Objective:To investigate the clinical efficacy of strengthening the spleen to nourish the lung in treating stable chronic obstructive pulmonary disease (COPD) with lung and spleen qi deficiency complicated by sarcopenia. Methods:This study was designed as a prospective study. A total of 65 patients with stable COPD and sarcopenia who received treatment at Kunshan Hospital of Chinese Medicine from January 2021 to December 2021 were included in the study. They were randomly divided into a control group and an observation group using the random number table method. The control group ( n = 34) was treated with conventional therapy, while the observation group ( n = 31) was treated with Shenling Baizhu Powder, a traditional Chinese medication based on the principle of strengthening the spleen to nourish the lung, in addition to the conventional therapy given to the control group. Both groups were treated for 1 month. Traditional Chinese medicine syndrome score, pulmonary function, grip strength, walking speed, albumin and prealbumin levels were compared between the two groups. Results:After treatment, the scores of all traditional Chinese medicine syndromes in the observation group were significantly lower than those in the control group (all P < 0.05). Compared with the control group, the levels of forced expiratory volume in the first second (FEV 1)[(1.51 ± 0.27) L vs. (1.32 ± 0.20) L, t = 3.11, P < 0.001 ] and FEV 1/forced vital capacity (FVC) [(57.20 ± 8.41)% vs. (52.89 ± 5.66)%, t = 2.30, P = 0.025] were significantly higher in the observation group. Compared with before treatment, gait speed [(1.07 ± 0.27) m/s vs. (0.90 ± 0.30) m/s, t = 7.66, P < 0.001], grip strength [(20.62 ± 5.07) kg vs. (19.42 ± 5.78) kg, t = 3.55, P < 0.001], albumin [(231.38 ± 49.40) g/L vs. (200.26 ± 65.87) g/L, t = 3.70, P < 0.001] and prealbumin [(39.53 ± 3.45) g/L vs. (35.81 ± 4.46) g/L, t = 4.08, P < 0.001] levels in the observation group were significantly increased after treatment. There were no significant differences in gait speed, grip strength, albumin, and prealbumin levels in the control group before and after treatment (all P > 0.05). Conclusions:The method of strengthening the spleen to nourish the lung shows good clinical efficacy in treating stable COPD with lung and spleen deficiency complicated by sarcopenia, and it has great potential for broader application.

Postnatal glucocorticoid has become an important measure for the prevention and treatment of bronchopulmonary dysplasia in preterm infants. Systemic application of glucocorticoids has therapeutical effectiveness but comes with significant side effects. Many studies have shown that nebulized budesonide may help prevent and treat bronchopulmonary dysplasia in preterm infants. However, there are no clear recommendations on the timing, route, dosage, and short- or long-term efficacy. Therefore, this paper reviews the research progress on the application of nebulized budesonide for the prevention and treatment of bronchopulmonary dysplasia in preterm infants.

Objective To explore the predictive value of troponin Ⅰ(TnⅠ)peak value upon admission for predicting left ventricular ejection fraction(LVEF)＜50％in patients with acute myocardial infarction(AMI)during the recovery period.Methods A retrospec-tive analysis was carried out on 220 AMI patients admitted to Beijing Friendship Hospital from 2018 to the present.The patients were di-vided into three groups based on the peak value of TnⅠ during their stay in hospital,and the baseline data were compared.Subsequently,three progressively complex regression models were constructed to evaluate the relationship between TnⅠ and LVEF＜50％.The optimal cutoff value was determined through restricted cubic spline and smooth curve analysis.Additionally,subgroup analysis was carried out to explore differences in the predictive value of TnⅠ in different populations.Results TnⅠ peak value was significantly associated(P＜0.05)with the ratio of emergency percutaneous coronary intervention(PCI),neutrophil-to-lymphocyte ratio,white blood cell count,neutro-phils,intra-aortic balloon pump usage,N-terminal pro-brain natriuretic peptide peak value,and so on.All three models showed a sig-nificant increase in the risk of LVEF＜50％with higher TnⅠ peak value(P＜0.05).Restricted cubic spline and smooth curve analysis re-vealed a linear relationship between TnⅠ peak value and LVEF values,with the optimal cutoff value for TnⅠ peak value consistently at 29.80ng/ml across the three models.Subgroup analysis showed that the predictive value of peak TnⅠ for LVEF＜50％demonstrated statisti-cally significant differences across the following subgroups:male patients,those with high BMI,hypertension,acute interventional treat-ment,as well as different age groups,and whether patients had diabetes,smoked,or consumed alcohol.Conclusion An admission TnⅠpeak value exceeding 29.80ng/ml is an independent risk factor for predicting LVEF＜50％during the recovery period in AMI patients.It can be used to identify high-risk individuals and provide a basis for early aggressive intervention.

