Objective To systematically evaluate the efficacy and safety of traditional Chinese medicine (TCM) compound in treating pulmonary nodules, providing evidence-based medical evidence for TCM intervention in pulmonary nodules. Methods Computer search of PubMed, CNKI, Wanfang, VIP, and SinoMed was conducted to select randomized controlled trials (RCTs) of TCM compound intervention in pulmonary nodules, with the retrieval time from the inception to November 29, 2023. The Cochrane bias risk assessment tool was used to evaluate the quality of the included studies, and Review Manager 5.4 was used for Meta-analysis. Results A total of 18 RCTs were included, covering 8 provinces across the country, with a total sample size of 1301 patients. The TCM compounds used in the included studies all incorporated the method of dissolving phlegm and dissipating nodules. There was a high risk of bias uncertainty in the included studies. Meta-analysis results suggested that TCM compound could significantly reduce the diameter of pulmonary nodules [MD=−1.41, 95%CI (−1.70, −1.13), P<0.001], decrease the number of nodules [MD=−0.37, 95%CI (−0.73, −0.01), P=0.05], alleviate clinical symptoms [MD=−4.84, 95%CI (−6.04, −3.64), P<0.001], and improve lung function [forced expiratory volume in one second (FEV1), MD=0.55, 95%CI (0.09, 1.01), P=0.02; FEV1/forced vital capacity, MD=6.12, 95%CI (4.47, 7.78), P<0.001]. However, there was no statistically significant difference in the probability of malignancy between the experimental group and the control group [MD=−0.01, 95%CI (−0.01, 0.00), P=0.09]. Conclusion TCM compound can significantly reduce the diameter of pulmonary nodules, decrease the number of nodules, alleviate clinical symptoms, and improve lung function, but future multicenter, large-sample, high-quality RCTs are still needed to further explore and verify this conclusion.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

By combing the mechanism of retrograde transmission of damp-heat epidemic to the pericardium,it is believed that the retrograde transmission of damp-heat epidemic to the pericardium is the transmission trend of damp-heat turbid epidemic evil from the lung wei or lung to the pericardium,and the turbid evil harming the clear is an important pathological mechanism leading to the retro-grade transmission of epidemic evil.Clinical treatment should be based on the theory of turbid evil harming the clear,and the lung qi should be disseminated to promote yang first to cut off the retrograde transmission of epidemic evil;if retrograde transmission occurs,phlegm and turbidity should be removed to promote yang,and be careful to prevent the separation of yin and yang.

OBJECTIVE:Nowadays,machine learning algorithms are gradually being applied to predict stroke and cardiovascular disease.Compared with traditional regression models,machine learning can learn from data to achieve high prediction accuracy by exploring the flexible relationship between a large number of predictive features and outcome variables,providing a new method for the formulation of individualized treatment and rehabilitation programs.This study aims to systematically evaluate stroke functional recovery and prognosis prediction models based on machine learning,comprehensively assessing their predictive performance and clinical application potential to provide references for the development,application,and promotion of related predictive models.METHODS:This review was conducted following the PRISMA(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)guidelines.Relevant literature on stroke prognosis prediction using machine learning methods was selected by searching PubMed,EMbase,Web of Science Core Collection,CNKI,WanFang,and the China Biomedical Literature Database,with the search period from January 1,2014,to July 1,2024.Two researchers independently screened the literature and extracted data based on inclusion and exclusion criteria,using the Prediction model Risk Of Bias ASsessment Tool(PROBAST)to assess model quality.RESULTS:(1)A total of 3 126 articles were obtained in the preliminary search.After screening and exclusion,18 articles were finally included.150 prediction models were constructed using 13 machine learning methods.The three most frequently used methods are Logistic Regression,Random Forest,and Extreme Gradient Boosting(XGBoost).Only one study was externally validated.Eight studies reported how the missing data were handled.(2)In terms of outcome indicators,8 studies used the combination of clinical data and imaging data to build models,9 studies only used clinical data to build models,and 1 study only used imaging data to build models.(3)Each of the 18 studies gave the most important characteristics of the study,with the most mentioned being the National Institute of Health Stroke Scale and age.All studies reported area under curve values ranging from 0.74 to 0.96,with the highest area under curve being 0.96.The overall risk of bias in all models was high.The high risk of bias in the field of model analysis was the main reason for the high risk of overall bias in all models.(4)The results of meta-analysis showed that age and National Institute of Health Stroke Scale score had significant influence on stroke prognosis,with age[MD=8.49,95％CI(6.24,10.75),P＜0.01]and National Institute of Health Stroke Scale score[MD=4.78,95％CI(2.56,7.00),P＜0.01].CONCLUSION:This study systematically evaluated the predictive model of functional recovery and prognosis of stroke based on machine learning,and all the models have good predictive potential.However,future studies should increase the sample size of the included model,adopt prospective studies,and add external validation of the model to improve the stability and prediction accuracy of the model,control the risk of bias,and contribute to the validation and promotion of the model in practical clinical applications.At the same time,the interpolation of missing values is more transparent and accurate.Although existing machine learning models show good predictive performance,it is also important to focus on the functionality and usability of the model,and the inclusion of features will reduce ease of use.We should develop easy to use model interfaces and user-friendly clinical tools to enable medical staff to better apply the model for clinical decision.

