ObjectiveTo construct a risk prediction model for frequent acute exacerbations of chronic obstructive pulmonary disease （COPD） under disease-syndrome combination， thus providing decision support for precise clinical intervention. MethodsA total of 2 029 patients with acute exacerbations of COPD admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2020 to August 2024 were retrospectively included. These patients were classified into groups of frequent acute exacerbations （≥2 times/year） and infrequent acute exacerbations （<2 times/year） according to the hospitalization times per year. Risk factors were screened by LASSO regression combined with logistic regression， and a nomogram model was constructed. The model performance was assessed based on the area under the curve （AUC）， calibration curves， and decision curve analysis （DCA）. ResultsThe differences in baseline characteristics between the frequent acute exacerbations group （1 196 cases） and infrequent acute exacerbations group （833 cases） were not statistically significant. LASSO regression combined with multivariate logistic regression screened the following independent risk factors： body mass index （BMI）， hospitalization days， number of smoking years， place of residence， use of noninvasive ventilators， oxygen-demanding therapy， liver cirrhosis， use of systemic glucocorticosteroids， and traditional Chinese medicine syndrome （phlegm and stasis obstructing the lung）. The nomogram model showed good discrimination and calibration in both the training set （AUC=0.748） and validation set （AUC=0.774）. ConclusionThe risk prediction model for frequent acute exacerbations of COPD， integrating traditional Chinese medicine syndrome， constructed in this study has high accuracy. It can provide a scientific basis for early clinical identification of high-risk patients and individualized intervention.

Objective To explore the application value of dual-phase dual-energy CT (DECT) perfusion imaging in preoperative lung function assessment of lung cancer patients. Methods Data were collected from patients with stageⅠA non-small cell lung cancer who underwent surgical treatment in the Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, from November 2022 to June 2024. All patients underwent DECT perfusion imaging and pulmonary function testing (PFT) before surgery. PFT observation indicators included ventilation function indicators such as forced expiratory volume in one second (FEV1), forced vital capacity (FVC), 1-second rate (FEV1/FVC), maximal voluntary ventilation (MVV), and diffusion function indicators such as diffusing capacity for carbon monoxide (DLCO) and DLCO per liter of alveolar volume (DLCO/VA). The software eXamine was used to obtain quantitative parameters of DECT perfusion imaging, including volume parameters and perfusion parameters of both lungs and each lung lobe. The correlation between the volume parameters and perfusion parameters of both lungs and the ventilation and diffusion function indicators of the patients, as well as the differences in quantitative parameters of each lung lobe, was analyzed. Results The end-inspiration lung volume and biphasic volume difference were strongly positively correlated with FEV1 and FVC (r=0.636, r=0.682, r=0.614, r=0.624, P<0.001) and moderately positively correlated with MVV and DLCO (r=0.499, r=0.514, r=0.549, r=0.447, P<0.001); the end-expiration lung volume was weakly negatively correlated with DLCO/VA (r=−0.295, P=0.026); the volume ratio was positively correlated with FEV1, FVC, MVV, and MVV% (r=0.424, r=0.399, r=0.415, r=0.310, P<0.05); the end-inspiration iodine content was weakly positively correlated with DLCO/VA% (rs=0.292, P=0.030); the end-expiration iodine content was weakly positively correlated with FEV1, FVC, MVV, DLCO%, and DLCO/VA (r=0.307, r=0.299, r=0.295, r=0.366, r=0.320, P<0.05) and moderately positively correlated with DLCO (r=0.439, P<0.001); the end-inspiration iodine concentration was negatively correlated with FEV1, FVC, MVV, and MVV% (rs=−0.407, rs=−0.426, rs=−0.352, rs=−0.277, P＜0.05); the end-expiratory phase iodine concentration was moderately positively correlated with DLCO/VA (r=0.403, P=0.002); both the iodine concentration difference and the iodine concentration ratio were moderately positively correlated with FEV1, FEV1%, FVC, MVV, MVV% (P<0.05). The lung volume and iodine concentration ratio values were both highest in the left upper lung lobe and lowest in the right middle lung lobe; the differences in lung volume, lung volume ratio, intrapulmonary iodine content, and intrapulmonary iodine concentration were all highest in the lower lobes of both lungs and lowest in the middle lobe of the right lung. Conclusion Dual-phase DECT perfusion imaging can accurately assess overall lung function and quantify regional lung function.

