BACKGROUND:Traditional Chinese medicine has rich experience and unique advantages in the empirical treatment of phlegm-heat and Fu-organs excess syndrome of ischemic stroke.In order to further explore the therapeutic targets and mechanisms of traditional Chinese medicine for this disease,it is crucial to establish a stable and reliable animal model of phlegm-heat and Fu-organs excess syndrome combined with empirical symptoms of ischemic stroke. OBJECTIVE:To explore the establishment method and evaluation system of the rat model of ischemic stroke with phlegm-heat and Fu-organ excess syndrome. METHODS:Sixty male Sprague-Dawley rats were randomly divided into four groups:blank control group(n=12),ischemic stroke group(n=18),disease+syndrome group(n=18),phlegm-heat and Fu-organ excess syndrome group(n=12),all of which were given high-fat diet for 25 days.On the 26th day,the rats in the blank control group and ischemic stroke group were intragastrically given normal saline and high fat diet,while those in the other two groups were intragastrically given autologous feces suspension and high fat diet for 3 continuous days.After gavage,ischemic stroke models were established using the suture method in the ischemic stroke group and disease+syndrome group.The changes in diet,water intake,body mass,body temperature,fecal traits,nasal secretions,sputum in the throat,and tongue image were recorded.Neurological deficits,tongue image,blood lipid levels,morphological changes of brain tissue and carotid artery,and the serum levels of motilin and somatostatin were detected. RESULTS AND CONCLUSION:Compared with the control group,the rats in the disease+syndrome group had shortness of breath,listlessness,irritability,bradykinesia,a large number of secretions around the nose,audible and heavy sputum in the throat,decreased diet and water intake,increased body mass,body temperature,and slingual vein score,decreased fecal pellet count,Bristol score and fecal moisture content,increased serum total cholesterol,triglyceride,low-density lipoprotein and somatostatin levels,decreased motilin level,increased neurological deficit score,significant pathological changes of the carotid artery,and significant morphological changes of the brain tissue.The ischemic stroke group only showed pathological changes of ischemic brain tissue,without the characteristics of phlegm-heat and Fu-organ excess syndrome.The phlegm-heat and Fu-organ excess syndrome group could present with the typical characteristics of traditional Chinese medicine syndromes,without the pathological changes of brain tissue with ischemic stroke.To conclude,the compound modeling method of high-fat induction combined with suture method and autologous feces gavage can establish an animal model of ischemic stroke with phlegm-heat and Fu-organ excess syndrome.

Objective:To systematically search, evaluate, and summarize evidence-based findings related to postoperative oral health management for orthognathic surgery patients, with the goal of providing clinical care professionals with evidence-based guidance for postoperative care, infection prevention, and functional recovery.Methods:Using the "6S" evidence hierarchy model, a systematic search was conducted in databases such as UpToDate, BMJ Best Practice, DynaMed, The Cochrane Library, World Health Organization (WHO), National Institute for Health and Care Excellence (NICE), Guidelines International Network (GIN), Registered Nurses′Association of Ontario (RNAO), Chinese Stomatological Association (CSA), American Association of Oral and Maxillofacial Surgeons (AAOMS), PubMed, and Scopus. The search included literature on postoperative oral health management for orthognathic surgery patients, such as guidelines, clinical decision-making tools, expert consensus, evidence summaries, and systematic reviews, covering publications from database inception to November 12, 2024. Two researchers independently assessed the quality of the included literature and extracted, summarized, and synthesized the evidence.Results:A total of 18 studies were included, consisting of 7 guidelines, 7 systematic reviews, 2 expert consensus documents and 2 randomized controued trials. Twenty-two best evidence statements were summarized, addressing six key areas: oral hygiene and infection prevention, wound care, oral functional recovery, dietary and nutritional support, oral comfort management, and long-term oral health maintenance.Conclusions:This study provides a comprehensive summary of the best available evidence for postoperative oral health management in orthognathic surgery patients. It offers theoretical support for clinical nursing practices and evidence-based recommendations for postoperative care specific to this patient population.

