Based on the theory of "shaoyang（少阳） resembling the pivot" and collateral diseases， this article proposes that pulmonary fibrosis （PF） can be divided into three stages including wind bi （痹）， constraint bi， and atrophy bi. The core pathogenesis of PF is the obstruction of the pivot and pulmonary collateral obstruction. In terms of treatment， the basic principles are to harmonize and regulate the pivot， and to promote the circulation of the lung collaterals. Depending on the different characteristics of the "essence-attribute-function"， treatment methods such as harmonizing and regulating the pivot， resolving phlegm and removing stasis， supplementing deficiency and harmonizing collaterals are suggested. This approach ensures the regulation of the pivot， smooth circulation of qi and blood， unblocking of the lung collaterals and nourishing the lung body， achieving the goals of balancing the ascending and descending of qi， removing phlegm and stasis， and relieving cough and wheezing.

Objective To observe the value of nomogram of ultrasound combined with laboratory indexes for predicting axillary lymph node metastasis(ALNM)of stage cT1N0 breast invasive ductal carcinoma(IDC).Methods A total of 77 cases with pathologically diagnosed stage cT1N0 single breast IDC were retrospectively collected,including 23 cases with and 54 cases without ALNM.Univariate and multivariate binary logistic regression analysis were used to analyze clinical data,laboratory indicators and ultrasonic manifestations,then the independent predictors of ALNM of stage cT1N0 breast IDC were screened to establish laboratory indexes model,ultrasound model and combined model,respectively,and nomogram of the combined model was drawn.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive efficacy of each model.The consistency of results of combined model and actual results was analyzed using calibration curve.Decision curve analysis(DCA)was used to explore the clinical value of each model.Results Serum carbohydrate antigen 153(CA153)(OR=1.132),platelet-to-lymphocyte ratio(PLR)(OR=1.020)and echo attenuation behind the lesion on ultrasound(OR=8.789)were all independent predictors of ALNM in stage cT1N0 breast IDC(all P＜0.05),and the area under the curve(AUC)of laboratory indexes model,ultrasound model and combined model for predicting ALNM of stage cT1N0 breast IDC was 0.757,0.616 and 0.836,respectively.The consistency of the predicted results of combined model and actual results was good.When the threshold was higher than 0.15,the net benefit of combined model was higher than that of the other 2 models.Conclusion Nomogram of ultrasound combined with laboratory indexes could effectively predict ALNM of stage cT1N0 breast IDC.

Objective:To explore the value of fetal heart quantification technology in assessing the morphology and function of the fetal heart during normal pregnancy.Methods:This prospective cohort study selected normal fetuses from healthy pregnant women who underwent prenatal ultrasound examinations at Hunan Provincial People's Hospital from January 2023 to October 2024. Using the GE Voluson E10 color Doppler diasonography, routine obstetric ultrasound and fetal echocardiography were performed to assess fetal growth and development and to exclude intracardiac and extracardiac malformations. Clear four-chamber view (4CV) dynamic images of the heart showing the endocardium (duration ≥3 s) were collected. Speckle-tracking analysis was performed using fetal heart quantification software. The measured indicators included the global spherical index (GSI), end-diastolic length of the heart (L-ED), end-diastolic width of the heart (W-ED), and the global longitudinal strain (GLS), fractional area change (FAC), and 24-segment spherical index (SI) of the left ventricle (LV) and right ventricle (RV). The cases were divided into five groups based on gestational age at the time of prenatal ultrasound: 20 +0 to 23 +6, 24 +0 to 27 +6, 28 +0 to 31 +6, 32 +0 to 35 +6, and 36 +0 to 40 +6 weeks. One-way analysis of variance, two independent samples t-test, univariate linear regression analysis, and Pearson correlation analysis were used to explore the differences in the above indicators among different gestational age groups and their correlation with gestational age. Results:A total of 200 pregnant women were included in the cohort, four cases were excluded due to poor image quality that prevented accurate tracking and measurement of relevant indicators. Ultimately, 196 cases (20 +0 to 23 +6 weeks 40 cases, 24 +0 to 27 +6 weeks 34 cases, 28 +0 to 31 +6 weeks 41 cases, 32 +0 to 35 +6 weeks 48 cases, and 36 +0 to 40 +6 weeks 33 cases) were included in the study, with a successful image analysis rate of 98.0%. (1) There were statistically significant differences in 4CV L-ED, 4CV W-ED, LV-FAC, and RV-FAC among the groups at 20 +0 to 23 +6, 24 +0 to 27 +6, 28 +0 to 31 +6, 32 +0 to 35 +6, and 36 +0 to 40 +6 weeks [4CV L-ED: 28.0±3.0, 32.6±4.3, 40.9±4.3, 46.7±4.8, 53.1±5.8, F=3.72; 4CV W-ED: 21.9±1.8, 25.1±4.2, 31.7±3.0, 37.4±4.0, 42.0±4.9, F=2.61; LV-FAC: (51.4±8.0)%, (49.0±10.4)%, (47.3±7.3)%, (43.1±7.5)%, (40.7±8.2)%, F=2.94; RV-FAC: (49.9±10.8)%, (46.2±12.0)%, (46.3±8.3)%, (43.2±8.0)%, (41.9±5.6)%, F=3.09; all P<0.05].(2) The size of the normal fetal heart gradually increased with gestational age, while the heart morphology remained relatively stable (4CV L-ED and 4CV W-ED were positively correlated with gestational age, with regression coefficients of 1.313 and 1.325, respectively, both P<0.001;LV-FAC and RV-FAC were negatively correlated with gestational age with regression coefficients of -0.783 and -0.552, respectively, both P<0.001; GSI, LV-GLS and RV-GLS had no correlations with gestational age, all P>0.05). (3) The SI of LV segments 1 to 17 were higher than the SI of the corresponding RV segments, and the SI of RV segments 20-24 were higher than that of the corresponding LV segments (all P<0.001). Conclusion:Fetal heart quantification technology has a certain value in the assessment of fetal cardiac morphology and function.

