ObjectiveTo evaluate the impact of yang-reinforcing and blood-activating therapy on the long-term prognosis for patients with dilated cardiomyopathy （DCM） of yang deficiency and blood stasis syndrome. MethodsA retrospective cohort study was conducted involving 371 DCM patients with yang deficiency and blood stasis syndrome. The yang-reinforcing and blood-activating therapy was defined as the exposure factor. Patients were categorized into exposure group （186 cases） and non-exposure group （185 cases） according to whether they received yang-reinforcing and blood-activating therapy combined with conventional western medicine for 6 months or longer. The follow-up period was set at 48 months， and the Kaplan-Meier survival analysis was used to assess the cumulative incidence of major adverse cardiovascular events （MACE） in both groups. Cox regression analysis was used to explore the impact of yang-reinforcing and blood-activating therapy on the risk of MACE， and subgroup analysis was performed. Changes in traditional Chinese medicine （TCM） syndrome score， left ventricular ejection fraction （LVEF）， left ventricular fractional shortening （LVFS）， left ventricular end-diastolic diameter （LVEDD）， and Minnesota Living with Heart Failure Questionnaire （MLHFQ） score were compared between groups at the time of first combined use of yang-reinforcing and blood-activating therapy （before treatment） and 1 year after receiving the therapy （after treatment）. ResultsMACE occurred in 31 cases （16.67%） in the exposure group and 47 cases （25.41%） in the non-exposure group. The cumulative incidence of MACE in the exposure group was significantly lower than that in the non-exposure group ［HR=0.559， 95%CI（0.361，0.895）， P=0.014］. Cox regression analysis showed that yang-reinforcing and blood-activating therapy was an independent factor for reducing the risk of MACE in DCM patients ［HR=0.623， 95%CI（0.396，0.980）， P=0.041］， and consistent results were observed in different subgroups. Compared with pre-treatment， the exposure group showed decreased TCM syndrome score and MLHFQ score， reduced LVEDD， and increased LVEF and LVFS after treatment （P＜0.05）； in the non-exposure group， TCM syndrome score decreased， LVEF and LVFS increased， and LVEDD reduced after treatment （P＜0.05）. After treatment， the exposure group had higher LVEF and LVFS， smaller LVEDD， and lower TCM syndrome score and MLHFQ score compared with the non-exposure group （P＜0.05）. ConclusionCombining yang-reinforcing and blood-activating therapy with conventional western medicine can reduce the risk of MACE in DCM patients with yang deficiency and blood stasis syndrome， meanwhile improving their clinical symptoms， cardiac function， and quality of life.

Objective:To explore the diagnostic value of quantitative analysis of contrast-enhanced ultrasound for the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS) thyroid nodules 4.Methods:A retrospective case series study was conducted. A total of 87 patients with thyroid nodules from Shanxi Province Cancer Hospital between October 2018 and July 2022 were selected. All patients were diagnosed as C-TIRADS 4 thyroid nodules by routine ultrasound and had DICOM storage format ultrasound contrast dynamic data. All 96 thyroid nodules in 87 patients had clear surgical and pathological results. Based on the contrast-enhanced ultrasound features of the nodules, the nodules were reclassified by using C-TIRADS according to 3 different criteria. VueBox analysis software was used to obtain dynamic contrast-enhanced ultrasound (DCE-US) quantitative parameters, the most effective quantitative parameters for diagnosing thyroid malignant nodules were obtained by using receiver operating characteristic (ROC) curves, and their optimal cut-off values were obtained. Based on ultrasound contrast and DCE-US quantitative parameters, the nodules were reclassified by using C-TIRADS. Based on pathological results, the malignancy rates of nodules classified by C-TIRADS based on the conventional ultrasound, contrast-enhanced ultrasound, and contrast-enhanced ultrasound combined with DCE-US quantitative parameters were calculated. ROC curves were drawn to compare the diagnostic efficacy of conventional ultrasound, contrast-enhanced ultrasound, and contrast-enhanced ultrasound combined with DCE-US quantitative parameters for thyroid malignant nodules.Results:Among the 96 thyroid nodules, the malignancy rates of C-TIRADS 4a, 4b, and 4c nodules evaluated by conventional ultrasound were 50.0% (17/34), 72.1% (31/43) and 100.0% (19/19), respectively, which were not within the reference range provided by the C-TIRADS guideline. After reclassifying the nodules according to the contrast-enhanced ultrasound standards, the malignancy rates of C-TIRADS 3, 4a, 4b, 4c, 5 of nodules were 0 (0/2), 25.0% (2/8), 31.3% (5/16), 71.9% (23/32), and 97.4% (37/38), respectively. Among them, the malignancy rate of the 4a type nodule was still relatively high, which was not within the reference range given by the C-TIRADS guideline. The area under the curve of DCE-US quantitative parameter peak intensity (PE) for diagnosing thyroid malignant nodules according to ROC curves was the largest with the optimal cut-off value of 2080.7a.u. Based on contrast-enhanced ultrasound and combined with PE, the nodules were classified again, and the malignancy rates of C-TIRADS 3, 4a, 4b, 4c, 5 of nodules were 0 (0/7), 9.1% (1/11), 27.3% (3/11), 83.3% (11/13), and 98.1% (53/54), respectively, all were within the reference range provided by the C-TIRADS guideline. ROC curve analysis showed that the AUC of contrast-enhanced ultrasound combined with DCE-US quantitative parameter PE for diagnosing thyroid malignant nodules was greater than that of conventional ultrasound and contrast-enhanced ultrasound (both P < 0.05); the optimal cut-off value was type 4b, with the sensitivity of 94.0%, the specificity of 89.7%, and the accuracy of 92.7%. Conclusions:The combination of contrast-enhanced ultrasound and DCE-US quantitative parameter PE is helpful for more accurate classification of C-TIRADS 4 thyroid nodules and improves the diagnostic efficiency of thyroid malignant nodules.

