistic regression to analyze the risk factors of anastomotic leakage after radical prostatectomy. Finally, the receiver operating characteristic (ROC) curve was drawn, and the area under the curve (AUC) was calculated. The accuracy of each factor in predicting urine leakage was obtained. Results:After PSM, 24 cases were successfully matched. The leakage group had shorter membranous urethral length (MUL) [(15.5±2.2)mm vs. (17.5±1.5)mm, P<0.001], thinner membranous urethral wall thickness (UWT) [(9.5±1.9)mm vs. (10.6±1.5)mm, P=0.024], longer anastomotic time of urethrovesical neck[(21.6±4.1)min vs. (16.9±2.9)min, P<0.001] and higher failure rate of water injection test [16.7% (4/24) vs. 4.2% (1/24), P=0.045] than the non-leakage group. There was no significant difference in other indicators between the two groups. The results of multivariate logistic regression analysis showed that short MUL ( OR=0.544, 95% CI 0.335-0.884, P=0.014), narrow UWT ( OR=0.538, 95% CI 0.313-0.924, P=0.025) and long anastomotic time of urethrovesical neck ( OR=1.519, 95% CI 1.122-2.110, P=0.009) were independent risk factors for anastomotic urine leakage. ROC curve analysis showed that the AUC of MUL, UWT, and anastomotic time were 0.789 (95% CI 0.651-0.927), 0.715 (95% CI 0.562-0.868), and 0.842 (95% CI 0.731-0.953), respectively. Conclusions:Narrow and short membranous urethra and long anastomosis time in patients with laparoscopic radical prostatectomy may be independent risk factors for postoperative anastomotic leakage, which may predict the occurrence of anastomotic leakage.

Transcranial direct current stimulation (tDCS) has become a new method of post-stroke rehabilitation treatment and is gradually accepted by people. However, the neurophysiological mechanism of tDCS in the treatment of stroke still needs further study. In this study, we recruited 30 stroke patients with damage to the left side of the brain and randomly divided them into a real tDCS group (15 cases) and a sham tDCS group (15 cases). The resting EEG signals of the two groups of subjects before and after stimulation were collected, then the difference of power spectral density was analyzed and compared in the band of delta, theta, alpha and beta, and the delta/alpha power ratio (DAR) was calculated. The results showed that after real tDCS, delta band energy decreased significantly in the left temporal lobes, and the difference was statistically significant ( P < 0.05); alpha band energy enhanced significantly in the occipital lobes, and the difference was statistically significant ( P < 0.05); the difference of theta and beta band energy was not statistically significant in the whole brain region ( P > 0.05). Furthermore, the difference of delta, theta, alpha and beta band energy was not statistically significant after sham tDCS ( P > 0.05). On the other hand, the DAR value of stroke patients decreased significantly after real tDCS, and the difference was statistically significant ( P < 0.05), and there was no significant difference in sham tDCS ( P > 0.05). This study reveals to a certain extent the neurophysiological mechanism of tDCS in the treatment of stroke.
Brain/physiopathology* ; Brain Waves/physiology* ; Electroencephalography/methods* ; Humans ; Stroke/therapy* ; Stroke Rehabilitation/methods* ; Transcranial Direct Current Stimulation/methods*

Transcranial direct current stimulation (tDCS) is an emerging non-invasive brain stimulation technique. However, the rehabilitation effect of tDCS on stroke disease is unclear. In this paper, based on electroencephalogram (EEG) and complex network analysis methods, the effect of tDCS on brain function network of stroke patients during rehabilitation was investigated. The resting state EEG signals of 31 stroke rehabilitation patients were collected and divided into stimulation group (16 cases) and control group (15 cases). The Pearson correlation coefficients were calculated between the channels, brain functional network of two groups were constructed before and after stimulation, and five characteristic parameters were analyzed and compared such as node degree, clustering coefficient, characteristic path length, global efficiency, and small world attribute. The results showed that node degree, clustering coefficient, global efficiency, and small world attributes of brain functional network in the tDCS group were significantly increased, characteristic path length was significantly reduced, and the difference was statistically significant (
Brain ; Electroencephalography ; Humans ; Stroke ; Stroke Rehabilitation ; Transcranial Direct Current Stimulation

