Objective: To investigate the effects of clinical routine X-ray irradiation dose (average irradiation dose: 29.7±0.54 Gy) on the function, apoptosis, activation state and mitochondrial function of platelets during in vitro storage, so as to provide experimental evidence for optimizing platelet irradiation strategies. Methods: A paired experimental design was adopted. Platelets were collected from 12 healthy donors, and each sample was equally divided into the irradiated group and the control group (non-irradiated). All samples were stored for 5 days under standard platelet preservation conditions (22±2℃, continuous oscillation). Flow cytometry was used to detect platelet count, apoptosis rate (Annexin V+ positive rate), activation markers (CD62P, PAC-1, CD42b) and reactive oxygen species (ROS) level. Meanwhile, mitochondrial-specific probes were used to evaluate changes in mitochondrial count, membrane potential and adenosine triphosphate (ATP) content. Additionally, transmission electron microscopy (TEM) was employed to observe the ultrastructure of platelets, with a focus on mitochondrial morphology, platelet membrane integrity and granule distribution. Results: Within 5 days of storage, the platelet count was (841±89.16)×10 /L in the irradiated group and (824.5±92.88)×10 /L in the control group, with no statistically significant difference between the two groups (P=0.54). The apoptosis rate was (4.94±1.39) % in the irradiated group and (5.50±0.83) % in the control group, showing no significant difference (P=0.31). For activation indicators, the CD62P expression rate was (24.32±7.57) % in the irradiated group versus (25.21±8.13) % in the control group (P=0.43). The PAC-1 positive rates were (12.15±4.43) % and (11.75±3.40) % in the irradiated group and control group, respectively (P=0.44). The CD42b expression rates were (12.14±4.43) % and (11.75±3.4) % in the two groups, respectively (P=0.47). The ROS levels were (31.98±8.1) % and (30.64±5.89) % in the two groups, respectively (P=0.45). No significant differences were found in the above indicators. For mitochondrial function indicators, the mitochondrial count was (55.88±11.49) % in the irradiated group and (53.5±7.24) % in the control group (P=0.57). The ATP contents were (42.45±5.29) % and (41.58±9.50) % in the irradiated group and control group, respectively (P=0.77). The relative membrane potential values were (59.53±10.89) % and (57.49±6.54) % in the two groups, respectively (P=0.47). No significant difference were observed on the mitochondrial function-related indicators. TEM further confirmed that the ultrastructure of platelets in the irradiation group was intact, the mitochondrial morphology was normal, and no pathological changes such as swelling or vacuolization were observed. Conclusion: This study evaluated the impact of conventional-dose X-ray irradiation on platelet storage quality, confirming that this dose does not significant impair platelet count, apoptosis rate, activation status, or mitochondrial function. This finding provides important experimental evidence for the clinical promotion of X-ray irradiation technology and suggests its potential as a safe alternative to γ irradiation. Future studies could further expand the sample size and extend the observation period to verify the effects of X-ray irradiation on long-term platelet storage and post-transfusion in vivo survival rate.

