Stroke is the leading cause of death and disability among adults in China， and its common complications include digestive system abnormalities， cognitive impairment， depression， stroke-associated pneumonia， and hemiplegia. The combination of traditional Chinese and Western medicine has great potential in treating post-stroke complications. Xinglou Chengqitang （XLCQT） is a representative prescription of alleviating the disease in the upper part by treating the lower part. It has definite therapeutic effect and high safety. Clinically， XLCQT is often used to treat stroke and its complications. However， the quantity and quality of clinical trials of XLCQT in treating post-stroke complications need to be improved. Additionally， since the basic research is weak， the material basis and multi-target mechanism for the efficacy of this prescription are unknown. This article reviews XLCQT in terms of the pharmacodynamic basis， medicinal properties， safety evaluation， and progress in clinical research and mechanisms in treating post-stroke complications. This article summarizes 22 key active ingredients of XLCQT in treating acute stroke complicated with syndrome of phlegm heat and fu-organ excess. Among these key active ingredients， resveratrol， kaempferol， luteolin， chrysoeriol， apigenin， （+）-catechin， and adenosine have good pharmacokinetic properties and high bioavailability. The mechanisms of XLCQT in treating post-stroke complications are complex， including inflammatory response， brain-gut axis， hypothalamic-pituitary-adrenal （HPA） axis， intestinal flora， neurotrophic factors， autophagy， oxidative stress， and free radical damage. This review helps to deeply understand the pharmacodynamic basis and mechanisms of XLCQT in treating post-stroke complications and provides a theoretical basis for the clinical application of XLCQT against post-stroke complications and the development of drugs.

Objective To explore an artificial intelligence (AI)-based method for automated hand hygiene monitoring and to compare the effectiveness of three algorithms (UniFormerV2, TDN, C3D) in recognizing hand hygiene steps in surgical settings, thereby aiding hospital infection control. Methods From April to October 2024, we non-invasively collected 641 video recordings of healthcare staff performing hand hygiene at four-bay scrub sinks in two tertiary hospitals using overhead HD cameras. The dataset was annotated by five trained experts for model training and validation. Results Following training on 385 samples, internal validation (n=119) showed the C3D model achieved 81% accuracy, 87% recall, and an 83% F1-score. The TDN model achieved 93%, 91%, and 92% for the same metrics. The UniFormerV2 model outperformed both, with an accuracy, recall, and F1-score of 93%—an improvement of over 10 percentage points compared to traditional CNNs (TDN, C3D). It also achieved an 84% accuracy in external validation, demonstrating strong generalization. Conclusion The UniFormerV2 model is more accurate than CNN-based models for hand hygiene step recognition and shows robust performance in external validation. It presents a viable tool for healthcare facilities to enhance hand hygiene management, ultimately improving medical quality and patient safety.

Stroke is the main cause of death and disability among adults in China and is characterized by high incidence， disability， mortality， and recurrence rates. The combination of traditional Chinese and Western medicine has great potential in treating stroke and its sequelae. The classic traditional Chinese medicine prescription Da Chengqitang （DCQT） has a long history and proven efficacy in treating stroke. Clinically， DCQT is often used to treat stroke and its sequelae. However， the number and quality of clinical trials of DCQT in treating stroke need to be improved. Because of the insufficient basic research， the active ingredients and multi-target mechanism of action of DCQT remain unclear. Our research group has previously confirmed that DCQT can effectively reverse neurological damage， reduce iron deposition， and downregulate the levels of pro-inflammatory cytokines in the rat model of hemorrhagic stroke. The treatment mechanism is related to the nuclear factor erythroid 2-related factor 2 （Nrf2）-mediated signaling pathway and p38 mitogen-activated protein kinase （MAPK） signaling-mediated microglia activation. To clarify the pharmacodynamic basis and anti-stroke mechanism of DCQT， this article reviews the research progress in the treatment of stroke with DCQT in terms of clinical trials， pharmacodynamic material basis， safety evaluation， and mechanisms of absorbed components. This article summarizes 45 major phytochemical components of DCQT， 11 of which are currently confirmed absorbed components. Among them， emodin， rhein， chrysophanol， aloe-emodin， synephrine， hesperidin， naringin， magnolol， and honokiol can be used as quality markers （Q-markers） of DCQT. The mechanism of DCQT in treating stroke is complex， involving regulation of inflammatory responses， neuronal damage， oxidative stress， blood-brain barrier， brain-derived neurotrophic factor， and anti-platelet aggregation. This article helps to deeply understand the pharmacodynamic basis and mechanism of DCQT in treating stroke and provides a theoretical basis for the clinical application of DCQT in treating stroke and the development of stroke drugs.

