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.

ObjectiveTo address the shortage of high-caliber multidisciplinary professionals in China's rehabilitation engineering field and the prominent issue of "separation between medicine and engineering" in existing curricula, this study introduces the World Health Organization rehabilitation competency framework (RCF) to construct a systematic curriculum system for rehabilitation engineering. MethodsGuided by the four core competency domains of RCF (practice, professionalism, learning and development, management and leadership) and their associated supporting knowledge, the rehabilitation engineering curriculum was restructured into a modular framework, piloted and validated within the Biomedical Engineering (Intelligent Robotics) program at University of Health and Rehabilitation Sciences. ResultsA four-tiered curriculum system comprising General Education-Disciplinary Platform-Professional Core-Diverse Electives with a total of 160 credits was established, achieving precise mapping between competency objectives and course content. The students in the pilot cohort demonstrated outstanding academic performance (50% ranked in the top ten of their major), they also gained a deeper understanding and mastery of interdisciplinary knowledge integrating medicine and engineering. ConclusionThe RCF-based curriculum system effectively promotes the organic integration of medical and engineering knowledge, providing an internationally aligned competency-oriented paradigm for rehabilitation engineering talent cultivation, which holds significant value for broader application.

Objective In order to understand the current resistance status of Aedes albopictus(Ae. albopictus) adult population to commonly used insecticides and the resistance dynamics development in Zhejiang Province and provide a theoretical basis for the scientific and rational use of hygienic insecticides. Methods Resistance determination was carried out using the diagnostic dose method(GB/T 26347-2010)recommended by WHO in the adult mosquito contact cylinder method to monitor the resistance of Ae. albopictus field populations in 11 cities and districts in Zhejiang Province in 2024. Results The monitoring result showed that adult Ae. albopictus in 11 areas were resistant or suspected resistant populations to both cis-cypermethrin and permethrin; suspected and resistant populations to the organophosphate insecticide malathion were as high as 81.82%; while suspected resistance to the carbamate insecticide residual carbofuran accounted for 45.45%, and the rest of the monitoring sites were sensitive to it. Conclusions The result suggest that the generalized resistance of Ae. albopictus populations to pyrethroids and organophosphorus insecticides in the field in Zhejiang Province needs to be highly emphasized. In future mosquito vector and mosquito-borne disease control, insecticides should be selected based on the resistance monitoring information, while following scientific guidelines for insecticide use.

Objective:To investigate the risk factors of new onset atrial fibrillation(AF)after off-pump coronary artery bypass grafting(OPCABG)and predictive efficacy of the nomogram model.Methods:A total of 116 patients who under-went OPCABG surgery in Jiangsu Provincial People's Hospital between January 2020 and December 2023 were included in this observational study.Multivariate Logistic regression was performed to analyze the risk factors of new onset AF after OPCABG and a nomogram model was constructed.Receiver operating characteristic(ROC)curve was used to assess the predictive efficacy of the model.Results:Among 111 patients in the final analysis,45 patients developed new AF after sur-gery.Multivariate Logistic regression showed that age＞65 years(OR 4.780,95％CI 2.503～9.126,P＜0.001),hyper-tension(OR 7.587,95％CI 3.925～14.666,P＜0.001),right coronary artery stenosis(OR 2.261,95％CI 1.159～4.408,P=0.017),renal insufficiency(OR 2.973,95％CI 1.631～5.420,P＜0.001),β-receptor blockers usage(OR 2.337,95％CI 1.238～4.410,P=0.009)and left ventricular end-diastolic diameter(LVEDd)＞50mm(OR 3.659,95％CI 1.923～6.960,P＜0.001)were independent risk factors for new onset AF after OPCABG surgery.Based on the above-mentioned risk factors,the nomogram prediction model of the risk of new onset AF after OPCABG surgery was es-tablished.ROC analysis showed that the corrected AUC of nomogram model was 0.903(95％CI:0.832～0.951).Conclu-sion:A nomogram constructed based on age＞65 years,hypertension,right coronary artery stenosis,renal insufficiency,β-receptor blockers usage and LVEDd＞50mm had good predictive performance for new onset AF after OPCABG.

