ObjectiveTo systematically evaluate the efficacy and safety of Qi-reinforcing and blood-activating/stasis-expelling Chinese patent medicines in the treatment of coronary microvascular disease （CMD）. MethodsPubMed， Cochrane Library， CNKI， Wanfang Data， and VIP were searched for the randomized controlled trials （RCTs） on the treatment of CMD with Chinese patent medicines for reinforcing Qi and activating blood/expelling stasis with the time interval from inception to December 31， 2023. The primary outcome indicators included the index of microcirculatory resistance （IMR）， coronary flow reserve （CFR）， and corrected TIMI flow frame count （cTFC）. The secondary outcome indicators included symptomatic efficacy， left ventricular ejection fraction （LVEF）， hypersensitive C-reactive protein （hs-CRP）， nitric oxide （NO）， and adverse events. Cochrane risk-of-bias assessment tool 2.0 （RoB 2.0） and Stata 17.0 were used for literature quality evaluation and meta-analysis of the included RCTs. The Grading of Recommendations， Assessment， Development and Evaluation （GRADE） was used to evaluate the quality of evidence. ResultsA total of 36 RCTs were included in this study， involving 3 029 patients. Compared with conventional Western medicine alone， the combined use of Chinese patent medicines for reinforcing Qi and activating blood/expelling stasis and Western medicine reduced the IMR ［mean difference （MD）=-5.93， 95% confidence interval （95%CI） ［-8.73，-3.14］， n=382， P<0.01］， cTFC （MD=-9.35， 95%CI ［-13.94，-4.76］， n=618， P<0.01）， and hs-CRP ［standard mean difference （SMD）=-1.50， 95%CI ［-1.90，-1.11］， n=1 483， P<0.01］， improved the CFR （SMD=1.14， 95%CI ［0.08，2.19］， n=304， P=0.03）， symptomatic efficacy ［relative risk （RR）=1.36， 95%CI ［1.21，1.53］， n=756， P<0.01］， LVEF （MD=4.39， 95%CI ［2.31，6.47］， n=533， P<0.01）， and NO （SMD=3.16， 95%CI ［2.07，4.25］， n=946， P<0.01） of CMD patients. In terms of safety， the combined therapy reduced the occurrence of adverse events in CMD patients （RR=0.49， 95%CI ［0.29，0.82］， n=591， P=0.01）. GRADE showed moderate quality evidence for adverse events， low quality evidence for cTFC， symptomatic efficacy， LVEF， and NO， and very low quality evidence for IMR， CFR， and hs-CRP. ConclusionBased on microcirculatory function indicators， the combined use of Qi-reinforcing and blood-activating/stasis-expelling Chinese patent medicines and Western medicine may further improve the coronary microvascular function in CMD patients with good safety. The above conclusions remain to be verified with high-quality clinical trials.

Objective To investigate the risk factors for acute respiratory failure in immunocompromised patients with Pneumocystis jirovecii pneumonia(PJP).Methods Clinical data of 123 immunocompromised patients complicated with PJP hospitalized at Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2021 to December 2023 were retrospectively collected and analyzed.SPSS 22.0 statistical software package was used to perform multivariate binary logistic regression analysis to identify risk factors for acute respiratory failure in PJP patients.Results Among the 123 PJP patients,77 were HIV-positive,and 46 were HIV-negative.HIV-negative PJP patients were more likely to have comorbidities such as hypertension(P＜0.001),diabetes mellitus(P＜0.001),coronary heart disease(P=0.034),chronic kidney disease(P＜0.001),chronic liver disease(P=0.019),chronic lung disease(P=0.011),and malignant tumor(P＜0.001).They were also more prone to respiratory failure(P＜0.001)and ICU admission(P＜0.001).The HIV-positive patients had significantly lower CD4+T lymphocyte counts and albumin levels(P＜0.001).Forty patients developed acute respiratory failure,and six patients died.Multivariate analysis showed that high neutrophil-to-lymphocyte ratio(NLR)(P=0.031),non-HIV infection(P=0.002),and concomitant infections with other pathogens(P＜0.001)were independent risk factors for incidence of respiratory failure.ROC curve analysis revealed that the area under the curve(AUC)was 0.686(0.584,0.789)for non-HIV infection,0.731(0.637,0.826)for concomitant infections with other pathogens,0.648(0.546,0.750)for NLR.The predicted probability was 0.845(0.778,0.912).Conclusions Non-HIV infection,high NLR,and concomitant infections with other pathogens are independent risk factors for incidence of respiratory failure in PJP patients.The panel combining these factors provides a higher predictive value for respiratory failure.Timely assessment of patient condition and early treatment are vital for better outcomes.

