ObjectiveTo evaluate the effects of Tongnaoyin on the blood-brain barrier status and neurological impairment in acute ischemic stroke （AIS） patients with the syndrome of phlegm-stasis blocking collaterals by dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI）. MethodsA total of 63 patients diagnosed with AIS in the Jiangsu Province Hospital of Chinese Medicine from October 2022 to December 2023 were enrolled in this study. According to random number table method，the patients were assigned into a control group （32 cases） and an observation group （31 cases）. The control group received conventional Western medical treatment，and the observation group took 200 mL Tongnaoyin after meals，twice a day from day 2 of admission on the basis of the treatment in the control group. After 7 days of treatment，the patients were examined by DCE-MRI. The baseline data for two groups of patients before treatment were compared. The National Institute of Health Stroke Scale （NIHSS） score and modified Rankin Scale （mRS） score were recorded before treatment and after 90 days of treatment for both groups. The rKtrans，rKep，and rVe values were obtained from the region of interest （ROI） of the infarct zone/mirror area and compared between the two groups. ResultsThere was no significant difference in the NIHSS or mRS score between the two groups before treatment. After 90 days of treatment，the NIHSS and mRS scores declined in both groups，and the observation group had lower scores than the control group （P<0.05）. After treatment，the rKtrans and rVe in the observation group were lower than those in the control group （P<0.01）. ConclusionCompared with conventional Western medical treatment alone，conventional Western medical treatment combined with Tongnaoyin accelerates the repair of the blood-brain barrier in AIS patients，thereby ameliorating neurological impairment after AIS to improve the prognosis.

The 20th National Congress of the Communist Party of China emphasized the expansion of international scientific and technological exchanges and cooperation. Against this backdrop, the radiological health research institutions bear important responsibilities in the field of international radiological health. As a key institution in the industry, the National Institute for Radiological Protection (NIRP), Chinese Center for Disease Control and Prevention shoulders the important mission of promoting international exchanges in radiation health in China. A case study was conducted on the NIRP using data of official overseas visits from 2010 to 2024. The SWOT analysis was used to comprehensively and systematically examine the strengths, weaknesses, opportunities, and challenges of NIRP in international cooperation and exchanges. To effectively enhance the depth and scope of international exchanges, this article proposes a series of innovative optimization strategies such as establishing dedicated personnel positions to ensure efficient handling of affairs, implementing stringent approval procedures to guarantee the rationality and compliance of overseas visits, strengthening pre-departure training to improve the professionalism of outbound personnel, conducting follow-up evaluations to continuously refine management practices, and centralizing the management of official passports to ensure their secure use. This article aims to provide practical optimization strategies for the management of official overseas visits for NIRP and other similar institutions, promote international exchanges and cooperation in the field of radiation health, and help China play a more important role in the global radiation health field.

Spontaneous intracerebral hemorrhage (ICH) is an acute cerebrovascular disease with high mortality and disability rates, but the available treatment methods are limited. Remote ischemic conditioning (RIC) refers to the induction of endogenous protective mechanisms through repeated and brief ischemia-reperfusion treatment of limbs, thereby exerting a protective effect on distant vital organs such as the brain and heart. This article aims to explore the intervention effect and potential mechanism of RIC on secondary brain injury after ICH, and provide new strategies for its clinical treatment in ICH.

Objective To investigate the efficacy of Xuanbi Decoction as an adjuvant therapy for rheumatoid arthritis(RA)with dampness-heat obstruction syndrome,and its impacts on the interleu-kin-23(IL-23)/helper T cell 17(Th 17)inflammatory axis,as well as the levels of matrix metallo-proteinase-3(MMP-3)and tissue inhibitor of metalloproteinase-1(TIMP-1).Methods A total of 95 RA patients with dampness-heat obstruction syndrome were selected as the study subjects,and randomly divided into control group(48 cases)and observation group(47 cases).The control group received western medicine treatment,while the observation group received Xuanbi Decoction treat-ment based on the control group.The clinical efficacy,traditional Chinese medicine(TCM)syn-drome scores,imaging assessment results,disease activity,indicators of the IL-23/Th17 inflammatory axis,MMP-3,TIMP-1 and adverse reactions were compared between the two groups.Results The total effective rate in the observation group was 95.74％,which was significantly higher than 81.25％in the control group(P＜0.05).After treatment,the TCM syndrome scores(joint pain,joint swell-ing,yellow and greasy tongue coating as well as slippery and rapid pulse)in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the DAS28 and Sharp scores in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the levels of IL-23,Th17,IL-17 and MMP-3 in the observation group were significantly lower than those in the control group,while the TIMP-1 level was significantly higher(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Xuanbi Decoction as an adjuvant therapy for RA patients with dampness-heat obstruction syndrome demonstrates significant efficacy and high safety.

