ObjectiveTo evaluate the efficacy and possible mechanism of Wei's Huoxue Tongluo Formula （韦氏活血通络方，WHTF） in treating atrophic-stage non-arteritic anterior ischemic optic neuropathy （NAION） with qi deficiency and blood stasis. MethodsA total of 82 atrophic-stage NAION patients with qi deficiency and blood stasis were randomly divided into a treatment group and a control group， with 41 cases in each group. The treatment group was given oral administration of WHTF twice a day plus acupoint injection of distilled water 2 ml at Taiyang （EX-HN5） once daily， while the control group received injection of compound anisodine injection 2 ml at Taiyang （EX-HN5） once daily and oral administration of WHTF placebo twice a day. Both groups received treatment for a course of 14 days. The best-corrected visual acuity （BCVA）， optic disc perfusion density （PD）， flux index （FI）， macular superficial PD， vascular density （VD）， and traditional Chinese medicine （TCM） syndrome scores were compared between groups before treatment and on day 7 and day 14 of treatment. Additionally， mean defect （MD） and mean sensitivity （MS） of visual fields were measured before treatment and on day 14， along with safety evaluation. ResultsAfter treatment， both groups showed significant improvement in BCVA， visual field MD and MS， and TCM syndrome scores （P＜0.05 or P＜0.01）. On day 14 of treatment， the TCM syndrome score in the treatment group was significantly lower than that in the control group （P＜0.05）. There was no significant improvement in optic disc PD and FI， and macular superficial PD and VD after treatment in either group （P＞0.05） except that on day 7 the macular superficial foveal PD in the control group was significantly better than that in the treatment group （P＜0.05）. During the treatment period， no serious adverse events occurred in either group. ConclusionWHTF can improve the visual function indicators including visual acuity and visual field， as well as TCM syndrome scores in atrophic-stage NAION patients with qi deficiency and blood stasis. It shows clinical safety， although it does not appear to have a significant effect on optic disc or macular blood flow.

To analyze the standard establishment approach and compilation rationale for metallic pharmaceutical packaging standard development in the 2025 edition of the Pharmacopeia of the People's Republic of China.This article systematically explained the background and process of establishing the guiding principles for metallic materials and containers used in pharmaceutical packaging in the Chinese Pharmacopoeia through basic information,relevant domestic and international standards,the establishment of key quality attributes of metallic pharmaceutical packaging materials,and the construction of metallic pharmaceutical packaging material standards.The newly established guidelines,the Pharmacopeia of the People's Republic of China 9625,prioritized product critical quality attributes(CQAs)and real-world applicability.This dual emphasis on rigidity and adaptability enhances drug safety,meets the regulatory requirements,and promotes the globalization and scientific advancement of China's pharmaceutical packaging industry.

Objective To investigate the association between lipoprotein(a)[Lp(a)]and the incidence and severity of coro-nary artery disease(CAD)among the young population.Methods A total of 2202 patients,aged 45 years or younger,who under-went coronary angiography,were included in this study.Clinical data were collected from a large data platform in the hospi-tal.Univariate and multivariate logistic regression analyses were used to evaluate the association between Lp(a)and CAD,mul-tivessel CAD,and high Gensini scores.Subgroup analyses were conducted to evaluate the heterogeneity of the association be-tween Lp(a)and CAD,multivessel CAD,and high Gensini scores under different clinical risk factors.Results In the overall population,after adjusting for confounding factors,when Lp(a)was treated as a continuous variable,Lp(a)levels were signifi-cantly positively associated with the incidence of CAD[OR(95％CI):1.21(1.10-1.33),P＜0.01],multivessel CAD[OR(95％CI):1.41(1.26-1.58),P＜0.01],and high Gensini scores[OR(95％CI):1.22(1.10-1.36),P＜0.01].When Lp(a)was treated as a categorical variable,with the first quartile(Q1)as the reference,the fourth quartile(Q4)of Lp(a)was significantly associated with the incidence of CAD[OR(95％CI):1.56(1.19-2.03),P＜0.01],multivessel CAD[OR(95％CI):2.32(1.71-3.14),P＜0.01],and high Gensini scores[OR(95％CI):1.62(1.20-2.18),P＜0.01].Subgroup analyses showed the inter-action between Lp(a)and low-density lipoprotein cholesterol(P for interaction＜0.05),as well as Lp(a)and high-density lipo-protein cholesterol(P for interaction＜0.01)in multivessel CAD.Conclusion In the overall young population,Lp(a)is signifi-cantly associated with the incidence and severity of CAD,independent of traditional risk factors and conventional lipids,emphasi-zing the importance of early detection and early intervention of Lp(a).

