ObjectiveTo investigate the mechanisms of Tongnao decoction （TND） in mice with acute ischemic stroke （AIS）. MethodsFifty male C57BL/6J mice were randomly divided into a sham operation group， model group， TND low-dose group （1.86 g·kg^-1）， TND high-dose group （3.72 g·kg^-1）， and butylphthalide （NBP） group （10 mg·kg^-1）， with 10 mice in each group. A mouse model of cerebral ischemic injury was established using photochemical thrombosis （PT）. The sham operation group and model group were administered an equal volume of normal saline by gavage. All five groups were treated once daily for 14 consecutive days. Behavioral tests were performed before modeling and at the end of administration. T₂-weighted imaging （T₂WI） was performed 3 days after modeling to evaluate the extent of injury. Hematoxylin-eosin （HE） staining was used to observe histological changes in the cerebral cortex， and Nissl staining was used to observe neuronal morphology. Cerebral blood flow in mice was detected using a laser speckle contrast imaging （LSCI） system. Immunofluorescence staining was used to detect the cell proliferation marker bromodeoxyuridine （BrdU） and the highly glycosylated type I transmembrane glycoprotein CD34. Western blot analysis was used to detect the expression levels of phosphatidylinositol 3-kinase （PI3K）， protein kinase B （Akt）， glycogen synthase kinase-3β （GSK-3β）， and their phosphorylation levels， as well as tight junction-related proteins zonula occludens-1 （ZO-1）， Occludin， and Claudin-5 in the peri-infarct tissue. Thirty-five zebrafish were randomly divided into normal control group， model group， TND low and high dose groups （0.16， 0.32 g·L^-1） and NBP group （10 μmol·L^-1）， with 7 in each group. A stereoscopic fluorescence microscope was used to observe vascular growth in zebrafish. ResultsImaging showed that PT caused ischemia in the right cortical region. Behavioral tests indicated that， compared with the model group， the drug-treated groups reduced the error rate of irregular balance ladder climbing on the affected side and shortened the tape removal time （P<0.05）. HE staining and Nissl staining showed that， compared with the model group， the drug-treated groups exhibited reduced brain tissue damage， fewer scars， and improved neuronal morphology. LSCI results showed that the drug-treated groups partially restored cerebral blood perfusion and promoted the establishment of collateral circulation compared with the model group. Immunofluorescence staining indicated that the drug-treated groups increased the positive rates of BrdU and CD34 compared with the model group （P<0.01）， promoting angiogenesis. Meanwhile， compared with the model group， the drug-treated groups upregulated the expression levels of p-PI3K， p-Akt， p-GSK-3β， and tight junction proteins ZO-1， Occludin， and Claudin-5 （P<0.05，P<0.01）， and increased the number of intersegmental vessels in zebrafish （P<0.05，P<0.01）. ConclusionTND can promote angiogenesis around the infarct in PT model mice by regulating the PI3K/Akt/GSK-3β signaling pathway， thereby improving cerebral ischemic injury.

OBJECTIVE To analyze the clinical characteristics and influential factors of drug-induced liver injury （DILI） in children caused by intravenous azithromycin. METHODS Clinical data of 157 DILI pediatric cases caused by intravenous azithromycin， reported by the Hengshui Adverse Drug Reaction Monitoring Center from January 2015 to January 2025， were collected as the observation group. Clinical data of pediatric patients who received intravenous azithromycin but did not develop DILI during the same period at Hengshui People’s Hospital were collected in a 1∶1 ratio to serve as the control group. The clinical classification， severity and prognosis of DILI in pediatric patients from the observation group were analyzed. Univariate and multivariate Logistic regression analyses were used to screen the independent risk factors for DILI in children caused by intravenous azithromycin. RESULTS Among 157 DILI cases， 92 cases （58.60%） had hepatocellular injury-type， 51 cases （32.48%） had cholestatic-type， and 14 cases （8.92%） had mixed-type. DILI severity was grade 1 in 117 cases （74.52%）， grade 2 in 33 cases （21.02%）， and grade 3 in 7 cases （4.46%）. Liver function had all recovered after stopping medication and symptomatic treatment. Combined with acetaminophen [OR＝3.769， 95%CI （1.615， 8.235）， P＝0.021]， daily dose of azithromycin＞10 mg/kg [OR＝ 2.237， 95%CI （1.075， 4.655）， P＝0.034] were independent risk factors for DILI in children caused by intravenous azithromycin. CONCLUSIONS Hepatocellular injury-type and cholestatic-type are relatively common in children with DILI caused by intravenous azithromycin， with mild severity being predominant and showing a favorable prognosis. Combination with acetaminophen and daily dose＞10 mg/kg are independent risk factors for azithromycin-induced DILI in children.

