ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

Background: and Purpose Live cell-based assays (LCBA) are increasingly used for serological antibody detection due to their ability to preserve antigen conformation, offering moderately higher sensitivity than fixed cell-based assays. However, the clinical necessity of prioritizing LCBA for the detection of aquaporin-4 immunoglobulin G (AQP4-IgG) in neuromyelitis optica spectrum disorder (NMOSD) remains unclear, especially when compared to its established role in diagnosing myelin oligodendrocyte glycoprotein antibody-associated disease. Methods: We compared the performance of live cell-based assays using immunofluorescence (LCBA-IF) and fixed cell-based assays using immunofluorescence (FCBA-IF) in detecting AQP4-IgG in 90 cases of NMOSD meeting 2015 International Panel for Neuromyelitis Optica Diagnosis criteria, alongside 40 controls. Additionally, we further investigated the relationship between AQP4-IgG titers as measured by LCBA-IF and FCBA-IF and clinical parameters in NMOSD patients. Results: Results showed 96.9% agreement between LCBA-IF and FCBA-IF (Cohen’s κ=0.935), with a strong Spearman correlation (0.977, p<0.001). Both methods demonstrated 100% specificity, with LCBA-IF showing slightly higher sensitivity compared to FCBA-IF. Within LCBAIF-tested groups, statistically significant differences in annualized relapse rates were observed across all pairwise comparisons (low-titer vs. moderate-titer, low-titer vs. high-titer, and moderate-titer vs. high-titer; all p<0.050). However, this association reached statistical significance in some FCBA-IF-tested groups. Conclusions Overall, there is a strong concordance between LCBA-IF and FCBA-IF in detecting AQP4-IgG, where LCBA-IF shows slightly higher sensitivity. Furthermore, there is a potential link between elevated AQP4-IgG titers and an increased risk of relapse, and this correlation may appear more pronounced when using LCBA-IF.

Objective To observe the effect of RAW264.7 cells on calcium sparks in a insulin resistance model of C2C12 cells induced by sodium palmitate.Methods C2C12 cells and RAW264.7 cells were co-cultured to simulate the in vivo state of skeletal muscle.C2C12 cells were cultured in high-glucose medium containing 2%horse serum to induce differentiation into mature myotubes,and then divided into 5 groups:control(RAW264.7 cells),co-culture of C2C12 with RAW264.7,C2C12 alone,co-culture of C2C12 with RAW264.7 plus sodium palmitate(PA),and C2C12 alone with PA.PA of 5 mmol/L was used to induce insulin resistance in C2C12 cells for 24 hours.Revived and expanded RAW264.7 cells were evenly added to C2C12 cells and co-cultured for two days.Subsequently,cells were maintained in modified suspension culture,and both cell types were loaded with the calcium ion fluorescent probe Fluo-4 AM.Finally,Paraxanthine was used to induce intracellular calcium sparks,which was captured and recorded under a laser confocal microscope.Results No significant calcium signal change was observed in the control group.Co-cultured C2C12 cells exhibited rapid and pronounced calcium signal changes,whereas calcium signals in C2C12 cells cultured alone increased slowly throughout the observation period without a sharp decline.The peak calcium signal was reached significantly faster in co-cultured C2C12 cells than that in C2C12 cells cultured alone(P<0.001).With PA induction,calcium signal changes in C2C12 cells were not markedly altered,while distinct calcium fluctuations were still observed in co-cultured C2C12 cells,and the peak calcium signal was reached significantly faster in co-cultured C2C12 cells than that in C2C12 cells cultured alone(P<0.001).Conclusion RAW264.7 cells enhance the dynamic responsiveness of calcium signaling in both normal and PA-stimulated C2C12 cells.