Objective:To explore the diagnostic value of gradient characteristics of quantitative parameters of contrast-enhanced ultrasound (CEUS) in papillary thyroid carcinoma.Methods:A retrospective case series study was conducted. The clinical data of 120 patients with thyroid diseases who underwent pathological examination for samples collected through fine needle aspiration or surgical resection and underwent CEUS examination before surgery at Shanxi Province Cancer Hospital from January 2018 to May 2023 were collected. A total of 120 thyroid nodules were selected and divided into the benign group (37 nodules) and the malignant group (83 nodules) according to pathological results. The VueBox software was used to depict the four regions of interest in nodules of the two groups, which were the overall, central and marginal areas and surrounding normal thyroid tissues. The time-intensity curve (TIC) was drawn and the relevant parameters including peak enhancement (PE), wash-in area under the curve (WiAUC), wash-in rate (WiR), wash-out rate (WoR), and time to increase (TI) were analyzed, and the gradient values (ΔPE within the nodules, ΔWiAUC within the nodules, ΔWiR within the nodules, ΔWoR within the nodules, ΔTI within the nodules) between two groups of nodules and surrounding normal tissues, as well as between the central and marginal areas of the nodules were calculated.Results:The conventional ultrasound characteristics of benign and malignant nodules showed only a statistically significant difference in aspect ratio ( χ2 = 14.76, P < 0.001). There were statistically significant differences in PE, WiAUC, WiR, and WoR between the overall malignant nodules and the surrounding normal tissues, as well as between the central and marginal areas within the nodules (all P < 0.05); there was a statistically significant difference in WiAUC between the overall benign nodules and the surrounding normal tissues (7 362.06 vs. 7 281.16, Z = -2.07, P = 0.038); there was no statistically significant difference in TI between the two groups of overall nodules and the surrounding normal tissues, as well as the central and marginal areas within the nodules (both P > 0.05); there were statistically significant differences in ΔPE, ΔWiAUC, ΔWiR, and ΔWoR in different regions of the nodules between the two groups (all P < 0.05); binary logistic analysis showed that overall ΔPE and intra nodule ΔWoR were independent predictive factors for the malignancy of thyroid nodules (both P < 0.05); receiver operating characteristic (ROC) curve analysis showed that the overall ΔPE had better diagnostic efficacy for benign and malignant thyroid nodules than the intra nodule ΔWoR, with a cut-off value of -536.23 a.u. Its combination with CEUS had the highest diagnostic efficacy for malignant thyroid nodules, with sensitivity, specificity, positive predictive value, and negative predictive value of 86.7%, 81.1%, 91.1%, and 73.2%, respectively. Conclusions:The peak intensity gradient value (overall ΔPE) between thyroid nodules and surrounding normal tissues can serve as an effective indicator for distinguishing between benign and malignant thyroid nodules. The combination of overall ΔPE and CEUS has good diagnostic efficacy.

One patient with kidney stones was prescribed Paishi granules and diclofenac sodium sustained-release tablets for pain relief in the outpatient setting.That evening,the patient took 1 sachet of Paishi granules and 1 diclofenac sodium sustained-release tablet together.The patient subsequently developed a generalized rash with itching.Liver function indexes of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(T-BiL),direct bilirubin(D-BiL),and alkaline phosphatase(ALP)were all 2 to 6 times higher than the upper limit of normal.After symptomatico treatment,the patients systemic rash had subsided,and the liver function indicators have returned to normal.

