The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

Background and Aims:Papillary thyroid carcinoma(PTC)is the most common endocrine malignancy,yet the molecular mechanisms underlying its invasion and metastasis remain unclear.This study aimed to investigate the role of the transcription factor ETV4 in PTC and its regulatory relationship with cadherin-3(CDHP/CDH3).Methods:Expression levels of ETV4 and CDHP were analyzed using TCGA and GTEx databases,and further validated in normal thyroid cells and multiple PTC cell lines by qRT-PCR and Western blot analysis.ETV4-knockdown models were established using siRNA,and changes in CDHP expression and cellular behaviors were assessed by qRT-PCR,Western blot,CCK-8,wound healing,and Transwell assays.Results:Bioinformatics analysis revealed significantly higher expression of ETV4 and CDHP in PTC tissues compared to normal thyroid tissues(P<0.001).Correlation analysis demonstrated a strong positive association between ETV4 and CDHP expression(R2>0.5,P<0.01).In vitro assays confirmed that both ETV4 and CDHP were upregulated in all tested PTC cell lines at the mRNA and protein levels(all P<0.05).Knockdown of ETV4 led to marked reduction of CDHP expression(P<0.05),accompanied by decreased cell proliferation,migration,and invasion as demonstrated by CCK-8,wound healing,and Transwell assays(all P<0.05).Conclusion:ETV4 may transcriptionally upregulates CDHP to promote proliferation,migration,and invasion of PTC cells.The ETV4/CDHP axis may serve as a novel biomarker and potential therapeutic target in PTC.

Objective To investigate the significance and clinical value of preoperative three-dimensional CT reconstruction of the whole abdomen guiding preserving the left colonic artery during laparoscopic radical resection of rectal cancer. Methods Patients with rectal cancer who underwent laparoscopic radical resection of rectal cancer in our hospital from January 2021 to January 2022 were selected,then 87 patients with left colonic artery were screened out through three-dimensional CT reconstruction of the whole abdomen before surgery,who were randomly divided into the observation group (received intraoperative low ligation of the inferior mesenteric artery,with preservation of the left colonic artery) with 40 cases and the control group (received intraoperative high ligation of the inferior mesenteric artery without preservation of the left colonic artery) with 47 cases. The perioperative indexes and postoperative pathological results of the two groups were compared. Results The intraoperative blood loss in the observation group was higher than that in the control group,and the operation time was longer than that in the control group,with statistically significant differences (P<0.05). The incidences of postoperative intestinal obstruction and anastomotic leakage in the observation group were lower than those in the control group,and the first postoperative discharge time was earlier than that in the control group,with statistically significant differences (P<0.05). There was no significant difference in the degree of tumor differentiation,tumor size,adenocarcinoma classification,number of lymph nodes dissected at the root of the inferior mesenteric artery,or the stage of intestinal wall invasion depth of tumor between the two groups (P>0.05). Conclusion The application of the three-dimensional CT reconstruction of the whole abdomen before surgery can understand the branch classification of the inferior mesenteric artery in advance,determine the location of the tumor and its adjacent relationship with the surrounding tissues,and determine the resection extent of intestinal segment. Intraoperative preservation of the left colonic artery can reduce the occurrence of postoperative complications in patients,which has positive clinical significance.

Objective To observe the clinical efficacy of therapy of resolving blood stasis and tranquilizing mind in the treatment of insomnia with internal blockage of blood stasis type.Methods A parallel randomized controlled trial was conducted on 88 cases of insomnia patients with internal blockage of blood stasis type who admitted to Bao'an Traditional Chinese Medicine Hospital Affiliated to Guangzhou University of Chinese Medicine from January 2024 to June 2024.The patients were randomly divided into an observation group and a control group,with 44 cases in each group.The observation group was treated with the self-made Huayu Anshen Prescription(modified Xuefu Zhuyu Decoction)orally following the therapy of resolving blood stasis and tranquilizing mind,while the control group was treated with Dexzopiclone Tablets orally.The course of treatment for the two groups covered four weeks.The changes in the scores of traditional Chinese medicine(TCM)syndrome,Pittsburgh Sleep Quality Index(PSQI),Self-Rating Depression Scale(SDS),and Self-Rating Anxiety Scale(SAS)in the two groups before and after treatment were observed,and then the clinical efficacy and medication safety of the patients in the two groups were evaluated.Results(1)After four weeks of treatment,the total effective rate of the observation group was 86.36%(38/44)and that of the control group was 70.45%(31/44),and the intergroup comparison showed that the clinical efficacy of the observation group was significantly superior to that of the control group,the difference being statistically significant(χ2=8.080,P<0.05).(2)After treatment,the scores of TCM syndrome,PSQI,SDS,and SAS of patients in the two groups were all significantly decreased compared with those before treatment(P<0.01),and the decrease in the observation group was significantly superior to that in the control group,the differences all being statistically significant(P<0.05).(3)During the treatment,there were no obvious adverse reactions occurred in the two groups,with higher safety.Conclusion Therapy of resolving blood stasis and tranquilizing mind for treating insomnia with internal blockage of blood stasis type can effectively alleviate patients'clinical symptoms,improve their sleep quality and relieve depression and anxiety,with stronger clinical efficacy and higher safety.

