ObjectiveTo evaluate the effects and safety of the optimized new Shengmai Powder （优化新生脉散方） on exercise tolerance in patients with chronic heart failure （CHF） of qi deficiency， blood stasis， and fluid retention syndrome. MethodsA randomized， double-blind， placebo-controlled trial was conducted. A total of 78 CHF patients with qi deficiency， blood stasis， and fluid retention syndrome were recruited and randomly assigned to a treatment group （39 cases） and a control group （39 cases）. On the basis of conventional western medical therapy， patients in the treatment group additionally received the optimized new Shengmai Powder granules， while the control group was given an oral placebo of optimized new Shengmai Powder granules. Patients in both groups took 30.6 g each time， twice a day， mixed with water for administration， with a total treatment course of 4 weeks. The primary outcomes were 6-minute walk distance （6MWD） and peak oxygen uptake （Peak VO₂） measured by cardiopulmonary exercise testing. Secondary outcomes included New York Heart Association （NYHA） functional classification， B-type natriuretic peptide （BNP） levels， cardiac function indexes including left ventricular ejection fraction （LVEF）， left ventri-cular end-systolic diameter （LVESD） and left ventricular end-diastolic diameter （LVEDD）， Minnesota Living with Heart Failure Questionnaire （MLHFQ） scores， and scores of four diagnostic information of traditional Chinese medicine （TCM）. All indicators were assessed once before and after treatment respectively. Safety indicators were evaluated， and adverse events during the trial were recorded. ResultsAll patients in both groups were included in the full ana-lysis set （FAS） and safety set （SS）. Compared with baseline， the 6MWD and Peak VO₂ of cardiopulmonary exercise test in the treatment group significantly increased after treatment， while the MLHFQ scores， serum BNP levels and scores of TCM four diagnostic information significantly decreased， and the NYHA cardiac function grade significantly improved （P＜0.01）. After treatment， the 6MWD and Peak VO₂ of cardiopulmonary exercise test， as well as their changes from baseline in the treatment group were higher than those in the control group； the MLHFQ scores， serum BNP levels and scores of TCM four diagnostic information in the treatment group were lower than those in the control group； and the improvement of NYHA cardiac function grade in the treatment group was superior to that in the control group （P＜0.01）. There was no statistically significant differences in all indicators after treatment in the control group （P＞0.05）. The incidence of adverse events was 5.1% （2/39） in the treatment group and 2.6% （1/39） in the control group， with no statistically significant difference between groups （P＞0.05）. ConclusionOn the basis of conventional western medicine treatment， the addition of the optimized new Shengmai Powder can further improve exercise tolerance， cardiac function and quality of life in patients with CHF of qi deficiency， blood stasis and fluid retention syndrome， and show good safety.

Objective To understand the current status of traditional Chinese medicine(TCM)systematic reviews/Meta-analysis over the past 10 years.Methods Cochrane Database of Systematic Reviews,PubMed,Web of Knowledge,CNKI,SinoMed,WanFang Data,VIP databases,as well as the Cochrane Register and PROSPERO registration platform were searched to collect TCM-related systematic reviews/Meta-analysis published between January 2015 and December 2024.Literature was screened,and standardization of institutions,countries,and journals was performed.Data cleaning was conducted,and trends in publication years,high-frequency diseases,journals,institutions,and highly cited papers were analyzed.Results A total of 11,174 papers were included,involving approximately 56,656 authors from 1,422 institutions across 44 countries,covering 1,300 journals and 1,070 diseases.The top five institutions in terms of publications were Beijing University of Chinese Medicine(954 papers),Guangzhou University of Chinese Medicine(928 papers),China Academy of Chinese Medical Sciences(537 papers),Tianjin University of Chinese Medicine(460 papers),and Chengdu University of Chinese Medicine(393 papers).Foreign institutions with the highest publication volumes were concentrated in South Korea,Iran,and Australia.The most frequently published Chinese journal was Zhongyi Clinical Research with 332 papers,while the most published English journal was Evidence-Based Complementary and Alternative Medicine with 311 papers.There were 282 single-author papers involving 271 authors,and the most cited paper was referenced 323 times,The three most frequently studied diseases were diabetes(267 papers,2.39％),angina pectoris(214 papers,1.92％),and osteoarthritis(210 papers,1.88％).Non-pharmacological interventions such as acupuncture(1,265 papers,11.32％),auricular therapy(101 papers,0.90％),and Tai Chi(98 papers,0.88％)were most frequently reported.In pharmacological interventions,studies on Tripterygium wilfordii tablets(76 papers,0.68％)and Danhong injection(54 papers,0.48％)were more common.Conclusion The systematic reviews/Meta-analysis method is widely used in the field of TCM,and the field continues to grow.Active academic teams,institutions,and journals have emerged.Over the past decade,there has been a considerable body of evidence in Chinese systematic reviews on TCM for chronic diseases such as diabetes,angina pectoris,and osteoarthritis.In English-language studies,non-pharmacological therapies like acupuncture have been more widely reported,and some high-impact studies have emerged.However,challenges remain,such as issues with research transparency and methodological standardization.Future efforts should focus on establishing transparent systems and quality control mechanisms to further enhance the reliability,accuracy,and dissemination of TCM evidence-based research.

