Objective To evaluate the efficacy and safety of CT-guided percutaneous radiofrequency ablation (RFA) as an alternative for video-assisted thoracoscopic surgery (VATS) in treating multiple pulmonary nodules. Methods A retrospective analysis was conducted on the clinical data of 113 patients with multiple pulmonary nodules admitted to Jiangsu Provincial Hospital of Traditional Chinese Medicine from October 2020 to October 2022. The patients were divided into the RFA group (n＝50) and the VATS group (n＝63) based on the treatment method. Perioperative indicators (operation time, intraoperative blood loss, postoperative length of hospital stay), oncological outcomes (recurrence-free survival [RFS], overall survival [OS]), and postoperative complication rates were compared between the two groups. Univariate and multivariate Cox regression analysis was performed to identify independent prognostic factors. Results The operation time in the RFA group was significantly shorter than that in the VATS group ([75.2±20.1] min vs [102.3±28.7]) min, P＜0.001). No statistically significant differences were observed in intraoperative blood loss and postoperative length of hospital stay. After follow-up of 24 (12, 30) months, no statistically significant differences were found in RFS (HR＝1.25, P＝0.445) or OS (HR＝1.42, P＝0.402) between the two groups. Mixed ground-glass nodules with high solid component and solid nodule were identified as independent risk factors for RFS (HR＝2.44, P＝0.023; HR＝2.97, P＝0.007) and OS (HR＝2.87, P＝0.022; HR＝3.43, P＝0.005) in patients with multiple pulmonary nodules. The total complication rate in the RFA group was lower than that in the VATS group (12.0% vs 34.9%, P＝0.009). Conclusions The efficacy of CT-guided RFA in treating multiple pulmonary nodules is comparable to that of VATS, with good safety, and it shows promise as an alternative to surgical treatment for multiple pulmonary nodules.

Objective: To systematically analyze the current status and influencing factors of platelet supply in medical institutions across China, and to explore the problems and future development directions of the existing supply models. Methods: From February 25 to March 5, 2025, a web-based questionnaire survey was performed. A self-designed questionnaire was distributed to staff in the blood transfusion departments of medical institutions nationwide in China. Data on the current status and influencing factors of platelet supply were collected and analyzed. Results: A total of 2 268 responses were collected in this survey, with 1 366 valid questionnaires finally included, covering 33 provinces, autonomous regions, and municipalities directly under the central government across China. The survey revealed that platelet supply in Chinese medical institutions exhibited a pattern of "sufficient in the eastern region, stable in the central region, and scarce in the western region": adequate in East China; generally favorable in South China except Guangxi; centered on Beijing and Tianjin in North China; basically met but with insufficient reserves in Central China; subject to seasonal fluctuations in Northeast China; only meeting the baseline supply in Yunnan, Guizhou, and Sichuan in Southwest China; and notably short in Qinghai, Ningxia, and Xinjiang in Northwest China. Family donor mobilization was required in 81.2% (1 109/1 366) of institutions, whereas this proportion was only 12.7% (173/1 366) among institutions with sufficient supply. Tertiary hospitals constituted the main users, among which tertiary Class A hospitals had the highest sufficiency rate, and secondary Class B hospitals showed the most pronounced shortage. A total of 84% (1 147/1 366) of institutions lacked a professional management team; only 19% (266/1 366) had an inventory warning system, of which 88% (234/266) considered it effective. Platelet reservation required 3 days in 33% (458/1 366) of institutions. The mandatory transfusion rate was 30.55% (29/118) when the reservation lead time exceeded 3 days, representing an increase of 5.98% compared with 24.57% (55/180) in the same-day reservation group. For optimization, most institutions called for improved blood donation services, strengthened education and incentives, establishment of regional coordination and policy collaboration, and supplementary suggestions focused on technologies for extending platelet shelf life. Conclusion: Regional imbalance in platelet supply across China is prominent, with supply shortages in some provinces, reliance on family donor mobilization in most institutions, weak grassroots support capacity, imperfect management systems, and supply timeliness constraining clinical practice. Systematic improvements are needed in optimizing blood donation services, strengthening regional coordination, improving relevant policies, and developing platelet preservation technologies, so as to enhance the level of supply security and patient safety.

