Objective To observe the clinical efficacy of Yishen Huoxue Decoction combined with acupuncture in treating premature ovarian insufficiency(POI)with kidney deficiency and blood stasis syndrome.Methods A total of 116 patients diagnosed with POI of kidney deficiency and blood stasis syndrome who attended the outpatient department of Sichuan North Medical College Affiliated Nanchong Traditional Chinese Medicine Hospital between April 2023 and October 2024 were selected as study subjects.Patients were randomly divided into an observation group and a control group using a random number table,with 58 cases in each group.The control group received sequential therapy with estrogen and progesterone,while the observation group received Yishen Huoxue Decoction combined with acupuncture in addition to the control group's treatment.The treatment was administered continuously for three menstrual cycles.After three months of treatment,the clinical efficacy of both groups was evaluated.Changes in TCM syndrome scores,serum hormone levels[follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),anti-Müllerian hormone(AMH)],immune factors[interleukin-2(IL-2),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)],and protein expression levels of the PI3K/AKT signaling pathway were observed and compared between the two groups before and after treatment.Safety and adverse reactions were also evaluated.Results(1)The total effective rate was 91.38％(53/58)in the observation group and 74.14％(43/58)in the control group.The efficacy of the observation group was significantly superior to that of the control group,with a statistically significant difference(P＜0.05).(2)After treatment,TCM syndrome scores were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(3)After treatment,serum levels of FSH,E2,LH,and AMH were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(4)After treatment,levels of IFN-γ,TNF-α,and IL-2 were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(5)After treatment,the protein expression levels of PI3K and AKT were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(6)During treatment,the incidence of adverse reactions was 10.34％(6/58)in the observation group and 8.62％(5/58)in the control group.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Based on the theory of"waxing and waning transformation of yin and yang",Yishen Huoxue Decoction combined with acupuncture significantly improves clinical symptoms,regulates the immune microenvironment,activates the PI3K/AKT signaling pathway,and effectively enhances ovarian function in patients with POI of kidney deficiency and blood stasis syndrome,demonstrating notable clinical efficacy.

Objective The objective of this study was to analyze the longitudinal trend of multidimensional treatment quality of breast cancer based on the latent growth mixture model(LGMM),identify potential change patterns and influencing factors,and pro-vide scientific basis for improving treatment quality and patient prognosis.Methods The quality monitoring data of breast cancer from four consecutive years were obtained in the National"Quality Monitoring System for Specific(single)Disease";Based on the item response theory(IRT),the treatment quality of breast cancer in the three dimensions of preoperative examination,treatment,and out-come was calculated;LGMM was constructed to analyze the independent and joint change trend of breast cancer treatment quality in all dimensions,and the optimal model was determined based on practical significance and statistical indicators.Results In the inde-pendent trend analysis,2 potential categories were identified for preoperative examination,treatment,and outcome dimensions.Among them,9%showed a rapid upward trend in the preoperative examination dimension,and 91%showed a relatively stable trend;The sta-ble growth accounted for 23%and slow decline accounted for 77%in the treatment dimension;13%of the outcome dimensions showed an upward trend,while 87%showed a downward trend.In the joint trend analysis of changes,2 potential categories were identified:the first category accounted for about 8%,and the preoperative examination dimension of this category had a good treatment quality,with mean intercepts and slopes of 3.326 and 3.367,respectively.The treatment quality in the treatment and outcome dimensions had steadily improved;The second category accounted for about 92%,and the treatment quality in this dimension was relatively good.Its mean intercept and slope were 0.548 and 0.018,respectively.There is still room for improvement in the treatment quality of the pre-operative examination and outcome dimensions;BMI and M stage in patient characteristics are important influencing factors on the trend of combined changes in treatment quality.Conclusion The treatment quality of breast cancer during this study period has im-proved to varying degrees in all dimensions of preoperative examination,treatment and outcome;In the joint trend analysis of the three dimensions,the improvement of treatment quality in the preoperative examination dimension can provide feasible references for subse-quent treatment and achieve the goal of reducing complications.

