OBJECTIVE To explore the mechanism by which Qingre antai decoction improves pregnancy outcomes of threatened abortion rats with blood heat syndrome. METHODS The pregnant rats were randomly divided into normal group， model group， dydrogesterone group （0.002 g/kg）， and Qingre antai decoction group （44.1 g/kg）， with 13 rats in each group. Except for normal group， other groups were given warming-yang Chinese medicine and corresponding drugs intragastrically， once a day， for 12 consecutive days. On the 13th day of pregnancy， a single intragastric administration of mifepristone （5 mg/kg） was performed to establish a model of threatened abortion with blood heat syndrome. On the 14th day of pregnancy， the abortion rate and uterine coefficient were calculated； the pathological morphology of pregnant uterine was observed； the serum levels of 3，5，3′-triiodothyronine （T3）， thyroid hormone （T4）， thyroid stimulating hormone （TSH）， as well as the levels of vascular endothelial growth factor （VEGF） and nitric oxide （NO） in the pregnant uterus were all determined； the expressions of mRNA and protein related to Janus kinase 2 （JAK2）/signal transducer and activator of transcription 3 （STAT3） and phosphatidylinositol 3-kinase （PI3K）/protein kinase B （AKT） pathways were detected. RESULTS Compared with normal group， the model group exhibited endometrial tissue damage， a reduced number of decidual cells， and a significant presence of blood stasis within the uterus； abortion rate， the serum levels of T3， T4 and TSH， the mRNA expressions of JAK2， STAT3 and suppressor of cytokine signaling 3 （SOCS3） as well as protein expressions of p-JAK2， p-STAT3 and SOCS3 in the pregnant uterus were increased significantly （ P ＜0.05）； uterine coefficient， the levels of VEGF and NO in pregnant uterus， mRNA expressions of VEGFR2， PI3K， AKT and endothelial nitric oxide synthase（eNOS）， protein expressions of VEGFR2， PI3K and eNOS as well as phosphorylation level of AKT in the pregnant uterus were significantly reduced （ P ＜0.05）. Compared with model group， the endometrial tissue damage and congestion in the Qingre antai decoction group were significantly improved， and the levels of the aforementioned quantitative indicators were significantly reversed （ P ＜0.05）. CONCLUSIONS Qingre antai decoction can improve the pregnancy outcomes in rats with threatened abortion of blood heat syndrome， the mechanism of which may be associated with inhibiting JAK2/STAT3 pathway and activating PI3K/AKT pathway.

Medical equipment, as an important indicator of smart hospital evaluation, plays a vital role in hospital operations. To ensure the safe and efficient operation of medical equipment, a reasonable performance evaluation system is indispensable. This study introduces a platform based on Internet of Things (IoT) technology that connects medical devices and collects data, achieving standardized and structured data processing, and supporting online operational supervision. Through the Delphi method, a performance evaluation system for large medical equipment is constructed, including 4 primary indicators and 22 secondary indicators. DICOM data acquisition devices are used to achieve functions such as efficiency analysis, benefit analysis, usage evaluation, and decision-making support for medical equipment. The study is still in its early stages, and in the future, it is expected to integrate more types of equipment, achieve rational resource allocation, and significantly impact decision-making for the development of public hospitals.
Internet of Things ; Delphi Technique

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To propose a novel method for immunohistochemically positive cell counting based on the improved YOLOv5s.Methods Regarding the small target characteristics of positive cells,a small target detection layer was added to refine feature extraction.Then,a bidirectional weighted feature pyramid network was used to replace path aggregation network(PANet)in the neck network for realizing multi-scale feature fusion.Additionally,the method used coordinate attention mechanism to make the model pay more attention to small target characteristics,and replaced the original GIoU with EIoU loss function for enhancing the detection performance.Results The model was trained on the self-built immunohistochemical image dataset.The average accuracy of the improved model was 89.3%,which was 4.0%higher than the original model and surpassed mainstream target detection models.The 5-year survival prediction model constructed with the method achieved an average accuracy of 76.8%and an average area under the curve of 0.81,demonstrating its superior prediction ability.Conclusion The proposed model can quickly detect the number of immunohistochemically positive cells and effectively assist doctors in survival prediction.