Objective Based on the national drug sampling inspection program,this study aims to comprehensively and systematically evaluate the quality of Xuanmai Ganjie preparations,analyze existing quality issues,and provide references and suggestions for quality control of this variety.Methods A total of 237 batches of Xuanmai Ganjie preparations were tested using legal standards,and methods were established for detecting adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels,and determining the content of platycodin D in Xuanmai Ganjie preparations.These methods were applied to the quality control and evaluation of Xuanmai Ganjie preparations.Results Through statutory inspection,one batch of Xuanmai Ganjie granules was found non-compliant.Specific batches were identified to contain the following irregularities:adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels exceeding proposed limits,and platycodin D content below the established threshold.Conclusion The overall quality of Xuanmai Ganjie granules was average,while the overall quality of Xuanmai Ganjie capsules and lozenges was relatively good.Manufacturing enterprises should strengthen their sense of primary responsibility and enhance control over the entire drug production process.

The academic literature on near-infrared brain functional imaging in the field of resuscitation medicine published in the Web of Science core collection,MEDLINE and PubMed databases from January 2006 to May 2025 were collected,which underwent statistical and visualized analyses with CiteSpace and VOSviewer software in terms of annual publication trends,authors,countries/regions,institutions,co-cited literature and keyword co-occurrence,clustering and emergence.It was pointed out that the overall number of publications in this research field had been on the rise in the past two decades.Stroke patients were the core research group in this field,and cortical activation mechanisms had always been the focus of research.Motor imagery was a high-frequency research content in this field,and multimodal technology integration was the trend of research in this field.New research ideas and methods were provided for relevent research in the field of rehabilitation medicine in China.

Objective:To investigate the safety, feasibility, and efficacy of pneumoperitoneum-assisted laparoscopic thyroidectomy via the subclavian approach (PSTSA) .Methods:Retrospective analysis of the clinical data of 24 papillary thyroid carcinoma (PTC) patients who underwent PSTSA,from Nov. 1,2024 to Dec. 31,2024 in Zhongshan Hospital of Xiamen University was performed. Data including the maximum tumor diameter,surgical duration,volume of drainage fluid,number of lymph nodes cleared,postoperative complications,cosmetic outcomes, and total hospitalization time were recorded.Results:All 24 cases were preoperatively diagnosed with PTC, with 12 female and 12 male patients.All cases were successfully completed without conversion to open surgery.The maximum tumor diameter in the pathological sections was 0.51±0.21 cm,the surgical duration was 71.54±11.62 minutes, the number of central compartment lymph nodes retrieved was 6.29±2.82 units,and the number of positive lymph nodes was 0.46±0.93.No CO2 gas embolism occurred during the surgery,and no postoperative complications such as hoarseness,numbness of hands and feet,or postoperative bleeding were observed.Conclusions:Pneumoperitoneum-assisted laparoscopic thyroidectomy via the subclavian approach (pneumoperitoneum-assisted laparoscopic thyroidectomy via the subclavian approach, PSTSA) is a safe and feasible surgical method for thyroidectomy.

Objective:To analyse the role of economic toxicity on anxiety symptoms in maintenance hemodialysis (MHD) patients, in order to provide reference for reducing anxiety symptoms and improving mental health literacy in MHD patients.Methods:This was a cross-sectional survey. A convenience sampling method was used to select MHD patients from Hangzhou Second People's Hospital Affiliated to Hangzhou Normal University and Deqing Hospital Affiliated to Hangzhou Normal University as the study subjects. The General Information Questionnaire, Economic Toxicity Composite Rating Scale, Family Resilience Questionnaire, Chronic Disease Management Self-Efficacy Scale, Social Support Rating Scale, and Self-rating Anxiety Scale were applied.The pathway of economic toxicity on anxiety symptoms in MHD patients was analyzed by AMOS26.0.Results:A total of 290 questionnaires were distributed, and 274 valid questionnaires were collected, with an effective response rate of 94% (274/290). Among the patients, there were 153 males and 121 females, aged (62.35 ± 12.57) years. The patients' economic toxicity score was (23.07 ± 5.36) points and anxiety symptom score (54.65 ± 17.31) points. The structural equation model was well fitted with χ2/ df=1.452, root mean square error of approximation was 0.041,goodness-of-fit index was 0.946,comparative fit index was 0.982, incremental fit index was 0.983, Tucker-Lewis index was 0.978. The results of the path analysis showed that economic toxicity in patients with MHD directly predicted anxiety symptoms, with an effect size of 36.4%; self-efficacy, family resilience, and social support played a significant role in the pathway between economic toxicity and anxiety symptoms pathways, with effect sizes of 23.4%, 27.4%, and 12.8%, respectively. Conclusions:Economic toxicity and anxiety symptoms in MHD patients are at risk values, and economic toxicity can directly affect anxiety symptoms, or indirectly through the mediating role of self-efficacy, family resilience, and social support.