Objective To investigate the clinical efficacy of Xiaozhi Tea(composed of Eupatorii Herba,Nelumbinis Folium,Chrysanthemi Flos,Cassiae Semen,Crataegi Fructus,bran-fried Atractylodis Macrocephalae Rhizoma,Poria,Pseudostellariae Radix,Citri Reticulatae Pericarpium,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle)combined with Atorvastatin Calcium Tablets for the treatment of hyperlipidemia patients with turbid phlegm obstruction syndrome.Methods A retrospective cohort study was conducted in 200 hyperlipidemia patients with turbid phlegm obstruction syndrome who visited the outpatient department of Shenzhen Bao'an Traditional Chinese Medicine Hospital Group from September 2023 to September 2024.The patients were equally divided into a trial group and a control group based on the treatment regimen,with 100 cases in each group.The control group received oral use of Atorvastatin Calcium Tablets alone,while the trial group received Xiaozhi Tea in addition to Atorvastatin Calcium Tablets orally,both groups were treated for 8 weeks.Changes in traditional Chinese medicine(TCM)syndrome scores and lipid profiles of total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)in the two groups were observed before and after treatment.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)There were 3 patients in the control group dropping out due to lack of follow-up data,leaving 197 patients who eventually completed the study,100 cases in the trial group and 97 cases in the control group.(2)After 8 weeks of treatment,the total effective rate in the trial group was 97.00%(97/100)and that in the control group was 87.63%(85/97).The intergroup comparison(tested by chi-square test)showed that the trial group showed significantly stronger efficacy than the control group(P＜0.05).(3)Both groups exhibited significant reductions in TCM syndrome scores after treatment in comparison with those before treatment(P＜0.05),and a more pronounced reduction was presented in the trial group(P＜0.05).(4)Both groups showed decreased TC,TG,and LDL-C levels(P＜0.05)and increased HDL-C level after treatment in comparison with those before treatment(P＜0.05).The trial group demonstrated more obvious reduction of TC,TG,LDL-C,and more obvious elevation of HDL-C than the control group(P＜0.05).(5)In terms of safety,no severe adverse reactions occurred in either group.The incidence of adverse reactions in the trial group was 1.00%(1/100)and that in the control group was 2.06%(2/97),with no statistically significant difference between groups(P＞0.05).Conclusion Xiaozhi Tea combined with Atorvastatin Calcium Tablets exerts certain efficacy in treating hyperlipidemia with turbid phlegm obstruction syndrome,and is effective on significantly improving lipid profiles and clinical symptoms.The combination therapy demonstrates superior efficacy compared to Atorvastatin Calcium Tablets alone.

Objective To explore primary care physicians' attitudes toward the use of AI-CDSS,and to examine the relationships and underlying mechanisms among AI system explainability,physicians' trust in AI-CDSS,and their willingness to use it.It aims to provide a reference for promoting AI-CDSS in primary healthcare institutions and better leveraging AI technology to empower primary healthcare services.Methods Primary care physicians in Tongling City,Anhui Province,were surveyed using standardized scales to collect data on AI system explainability,trust in AI-CDSS,and willingness to use it.Descriptive statistics,correlation analysis,and mediation effect testing were conducted using SPSS 26.0 software.Results AI system explainability,trust,and willingness to use were all positively correlated(r=0.788,0.865,P＜0.01),and AI system explainability was also positively correlated with trust(r=0.776,P＜0.01).Trust in the AI system partially mediated the relationship between system explainability and willingness to use,with a mediation effect value of 0.568(95％CI=0.373～0.669).Conclusion When promoting AI-CDSS,primary healthcare institutions should prioritize the adoption of AI systems with high explainability to enhance physicians' trust,thereby increasing their willingness to use such systems and ultimately promoting the effective application of AI technology in primary healthcare services.