The case teaching mode,as an important practical way of teaching reform in graduate educa-tion,plays a positive role in stimulating learning interest and improving comprehensive ability.As a core course in biology,advanced immunology is characterised by the depth of its theoretical system and the boundaries of its research scope.In this paper,we first analyzed the significance and current situation of case library construction at home and abroad,and pointed out the key issues that need to be further opti-mised in the existing case teaching mode.Based on the construction strategy of"Advanced Immunolo-gy",three typical teaching cases,namely tumour treatment strategy,gene editing technology to overcome organ transplant rejection,and synthetic immunology,are selected for empirical research,focusing on graduate students' innovative ability to raise questions and solve problems.The effectiveness of teaching practice was summarized from the improvement of teachers' ability,the award-winning of students' disci-plinary competitions,and the co-construction between the university and enterprises,which has a signifi-cant effect and guarantees the benign optimization of the teaching reform of immunology,and also has the popularization value and exemplary effect on the high-quality development of immunology-related courses.

To evaluate the effectiveness of the modified post anesthesia care unit (PACU) discharge assessment tool in the field of bone oncology, in order to prevent and reduce postoperative adverse events in patients undergoing bone tumor surgery. This is a prospective controlled study. 81 bone tumor patients who underwent general anesthesia surgery in the PACU from January to December 2023 were prospectively selected as the study subjects. They were randomly divided into a control group and an intervention group using a random number table method, with 43 and 38 cases, respectively. The control group and intervention group respectively used the fast track scoring system and the improved fast track scoring system as exit assessment tools. Independent sample t-test was used to compare the duration of PACU stay, mean arterial pressure (MAP) at PACU exit, heart rate, and blood oxygen saturation (SpO 2) between two groups of patients. Chi square test was used to compare the occurrence of adverse events between the two groups. The results showed that there was no statistically significant difference between the intervention group and the control group in terms of PACU dwell time [(55.58±23.83) min vs. (46.14±21.87) min], MAP at PACU [(88.23±11.52) mmHg vs. (86.25±10.62) mmHg], heart rate [(86.25±10.62) beats/min vs. (72.93±18.86) beats/min], and SpO 2 [(99.84±0.68)% vs. (99.86±0.91)%] ( t=1.859, 0.805, 1.003, 0.101,all P>0.05). The total incidence of adverse events in the intervention group was significantly lower than the control group (68.42% vs. 90.70%, χ2=4.988, P<0.05). In conclusion, the modified fast-tracking criteria can significantly reduce the incidence of adverse events in PACU patients undergoing bone tumor surgery, but does not affect PACU dwell time and patient circulatory status.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective To evaluate the relationship between systemic inflammation makers and bone mineral density(BMD)in male patients with type 2 diabetes(T2DM).Methods A total of 261 male patients with T2DM were selected and divided into three groups based on diagnostic criteria:the normal bone mass group(96 cases),the reduced bone mass group(111 cases)and the osteoporosis group(54 cases).Differences in systemic inflammation markers and bone metabolic markers were compared between the three groups.Multivariate ordered Logistic regression analysis was used to investigate factors influencing the progression from normal bone mass to osteoporosis in male patients with T2DM.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of inflammatory markers for osteoporosis in male patients with T2DM.Correlation analysis was conducted to investigate the correlation between inflammatory markers and BMD and bone turnover markers(BTM)in male patients with T2DM.Results Platelet count(PLT),platelet-to-lymphocyte ratio(PLR),systemic inflammatory index(SII)and neutrophil-to-lymphocyte ratio(NLR)were significantly higher in the osteoporosis group than those in the normal bone mass group(P＜0.05).Multivariate ordered Logistic regression analysis showed that PLR and SII were risk factors for the progression from normal bone mass to osteoporosis in male patients with T2DM(P＜0.05).The area under the ROC curve of PLR was 0.590,and the cut-off value was 96.67.The area under the curve of SII was 0.613,with a cut-off value of 307.9,and the area under the combined curve of the above two indicators was 0.612.In patients with osteoporosis and osteopenia,SII,PLR and PLT were negatively correlated with L1-4 BMD and left hip BMD(P＜0.05).SII was also negatively correlated with left femoral neck BMD(P＜0.05).Conclusion Inflammatory markers PLR and SII have predictive values for the progression from normal bone mass to bone loss and osteoporosis in male patients with T2DM.