Objective:To evaluate the effects of the logistic fitting algorithm in improving the calculation accuracy of low-sampled cerebral CT perfusion (CTP) and to explore the application value of this algorithm in reducing irradiation doses to cerebral CTP.Methods:Image data from 28 patients who underwent cerebral CTP were retrospectively analyzed. A total of 192 regions of interest (ROIs) were circled in the basal ganglia and the main blood-supplying areas of the anterior, middle, and posterior cerebral arteries. For each ROI, the time-density curve (TDC) was plotted, from which some data points were deleted to decrease the sampling frequency to half of the conventional scan, thus simulating low-dose scanning and obtaining low-dose TDCs. The logistic model was applied to fit and complete the low-dose TDCs. The potential decrease in radiation dose was assessed. Conventional TDCs, low-dose TDCs, and TDCs processed using the logistic fitting algorithm were compared. Perfusion calculations were performed based on these TDCs, and the calculated cerebral blood volume (CBV), cerebral blood flow (CBF), time to peak (TTP), and mean transit time (MTT) were compared and analyzed.Results:The total radiation dose for cerebral CTP examination could be reduced to 52% of the routine dose. The mean correlation coefficient R between the TDCs derived using the logistic fitting algorithm and the conventional TDCs was 0.958 ± 0.03. The CBV, CBF, TTP, and MTT calculated using the logistic fitting algorithm were compared with the conventional result, and the coefficients of determination R2 of linear regressions were determined at 0.943, 0.942, 0.955, and 0.891, respectively, indicating extremely high consistency(ICC > 0.90). Furthermore, the R2 values determined using the logistic fitting algorithm were all higher than those derived without applying the fitting algorithm. Conclusions:Applying the logistic fitting algorithm to under-sampled cerebral CTP can yield calculation result that are highly consistent with those of conventional sampling. By combining under-sampling with the logistic algorithm, the irradiation doses can be reduced while guaranteeing the accuracy of the effective perfusion result, demonstrating high application value.