Objective To evaluate the prognosis of infants with common Hirschsprung's disease who undergo laparoscopic-assisted Soave procedure below 6 months of age,and to explore its feasibility.Methods A retrospective analysis was conducted on the clinical data of 82 cases of common Hirschsprung's disease admitted to our department from January 2018 to August 2022.The patients were divided into two groups based on their age at the time of surgery:Young surgical age group(＜6 months,50 cases)and Old surgical age group(≥ 6 months,32 cases).All patients underwent the treatment of laparoscopic-assisted Soave procedure.The surgical time,length of hospital stay,postoperative complications,and anal function were compared between the two groups.Results There were no significant differences between young surgical age group and old surgical age group in terms of surgical time[(145.04±11.21)min vs.(149.25±12.18)min,P=0.20],length of hospital stay[(13.56+0.93)d vs.(13.91±0.99)d,P=0.55],postoperative complications[22.00％(11/50)vs.28.13％(9/32),P=0.53],and Rintala score for anal function[(18.58±1.44)vs.(17.22±1.64),P=0.06].The main postoperative complications,including enterocolitis[10.00％(5/50)vs.12.50％(4/32),P=0.72],fecal/anal incontinence[6.00％(3/50)vs.6.25％(2/32),P=0.96],and constipation[4.00％(2/50)and 6.25％(2/32),P=0.65],showed no significant differences between the two groups(all P＞0.05).However,there was a statistically significant difference in terms of bleeding volume[(7.86±2.02)ml vs.(9.13±2.17)ml,P＜0.05].No deaths occurred in this study.Conclusion Laparoscopic-assisted Soave procedure is safe and effective for infants below 6 months of age with common congenital Hirschsprung's disease.It can achieve satisfactory anal function and reduce the incidence of adverse events during the waiting period for surgery.

Objective:To explore the feasibility of autosegmentation and reconstruction of interstitial needles in intracavitary / interstitial brachytherapy (IC-ISBT) for cervical cancer based on deep learning.Methods:The data of 180 treatment plans from 98 patients who received IC-ISBT were retrospectively collected and divided into the training, validation, and testing sets in a 16:1:1 ratio. Masks of needles were created using the dwell positions of radiation sources, and a 3D U-Net model was trained. The performance of the model was evaluated using the Dice similarity coefficient (DSC). Absolute and relative accuracy rates were used to assess the results of this method, and the position bias was used to evaluate the precision of predictions in the transversal plan of CT scans. Wilcoxon rank-sum test was performed to evaluate the reconstruction efficiency by comparing the time required for automated versus manual reconstruction.Results:DSC of the model was 0.93 ± 0.02. The absolute and relative accuracy rates were 0.44 ± 0.09 and 0.95 ± 0.03, respectively. The distance deviation on the CT horizontal plane was (0.58 ± 0.54) mm. The average time of autosegmentation and reconstruction was (6.2 ± 0.4) s, leading to a significant reduction in time consumption compared with manual construction ( P<0.001). Conclusions:Based on deep learning, using the dwell positions of radiation sources for data annotation, combined with post-processing algorithms, accurate automated segmentation and digital reconstruction of needles in IC-ISBT three-dimensional CT images can be achieved, significantly improving reconstruction efficiency.