Objective The medication pattern of doctor Chen Jie in treating functional dyspepsia(FD)in children and the potential mechanism of action of core drug group were explored through data mining and network pharmacology methods.Methods The prescriptions for pediatric FD treated by doctor Chen Jie in the outpatient department of Second Affiliated Hospital of Wenzhou Medical University from January 2020 to December 2024 were collected to establish a prescription database.Excel 2019 and SPSS software were applied to statistically analyze the nature,taste,meridian tropism and frequency of drugs included in the prescriptions,and association rule analysis and cluster analysis were conducted.The potential mechanism of action of the core drug group was explored by using the network pharmacology method.Results A total of 603 prescriptions were included,involving 160 kinds of drugs,with a cumulative frequency of medication reaching 5012 times.Among them,the medicinal nature and flavour were mainly warm and sweet,and channel tropism were mainly the spleen,stomach and lung meridians.The core drug group obtained through association rules and cluster analysis was"Fuchao Baizhu-Fuling-Chenpi".Network pharmacological analysis was conducted on the core drug group,and it was found that its main components included naringenin,atractylenolide Ⅰ,atractylone,and hederagenin,as well as core genes such as AKT1,TNF,IL-6,ESR1,and IL-1β.The main enrichment pathways were lipids and atherosclerosis,advanced glycation end product-advanced glycation end product receptor signaling pathway,cancer pathway,etc..Conclusion Doctor Chen Jie's medication for treating FD in children mainly focuses on invigorating spleen and replenishing qi,regulating qi-flowing for eliminating dampness.The core drug group,"Fuchao Baizhu-Fuling-Chenpi",exerts its effects through multiple components,multiple targets and multiple pathways.

Objective To analyze the potential profiles of discharge readiness in patients after 125I seed implantation and the influencing factors of different profiles.Methods A total of 221 patients who underwent 125I seed implantation in the Interventional Therapy Department,Zhejiang Cancer Hospital from October 2023 to October 2024 were selected as the research objects by convenient sampling method.The general information questionnaire,discharge readiness scale and social support rating scale were used for investigation.Mplus8.3 software was used to conduct latent profile analysis on the discharge readiness of patients after 125I seed implantation,and multivariate Logistic regression model was used to analyze the influencing factors of different discharge readiness profiles.Results The discharge readiness of patients after 125I seed implantation was divided into three potential profiles,"low discharge readiness-low self-care group"(10.41％),"medium discharge readiness-low others care group"(32.58％)and"high discharge readiness-high emotional support group"(57.01％).Logistic regression analysis showed that the number of short-term complications and the level of social support were the influencing factors of the potential profiles of discharge readiness in patients after 125I seed implantation(P＜0.05).Conclusion There is heterogeneity in the discharge readiness of patients after 125I seed implantation,and personalized intervention strategies should be formulated according to different profiles.