Objective Based on polynomial logistic regression model,this study aimed to analyze the optimal length of hospi-tal stay for patients with non-small cell lung cancer(NSCLC)at different stages to achieve the best treatment quality,providing refer-ence for improving treatment quality and formulating relevant policies.Methods The data of NSCLC cases were collected and 16 di-agnosis and treatment process indicators were selected.Patients were stratified according to the stage of lung cancer.A polynomial lo-gistic regression model was constructed,including patient characteristics to analyze the impact of first hospitalization days on the quali-ty of comprehensive treatment.Results A total of 10,053 patients with NSCLC were collected in this study,with a median compre-hensive treatment quality score of 0.60.According to the staging of lung cancer,patients were divided into the early stage group(stageⅠ-Ⅱ),locally advanced stage group(stage Ⅲ),and advanced stage group(stage Ⅳ).The first hospitalization days and treatment quality of each subgroup showed a non-linear relationship.The polynomial model results showed that after adjusting the characteristics of patients,the length of hospitalization day and the quadratic term of hospital stay had a statistically significant impact on treatment quality in each subgroup:early patients had a first hospital stay of 18 days,and locally advanced and advanced patients had a first hos-pital stay of 22 days,with the highest probability of achieving high treatment quality.Conclusion Patients in different stages have va-rying degrees of illness and treatment plans,resulting in different first hospitalization days corresponding to the highest probability of obtaining high-quality treatment.Hospitals can improve the treatment quality and medical efficiency by implementing standardized di-agnosis and treatment guidelines,strengthening the management of the diagnosis and treatment process,and reasonably controlling the first hospitalization time of patients in different stages.

Objective The aim of this study was to estimate the causal effects of non-small cell lung cancer(NSCLC)treat-ment process on in-hospital mortality based on the double robust estimation(DR)method,and provide a reference basis for reducing in-hospital mortality of NSCLC.Methods According to the quality evaluation system of NSCLC treatment,the utilization rate of treatment process indicators was calculated,and patients were divided into the high-quality or low-quality groups based on the aver-age score of treatment process quality.In-hospital mortality was used as the outcome indicator,Kaplan-Meier method and Cox regres-sion adjusted for propensity score inverse probability of treatment weighting(IPTW)correction were used to analyze the impact of treat-ment process quality on in-hospital mortality in NSCLC.DR was combined to estimate the causal effects of the treatment process on in-hospital mortality.Results The median utilization rate of treatment process indicators was 66.88%,and the mean and standard de-viation of patients′ treatment process quality scores were 0.270±0.124,including 0.358±0.069 in the high-quality group,and 0.158±0.081 in the low-quality group.After the IPTW weighting,the standardized mean difference(SMD)of patients′baseline characteris-tics decreased;The difference in survival curves between the two groups of patients before and after ITPW was statistically significant(P<0.05),and the prognosis of patients in the high-quality group was better than that of patients in the low-quality group(pre-IPTW:HR=0.367,95%CI:0.275-0.491;post-IPTW:HR=0.228,95%CI:0.167-0.312).Compared with the low-quality group,the average causal effect of treatment process on in-hospital mortality was-0.026 in the high-quality group.Conclusion DR can compensate for the shortcomings of logistic or IPTW,avoid the risk of model error,and obtain for the causal effect of treatment process on in-hospital mortality.In medical practice,the utilization rate of treatment process indicators should be increased to improve patient prognosis;The study of causal effects suggests that besides the treatment process,other factors that affect in-hospital mortality cannot be ignored.