Objective:To analyze the association of peripheral blood systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)with disease severity and progno-sis in elderly patients with chronic pulmonary heart disease(CPHD).Methods:A total of 180 elderly CPHD pa-tients admitted in Xuancheng Central Hospital between September 2021 and January 2023 were enrolled as case group.Healthy volunteers who simultaneously underwent physical examinations in our hospital were selected as con-trol group(n=50).According to the 28d prognosis,the case group was divided into death group(n=45)and sur-vival group(n=135).Levels of peripheral blood SII,NLR and PLR were compared among above-mentioned groups;Spearman correlation analysis was used to analyze the association of above indexes with cardiac function class and prognosis in these patients.Multivariate Logistic regression analysis was used to analyze risk factors for death in these patients.The predictive value of SII,NLR,and PLR for death in elderly CPHD patients was ana-lyzed using receiver operating characteristic(ROC)curve.Results:Compared with those in control group,those in the case group had significant higher levels of peripheral blood SII,NLR and PLR(P＜0.001 all).Compared with NYHA class Ⅱ group and class Ⅲ group,those in class Ⅳ group had significant higher levels of peripheral blood SII[(1759.87±179.43)vs.(1148.33±121.57)vs.(1392.44±146.36)],NLR[(8.65±0.89)vs.(7.14±0.75)vs.(7.76±0.81)],PLR[(152.45±16.79)vs.(125.29±13.46)vs.(138.77±13.58)];and levels of peripheral blood SII,NLR,PLR in class Ⅲ group were significantly higher than those of class Ⅱ group(P＜0.001 all).Com-pared with patients in survival group,those in death group had significant higher levels of peripheral blood SII[(1723.86±189.65)vs.(1296.81±142.33)],NLR[(8.24±0.89)vs.(7.63±0.78)],PLR[(148.75±15.26)vs.(134.41±14.58)](P＜0.001 all).Spearman correlation analysis indicated that the levels of peripheral blood SII,NLR and PLR were significant positively correlated with the severity and poor prognosis(r=0.336～0.432,P＜0.05 or＜0.01;r=0.319～0.504,P＜0.05 or＜0.01)in elderly CPHD patients.Multivariate Logistic regression analy-sis indicated that peripheral blood SII,NLR,PLR and smoking were independent risk factors for death(OR=1.024～9.514,P＜0.05 or＜0.01)in elderly CPHD patients.ROC curve indicated that area under curve(AUC)of combination of SII,NLR and PLR predicting death in elderly CPHD patients was 0.979(95％CI 0.946～0.995),significantly higher than those of each single detection[SII:0.847(95％CI 0.786～0.896),NLR:0.832(95％CI 0.769～0.883),PLR:0.881(95％CI 0.825～0.925),Z=3.988,4.386,4.217,P＜0.01 all].The nomogram calibration curve and decision curve showed good consistency and net benefit of the model.Conclusion:Peripheral blood SII,NLR and PLR are associat-ed with the severity and prognosis of elderly CPHD patients,and have certain predictive value for patient's prognosis.

Objective:To investigate the status of post-traumatic stress disorder (PTSD) and its influencing factors in postoperative breast cancer patients.Methods:A convenience sampling method was used to select 410 postoperative breast cancer patients from the Provincial Hospital of the First Medical University of Shandong between January 2023 and December 2024. The PTSD Checklist-Civilian Version (PCL-C), the Connor-Davidson Resilience Scale (CD-RISC), and the Simple Coping Style Questionnaire (SCSQ) were used for assessment. Binary Logistic regression analysis was performed to analyze influencing factors.Results:A total of 410 questionnaires were distributed, and 405 valid questionnaires were returned, with an effective recovery rate of 98.78% (405/410). Among them, 150 patients were PTSD-positive. Binary Logistic regression analysis showed that educational level, monthly family income, psychological resilience, and coping style were influencing factors for PTSD in postoperative breast cancer patients ( P<0.05) . Conclusions:Low education level, low income, and negative coping style are risk factors for PTSD in postoperative breast cancer patients; positive coping style and high psychological resilience are protective factors. Clinical practitioners should develop preventive or intervention measures based on these influencing factors to reduce the occurrence of PTSD in postoperative breast cancer patients.

Objective To compare five time series models and predict the monthly incidence of bacillary dysentery in Qinghai Province in 2024,and provide reference for the prevention and control.Methods The epidemic charac-teristics of bacterial dysentery in Qinghai Province from 2014 to 2023 were analyzed.R4.3.1 software was used for establishing seasonal autoregressive integrated moving average(SARIMA)model,Holt-Winters triple exponential smoothing(Holt Winters)model,exponential smoothing(ETS)model,neural network autoregression(NNAR)model,and trigonometric seasonality,Box-Cox transformation,ARMA errors,trend and seasonal components(TBATS)model.Fitting effect of the models was analyzed and accuracy was compared.Results From 2014 to 2023,a total of 5 833 cases of bacterial dysentery were reported in Qinghai Province,without deaths,male to fe-male ratio being 1.23∶1.The highest incidence was reported in 2016(15.45 per 100 000 people),and the lowest in-cidence was reported in 2023(3.68 per 100 000 people).Incidence increased from 2014 to 2016,then decreased,showing an obvious overall downward trend.Case number in＜5 years age group was the highest,accounting for 29.76％of the total cases(n=1 736).Regarding population distribution,the top three were children in childcare institutions and scattered children(35.56％),farmers(24.65％),and students(12.62％).Except the additive Holt-Winters model,the predicted trends of the other four models were consistent with actuality.The ETS model had the best fitting effect,with a relatively balanced overall performance(training set:MAE=0.13,RMSE=0.21,MAPE=19.55％;testing set:MAE=0.11,RMSE=0.16,MAPE=28.66％).It is recommended to pre-dict the incidence of bacillary dysentery in Qinghai Province based on ETS model.Conclusion From 2014 to 2023,bacterial dysentery in Qinghai Province showed a downward trend,with the peak of the epidemic from June to Au-gust.Preschool and scattered children were high-risk groups.Among the five prediction models,ETS model has the best fitting effect,and can be used to predict the incidence of bacillary dysentery.