Objectives:This study aims to explore the relationship between the pericoronary fat attenuation index(FAI)and triglyceride-glucose(TyG)index and atrial fibrillation recurrence after radiofrequency catheter ablation(RFCA)in patients with atrial fibrillation(AF).Methods:This retrospective study enrolled consecutive AF patients who underwent their first successful RFCA at the Affiliated Hospital of Xuzhou Medical University from 2019 to 2023.Pericoronary FAI was quantitatively measured,and the TyG index was calculated.Patients were divided into three groups according to the TyG index quartile:T1 group(TyG index<8.45,n=114);T2 group(8.45≤TyG index≤8.93,n=114);T3 group(TyG index>8.93,n=120).Linear regression was used to analyze the correlation between the TyG index and proximal FAI of three coronary arteries.Logistic regression was employed to explore the correlation between pericoronary FAI,TyG index,and AF recurrence post-RFCA,restrictive cubic splines(RCS)were plotted.Additive interaction and mediation analyses were used to explore the role of pericoronary FAI in the relationship between the TyG index and post-RFCA AF recurrence.Subgroup analysis was performed to explore the predictive value of the TyG index for postoperative recurrence in different patient subgroups.Results:A total of 348 patients were included.After adjusting for confounding factors using linear regression analysis,each unit increase in the TyG index was associated with a 5.389 HU increase in left circumfleex artery(LCX-FAI)(95%CI:3.874-6.904,P<0.001).During one-year follow-up,90 cases(25.86%)experienced AF recurrence.RCS analysis indicated that there was no significant nonlinear relationship between LCX-FAI,TyG index,and AF recurrence after RFCA(Pnon-linear=0.378,Pnon-linear=0.469).The recurrence rate of AF in patients with TyG index>9.08 and LCX-FAI>-83.65 HU was about 57.737 times higher than those with TyG index≤9.08 and LCX-FAI≤-83.65 HU(OR=57.737,95%CI:23.755-155.656,P<0.001).There was an additive interaction between the TyG index and LCX-FAI:relative excess risk due to interaction(RERI)was 50.901(95%CI:0.215-101.587),attributable proportion due to interaction(AP)was 0.882(95%CI:0.769-0.994),and the synergy index(S)was 9.713(95%CI:3.380-27.910).Mediation analysis indicated that LCX-FAI mediated 22%of the relationship between the TyG index and AF recurrence.Subgroup analysis revealed no multiplicative interaction between the type of atrial fibrillation and the TyG index in terms of AF recurrence risk(Pinteraction=0.562).Conclusions:In patients with atrial fibrillation,the TyG index is positively correlated with LCX-FAI,patients with TyG index>9.08 and LCX-FAI>-83.65 HU have significantly increased risk of AF recurrence after RFCA.LCX-FAI partially mediates the relationship between the TyG index and post-RFCA recurrence.Furthermore,the TyG index can effectively predict AF recurrence in both persistent and paroxysmal atrial fibrillation patients.

Objective:To understand the impact of menopausal hormone therapy(MHT)on bone turnover markers(BTMs)in menopausal women and explore the feasibility of BTMs as efficacy monitoring indicators for MHT.Methods:Menopausal women who visited the Menopause Clinic and Gynecological Endocrine Clinic of our hospital from January 2018 to August 2022,received MHT and had regular reexaminations of BTMs were selected.According to the treatment plan at the initiation of MHT,they were divided into the estrogen group(continuous or cyclic sequential therapy or continuous combined therapy)and the tibolone group.All patients had reexaminations of BTMs,including osteocalcin(OC),beta C-terminal telopeptide of type Ⅰ collagen(β-CTX),and procollagen type Ⅰ N-terminal propeptide(P1NP),before treatment and at 6 months,12 months and 24 months after treatment.Meanwhile,their bone mineral density examination results in our hospital were collected.The BTMs before and af-ter treatment in each group were compared,as well as the changes in BTMs after treatment compared with those before treatment between the two groups.Meanwhile,the changes in bone mineral density were analyzed.Results:The levels and abnormal rates of BTMs(β-CTX,P1NP,OC)in both the estrogen group and the tibolone group were significantly decreased at 6,12,and 24 months after treatment compared with those before treatment,and the differences were statistically significant(P＜0.05).When comparing the changes in BTMs after treatment compared with those before treatment between the two groups,there was no statistically significant difference(P＞0.05).The incidences of osteopenia and osteoporosis in patients at 12 months and 24 months after treat-ment had no significant changes compared with those before treatment,and the differences were not statistically significant(P＞0.05).The lumbar spine bone mineral density was significantly improved at 12 months and 24 months after MHT treatment compared with that before treatment,and the differences were statistically significant(P＜0.05).The bone mineral densities of the femoral neck and hip were not significantly improved at 12 months and 24 months after MHT treatment compared with those before treatment,and the differences were not statisti-cally significant(P＞0.05).Conclusion:The anti-bone resorption effects of the two MHT regimens are similar.The BTMs(OC,β-CTX,PINP)are significantly decreased after 6 months of treatment and can maintain their ef-fectiveness.BTMs can be used as one of the important monitoring methods for the efficacy of menopausal hor-mone therapy.