Objective To investigate effects of Cordyceps sinensis(CS)on high glucose(HG)induced podocyte injury by regulating the adenylate activated protein kinase(AMPK)/mammalian target of rapamycin(mTOR)signaling pathway.Methods Mouse podocytes were cultured in vitro and divided into the normal glucose(NG)group,the HG group,the HG+CS group,the HG+CS+autophagy inhibitor(HG+CS+3MA)group and the HG+CS+AMPK inhibitor(HG+CS+Compound C)group.Podocyte viability was detected by CCK-8 method.Western blot assay was used to detect the expression levels of podocyte marker proteins podocin and nephrin,autophagy-related proteins Beclin-1 and P62,and pathway related proteins p-AMPK and p-mTOR.Results Compared with the NG group,the cell viability of podocytes decreased,the expression levels of podocin,nephrin,Beclin-1 and p-AMPK protein were decreased,and the expression levels of P62 and p-mTOR protein were increased in the HG group(P＜0.05).Compared with the HG group,the cell viability of podocytes was increased,the expression levels of podocin,nephrin,Beclin-1 and p-AMPK protein were significantly increased(P＜0.05),and the expression levels of P62 and p-mTOR protein were decreased in the HG+CS group(P＜0.05).Compared with the HG+CS group,the cell viability decreased in the HG+CS+3MA group and the HG+CS+Compound C group(P＜0.05).Compared with the HG+CS group,the HG+CS+3MA group and the HG+CS+Compound C group showed decreased expression levels of podocin,nephrin and Beclin-1 protein,and increased expression of P62 protein(P＜0.05).Compared with the HG+CS group,the expression of p-AMPK protein decreased and the expression of p-mTOR protein increased in the HG+CS+Compound C group(P＜0.05).Conclusion Cordyceps sinensis may play a protective role in diabetic nephropathy by up-regulating AMPK/mTOR signaling pathway to induce podocyte autophagy,alleviate high glucose induced podocyte injury and apoptosis.

Objective To investigate the effect of drug-eluting bead DACE(DEB-TACE)combined with systemic treatment for hepatocellular carcinoma(HCC)in different locations.Methods A total of 204 HCC patients who underwent DEB-TACE combined with systemic therapy(targeted and immunotherapy)were retrospectively collected.According to the anatomical location of HCC,86 cases with lesions located at the main trunk of portal vein(PV)or within 1 cm of the first PV branch were classified into central type group,while 118 cases with lesions located at the other areas were classified as peripheral type group.Follow-up was regularly performed after DEB-TACE until August,2024.The objective response rate(ORR)and disease control rate(DCR)at 1,3,6 and 12 months after DEB-TACE,also patients'progression-free survival(PFS)and overall survival(OS)were compared between groups.Results All patients were followed up for a median of 32.6 months,during which 164 cases died.Significant differences of ORR at 1 and 3 months after DEB-TACE(77.91％[67/86]vs.89.83％[106/118],34.88％[30/86]vs.54.24％[64/118])and DCR at 3 and 6 months after DEB-TACE(51.16％[44/86]vs.66.95％[79/118],34.88％[30/86]vs.50.00％[59/118])were found between groups(all P＜0.05).Patients'PFS(30.18[9.12,48.54]months)and OS(37.36[17.79,56.68])in peripheral type group were better than those in central type group(20.11[11.35,28.87]months and 23.24[3.11,43.47]months,x2=3.971,4.162,P=0.048,0.041).Conclusion The effect of DEB-TACE combined with systemic treatment for peripheral type HCC was better than for central type HCC.

Objective This study aimed to assess the clinical utility of combining the Controlling Nutri-tional Status(CONUT)score with the Prognostic Nutritional Index(PNI)for evaluating anemia risk in elderly colorectal cancer patients and to establish a risk prediction model.Methods A total of 661 elderly colorectal cancer patients treated at Xinjiang Uygur Autonomous Region People's Hospital from July 2018 to March 2025 were included in this retrospective study.Patients were categorized into anemic and non-anemic groups and randomly assigned to a training set and validation set at a 7:3 ratio.The XGBoost algorithm was applied to develop a predictive model for anemia risk,and its performance was assessed using the receiver operating characteristic(ROC)curve.SHAP value visualization,and other methods.Results Among the 661 patients,257(38.9％)were diagnosed with anemia.Compared with the non-anemic group,patients in the anemic group had significantly lower levels of PNI and albumin,but higher CONUT scores and blood urea nitrogen levels.Additionally,the anemic group had higher proportions of tumor diameter≥5 cm,poorly differentiated tumors,and stage Ⅲ-Ⅳ disease(all P<0.05).The XGBoost model demonstrated good discriminatory ability,with an AUC of 0.897(95％CI:0.868～0.925).SHAP value analysis identified PNI,CONUT score,albumin,blood urea nitrogen,TNM stage,tumor differentiation,and tumor size as major contributing variables.PNI and albumin were protective factors,whereas CONUT score,blood urea nitrogen,and tumor-related features were risk factors.Conclusion Nutritional indicators such as PNI and CONUT score,along with tumor characteristics,can effectively predict the risk of anemia in elderly patients with colorectal cancer.The XGBoost-based predictive model demonstrates high discriminatory power and good inter-pretability,providing valuable support for early screening of high-risk patients and guiding individualized nutri-tional interventions and anemia management.

