ObjectiveTo evaluate the clinical efficacy and safety of Xiaozhen Formula （消疹方） in preventing skin toxicity induced by epidermal growth factor receptor inhibitors （EGFRIs） in patients with EGFR-mutant non-small cell lung cancer （NSCLC）. MethodsA randomized， double-blind， placebo-controlled， multicenter clinical study was conducted. A total of 120 patients with EGFR-mutant NSCLC from seven centers were enrolled and randomly assigned to a treatment group （60 cases） or a control group （60 cases）. On the basis of EGFRI-targeted therapy， patients in the treatment group received Xiaozhen Formula granules， whereas those in the control group received Xiaozhen Formula placebo granules， both at 10 g twice daily for 4 consecutive weeks. The primary outcomes were the grading of skin toxicity evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events （NCI-CTCAE） version 5.0 and the incidence of rash. Secondary outcomes included the time to onset and time to resolution of the highest-grade rash， the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 （EORTC QLQ-C30） scores， the Hospital Anxiety and Depression Scale （HADS） scores， and disease control rate， together with safety assessments. ResultsBased on the full analysis set （FAS）， the incidence of skin toxicity in the treatment group was 18.33% （11/60）， significantly lower than 45.00% （27/60） in the control group （P＜0.01）， with the highest severity of skin toxicity in both groups was grade 2. Among patients who developed rash， the resolution rate in the treatment group was 90.91% （10/11）， higher than that 33.33% （9/27） in the control group. The median time to resolution was 15 days （95%CI： 8-17 days） in the treatment group and it was not reached in the control group； the distribution of time to resolution differed significantly between groups （P＜0.001）. After treatment， the treatment group had higher EORTC QLQ-C30 functional scale and global health status/quality-of-life scores， and lower symptom scale， single-item scores， as well as HADS-A， and HADS-D scores than the control group （P＜0.05）. In the FAS analysis， the disease control rate （DCR） was 85.0% （51/60） in the treatment group， lower than 100.0% （60/60） in the control group （P=0.003）， whereas no significant between-group difference was observed in the per-protocol set （PPS） analysis （P=0.464）. The incidence of adverse events did not differ significantly between the two groups （P＞0.05）， and no definite safety signals related to the investigational drug were observed. ConclusionXiaozhen Formula can reduce the incidence of EGFRI-induced skin toxicity， and improve the outcome of rash regression， the patients' quality of life and psychological status in EGFR-mutant NSCLC patients.

Objective To explore the feasibility and safety of ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer.Methods Totally 84 patients who underwent ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer were enrolled,and the technical success rate,complete ablation rate,complication rate,pain relief rate and survival time,etc.were observed.Results The median age of 84 cases was 61.5 years.Totally 86 tumors,including 44.19％(38/86)at the head/neck and 55.81％(48/86)at the body/tail of pancreas were detected,and a total of 85 ablation sessions were performed with the median ablation energy applied per tumor of 9.90(1.08,21.60)kJ and the complete ablation rate of 42.86％(36/84).The technical success rate was 100％(85/85).Thirty-nine complication events occurred in 25 cases,no ablation-related death.Among 34 patients underwent ablation mainly for pain symptoms,the pain score decreased from(6.22±1.12)points before treatment to(1.94±1.64)points after treatment(P＜0.001).During 6.8(3.3,12.9)months' follow-up,the mean survival time was(8.5±6.7)months,and all 47 patients died due to tumor progression.Conclusion Ultrasound-guided percutaneous microwave ablation was safe and feasible for unresectable pancreatic cancer.

