ObjectiveThis paper aims to investigate and evaluate the staged efficacy and safety of the representative empirical prescription of the “Zhu Ke Jiao” theory， Qijia Rougan prescription， combined with entecavir in the treatment of hepatic fibrosis in chronic hepatitis B. MethodsA multicenter randomized controlled clinical study was conducted， and 101 patients diagnosed with chronic hepatitis B-related hepatic fibrosis （CHB-HF） who met the diagnosis and inclusion criteria were randomly assigned to an observation group （Qijia Rougan prescription + entecavir） and a control group （entecavir）. The treatment duration was 24 weeks. Liver stiffness measurement （LSM）， fibrosis-4 index （FIB-4）， portal vein diameter， hepatitis B serology， biochemical indicators， hepatic fibrosis markers in serum ［hyaluronic acid （HA）， laminin （LN）， procollagen Ⅲ peptide （PⅢP）， and type Ⅳ collagen （Ⅳ-C）］， and traditional Chinese medicine syndrome scores were used as efficacy evaluation indicators. Efficacy assessments and explorations of different staged subgroups of Qijia Rougan prescription were conducted according to LSM values based on the Metavir pathological staging standard. ResultsA total of 98 cases were included for statistical analysis， with 49 cases in the observation group and 49 in the control group. The general data of the patients in both groups were comparable. Compared with the same group before treatment， the observation group showed a significant reduction in LSM and FIB-4 （P<0.01）， as well as notable improvements in LN， Ⅳ-C， and various TCM syndrome scores （P<0.05， P<0.01）. When compared to the control group after treatment， the observation group demonstrated significant improvements in LSM， FIB-4， and various TCM syndrome score indicators （P<0.05， P<0.01）， indicating that the observation group performed better than the control group. Subgroup analysis of the regression of hepatic fibrosis stages showed that compared to the same group before treatment， the observation group had better improvement in regression of stages F2 and F3 （P<0.05）. When compared to the control group after treatment， the observation group exhibited superior improvement in regression of stage F3 （P<0.05）. No adverse events occurred in either group during the treatment period. ConclusionCompared with entecavir alone， the combination of Qijia Rougan prescription and entecavir significantly improves the degree of hepatic fibrosis and clinical TCM symptoms in patients. The optimal intervention period is primarily during stage F3， which is a potential “interception” point of the “Zhu Ke Jiao” theory.