Aim To investigate the protective effects of methyl rosmarinate(MR)on myocardial injury in-duced by high-altitude hypoxia and explore its underly-ing mechanisms.Methods BALB/c mice were ran-domly divided into a control group,a model group,and low-,medium-,and high-dose MR groups(25,50,and 75 mg·kg-1,respectively).Except for the control group,all other groups were exposed to a hypobaric hypoxia chamber and administered MR via intraperitoneal injection daily for three days.After the experiment,myocardial tissues were collected for he-matoxylin and eosin(HE)staining to observe morpho-logical changes.Levels of malondialdehyde(MDA),glutathione(GSH),and superoxide dismutase(SOD)were measured to evaluate the anti-myocardial injury activity of MR.Network pharmacology was employed to predict drug-disease interaction targets,construct a protein-protein interaction(PPI)network,and identify core targets.Functional enrichment analysis was car-ried out using Gene Ontology(GO)and Kyoto Ency-clopedia of Genes and Genomes(KEGG)pathways.Molecular docking was used to verify the binding affini-ty of MR to core targets,and Western blot was conduc-ted to detect the expression of related proteins.Results MR significantly alleviated myocardial injury caused by high-altitude hypoxia.Network pharmacology analy-sis identified EGFR,Bcl-2,STAT3,MMP9,ESR1,and MTOR as key targets.Molecular docking con-firmed strong binding between MR and these core tar-gets.Western blot results demonstrated that MR im-proved myocardial injury by regulating the expression of STAT3,Bax,and Bcl-2 proteins.Conclusion MR may exert its protective effects on high-altitude hypoxi-a-induced myocardial injury through a multi-target mechanism.

AIM To investigate the in vivo pharmacokinetics of chlorogenic acid,isoquercetin,ferulic acid,isorhamnetin and shionone in Asteris Radix et Rhizoma in rats.METHODS Twelve rats were randomly assigned into 2 groups and given intragastric administration of conventional dose(0.63 g/kg)and large dose(3.3 g/kg)of Asteris Radix et Rhizoma extracts,respectively,after which blood collection was made at 0.083,0.167,0.33,0.5,0.75,1,1.5,2,4,6,8,12,24 h,UPLC-MS/MS was adopted in the plasma concentration determination of various effective constituents,and main pharmacokinetic parameters were calculated.RESULTS Various effective constituents in the large dose group demonstrated prolonged t1/2,MRT0-∞ as compared with those in the conventional dose group(P＜0.05).After dose correction,Cmax of chlorogenic acid,isoquercetin,shionone in the large dose group displayed no obvious changes(P＞0.05),while Cmax of ferulic acid,isorhamnetin,and AUC0-t,AUC0-∞ of various effective constituents were higher than those in the conventional dose group(P＜0.05).CONCLUSION Various effective constituents in the high dose of Asteris Radix et Rhizoma can maintain high-concentration and long-time effects on rat bladder tissue.

Objective:To explore the effect of Taichi motor imagination therapy combined with resistance exercise on the recovery of heart function and quality of life in patients with chronic heart failure(CHF).Methods:A total of 118 elderly CHF patients admitted to Huangshan Shoukang Hospital between January 2020 and December 2023 were included in this randomized controlled trial.Participants were randomly divided into intervention group(n=59)and control group(n=59).Participants in the control group received conventional anti-heart failure treatment,while those in the intervention group received additional Taichi motor imagination therapy and resistance exercise.The in-tervention lasted for 3 months.Cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd)and interventricular septal thickness at diastole(IVSTd)],quality of life[Minnesota Living with Heart Failure Questionnaire(MLHFQ)],markers of heart failure and neurohormones[B-type natri-uretic peptide(BNP),norepinephrine(NE),aldosterone(ALD)and angiotensin Ⅱ(AngⅡ)]levels and the inci-dence of major adverse cardiovascular events(MACE)during intervention were compared between the two groups.Results:Compared to those in the control group,participants in the intervention group had significant higher LVEF[(50.52±1.96)％vs.(45.84±2.21)％],and significant lower LVEDd[(57.12±1.72)mm vs.(60.45±2.14)mm],IVSTd[(8.84±0.82)mm vs.(10.00±1.19)mm],MLHFQ score[(28.86±5.34)points vs.(34.51±6.57)points],BNP[(9.23±1.35)pg/ml vs.(13.62±1.49)pg/ml],NE[(13.09±0.93)pmol/L vs.(16.63±0.86)pmol/L],ALD[(1.82±0.12)ng/L vs.(2.35±0.15)ng/L],AngⅡ[(0.75±0.07)ng/L vs.(0.90±0.06)ng/L]and incidence of MACE(6.90％vs.26.32％)(P＜0.01 all).Conclusion:Taichi motor imagination therapy combined with resistance exercise may improve the cardiac function and quality of life in CHF patients.

