Functional dyspepsia （FD） is a prioritized disease category where traditional Chinese medicine （TCM） demonstrates distinct therapeutic advantages. The current western medicine treatment for FD is mainly based on proton pump inhibitors and prokinetic agents， with digestive enzymes， probiotics and antidepressants serving as adjuvant medication， yet such therapies still have certain limitations. TCM treatment for FD includes oral administration of Chinese herbal formulas and Chinese patent medicines， as well as external TCM therapies such as acupuncture and moxibustion， acupoint application， hot medicinal compress therapy， rubbing with ointment， medicinal iontophoresis， auricular acupoint therapy and tui na （Chinese medical massage）. The combined treatment of FD with integrated TCM and western medicine can significantly improve clinical effectiveness and reduce adverse reactions. The common mechanisms underlying the therapeutic effects of both TCM and western medicine revolve around the core pathological processes of FD， mainly focusing on restoring gastrointestinal motility， regulating the levels of brain-gut peptides， modulating intestinal microecology， and ameliorating inflammatory status. The differential mechanisms lie in the precise targeting feature of western medicine versus the holistic-regulating and multi-target characteristics of TCM， and the two approaches exert a synergistic effect to enhance efficacy. This paper proposes to leverage the advantages of TCM in holistic regulation and the strengths of western medicine in targeted treatment， so as to provide personalized and comprehensive treatment regimens for FD patients.

Objective:To compare the outcomes of simultaneous versus staged nasal bone reduction and septoplasty in the treatment of traumatic nasal bone fractures with associated septal fractures. Methods:Patients with traumatic nasal bone fractures, with or without septal fractures, were recruited from two hospitals and divided into three groups. Group A underwent simultaneous nasal bone reduction and septoplasty, Group B underwent staged nasal bone reduction and septoplasty, and Group C underwent nasal bone reduction only. Nasal appearance scores and nasal congestion Visual Analogue Scale （VAS） scores were measured preoperatively, at 2 weeks postoperatively, and at 3 months postoperatively. For Group B, scores were also recorded at 2 weeks and 3 months after the second-stage surgery. Differences were analyzed using statistical software. Results:Two weeks post-surgery, the nasal appearance scores significantly decreased in all three groups compared to preoperative scores （P< 0.01）, with no statistically significant differences between the groups （P= 0.43, 0.71, 0.58）. In Group A, the VAS score for nasal congestion decreased significantly following simultaneous surgery （P<0.01）. In Group B, there were no significant differences in nasal congestion VAS scores between pre-surgery and post-first-stage, nor between three months post-first-stage and two weeks post-first-stage （P= 0.61, 0.13）. However, the VAS scores significantly decreased after the second-stage surgery compared to pre-surgery, and three months post-second-stage surgery compared to three months post-first-stage surgery （P<0.01）. The VAS scores for nasal congestion at two weeks post-surgery in Group A were lower than those in Group B after the first-stage surgery （P<0.01）. The incidence rates of nasal adhesions post-surgery in Groups A, B, and C were 0%, 6.9%, and 4.3%, respectively. Conclusion:For traumatic nasal bone fractures with associated septal fractures, performing simultaneous nasal bone reduction and septoplasty under general anesthesia using endoscopy is more time-efficient compared to staged surgery, and it results in a lower occurrence rate of post-surgical nasal adhesions.
Humans ; Nasal Bone/surgery* ; Nasal Septum/injuries* ; Treatment Outcome ; Rhinoplasty/methods* ; Male ; Female ; Adult ; Skull Fractures/surgery* ; Fractures, Bone/surgery* ; Middle Aged ; Adolescent