Objectives:To explore the predictive value of residual Murray's law-based quantitative flow ratio(μQFR)on long-term vessel-oriented composite endpoints(VoCE).Methods:This retrospective study included 3 510 patients from the FAVOR Ⅲ China trial.Offline residual μQFR analysis was performed on all vessels(diameter≥2.5 mm)with 50%-90%stenotic lesions.Patients were stratified into high-,intermediate-,and low-risk groups based on residual μQFR tertiles.The primary endpoint was 3-year VoCE,defined as a composite of cardiac death related to the target vessel,target vessel-related spontaneous myocardial infarction,and ischemia-driven target vessel revascularization.Results:Offline analysis was performed on 5 256 vessels from 3 510 patients.The mean residual μQFR was 0.92±0.75.The high-risk group(residual μQFR≤0.91)with 1 554 patients(1 958 vessels);the intermediate-risk group(residual μQFR 0.92-0.96)with 1 211 patients(1 906 vessels);and the low-risk group(residual μQFR>0.96)with 745 patients(1 392 vessels).Over 3-year follow-up,VoCE occurred in 227 vessels(4.3%).The 3-year VoCE incidence was significantly higher in the high-risk group compared to the intermediate-and low-risk groups(6.2%vs.4.1%vs.2.5%,log-rank P<0.001),primarily driven by ischemia-driven target vessel revascularization(5.0%vs.3.0%vs.1.6%,log-rank P<0.001).Hypertension(OR=0.83,95%CI:0.72-0.96),hypercholesterolemia(OR=0.84,95%CI:0.73-0.97),bifurcation lesions(OR=0.72,95%CI:0.63-0.83),moderate/severe calcification(OR=0.70,95%CI:0.57-0.84),and tandem lesions(OR=0.59,95%CI:0.47-0.75)were independent predictors of lower residual μQFR values.Conclusions:Lower residual μQFR is significantly associated with increased VoCE risk during the 3-year follow up period.

Objective:To explore the effect of electric acupuncture combined with Tianding acupoint on the efficacy,syndrome score,and quality of life of post-stroke intractable hiccup(IH).Methods:A total of 102 post-stroke IH patients admitted to our hospital from October 2022 to October 2023 were retrospectively included,and were divided into control group and observation group,with 51 cases in each group.The matched group patients were given conventional acupuncture treatment,while the observation group patients were given conventional electric acupuncture combined with Tianding acupoint treatment.The clinical efficacy,effectiveness,hiccup symptom scores before and Post-treatment,and quality of life score between two groups of patients.Results:The proportion of patients in the observation group who took immediate effect(27.45％vs.5.88％)and the proportion of patients who took effect within 24 hours of the first treatment(60.78％vs.17.65％)were higher than matched group.The average onset time[(32.14±9.72)h vs.(70.34±23.51)h]was significantly shorter than matched group(P＜0.05).The treatment recovery rate of observation group was higher than matched group(80.39％vs.50.98％,P＜0.05),and the total effective rate of treatment was not different from matched group(96.08％vs.86.27％,P＞0.05).Post-treatment,both groups of patients showed a significant decrease in hiccup symptom scores,and there were significant differences at different time points(P＜0.05).The hiccup symptom scores of the observation group patients at 1 d,3 d,and 5 d post-treatment were lower than matched group(P＜0.05).Post-treatment,the overall scores of appetite,mental state,sleep,and quality of life in both groups increased,and the scores in the observation group were higher than matched group(P＜0.05).Conclusion:The combination of electric acupuncture and Tianding acupoint has a significant therapeutic effect on post-stroke IH,which can quickly take effect,improve patients'clinical symptoms,and enhance their quality of life.