OBJECTIVE T o verify and compare the values of the different risk assessment scores in prediction of in-fections in the ST elevation myocardial infarction(STEMI)patients undergoing percutaneous coronary interven-tion(PCI)therapy.METHODS A total of 226 STEMI patients who received PCI in The Second Medical Center of Chinese PLA General Hospital from Aug.2019 to Jul.2024 were recruited as the research subjects.The efficien-cies of the six types of risk assessment scores,including age,serum creatinine,or glomerular filtration rate/ejec-tion fraction(ACEF/AGEF)score,Canadian acute coronary syndrome(C ACS)score,embolism risk score 2(CHADS2)score,global register of acute coronary events(GRACE)score and for contrast induced nephropathy(Mehran)scorein prediction of infections and major adverse clinical events(M ACE)were analyzed.RESULTS All of the risk assessment scores showed remarkable discriminating capability in prediction of infections(AUC:0 746 to 0 791)except CHADS2 score[the area under the curve(AUC)=0.682;95％CI=0.652 to 0.712)].All of the risk assessment scores showed the excellent performance in calibration of infections except CACS risk assess-ment score(calibration slope=0.77;95％CI=0.18 to 1.35).The risk assessment scores also showed tremen-dous capability in discriminating MACE during the hospital stay except CHADS2 score,with the AUC ranging be-tween 0.700 and 0.786.All of the six types of risk assessment scores showed the most excellent performance in calibration of MACE during the hospital stay.CONCLUSION ACEF,AGEF,CACS,GRACE and Mehran scores show remarkable discriminating capability and calibration in prediction of infections and MACE.

Objective To explore the mechanism of electroacupuncture in treating rats with urinary incontinence after suprasacral spinal cord injury based on EP3-HCN1 signaling pathway.Methods Totally 48 female SD rats were divided into sham-operation group(12 rats)and modeling group(36 rats,prepared as urinary incontinence model rats after suprasacral spinal cord injury)according to the random number table method.The molded rats were randomly divided into the model group,electroacupuncture group and electroacupuncture+EP3 agonist group after successful modeling,with 11 rats in each group.The electroacupuncture group stimulated"Guanyuan","Zhongji"and"Sanyinjiao"acupoints,and the electroacupuncture+EP3 agonist group injected EP3 agonist sulprostone into the tail vein before electroacupuncture treatment once a day for 7 days.The urodynamic indexes of rats were detected,the morphology of the bladder tissues were observed by HE staining,Western blot and RT-qPCR were used to detect the protein and mRNA expressions of c-Kit,EP3 and hyperpolarized activated cyclic nucleotide gated channel protein(HCN)1 in bladder tissue,respectively.Immunofluorescence was used to detect the positive expressions of c-Kit,EP3 and HCN1 in bladder tissue.Results Compared with the sham-operation group,the model group rats showed an increase in bladder basal pressure and leak point pressure(P<0.01),and a decrease in bladder maximum capacity and compliance(P<0.01);the arrangement of epithelial cells in bladder tissue was disordered,leading to pathological phenomena such as inflammatory cell infiltration,tissue edema and bleeding;the protein and mRNA expressions of c-Kit,EP3 and HCN1 in bladder tissue significantly increased(P<0.05,P<0.01).Compared with the model group,the electroacupuncture group showed a decrease in bladder basal pressure and leak point pressure(P<0.01),while the bladder maximum capacity and compliance increased(P<0.05,P<0.01);the morphology of bladder tissue was relatively normal;the protein and mRNA expressions of c-Kit,EP3 and HCN1 in bladder tissue were all decreased(P<0.05,P<0.01).Compared with the electroacupuncture group,the electroacupuncture+EP3 agonist group showed an increase in bladder basal pressure and leak point pressure(P<0.05,P<0.01),a decrease in bladder maximum capacity and compliance(P<0.05,P<0.01);aggravated pathological damage to bladder tissue;the protein and mRNA expressions of c-Kit,EP3 and HCN1 in bladder tissue increased(P<0.05,P<0.01).Conclusion Electroacupuncture of"Zhongji","Guanyuan"and"Sanyinjiao"alleviates excessive contraction of the bladder detrusor muscle by inhibiting the activation of the EP3-HCN1 pathway,thereby improving urinary incontinence symptoms after suprasacral spinal cord injury in rats.

