ObjectiveTo explore the spatial distribution patterns of flavonoid glycosides in Epimedium sagittatum and the influences of environmental factors on the accumulation of these components. MethodsThe spatial statistical analysis and GeoDetector model were used to analyze the distribution patterns of epimedin A，epimedin B，epimedin C，icariin，and total flavonoid glycosides in E. sagittatum samples from 92 different production areas in 36 cities of 13 provinces/municipalities/autonomous regions of China，as well as the effects of 28 environmental factors on the accumulation of each component. ResultsThe average content of flavonoid glycosides 64 （69.56%） producing areas and 30 （83.33%） cities met the quality standard of no less than 1.50% of total flavonoid glycosides in the 2020 edition of Chinese Pharmacopoeia.Epimedin A，epimedin B，epimedin C，icariin，and their sum showed significantly high accumulation.The hot spots regions of epimedin A and epimedin B were similar with each other，mainly located in western Hunan，eastern Hubei，eastern Guizhou，and northern Guangxi.The common hot spot areas of epimedin C and total flavonoid glycosides were in western and southwestern Hunan，southern Henan，northern Anhui，eastern Guizhou，and southern Chongqing.The hot spots areas of icariin were in southern Chongqing，western Hunan，and eastern and northeastern Guizhou.The interactions between environmental factors had stronger explanatory power for the accumulation of components than single factors.The strongest single factor and interactive factor affecting the accumulation of epimedin C were precipitation of wettest quarter （q=0.16） and its interaction with temperature seasonality （q=0.35），respectively.The strongest single factor influencing both the accumulation of icariin and total flavonoid glycosides was the precipitation of coldest quarter （q equals 0.15 and 0.22，respectively）.The strongest interactions were observed between precipitation of coldest quarter and gravel content （q=0.34），as well as between precipitation of coldest quarter and aspect （q=0.35）. ConclusionThirteen cities，including Zhumadian and Nanyang in Henan，Huaihua，Shaoyang，and Zhangjiajie in Hunan，and Zunyi，Qiandongnan，and Tongren in Guizhou，were hot spots of total flavonoid glycosides in E.sagittatum.Precipitation，gravel content，temperature seasonality，and aspect significantly influence the accumulation of flavonoid glycosides in E.sagittatum.This study provides reference for the utilization and production zoning of E.sagittatum.

Objective To systematically analyze the medical radiation exposure levels in a district of Ningbo City and to provide a scientific basis for the reasonable and effective control of medical radiation exposure. Methods Based on the radiological diagnosis frequency and dose information system, basic medical radiation exposure data were collected, such as radiation doses received by patients in various X-ray diagnostic examinations, from all 13 public medical institutions in a district of Ningbo City from January 1 to December 31, 2020. The data were analyzed for the percentage and collective effective dose of various diagnostic examinations, the distribution of examinations by sex and age, and the number of patients undergoing two or more examinations and their cumulative doses within multiple time intervals. Results Among medical X-ray diagnostic examinations in the district, the percentages of CT examination and routine photography examination were 50.88% and 47.93%, respectively, and the collective effective dose of CT examination accounted for 97.75%. By age and sex, the frequency of examination was the highest in the age group of 45-54 years, and the frequency of examination in the male was higher than that in the female before age 55. The annual effective dose for two patients exceeded 100 mSv. Conclusion In this study, CT examination accounted for up to 50.88% of all medical X-ray diagnostic examinations, and contributed 97.75% of the collective effective dose, highlighting the need for particular attention to the justification of medical radiation exposure from CT.