Objective:To examine the near-complete genomic analysis of norovirus (NoV) subtype GⅡ.17 [P17] outbreaks in Beijing Chaoyang District from 2014 to 2024.Methods:Data and specimens related to outbreaks of the NoV aggregation in Beijing′s Chaoyang District from 2014 to 2024 were collected. The NoV was identified using real-time fluorescence reverse transcription polymerase chain reaction (RT-PCR). Specimens with positive nucleic acid were amplified by standard PCR, whole genome sequencing and evolutionary analysis. Amino acid site variations were compared.Results:In Chaoyang District, from 2014 to 2024, a total of 637 aggregated outbreaks caused by the NoV infection were reported, of which 584 were successfully typed. The epidemic caused by the GⅡ.17 [P17] subtype accounted for 8.79% (56/637), which was the dominant epidemic gene subtype in 2014-2015, sporadic in 2016-2019, reappeared in 2022, and significantly increased in 2024 (27.27%, 24/88). Outbreaks caused by the GⅡ.17 [P17] subtype occurred mainly from October to December, with the main sites of occurrence in primary schools and kindergartens. This study yielded 53 near-complete genome sequences of the GⅡ.17 [P17] subtype from 46 incidents in Chaoyang District. The GⅡ.17 [P17] subtype sequences of Chaoyang District from 2014 to 2024 were segmented into three subgroups on the evolutionary tree, with sequences from 2014 to 2019, 2022 to April 2024, and May to December 2024 clustered into the d, e, and b subgroups, respectively. In the VP1 region′s P2 area, particularly at the HBGA binding site, subgroups b and e exhibited mutations in 22 and two sites, while subgroups b and e showed mutations in four and one sites, predominantly in the RdRp region.Conclusion:The outbreak caused by the NoV GⅡ.17 [P17] subtype in Chaoyang District from 2014 to 2024 continues, with a significant increase in 2024, and it becomes the dominant gene subtype from October to December. The sequence formation of the NoV GⅡ.17 [P17] subtype in Chaoyang District from January to April 2022 and from May to December 2024 shows two different evolutions, with specific mutation sites, requiring continuous monitoring of the NoV GⅡ.17 [P17] subtype.

In recent years, along with the rapid progress of innovative drugs, novel devices, frontier technologies, and artificial intelligence, the therapeutic model for tumors has undergone tremendous changes, with a greater emphasis on precise diagnosis and treatment of clinical issues. Nevertheless, in clinical practice, numerous problems still impede the implementation of precise treatment. This article intends to be guided by the crucial clinical issues in the diagnosis, surgery, and drug treatment of gastric cancer, to explore the strategies of precise diagnosis and treatment for gastric cancer and the frontier research directions, thereby providing new concepts and potential research directions for further enhancing the precision, efficacy of gastric cancer diagnosis and treatment, and the quality of life of patients.

Objective To investigate the relationship between the peak levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP)during hospitalization and the risk of left ventricular ejection fraction(LVEF)＜50％during the recovery period in pa-tients with acute myocardial infarction(AMI).Methods This retrospective cohort study included 220 AMI patients treated at Beijing Friendship Hospital,Capital Medical University from January 2018 to December 2023.The patients were divided into three groups accord-ing to the tripartite value of peak levels of NT-proBNP during hospitalization.Baseline clinical characteristics,laboratory test results,and peak levels of NT-proBNP were collected.The primary outcome was LVEF＜50％during the recovery period.By incorporating con-founding factors,three stepwise complex Logistic regression model and linear regression model were used to analyze the relationship be-tween peak levels of NT-proBNP and the risk of LVEF＜50％.Restricted cubic spline(RCS)was used to explore the nonlinear relation-ship between them.Results The peak levels of NT-proBNP were positively correlated with an increased risk of LVEF＜50％during the recovery period,even after adjusting for confounding factors.RCS analysis revealed the nonlinear relationships between them.When the peak levels of NT-proBNP was 1822.991pg/ml,the sensitivity and specificity of predicting LVEF＜50％were 57.14％and 70.97％.Conclusion The NT-proBNP peak levels of 1822.991 pg/ml is a useful indicator for predicting LVEF＜50％in AMI pa-tients during the recovery period,and it can be used to identify high-risk AMI groups and provide basis for early active intervention.