Objective To investigate the clinical efficacy of Jia Yi Formula(composed of Trionycis Carapax,Ranunculi Ternati Radix,Pinelliae Rhizoma Praeparatum,Trichosanthis Pericarpium,Poria,Curcumae Radix,Fritillariae Thunbergii Bulbus,and Albiziae Cortex)in improving anxiety symptoms of patients with hyperthyroidism(HT).Methods A total of 84 HT patients with yin deficiency with internal heat and phlegm blended with stasis syndrome accompanied by anxiety were enrolled from the Endocrinology Outpatient and Inpatient Departments of The Affiliated Guangzhou Traditional Chinese Medicine Hospital of Guangzhou University of Chinese Medicine between February and December of 2024.Patients were randomly divided into treatment group and control group(n=42 each)using a random number table.Both groups received conventional therapy,while the control group additionally received oral methimazole,and the treatment group received Jia Yi Formula and methimazole.The treatment duration was 12 weeks for both groups.Changes in Hamilton Anxiety Scale(HAMA)scores,traditional Chinese medicine(TCM)syndrome scores,and serum thyroid hormone levels[free triiodothyronine(FT3),free thyroxine(FT4),and thyroid-stimulating hormone(TSH)]were observed.The improvement in anxiety status,TCM syndrome efficacy,and drug safety were evaluated.Results(1)In terms of TCM syndrome improvement,the total effective rate was 92.86％(39/42)in the treatment group versus 71.43％(30/42)in the control group.Intergroup comparison(by Mann-Whitney U test)showed that the TCM syndrome improvement in the treatment group was superior to the control group(P＜0.05).(2)For anxiety improvement,the total effective rate was 83.33％(38/42)in the treatment group versus 69.05％(29/42)in the control group.Intergroup comparison(by Mann-Whitney U test)showed that the anxiety improvement in the treatment group was superior to the control group(P＜0.01).(3)After treatment,both groups showed significant reductions in HAMA scores and TCM syndrome scores(P＜0.01),with greater reductions observed in the treatment group(P＜0.01).(4)Thyroid hormone levels(FT3,FT4,TSH)were significantly improved in both groups(P＜0.01),with FT3 and TSH showing greater improvement in the treatment group(P＜0.05 or P＜0.01),while FT4 improvement did not differ significantly between groups(P＞0.05).(5)The incidence of adverse reactions was 4.76％(2/42)in the treatment group and 7.14％(3/42)in the control group.Intergroup comparison(by Fisher's exact test)showed that the difference was not statistically significant(P＞0.05).Conclusion Jia Yi Formula demonstrates significant efficacy in improving anxiety,clinical symptoms,and thyroid function in HT patients with yin deficiency with internal heat and phlegm blended with stasis syndrome,showing superior benefits when used together with methimazole compared to methimazole alone.

Objective:To evaluate the effects of the logistic fitting algorithm in improving the calculation accuracy of low-sampled cerebral CT perfusion (CTP) and to explore the application value of this algorithm in reducing irradiation doses to cerebral CTP.Methods:Image data from 28 patients who underwent cerebral CTP were retrospectively analyzed. A total of 192 regions of interest (ROIs) were circled in the basal ganglia and the main blood-supplying areas of the anterior, middle, and posterior cerebral arteries. For each ROI, the time-density curve (TDC) was plotted, from which some data points were deleted to decrease the sampling frequency to half of the conventional scan, thus simulating low-dose scanning and obtaining low-dose TDCs. The logistic model was applied to fit and complete the low-dose TDCs. The potential decrease in radiation dose was assessed. Conventional TDCs, low-dose TDCs, and TDCs processed using the logistic fitting algorithm were compared. Perfusion calculations were performed based on these TDCs, and the calculated cerebral blood volume (CBV), cerebral blood flow (CBF), time to peak (TTP), and mean transit time (MTT) were compared and analyzed.Results:The total radiation dose for cerebral CTP examination could be reduced to 52% of the routine dose. The mean correlation coefficient R between the TDCs derived using the logistic fitting algorithm and the conventional TDCs was 0.958 ± 0.03. The CBV, CBF, TTP, and MTT calculated using the logistic fitting algorithm were compared with the conventional result, and the coefficients of determination R2 of linear regressions were determined at 0.943, 0.942, 0.955, and 0.891, respectively, indicating extremely high consistency(ICC > 0.90). Furthermore, the R2 values determined using the logistic fitting algorithm were all higher than those derived without applying the fitting algorithm. Conclusions:Applying the logistic fitting algorithm to under-sampled cerebral CTP can yield calculation result that are highly consistent with those of conventional sampling. By combining under-sampling with the logistic algorithm, the irradiation doses can be reduced while guaranteeing the accuracy of the effective perfusion result, demonstrating high application value.