Objective To understand the current status of traditional Chinese medicine(TCM)systematic reviews/Meta-analysis over the past 10 years.Methods Cochrane Database of Systematic Reviews,PubMed,Web of Knowledge,CNKI,SinoMed,WanFang Data,VIP databases,as well as the Cochrane Register and PROSPERO registration platform were searched to collect TCM-related systematic reviews/Meta-analysis published between January 2015 and December 2024.Literature was screened,and standardization of institutions,countries,and journals was performed.Data cleaning was conducted,and trends in publication years,high-frequency diseases,journals,institutions,and highly cited papers were analyzed.Results A total of 11,174 papers were included,involving approximately 56,656 authors from 1,422 institutions across 44 countries,covering 1,300 journals and 1,070 diseases.The top five institutions in terms of publications were Beijing University of Chinese Medicine(954 papers),Guangzhou University of Chinese Medicine(928 papers),China Academy of Chinese Medical Sciences(537 papers),Tianjin University of Chinese Medicine(460 papers),and Chengdu University of Chinese Medicine(393 papers).Foreign institutions with the highest publication volumes were concentrated in South Korea,Iran,and Australia.The most frequently published Chinese journal was Zhongyi Clinical Research with 332 papers,while the most published English journal was Evidence-Based Complementary and Alternative Medicine with 311 papers.There were 282 single-author papers involving 271 authors,and the most cited paper was referenced 323 times,The three most frequently studied diseases were diabetes(267 papers,2.39％),angina pectoris(214 papers,1.92％),and osteoarthritis(210 papers,1.88％).Non-pharmacological interventions such as acupuncture(1,265 papers,11.32％),auricular therapy(101 papers,0.90％),and Tai Chi(98 papers,0.88％)were most frequently reported.In pharmacological interventions,studies on Tripterygium wilfordii tablets(76 papers,0.68％)and Danhong injection(54 papers,0.48％)were more common.Conclusion The systematic reviews/Meta-analysis method is widely used in the field of TCM,and the field continues to grow.Active academic teams,institutions,and journals have emerged.Over the past decade,there has been a considerable body of evidence in Chinese systematic reviews on TCM for chronic diseases such as diabetes,angina pectoris,and osteoarthritis.In English-language studies,non-pharmacological therapies like acupuncture have been more widely reported,and some high-impact studies have emerged.However,challenges remain,such as issues with research transparency and methodological standardization.Future efforts should focus on establishing transparent systems and quality control mechanisms to further enhance the reliability,accuracy,and dissemination of TCM evidence-based research.

Objective To evaluate the prognosis of infants with common Hirschsprung's disease who undergo laparoscopic-assisted Soave procedure below 6 months of age,and to explore its feasibility.Methods A retrospective analysis was conducted on the clinical data of 82 cases of common Hirschsprung's disease admitted to our department from January 2018 to August 2022.The patients were divided into two groups based on their age at the time of surgery:Young surgical age group(＜6 months,50 cases)and Old surgical age group(≥ 6 months,32 cases).All patients underwent the treatment of laparoscopic-assisted Soave procedure.The surgical time,length of hospital stay,postoperative complications,and anal function were compared between the two groups.Results There were no significant differences between young surgical age group and old surgical age group in terms of surgical time[(145.04±11.21)min vs.(149.25±12.18)min,P=0.20],length of hospital stay[(13.56+0.93)d vs.(13.91±0.99)d,P=0.55],postoperative complications[22.00％(11/50)vs.28.13％(9/32),P=0.53],and Rintala score for anal function[(18.58±1.44)vs.(17.22±1.64),P=0.06].The main postoperative complications,including enterocolitis[10.00％(5/50)vs.12.50％(4/32),P=0.72],fecal/anal incontinence[6.00％(3/50)vs.6.25％(2/32),P=0.96],and constipation[4.00％(2/50)and 6.25％(2/32),P=0.65],showed no significant differences between the two groups(all P＞0.05).However,there was a statistically significant difference in terms of bleeding volume[(7.86±2.02)ml vs.(9.13±2.17)ml,P＜0.05].No deaths occurred in this study.Conclusion Laparoscopic-assisted Soave procedure is safe and effective for infants below 6 months of age with common congenital Hirschsprung's disease.It can achieve satisfactory anal function and reduce the incidence of adverse events during the waiting period for surgery.

Objective:To explore the feasibility of autosegmentation and reconstruction of interstitial needles in intracavitary / interstitial brachytherapy (IC-ISBT) for cervical cancer based on deep learning.Methods:The data of 180 treatment plans from 98 patients who received IC-ISBT were retrospectively collected and divided into the training, validation, and testing sets in a 16:1:1 ratio. Masks of needles were created using the dwell positions of radiation sources, and a 3D U-Net model was trained. The performance of the model was evaluated using the Dice similarity coefficient (DSC). Absolute and relative accuracy rates were used to assess the results of this method, and the position bias was used to evaluate the precision of predictions in the transversal plan of CT scans. Wilcoxon rank-sum test was performed to evaluate the reconstruction efficiency by comparing the time required for automated versus manual reconstruction.Results:DSC of the model was 0.93 ± 0.02. The absolute and relative accuracy rates were 0.44 ± 0.09 and 0.95 ± 0.03, respectively. The distance deviation on the CT horizontal plane was (0.58 ± 0.54) mm. The average time of autosegmentation and reconstruction was (6.2 ± 0.4) s, leading to a significant reduction in time consumption compared with manual construction ( P<0.001). Conclusions:Based on deep learning, using the dwell positions of radiation sources for data annotation, combined with post-processing algorithms, accurate automated segmentation and digital reconstruction of needles in IC-ISBT three-dimensional CT images can be achieved, significantly improving reconstruction efficiency.