BackgroundPatients with colorectal cancer are frequently comorbid with depression， which severely affects the quality of life and treatment compliance， while compromising the efficacy of anticancer treament and prognosis. Current therapeutic strategies still have notable limitations， particularly the lack of systematic and targeted synergistic regimens that integrate oncological management and anti-depressive intervention. It is of great clinical significance to explore a safe and effective new comprehensive intervention protocol and clarify its underlying mechanism of action. ObjectiveTo explore the effectiveness and safety of Shugan Yunpi Decoction in alleviating depressive and anxiety symptoms in colorectal cancer patients with depressive disorder through the PI3K-AKT signaling pathway， in order to provide references for the comprehensive treatment of colorectal cancer and depressive disorder. MethodsThis study was a randomized controlled trial. A total of 106 patients admitted to the Baoding No.1 Hospital of traditional Chinese medicine from November 2023 to July 2025 were enrolled， who met the diagnostic criteria for the Chinese protocol of diagnosis and treatment of colorectal cancer （2023 edition） and the diagnostic criteria for depressive disorder as specified in the Chinese Classification and Diagnostic Criteria of Mental Disease， third edition （CCMD-3）. Patients were divided into the study group and the control group using a random number table， with 53 cases in each group. The control group received conventional chemotherapy combined with traditional Chinese medicine five-element music therapy， while the study group received conventional chemotherapy combined with Shugan Yunpi Decoction therapy. Both groups were treated for 8 weeks. Depressive and anxiety symptoms were assessed using the Hamilton Depression Scale-17 item（HAMD-17） and Hamilton Anxiety Scale （HAMA）， respectively. Western blot protein immunoblotting was used to detect the expression levels of PI3K， AKT， and pAKT. Real-time fluorescence quantitative reverse transcription polymerase chain reaction （qRT-PCR） was used to detect the expression levels of PI3K mRNA and AKT mRNA. Adverse reactions were recorded using a self-designed adverse reaction record form. ResultsRepeated measures analysis of variance showed that the time effects （F=139.336， 234.747）， group effects （F=43.900， 101.266）， and time-group interaction effects （F=13.409， 43.216） for HAMD-17 and HAMA scores in both groups were statistically significant （P<0.01）. After 4 and 8 weeks of treatment， the HAMD-17 and HAMA scores in both groups were lower than those before treatment， with statistically significant differences （P<0.05）. HAMD-17 and HAMA scores in the study group were lower than those in the control group （P<0.05）. The time effects （F=571.356， 309.266， 414.492）， group effects （F=6.901， 26.361， 39.362）， and time-group interaction effects （F=18.592， 19.266， 33.484） for the protein expression levels of PI3K， AKT， and pAKT in both groups were all statistically significant （P<0.01）. After 8 weeks of treatment， the protein expression levels of PI3K and pAKT in the study group were lower than those in the control group， while the AKT protein expression level was higher than that in the control group（P<0.01）. The time effects （F=338.555， 225.059）， group effects （F=5.429， 9.726）， and time-group interaction effects （F=12.953， 21.214） for PI3K mRNA and AKT mRNA expression levels in two groups were all statistically significant （P<0.01）. After 8 weeks of treatment， the expression levels of PI3K mRNA and AKT mRNA in the study group were lower than those in the control group （P<0.05）. The incidence of adverse reactions in the study group was lower than that in the control group （χ²=4.810， P<0.05）. ConclusionShugan Yunpi Decoction may help to ameliorate depressive and anxiety symptoms in colorectal cancer patients with depressive disorder by regulating the PI3K-AKT signaling pathway， decreasing the levels of PI3K， pAKT， PI3K mRNA， and AKT mRNA， with a favorable safety profile. ［Funded by Baoding City Science and Technology Planning Project （number， 2341ZF291）］

By systematically analyzing the bottlenecks in current traditional Chinese medicine （TCM） efficacy evaluation， this study addresses the limitations of TCM efficacy assessment methods in terms of individualization， holism， and complexity representation. Drawing on the concepts and methodologies of evidence-based medicine and systems biology， this paper proposes a new evaluation path by integrating multidisciplinary technologies such as big data， artificial intelligence （AI）， omics techniques， and bioinformatics， and encompassing from foundational data， individualized evaluation， and mechanistic analysis to evidence translation. The path first integrates real-world data， multi-omics profiling， and dynamic monitoring via smart devices to construct a high-dimensional dynamic data foundation. Subsequently， leveraging this foundation， it combines digital twins， dynamic symptom networks， and reinforcement learning to develop a dynamic efficacy evaluation method based on individual self-reference， enabling a shift from group mean comparisons to individual potential outcome comparisons. Furthermore， adopting the systems biology paradigm， it employs dynamic omics monitoring and deep learning models to dissect the synergistic mechanisms of TCM compound prescriptions from network regulation， emergent effects， and dynamic evolution dimensions. Finally， it enhances real-world evidence strength through target trial emulation and causal inference， achieving model iteration via incremental learning. This path aims to advance efficacy evaluation from "point validation" to "systematic characterization" and from "outcome assessment" to "process mechanism elucidation，" providing methodological support for the modernization of TCM.