Objective To use imaging features of pulmonary nodules to predict the risk of lymph node metastasis in patients with cT1-stage non-small cell lung cancer (NSCLC), providing a reference for clinical decision-making. Methods A retrospective analysis was conducted on the imaging features and postoperative pathological results of cT1 NSCLC patients who underwent surgical treatment at Linyi People’s Hospital from July 2019 to July 2022. Patients were grouped and analyzed according to lymph node metastasis status. Results A total of 1 123 patients were included, comprising 471 males and 652 females, with a median age of 59 (52, 66) years. Comparative analysis revealed that sex, age, nodule location, nodule size on imaging, solid component size, consolidation tumor ratio (CTR), average CT value, and tumor proximity to the pleura all influenced lymph node metastasis. A nomogram was constructed, indicating that the probability of lymph node metastasis in cT1 NSCLC was positively correlated with solid component size, CTR, and average CT value of the pulmonary nodule, and negatively correlated with patient age. The area under the receiver operating characteristic curve was 0.929. Conclusion For cT1 NSCLC patients, the probability of lymph node metastasis can be predicted by measuring the solid component size, CTR, and average CT value of the pulmonary nodule, in conjunction with patient age. However, relying solely on pulmonary nodule imaging characteristics is insufficient to determine a specific lymph node dissection strategy.

Objective:To systematically evaluate and integrate the qualitative research of nursing students participating in hospice care practice experience, to provide a basis for the better development of hospice care education.Methods:A computer search was conducted on the China national knowledge infrastructure, Chinese Biomedical Literature Database, VIP database, Wanfang Medical Database, Cochrane Library, Embase, Web of Science, and PubMed for qualitative research on nursing students' participation in hospice care practices. The search period was from the establishment of the database to February 2023. The quality of the included literature was evaluated using the qualitative research quality evaluation criteria of the Australian JBI Evidence Based Health Care Center. A aggregative integration method was used for result integration.Results:A total of 16 articles were included, and 46 major research results were extracted and summarized into 9 new categories, forming 4 integrated results: providing hospice care services for patients and their families; emotional experience of nursing dying patients; coping with negative experience and harvesting personal growth; needs and difficulties.Conclusions:Nursing students experience multiple emotional experiences in hospice care practice, and are eager to help and support in various aspects. It is suggested for managers to pay attention to the inner experience and needs of nursing students, improve hospice care education in China, and improve the end-of-life care ability of nursing students.

Objective To discuss the value of clinical radiomic nomogram(CRN)and deep convolutional neural network(DCNN)in distinguishing atypical pulmonary hamartoma(APH)from atypical lung adenocarcinoma(ALA).Methods A total of 307 patients were retrospectively recruited from two institutions.Patients in institu-tion 1 were randomly divided into the training(n=184:APH=97,ALA=87)and internal validation sets(n=79:APH=41,ALA=38)in a ratio of 7∶3,and patients in institution 2 were assigned as the external validation set(n=44:APH=23,ALA=21).A CRN model and a DCNN model were established,respectively,and the performances of two models were compared by delong test and receiver operating characteristic(ROC)curves.A human-machine competition was conducted to evaluate the value of AI in the Lung-RADS classification.Results The areas under the curve(AUCs)of DCNN model were higher than those of CRN model in the training,internal and external validation sets(0.983 vs 0.968,0.973 vs 0.953,and 0.942 vs 0.932,respectively),however,the differences were not statistically significant(p=0.23,0.31 and 0.34,respectively).With a radiologist-AI com-petition experiment,AI tended to downgrade more Lung-RADS categories in APH and affirm more Lung-RADS cat-egories in ALA than radiologists.Conclusion Both DCNN and CRN have higher value in distinguishing APH from ALA,with the former performing better.AI is superior to radiologists in evaluating the Lung-RADS classification of pulmonary nodules.

Objective:To investigate the effect of roxadustat combined with levocarnitine in the treatment of renal anemia in hemodialysis patients with diabetic kidney disease (DKD), and its effects on iron metabolism, microinflammation status and microvascular complications.Methods:The clinical data of 89 hemodialysis renal anemia patients with DKD from January 2020 to October 2021 in Beijing Geriatric Hospital were retrospectively analyzed. Among them, 44 patients (control group)were treated with recombinant human erythropoietin and levocarnitine for renal anemia, and 45 patients (study group) were treated with recombinant human erythropoietin, levocarnitine and roxadustat for renal anemia. Both groups were treated for 3 months. The efficacy was compared between two groups. The laboratory indexes were measured before treatment and after 1, 3 months of treatment, including anemia related indexes such as hemoglobin, red blood cell count and mean corpuscular volume (MCV); iron metabolism indexes such as serum iron, ferritin and transferrin saturation (TSAT); inflammatory indexes such as interleukin-8 (IL-8), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α). The adverse reactions were recorded. The patients were followed up for 1 year after treatment, the incidence of diabetic microvascular complications, including diabetic peripheral neuropathy (DPN) and diabetic retinopathy (DR), was recorded.Results:The total effective rate in study group was significantly higher than that in control group: 93.33% (42/45) vs. 77.27% (34/44), and there was statistical difference ( χ2 = 4.60, P<0.05). There were no statistical differences in the laboratory indexes before treatment between two groups ( P<0.05); the hemoglobin, red blood cell count, MCV, serum iron, ferritin and TSAT after 1 and 3 months of treatment in study group were significantly higher than those in control group, the IL-8, CRP and TNF-α were significantly lower than those in control group, and there were statistical differences ( P<0.01 or <0.05). There was no significant difference in the incidence of adverse reactions between two groups ( P>0.05). After 1 year follow-up, 2 cases were lost in study group and 3 cases in the control group. The incidence of DR and DPN in study group were significantly lower than those in control group: 0 vs. 14.63% (6/41) and 2.33% (1/43) vs. 19.51% (8/41), and there were statistical differences ( χ2 = 4.75 and 4.81, P<0.05). Conclusions:Roxadustat combined with levocarnitine in the treatment of renal anemia in hemodialysis patients with DKD is reliable and safe, and can effectively relieve anemia symptoms, improve iron metabolism, reduce inflammatory response, and reduce the risk of diabetic microvascular complications.