BACKGROUND:Currently,traditional Chinese medicine has accumulated extensive experience in the treatment and management of ischemic stroke.The application of latent structure combined with association rule analysis to deeply explore and summarize the"medicine-prescription-syndrome"rules is conducive to promoting the optimization of ischemic stroke prevention and treatment strategies.OBJECTIVE:To explore the rules of Chinese medicine in the treatment of ischemic stroke,and provide a reference for the clinical treatment of ischemic stroke based on syndrome differentiationMETHODS:A systematic search was conducted for clinical research literature on traditional Chinese medicine treatment of ischemic stroke from China National Knowledge Infrastructure(CNKI),WanFang,VIP,and SinoMed databases,covering the period from January 1,1990,to August 15,2024.The relevant studies were selected and the data were extracted into an Excel 2019 database for analysis.The frequency of use of Chinese herbs,their properties,meridional tropism,therapeutic effects and associated syndromes were analyzed.High-frequency herbs(＞4％)were subjected to latent structure modeling,comprehensive clustering,and association rule analysis using Lantern 5.0 and RStudio software,followed by summary of medication patterns and potential traditional Chinese medicine syndromes for ischemic stroke.RESULTS AND CONCLUSION:(1)A total of 231 articles were included,involving 203 kinds of traditional Chinese medicine,and the frequency of use was 2 524 times.(2)The high-frequency Chinese herbs were Chuanxiong,Earthworm,Angelica,Astragalus,Salviorrhiza,red peony root,safflower,leech,peach kernel,and pinellia.These herbs had predominantly warm,cold,or neutral properties,with bitter,sweet,and pungent flavors.Primary meridional tropism targets the liver,spleen and heart.Drug for invigorating blood circulation and eliminating stasis,deficiency tonifying drug,calming liver wind drug,expectorant cough suppressant and anti-asthmatic drug were used more frequently.(3)The latent structure model analysis identified 7 latent variables,14 latent classes,6 comprehensive clustering models,and 19 core prescriptions.It is hypothesized that the main traditional Chinese medicine syndromes for ischemic stroke are qi deficiency and blood stasis syndrome,wind-phlegm obstructing the channels syndrome,phlegm and blood stasis obstructing the channels syndrome,and phlegm-heat obstructing the viscera syndrome.(4)The association rule analysis revealed 29 strongly associative rules,including 2 two-item rules and 27 three-item rules.The highest degree of support was Angelica-Chuanxiong,and the highest degree of confidence was Angelica+licorice-Chuanxiong.The results show that ischemic stroke is a syndrome with qi and blood deficiency,liver and kidney Yin deficiency as the root causes,and wind,phlegm,blood stasis,and fire as the manifestations.The treatment is mainly to benefit qi and strengthen health,promote blood circulation and remove blood stasis,combined with pathological factors such as"phlegm and heat,""qi stagnation,""Yin deficiency,"and"liver fire,"supplemented by clearing heat and phlegm,promoting qi stagnation,nourishing liver and kidney,clearing liver and reducing fire.

To explore the diagnostic value of endoscopic retrograde cholangiopancreatography (ERCP) combined with modified biopsy forceps for suspected malignant biliary obstruction, 72 patients with suspected malignant biliary obstruction who underwent ERCP using modified biopsy forceps from January 2017 to April 2023 in the First Affiliated Hospital of Henan University of Chinese Medicine were selected as the modified group, while 61 contemporaneous patients who underwent ERCP with traditional biopsy forceps were selected as the control group at the same time. The stenosis site was identified during the operation, and the effective pathological tissue was obtained by biopsy. Benign or malignant tumor was determined according to the medical history and clinical follow-up data. The sensitivity and specificity of the two groups were compared. The success rate of biopsy was 100.00% in the two groups. All patients had no serious complications and were diagnosed histologically. Sixty-seven cases were finally diagnosed as malignant and 5 cases were benign in the modified group. In the control group, 58 cases were malignant and 3 cases were benign. The sensitivity for diagnosis of malignant biliary stricture was 79.10% (54/67) in the modified group, and 60.34% (35/58) in the control group, with significant difference ( χ2=6.218, P= 0.013). The specificity of the two methods for the diagnosis of malignant stenosis was 100.00%. Therefore, it is safe and effective to apply ERCP combined with the modified biopsy forceps in the diagnosis of extrahepatic malignant bile duct stenosis.