Objective:To explore the value of fetal heart quantification technology in assessing the morphology and function of the fetal heart during normal pregnancy.Methods:This prospective cohort study selected normal fetuses from healthy pregnant women who underwent prenatal ultrasound examinations at Hunan Provincial People's Hospital from January 2023 to October 2024. Using the GE Voluson E10 color Doppler diasonography, routine obstetric ultrasound and fetal echocardiography were performed to assess fetal growth and development and to exclude intracardiac and extracardiac malformations. Clear four-chamber view (4CV) dynamic images of the heart showing the endocardium (duration ≥3 s) were collected. Speckle-tracking analysis was performed using fetal heart quantification software. The measured indicators included the global spherical index (GSI), end-diastolic length of the heart (L-ED), end-diastolic width of the heart (W-ED), and the global longitudinal strain (GLS), fractional area change (FAC), and 24-segment spherical index (SI) of the left ventricle (LV) and right ventricle (RV). The cases were divided into five groups based on gestational age at the time of prenatal ultrasound: 20 +0 to 23 +6, 24 +0 to 27 +6, 28 +0 to 31 +6, 32 +0 to 35 +6, and 36 +0 to 40 +6 weeks. One-way analysis of variance, two independent samples t-test, univariate linear regression analysis, and Pearson correlation analysis were used to explore the differences in the above indicators among different gestational age groups and their correlation with gestational age. Results:A total of 200 pregnant women were included in the cohort, four cases were excluded due to poor image quality that prevented accurate tracking and measurement of relevant indicators. Ultimately, 196 cases (20 +0 to 23 +6 weeks 40 cases, 24 +0 to 27 +6 weeks 34 cases, 28 +0 to 31 +6 weeks 41 cases, 32 +0 to 35 +6 weeks 48 cases, and 36 +0 to 40 +6 weeks 33 cases) were included in the study, with a successful image analysis rate of 98.0%. (1) There were statistically significant differences in 4CV L-ED, 4CV W-ED, LV-FAC, and RV-FAC among the groups at 20 +0 to 23 +6, 24 +0 to 27 +6, 28 +0 to 31 +6, 32 +0 to 35 +6, and 36 +0 to 40 +6 weeks [4CV L-ED: 28.0±3.0, 32.6±4.3, 40.9±4.3, 46.7±4.8, 53.1±5.8, F=3.72; 4CV W-ED: 21.9±1.8, 25.1±4.2, 31.7±3.0, 37.4±4.0, 42.0±4.9, F=2.61; LV-FAC: (51.4±8.0)%, (49.0±10.4)%, (47.3±7.3)%, (43.1±7.5)%, (40.7±8.2)%, F=2.94; RV-FAC: (49.9±10.8)%, (46.2±12.0)%, (46.3±8.3)%, (43.2±8.0)%, (41.9±5.6)%, F=3.09; all P<0.05].(2) The size of the normal fetal heart gradually increased with gestational age, while the heart morphology remained relatively stable (4CV L-ED and 4CV W-ED were positively correlated with gestational age, with regression coefficients of 1.313 and 1.325, respectively, both P<0.001;LV-FAC and RV-FAC were negatively correlated with gestational age with regression coefficients of -0.783 and -0.552, respectively, both P<0.001; GSI, LV-GLS and RV-GLS had no correlations with gestational age, all P>0.05). (3) The SI of LV segments 1 to 17 were higher than the SI of the corresponding RV segments, and the SI of RV segments 20-24 were higher than that of the corresponding LV segments (all P<0.001). Conclusion:Fetal heart quantification technology has a certain value in the assessment of fetal cardiac morphology and function.