Objective To explore the effects of Shenyuan Yiqi Huoxue Capsules on cardiopulmonary exercise function and quality of life in patients with ischemic cardiomyopathy.Methods Totally 66 patients with ischemic cardiomyopathy were divided into treatment group and control group using random number table method,with 33 cases in each group.Both groups received standardized Western medicine treatment,and the treatment group was additionally given Shenyuan Yiqi Huoxue Capsules,the control group was given Shenyuan Yiqi Huoxue Capsules simulator,three capsules per time,three times a day,orally.The observation period was 30 days.To evaluate the efficacy of TCM syndrome in two groups.The observation indicators included baseline data,TCM syndrome scores,cardiopulmonary exercise test detection indicators,MLHFQ score,SF-36 score,echocardiographic indicators,N-terminal pro-B-type natriuretic peptide(NT-pro BNP)and safety indicators.Results The total effective rate of the treatment group was 93.94%(31/33),while that of the control group was 78.79%(26/33).The treatment group was significantly better than the control group(P<0.05).Compared with before treatment,the TCM syndrome scores of the two groups of patients decreased(P<0.05),and after treatment,the TCM syndrome score of the treatment group was lower than that of the control group(P<0.05).Compared with before treatment,the peak oxygen uptake(peak VO2),anaerobic threshold(AT)and peak oxygen pulse(peak O2 pulse)of both groups of patients increased,while the carbon dioxide ventilation equivalent slope(VE/VCO2 slope)decreased(P<0.05).After treatment,the treatment group had higher peak VO2,AT and peak O2 pulse than the control group,while the VE/VCO2 slope was lower than the control group(P<0.05).Compared with before treatment,both groups of patients showed a decrease in MLHFQ score and an increase in SF-36 score(P<0.05);after treatment,the MLHFQ score in the treatment group was lower than that in the control group,and the SF-36 score was higher than that in the control group(P<0.05).Compared with before treatment,both groups of patients showed a decrease in left ventricular end systolic diameter,left ventricular end diastolic diameter and NT-pro BNP levels,while myocardial motion index and left ventricular ejection fraction increased(P<0.05);after treatment,the treatment group showed a decrease in left ventricular end systolic diameter,left ventricular end diastolic diameter and NT-pro BNP levels,while myocardial motion index and left ventricular ejection fraction increased(P<0.05).During the treatment period,no adverse reactions such as dizziness,nausea,vomiting or diarrhea were found in both groups of patients.Conclusion Shenyuan Yiqi Huoxue Capsules can significantly improve the clinical efficacy of ischemic cardiomyopathy patients,alleviate TCM symptoms,improve their cardiorespiratory function and quality of life.

Objective To study the effect of practicing traditional Chinese medicine(TCM)guidance on the health in weightless conditions based on the examination results of the TCM diagnostic instrument.Methods 6 subjects in weightless conditions practiced TCM guidance for 14 consecutive days,once a day for 8 minutes each time.The Digital TCM Diagnostic Instrument and TCM Syndrome Diagnosis Scale were used to collect information before and after their practice of TCM guidance through diagnostic methods of observation,palpation and inquiry according to TCM theory.The data such as the degree of virtual-reality,pulse rate,and characteristic parameters of pulse diagrams h3/h1,h4/h1,t1,h1/t1 were processed and analyzed,and the changes before and after the practice were compared.Results Compared with before the practice,the degree of deficiency syndrome was significantly reduced after practicing TCM guidance(P<0.05),the pulse rate was significantly decreased(P<0.01),and the pulse diagnosis parameters h3/h1 and t1 were significantly decreased(P<0.05),while h4/h1 and h1/t1 showed no significant changes.Conclusion Practicing TCM guidance in weightless conditions is helpful for enhance cardiovascular regulatory function,correcting symptom bias,adjusting the body's balance state,and has a positive effect on health.