Objective: To explore the longitudinal associations between dietary macronutrients and lung function in schoolaged children, so as to provide the nutritional research evidence for promoting children s lung health. Methods: In November 2021, two primary schools located in Chengdu, Sichuan Province were selected from the Southwest China Childhood Nutrition and Growth (SCCNG) cohort by a stratified cluster random sampling method, enrolling a total of 1 112 school aged children aged 8 to 13 years. At baseline, the dietary and sociodemographic characteristics of the children were assessed. One year later, the forced vital capacity (FVC) of the children was measured and converted into Z scores (FVC- Z ), while the vital capacity index (VCI) was also calculated. Generalized linear regression analysis was employed to examine the associations between dietary macronutrients and lung function, considering interactions with gender and age, followed by stratified analysis. Results: After adjusting for confounding factors, the analysis results of the generalized linear regression model showed that the carbohydrate energy ratio was negatively correlated with FVC- Z ( β =-0.02) and VCI ( β =-0.16), while the fat energy ratio showed a positive correlation with FVC- Z ( β =0.03) and VCI ( β =0.23) ( P <0.05). The protein energy ratio was positively correlated with FVC- Z ( β =0.09) and VCI ( β =0.60) specifically in girls ( P <0.05). Additionally, there was an interaction effect of age on the associations between macronutrients and lung function ( P <0.01); in children aged 8-9 and 10-11, the carbohydrate energy supply ratio was negatively correlated with FVC- Z ( β =-0.04, -0.03) and VCI ( β =-0.29, -0.21), and fat energy supply ratio was positively correlated with FVC- Z ( β =0.07, 0.05) and VCI ( β =0.46, 0.32) ( P <0.05). Conclusions There are age and sex differences in the association of dietary macronutrients with lung function, with a low carbohydrate, high fat diet promoting lung function in children. Additionally, protein intake appears to have a positive influence on the lung function of girls. The early school age period may represent a critical window for dietary interventions aimed at promoting lung health.

Objective To review clinical trial registration status of TCM treatment for coronary microvascular disease;To analyze the effectiveness and safety of TCM in treating coronary microvascular disease.Methods The clinical trials of TCM in the treatment of coronary artery microvascular disease included in the Chinese Clinical Trials Registry and the US Clinical Trials Registry from the establishment of the database to January 31,2024 were retrieved,and the general characteristics(time,region,funding source),design type,intervention regimen and outcome indicators of the included clinical trials were extracted and analyzed using Excel 2019 software.Results A total of 17 clinical trials were included,including 16 pre-registrations.The registered units were distributed in 5 provinces across the country,involving 17 registration institutions.The two regions with the most distribution were Shanghai(6 studies,35.29%)and Beijing(5 studies,29.41%).The types of studies were mainly interventional studies,and most of the study designs were randomized parallel controlled studies(16 studies,94.12%).A total of 8 interventions were reported,including Chinese patent medicine,TCM decoction,TCM intravenous preparation,and acupuncture and moxibustion.A total of 143 outcome indicators were designed,including 10 first-level indicators,including coronary artery microcirculation,clinical efficacy,symptoms and signs,TCM syndromes,quality of life,exercise tolerance,cardiac function,physical and chemical testing,safety,and pharmacoeconomic evaluation.Conclusion The registration of clinical trials by TCM in the treatment of coronary microvascular diseases has been gradually receiving attention from researchers,but the overall number is still small.At present,the study needs to be optimized in terms of study design and index selection.

Objective To explore the prognosis-related genes of lung adenocarcinoma(LUAD)and establish a prognostic prediction model for LUAD.Methods The differentially expressed genes of LUAD tissues and adjacent normal tissues in the GSE43458,GSE7670,and GSE140797 datasets were screened.The protein-protein interaction(PPI)network analysis,gene ontology(GO)function,Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway enrichment analyses,least absolute shrinkage and selection operator for prognosis coefficient screening,disease-specific survival analysis,Cox regression analysis,and gene correlation analysis were performed.Independent prognostic genes of LUAD were screened from the differential genes,and a prognostic prediction model of LUAD was established.The expression of independent prognostic genes was analyzed,and the predictive model was evaluated by receiver operating characteristic(ROC)curve.The GSE68465 data set was used as an external validation set to verify the predictive model.Results There were 197 up-regulated differential genes and 77 down-regulated differential genes in LUAD and adjacent normal tissues common to the three datasets.Through stepwise screening,two genes,IL7R and SLC2A1,were identified as independent prognostic factors for LUAD.IL7R was an independent protective factor,while the SLC2A1 was an independent risk factor.A prediction model for curve was built with IL7R and SLC2A1.The prediction model for LUAD constructed with IL7R and SLC2A1 is as follows:Risk score=(-0.694)×expression level of IL7R+0.763×expression level of SLC2A1.Conclusion This study screened out IL7R as an independent prognostic protective factor for LUDA,and SLC2A1 as an independent prognostic risk factor for LUAD.The LUDA prediction model constructed based on these two genes has good predictive ability and generalization ability,which can provide references for the research and clinical individualized treatment of LUAD.