Objectives:This study aims to explore the relationship between the pericoronary fat attenuation index(FAI)and triglyceride-glucose(TyG)index and atrial fibrillation recurrence after radiofrequency catheter ablation(RFCA)in patients with atrial fibrillation(AF).Methods:This retrospective study enrolled consecutive AF patients who underwent their first successful RFCA at the Affiliated Hospital of Xuzhou Medical University from 2019 to 2023.Pericoronary FAI was quantitatively measured,and the TyG index was calculated.Patients were divided into three groups according to the TyG index quartile:T1 group(TyG index<8.45,n=114);T2 group(8.45≤TyG index≤8.93,n=114);T3 group(TyG index>8.93,n=120).Linear regression was used to analyze the correlation between the TyG index and proximal FAI of three coronary arteries.Logistic regression was employed to explore the correlation between pericoronary FAI,TyG index,and AF recurrence post-RFCA,restrictive cubic splines(RCS)were plotted.Additive interaction and mediation analyses were used to explore the role of pericoronary FAI in the relationship between the TyG index and post-RFCA AF recurrence.Subgroup analysis was performed to explore the predictive value of the TyG index for postoperative recurrence in different patient subgroups.Results:A total of 348 patients were included.After adjusting for confounding factors using linear regression analysis,each unit increase in the TyG index was associated with a 5.389 HU increase in left circumfleex artery(LCX-FAI)(95%CI:3.874-6.904,P<0.001).During one-year follow-up,90 cases(25.86%)experienced AF recurrence.RCS analysis indicated that there was no significant nonlinear relationship between LCX-FAI,TyG index,and AF recurrence after RFCA(Pnon-linear=0.378,Pnon-linear=0.469).The recurrence rate of AF in patients with TyG index>9.08 and LCX-FAI>-83.65 HU was about 57.737 times higher than those with TyG index≤9.08 and LCX-FAI≤-83.65 HU(OR=57.737,95%CI:23.755-155.656,P<0.001).There was an additive interaction between the TyG index and LCX-FAI:relative excess risk due to interaction(RERI)was 50.901(95%CI:0.215-101.587),attributable proportion due to interaction(AP)was 0.882(95%CI:0.769-0.994),and the synergy index(S)was 9.713(95%CI:3.380-27.910).Mediation analysis indicated that LCX-FAI mediated 22%of the relationship between the TyG index and AF recurrence.Subgroup analysis revealed no multiplicative interaction between the type of atrial fibrillation and the TyG index in terms of AF recurrence risk(Pinteraction=0.562).Conclusions:In patients with atrial fibrillation,the TyG index is positively correlated with LCX-FAI,patients with TyG index>9.08 and LCX-FAI>-83.65 HU have significantly increased risk of AF recurrence after RFCA.LCX-FAI partially mediates the relationship between the TyG index and post-RFCA recurrence.Furthermore,the TyG index can effectively predict AF recurrence in both persistent and paroxysmal atrial fibrillation patients.

Objective:To understand the impact of menopausal hormone therapy(MHT)on bone turnover markers(BTMs)in menopausal women and explore the feasibility of BTMs as efficacy monitoring indicators for MHT.Methods:Menopausal women who visited the Menopause Clinic and Gynecological Endocrine Clinic of our hospital from January 2018 to August 2022,received MHT and had regular reexaminations of BTMs were selected.According to the treatment plan at the initiation of MHT,they were divided into the estrogen group(continuous or cyclic sequential therapy or continuous combined therapy)and the tibolone group.All patients had reexaminations of BTMs,including osteocalcin(OC),beta C-terminal telopeptide of type Ⅰ collagen(β-CTX),and procollagen type Ⅰ N-terminal propeptide(P1NP),before treatment and at 6 months,12 months and 24 months after treatment.Meanwhile,their bone mineral density examination results in our hospital were collected.The BTMs before and af-ter treatment in each group were compared,as well as the changes in BTMs after treatment compared with those before treatment between the two groups.Meanwhile,the changes in bone mineral density were analyzed.Results:The levels and abnormal rates of BTMs(β-CTX,P1NP,OC)in both the estrogen group and the tibolone group were significantly decreased at 6,12,and 24 months after treatment compared with those before treatment,and the differences were statistically significant(P＜0.05).When comparing the changes in BTMs after treatment compared with those before treatment between the two groups,there was no statistically significant difference(P＞0.05).The incidences of osteopenia and osteoporosis in patients at 12 months and 24 months after treat-ment had no significant changes compared with those before treatment,and the differences were not statistically significant(P＞0.05).The lumbar spine bone mineral density was significantly improved at 12 months and 24 months after MHT treatment compared with that before treatment,and the differences were statistically significant(P＜0.05).The bone mineral densities of the femoral neck and hip were not significantly improved at 12 months and 24 months after MHT treatment compared with those before treatment,and the differences were not statisti-cally significant(P＞0.05).Conclusion:The anti-bone resorption effects of the two MHT regimens are similar.The BTMs(OC,β-CTX,PINP)are significantly decreased after 6 months of treatment and can maintain their ef-fectiveness.BTMs can be used as one of the important monitoring methods for the efficacy of menopausal hor-mone therapy.