Objective:To construct an integrated management model for early screening and diagnosis of PCa based on the In-novative Care for Chronic Conditions Framework(ICCC)and the 1+1 contract-based tiered diagnosis and treatment system(TDTS)in China.Methods:Based on the 1+1 contract-based TDTS platform,we conducted PCa screening for the male residents aged 60 years and above during health check-ups in Pujin Community Health Center from January 1,2023 to December 31,2023.For those with abnormal total prostate-specific antigen(tPSA)≥4 μg/L,we promptly referred them to higher-level hospitals for further diagno-sis and treatment via the two-way referral green channel platform and information sharing service using the 1+1 contract model.We further analyzed the relevant data on screening and diagnosis.Results:A total of 4 080 males aged 71.39±5.059 years received PCa screening from January to December 2023.PSA screening was performed in 43.96％of the male residents,revealing 654 cases of PSA abnormality,with a PSA positivity rate of 16.03％,which was higher than that found in the previous large-scale PCa screenings in other regions of China.Among the males with PSA abnormality,292(44.65％)expressed their willingness for medical referral,while the others did not seek further medical attention for reasons of being asymptomatic,low awareness of the disease,no accompany for medical visits,and concerns about further costs of diagnosis and treatment.Prostate biopsy was recommended to 154 cases after further examinations,which was accepted by 92(59.74％).Fifty-eight cases were diagnosed with Pa,and thedetection rate reached 63.04％.Conclusion:The integrated management model for PSA examination-based early screening and diagnosis of PCa using the 1+1 contract-based TDTS platform is plays a significant role in enhancing peoples awareness and knowledge of PCa and improving the early detection rate of the malignancy.

Objective:To investigate factors influencing frequent episodes (≥ 4 episodes within 1 year) in children with moderate-to-severe atopic dermatitis (AD) in China.Methods:A national multicenter cross-sectional study was conducted. Patients under the age of 18 years diagnosed with moderate-to-severe AD were enrolled at dermatology clinics in 18 medical institutions across 12 provinces and municipalities in China between June 12 and August 8, 2023. At the time of the visit, their guardians completed a structured questionnaire covering demographic characteristics, clinical features of AD, personal and family history, factors associated with frequent episodes of moderate-to-severe AD, compliance with treatment, and disease awareness. Statistical analyses included t tests, one-way analysis of variance, rank-sum tests, and chi-square tests, with multiple-response analysis applied for multiple-choice questions. Results:A total of 965 valid questionnaires were collected, and 965 children with moderate-to-severe AD were included. Among them, there were 531 males and 434 females, 678 (70.3%) were aged 2 - < 12 years, 837 (86.7%) were from urban areas, the age at onset was 2.47 ± 3.03 years, and the median frequency of AD episodes in the past year was 4 times. These children were divided into 2 groups based on the median episode frequency: < 4-episode group (439 cases, 45.5%) and ≥ 4-episode group (526 cases, 54.5%). Compared with the < 4-episode group, children in the ≥ 4-episode group showed younger ages at onset (2.22 ± 2.98 years vs. 2.76 ± 3.06 years, P = 0.006) and higher proportions of patients with comorbid allergic diseases in both the children themselves (82.9% [436/526] vs. 69.7% [306/439], χ2 = 23.42, P < 0.001) and their relatives (66.0% [347/526] vs. 57.4% [252/439], χ2 = 7.46, P = 0.006). Children in the ≥ 4- episode group also had higher monthly usage of moisturizers (150 [30, 300] g vs. 60 [6, 200] g) and daily frequency of moisturizer use, greater disease awareness, but more severe fear of medication use (all P < 0.05). The region and the human development index level were both significantly associated with the episode frequency (both P < 0.001), with the highest proportion of children from South China in the ≥ 4- episode group (36.3%, 191/526). Children in the ≥ 4-episode group also had a longer duration of topical glucocorticoid use than those in the < 4-episode group ( Z = -2.21, P = 0.027). External triggers associated with AD episodes mainly included heat exposure (50.36%, 486/965), hot water bathing (40.73%, 393/965), seafood (23.52%, 227/965), and dust mites (33.37%, 322/965) . Conclusion:In children with moderate-to-severe AD in China, factors influencing frequent episodes may include residence in southern or economically developed regions, earlier age at onset, having a personal or family history of allergic diseases, and fear of medication use.