Objective Evaluate the performance of the encephalon state index(ESI)in depth of anesthesia monitoring during clinical surgery,compared with the bispectral index(BIS).Methods ESI and BIS data were collected from 60 patients in a single-center clinical trial to compare their efficacy in measuring the depth of anesthesia.Results Consistency analysis revealed mean differences and standard deviations of-0.18±5.42 and-0.11±6.51 between ESI and BIS for awake and anesthetized states,respectively.Correlation analysis showed a correlation coefficient of 0.92 throughout the operative period.Prediction probability analysis indicated that both ESI and BIS had prediction probabilities of 0.97,effectively predicting anesthesia status.Conclusion ESI and BIS show good equivalence in monitoring depth of anesthesia during clinical surgery,which meet the requirements of clinical anesthesia.

ObjectiveTo evaluate the effect and safety of Jiuxin Pill （救心丸） on exercise tolerance and quality of life in patients with stable angina pectoris （SAP）. MethodsA randomised， double-blind， placebo-controlled， multicentre study design was used to enroll 170 patients of SAP from nine centres， which were divided into 85 patients each in the trial group and control group with 1∶1 ratio. Both groups maintained the original western medicine treatment plan， and added Jiuxin Pill or placebo respectively， 2 pills （0.05 g） each time twicely for 28 days. The main outcomes were total exercise time （TED） in the exercise treadmill test and Seattle Angina Questionnaire （SAQ） scores including physical limitation （PL）， angina stability （AS）， angina frequency （AF）， treatment satisfaction （TS）， and disease perception （DP）. The secondary outcomes were exercise treadmill test indicators including heart rate recovery in 1 min （HRR1）， metabolic equivalents （METs）， maximum magnitude of ST-segment depression， and the Borg rating of perceived exertion scale， the average number of angina attacks per week， withdrawal and reduction rate of nitroglycerin， traditional Chinese medicine syndrome scores， incidence of major adverse cardiovascular events. Safety indicators were evaluated and the occurrence of adverse events during the trial was recorded. Data was collected before treatment， day 28±2 in treatment period， and follow-up at day 56 which is 28±2 days after treatment period finished. ResultsEighty-four and eighty-five patients respectively from trial group and control group were included to the full analysis set （FAS） and safety analysis set （SS）. Compared with the group before treatment and with the control group after treatment， the trial group had higher TED， HRR1， and METs， and lower maximum magnitude of ST-segment depression and Borg rating of perceived exertion scores after treatment （P＜0.01）. Compared with the group before treatment and with the control group after treatment and at follow-up， the total SAQ score and scores of AS， AF， TS and DP of the trial group after treatment and at follow-up elevated， while the average number of angina attacks per week and traditional Chinese medicine syndrome scores reduced （P＜0.01）. There was no statistically significant difference in the withdrawal and reduction rate of nitroglycerin between groups （P＞0.05）. Major adverse cardiovascular events occurred in 1 case （1/84， 1.19%） in the trial group and 1 case （1/85， 1.18%） in the control group， and the difference between groups was not statistically significant （P＞0.05）. A total of 3 cases of adverse events occurred in the trial group （3/84， 3.57%）， and a total of 6 cases of adverse events occurred in the control group （6/85， 7.06%）， and there was no statistically significant difference in the incidence of adverse events between groups （P＞0.05）. ConclusionIn the treatment of SAP， Jiuxin Pill combined with conventional western medicine can further enhance exercise tolerance， improve quality of life， and demonstrate great safety.

At present, pancreatic cancer is a solid tumor with the worst prognosis. Compared with surgery and chemotherapy, radiotherapy plays an auxiliary role in the treatment of pancreatic cancer. In recent years, significant advances have been achieved in radiotherapy technology, which have been gradually applied in the diagnosis and treatment of pancreatic cancer. In this article, the progress in radiation therapy in the treatment of pancreatic cancer was reviewed, especially the clinical application of magnetic resonance imaging-guided radiation therapy in the treatment of pancreatic cancer, aiming to deepen the understand of the progress in radiation therapy for pancreatic cancer, and providing reference for improving the survival rate of pancreatic cancer patients.