Objective To investigate the mechanism of astragalus polysaccharide(APS)in inhibiting the proliferation and metastasis of osteosarcoma cells.Methods Cell counting kit-8(CCK8)assay was used to detect the inhibitory effect of APS on the proliferation of osteosarcoma cell lines U2OS,HOS,MG63 and osteoblast cell line hFOB1.19,the cell line with the most significant inhibitory effect of APS on osteosarcoma cells was selected for subsequent experiments.Osteosarcoma cells were divided into control group(NC group),APS group,APS+sh-SP1 co treatment group with transfected SP1 knockdown plasmid(APS+sh-SP1),and APS+oe SP1 co treatment group with transfected SP1 overexpression plasmid(APS+oe SP1 group).Western blotting was used to detect the expression of SP1 protein in each group.CCK8 assay was used to detect the proliferation ability of each group.Transwell assay was used to detect the metastatic ability of cells in each group.TOP/FOP Flash assay was used to detect the activity of Wnt/β-catenin signaling pathway.The protein expressions of Wnt3a,β-catenin,CyclinD1,cMYC,matrix metalloproteinase 2(MMP2)and Snail were detected by western blotting.Result After 48h of APS treatment,the cell proliferation inhibition rates of osteosarcoma cells U2OS,HOS,MG63 and osteoblast cells hFOB1.19 were 62.93%±4.79%,20.66%±1.10%,39.31%±3.20%and 5.97%±0.72%,respectively.Compared with osteoblast hFOB1.19,APS significantly inhibited the proliferation of osteosarcoma cells,and the difference was statistically significant(F=208.400,P<0.001),and the inhibitory effect on osteosarcoma U2OS cells was the most significant(t=20.380,P<0.001).Compared with NC group,SP1 protein expression,cell proliferation ability,number of transmembrane cells,Wnt/β-catenin signaling pathway activity in cells,Wnt/β-catenin signaling pathway key proteins Wnt3a,β-catenin,downstream proliferation-related protein CyclinD1,cMYC,and downstream metastasis related proteins MMP2 and Snail in the APS group were decreased,and the differences were statistically significant(t=9.740～90.780,all P<0.05).Compared with the APS group,the expression of SP1 protein,cell proliferation ability,the number of transmembrane cells,the activity of Wnt/β-catenin signaling pathway and the expression of Wnt/β-catenin signaling pathway related proteins in the APS+sh-SP1 group were further decreased,and the differences were statistically significant(t=3.032～12.940,all P<0.05).Compared with the APS group,the expression of SP1 protein,cell proliferation ability,the number of transmembrane cells,the activity of Wnt/β-catenin signaling pathway and the expression of Wnt/β-catenin signaling pathway related proteins in the APS+oe-SP1 group were increased,and the differences were statistically significant(t=3.350～22.450,all P<0.05).Conclusion APS inhibits the proliferation and metastasis of osteosarcoma cells by targeting SP1/Wnt/β-catenin signaling axis.

Objective:To evaluate the value of ultrasound radiomics combined with machine learning for early diagnosis of seronegative Hashimoto’s thyroiditis (SN-HT) .Methods:This retrospective study included 164 patients from Liaoning Provincial People’s Hospital , Lixin County People’s Hospital, Linghai Dalinghe Hospital, Fengcheng Phoenix Hospital, who underwent thyroidectomy for solitary nodules with normal thyroid function between Nov. 2016 and Jan. 2024. Postoperative pathology confirmed Hashimoto’s thyroiditis (HT) in some cases, who were further categorized into antibody-positive and antibody-negative groups based on serum antibody status. Patients without Hashimoto’s thyroiditis served as the control group. A total of 298 ultrasound images were analyzed. Radiomics features were extracted from hypoechoic non-nodular areas within 0.5 cm surrounding the tumor. Two senior pathologists and two senior ultrasound physicians independently assessed lymphocytic infiltration, eosinophilic changes of follicular epithelium, and the proportion of hypoechoic areas in pathology and ultrasound images, respectively. A machine learning model, CCH-NET, was developed using linear regression and t-distributed stochastic neighbor embedding (t-SNE) techniques. The dataset was divided into a training set (80%) and a validation set (20%) to compare the diagnostic accuracy of CCH-NET with that of senior ultrasound physicians. Results:In internal validation, CCH-NET achieved a diagnostic accuracy of 88.89% for both antibody-positive and antibody-negative groups, significantly higher than the 66.67% accuracy of senior ultrasound physicians ( P<0.01). In external validation, CCH-NET achieved 75.00% and 66.67% accuracy for the two groups, compared to 50.00% by senior ultrasound physicians. For the control group, both methods achieved 93.33% accuracy. The AUC of CCH-NET was 0.848, outperforming senior ultrasound physicians (0.681) ,demonstrating superior diagnostic performance. Conclusion:The radiomics-based CCH-NET model, using non-nodular hypoechoic areas as a specific indicator, can accurately identify early SN-HT in euthyroid patients. It significantly outperforms senior ultrasound physicians, improving diagnostic accuracy and reducing missed diagnoses.