Objective: To investigate the indoor radon concentration and its distribution characteristics in residential buildings in Wuxi City, Jiangsu Province, so as to provide the evidence for indoor radon risk assessment and health protection. Methods: From April to September 2023, a stratified random sampling method was used to select 120 residential units from 6 districts (cities) in Wuxi City as measurement points, with monitoring conducted over a period of 3 months. Additionally, 27 residential units were selected for monitoring at the same location in both spring and summer. Sampling was performed using Rn-2012 passive cumulative radon cups, and radon concentration was measured using the TASLimage solid state nuclear track detector etching measurement and analysis system after etching. Indoor radon concentrations were analyzed by region, floor level, season, and building age, and the annual effective dose attributable to indoor radon was estimated. Results: The mean indoor radon concentration in Wuxi City was (62.43±40.41) Bq/m3. Twelve measurement points (10.00%) had radon concentrations >100 Bq/m3. The average annual effective dose to the public from indoor radon was 2.04 mSv. The mean indoor radon concentrations in Binhu District, Liangxi District, Xinwu District, Huishan District, Xishan District, and Yixing City were (68.13±41.13), (42.63±24.86), (70.00±40.37), (41.97±24.52), (65.50±48.44), and (56.04±27.49) Bq/m3, respectively, with no statistically significant difference (P>0.05). The median indoor radon concentrations for floors 1-5, 6-9, 10-20, and >20 were 49.20 (interquartile range, 29.68), 67.60 (interquartile range, 62.00), 76.09 (interquartile range, 49.65), and 48.26 (interquartile range, 17.27) Bq/m3, respectively, with no statistically significant difference (P>0.05). Among the 27 measurement points, the mean summer indoor radon concentration was (96.86±13.01) Bq/m3, which was significantly higher than that in spring (59.00±10.20) Bq/m3 (P<0.05). The median radon concentration for residential buildings constructed between 1990 and 2009 was 48.00 (interquartile range, 33.92) Bq/m3, and that for buildings constructed between 2010 and 2023 was 53.80 (interquartile range, 41.25) Bq/m3, with no statistically significant difference (P>0.05). Conclusions The mean indoor radon concentration in residential buildings in Wuxi City is below the national annual average radon concentration target level. However, the annual effective dose to the public attributable to indoor radon is relatively high. Attention should be paid to the effects of building material type, seasonal variation, and ventilation conditions on radon concentration.

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

Allergen-specific immunotherapy（AIT） remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis（AR）. Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group（CRRCG） convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans ; Allergens/immunology* ; China ; Consensus ; Desensitization, Immunologic ; Immunoglobulin E ; Quality of Life ; Rhinitis, Allergic/therapy* ; Treatment Outcome ; East Asian People

Objective:To study the diagnostic value and correlation of contrast-enhanced ultrasound time-intensity curve in the main pathological features of cervical cancer.Methods:From August 2021 to August 2023, 100 patients with cervical cancer and 100 patients with benign cervical tumors examined in Dingzhou People’s Hospital were selected for study. Patients with benign cervical tumors were included in the control group, and patients with cervical cancer were included in the observation group.The two groups of patients were examined by PHILIPS EPIQ7 C color Doppler ultrasound diagnostic instrument and PHILIPS EPIQ5 color Doppler ultrasound diagnostic instrument to obtain the quantitative parameters of the time-intensity curve of the two groups. The bivariate Spearman correlation test was used to analyze the main pathological features of cervical cancer patients (lesion diameter, pathological type, vascular invasion, lymph node metastasis, differentiation degree, clinical stage) and the correlation between radiotherapy and chemotherapy and the acquisition of time-intensity curve. The receiver operating characteristic curve (ROC) was drawn to analyze the diagnostic value of the time-intensity curve.Results:The time to peak (TTP) value of the cervical cancer group was lower than that of the control group, and the peak intensity (PI) and maximum peak intensity ratio (PI/PIc) values were higher than those of the control group, the differences were statistically significant ( P<0.05). Compared with patients with non-squamous cell carcinoma, vascular invasion < 1/2, no lymph node metastasis, moderate to high differentiation, stage I-II, and after radiotherapy and chemotherapy, patients with squamous cell carcinoma, vascular invasion ≥ 1/2, lymph node metastasis, low differentiation, stage III-IV, and before radiotherapy and chemotherapy had lower TTP values, higher PI and PI/PIc values, and the differences were statistically significant ( P<0.05). Pathological type, vascular invasion, lymph node metastasis, differentiation degree and clinical stage were negatively correlated with TTP, and positively correlated with PI and PI/PIc ( P<0.05) .Chemoradiotherapy was positively correlated with TTP, and negatively correlated with PI and PI/PIc ( P<0.05). The sensitivity and specificity of combined detection of time intensity curve were higher than those of TTP, PI, PI/Ic, area under curve (AUCTC) and mean transit time (MTT), and the differences were statistically significant ( P<0.05). The AUC values of combined detection of TTP, PI, PI/PIc and time intensity curve were all > 0.85, and the diagnostic value was high. Conclusions:The time-intensity curve of contrast-enhanced ultrasound is closely related to the main pathological features of cervical cancer, such as pathological type, lymph node metastasis and staging. According to the changes, the effect of radiotherapy and chemotherapy can be judged, which can provide a good reference for the diagnosis and treatment of cervical cancer.