Objectives:To explore the predictive value of residual Murray's law-based quantitative flow ratio(μQFR)on long-term vessel-oriented composite endpoints(VoCE).Methods:This retrospective study included 3 510 patients from the FAVOR Ⅲ China trial.Offline residual μQFR analysis was performed on all vessels(diameter≥2.5 mm)with 50%-90%stenotic lesions.Patients were stratified into high-,intermediate-,and low-risk groups based on residual μQFR tertiles.The primary endpoint was 3-year VoCE,defined as a composite of cardiac death related to the target vessel,target vessel-related spontaneous myocardial infarction,and ischemia-driven target vessel revascularization.Results:Offline analysis was performed on 5 256 vessels from 3 510 patients.The mean residual μQFR was 0.92±0.75.The high-risk group(residual μQFR≤0.91)with 1 554 patients(1 958 vessels);the intermediate-risk group(residual μQFR 0.92-0.96)with 1 211 patients(1 906 vessels);and the low-risk group(residual μQFR>0.96)with 745 patients(1 392 vessels).Over 3-year follow-up,VoCE occurred in 227 vessels(4.3%).The 3-year VoCE incidence was significantly higher in the high-risk group compared to the intermediate-and low-risk groups(6.2%vs.4.1%vs.2.5%,log-rank P<0.001),primarily driven by ischemia-driven target vessel revascularization(5.0%vs.3.0%vs.1.6%,log-rank P<0.001).Hypertension(OR=0.83,95%CI:0.72-0.96),hypercholesterolemia(OR=0.84,95%CI:0.73-0.97),bifurcation lesions(OR=0.72,95%CI:0.63-0.83),moderate/severe calcification(OR=0.70,95%CI:0.57-0.84),and tandem lesions(OR=0.59,95%CI:0.47-0.75)were independent predictors of lower residual μQFR values.Conclusions:Lower residual μQFR is significantly associated with increased VoCE risk during the 3-year follow up period.

Objective:To explore the effect of electric acupuncture combined with Tianding acupoint on the efficacy,syndrome score,and quality of life of post-stroke intractable hiccup(IH).Methods:A total of 102 post-stroke IH patients admitted to our hospital from October 2022 to October 2023 were retrospectively included,and were divided into control group and observation group,with 51 cases in each group.The matched group patients were given conventional acupuncture treatment,while the observation group patients were given conventional electric acupuncture combined with Tianding acupoint treatment.The clinical efficacy,effectiveness,hiccup symptom scores before and Post-treatment,and quality of life score between two groups of patients.Results:The proportion of patients in the observation group who took immediate effect(27.45％vs.5.88％)and the proportion of patients who took effect within 24 hours of the first treatment(60.78％vs.17.65％)were higher than matched group.The average onset time[(32.14±9.72)h vs.(70.34±23.51)h]was significantly shorter than matched group(P＜0.05).The treatment recovery rate of observation group was higher than matched group(80.39％vs.50.98％,P＜0.05),and the total effective rate of treatment was not different from matched group(96.08％vs.86.27％,P＞0.05).Post-treatment,both groups of patients showed a significant decrease in hiccup symptom scores,and there were significant differences at different time points(P＜0.05).The hiccup symptom scores of the observation group patients at 1 d,3 d,and 5 d post-treatment were lower than matched group(P＜0.05).Post-treatment,the overall scores of appetite,mental state,sleep,and quality of life in both groups increased,and the scores in the observation group were higher than matched group(P＜0.05).Conclusion:The combination of electric acupuncture and Tianding acupoint has a significant therapeutic effect on post-stroke IH,which can quickly take effect,improve patients'clinical symptoms,and enhance their quality of life.