Objective Based on multi-dimensional bioinformatics technology,the molecular pathological mechanism of acute hypotension is systematically analyzed.Methods Integrate the gene expression profile of the Gene Expression Omnibus database(GSE2401),use limma package(R software)to screen differential genes,and optimize targets through data dimensionality reduction(log2(FC)＞1,P＜0.05);Further combine Gene Ontology,Kyoto Encyclopedia of Genes and Genomes and gene set enrichment analysis pathway enrichment and STRING-Cytoscape(MCODE,CytoHubba plug-in)to build a protein-protein interaction(PPI)network to mine core genes;realize the full-chain analysis of"differential gene-functional pathway-PPI network".Results 676 differential genes(304 upregulated,372 downregulated),ribosome structural components(Rps8,Rps27,Rpl35,etc.)and multiple pathways such as forkhead box protein and cyclic adenosine monophosphate were found to coordinate the regulation of acute hypotension.Conclusion This study uses a low-cost and efficient bioinformatics analysis framework to reveal the association between ribosomal dysfunction,changes in insulin signal efficacy and blood pressure regulation,providing new ideas for targeted therapy.

Objective To explore the diagnostic value of combined detection of Krebs Von den Lungen-6(KL-6),C-reactive protein(CRP),and some indicators in blood routine for lung injury in patients with influ-enza A virus infection.Methods A total of 92 patients with influenza A admitted to the hospital in December 2023 were selected as the observation group.Based on whether there were obvious texture changes such as patchy and ground glass opacities in the lungs on X-ray examination,the patients were divided into a lung inju-ry positive group(T1 group,30 cases)and a lung injury negative group(T2 group,62 cases).Additionally,53 healthy individuals who underwent physical examinations during the same period were selected as the control group.Peripheral blood routine,CRP,and KL-6 levels were detected.Peripheral blood routine,CRP,and KL-6 levels were compared between the observation group and control group,and between T1 group and T2 group.receiver operating characteristic(ROC)curve were used to evaluate the diagnostic efficacy of individual indica-tors and combined detection for patients with lung injury who infected with influenza A.Results Compared with the control group,white blood cell count,neutrophil ratio,monocyte ratio,neutrophil/lymphoid ratio(NLR),monocyte/lymphoid ratio(MLR),platelet/lymphoid ratio(PLR),CRP and KL-6 levels in the obser-vation group were increased,while the lymphocyte ratio and platelet count decreased(P<0.05).Compared with the T2 group,the CRP and KL-6 levels increased and the incidence of anemia increased in the T1 group(P<0.05).The results of binary Logistic regression analysis showed that blood routine,KL-6,and CRP were all influencing factors of lung injury in patients with influenza A(P<0.05).The area under the curve of single detection of KL-6,CRP,blood routine,the combined detection of KL-6 and CRP,and the combined detection of KL-6,CRP and blood routine were 0.679,0.641,0.604,0.727 and 0.781.Conclusion KL-6 combined with CRP and blood routine testing has high diagnostic efficacy for lung injury in patients with influenza A and has significant clinical significance.

By combining the origin and research progress of the combination of disease and syndrome, the core pathogenesis, this article explored the research ideas and methods of the core pathogenesis of TCM. It is found that modern TCM is mostly guided by the idea of classification-staging-syndrome differentiation, the main prescription of the main disease, the special prescription of the special disease, and the idea of "dynamic-fixed sequential". The tongue image syndrome differentiation method, clustering analysis method, drug test syndrome method, compound pathogenesis method, "evidence-based pathogenesis-syndrome treatment system" research model, and the integration of traditional Chinese and Western medicine theory were used to explore the core pathogenesis of TCM under the condition of disease. Combined with the advantages of modern medical disease differentiation and TCM syndrome differentiation, the individualized diagnosis and treatment methods of integrated traditional Chinese and Western medicine have been continuously improved, in order to solve the stage contradictions of different clinical stages, effectively delay the progression of the disease and improve the prognosis of the disease.