Objective:To investigate the clinical characteristics, prognosis, and the impact of different secondary prevention strategies on stroke recurrence in patients with carotid web (CaW)-associated acute anterior circulation large vessel occlusion (LVO).Methods:A retrospective analysis was conducted on 401 patients with acute anterior circulation LVO who underwent mechanical thrombectomy at 2 advanced stroke centers, Xingtai Central Hospital and Xingtai People′s Hospital, from January 2018 to June 2024. CaW was identified using digital subtraction angiography (DSA) and other imaging modalities. Based on the presence of CaW, patients were divided into CaW group and non-CaW group. Differences between the 2 groups in baseline characteristics, clinical features, and clinical outcomes were compared, and long-term follow-up was conducted for the CaW group.Results:Among the 401 patients, the CaW group consisted of 16 patients (4.0%), while the non-CaW group included 385 patients (96.0%). Compared to the non-CaW group, patients in the CaW group were younger [53 (46, 58) years vs 65 (56, 76) years, Z=-3.811, P<0.001], had a higher proportion of M1 segment middle cerebral artery occlusion [13/16 vs 54.0% (208/385), χ2=4.602, P=0.032] and a lower proportion of internal carotid artery terminus occlusion [1/16 vs 40.0% (154/385), χ2=6.024, P=0.014]; the 90-day modified Rankin Scale (mRS) score was significantly lower in the CaW group [1.00 (0, 1.75) vs 3.00 (1.00, 4.00), Z=14.210, P<0.001], and the proportion of patients with favorable functional independence (mRS score 0-2) was significantly higher [15/16 vs 45.7% (176/385), χ2=12.350, P<0.001] in the CaW group; the incidence of pneumonia in the CaW group was significantly lower [2/16 vs 42.6% (164/385), χ2=4.562, P=0.033]. Among the 16 CaW patients, 10 received antiplatelet therapy, 4 underwent carotid artery stenting (CAS), and 2 underwent carotid endarterectomy (CEA). During a median follow-up of 29 months, patients who underwent CAS and CEA had no stroke recurrence, while 2 patients who received antiplatelet therapy had stroke recurrence and subsequently underwent CAS and CEA. Conclusions:The proportion of CaW among patients with acute anterior circulation LVO was 4.0%. The patients with CaW were younger and had a higher proportion of M1 segment middle cerebral artery occlusion. Following mechanical thrombectomy, patients in the CaW group had good functional outcomes. Simple drug therapy may be insufficient to prevent stroke recurrence in CaW patients, and CAS and CEA may be effective therapeutic options.