Objective:To investigate the detection status of serological markers for hepatitis B virus (HBV) among Tibetan college students and their relationship with HBV- deoxyribonucleic acid (DNA) load.Methods:A cross-sectional study was carried out to retrospectively analyze data from 1 514 Tibetan college students who visited the Affiliated Hospital of Xizang Minzu University for consultations or health examinations between June 1, 2021 and June 1, 2022. The prevalence of HBV infection among these students was analyzed, the primary epidemiological patterns of HBV markers were identified, and their relationship with HBV-DNA load was determined.Results:The positive rate of hepatitis B surface antigen (HBsAg) among the 1 514 Tibetan college students was 6.7% (101/1 514), while the positive rate for Hepatitis B surface antibody (HBsAb) was 42.2% (639/1 514). The primary serological pattern of HBV infection consisted of positive results for HBsAg, HBeAg, and HBcAb, which accounted for 48.5% of cases. This pattern showed significantly higher rates of HBV-DNA positivity and elevated viral load compared with other serological patterns ( χ2 = 8.70, P < 0.05). Conclusions:The HBV infection rate among Tibetan college students is 6.7%. The primary infection pattern is characterized by positive tests for HBsAg, HBeAg, and HBcAb, with an HBV-DNA positivity rate as high as 87.0% and elevated viral loads.

ObjectiveTo investigate the prevalence and its influencing factors of hyperuricemia (HUA) among the employed individuals who undergo occupational health screening in Shanghai, so as to provide a scientific basis for the prevention and control of HUA and for the health promotion in this population. MethodsCluster sampling methods were performed to recruit all the employed individuals who underwent routine health check-ups at the Shanghai Health and Medical Center from January to December 2023. Relevant data, including physical examination results, laboratory tests, and questionnaire surveys, were collected for analyses. Based on the diagnostic criteria for HUA, participants were categorized into HUA group and non-HUA group. Logistic regression analysis was used to identify the influencing factors of HUA. ResultsThe detection rate of HUA in the employed population of Shanghai was 23.26%, with a significantly higher rate in males (31.12%) than that in females (10.43%) (χ²=381.853,P<0.001). The detection rate of HUA increased with age (χ²_trend=5.728, P_trend=0.017). Logistic regression analysis revealed that males had a higher risk for HUA the females, with overweight, obesity, meat-predominant diet, hypertension, and dyslipidemia being positively correlated with HUA risk. While, individuals aged 40‒ and 50‒ years had a lower risk for HUA compared with those aged 20‒ years. ConclusionThe prevalence of HUA among the employed individuals who undergo health check-ups in Shanghai is relatively high. Attention should be paid to maintaining a healthy lifestyle and keeping a balanced diet. Targeted health management should prioritize for males, individuals with hypertension and BMI overweight and obesity, and those with dyslipidemia to reduce the risk of HUA.

Objective This study aims to compare the clinical efficacy and complications associated with microwave ablation(MWA)and sublobectomyfor treating stage ⅠA non-small cell lung cancer(NSCLC).Methods Data from stage ⅠA1-ⅠA3 NSCLC patients treated at Yunnan Cancer Hospital between January 2021 and December 2022 were retrospectively collected.A total of 82 patients who underwent MWA and 82 patients who received sublobectomy were selected through propensity score matching.Periprocedural conditions,short-term efficacy,and complications were compared between the two groups.Progression-free survival(PFS)and Disease-free survival(DFS)were monitored and evaluated.The Kaplan-Meier method was employed to construct survival curves,and logistic regression was utilized to analyze the factors influencing complications.Results The MWA group exhibited shorter procedure times,less intraprocedural blood loss,less postprocedure pain,shorter hospitalization durations,and lower hospitalization costs compared to the sublobectomy group(P<0.001).All patients successfully underwent the procedures,with a complete ablation rate of 97.6%and a local control rate of 87.8%in the MWA group.The median follow-up duration was 26.5 months.Survival curve analysis indicated no statistically significant differences in PFS and DFS between the two groups.The primary complications observed were pneumothorax(24.4%,20/82)and moderate to severe pain(11.0%,9/82)in the MWA group,while the sublobectomy group experienced moderate to severe pain(41.5%,34/82)and pulmonary infection(12.2%,10/82).Single-factor analysis demonstrated six variables influenced the occurrence of MWA pneumothorax.Multi-factor logistic regression revealed that the shortest distance from the tumor to the pleura(P=0.021,OR=15.341,95%CI:1.699～24.367)and the number of punctures through the pleura(P=0.024,OR=0.068,95%CI:0.001～0.612)were identified as independent risk factors for pneumothorax.Conclusion MWA demonstrates good efficacy for treating stage ⅠA NSCLC due to minimal trauma,low cost,rapid recovery,few and mild complications.Additionally,MWA and sublobectomy exhibit comparable PFS and DFS,making MWA a safe and effective treatment method.Therefore,MWA is worthy of promotion in clini-cal practice.