Objective To observe the value of nomogram of ultrasound combined with laboratory indexes for predicting axillary lymph node metastasis(ALNM)of stage cT1N0 breast invasive ductal carcinoma(IDC).Methods A total of 77 cases with pathologically diagnosed stage cT1N0 single breast IDC were retrospectively collected,including 23 cases with and 54 cases without ALNM.Univariate and multivariate binary logistic regression analysis were used to analyze clinical data,laboratory indicators and ultrasonic manifestations,then the independent predictors of ALNM of stage cT1N0 breast IDC were screened to establish laboratory indexes model,ultrasound model and combined model,respectively,and nomogram of the combined model was drawn.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive efficacy of each model.The consistency of results of combined model and actual results was analyzed using calibration curve.Decision curve analysis(DCA)was used to explore the clinical value of each model.Results Serum carbohydrate antigen 153(CA153)(OR=1.132),platelet-to-lymphocyte ratio(PLR)(OR=1.020)and echo attenuation behind the lesion on ultrasound(OR=8.789)were all independent predictors of ALNM in stage cT1N0 breast IDC(all P＜0.05),and the area under the curve(AUC)of laboratory indexes model,ultrasound model and combined model for predicting ALNM of stage cT1N0 breast IDC was 0.757,0.616 and 0.836,respectively.The consistency of the predicted results of combined model and actual results was good.When the threshold was higher than 0.15,the net benefit of combined model was higher than that of the other 2 models.Conclusion Nomogram of ultrasound combined with laboratory indexes could effectively predict ALNM of stage cT1N0 breast IDC.

Objective To study the correlation of an ultra high performance liquid chromatography(UPLC)fingerprint of Xiaochengqitang pieces(decoction and granules).Methods The UPLC method was used to establish the fingerprint of 15 batches of Xiaochengqitang pieces(decoction and granules).The correlation of the three UPLC fingerprints was evaluated by similarity analysis,pearson correlation analysis,cluster analysis(CA),principal component analysis(PCA)and orthogonal partial least squares-discriminant analysis(OPLS-DA).Results UPLC fingerprints of 15 batches of Xiaochengqitang pieces(decoction and granules)determined 16 common peaks,and 14 peaks were identified.The similarity of the fingerprints of the 15 batches of Xiaochengqitang pieces(decoction and granules)with the corresponding control fingerprints was greater than 0.90,and the similarity of the three control fingerprints was greater than 0.88.The results of pearson correlation analysis showed that 8 common peaks in Xiaochengqitang pieces(decoction and granules)had a very significant positive correlation.The results of CA showed that the properties of Xiaochengqitang decoction and granules were more similar.The results of PCA showed that the principal components with 4 eigenvalues greater than 1 contained 88％of the information of the original data.OPLS-DA screened 7 differential markers with variable importance projection value greater than 1.Conclusion The main chemical compositions of Xiaochengqitang pieces(decoction and granules)are consistent,which can provide data support for the quality control and clinical use of Xiaochengqitang compound preparation.