Objective To investigate the intervention effects and mechanism of Danggui Shaoyao power on spontaneous abortion rats.Methods A total of 60 first-day pregnant rats were randomly divided into normal group,model group,dydrogesterone group and Danggui Shaoyao power low,middle,and high dose groups,with 10 rats in each group.The low,middle,and high dose groups were given Danggui Shaoyao power 5.175 g·kg-1,10.35 g·kg-1,20.7 g·kg-1,respectively,from 1 to 12 days of gestation,and the dydrogesterone group was given dydrogesterone tablet solution 2 mg·kg-1 once a day.On the 13th day of gestation,rats model of spontaneous abortion was established by intragastric administration of 5 mg·kg-1 of mifepristone tablet solution except for the normal group.Serum levels of GnRH,FSH,LH,E2 were measured,and abortion rates and uterine coefficients were calculated.The pathological changes of pregnant uterus were observed by haematoxylin-eosin(HE)staining.The differential proteins in rats pregnant uterus were detected by Label-Free shotgun proteomic technique,and the PPI,Gene Ontology(GO),and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways analysis of the differential proteins were analyzed.Immunohistochemistry was used to verify the expression levels of differential proteins.Results Compared with normal group,the serum levels of GnRH,FSH,LH,E2 and uterine coefficients were decreased,and the abortion rates were increased in model group(P<0.05).There were abortion lesions of spontaneous abortion in model group.Compared with model group,the serum levels of GnRH,FSH,LH,E2 and uterine coefficients were increased(P<0.05),and the abortion rates were decreased(P<0.05)in dydrogesterone group and Danggui Shaoyao power low,middle,and high dose groups.Proteomic results showed that a total of 550 proteins were quantified in this study.PPI analysis showed that a total of 159 proteins interacted with other proteins as hubs;the results of GO and KEGG enrichment analysis showed that the intervention effect of Danggui Shaoyao power on spontaneous abortion is related to the focal adhesion pathway,and involved upregulation of Akt2,Col6a1,Col6a2 and downregulation of Pten.Immunohistochemistry results showed that compared with normal group,the expression level of Akt2,Col6a1 and Col6a2 were decreased(P<0.05),and the expression level of Pten was increased(P<0.05)in model group.Compared with model group,the expression level of Akt2,Col6a1 and Col6a2 were increased(P<0.05),and the expression level of Pten was decreased(P<0.05)in dydrogesterone group and Danggui Shaoyao power low,middle,and high dose groups.Conclusions Danggui Shaoyao power has the intervention effect on spontaneous abortion,and its mechanism may be related to by demoting the protein expressions of Pten,and promoting the protein expressions of Akt2,Col6a1 and Col6a2.