OBJECTIVE To study the anti-fatigue effects of differently-cultivated Astragalus extract in a hypoxic environment of the plateau and explore the related mechanisms.METHODS Fifty-six male KM mice were randomly divided into the hypoxic swimming control(HSC)group,imitation wild Astragalus extract(IWA)430,860 and 1 720 mg·kg-1 groups,and cultivated Astragalus extract(CA)463,925 and 1 850 mg·kg-1 groups.The drug was administered by gavage once daily for 15 days,while body mass was monitored every three days.After 15 days of gavage,the mice were subjected to load swimming(5%body weight)in a hypobaric chamber(simulating a 4 000 m altitude),with exhaus-tive swimming time measured to identify the optimal dosage.Following randomization,fifty male KM mice were assigned to five groups:normoxic control(NC),hypoxic control(HC),HSC,IWA 860 and CA 925 mg·kg-1.All groups underwent daily gavage for 15 d before 90 min non-weight-bearing swimming was conducted in the HSC,IWA 860 and CA 925 mg·kg-1 groups within a hypobaric chamber,followed by immediate measurement of muscle strength.Hematoxylin-eosin(HE)staining was used to observe the histopathological changes in liver and gastrocnemius muscle tissues.Blood urea nitrogen(BUN),blood glucose(BG)and serum lactic acid(LA),glutathione(GSH),glutathione peroxidase(GSH-Px),malondialdehyde(MDA),superoxide dismutase(SOD),liver glycogen(LG)and muscle glycogen(MG)in livers and muscles,and total antioxidant capacity(T-AOC)and reactive oxygen species(ROS)in muscles were measured by commercial kits.Taurine and hypotaurine were measured by HPLC.Enzyme-linked immunosorbent assay(ELISA)was used for cysteine sulfenic acid decarboxylase(CSAD)measure-ment.Western blotting was used to detect protein expressions of phosphatidylinositol 3-kinase(PI3K),protein kinase B(Akt),nuclear factor E2-related factor 2(Nrf2),and heme oxygenase-1(HO-1)in skeletal muscles.RESULTS Compared with the HSC group,the swimming time was prolonged in IWA 463,IWA 860,CA 925 and CA 1 850 mg·kg-1 groups.Compared with the HSC group,the muscle strength of mice in the IWA 860 mg·kg-1 group and the CA 925 mg·kg-1 group was significantly increased,histo-pathological damage in the liver and gastrocnemius muscle was reduced,serum levels of LA and BUN were significantly decreased,levels of BG,LG and MG were significantly increased,levels of GSH,GSH-Px and SOD were significantly increased,contents of MDA were significantly decreased,expressions of CSAD were significantly increased in liver tissue,contents of GSH,T-AOC,taurine and hypotaurine were significantly increased,levels of ROS were significantly decreased,and protein expressions of PI3K,Akt,Nrf2,HO-1 were significantly upregulated in muscle tissues.CONCLUSION Under simulated high-altitude hypoxic conditions,extracts of Astragalus membranaceus cultivated by two methods consis-tently exhibit anti-fatigue effects.Its mechanisms may be mitigating oxidative stress,augmenting taurine and hypotaurine metabolic regulation,and activating PI3K/Akt and Nrf2/HO-1 signaling pathways.IWA has a better anti-fatigue effect than CA.

Objective To explore the predictive value of troponin Ⅰ(TnⅠ)peak value upon admission for predicting left ventricular ejection fraction(LVEF)＜50％in patients with acute myocardial infarction(AMI)during the recovery period.Methods A retrospec-tive analysis was carried out on 220 AMI patients admitted to Beijing Friendship Hospital from 2018 to the present.The patients were di-vided into three groups based on the peak value of TnⅠ during their stay in hospital,and the baseline data were compared.Subsequently,three progressively complex regression models were constructed to evaluate the relationship between TnⅠ and LVEF＜50％.The optimal cutoff value was determined through restricted cubic spline and smooth curve analysis.Additionally,subgroup analysis was carried out to explore differences in the predictive value of TnⅠ in different populations.Results TnⅠ peak value was significantly associated(P＜0.05)with the ratio of emergency percutaneous coronary intervention(PCI),neutrophil-to-lymphocyte ratio,white blood cell count,neutro-phils,intra-aortic balloon pump usage,N-terminal pro-brain natriuretic peptide peak value,and so on.All three models showed a sig-nificant increase in the risk of LVEF＜50％with higher TnⅠ peak value(P＜0.05).Restricted cubic spline and smooth curve analysis re-vealed a linear relationship between TnⅠ peak value and LVEF values,with the optimal cutoff value for TnⅠ peak value consistently at 29.80ng/ml across the three models.Subgroup analysis showed that the predictive value of peak TnⅠ for LVEF＜50％demonstrated statisti-cally significant differences across the following subgroups:male patients,those with high BMI,hypertension,acute interventional treat-ment,as well as different age groups,and whether patients had diabetes,smoked,or consumed alcohol.Conclusion An admission TnⅠpeak value exceeding 29.80ng/ml is an independent risk factor for predicting LVEF＜50％during the recovery period in AMI patients.It can be used to identify high-risk individuals and provide a basis for early aggressive intervention.