Objective To explore the application effect of promoting excellence and reflective learning in the full-process situational simulation training of team collaboration in the emergency departments,and to provide a reference for cultivating clinical nursing talents.Methods Stratified random sampling combined with sequential substitution method was adopted to conduct situational simulation training for 56 nurses in the emergency department from October to December 2024.The method of promoting excellence and reflective learning was used for guiding feedback,including 5 steps:pre-feedback,response,description,analysis,and summary.The clinical reasoning and reflection ability,clinical practice ability and teamwork ability of nurses were compared before and after the training.Results After the training,nurses improved in all dimensions of clinical reasoning and self-assessment ability of reflection(P＜0.001).The theoretical examination and team operation assessment scores of nurses were improved compared with those before the training(P＜0.001).The leadership,teamwork ability,overall evaluation and total score of nurses were all improved compared with those before the training(P＜0.05).Conclusion The use of promoting excellence and reflective learning for training in the scenario simulation of team collaboration in the emergency departments is helpful to improve nurses' clinical reasoning and reflection ability,clinical practice ability and teamwork ability

Objective To compare the impact of NaClO and EDTA pretreatment on the enamel surfaces pore exposure rate,resin in-filtration effectiveness and shear bond strength between the enamel white spot lesions(WSLs)and resin composite.Methods A total of 104 sound premolars were selected for the study.4 mm×4 mm×2 mm enamel blocks from 64 sound premolars were cut in the center of the buccal surfaces of the teeth.All blocks were randomly divided into five groups:group SE(sound enamels as negative control);group DE(enamel blocks demineralised as positive control);group RI(resin infiltration);group N/RI(5.25％NaClO pretreatment and resin infiltration)and group E/RI(17％EDTA pretreatment and resin infiltration).The pore exposure rate of enamel surfaces and resin penetration depths were observed by scanning electron microscopy(SEM)and confocallaser scanning microscopy(CLSM)in each group.The remaining 40 premolars were cut from the cervical roots and the residual crowns were embedded in self-condensing resin ma-terial(buccal surfaces of the enamel exposed only).According to the grouping information,the samples were given the corresponding pretreatments and resin infiltration respectively and were bonded with a cylindrical resin cylinder on the buccal enamel surface for shear bond test.The shear bond strength and fracture modes were recorded and analyzed in each group.Results Compared to group RI,the pore exposure rate of the enamel surface,resin penetration depths,and percentage of resin penetration area in the N/RI and E/RI groups were significantly increased(P＜0.05).The shear bond strength of the samples in group SE was the highest,and the lowest in group DE.Compared to group DE,the shear bond strength in groups RI,N/RI,and E/RI was significantly increased(P＜0.05).Con-clusion Enamel surface pretreatment with 5.25％NaClO or 17％EDTA has been demonstrated to effectively enhance the enamel pore exposure rate,resin penetration depth and the shear bond strength between WSLs and resin composite.

Medical therapy and surgical intervention are the two primary approaches for treating myocardial bridge.However,there remains controversy regarding the use of coronary artery bypass grafting(CABG)and myocardial bridge unroofing.Here,we report a case of myocardial infarction following CABG in a patient with a myocardial bridge.The patient was admitted to Lanzhou First Peopie's Hospital with persistent chest pain,chest tightness,and shortness of breath lasting 2 hours.Physical examination revealed no significant abnormalities.Electrocardiography(ECG)indicated extensive anterior wall myocardial infarction.Laboratory findings showed myoglobin levels of 140.1 ng/ml and troponin Ⅰ levels of 2.59 ng/ml,with no other significant abnormalities.The initial diagnosis was acute extensive anterior wall myocardial infarction.Emergency coronary angiography revealed a myocardial bridge in the mid-segment of the left anterior descending artery(LAD).Emergency CABG using the left internal mammary artery to the LAD was performed,leading to symptomatic improvement,and the patient was discharged in stable condition.However,the patient experienced a recurrent myocardial infarction seven years post-surgery and received secondary preventive medical therapy.The patient is currently under ongoing follow-up care.CABG is an effective treatment for myocardial bridge.However,based on the case reported in this study,we recommend careful evaluation of whether a patient may benefit from CABG.