The case teaching mode,as an important practical way of teaching reform in graduate educa-tion,plays a positive role in stimulating learning interest and improving comprehensive ability.As a core course in biology,advanced immunology is characterised by the depth of its theoretical system and the boundaries of its research scope.In this paper,we first analyzed the significance and current situation of case library construction at home and abroad,and pointed out the key issues that need to be further opti-mised in the existing case teaching mode.Based on the construction strategy of"Advanced Immunolo-gy",three typical teaching cases,namely tumour treatment strategy,gene editing technology to overcome organ transplant rejection,and synthetic immunology,are selected for empirical research,focusing on graduate students' innovative ability to raise questions and solve problems.The effectiveness of teaching practice was summarized from the improvement of teachers' ability,the award-winning of students' disci-plinary competitions,and the co-construction between the university and enterprises,which has a signifi-cant effect and guarantees the benign optimization of the teaching reform of immunology,and also has the popularization value and exemplary effect on the high-quality development of immunology-related courses.

Objective To compare the differences of endoscopic ultrasound (EUS)-guided non-invasive measurement of portal venous pressure and EUS-guided portal pressure gradient(EUS-PPG) in measurement of portal venous pressure on animals and their correlation. Methods Twenty-four miniature pigs were selected and fed with carbon tetrachloride and phenobarbital sodium combined with high-fat,low-protein and low-choline diet for 16 weeks to establish a liver cirrhotic portal hypertension model. The changes of biochemical indexes of liver function and liver pathology in the experimental pigs were observed to evaluate whether the model was successful. After the model was successfully established,the hemodynamic parameters of the portal venous trunk were measured non-invasively under EUS guidance,including portal venous blood flow and splenic artery pulsatility index,thereby calculating portal venous pressure. Then,taking EUS-PPG,the portal vein,hepatic vein,and inferior vena cava were punctured with an 18G puncture needle under general anesthesia guided by the translinear endoscopic ultrasound,and the PPG was calculated through the central venous pressure monitoring system.The Pearson correlation analysis,Kappa test,ICC intraclass correlation coefficient and Bland-Altman plot were used for consistency analysis. Results All the 24 pigs survived 16 weeks after modeling.The serum levels of alanine transaminase (ALT),aspartate transaminase (AST),albumin (ALB),globulin (GLB),total bilirubin (TBIL) and indirect bilirubin (IBIL)after modeling were higher than those before modeling(P<0.05). HE staining and Sirius red staining showed abnormal liver morphology and increased collagen fibers after modeling,suggesting that the experimental pig model of liver cirrhotic portal hypertension was successfully established. The results of EUS-guided non-invasive measurement of portal venous pressure showed that the mean splenic artery pulsatility index was (2.03±0.68),the mean portal vein flow was (17.27±4.31)cm/s,and the mean portal venous pressure was (15.97±3.65)mmHg. The measurement results of the mean portal venous pressure,hepatic venous pres-sure and PPG of EUS-PPG were (20.68±4.71)mmHg,(4.07±2.14)mmHg and (16.38±4.28)mmHg respectively. Pearson correlation analysis showed that there was a significant positive correlation between the portal venous pressures measured by the two methods (r=0.902,P<0.001);the consistency tests of Kappa test and ICC intraclass correlation coefficient showed that the measurement results of the two methods were highly consistent (Kappa=0.699,P<0.001;ICC=0.945);Bland-Altman plot analysis showed that most of the points fell within 95％ limits of agreement. Conclusion EUS-guided non-invasive measurement of portal venous pressure has a high correlation and consistency with the measurement results by EUS-PPG,which has high success rate,and accurate reflection of portal venous pressure,with low cost and good safety.