ObjectiveTo observe the short-term and long-term efficacy of traditional Chinese medicine （TCM） surgical operations in treating mixed hemorrhoids. MethodsA multi-center retrospective cohort study was conducted， collecting clinical data from 17，831 mixed hemorrhoid surgery patients in 8 top-tier TCM hospitals in Jiangsu Province. Standardized and structured datasets were obtained through artificial intelligence models. Patients who underwent western surgical treatment were categorized into the western surgery group （11,646 cases）， and those receiving TCM surgical operations were categorized into the TCM surgery group （6185 cases）. Propensity score matching （1∶1 matching） was used to balance baseline data between groups. The primary outcome was the one-year recurrence rate， and secondary outcomes included the main symptoms （rectal bleeding， degree of prolapse） and secondary symptoms （anal distension， anal edema， wound secretion and exudation， anal stenosis， residual skin tags， perianal itching， and anal pain） measured on days 7， 28， and 60 after discharge. ResultsAfter matching， 2194 patients were included in each group. Symptom scores showed that at 28 days after discharge， the TCM surgical group had superior improvement in rectal bleeding ［OR=5.786， 95%CI （3.092，10.827）］， degree of prolapse ［OR=4.510， 95%CI （1.649，12.333）］， and anal edema ［OR=3.188， 95%CI （1.295，7.845）］ compared to the western surgical group. At 60 days post-discharge， the TCM group still showed advantages in improving rectal bleeding ［OR=5.237， 95%CI （1.077，25.464）］ and anal pain ［OR=11.697， 95%CI （1.186，115.336）］ （P＜0.05）. Long-term follow-up showed that the one-year recurrence rate in the TCM surgery group was 1.1% （8/726）， while that in the western surgery group was 2.3% （10/444）， with no statistically significant difference between the two groups （P＞0.05）. ConclusionBased on real-world data， TCM surgical treatment for mixed hemorrhoids shows significant short-term symptom improvement， particularly in terms of hemostasis， reducing swelling， and alleviating prolapse of anal masses.

ObjectiveTo construct a risk prediction model for frequent acute exacerbations of chronic obstructive pulmonary disease （COPD） under disease-syndrome combination， thus providing decision support for precise clinical intervention. MethodsA total of 2 029 patients with acute exacerbations of COPD admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2020 to August 2024 were retrospectively included. These patients were classified into groups of frequent acute exacerbations （≥2 times/year） and infrequent acute exacerbations （<2 times/year） according to the hospitalization times per year. Risk factors were screened by LASSO regression combined with logistic regression， and a nomogram model was constructed. The model performance was assessed based on the area under the curve （AUC）， calibration curves， and decision curve analysis （DCA）. ResultsThe differences in baseline characteristics between the frequent acute exacerbations group （1 196 cases） and infrequent acute exacerbations group （833 cases） were not statistically significant. LASSO regression combined with multivariate logistic regression screened the following independent risk factors： body mass index （BMI）， hospitalization days， number of smoking years， place of residence， use of noninvasive ventilators， oxygen-demanding therapy， liver cirrhosis， use of systemic glucocorticosteroids， and traditional Chinese medicine syndrome （phlegm and stasis obstructing the lung）. The nomogram model showed good discrimination and calibration in both the training set （AUC=0.748） and validation set （AUC=0.774）. ConclusionThe risk prediction model for frequent acute exacerbations of COPD， integrating traditional Chinese medicine syndrome， constructed in this study has high accuracy. It can provide a scientific basis for early clinical identification of high-risk patients and individualized intervention.

Triatoma rubrofasciata is currently the most widely distributed species of Triatoma worldwide, and it is also widespread in southern China. T. rubrofasciata has been proven to transmit Trypanosoma cruzi, and is one of vectors transmitting Chagas disease, which poses a potential risk for transmission of imported Chagas disease in China. Findings from latest studies have shown that T. rubrofasciata naturally infects T. lewisi, T. conorhini, and T. rangeli, which undoubtedly increases significant risks of and challenges to trypanosomiasis control in China. This article briefly describes the species of T. rubrofasciata-transmitted trypanosomes, and summarizes the epidemiological characteristics of trypanosomiasis, so as to provide insights into T. rubrofasciata-transmitted trypanosomiasis surveillance and control, and prevention of trypanosomiasis development and transmission in China.

BACKGROUND:It is urgent to improve the study on the molecular mechanism of Ban's Culuan Zhuyun Decoction improving oocyte quality in polycystic ovary syndrome.OBJECTIVE:To observe the effects of Ban's Culuan Zhuyun Decoction on oocyte quality in a mouse model of polycystic ovary syndrome and to explore the underlying mechanisms of its intervention in polycystic ovary syndrome.METHODS:Subcutaneous injection of dehydroepiandrosterone sulfate was used to establish the polycystic ovary syndrome model in 21-day-old female Kunming mice,and the treatment was conducted for 21 consecutive days.The estrous cycle and pregnancy was recorded.ELISA was used to detect serum sex hormone levels.The rate of apoptosis in oocytes was detected using Annexin V staining.The level of reactive oxygen species in oocytes was detected using dichlorodihydrofluorescein diacetate.The condition of spindle bodies and chromosomes in oocytes were detected using the immunofluorescence method.Network pharmacology and molecular docking were used to verify the binding properties of Ban's Culuan Zhuyun Decoction core active components and oocyte maturation-related factors(growth differentiation factor 9 and bone morphogenetic protein 15).Real-time fluorescence quantitative PCR and western blot were used to detect the mRNA and protein expression levels of growth differentiation factor 9 and bone morphogenetic protein 15 in oocytes,respectively.RESULTS AND CONCLUSION:(1)Ban's Culuan Zhuyun Decoction core active components(quercetin,kaempferol,and β-sitosterol)showed good binding activities with growth differentiation factor 9 and bone morphogenetic protein 15.(2)Ban's Culuan Zhuyun Decoction ameliorated the estrous cycle,regulated serum hormone,increased the pregnancy,decreased the rate of apoptosis,declined the level of reactive oxygen species,diminished the rate of abnormal spindle assembly and chromosome loss(P<0.01,P<0.05);and promoted the mRNA and protein expression of growth differentiation factor 9 and bone morphogenetic protein 15(P<0.05).Therefore,Ban's Culuan Zhuyun Decoction may improve the oocyte quality and increase the fertility of polycystic ovary syndrome mice by regulating the gene expression of growth differentiation factor 9 and bone morphogenetic protein 15.