Objective To explore the mechanism of electroacupuncture in treating rats with urinary incontinence after suprasacral spinal cord injury based on EP3-HCN1 signaling pathway.Methods Totally 48 female SD rats were divided into sham-operation group(12 rats)and modeling group(36 rats,prepared as urinary incontinence model rats after suprasacral spinal cord injury)according to the random number table method.The molded rats were randomly divided into the model group,electroacupuncture group and electroacupuncture+EP3 agonist group after successful modeling,with 11 rats in each group.The electroacupuncture group stimulated"Guanyuan","Zhongji"and"Sanyinjiao"acupoints,and the electroacupuncture+EP3 agonist group injected EP3 agonist sulprostone into the tail vein before electroacupuncture treatment once a day for 7 days.The urodynamic indexes of rats were detected,the morphology of the bladder tissues were observed by HE staining,Western blot and RT-qPCR were used to detect the protein and mRNA expressions of c-Kit,EP3 and hyperpolarized activated cyclic nucleotide gated channel protein(HCN)1 in bladder tissue,respectively.Immunofluorescence was used to detect the positive expressions of c-Kit,EP3 and HCN1 in bladder tissue.Results Compared with the sham-operation group,the model group rats showed an increase in bladder basal pressure and leak point pressure(P<0.01),and a decrease in bladder maximum capacity and compliance(P<0.01);the arrangement of epithelial cells in bladder tissue was disordered,leading to pathological phenomena such as inflammatory cell infiltration,tissue edema and bleeding;the protein and mRNA expressions of c-Kit,EP3 and HCN1 in bladder tissue significantly increased(P<0.05,P<0.01).Compared with the model group,the electroacupuncture group showed a decrease in bladder basal pressure and leak point pressure(P<0.01),while the bladder maximum capacity and compliance increased(P<0.05,P<0.01);the morphology of bladder tissue was relatively normal;the protein and mRNA expressions of c-Kit,EP3 and HCN1 in bladder tissue were all decreased(P<0.05,P<0.01).Compared with the electroacupuncture group,the electroacupuncture+EP3 agonist group showed an increase in bladder basal pressure and leak point pressure(P<0.05,P<0.01),a decrease in bladder maximum capacity and compliance(P<0.05,P<0.01);aggravated pathological damage to bladder tissue;the protein and mRNA expressions of c-Kit,EP3 and HCN1 in bladder tissue increased(P<0.05,P<0.01).Conclusion Electroacupuncture of"Zhongji","Guanyuan"and"Sanyinjiao"alleviates excessive contraction of the bladder detrusor muscle by inhibiting the activation of the EP3-HCN1 pathway,thereby improving urinary incontinence symptoms after suprasacral spinal cord injury in rats.

Objective To explore the feasibility and safety of ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer.Methods Totally 84 patients who underwent ultrasound-guided percutaneous microwave ablation for unresectable pancreatic cancer were enrolled,and the technical success rate,complete ablation rate,complication rate,pain relief rate and survival time,etc.were observed.Results The median age of 84 cases was 61.5 years.Totally 86 tumors,including 44.19％(38/86)at the head/neck and 55.81％(48/86)at the body/tail of pancreas were detected,and a total of 85 ablation sessions were performed with the median ablation energy applied per tumor of 9.90(1.08,21.60)kJ and the complete ablation rate of 42.86％(36/84).The technical success rate was 100％(85/85).Thirty-nine complication events occurred in 25 cases,no ablation-related death.Among 34 patients underwent ablation mainly for pain symptoms,the pain score decreased from(6.22±1.12)points before treatment to(1.94±1.64)points after treatment(P＜0.001).During 6.8(3.3,12.9)months' follow-up,the mean survival time was(8.5±6.7)months,and all 47 patients died due to tumor progression.Conclusion Ultrasound-guided percutaneous microwave ablation was safe and feasible for unresectable pancreatic cancer.