Objective To explore the correlation of traditional Chinese medicine(TCM)syndrome elements with language function and activities of daily living(ADL)in patients suffering post-stroke aphasia(PSA).Methods Ninety-eight PSA patients hospitalized at the College of Rehabilitation Medicine,Fujian University of Traditional Chinese Medicine from April 2023 to April 2024 were selected.The language function,TCM syndrome elements,and their correlations were analyzed.Results(1)Among PSA patients,males outnumbered females.PSA patients exhibited different performances on various aphasia-related scales,with language impairments mainly concentrated in naming and spontaneous speech.(2)The distribution of TCM syndrome elements varied in PSA patients with different age groups.In the age group＜50 years old,qi obstruction(100.00%),phlegm syndrome(100.00%),and dampness syndrome(100.00%)were predominant.In the age group of 50-59 years old,phlegm syndrome(100.00%)and yang hyperactivity syndrome(96.30%)were predominant.In the age group of 60-69 years old,phlegm syndrome(100.00%)and yang hyperactivity syndrome(96.15%)were also predominant.In the age group of 70-79 years old,qi deficiency syndrome(100.00%)was predominant.In the age group of 80-89 years old,syndromes such as qi insecurity,qi obstruction,qi deficiency,phlegm,yang hyperactivity,blood stasis,wind stirring,and blood cold were concentrated(all 100.00%).However,there were no statistically significant differences in the distribution of TCM syndrome elements among various age groups(P＞0.05).(3)The distribution of deficiency and excess syndrome elements varied in PSA patients with different genders.Among deficiency syndrome elements,yang hyperactivity,qi deficiency,and yin deficiency were predominant in males,while yang hyperactivity,qi deficiency,and blood deficiency were predominant in females.Among excess syndrome elements,phlegm syndrome,qi obstruction,and dampness syndrome were predominant in males,while phlegm syndrome,qi obstruction,and qi stagnation syndrome were predominant in females.However,there were no statistically significant differences in the distribution of deficiency and excess syndrome elements between genders(P＞0.05).(4)After controlling the factors of age group and gender,partial correlation analysis of syndrome elements and language function showed that among the disease-location syndrome elements,spontaneous naming(r=-0.588,P=0.027)and sematic cued naming(r=-0.558,P=0.038)in the Boston Naming Test(BNT)were negatively correlated with the large intestine;among the disease-nature syndrome elements,BNT sematic cued naming(r=0.821,P＜0.001)was positively correlated with qi sinking,while BNT spontaneous naming was negatively correlated with blood heat(r=-0.544,P=0.044)and was positively correlated with fluid depletion(r=0.860,P=0.028);BNT recognitive naming was positively correlated with external wind(r=0.966,P=0.034);errors in BNT sematic cued naming were negatively correlated with qi sinking(r=-0.540,P=0.005);the Modified Barthel Index(MBI)was positively correlated with essence deficiency(r=0.572,P=0.021).Conclusion The TCM syndrome elements of phlegm,qi block,yang hyperactivity,and qi deficiency are commonly seen in PSA patients.There is a certain correlation of language function and ADL with TCM syndrome elements in PSA patients.

Objective To explore the effectiveness of safety management strategies and nursing quality control measures for in-hospital emergency transfers of patients with acute cerebral hemorrhage.Methods A total of 100 patients with acute cerebral hemorrhage were divided into control group(be-fore implementation,n=50)and observation group(after implementation,n=50)based on the tim-ing of implementation of the standard and measures.The preparation time for transfer,incidence of ad-verse events,personnel allocation for transfer,equipment completeness,changes in Glasgow Coma Scale(GCS)scores,and length of hospital stay were compared between the two groups.Results The prepa-ration time for transfer in the observation group was shorter than that of the control group[(15.2±3.5)min versus(23.7±5.8)min,P＜0.05];the incidence of adverse events was lower in the observation group than that in the control group(6.0％versus 22.0％,P＜0.05);personnel allocation complete-ness rate was reasonable in the observation group compared to that in the control group(68.0％versus 100％,P＜0.05);equipment completeness was higher in the observation group than that in the con-trol group(98.0％versus 82.0％,P＜0.05);GCS score was less in the observation group than that in the control group[(0.5±0.3)points versus(1.1±0.9)points,P＜0.05];the length of hospi-tal stay in the observation group was shorter than that in the control group[(14.5±3.2)days versus(18.3±4.1)days,P＜0.05].Conclusion Implementing standardized in-hospital emergency transfer safety management strategies and nursing quality control measures can improve the safety of pa-tient transfers,reduce occurrence of adverse events,and improve short-term prognosis for patients with acute cerebral hemorrhage.