OBJECTIVE To estimate the quality markers of antioxidant activity for standard decoction of Schisandrae Chinensis Fructus.METHODS 15 batches of Schisandrae Chinensis Fructus standard decoctions were subjected to quality evaluation by ultra high-performance liquid chromatography(UPLC)based on single-marker(QAMS)method,before being summarized by chemometrics analysis.The antioxidant abilities of 15 batches of samples were determined by DPPH and ABTS methods,while gray correlation analy-sis(GRA)and the partial least squares regression(PLSR)methods were subsequently applied to investigating the relationship between the contents of 8 components and the antioxidant activity.Ultimately,molecule docking was utilized to explore the binding properties between candidate quality markers and the core targets of anti-oxidation,with the experimental verification being executed on the indi-vidual compound by in vitro anti-oxidation.RESULTS There was no remarkable difference between the results of QAMS and external standard method(ESM),with P valued greater than 0.05.And it was speculated that protocatechuic acid,gomisin A,schizantherin B and schisandrin B were the constituents of quality difference.Moreover,the 4 quality variation components were reckoned to be the al-ternative markers on antioxidant according to the results of GRA and PLSR.The molecule docking result also showed that 4 candidate quality markers presented good binding affinity with the antioxidant core targets.The antioxidant capacity was presumably originated from the collaborated effects by multi-components in the standard decoction of Schisandrae Chinensis Fructus.In the interim,protocate-chuic acid exhibited noteworthy antioxidant efficacy with dosage-depended manner in the results of single-compound verification,which was best conformed to the characteristics of quality markers and supposed to be the antioxidant quality marker for Schisandrae Chinensis Fructus standard decoction.CONCLUSION This research predicts the potential antioxidant substances on the basis of content deter-mination by UPLC and in vitro antioxidant assay,but also provides rational foundation for quality assessment on other preparations of Schisandrae Chinensis Fructus.

The vast majority of thyroid cancers show a good prognosis. However, the treatment of locally advanced thyroid cancer presents a huge problem. The wide application of targeted and immunotherapy in neoadjuvant therapy for locally advanced thyroid cancer has become a new therapeutic direction. This article summarizes the research on neoadjuvant chemotherapy, radiotherapy, and targeted therapy and immunotherapy related to various pathological types of thyroid cancer, with a focus on the recent advancements and thoughts on the application of targeted and immunotherapeutic drugs in neoadjuvant therapy. The results provide additional options for the clinical treatment of locally advanced thyroid cancer.

Objective To investigate the effectiveness of team-based learning(TBL)combined with research-based learning(RBL)in enhancing evidence-based nursing practice skills of undergraduate nursing interns.Methods A total of 114 undergraduate nursing students who interned in the operating room of a ⅢA hospital in Guangzhou from July 2021 to April 2022 were selected as study subjects.A randomized cluster sampling method based on a random number table was used to divide the students into a control group and a trial group.The control group received traditional teaching methods,while the trial group was taught using a combination of TBL and RBL.The two groups were compared in terms of evidence-based practice skills,critical thinking abilities,and their evaluations on the teaching methods.Results The differences in evidence-based practice skills and critical thinking abilities before and after the internship were significantly higher in the observation group compared to the control group(t=35.108,35.897;both P<0.05).Additionally,post-internship evaluation scores for the teaching methods in the trial group were significantly higher than those in the control group(t=-17.580,P<0.05).Conclusion TBL combined with RBL effectively enhances the evidence-based nursing practice skills and critical thinking abilities of undergraduate nursing interns.This approach also improves students'evaluations on the teaching methods and fosters the cultivation of excellent clinical evidence-based nursing professionals.

Objective To investigate the popularization of cardiopulmonary resuscitation(CPR)knowledge and science popularization needs among urban and rural residents in Tonghai County,Yuxi City,Yunnan Province,so as to explore the establishment of an efficient and appropriate science popularization model.Methods A total of 300 residents aged 15-60 years old were selected from Tonghai County,Yuxi City,Yunnan Province using stratified and simple random sampling methods.A self-designed questionnaire was used to conduct an anonymous questionnaire survey.Results Only 20.3%of Tonghai County residents master CPR skills,and 26.2%of Tonghai County residents have never heard of CPR.There is a statistically significant difference in the awareness rate of CPR between rural residents and non-rural residents(P<0.01).There are differences in residents'age and CPR awareness(P<0.01),the age and CPR are inversely proportional.The residents have a higher willingness to perform chest compressions and mouth-to-mouth resuscitation on strangers,66.2%and 68.6%respectively.63.79%of residents have never attended relevant training.But 92.76%of the people said they were willing to participate in the relevant training when they learned the training news.Conclusion Residents in Tonghai County generally lack knowledge of CPR first aid,but the demand for first aid knowledge of residential CPR is high and the attitude towards rescue is positive.It is recommended that relevant departments increase CPR science popularization and training efforts,and popularize CPR into villages.