Objective To investigate the effect of drug-eluting bead DACE(DEB-TACE)combined with systemic treatment for hepatocellular carcinoma(HCC)in different locations.Methods A total of 204 HCC patients who underwent DEB-TACE combined with systemic therapy(targeted and immunotherapy)were retrospectively collected.According to the anatomical location of HCC,86 cases with lesions located at the main trunk of portal vein(PV)or within 1 cm of the first PV branch were classified into central type group,while 118 cases with lesions located at the other areas were classified as peripheral type group.Follow-up was regularly performed after DEB-TACE until August,2024.The objective response rate(ORR)and disease control rate(DCR)at 1,3,6 and 12 months after DEB-TACE,also patients'progression-free survival(PFS)and overall survival(OS)were compared between groups.Results All patients were followed up for a median of 32.6 months,during which 164 cases died.Significant differences of ORR at 1 and 3 months after DEB-TACE(77.91％[67/86]vs.89.83％[106/118],34.88％[30/86]vs.54.24％[64/118])and DCR at 3 and 6 months after DEB-TACE(51.16％[44/86]vs.66.95％[79/118],34.88％[30/86]vs.50.00％[59/118])were found between groups(all P＜0.05).Patients'PFS(30.18[9.12,48.54]months)and OS(37.36[17.79,56.68])in peripheral type group were better than those in central type group(20.11[11.35,28.87]months and 23.24[3.11,43.47]months,x2=3.971,4.162,P=0.048,0.041).Conclusion The effect of DEB-TACE combined with systemic treatment for peripheral type HCC was better than for central type HCC.

Objective:To systematically retrieve and summarize the best available evidence on aerobic exercise combined with resistance training in stroke patients.Methods:Using a structured computer-assisted search strategy based on the "6S" model, literature was retrieved top-down from clinical decision support systems, guideline databases, professional society websites, evidence-based databases, and comprehensive databases. The search included literature related to aerobic and resistance training in stroke patients, including clinical decision tools, guidelines, recommended practices, evidence summaries, systematic reviews, expert consensus documents, and randomized controlled trials (RCT) . The search was performed from the inception of each database to February 28, 2025. Two researchers independently screened the literature, assessed quality, and extracted and synthesized the evidence.Results:A total of 21 publications were included: nine guidelines, three systematic reviews, one expert consensus, and eight RCTs. A total of 32 best evidence statements were summarized across 12 dimensions: timing of training initiation, training methods, training modes, intensity formulation strategies, training dosage, rest intervals, progression principles, progression strategies, training effects, individualized modifications, safety, and adherence management.Conclusions:This study systematically identified and summarized best-practice evidence for aerobic and resistance training in stroke patients. The findings provide strong evidence-based support for developing tailored and effective exercise interventions in stroke rehabilitation.

Objective This study aimed to assess the clinical utility of combining the Controlling Nutri-tional Status(CONUT)score with the Prognostic Nutritional Index(PNI)for evaluating anemia risk in elderly colorectal cancer patients and to establish a risk prediction model.Methods A total of 661 elderly colorectal cancer patients treated at Xinjiang Uygur Autonomous Region People's Hospital from July 2018 to March 2025 were included in this retrospective study.Patients were categorized into anemic and non-anemic groups and randomly assigned to a training set and validation set at a 7:3 ratio.The XGBoost algorithm was applied to develop a predictive model for anemia risk,and its performance was assessed using the receiver operating characteristic(ROC)curve.SHAP value visualization,and other methods.Results Among the 661 patients,257(38.9％)were diagnosed with anemia.Compared with the non-anemic group,patients in the anemic group had significantly lower levels of PNI and albumin,but higher CONUT scores and blood urea nitrogen levels.Additionally,the anemic group had higher proportions of tumor diameter≥5 cm,poorly differentiated tumors,and stage Ⅲ-Ⅳ disease(all P<0.05).The XGBoost model demonstrated good discriminatory ability,with an AUC of 0.897(95％CI:0.868～0.925).SHAP value analysis identified PNI,CONUT score,albumin,blood urea nitrogen,TNM stage,tumor differentiation,and tumor size as major contributing variables.PNI and albumin were protective factors,whereas CONUT score,blood urea nitrogen,and tumor-related features were risk factors.Conclusion Nutritional indicators such as PNI and CONUT score,along with tumor characteristics,can effectively predict the risk of anemia in elderly patients with colorectal cancer.The XGBoost-based predictive model demonstrates high discriminatory power and good inter-pretability,providing valuable support for early screening of high-risk patients and guiding individualized nutri-tional interventions and anemia management.