Objective:To synthesize the real experiences of medical staff's organizational silence behavior.Methods:A systematic search was conducted in databases including PubMed, Web of Science, Embase, Cochrane Library, CINAHL, EBSCO, ProQuest, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc, collecting qualitative studies on medical staff's experiences related to organizational silence behavior. The search period covered the establishment of the databases until June 2024. The quality of the included studies was assessed using the Joanna Briggs Institute's qualitative research quality evaluation standards, and results were integrated using an aggregative synthesis approach.Results:A total of 10 studies were included, with 65 findings summarized into 11 new categories, which were further synthesized into four overarching conclusions: organizational silence is complex, with respect and concern coexisting, many factors contribute to organizational silence, medical staff experience negative emotions as a result of organizational silence, there is a desire for recognition and support.Conclusions:The experience of organizational silence behavior among medical staff is complex. Managers should focus on this issue, encourage individuals to voice their concerns, provide diverse support mechanisms, and enhance positive experiences to reduce the prevalence of organizational silence.

Objective to analyze the Budget Execution Rate of administrative departments in sample hospitals,and to realize the cost control of Budget performance integration with Balanced Score Card(BSC)Financial Dimension Quantitative Assessment.Methods The budget and execution data of 23 administrative departments were collected from January to June in the sample 2023.The budget execution rate was calculated and cleaned,and the data were segmented by histogram.Using the financial dimension 25 to divide by the total number of items in each department's budget to obtain the scoreof each item in each department,and using the interpolation method to calculate the cost scores of each department,then into the performance appraisal.Results(1)Each item score should be multiplied by item coefficient,and then sum up;(2)The total score of self-executing Project+the total score of centralized executing project.(3)Cost score:1 the scores of 8 departments of non-homing items were 5.54～15.76,2 the scores of 15 departments of homing items were 7.68～17.06.Conclusion It adopts the concept of BSC and Hospital Resource Planning as the cost control of administrative departments to make up for the lack of qualitative and quantitative BSC;can focus on monitoring the dispersion of large data;histogram score results of segmentation objective and easy to operate,makes the interpolation calculation more credible.In a word,it provides quantitative ideas and methods in the aspects of different responsibilities and difficult performance evaluation.

Objective to analyze the Budget Execution Rate of administrative departments in sample hospitals,and to realize the cost control of Budget performance integration with Balanced Score Card(BSC)Financial Dimension Quantitative Assessment.Methods The budget and execution data of 23 administrative departments were collected from January to June in the sample 2023.The budget execution rate was calculated and cleaned,and the data were segmented by histogram.Using the financial dimension 25 to divide by the total number of items in each department's budget to obtain the scoreof each item in each department,and using the interpolation method to calculate the cost scores of each department,then into the performance appraisal.Results(1)Each item score should be multiplied by item coefficient,and then sum up;(2)The total score of self-executing Project+the total score of centralized executing project.(3)Cost score:1 the scores of 8 departments of non-homing items were 5.54～15.76,2 the scores of 15 departments of homing items were 7.68～17.06.Conclusion It adopts the concept of BSC and Hospital Resource Planning as the cost control of administrative departments to make up for the lack of qualitative and quantitative BSC;can focus on monitoring the dispersion of large data;histogram score results of segmentation objective and easy to operate,makes the interpolation calculation more credible.In a word,it provides quantitative ideas and methods in the aspects of different responsibilities and difficult performance evaluation.

This paper reviews the current status, evaluation tools, influencing factors, and intervention measures of social alienation in colorectal cancer patients with enterostomy, in order to provide reference for the research on social alienation in colorectal cancer patients with enterostomy in China.

Objective:To evaluate the methodological quality and measurement characteristics of children's needs assessment tools.Methods:Literature on children's needs assessment tools was searched in Cochrane Library, PubMed, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), WanFang Data, VIP, and China Biology Medicine disc. The search period was from database establishment to April 2, 2023. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guideline was used to evaluate the methodological quality and measurement characteristics of assessment tools, and integrate the evaluation results to form recommendations.Results:Six studies were included in total. The recommended opinions for the two evaluation tools (Needs of Children Questionnaire and Male Adolescent Health Needs-Assessment Scale) were A level. The recommended opinions for the four evaluation tools were B level. The Male Adolescent Health Needs-Assessment Scale had high cultural specificity.Conclusions:The evidence quality of the Needs of Children Questionnaire is relatively high and can be temporarily recommended for use, but other measurement characteristics still need further verification.