ObjectiveTo evaluate the effects and safety of the optimized new Shengmai Powder （优化新生脉散方） on exercise tolerance in patients with chronic heart failure （CHF） of qi deficiency， blood stasis， and fluid retention syndrome. MethodsA randomized， double-blind， placebo-controlled trial was conducted. A total of 78 CHF patients with qi deficiency， blood stasis， and fluid retention syndrome were recruited and randomly assigned to a treatment group （39 cases） and a control group （39 cases）. On the basis of conventional western medical therapy， patients in the treatment group additionally received the optimized new Shengmai Powder granules， while the control group was given an oral placebo of optimized new Shengmai Powder granules. Patients in both groups took 30.6 g each time， twice a day， mixed with water for administration， with a total treatment course of 4 weeks. The primary outcomes were 6-minute walk distance （6MWD） and peak oxygen uptake （Peak VO₂） measured by cardiopulmonary exercise testing. Secondary outcomes included New York Heart Association （NYHA） functional classification， B-type natriuretic peptide （BNP） levels， cardiac function indexes including left ventricular ejection fraction （LVEF）， left ventri-cular end-systolic diameter （LVESD） and left ventricular end-diastolic diameter （LVEDD）， Minnesota Living with Heart Failure Questionnaire （MLHFQ） scores， and scores of four diagnostic information of traditional Chinese medicine （TCM）. All indicators were assessed once before and after treatment respectively. Safety indicators were evaluated， and adverse events during the trial were recorded. ResultsAll patients in both groups were included in the full ana-lysis set （FAS） and safety set （SS）. Compared with baseline， the 6MWD and Peak VO₂ of cardiopulmonary exercise test in the treatment group significantly increased after treatment， while the MLHFQ scores， serum BNP levels and scores of TCM four diagnostic information significantly decreased， and the NYHA cardiac function grade significantly improved （P＜0.01）. After treatment， the 6MWD and Peak VO₂ of cardiopulmonary exercise test， as well as their changes from baseline in the treatment group were higher than those in the control group； the MLHFQ scores， serum BNP levels and scores of TCM four diagnostic information in the treatment group were lower than those in the control group； and the improvement of NYHA cardiac function grade in the treatment group was superior to that in the control group （P＜0.01）. There was no statistically significant differences in all indicators after treatment in the control group （P＞0.05）. The incidence of adverse events was 5.1% （2/39） in the treatment group and 2.6% （1/39） in the control group， with no statistically significant difference between groups （P＞0.05）. ConclusionOn the basis of conventional western medicine treatment， the addition of the optimized new Shengmai Powder can further improve exercise tolerance， cardiac function and quality of life in patients with CHF of qi deficiency， blood stasis and fluid retention syndrome， and show good safety.

BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

BACKGROUND:Due to the complex movement of the scapula,which is a six-degree-of-freedom activity in three-dimensional space,it is difficult to measure it accurately using traditional methods.The image and model matching technology based on dual-plane X-ray is a three-dimensional measurement method that has gradually developed and matured in recent years.Two high-speed cameras are used to project and shoot from orthogonal directions.Compared with a single perspective,this method has advantages in observation range and reduction of out-of-plane errors,and is suitable for the study of scapula kinematics.OBJECTIVE:X-ray biplane and image-model registration technology were used to explore the differences in scapular kinematics between normal individuals and patients with rotator cuff tears,providing a basis for the treatment and rehabilitation of rotator cuff tear patients.METHODS:From April 2023 to January 2024,10 patients with normal shoulders and 10 patients with rotator cuff tears who met the inclusion criteria were enrolled from Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.The subjects underwent a shoulder CT scan to create a 3D model and a local scapular coordinate system.X-ray biplane images were taken during shoulder abduction with two C-arm machines.The 2D and 3D images were registered to compare scapular kinematic differences between the two groups at 0°,15°,30°,45°,60°,75°,and 90° of abduction,including scapular rotation angle and displacement distance.RESULTS AND CONCLUSION:(1)During shoulder abduction,the scapula of both groups showed upward rotation,but the upward rotation of the rotator cuff tear group was greater than that of the control group,and the difference was significant when the abduction was 30°-90°(P＜0.01).At the same time,the scapula internal rotation of both groups gradually increased,but the rotator cuff tear group was significantly greater than the control group when the abduction was 45°-90°(P＜0.01).In addition,the anteroposterior tilt of the scapula of the two groups was significantly different when the abduction was 15°-90°(P＜0.01).The scapula posterior tilt of the control group gradually increased during abduction,while the scapula of the rotator cuff tear group tilted forward except for a slight posterior tilt at 15°-30° abduction.(2)In terms of displacement,the upward displacement of the rotator cuff tear group was less than that of the control group during abduction,and the difference was significant at 15°-90°(P＜0.05),but there was no significant difference in lateral and anterior-posterior displacement between the two groups(P＞0.05).(3)Rotator cuff tear can cause scapular dyskinesis,characterized by increased upward rotation,internal rotation,and abnormal forward tilt during shoulder abduction.Identifying and addressing scapular dyskinesis is crucial for treating rotator cuff tear.