Purpose To investigate the clinical value of multi-center digital mammography radiomics nomogram model in predicting triple-negative breast cancer(TNBC).Materials and Methods The digital mammograms of 462 patients with pathologically confirmed breast cancer from November 2016 to March 2022 were retrospectively analyzed,including 243 cases from Yijishan Hospital of Wannan Medical College(institution 1),106 cases from Fuyang People's Hospital(institution 2)and 113 cases from Taihe People's Hospital(institution 3).According to the results of immunohistochemistry,a total of 349 breast cancer patients in institution 1 and institution 2 were randomly divided into the training group(244 cases,including 41 TNBC and 203 non-TNBC)and the validation group(105 cases,including 18 TNBC and 87 non-TNBC)according to the ratio of 7∶3,113 breast cancer patients(24 TNBC and 89 non-TNBC)from institution 3 were included in the external validation group.Comparing the mediolateral oblique and cranial cauda digital mammography images,the mammography imaging with larger lesion areas were selected,and the image segmentation and radiomics feature extraction were performed.The radiomics model was constructed by using Logistic regression.The clinicopathological parameters and radiomics scores were used to construct a nomogram.Receiver operating characteristic and decision curve analysis were used to evaluate the model performance.To compare The predictive performance between the models was compared.Results Finally,four radiomics features closely related to TNBC were selected to construct an radiomics model.The area under the curve,sensitivity and specificity of TNBC predicted by the radiomics model in training group,validation group and external test group were 0.868,90.24%and 72.91%,0.827,72.22%and 75.86%,0.837,70.83%and 78.65%,respectively.The area under the curve,sensitivity and specificity of TNBC predicted by the combined model in the training group,validation group and external test group were 0.903,80.49%and 86.70%,0.890,77.78%and 88.51%,0.870,62.50%and 85.39%,respectively.The combined model was better than the single image omics model in predicting TNBC,and the difference was statistically significant between the training group and the verification group(Z=2.061,2.064,both P<0.05),but not between the external test group(Z=1.223,P=0.221).In three group,decision curve analysis showed that the nomogram predicted a higher net benefit than the radiomics model for triple-negative breast cancer.Conclusion The radiomics model has high diagnostic efficiency in predicting TNBC,and the nomogram model combined with the radiomics score and histological grading can further improve the prediction efficiency.

