Objective:To explore the medication law of TCM external therapy for the treatment of diabetic foot using data mining methods.Methods:Literature on TCM external treatment for diabetic foot was retrieved from CNKI, Wanfang Data, and Chongqing VIP from the establishment of the databases to June 30, 2024. Excel 2019 software was used to conduct frequency statistics on drug frequency, properties, tastes and meridian tropism, drug efficacy, and commonly used drug pairs. Ancient and Modern Medical Cases Cloud Platform V3.5 was used for association rules, and SPSS Statistics 27.0 was used for complex network analyses.Results:A total of 425 articles were included, involving 328 prescriptions and 232 drugs. The drugs with higher frequency were Carthami Flos, Angelicae Sinensis Radix, Cinnamomi Ramulus, Olibanum, etc. The main tastes were pungent, bitter, and sweet; the main properties were cold and warm; the main meridians were heart, spleen, and liver meridians. The main efficacy was promoting blood circulation and removing blood stasis, clearing heat, and tonifying deficiency; association rule analysis obtained 20 commonly used drug pairs; clustering analysis resulted in four core drug combinations; complex network analysis led to one core prescription.Conclusions:TCM external therapy for diabetic foot follows the guiding principles of "promoting blood circulation and unblocking collaterals, tonifying deficiency and clearing heat" with coordinated regulation of the "heart-liver-spleen meridians". The core prescription and stage-specific formulation strategies reflect a trinity diagnostic and therapeutic approach of "disease differentiation-syndrome differentiation-stage differentiation", providing valuable reference and insights for clinical prescription practices.

ObjectiveTo explore the establishment and evaluation methods of the rat model of acute myocardial infarction （AMI） in coronary heart disease with the syndrome of Qi and Yin deficiency by sleep deprivation （SD） combined with isoproterenol （ISO） and preliminarily explore its biological basis. MethodForty SD rats were assigned into normal （no treatment）， SD （treatment in modified multi-platform water environment for 96 h）， ISO （subcutaneous injection of ISO at 100 mg·kg^-1 once every other day for a total of 2 times）， and SD+ISO （injection of 100 mg·kg^-1 ISO after SD for 72 h and 96 h） groups. The cardiac function was detected by small animal echocardiography. The serum levels of creatine kinase （CK）， creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， and cardiac troponin T （cTnT） were measured by biochemical methods. The pathological changes of the myocardial tissue were observed by hematoxylin-eosin staining. The general state， body weight， grip strength， body temperature， behaviors in open field test， serum levels of cyclic adenosine monophosphate （cAMP）， cyclic guanosine monophosphate （cGMP）， cAMP/cGMP ratio， red （R）， green （G）， blue （B） values of the tongue surface， and pulse amplitude were observed and measured to evaluate the modeling results. Enzyme-linked immunosorbent assay was employed to determine the serum levels of interleukin-18 （IL-18）， tumor necrosis factor-α （TNF-α）， superoxide dismutase （SOD）， malondialdehyde （MDA）， corticotropin-releasing factor （CRF）， adrenocorticotropic hormone （ACTH）， triiodothyronine （T3）， tetraiodothyronine （T4）， cluster of differentiation 4 （CD4）， and cluster of differentiation 8 （CD8）. ResultIn terms of disease indicators， the ISO and SD+ISO groups had lower cardiac function indicators than the normal group （P<0.01）. The levels of CK， CM-MB， LDH and cTnT elevated in each model group compared with the normal group （P<0.01）. The pathological changes of myocardial tissue were obvious in the ISO and SD+ISO groups. In terms of syndrome indicators， compared with the normal group， the SD and SD+ISO groups showed decreased body weight at each time point （P<0.01）， and the ISO group showed decreased body weight at the time points of 48 h and 72 h （P<0.05， P<0.01）. The paw temperature and rectal temperature increased in the SD group （P<0.01）. The model groups showed weakened grasp strength， lowered R， G， and B values of the tongue surface （P<0.01）， prolonged immobility time （P<0.01）， reduced total distance and number of entering the central area （P<0.01）， decreased average speed （P<0.05， P<0.01）， and increased cAMP and cGMP （P<0.05， P<0.01）. The cAMP/cGMP ratio was increased in the SD+ISO group （P<0.01）， and the pulse amplitude was decreased in the SD and SD+ISO groups （P<0.01）. In terms of serological indicators，compared with the normal group， the levels of IL-18， TNF-α， SOD and MDA were significantly increased in the ISO and SD+ISO groups （P<0.01）， the CRF， ACTH， CORT， T3， T4， CD4 and CD8 in the model groups were increased （P<0.05， P<0.01）. ConclusionSleep deprivation for 96 h combined with high-dose ISO can successfully establish a rat model of acute myocardial infarction in coronary heart disease with the syndrome of Qi and Yin deficiency. The model evaluation system can be built with disease indicators of western medicine， histopathological indicators， macroscopic indicators of traditional Chinese medicine， and serological indicators.

