ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

Objective:To evaluate the value of ultrasound radiomics combined with machine learning for early diagnosis of seronegative Hashimoto’s thyroiditis (SN-HT) .Methods:This retrospective study included 164 patients from Liaoning Provincial People’s Hospital , Lixin County People’s Hospital, Linghai Dalinghe Hospital, Fengcheng Phoenix Hospital, who underwent thyroidectomy for solitary nodules with normal thyroid function between Nov. 2016 and Jan. 2024. Postoperative pathology confirmed Hashimoto’s thyroiditis (HT) in some cases, who were further categorized into antibody-positive and antibody-negative groups based on serum antibody status. Patients without Hashimoto’s thyroiditis served as the control group. A total of 298 ultrasound images were analyzed. Radiomics features were extracted from hypoechoic non-nodular areas within 0.5 cm surrounding the tumor. Two senior pathologists and two senior ultrasound physicians independently assessed lymphocytic infiltration, eosinophilic changes of follicular epithelium, and the proportion of hypoechoic areas in pathology and ultrasound images, respectively. A machine learning model, CCH-NET, was developed using linear regression and t-distributed stochastic neighbor embedding (t-SNE) techniques. The dataset was divided into a training set (80%) and a validation set (20%) to compare the diagnostic accuracy of CCH-NET with that of senior ultrasound physicians. Results:In internal validation, CCH-NET achieved a diagnostic accuracy of 88.89% for both antibody-positive and antibody-negative groups, significantly higher than the 66.67% accuracy of senior ultrasound physicians ( P<0.01). In external validation, CCH-NET achieved 75.00% and 66.67% accuracy for the two groups, compared to 50.00% by senior ultrasound physicians. For the control group, both methods achieved 93.33% accuracy. The AUC of CCH-NET was 0.848, outperforming senior ultrasound physicians (0.681) ,demonstrating superior diagnostic performance. Conclusion:The radiomics-based CCH-NET model, using non-nodular hypoechoic areas as a specific indicator, can accurately identify early SN-HT in euthyroid patients. It significantly outperforms senior ultrasound physicians, improving diagnostic accuracy and reducing missed diagnoses.

Objective To observe the effect of Shaoyao Gancao decoction combined with electroacupuncture on poststroke spasticity in rats.Methods Healthy male Sprague-Dawley(SD)rats were randomly divided into blank group,model group,electroacupuncture group,baclofen group,electroacupuncture combined with high dose of Chinese medicine group,electroacupuncture combined with middle dose of Chinese medicine group,electroacupuncture combined with low dose of Chinese medicine group,high dose of Chinese medicine group,middle dose of Chinese medicine group and low dose of Chinese medicine group,with 10 rats in each group.Open field test and integrated electromyography of quadriceps femoris were tested before modeling and on the 1st,3rd and 6th day after modeling.The samples were taken on day 6.The expression of inflammatory factors in M1 cortex were detected by liquid phase factor technique.The expression of brain-derived neurotrophic factor(BDNF),synaptophysin(SYP),postsynaptic density 95(PSD95),Nestin and β-catenin in M1 cortex was detected by ELISA and Western blot.Results Compared with model group and other intervention groups,the electroacupuncture combined with middle dose of Chinese medicine group make best total distance(P=0.021)and average speed(P=0.021)in open field test on 6th day.make better in integrated electromyography of quadriceps femoris test(P=0.006)on day 3,have higher Ⅱ type fiber ratio,promote IL-10(P=0.006),GMcsf(P=0.045)secretion.ELISA and Western blot also showed that this group behave better in the test of BDNF,SYP,PSD95,Nestin and β-catenin.Conclusion Electroacupuncture combined with Shaoyao-Gancao decoction groups were effective in the treatment of poststroke spasticity in rats,and its mechanism may be to improve the inflammatory environment of the injured site,promote the proliferation of neural stem cells and synaptic regeneration.

The red blood cell membrane is an important place for signaling,material transport,energy exchange and other life activities inside and outside the erythrocyte,and its function is mainly realized by the protein complexes on the membrane sur-face.Glycoproteins,integrins,signaling proteins,channel pro-teins and other proteins that constitute the erythrocyte membrane protein complexes interact with each other through direct physi-cal effects or regulatory factor-mediated mechanisms,playing a role in regulating oxygen transport,maintaining cellular morphol-ogy and stability,participating in the regulation of signaling,as well as supporting the cytoskeleton and other functions.Hemo-globin is the mediator of oxygen transport and delivery in blood erythrocytes,and regulating its conformational changes can in-crease the efficiency of oxygen supply to alleviate hypoxia in plateau hypoxia.This review describes the composition,func-tion,interaction mechanism,and adaptive regulation of hemoglo-bin to hypoxia in erythrocyte membrane protein complexes,with the aim of providing new reference for the prevention of hypoxia symptoms,the formulation of therapeutic regimens and the devel-opment of anti-hypoxia drugs.