Objective To assess the clinical feasibility of a self-developed augmented reality(AR)system in surgeries for cerebral arteriovenous malformation(AVM),dural arteriovenous fistula(DAVF),moyamoya,and internal carotid artery stenosis.This system integrates preoperative vascular imaging(CTA,MRA,DSA)with intraoperative real-time visualization through high-precision patient-image registration and virtual-real integration technology.Methods A retrospective analysis was conducted on 6 patients(1 cerebral AVM,1 DAVF,3 moyamoya and 1 internal carotid artery stenosis)collected between March 2023 and April 2024.AR with three-dimensional reconstruction was used for preoperative precise localization and intraoperative navigation guidance.Clinical feasibility was evaluated and analyzed using an intraoperative self-controlled method.Results All 6 patients with diverse etiologies successfully underwent preoperative precise localization and intraoperative navigation guidance under AR three-dimensional reconstruction modeling.This technology achieved visualization of intracranial arteriovenous structures and precise lesion locations,providing surgeons with a visual reference for accurate planning of the surgical approach and operative field.Conclusion The application of AR with three-dimensional reconstruction is safe and feasible in neurosurgical procedures for cerebrovascular diseases.It demonstrates satisfactory effectiveness in preoperative localization and intraoperative navigation guidance.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To establish a rapid and precise dose measurement method with EBT4 film and ensure its measurement accuracy to be within the required range through strict operational procedures for the purpose of addressing the two essential issues of poor measurement accuracy and timeliness of EBT film under FLASH conditions.Methods:After storing under different humidity conditions for a certain period of time, the film was exposed to radiation for analyzing the influence of air humidity on the intrinsic performance of EBT film. By means of repeated scanning operations and the film angle rotation, the influences of repeated scanning and film placement angle were analuzed. Parabolic correction method was used to reduce the spatial position influence during the scanning process. By analying the relationship between net optical density (netOD) and absorbed dose through the comparison of three fitting method, the optimal fitting curve was selected. After irradiation of the same batch of films for 5 min and 24 h, the film doses were calibrated and then compared with ionization chamber-measured result. The rapid and precise film dosimetry method was used to measure both the percentage depth dose from X-rays at ultra-high dose rate and the dose distribution at a depth of 2 cm in water.Results:Air humidity had the greatest influence on the intrinsic performance of EBT film (approximately 20%). The average deviation of repeated scans is within 0.5%. The angle at which the film is placed significantly affected the readouts of the film with the maximum influence approximately 70%. The net optical density combined with polynomial fitting can control the fitting residuals of 1-16 Gy within 3%. The change rate of light channels at 5 min already mostly met the requirements of the rapid mode (< 0.5%). Compared with the measurement result obtained using the reference ionization chamber, the deviations of the 5 min or 24 h dose calibration curves were all within 2%.Conclusions:The EBT4 film can be employed as a precise dosimeter to quickly measure the FLASH radiation dose. Rapid and precise FLASH dose measurements can meet the stringent requirements of both preclinical and clinical FLASH research.

Objective:To investigate the radiation field distribution characteristics in a 9 MeV electron FLASH (e-FLASH) linear accelerator treatment room.Methods:The Geant4 Monte Carlo program was employed for physical simulating of the radiation field distribution inside and outside the treatment room under a single-beam delivery condition with a total dose of 50 Gy at the reference point and a dose rate of 250 Gy/s. High-sensitivity radiation detectors (AT1123) were used to validate the measurements at key points.Results:The dose rate at the reference point was approximately 9×10 11 μSv/h. Due to the scattering and shielding effects, the deviation of the attenuation rate from the inverse-square law was observed and the isodose lines exhibited spatial drift. Measured dose rates at key points showed good agreement with the simulation result, with a maximum deviation within 30%. Conclusions:The complex radiation field distribution can be effectively simulated using Geant4 in an e-FLASH treatment room. This indicated the Geant4 is not only applicable for the shielding calculations in e-FLASH radiotherapy facilities, but also for the design optimization through, reduction of trial-and-error iterations and engineering costs.