Objective:To observe the safety and short-term efficacy of using an autologous fascia lata sling (AFLS) for tension-free mid-urethral sling (MUS) in the treatment of stress urinary incontinence (SUI).Methods:Between February 2022 and December 2023, 11 patients with SUI underwent AFLS-MUS. Preoperative data were recorded, including basic patient information and completion of urinary distress inventory 6 (UDI-6). During surgery, AFLS was harvested through a small incision using a tendon extractor, and used as a sling for transobturator or retropubic MUS. Perioperative indicators were recorded, including surgical approach, operation time, intraoperative blood loss, postoperative hospital stay, duration of catheterization, perioperative complications (Clavien-Dindo classification), and surgical costs. Follow-ups included outpatient physical examination at 2 months postoperatively, and telephone follow-up at 6 months, 1 year, and annually thereafter. Follow-up content included the presence or absence of urinary leakage symptoms, UDI-6, satisfaction, patient global impression of improvement (PGI-I), and complications.Results:The age of the 11 patients was (54.8±10.9) years (range: 41-72 years), with body mass index of (23.9±1.8) kg/m2 (range: 21.4-27.3 kg/m2). All patients experienced urinary leakage after coughing, sneezing and physical activity, with positive SUI provocation tests. The preoperative UDI-6 was 50.0±21.6 (range: 16.7-79.2), the result of 1-hour pad test was (18.9±12.0) g (range: 2.5-71.2 g). Four cases underwent MUS only, with operation time of (98.0±13.3) minutes (range: 86-117 minutes), and intraoperative blood loss of (17.5±5.0) ml (range: 10-20 ml); 7 cases also underwent pelvic floor repair simultaneously. The postoperative hospital stay was (3.5±2.0) days (range: 2-9 days). The duration of catheterization was (4.5±3.8) days (range: 2-11 days), with postoperative urinary retention in three cases, one of which underwent sling release surgery due to severe postoperative voiding difficulty 1 week after MUS, with no other complications of Clavien-Dindo grade 2 or above. The cost of AFLS harvest plus MUS was (2 762±293) yuan. At the 2-month outpatient follow-up, all patients were free of urinary leakage symptoms, with UDI-6 of 2.3±1.9 (range: 0-8.3); satisfaction was "very satisfied" in 10 cases and "fairly satisfied" in 1 case, with PGI-I all being "much better", and pelvic examinations were normal. Telephone follow-up showed one case lost to follow-up, and the remaining 10 cases had follow-up time of (18.6±4.9) months (range: 7-26 months), all without urinary leakage, with UDI-6 of 2.7±2.6, satisfaction rated as "very satisfied", and PGI-I all "much better".Conclusion:This modified AFLS-MUS for the treatment of SUI shows good short-term efficacy and high safety in harvest site, with the need for more data accumulation and long-term follow-up.

Objective To explore the mechanism of Danggui Sini Decoction in treating knee osteoarthritis(KOA)by using network pharmacology,combined with in vitro experimental verification.Methods The active components of Danggui Sini Decoction were retrieved and screened through TCMSP,CNKI and PubMed databases,and their corresponding targets were predicted using the SwissTarget Prediction platform.KOA related targets were retrieved from GeneCards and OMIM databases.Intersection of drug targets and KOA targets was obtained,and key components,core targets,and their related biological mechanisms were identified through network topology analysis,GO and KEGG pathway enrichment analysis.Molecular docking was used to verify the degree of binding between key components and core targets.Danggui Sini Decoction containing serum was prepared,and an in vitro KOA model was constructed by inducing rat articular chondrocytes with lipopolysaccharide.The CCK-8 method was used to screen for the optimal concentration of drug containing serum intervention,fluorescent probes were used to detect intracellular ROS content,immunofluorescence was used to detect NF-κB p65 nuclear translocation,RT-qPCR was used to detect the expressions of IL-6,IL-1β and TNF-α mRNA,Western blot was used to detect the expression of Toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),NF-κB p65 and p-NF-κB p65 proteins.Results The results of network pharmacology analysis indicated that the treatment of KOA with Danggui Sini Decoction may involve regulating Toll like receptors,MAPK,TNF,apoptosis and other inflammatory and aging signaling pathways,compounds such as quercetin,kaempferol and glycyrrhizin may play important roles.Core targets included IL6,IL1B,TNF,TLR4,NFKB1,JUN,MAPK1,RELA.In vitro experiments showed that compared with the blank group,the ROS content in chondrocytes of the model group significantly increased(P<0.01),NF-κB p65 protein was significantly nuclear translocation(P<0.01),and mRNA expressions of IL-6,IL-1β,TNF-α mRNA and protein expressions of TLR4,MyD88 and p-NF-κB p65 significantly increased(P<0.01);compared with the model group,the intervention of Danggui Sini Decoction containing serum could significantly reduce intracellular ROS content(P<0.05),inhibit NF-κB p65 nuclear translocation(P<0.01),and reduce the expression of inflammatory factor mRNA and related proteins(P<0.05,P<0.01).Conclusion Danggui Sini Decoction can significantly reduce the inflammatory response of rat articular chondrocytes induced by lipopolysaccharide and exert therapeutic effects on KOA.Its mechanism may be related to the inhibition of TLR4/MyD88/NF-κB pathway.