Objective To analyze the risk factors of permanent hypoparathyroidism(pHPP)after total thyroidectomy in patients with thyroid cancer and establish a nomogram prediction model.Methods A total of 245 patients with thyroid cancer who received total thyroidectomy in our hospital were enrolled between January 2020 and January 2024.According to presence or absence of postoperative pHPP,patients were divided into the pHPP group and the non-pHPP group.The influencing factors of postoperative pHPP in patients with thyroid cancer were analyzed by univariate and multivariate Logistic regression analysis.The nomogram prediction model for postoperative pHPP in patients with thyroid cancer was constructed and varified,and efficiency of the model was evaluated.Results In 245 patients with thyroid cancer,the incidence of pHPP within 6 months after surgery was 10.20%(25/245).Univariate analysis showed that there were significant differences in tumor size,surgical method,central lymph node dissection,use of nano carbon tracer,envelope invasion,parathyroid excision by mistake,Hashimoto thyroiditis,serum calcium and parathyroid hormone at 1 d after surgery between the two groups(P＜0.05),but there were no significant differences in gender,age,smoking,drinking,extraglandular invasion,parathyroid autologous transplantation,preoperative vitamin D or serum phosphorus at 1 d after surgery between the two groups(P＞0.05).Multivariate analysis showed that maximum tumor diameter≥4 cm,routine and open total thyroidectomy,central lymph node dissection,no use of nano carbon tracer and parathyroid excision by mistake were all independent risk factors for postoperative pHPP in patients with thyroid cancer(P＜0.05).Results of nomogram prediction model showed that C-index was 0.921,the corrected curve was close to ideal curve,and AUC of nomogram model for predicting postoperative pHPP was 0.926(95%CI:0.871-0.981).Conclusion The nomogram prediction model constructed based on independent risk factors of postoperative pHPP has good predictive efficiency in patients with thyroid cancer.

Objective To analyze the risk factors of permanent hypoparathyroidism(pHPP)after total thyroidectomy in patients with thyroid cancer and establish a nomogram prediction model.Methods A total of 245 patients with thyroid cancer who received total thyroidectomy in our hospital were enrolled between January 2020 and January 2024.According to presence or absence of postoperative pHPP,patients were divided into the pHPP group and the non-pHPP group.The influencing factors of postoperative pHPP in patients with thyroid cancer were analyzed by univariate and multivariate Logistic regression analysis.The nomogram prediction model for postoperative pHPP in patients with thyroid cancer was constructed and varified,and efficiency of the model was evaluated.Results In 245 patients with thyroid cancer,the incidence of pHPP within 6 months after surgery was 10.20%(25/245).Univariate analysis showed that there were significant differences in tumor size,surgical method,central lymph node dissection,use of nano carbon tracer,envelope invasion,parathyroid excision by mistake,Hashimoto thyroiditis,serum calcium and parathyroid hormone at 1 d after surgery between the two groups(P＜0.05),but there were no significant differences in gender,age,smoking,drinking,extraglandular invasion,parathyroid autologous transplantation,preoperative vitamin D or serum phosphorus at 1 d after surgery between the two groups(P＞0.05).Multivariate analysis showed that maximum tumor diameter≥4 cm,routine and open total thyroidectomy,central lymph node dissection,no use of nano carbon tracer and parathyroid excision by mistake were all independent risk factors for postoperative pHPP in patients with thyroid cancer(P＜0.05).Results of nomogram prediction model showed that C-index was 0.921,the corrected curve was close to ideal curve,and AUC of nomogram model for predicting postoperative pHPP was 0.926(95%CI:0.871-0.981).Conclusion The nomogram prediction model constructed based on independent risk factors of postoperative pHPP has good predictive efficiency in patients with thyroid cancer.

Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Practice Guidelines as Topic ; Drugs, Chinese Herbal/therapeutic use*

Objective:To investigate the risk factors of new onset atrial fibrillation(AF)after off-pump coronary artery bypass grafting(OPCABG)and predictive efficacy of the nomogram model.Methods:A total of 116 patients who under-went OPCABG surgery in Jiangsu Provincial People's Hospital between January 2020 and December 2023 were included in this observational study.Multivariate Logistic regression was performed to analyze the risk factors of new onset AF after OPCABG and a nomogram model was constructed.Receiver operating characteristic(ROC)curve was used to assess the predictive efficacy of the model.Results:Among 111 patients in the final analysis,45 patients developed new AF after sur-gery.Multivariate Logistic regression showed that age＞65 years(OR 4.780,95％CI 2.503～9.126,P＜0.001),hyper-tension(OR 7.587,95％CI 3.925～14.666,P＜0.001),right coronary artery stenosis(OR 2.261,95％CI 1.159～4.408,P=0.017),renal insufficiency(OR 2.973,95％CI 1.631～5.420,P＜0.001),β-receptor blockers usage(OR 2.337,95％CI 1.238～4.410,P=0.009)and left ventricular end-diastolic diameter(LVEDd)＞50mm(OR 3.659,95％CI 1.923～6.960,P＜0.001)were independent risk factors for new onset AF after OPCABG surgery.Based on the above-mentioned risk factors,the nomogram prediction model of the risk of new onset AF after OPCABG surgery was es-tablished.ROC analysis showed that the corrected AUC of nomogram model was 0.903(95％CI:0.832～0.951).Conclu-sion:A nomogram constructed based on age＞65 years,hypertension,right coronary artery stenosis,renal insufficiency,β-receptor blockers usage and LVEDd＞50mm had good predictive performance for new onset AF after OPCABG.

Objectives:To explore the value of improving the sensitivity of Epstein-Barr virus(EBV) DNA detection for the diagnosis and efficacy assessment of nasopharyngeal carcinoma.Methods:This was an observational study. The precision of the EBV DNA detection system used in this study was verified at the level of 100 copies/ml in accordance with the requirements of verification experiments, and the accuracy of the detection system was evaluated by comparing with digital PCR method. Totally 52 plasma samples were collected from patients who were newly diagnosed with undifferentiated non-keratinizing carcinoma of the nasopharynx at Nanfang Hospital of Southern Medical University from December 2021 to May 2022 in addition to156 plasma samples from nasopharyngeal carcinoma patients treated at the Radiotherapy Department of the hospital, and a retrospective analysis was also performed on 5 488 plasma samples that had been submitted for quantitative EBV DNA detection over the same period at the hospital. The effetcs of raising the EBV DNA detection threshold from 500 copies/ml to 100 copies/ml on the detection rate of nasopharyngeal carcinoma and the therapeutic efficacy assessment were compared.Results:The bias between the logarithmic values of the detected quantities and the target quantities was below±0.4 ( CV=6.94%) for the testings of 30 repetitions of the sample at the level of 100 copies/ml. The circulating EBV DNA of 156 patients with nasopharyngeal carcinoma was measured by the detection system and by digital PCR, and the results of the two methods showed good consistency ( r=0.95, P<0.001). By raising the EBV DNA detection threshold from 500 copies/ml to 100 copies/ml, the detection rate of nasopharyngeal carcinoma in untreated patients increased from 67.31% (35/52) to 82.69% (43/52). For nasopharyngeal carcinoma patients under treatment, the peripheral blood EBV DNA detection rates were 12.82% (20/156) and 23.72% (37/156) with detection thresholds of 500 copies/ml and 100 copies/ml, respectively. Conclusion:This research improved the EBV detection rate by increasing the sensitivity of EBV DNA assays, which is of great significance for the auxiliary diagnosis and therapeutic efficacy assessment in nasopharyngeal carcinoma patients.