Objective To investigate the effects of different hemostatic devices on the safety and comfort of compression hemostasis in the patients undergoing transradial coronary intervention(TRI).Methods From March to September 2023,900 patients undergoing TRI in the cardiology department of some hospital were divided into three groups according to the randomized numerical table method:STEPTY P hemostatic patch group(group A),spinning hemostatic group(group B)and balloon hemostatic group(group C),with 300 cases in each group.The three groups were compared in terms of the hemostatic effect,local complications and comfort of the puncture sites.Results The three groups had no statistical differences in hematoma grade and incidence rates of hematoma and hemorrhage(all P＞0.05).There were significant differences in the occurrence of skin injury among the three groups(P=0.011),and group A had the skin injury incidence rate(1.0％)statistically lower than those of group B(4.3％)and C(5.3％)(P＜0.05).There were obvious differences among the three groups in the incidence rates of pain on the operative side,palm swelling and limb numbness(P＜0.05),and group A had the incidence rates significantly lower than those of group B and C(all P＜0.05).Conclusion All the three compression hemostatic devices can achieve safe and effective post-TRI hemostasis.When compared with the other two devices,STEPTY P hemostatic patch is more effective in reducing the probability of related complications and improving patient comfort while effectively compressing the puncture site for hemostasis.[Chinese Medical Equipment Journal,2025,46(1):49-54]

Objective To investigate the impacts of epidural anesthesia with ropivacaine combined with dezocine on lower limb motor nerve block and maternal and infant outcomes in primipara undergoing painless delivery.Methods A total of 159 primiparas who delivered in Nanjing Jiangbei Hospital were selected as the research objects,and divided into the blank group(53 cases),the ropivacaine group(53 cases)and the combined group(53 cases)by the random number table method.Parturients in the blank group were given natural delivery mode,parturients in the ropivacaine group were given ropivacaine epidural anesthesia,and parturients in the combined group were given dezocine anesthesia on the basis of ropivacaine.Analgesic effect at different time points,time of the first,second and third stage of labor,pressing times of analgesic pump,lower limbs motor nerve block,maternal and infant outcomes,and adverse reactions of parturients were compared among the three groups.Results At 10 minutes after analgesia,60 minutes after analgesia,when the cervix was fully dilated and when the fetus was delivered,the VAS scores of the parturients in the ropivacaine group and the combined group were lower than those in the blank group(P<0.05),and the VAS scores of the parturients in the combined group were significantly lower than those in the ropivacaine group(P<0.05).There was no significant difference in the time of the first,second or third stage of labor of parturients among the three groups(P>0.05);The pressing times of analgesic pump of parturients in the combined group was significantly less than that in the ropivacaine group(P<0.05).There was no statistically significant difference in terms of low limb motor nerve block after painless labor of parturients among the three groups(P>0.05).There were no statistically significant differences in the perineal incision rate or the Apgar scores of newborns at 1 minute and 5 minutes after birth among the three groups(P>0.05).The usage rate of forceps and the rate of conversion to cesarean section in the combined group were significantly lower than those in the ropivacaine group and the blank group(P<0.05).There was no statistically significant difference in the incidence of total adverse reactions among the blank group,the ropivacaine group and the combined group(P>0.05).Conclusion The combination of ropivacaine and dezocine for epidural anesthesia has a better analgesic effect on primiparas with painless delivery,has a smaller impact on lower limb motor nerve block in parturients,and can achieve better maternal and infant outcomes.