ObjectiveTo construct a theoretical framework for rehabilitation fitness and sports services for people with disabilities, analyze the practical challenges facing their development, and propose targeted optimization pathways to improve service quality. MethodsUsing literature review, policy analysis and logical reasoning, this study integrated the six building blocks of the World Health Organization health service system into a theoretical framework for rehabilitation fitness and sports services. From macro system architecture, meso-level element coordination and micro-level implementation, it elucidated the internal operational logic of each component, combined with a systematic analysis grounded in China's national context. ResultsThe theoretical framework of rehabilitation fitness and sports services for people with disabilities comprised six key elements: policy and regulation, financial support, human resources, service content, technological support and information monitoring. These elements formed a progressively deepening operational pathway from macro to micro levels, creating a continuous structure of top-level design, institutional coordination and practical implementation. The current services in China still faced structural constraints, including insufficient institutional coordination, a single-source funding structure, imbalanced resource allocation, weak professional support, lagging accessibility environments and inadequate digital governance, requiring systematic optimization through targeted interventions. ConclusionRehabilitation fitness and sports services for people with disabilities should strengthen top-level design and establish a diversified and coordinated policy system, expand funding channels to build a sustainable multi-source financing mechanism, enhance human resource development to improve long-term competency, clarify service processes to increase integration and alignment, advance the development of accessible technologies and expand the application of assistive devices, and build an intelligent regulatory system to leverage digital technologies.

BACKGROUND: Epidemiological data on chronic diarrhea in the Chinese population are lacking, and the association between obesity and chronic diarrhea in East Asian populations remains inconclusive. This study aimed to investigate the prevalence of chronic diarrhea and its association with obesity in a representative community-dwelling Chinese population. METHODS: This cross-sectional study was based on a multistage, randomized cluster sampling involving 3503 residents aged 20-69 years from representative urban and rural communities in Beijing. Chronic diarrhea was assessed using the Bristol Stool Form Scale (BSFS), and obesity was determined based on body mass index (BMI). Logistic regression analysis and restricted cubic splines were used to evaluate the relationship between obesity and chronic diarrhea. RESULTS: The standardized prevalence of chronic diarrhea in the study population was 12.88%. The average BMI was 24.67 kg/m 2 . Of all the participants, 35.17% (1232/3503) of participants were classified as overweight and 16.13% (565/3503) as obese. After adjustment for potential confounders, individuals with obesity had an increased risk of chronic diarrhea as compared to normal weight individuals (odds ratio = 1.58, 95% confidence interval: 1.20-2.06). A nonlinear association between BMI and the risk of chronic diarrhea was observed in community residents of males and the overall participant group ( P  = 0.026 and 0.017, respectively). CONCLUSIONS This study presents initial findings on the prevalence of chronic diarrhea among residents of Chinese communities while offering substantiated evidence regarding the significant association between obesity and chronic diarrhea. These findings offer a novel perspective on gastrointestinal health management.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Body Mass Index ; China/epidemiology* ; Chronic Disease/epidemiology* ; Cross-Sectional Studies ; Diarrhea/epidemiology* ; Obesity/complications* ; Prevalence ; East Asian People/statistics & numerical data*