Objective:To improve the diagnosis and treatment of thyroid carcinoma in flying personnel by analyzing the clinical characteristics of thyroid carcinoma.Methods:The clinical and pathological data of flying personnel with thyroid carcinoma diagnosed and treated by Air Force Medical Center of PLA from January of 2010 to December of 2022 were retrospectively analyzed. Clinical characteristics such as age, flying hours, aircraft types, thyroid function at diagnosis, and pathological characteristics such as tumor site, tumor size, lymph node metastasis, calcification and sand and Ki-67 positive ratio were collected, and the clinical and pathological characteristics were statistically analyzed.Results:Thyroid nodule was found as the first diagnosis of thyroid carcinoma in 57 flying personnel. The age of onset was 22-58 years old, the median age was 37 years old, the flying hours was 4-18 000 h, and the median flying hours was 2 000 h. Thyroid carcinoma was detected in both thyroid glands, and the histological type was papillary thyroid carcinoma. Thyroid function was normal in most cases when thyroid carcinoma was detected. Lymph node metastasis of thyroid carcinoma was low positively correlated with tumor size ( r=0.304, P=0.021), and was low positively correlated with the positive proportion of Ki-67 ( r=0.360, P=0.006). Other clinical and pathological characteristics did not show clear correlation. With the extension of flying hours, the incidence of lymph node metastasis of thyroid carcinoma increased, and the difference was statistically significant ( χ2=6.32, P=0.012). There was no statistical difference among the clinical characteristics of flying personnel with different age and aircraft types ( P>0.05). Conclusions:The thyroid carcinoma is usually diagnosed without clinical symptoms and the thyroid function is basically normal. The thyroid ultrasound examination should be emphasized during physical examination, and further examination should be conducted for the flying personnel with thyroid nodules.

Objective:To improve the diagnosis and treatment of thyroid carcinoma in flying personnel by analyzing the clinical characteristics of thyroid carcinoma.Methods:The clinical and pathological data of flying personnel with thyroid carcinoma diagnosed and treated by Air Force Medical Center of PLA from January of 2010 to December of 2022 were retrospectively analyzed. Clinical characteristics such as age, flying hours, aircraft types, thyroid function at diagnosis, and pathological characteristics such as tumor site, tumor size, lymph node metastasis, calcification and sand and Ki-67 positive ratio were collected, and the clinical and pathological characteristics were statistically analyzed.Results:Thyroid nodule was found as the first diagnosis of thyroid carcinoma in 57 flying personnel. The age of onset was 22-58 years old, the median age was 37 years old, the flying hours was 4-18 000 h, and the median flying hours was 2 000 h. Thyroid carcinoma was detected in both thyroid glands, and the histological type was papillary thyroid carcinoma. Thyroid function was normal in most cases when thyroid carcinoma was detected. Lymph node metastasis of thyroid carcinoma was low positively correlated with tumor size ( r=0.304, P=0.021), and was low positively correlated with the positive proportion of Ki-67 ( r=0.360, P=0.006). Other clinical and pathological characteristics did not show clear correlation. With the extension of flying hours, the incidence of lymph node metastasis of thyroid carcinoma increased, and the difference was statistically significant ( χ2=6.32, P=0.012). There was no statistical difference among the clinical characteristics of flying personnel with different age and aircraft types ( P>0.05). Conclusions:The thyroid carcinoma is usually diagnosed without clinical symptoms and the thyroid function is basically normal. The thyroid ultrasound examination should be emphasized during physical examination, and further examination should be conducted for the flying personnel with thyroid nodules.