Objective To investigate the evaluating the value of CT quantitative analysis and visual scores on pulmonary alveolar proteinosis (PAP). Methods Thirty one patients with PAP who underwent chest HRCT scans and pulmonary function tests(PFTs)between July 2014 and April 2016 in our hospital were collected and analyzed.HRCT mean lung density(MLD)was measured by syngo InSpace Lung Parenchyma Analysis.Using CT visual scores(HRCT score and RE score),two radiologists with three-years experience at least evaluated pulmonary lesions retrospectively. SPSS 21.0 statistical software was used to analyze the data. Spearman correlation analysis was used to evaluate the correlation between MLD, HRCT score and RE score.The correlation between MLD, HRCT score, RE score, the parameters of PFTs, and blood gas parameters were also analyzed by Spearman correlation analysis. Results There were correlations between MLD,HRCT score and RE score.The correlation coefficient among MLD,HRCT score and RE score were r=0.835 vs r=0.768 vs r=0.838 in baseline. The correlation coefficient among MLD, HRCT score and RE score were r=0.827 vs r=0.780 vs r=0.896 in follow-up. And there were also strong correlation between ΔMLD, ΔHRCTscore and ΔREscore. The correlation coefficient among ΔMLD, ΔHRCTscore and ΔREscore were r=0.599 vs r=0.651 vs r=0.867. There were significantly (P＜0.05) negative correlations among MLD, HRCT score, RE score and VA, DLCO in baseline and follow-up retrospectively. There were significantly (P≤0.001) negative correlations among the ΔMLD, ΔHRCTscore, ΔREscore and ΔVA, ΔDLCO.The correlation among MLD, HRCT score, RE score and DLCO was more significant than that of VA. The correlation among ΔMLD, ΔHRCTscore,ΔREscore and ΔDLCO was more significant than that of ΔVA.There were markedly(P＜0.05) negative correlations between MLD and PO2,and the correlation coefficient were r=-0.738 in baseline vs r=- 0.810 in follow-up. Conclusion The HRCT quantitative analysis and HRCT visual scores are feasible to evaluate PAP.

Arginine deiminase (ADI) was first high-efficient expressed in Corynebacterium crenatum SYPA 5-5. The ADI was purified by Ni-NTA affinity chromatography and SDS-PAGE analysis showed the molecular weight (MW) was 46.8 kDa. The optimal temperature and pH of ADI were 37 ℃ and 6.5 respectively. The Michaelis constant was 12.18 mmol/L and the maximum velocity was 0.36 μmol/(min·mL). Under optimal conditions, 300 g/L of arginine was transformed and the productivity reach 8 g/(L·h). The recombinant strain was cultivated in a 5-L fermentor and used for whole-cell transformation of 300 g/L arginine, under repeated-batch bioconversion, the cumulative production reached 1 900 g/L.

Objective To assess the application of high-pitch CT pulmonary angiography (CTPA) at 70 kV tube voltage with 15 ml contrast medium using third-generation dual-source CT. Methods A total of 70 patients with clinically suspected pulmonary embolism were randomly divided into two groups: group A (n=35) underwent CTPA on conventional scanning mode (120 kV,80 ml contrast medium);and group B (n=35) underwent CTPA on high-pitch scanning mode at 70 kV tube voltage with 15 ml contrast medium. The CT values and standard deviations of the main pulmonary artery,apical segment of right upper pulmonary lobe (S1),and posterior basal segment of the right lower pulmonary lobe (S10),anterior thoracic air,and back muscles were measured. The signal to noise ratio (SNR),contrast to noise ratio (CNR),and effective dose (ED) were calculated. The overall image quality was evaluated by two blinded radiologists. The quality image was compared using non-parametric test on two independent samples. The potential differences in CT value,SNR,CNR,and ED were analyzed using the independent sample t-test. Results The CT values of main pulmonary artery [(300.62±77.54)HU vs.(332.80±102.80)HU;t=-1.53,P=0.13],S1 [(361.72±84.92)HU vs. (325.37±87.86)HU;t=1.81,P=0.08],and S10 [(359.54±89.61)HU vs. (318.26±87.19)HU;t=2.00,P=0.05] of right lung were not significantly different between group A and group B. The CNR of S1 (22.81±6.05 vs. 19.80±6.60;t=2.05,P=0.04) and S10 (22.65±6.37 vs. 19.28±6.63;t=2.23,P=0.03) of right lung in group A was significantly higher than in group B. The SNR of main pulmonary artery,S1,and S10 of right lung were not significantly different between group A and B. The subjective diagnostic quality values of group A and B were 1 (1,1) and 1 (1,1),respectively (Z=-0.08,P=0.93). The subjective diagnostic quality values evaluated by two radiologists showed excellent consistency(κ=0.87,P=0.01). The mean ED was 79% lower in group B [(0.92±0.23)mSv] than in group A [(4.33±1.80) mSv] (t=11.72,P=0.00).Conclusion Application of high-pitch mode in CTPA at 70 kV with 15 ml contrast medium using third-generation dual-source CT can remarkably reduce radiation dose without affecting image quality.
Computed Tomography Angiography ; methods ; Humans ; Lung ; diagnostic imaging ; Pulmonary Embolism ; diagnostic imaging ; Radiation Dosage ; Signal-To-Noise Ratio ; Stenosis, Pulmonary Artery ; diagnostic imaging