Objective:To evaluate the value of ultrasound radiomics combined with machine learning for early diagnosis of seronegative Hashimoto’s thyroiditis (SN-HT) .Methods:This retrospective study included 164 patients from Liaoning Provincial People’s Hospital , Lixin County People’s Hospital, Linghai Dalinghe Hospital, Fengcheng Phoenix Hospital, who underwent thyroidectomy for solitary nodules with normal thyroid function between Nov. 2016 and Jan. 2024. Postoperative pathology confirmed Hashimoto’s thyroiditis (HT) in some cases, who were further categorized into antibody-positive and antibody-negative groups based on serum antibody status. Patients without Hashimoto’s thyroiditis served as the control group. A total of 298 ultrasound images were analyzed. Radiomics features were extracted from hypoechoic non-nodular areas within 0.5 cm surrounding the tumor. Two senior pathologists and two senior ultrasound physicians independently assessed lymphocytic infiltration, eosinophilic changes of follicular epithelium, and the proportion of hypoechoic areas in pathology and ultrasound images, respectively. A machine learning model, CCH-NET, was developed using linear regression and t-distributed stochastic neighbor embedding (t-SNE) techniques. The dataset was divided into a training set (80%) and a validation set (20%) to compare the diagnostic accuracy of CCH-NET with that of senior ultrasound physicians. Results:In internal validation, CCH-NET achieved a diagnostic accuracy of 88.89% for both antibody-positive and antibody-negative groups, significantly higher than the 66.67% accuracy of senior ultrasound physicians ( P<0.01). In external validation, CCH-NET achieved 75.00% and 66.67% accuracy for the two groups, compared to 50.00% by senior ultrasound physicians. For the control group, both methods achieved 93.33% accuracy. The AUC of CCH-NET was 0.848, outperforming senior ultrasound physicians (0.681) ,demonstrating superior diagnostic performance. Conclusion:The radiomics-based CCH-NET model, using non-nodular hypoechoic areas as a specific indicator, can accurately identify early SN-HT in euthyroid patients. It significantly outperforms senior ultrasound physicians, improving diagnostic accuracy and reducing missed diagnoses.

Objective To investigate the mechanism of astragalus polysaccharide(APS)in inhibiting the proliferation and metastasis of osteosarcoma cells.Methods Cell counting kit-8(CCK8)assay was used to detect the inhibitory effect of APS on the proliferation of osteosarcoma cell lines U2OS,HOS,MG63 and osteoblast cell line hFOB1.19,the cell line with the most significant inhibitory effect of APS on osteosarcoma cells was selected for subsequent experiments.Osteosarcoma cells were divided into control group(NC group),APS group,APS+sh-SP1 co treatment group with transfected SP1 knockdown plasmid(APS+sh-SP1),and APS+oe SP1 co treatment group with transfected SP1 overexpression plasmid(APS+oe SP1 group).Western blotting was used to detect the expression of SP1 protein in each group.CCK8 assay was used to detect the proliferation ability of each group.Transwell assay was used to detect the metastatic ability of cells in each group.TOP/FOP Flash assay was used to detect the activity of Wnt/β-catenin signaling pathway.The protein expressions of Wnt3a,β-catenin,CyclinD1,cMYC,matrix metalloproteinase 2(MMP2)and Snail were detected by western blotting.Result After 48h of APS treatment,the cell proliferation inhibition rates of osteosarcoma cells U2OS,HOS,MG63 and osteoblast cells hFOB1.19 were 62.93%±4.79%,20.66%±1.10%,39.31%±3.20%and 5.97%±0.72%,respectively.Compared with osteoblast hFOB1.19,APS significantly inhibited the proliferation of osteosarcoma cells,and the difference was statistically significant(F=208.400,P<0.001),and the inhibitory effect on osteosarcoma U2OS cells was the most significant(t=20.380,P<0.001).Compared with NC group,SP1 protein expression,cell proliferation ability,number of transmembrane cells,Wnt/β-catenin signaling pathway activity in cells,Wnt/β-catenin signaling pathway key proteins Wnt3a,β-catenin,downstream proliferation-related protein CyclinD1,cMYC,and downstream metastasis related proteins MMP2 and Snail in the APS group were decreased,and the differences were statistically significant(t=9.740～90.780,all P<0.05).Compared with the APS group,the expression of SP1 protein,cell proliferation ability,the number of transmembrane cells,the activity of Wnt/β-catenin signaling pathway and the expression of Wnt/β-catenin signaling pathway related proteins in the APS+sh-SP1 group were further decreased,and the differences were statistically significant(t=3.032～12.940,all P<0.05).Compared with the APS group,the expression of SP1 protein,cell proliferation ability,the number of transmembrane cells,the activity of Wnt/β-catenin signaling pathway and the expression of Wnt/β-catenin signaling pathway related proteins in the APS+oe-SP1 group were increased,and the differences were statistically significant(t=3.350～22.450,all P<0.05).Conclusion APS inhibits the proliferation and metastasis of osteosarcoma cells by targeting SP1/Wnt/β-catenin signaling axis.