Objective:To explore the clinical characteristics, treatment methods, and prognosis of refractory pharyngeal ulcers. Methods:A retrospective analysis was conducted on the clinical manifestations, laryngoscopic features, laboratory tests, histopathological examinations, and treatments of 78 patients diagnosed with refractory pharyngeal ulcers. Results:There was no significant difference in the proportion of males-to-females in benign lesions, while males were significantly more prevalent in cases of malignant lesions. Seven distinct pathological types of pharyngeal ulcers were identified, with the most common being simple inflammatory ulcers（18 cases）, followed by tuberculosis（16 cases）, fungi（15 cases）, lymphoma（14 cases）, squamous cell carcinoma（10 cases）, Behcet's disease（3 cases）, and myelosarcoma（2 cases）. Conclusion:The clinical manifestations and lesions associated with refractory pharyngeal ulcers are diverse. A clear diagnosis should be established based on a systematic and comprehensive medical history, specialized examinations, and additional tests to avoid misdiagnosis and mistreatment. Laryngoscopy and histopathological examinations are essential for identifying the type of lesion and guiding appropriate treatment.
Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Adult ; Aged ; Pharyngeal Diseases/pathology* ; Young Adult ; Ulcer/pathology* ; Adolescent ; Aged, 80 and over

Organ fibrosis is a chronic tissue injury caused by multiple causes,and the continuous dynamic progression will lead to abnormal organ structure and function.Recent studies have shown that Chinese materia medica can inhibit organ fibrosis by regulating the PI3K/Akt pathway,which holds potential significance for developing anti-fibrosis strategies.This article systematically reviewed the role of the PI3K/Akt signaling pathway in the entire process of fibrosis,and summarized the potential mechanisms of Chinese materia medica monomers,drug pairs and compounds that can target and intervene in PI3K/Akt signaling transduction in preventing and treating organ fibrosis,in order to provide reference for the intervention of Chinese materia medica in the PI3K/Akt pathway for the treatment of organ fibrosis.

OBJECTIVE By conducting evidence evaluation research on literatures,this study aims to reveal the o-verall characteristics and research hotspots in the field of combat trauma-related infections,ultimately providing data support for the prevention and control of such infections.METHODS Relevant research in this field was sys-tematically collected from open-source databases to construct a dataset.The overall characteristics,research hotspots,prevention and control strategies,and future challenges of trauma-related infections were summarized and analyzed.RESULTS From 2004 to 2024,184 papers were published.The United States contributed the most publications,with Uniformed Services University of the Health Sciences being the most productive research insti-tution and Professor Clinton K.Murray as the author with the highest number of publications.The top five key-words with the highest frequency were combat related injury,infection,Acinetobacter baumannii,epidemiology and management.Among the publicly published literature data on war trauma-related infections,blast injuries ac-counted for the largest proportion,mainly multi-site injuries,with limb injuries being the most common.Bacteri-al infections were more common than fungal infections,with gram-negative bacteria being predominant and A.baumannii being the most common.Besides early wound management and the use of antibacterial drugs,in-creased attention should be paid to infection prevention and control in austere environments and the development of novel countermeasures.These advancements are critical to address projected changes in combat trauma,inclu-ding increasingly complex injuries and substantially elevated risks of infection and antimicrobial resistance.CONCLUSION This study systematically presents research hotspots,developmental trends,and prospects in com-bat trauma-related infections through evidence evaluation study,providing novel perspectives for researchers and facilitating further development in this field.