Objective:To analyze the incidence, clinical characteristics, and prognosis of basilar artery occlusion (BAO) patients presenting with paroxysmal sympathetic hyperactivity (PSH) as an initial symptom.Methods:A retrospective analysis was conducted on BAO patients with PSH manifestations who received endovascular treatment at Xingtai Central Hospital between January 2018 and August 2024. Demographic characteristics, clinical data, imaging findings, and follow-up information were collected.Results:A total of 136 BAO patients were included, of whom 22 cases (16.2%) were diagnosed with PSH. The age of the patients was (56.81±9.92) years, with males accounting for 86.4%(19/22). On admission, the Glasgow Coma Scale score was 4(3, 5), and the National Institutes of Health Stroke Scale score was 30(25, 35). The successful reperfusion (modified Thrombolysis In Cerebral Infarction 2b-3) rate was 90.9%(20/22). In-hospital mortality was 50.0%(11/22), symptomatic hemorrhagic transformation occurred in 4.5% (1/22), and any type of intracranial hemorrhage occurred in 9.1%(2/22). Clinical features of PSH included tachycardia, tachypnea, hypertension, fever, diaphoresis, and increased muscle tone. Imaging analysis showed a high proportion of cerebellar (100.0%, 22/22) and midbrain (72.7%, 16/22) involvement. The 90-day follow-up showed that 72.7%(16/22) of the patients had poor functional outcomes (modified Rankin Scale score of 4-6), and the 90-day mortality rate was 59.1%(13/22).Conclusions:Among patients with BAO undergoing endovascular therapy, the incidence of PSH as the initial manifestation was 16.2%(22/136). These patients were predominantly middle-aged men and commonly presented with tachycardia, tachypnea, hypertension, fever, diaphoresis, and increased muscle tone. Imaging findings mainly involved the cerebellum and midbrain. Despite a relatively high rate of recanalization, patients with PSH exhibited a higher risk of mortality and poor functional outcomes.

Objective To explore the predictive value of transforming growth factor beta 1(TGF-β1),chromobox homolog 7(CBX7),and soluble urokinase type plasminogen activator receptor(suPAR)for post-operative recurrence of cervical intraepithelial neoplasia after cervical conization.Methods A total of 200 pa-tients with cervical intraepithelial neoplasia admitted to the hospital from April 2020 to June 2023 were select-ed as the research subjects.All patients were treated with cervical conization.All patients were followed up for one year.According to the postoperative recurrence of cervical intraepithelial neoplasia patients after cervical conization,they were divided into the recurrence group and the non-recurrence group.Univariate and multiva-riate Logistic regression analyses were conducted to analyze the risk factors influencing the postoperative re-currence of cervical intraepithelial neoplasia after cervical conization.The receiver operating characteristic(ROC)curve was drawn to analyze the value of TGF-β1,CBX7 and suPAR in predicting the postoperative re-currence of cervical intraepithelial neoplasia after cervical conization.A nomogram model for predicting the postoperative recurrence of cervical intraepithelial neoplasia after cervical conization was established using R software and verified both internally and externally.The calibration curve and decision curve were used to ana-lyze the calibration ability and application value of the nomogram.Results The levels of TGF-β1,CBX7 and suPAR in the recurrence group were all higher than those in the non-recurrence group,and the difference was statistically significant(P<0.05).The results of multivariate Logistic analysis showed that TGF-β1,CBX7,and suPAR were all risk factors for postoperative recurrence of cervical intraepithelial neoplasia after cervical conization(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of the combined prediction of TGF-β1,CBX7,and suPAR for the postoperative recurrence of cervical intraepithelial neoplasia after cervical conization was higher than AUC of the individual detection of each index(Z=3.554,2.311,2.520,P<0.05).The correction curve of the nomogram model for predicting the postoperative recur-rence of cervical intraepithelial neoplasia after cervical conization approached the ideal curve(P=0.298,0.687).Conclusion The combination of TGF-β1,CBX7 and suPAR has certain value in predicting the postoperative recurrence of cervical intraepithelial neoplasia after cervical conization.