Objective:To investigate the effectiveness of surgical treatment for patients with T 4 stage prostate cancer. Methods:The clinical data and prognosis of 18 patients with T 4 stage prostate cancer treated in Shanghai Tenth People's Hospital from July 2013 to December 2019 were retrospectively analyzed. The average age of these 18 patients was 68.3 (53-81)years. 10 patients were castration resistant prostate cancer (CRPC) and 8 patients were hormone-sensitive prostate cancer (HSPC). 10 CRPC patients were treated with surgical treatment due to bladder clot packing and/or lower urinary tract obstruction. 8 HSPC patients had severe hematuria, severe dysuria and local symptoms. The KPS scores of all patients were ≥80 points with an average score of 84 (80-90). The average QOL score of 18 patients was 28 (21-32). 2 cases in 18 patients underwent total pelvic resection for rectal invasion (one CRPC and one HSPC). 7 cases underwent radical cystoprostatectomy for ureteral invasion (5 cases of CRPC, 2 cases of HSPC), 9 cases underwent bladder preservation surgery for bladder neck invasion (4 cases of CRPC, 5 cases of HSPC), of which 4 cases of enlarged lymph node dissection were all HSPC patients. Results:All cases of T 4 stage prostate cancer patients operation were successfully completed, the average operation time was 256 (219-310)min and the median intraoperative blood loss was about 300 (250-350)ml. Four of them (3 cases of CRPC and 1 case of HSPC) received blood transfusion after operation. The average postoperative hospital stay was 21(11-37) days. All 18 cases were followed up and the median follow-up time was 23.8 months. There was no perioperative death, and no bladder-preserving patients had true urinary incontinence or bladder outlet stenosis.2 CRPC cases died 8 and 15 months after surgery respectively, 7 patients were PSA relapse treated with docetaxel or abiterone therapy, and 1 HSPC patient with rectal invasion was followed up for 58 months after total pelvic resection, the PSA level was still 0.003ng/ml, no distant metastasis was found. 8 cases of hormone-sensitive patients were treated with endocrine therapy, and PSA was less than 0.2 ng/ml. The average QOL of 18 patients 3 months after operation was 37 points (25-45), which was significantly higher than that before operation. The average maximum urine flow rate of patients with bladder preservation was 23(19-25)ml/s. Conclusions:For T 4 stage prostate cancer, surgical treatment is feasible and safe for doctors with extensive surgical experience. For CRPC patients, the surgery can significantly improve short-term symptoms and quality of life, and long-term benefits need to be further evaluated with a large sample. For HSPC patients, it can not only improve clinical symptoms and QOL of patients, but also provide long-term benefits.

In order to stimulate the patients' active participation in the process of robot-assisted rehabilitation training of stroke patients, the rehabilitation robots should provide assistant torque to patients according to their rehabilitation needs. This paper proposed an assist-as-needed control strategy for wrist rehabilitation robots. Firstly, the ability evaluation rules were formulated and the patient's ability was evaluated according to the rules. Then the controller was designed. Based on the evaluation results, the controller can calculate the assistant torque needed by the patient to complete the rehabilitation training task and send commands to motor. Finally, the motor is controlled to output the commanded value, which assists the patient to complete the rehabilitation training task. The control strategy was implemented to the wrist function rehabilitation robot, which could achieve the training effect of assist-as-needed and could avoid the surge of assistance torque. In addition, therapists can adjust multiple parameters in the ability evaluation rules online to customize the difficulty of tasks for patients with different rehabilitation status. The method proposed in this paper does not rely on the information from force sensor, which reduces development costs and is easy to implement.

Objective: To analyze the clinical features of patients with chronic obstructive pulmonary disease(COPD) complicated with pulmonary thromboembolism(PTE). Methods: The clinical data of 21 patients with COPD and PTE and 26 patients with acute exacerbation of COPD(AECOPD) from June 2015 to March 2018 in Taiyuan Central Hospital were retrospectively analyzed.The SSPS 22.0 statistical software was used to analyze the clinical data.General data, blood gas analysis results, lung function, hemoglobin, coagulation parameters, combined disease were analyzed. Results: There were no statistically significant differences in age, gender and lung function grading between the COPD complicated with PTE group and AECOPD group (all P>0.05). The incidence rates of chest pain(8 cases, 38.1%) and syncope(2 cases, 10.5%) in the COPD complicated with PTE group were higher than those in the AECOPD group[chest pain(3 cases, 11.5%), syncope(1 case, 3.8%)](χ²=7.645, 9.413, all P<0.05). There was no statistically significant difference in carbon dioxide partial pressure(PaCO₂)retention between the two groups(P>0.05). The blood oxygen partial pressure(PaO₂) of the COPD complicated with PTE group was (62.86±15.10)mmHg, which was lower than that of the AECOPD group [(74.83±17.59)mmHg](t=4.642, P<0.05). The hemoglobin, activated partial thromboplastin time(APTT), fibrinogen(FIB), D-dimer levels in the COPD complicated with PTE group were (146.78±21.40)g/L, (35.62±5.93)s, (4.34±1.18)g/L, (5.02±3.63)mg/L, respectively, which were higher than those in the AECOPD group [(137.45±15.15)g/L, (29.38±3.16)s, (3.62±1.08)g/L, (0.92±0.42)mg/L] (t=4.375, 4.654, 3.869, 18.653, all P<0.05). There were no statistically significant differences in the proportion of comorbidities such as diabetes, hypertension, hyperlipidemia and lower extremity(all P>0.05). Conclusion COPD patients complicated with PTE have the following characteristics: elderly and male patients accounted for a high proportion, chest pain and syncope symptoms occurred in a high proportion, severe hypoxia, hemoglobin and D-dimer increased significantly.