Objective:To develop a health management model tailored for the elderly population in rural areas and to evaluate its effectiveness.Methods:This before-and-after controlled intervention study was conducted from January 2024 to June 2024 in rural areas of Jiaocheng County, Shanxi Province. A multi-stage stratified random sampling method was used to include 5 000 permanent residents aged ≥65 years. A baseline health survey was first conducted to collect multidimensional data, including demographic characteristics, chronic disease information, cognitive and psychological scales, sleep quality, and health service utilization. Using the comprehensive health index as the outcome variable, seven machine learning models, including LightGBM, were constructed to identify key factors influencing health status and explore intervention pathways. Subsequently, under the framework of a "five-level linkage+shared database, " comprehensive interventions such as health communication, integrated medical and elderly care, and dynamic follow-ups were implemented. Differences in major health indicators were compared before and after the 6-month intervention.Results:At baseline, the prevalence rates of hypertension, diabetes, and coronary heart disease were 58.2%, 24.8%, and 16.1%, respectively. The rate of cognitive impairment was 36.9%, and the positive rates for depression and anxiety were 27.3% and 17.4%, respectively. Machine learning analysis showed that the Naive Bayes model had the best predictive performance (area under the curve=0.966), with key influencing factors including number of follow-ups, number of health lectures, and medical check-up frequency. After six months of intervention, systolic blood pressure decreased from (142.95±15.84) to (138.37±17.20) mmHg (1 mmHg=0.133 kPa), fasting glucose from (6.43±1.26) to (6.09±1.40) mmol/L, and MMSE scores increased from (25.04±3.28) to (25.71±3.29) points. The positive rates of anxiety and depression declined from 17.4% to 12.8% and 27.3% to 20.6%, respectively. Follow-up compliance improved from 76.5% to 80.5%, and health record completeness from 69.8% to 75.8% (all P<0.001). Conclusions:The integrated health management model based on the"five-level linkage+shared database,"incorporating health education and the integration of medical and elderly care, effectively improves chronic disease control and enhances cognitive and psychological health among older adults in rural areas of Shanxi Province. This model also strengthens service adherence and management efficiency.

OBJECTIVE To evaluate the quality of Yindan huoxue tongyu granules. METHODS Taking high performance liquid chromatography with ultraviolet and evaporative light scattering detection as method， the fingerprint of 15 batches of Yindan huoxue tongyu granules was established， and similarity evaluation was performed by Similarity Evaluation System of Chromatographic Fingerprint of TCM （2012 edition） to determine common peaks. The common peaks were identified by comparing with reference substance chromatograms and single decoction piece chromatograms. Network pharmacology was used to screen out core targets and pathways of identified components， construct a “component-target-pathway” network diagram， and predict the pharmacodynamic components of Yindan huoxue tongyu granules， and the content determination of these components was carried out by the same method. RESULTS HPLC fingerprints of 15 batches of Yindan huoxue tongyu granules were characterized with 40 common peaks， and 17 components including salvianolic acid B， astragaloside Ⅳ， notoginsenoside R1， and ginkgolide A were identified. Network pharmacology predicted that 17 components mainly acted on 97 core targets and 137 pathways to exert their pharmacological effect. Average contents of 13 bioactive components in 15 batches of samples were 0.126 8， 0.232 0， 0.073 8， 0.353 2， 3.620 2， 0.191 0， 0.333 3， 0.317 4， 0.785 0， 0.538 2， 0.460 0， 2.475 1 and 0.347 7 mg/g， including calycosin-7-O-β-D-glucoside， rosmarinic acid， formononetin， lithospermic acid， salvianolic acid B， ononin， ginsenoside Rb1， ginsenoside Rd， ginkgolide C， ginkgolide A， ginkgolide B， notoginsenoside R1， and astragaloside Ⅳ. CONCLUSIONS The established fingerprint of Yindan huoxue tongyu granules can reflect the overall characteristics of the preparation. The content determination method for its pharmacodynamic components， developed in combination with network pharmacology， is accurate， reliable， and exhibits good repeatability， making it suitable for evaluating the quality of Yindan huoxue tongyu granules.