Objective To explore the core theories and medication characteristics of traditional Chinese medicine in the treatment of Sj?gren syndrome(SS).Methods Search for relevant literatures on the treatment of SS with traditional Chinese medicine published in CNKI,Wanfang Data Knowledge Service Platform,VIP,and SinoMed from the establishment of the database to September 30,2022,screen the prescriptions for the treatment of SS with traditional Chinese medicine and conduct data mining.Results A total of 137 prescriptions were finally selected,involving 186 Chinese medicines.Among them,yin-nourishing medicines,interior heat-clearing medicines and qi-tonifying medicines were used most frequently,and Maidong,Shengdihuang,Baishao ranked among the top 3 in terms of usage frequency.The four qi of Chinese medicines were mainly based on the cold,and the five flavors were based on the sweet flavors.The channel tropism were based on lung meridian and liver meridian.Entropy clustering analysis finally obtained four new prescriptions.Conclusion The treatment of SS is based on nourishing yin for moistening dryness,invigorating spleen and replenishing qi,removing toxicity substance and resolving macula,and dredging channels.At the same time,it emphasizes the application of concepts such as sour and sweet transform into yin,body fluids and blood share the same source,and seeking yin from yang.

Objective:To explore the effect of repetitive transcranial magnetic stimulation (rTMS) on the cognition and ability in the activities of daily living (ADL) of persons with cerebral small vessel disease.Methods:A total of 71 patients with cognitive impairment due to cerebral small vessel disease were randomly divided into a control group ( n=35) and a treatment group ( n=36). The treatment group was further divided into a group with mild cognitive impairment (a score of 21 to 26 on the mini-mental state exam, n=23) and a moderate cognitive impairment group (scoring 10 to 20, n=13). The treatment groups received 10Hz rTMS, while the control group received sham rTMS. Before and after 90 days of treatment, all were assessed using the mini-mental state examination (MMSE) and the cognitive subscale of the vascular dementia assessment scale (VaDAS-cog). Ability in the activities of daily living was quantified using the Barthel Index (BI). Results:After treatment, significantly increased MMSE and BI scores, but significantly decreased VaDAS-cog scores were observed in both groups. At that point the treatment group showed a significantly higher average post-treatment MMSE score (25.61±2.94) and BI score (80.00±7.85), but a significantly lower average VaDAS-cog score (44.06±3.41) than the control group. The average MMSE scores were not significantly different between the mild and moderate cognitive impairment subgroups. No severe adverse reactions were observed during the rTMS treatment.Conclusions:The 10Hz rTMS can effectively improve the cognition and daily living ability of persons with cerebral small vessel disease.

Objective This study aims to compare the clinical efficacy and complications associated with microwave ablation(MWA)and sublobectomyfor treating stage ⅠA non-small cell lung cancer(NSCLC).Methods Data from stage ⅠA1-ⅠA3 NSCLC patients treated at Yunnan Cancer Hospital between January 2021 and December 2022 were retrospectively collected.A total of 82 patients who underwent MWA and 82 patients who received sublobectomy were selected through propensity score matching.Periprocedural conditions,short-term efficacy,and complications were compared between the two groups.Progression-free survival(PFS)and Disease-free survival(DFS)were monitored and evaluated.The Kaplan-Meier method was employed to construct survival curves,and logistic regression was utilized to analyze the factors influencing complications.Results The MWA group exhibited shorter procedure times,less intraprocedural blood loss,less postprocedure pain,shorter hospitalization durations,and lower hospitalization costs compared to the sublobectomy group(P<0.001).All patients successfully underwent the procedures,with a complete ablation rate of 97.6%and a local control rate of 87.8%in the MWA group.The median follow-up duration was 26.5 months.Survival curve analysis indicated no statistically significant differences in PFS and DFS between the two groups.The primary complications observed were pneumothorax(24.4%,20/82)and moderate to severe pain(11.0%,9/82)in the MWA group,while the sublobectomy group experienced moderate to severe pain(41.5%,34/82)and pulmonary infection(12.2%,10/82).Single-factor analysis demonstrated six variables influenced the occurrence of MWA pneumothorax.Multi-factor logistic regression revealed that the shortest distance from the tumor to the pleura(P=0.021,OR=15.341,95%CI:1.699～24.367)and the number of punctures through the pleura(P=0.024,OR=0.068,95%CI:0.001～0.612)were identified as independent risk factors for pneumothorax.Conclusion MWA demonstrates good efficacy for treating stage ⅠA NSCLC due to minimal trauma,low cost,rapid recovery,few and mild complications.Additionally,MWA and sublobectomy exhibit comparable PFS and DFS,making MWA a safe and effective treatment method.Therefore,MWA is worthy of promotion in clini-cal practice.