Objective:To construct an evidence-based cluster intervention program for the prevention of enteral nutrition complicated with diarrhea in patients with craniocerebral injury, and to verify its effect, in order to provide the best evidence for reducing the incidence of enteral nutrition complicated with diarrhea in patients with craniocerebral injury and improve the quality of nursing.Methods:By the method of non-synchronous controlled trials, the patients with craniocerebral injury treated by enteral nutrition in the Department of Neurosurgery, Lu'an Hospital of Traditional Chinese Medicine were selected as the research objects by convenient sampling method. Fify-two cases of routine intervention from January 2021 to March 2022 were divided into control group, and 51 cases of evidence-based cluster prevention intervention from April 2022 to February 2024 were divided into observation group. After 14 days of intervention, diarrhea [incidence of diarrhea and defecation traits (watery stool, loose stool), frequency of defecation, time of diarrhea and duration of diarrhea], other complications, nutritional status (serum total protein, serum albumin and hemoglobin), and nursing satisfactory degree were compared between the two groups.Results:Both groups of patients completed the study. There were 33 males and 19 females in the control group, aged (53.96 ± 17.44) years old, and 37 males and 14 females in the observation group, aged (60.05 ± 18.61) years old. The incidence of diarrhea and watery stools in the observation group was 11.76% (6/51) and 7.84% (4/51), respectively, which was lower than the 28.85% (15/52) and 23.08% (12/52) in the control group, and the differences were statistically significant ( χ2=4.63, 4.55, both P<0.05). The frequency of defecation in the observation group was (6.71 ± 1.64) times, which was lower than that in the control group (9.34 ± 2.10) times, and the difference was statistically significant ( t=7.08, P<0.05). The occurrence time of diarrhea in the observation group was (1.97 ± 0.54) d, which was later than that in the control group (1.59 ± 0.42) d, and the difference was statistically significant ( t=3.99, P<0.05). The duration of diarrhea in the observation group was (3.11 ± 0.86) d, which was shorter than that in the control group (5.12 ± 1.74) d, and the difference was statistically significant ( t=7.41, P<0.05). The incidence of other complications in the observation group was 9.80% (5/51), which was lower than the 25.00% (13/52) in the control group, and the difference was statistically significant ( χ2=4.12, P<0.05). After 14 days of intervention, the serum total protein, serum albumin, and hemoglobin levels in the observation group were (60.58 ± 6.37), (41.29 ± 8.24), (120.81 ± 11.72) g/L, respectively, which were higher than those in the control group (57.86 ± 6.15), (37.56 ± 7.64), (111.26 ± 11.25) g/L, and the differences were statistically significant ( t=2.21, 2.38, 4.22, all P<0.05). The patients′ overall satisfaction with nursing care in the observation group was 96.08% (49/51), which was higher than the control group′s 80.77% (42/52), and the difference was statistically significant ( χ2=5.86, P<0.05). Conclusions:The implementation of evidence-based cluster prevention intervention for enteral nutrition patients with craniocerebral injury can reduce the incidence of diarrhea in patients, which is conducive to the recovery of nutritional status, improve nursing satisfaction.

Objective:To construct an evidence-based cluster intervention program for the prevention of enteral nutrition complicated with diarrhea in patients with craniocerebral injury, and to verify its effect, in order to provide the best evidence for reducing the incidence of enteral nutrition complicated with diarrhea in patients with craniocerebral injury and improve the quality of nursing.Methods:By the method of non-synchronous controlled trials, the patients with craniocerebral injury treated by enteral nutrition in the Department of Neurosurgery, Lu'an Hospital of Traditional Chinese Medicine were selected as the research objects by convenient sampling method. Fify-two cases of routine intervention from January 2021 to March 2022 were divided into control group, and 51 cases of evidence-based cluster prevention intervention from April 2022 to February 2024 were divided into observation group. After 14 days of intervention, diarrhea [incidence of diarrhea and defecation traits (watery stool, loose stool), frequency of defecation, time of diarrhea and duration of diarrhea], other complications, nutritional status (serum total protein, serum albumin and hemoglobin), and nursing satisfactory degree were compared between the two groups.Results:Both groups of patients completed the study. There were 33 males and 19 females in the control group, aged (53.96 ± 17.44) years old, and 37 males and 14 females in the observation group, aged (60.05 ± 18.61) years old. The incidence of diarrhea and watery stools in the observation group was 11.76% (6/51) and 7.84% (4/51), respectively, which was lower than the 28.85% (15/52) and 23.08% (12/52) in the control group, and the differences were statistically significant ( χ2=4.63, 4.55, both P<0.05). The frequency of defecation in the observation group was (6.71 ± 1.64) times, which was lower than that in the control group (9.34 ± 2.10) times, and the difference was statistically significant ( t=7.08, P<0.05). The occurrence time of diarrhea in the observation group was (1.97 ± 0.54) d, which was later than that in the control group (1.59 ± 0.42) d, and the difference was statistically significant ( t=3.99, P<0.05). The duration of diarrhea in the observation group was (3.11 ± 0.86) d, which was shorter than that in the control group (5.12 ± 1.74) d, and the difference was statistically significant ( t=7.41, P<0.05). The incidence of other complications in the observation group was 9.80% (5/51), which was lower than the 25.00% (13/52) in the control group, and the difference was statistically significant ( χ2=4.12, P<0.05). After 14 days of intervention, the serum total protein, serum albumin, and hemoglobin levels in the observation group were (60.58 ± 6.37), (41.29 ± 8.24), (120.81 ± 11.72) g/L, respectively, which were higher than those in the control group (57.86 ± 6.15), (37.56 ± 7.64), (111.26 ± 11.25) g/L, and the differences were statistically significant ( t=2.21, 2.38, 4.22, all P<0.05). The patients′ overall satisfaction with nursing care in the observation group was 96.08% (49/51), which was higher than the control group′s 80.77% (42/52), and the difference was statistically significant ( χ2=5.86, P<0.05). Conclusions:The implementation of evidence-based cluster prevention intervention for enteral nutrition patients with craniocerebral injury can reduce the incidence of diarrhea in patients, which is conducive to the recovery of nutritional status, improve nursing satisfaction.