Objective To analyze the potential profiles of discharge readiness in patients after 125I seed implantation and the influencing factors of different profiles.Methods A total of 221 patients who underwent 125I seed implantation in the Interventional Therapy Department,Zhejiang Cancer Hospital from October 2023 to October 2024 were selected as the research objects by convenient sampling method.The general information questionnaire,discharge readiness scale and social support rating scale were used for investigation.Mplus8.3 software was used to conduct latent profile analysis on the discharge readiness of patients after 125I seed implantation,and multivariate Logistic regression model was used to analyze the influencing factors of different discharge readiness profiles.Results The discharge readiness of patients after 125I seed implantation was divided into three potential profiles,"low discharge readiness-low self-care group"(10.41％),"medium discharge readiness-low others care group"(32.58％)and"high discharge readiness-high emotional support group"(57.01％).Logistic regression analysis showed that the number of short-term complications and the level of social support were the influencing factors of the potential profiles of discharge readiness in patients after 125I seed implantation(P＜0.05).Conclusion There is heterogeneity in the discharge readiness of patients after 125I seed implantation,and personalized intervention strategies should be formulated according to different profiles.

Objective To explore the effects of Shenyuan Yiqi Huoxue Capsules on cardiopulmonary exercise function and quality of life in patients with ischemic cardiomyopathy.Methods Totally 66 patients with ischemic cardiomyopathy were divided into treatment group and control group using random number table method,with 33 cases in each group.Both groups received standardized Western medicine treatment,and the treatment group was additionally given Shenyuan Yiqi Huoxue Capsules,the control group was given Shenyuan Yiqi Huoxue Capsules simulator,three capsules per time,three times a day,orally.The observation period was 30 days.To evaluate the efficacy of TCM syndrome in two groups.The observation indicators included baseline data,TCM syndrome scores,cardiopulmonary exercise test detection indicators,MLHFQ score,SF-36 score,echocardiographic indicators,N-terminal pro-B-type natriuretic peptide(NT-pro BNP)and safety indicators.Results The total effective rate of the treatment group was 93.94%(31/33),while that of the control group was 78.79%(26/33).The treatment group was significantly better than the control group(P<0.05).Compared with before treatment,the TCM syndrome scores of the two groups of patients decreased(P<0.05),and after treatment,the TCM syndrome score of the treatment group was lower than that of the control group(P<0.05).Compared with before treatment,the peak oxygen uptake(peak VO2),anaerobic threshold(AT)and peak oxygen pulse(peak O2 pulse)of both groups of patients increased,while the carbon dioxide ventilation equivalent slope(VE/VCO2 slope)decreased(P<0.05).After treatment,the treatment group had higher peak VO2,AT and peak O2 pulse than the control group,while the VE/VCO2 slope was lower than the control group(P<0.05).Compared with before treatment,both groups of patients showed a decrease in MLHFQ score and an increase in SF-36 score(P<0.05);after treatment,the MLHFQ score in the treatment group was lower than that in the control group,and the SF-36 score was higher than that in the control group(P<0.05).Compared with before treatment,both groups of patients showed a decrease in left ventricular end systolic diameter,left ventricular end diastolic diameter and NT-pro BNP levels,while myocardial motion index and left ventricular ejection fraction increased(P<0.05);after treatment,the treatment group showed a decrease in left ventricular end systolic diameter,left ventricular end diastolic diameter and NT-pro BNP levels,while myocardial motion index and left ventricular ejection fraction increased(P<0.05).During the treatment period,no adverse reactions such as dizziness,nausea,vomiting or diarrhea were found in both groups of patients.Conclusion Shenyuan Yiqi Huoxue Capsules can significantly improve the clinical efficacy of ischemic cardiomyopathy patients,alleviate TCM symptoms,improve their cardiorespiratory function and quality of life.