Objective To study the clinical characteristics,imaging findings,pathological features,treatment methods,and prognosis of nasopharyngeal carcinoma in children.Methods The clinical data of 6 children(<18 years)with nasopharyngeal carcinoma admitted to the Department of Pediatrics,Beijing Tongren Hospital from March 2021 to February 2025 were retrospectively reviewed,and outcomes were followed up.Results All 6 patients were male.Age at onset ranged from 11 to 15 years,with a median of 12.5 years.The interval from onset to diagnosis was 1-6 months.The main clinical symptoms were cervical mass(4 cases,67%)and headache(3 cases,50%);some patients also had nasal congestion and rhinorrhea,epistaxis,or limited mouth opening.TNM staging was stage III in 4 cases and stage IVa in 2 cases.All patients had non-keratinizing undifferentiated nasopharyngeal carcinoma on pathology.Treatments included radiotherapy,chemotherapy,surgery,targeted therapy,and immunotherapy.By July 1,2025,after comprehensive treatment,5 patients(83%)achieved complete remission,and 1 patient(17%)experienced recurrence and progression and died.Conclusions Comprehensive treatment based on combined radiotherapy and chemotherapy is the mainstay for childhood nasopharyngeal carcinoma,overall prognosis is favorable,and long-term follow-up is required.Molecular targeted therapy and immunotherapy are expected to improve the prognosis of advanced nasopharyngeal carcinoma and require further research for validation.

Organizational and institutional management plays a pivotal role in the pharmaceutical management of medi-cal institutions.Strengthening management in this area significantly enhances the quality of medical services and promotes the standardization,refinement,and scientific management of hospitals at all levels and types.To achieve homogenization in organiza-tional and institutional management,the Pharmaceutical Specialized Committee,Chinese Hospital Association compilation team adhered to principles of scientific,universality,instructiveness,and operability.After in-depth problem sorting,extensive opinion collection,and rigorous expert deliberation,we have formulated the first domestic group standard for regulating the organizational and institutional systems of pharmaceutical management in medical institutions.This article aims to detail the process of formula-ting this standard and to provide an in-depth analysis of its content,hoping to offer valuable advice and guidance for the construc-tion of organizational and institutional management in pharmaceutical affairs for medical institutions of all levels and types.

Objective To compare the accuracy differences of three-dimensional reconstruction of zygomatic-maxillary complex using cone beam computed tomography(CBCT)and multi-slice spiral computed tomography(MSCT)in the parameters related to zygomatic implantation.Methods Five adult skull specimens(10 zygomatic-maxillary complexes in total)were selected.According to the clinical application characteristics of zygomatic implantation,the parameter location for each skull specimen was conducted,and then CBCT and MSCT were used for scanning and three-dimensional reconstruction.Four parameters were measured on both skull specimens and reconstructed models:the thickness of the maxillary zygomatic process at the intersection of the zygomatic implant path and zygomaticomaxil-lary suture(LB-B1),the thickness of the zygomatic bone at the intersection of the zygomatic implant path and the midpoint of the zygomatic bone surface(LC-C1),the width of the alveolar ridge between the second premolar and the first molar(LAR),and the buccolingual width of the first molar(LM).The specimen group was measured by electronic vernier caliper,and the CBCT group and MSCT group were measured based on CBCT and MSCT.The absolute and relative errors of these four parameters were calculated,and the accuracy of the CBCT and MSCT three-dimensional reconstruction models were analyzed.Results All parameters demonstrated excellent measurement reliability and repeatability,with intra-class correlation coefficient(ICC)≥0.90.The measurement results of each parameter in the CBCT group and the MSCT group showed statistically significant differences compared with those in the specimen group(P<0.05).The measurement result of LM in the CBCT group was smaller than that in the MSCT group,and the difference was statistically significant(P<0.05).However,the measurement results of LB-B1,LC-C1 and LAR in the CBCT group showed no statistically significant difference compared with those in the MSCT group(P>0.05).The mean absolute error and relative error of the LM measurement results to the specimen group in the CBCT group were both smaller than those in the MSCT group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the mean absolute error or relative error of the LB-B1,LC-C1 and LAR measurement results to the specimen group between the CBCT group and the MSCT group(P>0.05).Conclusion CBCT and MSCT demonstrat comparable accuracy in three-dimensional reconstruction of the zygomatic-maxillary complex.However,CBCT exhibits superior accuracy for fine structures such as dental tissues,which is recommended as the primary choice for imaging data acquisition in zygomatic implantation.