Objective:To explore the clinical efficacy of metoprolol combined with trimetazidine on elderly patients with coronary heart disease(CHD)and chronic heart failure(CHF).Methods:This randomized controlled trial enrolled 120 elderly CHD+CHF patients admitted to Army 73rd Group Military Hospital of Chinese PLA between June 2020 and June 2023.Patients were divided into control group(metoprolol based on routine treatment)and in-tervention group(additional trimetazidine therapy).Each group consisted of 60 patients,treated for 1 month.The clinical efficacy,left ventricular ejection fraction(LVEF),cardiac index(CI),left ventricular end-systolic diame-ter(LVESd),left ventricular end-diastolic diameter(LVEDd),serum levels of brain natriuretic peptide(BNP),high sensitive C-reactive protein(hsCRP),platelet a granule membrane protein-140(GMP-140),intercellular adhesion molecule-1(ICAM-1)and growth differentiation factor 15(GDF-15),and incidence of adverse reac-tions were compared between the two groups.Results:The total effective rate of the intervention group was significant-ly higher than that of the control group(95.00％vs.81.67％,P=0.023).Compared to patients in the control group,those in the intervention group had significant lower LVESd[(35.03±5.14)mm vs.(40.63±3.87)mm],LVEDd[(43.53±4.27)mm vs.(48.36±5.22)mm],levels of BNP[(94.35±7.55)pg/ml vs.(127.86±45.11)pg/ml],hsCRP[(0.91±0.28)mg/L vs.(1.47±0.52)mg/L],GMP-140[(7.14±1.06)μg/L vs.(9.37±1.59)μg/L],ICAM-1[(43.81±5.75)pg/ml vs.(52.74±5.83)pg/ml]andGDF-15[(891.46±62.51)pg/ml vs.(1025.57±110.08)pg/ml],and significant higher LVEF[(55.62±5.11)％vs.(47.35±8.61)％]and CI[(3.41±0.38)L·min-1·m-2 vs.(3.08±0.31)L·min-1·m-2](P＜0.001 all).There was no significant difference in the total inci-dence of adverse reactions between the intervention group and control group(8.33％vs.11.67％,P=0.543).Conclu-sion:Metoprolol combined trimetazidine may relieve myocardial inflammatory response and injury,and inhibit ventricular remodeling,thereby improve cardiac function in elderly patients with CHD and CHF.

Objective:To explore the clinical efficacy of metoprolol combined with trimetazidine on elderly patients with coronary heart disease(CHD)and chronic heart failure(CHF).Methods:This randomized controlled trial enrolled 120 elderly CHD+CHF patients admitted to Army 73rd Group Military Hospital of Chinese PLA between June 2020 and June 2023.Patients were divided into control group(metoprolol based on routine treatment)and in-tervention group(additional trimetazidine therapy).Each group consisted of 60 patients,treated for 1 month.The clinical efficacy,left ventricular ejection fraction(LVEF),cardiac index(CI),left ventricular end-systolic diame-ter(LVESd),left ventricular end-diastolic diameter(LVEDd),serum levels of brain natriuretic peptide(BNP),high sensitive C-reactive protein(hsCRP),platelet a granule membrane protein-140(GMP-140),intercellular adhesion molecule-1(ICAM-1)and growth differentiation factor 15(GDF-15),and incidence of adverse reac-tions were compared between the two groups.Results:The total effective rate of the intervention group was significant-ly higher than that of the control group(95.00％vs.81.67％,P=0.023).Compared to patients in the control group,those in the intervention group had significant lower LVESd[(35.03±5.14)mm vs.(40.63±3.87)mm],LVEDd[(43.53±4.27)mm vs.(48.36±5.22)mm],levels of BNP[(94.35±7.55)pg/ml vs.(127.86±45.11)pg/ml],hsCRP[(0.91±0.28)mg/L vs.(1.47±0.52)mg/L],GMP-140[(7.14±1.06)μg/L vs.(9.37±1.59)μg/L],ICAM-1[(43.81±5.75)pg/ml vs.(52.74±5.83)pg/ml]andGDF-15[(891.46±62.51)pg/ml vs.(1025.57±110.08)pg/ml],and significant higher LVEF[(55.62±5.11)％vs.(47.35±8.61)％]and CI[(3.41±0.38)L·min-1·m-2 vs.(3.08±0.31)L·min-1·m-2](P＜0.001 all).There was no significant difference in the total inci-dence of adverse reactions between the intervention group and control group(8.33％vs.11.67％,P=0.543).Conclu-sion:Metoprolol combined trimetazidine may relieve myocardial inflammatory response and injury,and inhibit ventricular remodeling,thereby improve cardiac function in elderly patients with CHD and CHF.

Background and Aims:Papillary thyroid carcinoma(PTC)is the most common endocrine malignancy,yet the molecular mechanisms underlying its invasion and metastasis remain unclear.This study aimed to investigate the role of the transcription factor ETV4 in PTC and its regulatory relationship with cadherin-3(CDHP/CDH3).Methods:Expression levels of ETV4 and CDHP were analyzed using TCGA and GTEx databases,and further validated in normal thyroid cells and multiple PTC cell lines by qRT-PCR and Western blot analysis.ETV4-knockdown models were established using siRNA,and changes in CDHP expression and cellular behaviors were assessed by qRT-PCR,Western blot,CCK-8,wound healing,and Transwell assays.Results:Bioinformatics analysis revealed significantly higher expression of ETV4 and CDHP in PTC tissues compared to normal thyroid tissues(P<0.001).Correlation analysis demonstrated a strong positive association between ETV4 and CDHP expression(R2>0.5,P<0.01).In vitro assays confirmed that both ETV4 and CDHP were upregulated in all tested PTC cell lines at the mRNA and protein levels(all P<0.05).Knockdown of ETV4 led to marked reduction of CDHP expression(P<0.05),accompanied by decreased cell proliferation,migration,and invasion as demonstrated by CCK-8,wound healing,and Transwell assays(all P<0.05).Conclusion:ETV4 may transcriptionally upregulates CDHP to promote proliferation,migration,and invasion of PTC cells.The ETV4/CDHP axis may serve as a novel biomarker and potential therapeutic target in PTC.