Objective:To develop a blockchain-based clinical configuration management model for medical equipment and evaluate its application value in optimizing clinical configuration management of hospital emergency and life-support devices.Methods:A data traceability management model was implemented.The Spatial Durbin Model(SDM)was used to identify issues in equipment configuration,and a blockchain-enabled review framework was established for procurement management of emergency and life-support devices.From January 2019 to December 2022,57 emergency and life-support devices deployed in Shaanxi Provincial People's Hospital were retrospectively analyzed.Among them,26 devices(January 2019-December 2020)were managed via conventional expert evaluation,while 31 devices(January 2021-December 2022)were managed using blockchain-based review.In the conventional mode,four traceability parameters-procurement declaration,supplier qualification,transaction records,and after-sales support-were randomly sampled 128,85,119,and 100 times,respectively;in the blockchain mode,these parameters were sampled 145,94,124,and 105 times.Procurement process compliance was evaluated across device categories:emergency,monitoring,therapeutic,and others required 25,40,30,and 35 review steps(conventional mode)versus 30,45,45,and 35 steps(blockchain mode).Comparative metrics included data traceability rates,process compliance rates,and procurement performance target achievement rates.Results:The blockchain mode demonstrated superior traceability rates:92.41%(134/145)for declarations,100.00%(94/94)for suppliers,97.58%(121/124)for transactions,and 97.14%(102/105)for after-sales support-all significantly higher than the conventional mode(x2=5.898,4.525,9.185,8.362,P＜0.05).Process compliance rates reached 100.00%(30/30)for emergency devices,95.56%(43/45)for monitoring devices,97.78%(44/45)for therapeutic devices,and 97.14%(34/35)for others,with statistically significant improvements(x2=5.176,4.936,5.103,3.968,P＜0.05).Procurement performance targets for progress,benefit,quality,and satisfaction were achieved at 96.77%(30/31),100.00%(31/31),100.00%(31/31),and 93.55%(29/31),respectively,surpassing the conventional mode(x2=6.581,6.535,5.129,5.780,P＜0.05).Conclusion:The blockchain-based clinical configuration management model enhances data traceability,standardizes procurement workflows,and improves performance goal attainment in hospital emergency and life-support device deployment.

In the era of intelligence and individualization, gastric cancer surgery is under-going multidimensional advancements. The authors focus on the cutting-edge progress and future challenges of artificial intelligence (AI) in the diagnosis and decision-making, treatment and drug development, as well as postoperative rehabilitation in gastric cancer surgery. In terms of diagnosis, AI integrates imaging, liquid biopsy, pathology, and multimodal technologies to enhance diagnostic comprehensiveness and accuracy. Regarding decision-making, AI assists in formulating personalized treatment plans, conducting risk assessments, and predicting prognoses. In the treatment domain, AI facilitates the advancement of individualized surgical approaches, supports postoperative follow-up, and aids in physician education and training. In drug development, the introduction of virtual cell models and AlphaFold has improved the efficiency and accuracy of mechanistic and clinical research. For postoperative rehabilitation guidance, AI provides personalized recommendations to optimize treatment outcomes.AI holds great promise in gastric cancer surgery across diagnosis and decision-making, treatment and drug development, and postoperative rehabilitation. However, current AI technologies face challenges such as data sharing and privacy protection, multicenter research and model generalization, human-machine collaboration, interpretability, ethical considerations, sustaina-bility, and widespread adoption. Addressing these challenges will require collective efforts to fully leverage AI′s advantages in gastric cancer diagnosis and treatment.