This study summarized the nursing experience of midline catheter insertion in 12 patients with a body mass index≥50,providing clinical references.Key nursing interventions included:pre-insertion patient positioning was adjusted to semi-Fowler's or sitting position based on respiratory status.The puncture sites were chosen at the middle or distal third of the upper arm with elbow flexion.The widened tourniquets and extended-length needles/catheter sheaths were used according to vascular depth and puncture angle.The modified pre-insertion length measurement and real-time ultrasound-guided vascular puncture were applied.The catheter with crisscross elastic bandage was secured post-insertion.All 12 patients successfully underwent catheterization,with devices removed after completing intravenous therapy and blood sampling.

Objective To compare the early efficacy and safety of Huoluo Xiaotong capsules and Jingtong granules in treating cervical spondylosis radiculopathy(CSR).Methods A real-world study was conducted among CSR patients who visited three tertiary-grade-A hospitals in Changsha between January 2024 and February 2025.Patients were divided into a control group(Jingtong granules,4 g,po,tid)and an observation group(Huoluo Xiaotong capsules,1.4 g,po,tid);both groups were treated for 2 weeks.Baseline characteristics were balanced with inverse probability of treatment weighting(IPTW).Numeric rating scale(NRS)scores,overall response rates,and traditional Chinese medicine(TCM)symptom scores were compared at baseline,1 week,and 2 week.Results A total of 120 patients were ultimately included,with 30 in the control group and 90 in the observation group.After IPTW adjustment,at 1 week of treatment,the clinical efficacy rate of observation group(98.85％)were significantly exceeded that of control group(80.14％)(P＜0.001);at 2 weeks,the clinical efficacy rate of the two groups were both 100.00％.NRS and TCM syndrome scores showed no intergroup differences at baseline or 1 week(P＞0.05),at 2 weeks,the observation group demonstrated significantly lower NRS and TCM syndrome scores versus controls(P＜0.001).No adverse reactions occurred in either group.Conclusion Huoluo Xiaotong capsules demonstrate favorable short-term efficacy and safety in CSR,significantly alleviating pain and improving TCM symptoms within 2 weeks.High-quality randomized controlled trials are warranted to confirm these findings.

Objective:Transcranial direct current stimulation(tDCS),a non-invasive and safe neuromodulation technique,has been widely applied in stroke rehabilitation and motor function enhancement.However,differences in the ef-fects of conventional tDCS and high-definition tDCS(HD-tDCS)remain unclear.This study aims to compare the effects of tDCS and HD-tDCS on motor cortex excitability in healthy adults,providing evidence for the optimization of clinical neuromodulation strategies.Method:Forty healthy participants who met the inclusion criteria were enrolled and randomly assigned to two groups(group A and group B),with 20 participants in each group.A two-phase,two-treatment crossover de-sign was employed.In the first phase,participants in Group A received HD-tDCS with a center-anodal configu-ration over the motor cortex corresponding to the hemisphere with a higher resting motor threshold(RMT)de-termined by transcranial magnetic stimulation(TMS).The stimulation intensity was 1.5 mA and lasted for 20 minutes.After a 24-hour washout,the second phase involved anodal tDCS with identical stimulation parame-ters and location.In contrast,group B first received anodal tDCS followed by HD-tDCS after the washout pe-riod.Changes in motor evoked potential(MEP)of the bilateral motor cortices were assessed at multiple time points,including changes in bilateral RMT,the RMT difference(ΔRMT),and central motor conduction time(CMCT).Result:No significant differences were found between the two phases for any of the observed variables(P>0.05).Compared with baseline,both stimulation methods led to immediate and significant reductions in bilater-al RMT and ΔRMT,as well as shortened CMCT on the stimulated side(P<0.05).On stimulated-side,tDCS produced a more immediate reduction in RMT,while HD-tDCS showed a peak reduction at 30 minutes post-stimulation.In both cases,RMT gradually returned to baseline by 120 minutes.A significant difference in RMT changes between the two methods was observed after 30 minutes(P<0.05).On non-stimulated-side,a marked immediate increase was observed following tDCS,but subsequent trends were similar between the two methods,with no significant differences.Bilateral CMCT decreased after both types of stimulation,with no significant differences in changes over time between the two methods.Conclusion:tDCS has a more pronounced immediate effect on RMT modulation,while HD-tDCS exhibits more prominent delayed effects.

Objective To compare the early efficacy and safety of Huoluo Xiaotong capsules and Jingtong granules in treating cervical spondylosis radiculopathy(CSR).Methods A real-world study was conducted among CSR patients who visited three tertiary-grade-A hospitals in Changsha between January 2024 and February 2025.Patients were divided into a control group(Jingtong granules,4 g,po,tid)and an observation group(Huoluo Xiaotong capsules,1.4 g,po,tid);both groups were treated for 2 weeks.Baseline characteristics were balanced with inverse probability of treatment weighting(IPTW).Numeric rating scale(NRS)scores,overall response rates,and traditional Chinese medicine(TCM)symptom scores were compared at baseline,1 week,and 2 week.Results A total of 120 patients were ultimately included,with 30 in the control group and 90 in the observation group.After IPTW adjustment,at 1 week of treatment,the clinical efficacy rate of observation group(98.85％)were significantly exceeded that of control group(80.14％)(P＜0.001);at 2 weeks,the clinical efficacy rate of the two groups were both 100.00％.NRS and TCM syndrome scores showed no intergroup differences at baseline or 1 week(P＞0.05),at 2 weeks,the observation group demonstrated significantly lower NRS and TCM syndrome scores versus controls(P＜0.001).No adverse reactions occurred in either group.Conclusion Huoluo Xiaotong capsules demonstrate favorable short-term efficacy and safety in CSR,significantly alleviating pain and improving TCM symptoms within 2 weeks.High-quality randomized controlled trials are warranted to confirm these findings.