Objective:To explore the therapeutic effect and psychological influence of biofeedback pelvic floor muscle training on fecal incontinence after anorectal surgery in children.Methods:A retrospective case-control study.A total of 37 children who were admitted to the First Affiliated Hospital of Xinxiang Medical University from July 2021 to April 2023 for fecal incontinence after anorectal surgery were collected.Biofeedback pelvic floor muscle training was performed with a Laborie biofeedback therapy device, and pelvic floor muscle contraction function exercise was performed no less than 200 times a day.The anal canal current intensity, basic motion myoelectric value, contractile myoelectric difference and continuous anal contraction time were measured at before treatment, at the end of 1 course, 1 month and 1 year after treatment.Ten healthy children of the same age were selected as the healthy control group.The Strengths and Difficulties Questionnaire was used for psychological evaluation at before treatment and 1 year after treatment.Paired sample t test and independent sample t test were used to compare and analyze the results of this study. Results:Before treatment, at the end of 1 course, 1 month and 1 year after treatment, the anal canal current intensity of children with fecal incontinence were(11.32±1.92) mA, (10.22±1.28) mA, (8.45±1.09) mA, and(7.80±1.23) mA, respectively; the anal canal basic motion myoelectric value were(235.58±55.03) μV, (185.65±34.30) μV, (124.81±36.56) μV, and(93.99±28.29) μV, respectively; the anal canal contractile myoelectric difference were(45.64±20.38) μV, (64.20±16.59) μV, (93.63±25.53) μV, and(109.83±26.95) μV, respectively; the continuous anal contraction time were(1.27±0.43) s, (1.58±0.40) s, (2.04±0.39) s, and(2.47±0.38) s, respectively.These parameters before treatment, at the end of 1 course and 1 month after treatment were significantly different from those in the healthy control group[(7.20±1.09) mA, (88.65±21.76) μV, (120.73±27.57) μV, (2.68±0.29) s](all P<0.05).These parameters at 1 year after treatment were significantly different from those before treatment and 1 month after treatment(all P<0.05).However, there were no significant differences in these parameters between the healthy control group and the treatment group at 1 year after treatment(all P>0.05).There were statistically significant differences in emotional symptoms, hyperactivity symptoms, peer interaction, prosocial behavior and difficulty scores before and after treatment[(3.46±1.88) points vs.(2.59±1.32) points, (5.78±2.12) points vs.(3.70±1.78) points, (3.05±1.72) points vs.(2.49±1.30) points, (7.30±1.54) points vs.(8.27±1.39) points, (21.57±4.57) points vs.(18.54±3.14) points](all P<0.05). Conclusions:Biofeedback pelvic floor muscle training is a reliable and non-invasive method for the treatment of postoperative fecal incontinence after anorectal surgery in children and can effectively relieve the psychological and behavioral problems caused by fecal incontinence in children.

Objective To explore the value of combined prediction model based on clinical and CT radiomics features in discriminating atypical pulmonary hamartoma(APH)from atypical lung adenocarcinoma(ALA).Methods A total of 290 patients with APH and ALA confirmed by pathology were retrospectively selected.250 patients from the First Affiliated Hospital of Anhui Medical University were randomly assigned into a training set(APH=91,ALA=84)and an internal validation set(APH=39,ALA=36)at a ratio of 7∶3,and other 40 patients from the First Affiliated Hospital of USTC were assigned as an external validation set(APH=21,ALA=19).The independent model and multivariate logistic regression combined model were constructed using the selected clinical-CT features and radiomics features,respectively,and a nomogram was drawn.Receiver operating characteristic(ROC)curve and DeLong test were used to evaluate and compare the performances of the models.Results The area under the curve(AUC)of the combined model established by 3 clinical-CT features and 4 radiomics features in the training set was 0.980,which was higher than that of clinical-CT model(AUC=0.885,P＜0.001)and radiomics model(AUC=0.975,P=0.042).The AUC of the combined model in the internal and external validation sets(0.963 vs 0.917)were also higher than those of clinical-CT model(0.858 vs 0.774)and radiomics model(0.953 vs 0.897),respectively.Conclusion The combined prediction model based on clinical and CT radiomics features can improve the differential diagnosis ability of APH and ALA.