Purpose/Significance To investigate the application of cutting-edge technologies in predicting the incidence of hemor-rhagic fever with renal syndrome(HFRS),to compile and integrate various time-series analysis methods,evaluate and select the opti-mal model.Method/Process By utilizing national HFRS incidence data from 2004 to 2020,the effectiveness of models is predicted based on statistical methods:SARIMA,STL-ARIMA and TBATS,neural network approaches:NNAR,LSTM and combined models of SARIMA-LSTM with 3 different weighting schemes.The performance of these models is comprehensively assessed using RMSE,MAE and MAPE.Result/Conclusion The SARIMA and LSTM models are identified as the superior individual models.The combined SARI-MA-LSTM model demonstrates enhanced performance compared to individual models.The SARIMA-LSTM model optimized using the reciprocal of error method is deemed the optimal model.The optimal model is expected to provide technical support and references for the early warning system model design of HFRS.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Objective:To compare the efficacy and safety between WangShiBaoChiWan and mosapride in the treatment of functional dyspepsia (FD).Methods:From September 2019 to September 2020, patients with postprandial fullness and early satiation who met the Rome Ⅳ criteria for FD diagnosis were enrolled from 15 hospitals, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Beijing Traditional Chinese Medicine Hospital Affiliated to Capital Medical College. The subjects were randomly divided into WangShiBaoChiWan (experimental) group and mosapride (control) group in the ratio of 1∶1. The treatment regimens were WangShiBaoChiWan+ mosapride simulator, WangShiBaoChiWan simulator+ mosapride, respectively with a treatment period of 2 weeks. The primary efficacy outcome was the improvement rates of main symptoms before and after treatment, the secondary efficacy primary efficacy outcome was the total clinical effective rate and the change of the single symptom score. And the safety indicator included adverse events. Independent sample t-test, paired t-test and chi-square test were used for statistical analysis. Results:A total of 251 FD patients were enrolled in the full analysis set, including 124 in the experimental group and 127 in the control group; 241 FD patients were in the per-protocol analysis set, including 117 in the experimental group and 124 in the control group. The analysis of per-protocol analysis set showed that the improvement rates of the main symptoms of the experimental group and the control group were (66±29)% and (60±30)%, respectively, and the difference was not statistically significant ( P>0.05). The improvement rate of the main symptoms of the experimental group reached 117% of that of the control group, which exceeded the expected non-inferiority standard of 80%. The total clinical effective rates of the experimental group and the control group were 76.07% (89/117) and 75.81% (94/124), respectively, and the difference was not statistically significant ( P>0.05). The results of full analysis set showed that the incidence of adverse events of the experimental group and the control group was 1.62% (2/124) and 1.57% (2/127), respectively, and the difference was not statistically significant ( P>0.05). There were no serious adverse events in the two groups. Conclusion:The improvement rate of the main symptoms of WangShiBaoChiWan is not inferior to that of mosapride in the treatment of FD, and it has good safety.

Objective: Combining the aluminium content data of food in Henan Province with the data of children s food consumption, to evaluate probability of dietary aluminum exposure among primary school students. Methods: Database of nine types of aluminum containing food and their consumption among primary school students in Henan Province were established. The probability distribution of dietary aluminum exposure was calculated by Monte Carlo simulation using Crystal Ball 11.1.2.4 software, and the sensitivity analysis of exposure was conducted. Results: The average content of aluminum in fried bread stick was the highest, with the value of 150.89 mg/kg. The consumption of dietary aluminum was highest in steamed bun, with the value of 0.15 g. The average dietary aluminum exposure per kilogram of body weight was 1.99 mg per week of primary school students in Henan Province, accounting for 99.7% of the provisional tolerable weekly intake (PTWI). The 95th percentile of aluminum exposure per kilogram of body weight per week was 6.16 mg, which was three times of that of PTWI. Nearly 13.22% of primary school students had dietary aluminum exposure higher than PTWI. Among all kinds of food, the average aluminum exposure of fried bread stick per kilogram of body weight per week was the highest 1.19 mg. Aluminum content in fried bread stick accounted the highest proportion of average dietary aluminum exposure among primary school students. Conclusion The average dietary aluminum exposure level of primary school students in Henan Province is close to the PTWI established by JECFA, with the high consumption population exceeds the PTWI. Measures should be taken to reduce the dietary aluminum exposure risk of primary school students.