Objective:To investigate factors influencing frequent episodes (≥ 4 episodes within 1 year) in children with moderate-to-severe atopic dermatitis (AD) in China.Methods:A national multicenter cross-sectional study was conducted. Patients under the age of 18 years diagnosed with moderate-to-severe AD were enrolled at dermatology clinics in 18 medical institutions across 12 provinces and municipalities in China between June 12 and August 8, 2023. At the time of the visit, their guardians completed a structured questionnaire covering demographic characteristics, clinical features of AD, personal and family history, factors associated with frequent episodes of moderate-to-severe AD, compliance with treatment, and disease awareness. Statistical analyses included t tests, one-way analysis of variance, rank-sum tests, and chi-square tests, with multiple-response analysis applied for multiple-choice questions. Results:A total of 965 valid questionnaires were collected, and 965 children with moderate-to-severe AD were included. Among them, there were 531 males and 434 females, 678 (70.3%) were aged 2 - < 12 years, 837 (86.7%) were from urban areas, the age at onset was 2.47 ± 3.03 years, and the median frequency of AD episodes in the past year was 4 times. These children were divided into 2 groups based on the median episode frequency: < 4-episode group (439 cases, 45.5%) and ≥ 4-episode group (526 cases, 54.5%). Compared with the < 4-episode group, children in the ≥ 4-episode group showed younger ages at onset (2.22 ± 2.98 years vs. 2.76 ± 3.06 years, P = 0.006) and higher proportions of patients with comorbid allergic diseases in both the children themselves (82.9% [436/526] vs. 69.7% [306/439], χ2 = 23.42, P < 0.001) and their relatives (66.0% [347/526] vs. 57.4% [252/439], χ2 = 7.46, P = 0.006). Children in the ≥ 4- episode group also had higher monthly usage of moisturizers (150 [30, 300] g vs. 60 [6, 200] g) and daily frequency of moisturizer use, greater disease awareness, but more severe fear of medication use (all P < 0.05). The region and the human development index level were both significantly associated with the episode frequency (both P < 0.001), with the highest proportion of children from South China in the ≥ 4- episode group (36.3%, 191/526). Children in the ≥ 4-episode group also had a longer duration of topical glucocorticoid use than those in the < 4-episode group ( Z = -2.21, P = 0.027). External triggers associated with AD episodes mainly included heat exposure (50.36%, 486/965), hot water bathing (40.73%, 393/965), seafood (23.52%, 227/965), and dust mites (33.37%, 322/965) . Conclusion:In children with moderate-to-severe AD in China, factors influencing frequent episodes may include residence in southern or economically developed regions, earlier age at onset, having a personal or family history of allergic diseases, and fear of medication use.

OBJECTIVE T o verify and compare the values of the different risk assessment scores in prediction of in-fections in the ST elevation myocardial infarction(STEMI)patients undergoing percutaneous coronary interven-tion(PCI)therapy.METHODS A total of 226 STEMI patients who received PCI in The Second Medical Center of Chinese PLA General Hospital from Aug.2019 to Jul.2024 were recruited as the research subjects.The efficien-cies of the six types of risk assessment scores,including age,serum creatinine,or glomerular filtration rate/ejec-tion fraction(ACEF/AGEF)score,Canadian acute coronary syndrome(C ACS)score,embolism risk score 2(CHADS2)score,global register of acute coronary events(GRACE)score and for contrast induced nephropathy(Mehran)scorein prediction of infections and major adverse clinical events(M ACE)were analyzed.RESULTS All of the risk assessment scores showed remarkable discriminating capability in prediction of infections(AUC:0 746 to 0 791)except CHADS2 score[the area under the curve(AUC)=0.682;95％CI=0.652 to 0.712)].All of the risk assessment scores showed the excellent performance in calibration of infections except CACS risk assess-ment score(calibration slope=0.77;95％CI=0.18 to 1.35).The risk assessment scores also showed tremen-dous capability in discriminating MACE during the hospital stay except CHADS2 score,with the AUC ranging be-tween 0.700 and 0.786.All of the six types of risk assessment scores showed the most excellent performance in calibration of MACE during the hospital stay.CONCLUSION ACEF,AGEF,CACS,GRACE and Mehran scores show remarkable discriminating capability and calibration in prediction of infections and MACE.