Objective To propose a novel method for immunohistochemically positive cell counting based on the improved YOLOv5s.Methods Regarding the small target characteristics of positive cells,a small target detection layer was added to refine feature extraction.Then,a bidirectional weighted feature pyramid network was used to replace path aggregation network(PANet)in the neck network for realizing multi-scale feature fusion.Additionally,the method used coordinate attention mechanism to make the model pay more attention to small target characteristics,and replaced the original GIoU with EIoU loss function for enhancing the detection performance.Results The model was trained on the self-built immunohistochemical image dataset.The average accuracy of the improved model was 89.3%,which was 4.0%higher than the original model and surpassed mainstream target detection models.The 5-year survival prediction model constructed with the method achieved an average accuracy of 76.8%and an average area under the curve of 0.81,demonstrating its superior prediction ability.Conclusion The proposed model can quickly detect the number of immunohistochemically positive cells and effectively assist doctors in survival prediction.

Objective To investigate the intervention effects and mechanism of Danggui Shaoyao power on spontaneous abortion rats.Methods A total of 60 first-day pregnant rats were randomly divided into normal group,model group,dydrogesterone group and Danggui Shaoyao power low,middle,and high dose groups,with 10 rats in each group.The low,middle,and high dose groups were given Danggui Shaoyao power 5.175 g·kg-1,10.35 g·kg-1,20.7 g·kg-1,respectively,from 1 to 12 days of gestation,and the dydrogesterone group was given dydrogesterone tablet solution 2 mg·kg-1 once a day.On the 13th day of gestation,rats model of spontaneous abortion was established by intragastric administration of 5 mg·kg-1 of mifepristone tablet solution except for the normal group.Serum levels of GnRH,FSH,LH,E2 were measured,and abortion rates and uterine coefficients were calculated.The pathological changes of pregnant uterus were observed by haematoxylin-eosin(HE)staining.The differential proteins in rats pregnant uterus were detected by Label-Free shotgun proteomic technique,and the PPI,Gene Ontology(GO),and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways analysis of the differential proteins were analyzed.Immunohistochemistry was used to verify the expression levels of differential proteins.Results Compared with normal group,the serum levels of GnRH,FSH,LH,E2 and uterine coefficients were decreased,and the abortion rates were increased in model group(P<0.05).There were abortion lesions of spontaneous abortion in model group.Compared with model group,the serum levels of GnRH,FSH,LH,E2 and uterine coefficients were increased(P<0.05),and the abortion rates were decreased(P<0.05)in dydrogesterone group and Danggui Shaoyao power low,middle,and high dose groups.Proteomic results showed that a total of 550 proteins were quantified in this study.PPI analysis showed that a total of 159 proteins interacted with other proteins as hubs;the results of GO and KEGG enrichment analysis showed that the intervention effect of Danggui Shaoyao power on spontaneous abortion is related to the focal adhesion pathway,and involved upregulation of Akt2,Col6a1,Col6a2 and downregulation of Pten.Immunohistochemistry results showed that compared with normal group,the expression level of Akt2,Col6a1 and Col6a2 were decreased(P<0.05),and the expression level of Pten was increased(P<0.05)in model group.Compared with model group,the expression level of Akt2,Col6a1 and Col6a2 were increased(P<0.05),and the expression level of Pten was decreased(P<0.05)in dydrogesterone group and Danggui Shaoyao power low,middle,and high dose groups.Conclusions Danggui Shaoyao power has the intervention effect on spontaneous abortion,and its mechanism may be related to by demoting the protein expressions of Pten,and promoting the protein expressions of Akt2,Col6a1 and Col6a2.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.