Objective:To explore the the possibility and potential mechanism of Coptis chinensis in treating caries based on network pharmacology and molecular docking technology.Methods:The active ingredients of Coptis chinensis and the targets of the active in-gredients and caries were obtained through a variety of databases.The intersection targets of Coptis chinensis and caries were obtained by VENNY.Based on the target of the intersection,the protein-protein interaction(PPI)networks relationship diagram was formed on the STRING platform.The core target diagram was formed through the Cytoscape software,and the Coptis chinensis-active ingre-dient-target network diagram was constructed.The intersection targets are analyzed by GO and KEGG.The core targets of Coptis chinensis active ingredients in treating caries was analyzed by molecular docking.Results:The 11 Coptis chinensis active ingredi-ents,465 targets of Coptis chinensis active ingredients and 1 160 targets of caries were obtained from the database.After analysis,71 targets of Coptis chinensis-caries intersection and 12 core targets were obtained.The potential therapeutic effect of Coptis chinensis on caries involved relaxin,phosphatidylinositol 3-kinase-protein kinase B(PI3K-Akt),mitogen activated protein kinase(MAPK),ras-re-lated protein 1(RAP1)and other signaling pathways.Berberine,one of the main active components of Coptis chinense,had strong binding activity on epidermal growth factor receptor(EGFR),matrix metalloproteinase 9(MMP9)and other core targets.Coptis chinen-sis and its active components can play a role in the treatment of caries through EGFR,MMP9 and PI3K-AKT,MAPK and other path-ways.Conclusion:Coptis chinensis and its active components can regulate several targets and signaling pathways such as EGFR,MMP9,PI3K-AKT and MAPK.Coptis chinensis may play a role in the prevention and treatment of caries through multiple pathways.

Objective:To evaluate the value of ultrasound radiomics combined with machine learning for early diagnosis of seronegative Hashimoto’s thyroiditis (SN-HT) .Methods:This retrospective study included 164 patients from Liaoning Provincial People’s Hospital , Lixin County People’s Hospital, Linghai Dalinghe Hospital, Fengcheng Phoenix Hospital, who underwent thyroidectomy for solitary nodules with normal thyroid function between Nov. 2016 and Jan. 2024. Postoperative pathology confirmed Hashimoto’s thyroiditis (HT) in some cases, who were further categorized into antibody-positive and antibody-negative groups based on serum antibody status. Patients without Hashimoto’s thyroiditis served as the control group. A total of 298 ultrasound images were analyzed. Radiomics features were extracted from hypoechoic non-nodular areas within 0.5 cm surrounding the tumor. Two senior pathologists and two senior ultrasound physicians independently assessed lymphocytic infiltration, eosinophilic changes of follicular epithelium, and the proportion of hypoechoic areas in pathology and ultrasound images, respectively. A machine learning model, CCH-NET, was developed using linear regression and t-distributed stochastic neighbor embedding (t-SNE) techniques. The dataset was divided into a training set (80%) and a validation set (20%) to compare the diagnostic accuracy of CCH-NET with that of senior ultrasound physicians. Results:In internal validation, CCH-NET achieved a diagnostic accuracy of 88.89% for both antibody-positive and antibody-negative groups, significantly higher than the 66.67% accuracy of senior ultrasound physicians ( P<0.01). In external validation, CCH-NET achieved 75.00% and 66.67% accuracy for the two groups, compared to 50.00% by senior ultrasound physicians. For the control group, both methods achieved 93.33% accuracy. The AUC of CCH-NET was 0.848, outperforming senior ultrasound physicians (0.681) ,demonstrating superior diagnostic performance. Conclusion:The radiomics-based CCH-NET model, using non-nodular hypoechoic areas as a specific indicator, can accurately identify early SN-HT in euthyroid patients. It significantly outperforms senior ultrasound physicians, improving diagnostic accuracy and reducing missed diagnoses.

Objective To explore the effect of chrysin on intestinal flora in mice with alcoholic liver disease(ALD).Methods Mice were randomly assigned to normal control group,ALD model group,Silymarin group,chrysin low-dose group,chrysin high-dose group(25,50 mg·kg-1).The mice were fed with alcoholic liquid diet and a single dose of alcohol(5 g·kg-1)for eight weeks to establish the ALD model.After eight weeks of oral administration,each group's serum and plasma lipids and liver function indices were collected and detected using kits;then collected the liver and observed the pathological changes of the liver using HE staining;meanwhile,intestinal contents were collected and changes in mouse gut flora were analyzed by 16S rDNA sequencing.Results Compared with the ALD group,the level of aspartate transaminase(AST),alanine transaminase(ALT)and triacylglycerol(TG)of low-dose and high-dose chrysin groups were significantly reduced,and it can alleviate liver cell steatosis and inflammatory reactions caused by alcohol.16S rDNA results showed that the total number and types of intestinal flora in the ethanol group were significantly reduced,as well as a change in the dominant genus to Escherichia-Shigella and Akkermansia.Compared to the ALD model group,the Shannon index of the intestinal microbiota increased significantly in mice treated with low and high doses of chrysin.In addition,at the phylum and genus level,the abundance of the high-dose chrysin group increased significantly,resulting in an overall increase in the total number and amount of microbiota.The abundance of dominant bacterial groups,such as Oscillospirales,irmicutes,andAlloprevotella,was also significantly increased.Conclusion Chrysin may exert therapeutic effects on ALD by improving intestinal flora imbalance in ALD mice.