A 71-year-old male patient with advanced lung adenocarcinoma received pemetrexed (0.8 g, IV infusion on the first day) and carboplatin (500 mg, IV infusion on the first day) combined with pembrolizumab (200 mg, IV infusion on the second day) and 21 days was a cycle. Before the third cycle of treatment, the patient developed palpitations, irritability, increased appetite, and emaciation. Laboratory tests showed triiodothyronine (T 3) 2.88 nmol/L, thyroxine (T 4) 247.90 nmol/L, free triiodothyronine (FT 3) 10.57 pmol/L, free thyroxine (FT 4) 39.63 pmol/L, thyroid stimulating hormone (TSH) 0.014 mU/L, anti-thyroglobulin antibody (TGAb) 15.9 μg/L, thyroid peroxidase antibody (TPOAb) >1 300.0 kU/L. Immunerelated hyperthyroidism was considered, which may be related to pembrolizumab. The above-mentioned treatment was continued due to the patient′s condition, and thiamazole and metoprolol were given orally at the same time. One month later, laboratory tests showed T 3 2.50 nmol/L, T 4 153.40 nmol/L, FT 3 7.70 pmol/L, FT 4 33.61 pmol/L, TSH 0.007 mU/L, TGAb 15.7 μg/L and TPOAb >1 300.0 kU/L; 2 months later, laboratory tests showed T 3 1.84 nmol/L, T 4 81.20 nmol/L, FT 3 3.86 pmol/L, FT 4 11.56 pmol/L, TSH 1.979 mU/L, TGAb 15.7 μg/L, and TPOAb >1 300.0 kU/L. His symptoms of palpitation and irritability were alleviated.

A 71-year-old male patient with advanced lung adenocarcinoma received pemetrexed (0.8 g, IV infusion on the first day) and carboplatin (500 mg, IV infusion on the first day) combined with pembrolizumab (200 mg, IV infusion on the second day) and 21 days was a cycle. Before the third cycle of treatment, the patient developed palpitations, irritability, increased appetite, and emaciation. Laboratory tests showed triiodothyronine (T 3) 2.88 nmol/L, thyroxine (T 4) 247.90 nmol/L, free triiodothyronine (FT 3) 10.57 pmol/L, free thyroxine (FT 4) 39.63 pmol/L, thyroid stimulating hormone (TSH) 0.014 mU/L, anti-thyroglobulin antibody (TGAb) 15.9 μg/L, thyroid peroxidase antibody (TPOAb) >1 300.0 kU/L. Immunerelated hyperthyroidism was considered, which may be related to pembrolizumab. The above-mentioned treatment was continued due to the patient′s condition, and thiamazole and metoprolol were given orally at the same time. One month later, laboratory tests showed T 3 2.50 nmol/L, T 4 153.40 nmol/L, FT 3 7.70 pmol/L, FT 4 33.61 pmol/L, TSH 0.007 mU/L, TGAb 15.7 μg/L and TPOAb >1 300.0 kU/L; 2 months later, laboratory tests showed T 3 1.84 nmol/L, T 4 81.20 nmol/L, FT 3 3.86 pmol/L, FT 4 11.56 pmol/L, TSH 1.979 mU/L, TGAb 15.7 μg/L, and TPOAb >1 300.0 kU/L. His symptoms of palpitation and irritability were alleviated.

Objective To explore the clinical value of high frequency ultrasound combined with serum tumor specific growth factor in diagnosis of thyroid cancer.Methods 155 patients with thyroid tumor received preoperative high frequency ultrasound and the detection of TSGF content,the histopathologic examination was given after operation.The clinical value of high frequency ultrasound and TSGF detection in diagnosis of thyroid cancer was analyzed.Results The sensitivity of high frequency ultrasound in diagnosis of thyroid carcinoma was 82.54％,the specificity was 81.52％.The sensitivity of TSGF in diagnosis of thyroid cancer was 79.37％,the specificity was 78.26％.The sensitivity of high frequency ultrasound combined with TSGF in diagnosis of thyroid cancer was 92.06％,the specificity was 93.48％.And the coincidence rate of combined detection was significantly higher than the two methods used alone,the difference was statistically significant (P ＜ 0.05).Conclusion High frequency ultrasound combined with TSGF detection can make up the shortage of the two methods,which has important value in improving the diagnosis of thyroid carcinoma.

OBJECTIVE To investigate the clinical feature of nosocomial infections in general hospital,based on which effective methods are taken.METHODS An analysis was made on the basis of the survey,the data came from 73 690 hospitalized cases from 2000 to 2004.Bacterium appraise adopted French VITEK-32 fully automatic Expression.RESULTS Their prevalence rate was 5.34%,the main infection site was lower respiratory tract,and followed by upper respiratory tract and urinary tract.Among bacteria isolated from clinical cases,49.24% were G~-,(25.30%) were G~+,and 25.46% were fungi.The proportion of conditional bacteria showed an increasing trend from 2000 to 2004.CONCLUSIONS The conditional bacteria show an increasing trend in the nosocomial(infections.) Strengthening the nosocomial infection management,treating underlying disease actively,lessing(invasive) process,supervising towards bacteria,and using antibacterial drug rationally are effective methods to(reducing) the rate of nosocomial infections.