Objective:Transcranial direct current stimulation(tDCS),a non-invasive and safe neuromodulation technique,has been widely applied in stroke rehabilitation and motor function enhancement.However,differences in the ef-fects of conventional tDCS and high-definition tDCS(HD-tDCS)remain unclear.This study aims to compare the effects of tDCS and HD-tDCS on motor cortex excitability in healthy adults,providing evidence for the optimization of clinical neuromodulation strategies.Method:Forty healthy participants who met the inclusion criteria were enrolled and randomly assigned to two groups(group A and group B),with 20 participants in each group.A two-phase,two-treatment crossover de-sign was employed.In the first phase,participants in Group A received HD-tDCS with a center-anodal configu-ration over the motor cortex corresponding to the hemisphere with a higher resting motor threshold(RMT)de-termined by transcranial magnetic stimulation(TMS).The stimulation intensity was 1.5 mA and lasted for 20 minutes.After a 24-hour washout,the second phase involved anodal tDCS with identical stimulation parame-ters and location.In contrast,group B first received anodal tDCS followed by HD-tDCS after the washout pe-riod.Changes in motor evoked potential(MEP)of the bilateral motor cortices were assessed at multiple time points,including changes in bilateral RMT,the RMT difference(ΔRMT),and central motor conduction time(CMCT).Result:No significant differences were found between the two phases for any of the observed variables(P>0.05).Compared with baseline,both stimulation methods led to immediate and significant reductions in bilater-al RMT and ΔRMT,as well as shortened CMCT on the stimulated side(P<0.05).On stimulated-side,tDCS produced a more immediate reduction in RMT,while HD-tDCS showed a peak reduction at 30 minutes post-stimulation.In both cases,RMT gradually returned to baseline by 120 minutes.A significant difference in RMT changes between the two methods was observed after 30 minutes(P<0.05).On non-stimulated-side,a marked immediate increase was observed following tDCS,but subsequent trends were similar between the two methods,with no significant differences.Bilateral CMCT decreased after both types of stimulation,with no significant differences in changes over time between the two methods.Conclusion:tDCS has a more pronounced immediate effect on RMT modulation,while HD-tDCS exhibits more prominent delayed effects.

This study summarized the nursing experience of midline catheter insertion in 12 patients with a body mass index≥50,providing clinical references.Key nursing interventions included:pre-insertion patient positioning was adjusted to semi-Fowler's or sitting position based on respiratory status.The puncture sites were chosen at the middle or distal third of the upper arm with elbow flexion.The widened tourniquets and extended-length needles/catheter sheaths were used according to vascular depth and puncture angle.The modified pre-insertion length measurement and real-time ultrasound-guided vascular puncture were applied.The catheter with crisscross elastic bandage was secured post-insertion.All 12 patients successfully underwent catheterization,with devices removed after completing intravenous therapy and blood sampling.

Purpose: Patients with advanced biliary tract cancer (BTC) have a poor survival. We aim to evaluate the efficacy and safety of nab-paclitaxel plus gemcitabine and cisplatin regimen in Chinese advanced BTC patients. Materials and Methods: Eligible patients with locally advanced or metastatic BTC administrated intravenous 100 mg/m2 nab-paclitaxel, 800 mg/m2 gemcitabine, and 25 mg/m2 cisplatin every 3 weeks. The primary endpoint was progression-free survival (PFS). The secondary endpoints included overall survival (OS) and adverse events, while exploratory endpoint was the association of biomarkers with efficacy. Results: After the median follow-up of 25.0 months, the median PFS and OS of 34 enrolled patients were 7.1 months (95% confidence interval [CI], 5.4 to 13.7) and 16.4 months (95% CI, 10.9 to 23.6), respectively. The most common treatment-related adverse events at ≥ 3 grade were neutropenia (26.5%) and leukopenia (26.5%). Survival analyses demonstrated that carcinoembryonic antigen (CEA) levels could monitor patients’ survival outcomes. A significant increase in the number of infiltrating CD4+ cells (p=0.008) and a decrease in programmed death-1–positive (PD-1+) cells (p=0.032) were observed in the response patients. Conclusion In advanced BTC patients, nab-paclitaxel plus gemcitabine and cisplatin regimen showed therapeutic potential. Potential prognostic factors of CEA levels, number of CD4+ cells and PD-1+ cells may help us maximize the efficacy benefit.