Objective To evaluate the image quality and radiation dose of third-generation dual-source CT with tin filtration for spectral shaping and iterative reconstructions.Methods Thirty-five patients underwent low-dose CT (LDCT) for lung cancer screening on second-generation dual-source CT and follow-ups on third-generation dual-source CT. Image quality and radiation dose were compared between the two examinations.ResultsThe radiation dose of third-generation dual-source CT [dose-length product (DLP)(49.7±18.2)mGy·cm, effective dose (ED)(0.73±0.26)mSv] was lower than second-generation dual-source CT [DLP (86.37±13.44) mGy·cm, ED(1.20±0.42)mSv](t=6.01, P=0.000;t=6.57, P=0.000). The objective image noise of second-generation dual-source CT [(25.7±2.9)HU] was higher than that of third-generation dual-soure CT[(18.6±4.2)HU](t=5.24,P=0.000).The subjective image noise of second-generation dual-source CT [(4.60±0.49)scores] was significantly lower than that of third-generation dual-source CT [(4.80±0.40)scores] (t=4.15, P=0.000). Conclusion Chest CT for the detection of pulmonary nodules can be performed with third-generation dual-source CT that produces high image quality and low radiation dose when using a stellar infinity detector with spectral shaping.
Early Detection of Cancer ; methods ; Humans ; Lung Neoplasms ; diagnostic imaging ; Radiation Dosage ; Radiographic Image Interpretation, Computer-Assisted ; Thorax ; diagnostic imaging ; Tomography, X-Ray Computed ; methods

Objective To evaluate retrospectively the image quality and detection of nodules with low-dose chest computed tomography (LDCT)by photon detector and iterative reconstruction (IR).Methods Sixty-six patients with lung nodules underwent routine LDCT with image reconstruction using filtered back projection (FBP).These patients were followed up by LDCT with photon detector 6 months later with image reconstruction using FBP and SAFIRE.Image quality and detection rate of the nodules were compared among groups including routine LDCT,photon decector+FBP and photon Decector+IR groups.Results Noise was decreased and SNR was increased in turn for routine LDCT,photon detector+FBP and photon detector +IR,exhibiting statistical differences (all P<0.001).The CT image quality score among routine LDCT,photon decector+ FBP and photon decector+ IR groups were increased in turn with statistical differences (χ2 =32.65,P<0.001).132 lung solid nodules (SN)were all identified in three groups with average diameter of (5.13±1.49)mm, (5.1 1±1.57)mm and (5.08±1.54)mm,respectively,and the difference was not statistically significant (P >0.05).14 ground glass nodules (GGN )in routine LDCT group and 15 in other two groups were identified with the average diameter of (6.44±1.86)mm, (7.23±1.74)mm and (7.31±1.68)mm,respectively.The ability of routine LDCT to detect the GGNs was lower than that of the others.Conclusion Photon detector and IR are able to decrease image noise,improve image quality,and increase detection rate and measurement accuracy of GGN.