Objective:To evaluate the effect of Qishi Tongguan Prescription on pregnancy outcomes after interventional recanalisation in patients with tubal infertility (TFI).Methods:This was a retrospective study based on real-world and propensity score matching. Totally 260 patients with TFI from January 2020 to October 2021 in Shuguang Hospital of Shanghai University of Traditional Chinese Medicine and Maternal and Child Health Hospital of Pudong New Area were selected as observation subjects, and were divided into 123 cases in the TCM combination group and 137 cases in the control group based on whether they were treated with Qishi Tongguan Prescription in combination with interventional revascularization. Propensity score matching (PSM) was used as a covariate to obtain a new sample of inter group covariate equilibrium, and confounding factors that may affect the pregnancy outcome of TFI patients undergoing interventional recanalization surgery were used as covariates. The intrauterine pregnancy rate, ectopic pregnancy rate, biochemical pregnancy rate, early abortion rate and adverse reactions of the two groups of patients within 12 months of follow-up were compared, and the influence of TFI intervention and recanalization combined with Qishi Tongguan Prescription on intrauterine pregnancy rate was evaluated.Results:Age, years of infertility, type of infertility, history of miscarriage, history of ectopic pregnancy, history of biochemical pregnancy, history of uterine surgery, history of pelvic laparotomy, and degree of tubal patency had an effect on whether intrauterine pregnancy was achieved after interventional reversal in patients with TFI ( P<0.05), with age [ OR (95% CI) was 0.843 (0.769, 0.926)], history of pelvic laparotomy [ OR (95% CI) was 0.477 (0.248, 0.920)] and the degree of tubal obstruction [ OR (95% CI) was 0.152 (0.046, 0.500)] were independent factors ( P<0.01 or P<0.05). 81 patients were seen in each of the 2 groups after PSM, of whom the intrauterine pregnancy rates in the combined herbal group at 9 and 12 months after recanalisation were 48.1% (39/81) and 58.0% (47/81) respectively, compared with 32.1% (26/81) and 35.8% (29/81) in the control group, with statistical significance between the 2 groups ( χ2 values of 4.34 and 8.03, respectively, P<0.01); there was no statistical significance in the ectopic pregnancy rate, biochemical pregnancy rate and early abortion rate between the 2 groups ( P>0.05). There were no significant adverse reactions during the treatment. Conclusion:Qishi Tongguan Prescription combined with interventional recanalization can effectively improve the intrauterine pregnancy rate and shorten the waiting time for pregnancy in patients with TFI with higher safety.

Nasopharyngeal carcinoma (NPC) is a common malignant tumor in China. Radiotherapy is the first-line treatment. After appropriate radiotherapy, about 5%-15% patients experience recurrence. In view of the poor efficacy and high incidence of severe late toxicities associated with re-irradiation, salvage surgery by the transnasal endoscopic approach is recommended for recurrent NPC (rNPC). Compared with re-irradiation, endoscopic surgery can better prolong survival, improve the quality of life, and reduce complications and medical expenses of patients with rNPC. However, the complexity of the nasopharyngeal skull base enhances the difficulty and risk of surgery. Expanding the boundary of surgical resection remains a clinical challenge for otolaryngologists. In this regard, to help more advanced patients with rNPC, the surgical innovative system of NPC needs to be established by multi-disciplinary cooperation, involving skull base anatomy-based investigation, appropriate administration of the internal carotid artery (ICA), repair of skull base defect, and establishment of various types of endoscopic endonasal nasopharyngectomy.

Objective: To explore and construct the cognitive response model for patients suffering conflicts with nurses, and to provide guidance cues for the prevention and treatment of nurse-patient conflict. Methods: According to the grounded theory approach devoloped by Strauss, a total of 9 patients were observed and interviewed in a semi-structured way, and the collected data was analysed to extract the cognitive response theme. Results: A cognitive response model for patients with nurse-patient conflicts was established, which included three phases, i.e., the demands of expectations, the emotional catharsis, and the introspection of right and wrong. Conclusion The established congnitive response model confirmes the relationships among environmental factors, patients′ cognitive processes, and patients′ reponse, and can be used to prevent and deal with the conflicts between patients and nurses.

In the long course of traditional Chinese medicine (TCM) development history,generations of physicians in their long-term medical practice,have paid attention to assimilate and apply new technology and new theory,constantly enrich and perfect the medical technologies,methods and theory systems.It is particularly important to promote the innovation of TCM theory and guide the clinical application of TCM through the learning and absorption of advantages from modern technologies and biomedicine to transform as part of TCM,and then,to expatiate with TCM language.It is especially important in the promotion of TCM theory innovation and clinical guidance of TCM practice.This paper overviewed the common points between TCM and modern medicine from the aspects of balance and steady state of organism,zangfu-organ relationship,etiology and pathogenesis,syndrome differentiation methods,compatibility of Chinese herbal medicine and formula,medicinal properties and pharmacology,etc.The feasibility of applying modern medicine in the interpretation of TCM and its development prospects was expatiated.It provided new ideas and new methods in TCM development.