Objective To analyze the application effect of anterolateral femoral free flap transplantation based on three-dimensional reconstruction in CT angiography in the treatment of chronic osteomyelitis of the foot and ankle complicated with soft tissues defect.Methods A retrospective analysis was conducted on the clinical data of 105 patients with chronic osteomyelitis of the foot and ankle complicated with soft tissues defect who were admitted to Suining Central Hospital in Sichuan Province from January 2020 to January 2023.Patients enrolled were divided into the control group(n=52)and the observation group(n=53)according to different perforating blood vessel examination methods before surgery.The control group underwent anterolateral femoral free flap transplantation based on handheld Doppler ultrasound,while the observation group underwent anterolateral femoral free flap transplantation based on CTA three-dimensional reconstruction technology.Comparison between the groups was made on inflammatory factors(CRP,TNF-α and IL-6),skin flap repair effect,foot and ankle function(AOFAS)score,flap sensation,survival rate of skin flaps,and the incidence of adverse events.Results On day 14 after operation,serum CRP,TNF-α and IL-6 levels in the observation group were lower than those in the control group(P＜0.05).Six months after operation,the effect of flap repair in observation group was better than that in control group,and the survival rate of flap was higher than that in control group(100.00％vs 92.31％)(P＜0.05).Twelve months after operation,AOFAS score and flap sensation score of the observation group were higher(P＜0.05).The incidence of adverse events was lower in the observation group than in the control group(3.77％ vs.15.38％)(P＜0.05).Conclusion Anterolateral femoral free flap transplantation based on CTA 3D reconstruction technique can repair soft tissue defect and reduce the risk of adverse events while can cure chronic osteomyelitis.

Objective To investigate the diagnostic value of endoscopic ultrasonography(EUS)and contrast-enhanced endoscopic ultrasonography(CE-EUS)with sulfur hexafluoride microbubbles for injection in upper gastrointestinal submucosal tumors(SMT).Methods The subjects of this study were 82 upper gastrointestinal SMT patients from January 2021 to August 2023.All of them underwent EUS and CE-EUS using sulfur hexafluoride microbubbles as contrast agents.Features of EUS images of upper gastrointestinal benign SMT and gastrointestinal stromal tumor(GIST),and CE-EUS images using sulfur hexafluoride microbubbles as contrast agents were analyzed.EUS,CE-EUS using sulfur hexafluoride microbubbles as contrast agents,and combination of the two were compared in upper gastrointestinal benign SMT and GIST diagnosis based on surgical pathological findings as the golden standard.Results 82 cases of upper gastrointestinal SMT were confirmed by imaging examination and surgical results to have tumors located in the upper,middle,lower segments esophagus,cardia,fundus,body,antrum of stomach,and duodenal bulb,accounting for 7.32%,10.98%,10.98%,4.88%,29.27%,26.83%,6.10%,and 3.66%respectively.According to pathological results,there were 51 cases of upper gastrointestinal benign SMT,accounting for 62.20%and 31 cases of GIST,accounting for 37.80%.Among them,SMT in the upper gastrointestinal tract was mainly located in the esophagus and stomach,with leiomyoma being the most common.GIST was mainly located in the stomach and was more common in the fundus and body of the stomach.The proportion of benign SMT group with uniform echo,smooth surface mucosa,and regular edges was significantly higher than that of GIST group(P＜0.05).GIST group had much higher proportion in doppler rich blood flow signals and origination from the muscularis propria than benign SMT group did(P＜0.05).There was no difference between the two groups in terms of proportion of echo properties(P＞0.05).The proportion of homogeneous enhancement in the benign SMT group was significantly higher than that in the GIST group(P＜0.05).The proportion of arterial phase hyperenhancement,venous phase diffuse enhancement,and irregular blood vessels in the GIST group was significantly higher than that in the benign SMT group(P＜0.05).The sensitivity,specificity,and accuracy of EUS in distinguishing GIST and benign SMT were 64.52%,74.51%,and 70.73%respectively,those of the CE-EUS using sulfur hexafluoride microbubbles as contrast agent were 90.32%,88.24%,and 89.02%respectively,and those of EUS+CE-EUS using sulfur hexafluoride microbubbles as contrast agent were 100.00%,90.20%,and 93.90%respectively.Conclusion EUS and CE-EUS with sulfur hexafluoride microbubbles as contrast agents has high diagnostic value for upper gastrointestinal benign SMT and GIST.