Objective:To investigate the protective effect of PSD95 on neurobehavioral abnormalities and synaptic damage in cortex induced by hypoxia exposure in mice.Methods:The 3-week-old C57BL/6 male mice were injected with neuron-specific adeno-associated virus through stereotaxic brain after 7 days of normal environment adaptation.The mice were divided into normoxia group(AAV-NC-Nor),control hypoxia group(AAV-NC-Hyp),normal oxygen group with over-expression of postsynaptic density-95(PSD95)(AAV-PSD95-Nor),and hypoxia group with over-expression of PSD95(AAV-PSD95-Hyp).Using a hypobaric hypoxia chamber,PSD95-overexpressing mice were continuously ex-posed to hypoxic conditions for 14 days to establish a hypoxia exposure model.The open field,elevated cross maze and conditioned fear tests were used to detect the neurobehavioral activities of mice,and Golgi staining was used to observe the density of neuronal dendritic spines in cortex.The expression of PSD95,SYN1 and N-methyl-D-aspartate receptor subtype 2A(NMDAR2A)were detected by Western blot.Result:Compared with the normal oxygen group,the total distance and average speed of exercise in the open field experiment of mice in hypoxia group increased(P＜0.01),the rigidity time of mice in the conditioned fear box decreased(P＜0.01),and the density of dendritic spines in cortical region decreased(P＜0.05).The expressions of PSD95,SYN1 and NMDAR2A were decreased(P＜0.05).After the over-expression of PSD95,the autonomic activity of mice was reduced,the fear memory was relieved(P＜0.05),the dendrite density was reversed(P＜0.05),and the expression of synaptic related protein was increased(P＜0.05).Conclusion:Over-expression of PSD95 can alleviate neurobehavioral abnormalities and decline of fear memory induced under hypoxia exposure,protect neuronal dendritic spine injury in cortical region,and up-regulate the expression of syn-aptic protein.

Objective:To investigate the protective effect of PSD95 on neurobehavioral abnormalities and synaptic damage in cortex induced by hypoxia exposure in mice.Methods:The 3-week-old C57BL/6 male mice were injected with neuron-specific adeno-associated virus through stereotaxic brain after 7 days of normal environment adaptation.The mice were divided into normoxia group(AAV-NC-Nor),control hypoxia group(AAV-NC-Hyp),normal oxygen group with over-expression of postsynaptic density-95(PSD95)(AAV-PSD95-Nor),and hypoxia group with over-expression of PSD95(AAV-PSD95-Hyp).Using a hypobaric hypoxia chamber,PSD95-overexpressing mice were continuously ex-posed to hypoxic conditions for 14 days to establish a hypoxia exposure model.The open field,elevated cross maze and conditioned fear tests were used to detect the neurobehavioral activities of mice,and Golgi staining was used to observe the density of neuronal dendritic spines in cortex.The expression of PSD95,SYN1 and N-methyl-D-aspartate receptor subtype 2A(NMDAR2A)were detected by Western blot.Result:Compared with the normal oxygen group,the total distance and average speed of exercise in the open field experiment of mice in hypoxia group increased(P＜0.01),the rigidity time of mice in the conditioned fear box decreased(P＜0.01),and the density of dendritic spines in cortical region decreased(P＜0.05).The expressions of PSD95,SYN1 and NMDAR2A were decreased(P＜0.05).After the over-expression of PSD95,the autonomic activity of mice was reduced,the fear memory was relieved(P＜0.05),the dendrite density was reversed(P＜0.05),and the expression of synaptic related protein was increased(P＜0.05).Conclusion:Over-expression of PSD95 can alleviate neurobehavioral abnormalities and decline of fear memory induced under hypoxia exposure,protect neuronal dendritic spine injury in cortical region,and up-regulate the expression of syn-aptic protein.