Objective:To explore the the possibility and potential mechanism of Coptis chinensis in treating caries based on network pharmacology and molecular docking technology.Methods:The active ingredients of Coptis chinensis and the targets of the active in-gredients and caries were obtained through a variety of databases.The intersection targets of Coptis chinensis and caries were obtained by VENNY.Based on the target of the intersection,the protein-protein interaction(PPI)networks relationship diagram was formed on the STRING platform.The core target diagram was formed through the Cytoscape software,and the Coptis chinensis-active ingre-dient-target network diagram was constructed.The intersection targets are analyzed by GO and KEGG.The core targets of Coptis chinensis active ingredients in treating caries was analyzed by molecular docking.Results:The 11 Coptis chinensis active ingredi-ents,465 targets of Coptis chinensis active ingredients and 1 160 targets of caries were obtained from the database.After analysis,71 targets of Coptis chinensis-caries intersection and 12 core targets were obtained.The potential therapeutic effect of Coptis chinensis on caries involved relaxin,phosphatidylinositol 3-kinase-protein kinase B(PI3K-Akt),mitogen activated protein kinase(MAPK),ras-re-lated protein 1(RAP1)and other signaling pathways.Berberine,one of the main active components of Coptis chinense,had strong binding activity on epidermal growth factor receptor(EGFR),matrix metalloproteinase 9(MMP9)and other core targets.Coptis chinen-sis and its active components can play a role in the treatment of caries through EGFR,MMP9 and PI3K-AKT,MAPK and other path-ways.Conclusion:Coptis chinensis and its active components can regulate several targets and signaling pathways such as EGFR,MMP9,PI3K-AKT and MAPK.Coptis chinensis may play a role in the prevention and treatment of caries through multiple pathways.

Objective:To extract, evaluate, and summarize evidence related to family participation in delirium management of ICU patients and provid a reference for clinical practice.Methods:A systematic search was conducted in databases such as UpToDate, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, Medlive, Cochrane Library, PubMed, Embase, CINAHL, China National Knowledge Infrastructure, and China Biology Medicine disc. The search covered clinical decisions, guidelines, expert consensus, evidence summaries, systematic reviews, and randomized controlled trials related to family participation in ICU delirium management, with a timeframe up to March 20, 2024. Two researchers independently screened literature, assessed quality, extracted evidence, and graded it.Results:A total of 28 articles were included, comprising seven evidence summaries, five guidelines, three expert consensuses, six systematic reviews, and seven randomized controlled trials. The findings were synthesized into five themes: visitation, assessment, non-pharmacological management, psychological and physical care, and health education, with a total of 26 best evidence points.Conclusions:The best evidence summarized in this study provides an evidence-based foundation for ICU healthcare providers to guide and encourage family participation in delirium management, which aida in the prevention of delirium in ICU patients.

Objective:To evaluate the efficacy of dexmedetomidine-scalp nerve block (SNB) combined with general anesthesia in the patients with acute traumatic brain injury (TBI) undergoing craniotomy.Methods:In this randomized controlled trial, 74 American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ patients of either sex with acute TBI, aged 30-78 yr, with body mass index of 18-30 kg/m 2, underwent craniotomy for hematoma evacuation combined with decompressive craniectomy at the Traditional Chinese Medicine Hospital of Kunshan from January to December 2024, of the Glasgow Coma Scale score 8-12, were selected and divided into 2 groups ( n=37 each) using a random number table method: dexmedetomidine combined with ultrasound-guided SNB group (DS group) and ultrasound-guided SNB group (S group). Before anesthesia, dexmedetomidine was infused as a loading dose of 1 μg/kg over 10 min followed by an infusion of 0.3 μg·kg -1·h -1 until the end of operation. Ultrasound-guided SNB was performed after completion of intubation in both groups. The consumption of intraoperative fentanyl, propofol and remifentanil and the usage of vasoactive drugs were recorded. Before surgery (T 0), at 1 h after the start of surgery (T 1) and at the end of surgery (T 2), blood samples from the jugular bulbar and radial artery were collected, the jugular venous oxygen saturation was recorded, the arteriovenous oxygen content and cerebral oxygen uptake rate were calculated, and the occurrence of postoperative complications was also recorded. Results:Compared with group S, the consumption of fentanyl, propofol and remifentanil was significantly reduced, the usage rate of vasoactive drugs was decreased, the arteriovenous oxygen content and cerebral oxygen uptake rate were decreased at T 1 and T 2, the jugular venous oxygen saturation was increased, and the incidence of postoperative agitation was decreased in group DS ( P<0.05). Conclusions:Dexmedetomidine-SNB combined with general anesthesia can optimize the analgesic effect, improve cerebral oxygen supply and demand, reduce the occurrence of postoperative agitation when used in patients with acute TBI undergoing craniotomy.