To construct a subgenomic replication subsystem of foot-and-mouth disease virus(FM-DV)carrying fluorescent protein(UnaG),the full-length cDNA plasmid of FMDV was employed as the template.A few of structural and non-structural protein genes of FMDV were removed by double-enzyme digestion.By substituting reporter gene sequences expressing the green fluorescent protein UnaG for specific structural protein sequences of FMDV,FMDV-UnaG replicators were successfully created.After PCR and sequencing,linearized FMDV-UnaG replicons were transfected into BSR/T7 cells expressing T7 RNA polymerase,and the fluorescence signal was observed through fluorescence microscopy and laser confocal technique.The results demonstrated that the constructed FMDV-UnaG replicons could effectively express UnaG protein,and the protein colo-calized with FMDV 3A protein.Additionally,Western blot and RT-qPCR also detected that the replicator RNA could express the non-structural proteins of the virus and replicate autonomously in BSR/T7 cells,respectively.In conclusion,the successful construction of FMDV-UnaG sub-genomic replicators offers a favorable tool for further research on the replication and translation mechanism of FMDV and the development of vaccine vectors.

Objective To discuss the method of constructing TCM word network and the subsequent optimization method;To solve the problems of natural language processing in the TCM-clinical decision support system using TCM terminology.Methods This study was based on several national standards and terminology dictionaries of TCM,such as Zhong Yi Lin Chuang Zhen Liao Shu Yu Ji Bing Part and Zhong Yi Yao Xue Zhu Ti Ci Biao,supplemented with related corpus on the Internet,and the framework of TCM word network was constructed with ontology as the guide.Word2Vec was used to load pre-trained models for similarity calculation,statistical and rule-based new word discovery,bibliometric analysis,and other methods to add or delete concept words and synonyms such as symptom terms and prescription terms.Results The TCM word network contained 55 semantic types and 13 semantic relationships,more than 110 000 concept words,and more than 300 000 synonyms.In addition to classifying concept words by semantic types,more detailed semantic classification was carried out in the upper and lower tree structures,in which more than 30 000 concept words had superordinate words,and nearly 2 600 concept words had subordinate words.At the same time,a process-based terminology supplementation mechanism,update review mechanism and cleaning mechanism were created.Conclusion TCM word network can not only be applied to the natural language processing process of TCM-clinical decision support system,but also can be applied to the normalization of data and the automatic construction of knowledge graph.

Objective To conduct a comprehensive review on application status and future development prospects of proton therapy for pediatric medulloblastoma.Methods A total of 218 literatures were retrieved from PubMed and CNKI database using the search terms"pediatric medulloblastoma,proton therapy,radiotherapy"(English)and"儿童髓母细胞瘤,质子治疗,放射治疗"(Chinese),with a publication timeframe from January 1,2004,to June 1,2025.Inclusion criteria were as follow:(1)proton therapy for pediatric medulloblastoma;(2)radiotherapy for pediatric medulloblastoma;(3)proton therapy for pediatric brain tumors;(4)development and applications of proton therapy.Exclusion criteria were as follow:(1)outdated literatures;(2)redundant or highly similar studies.After screening,89 literatures met the inclusion criteria.Results Compared with conventional treatments such as surgery,photon therapy,and chemotherapy,proton therapy for pediatric medulloblastoma significantly reduced acute toxicity and long-term side effects including cognitive dysfunction,endocrine disorders,and hearing loss.Additionally,proton therapy exhibited favorable cost-effectiveness.In the future,the therapeutic outcomes would be further enhanced through the optimization of proton therapy techniques,treatment planning,and equipment.Conclusion With ongoing technological advancements and growing clinical experience,proton therapy is expected to become one of the standard treatment modalities for pediatric medulloblastoma.

Objective To investigate the preventive efficacy of recombinant human granulocyte-macrophage colony-stimulating factor(rhGM-CSF)combined with Kangfuxin liquid on radiation dermatitis in breast cancer patients underwent radiotherapy.Methods A total of 90 breast cancer patients were randomized into the control group(45 cases,rhGM-CSF alone)and the observation group(45 cases,rhGM-CSF+Kangfuxin liquid).Both groups received radiotherapy.The incidence of radiation dermatitis,the time of first occurrence,the healing time and severity of radiation dermatitis(graded by RTOG criteria)were compared between the two groups.Skin growth factors[epidermal growth factor(EGF),basic fibroblast growth factor(bFGF),transforming growth factor-β(TGF-β)]were measured via enzyme linked immunosorbent assay(ELISA)before radiotherapy and 2 weeks after radiotherapy.The quality of life of patients was assessed using the EORTC QLQ-C30 V3.0 questionnaire.Results The incidence of radiation dermatitis was significantly lower in the observation group(35.56%,16/45)than that in the control group(68.89%,31/45,P＜0.05),and the first occurrence time of dermatitis was later,the healing time was shorter,and the severity grade of dermatitis was lower(P＜0.05).Two weeks after radiotherapy,levels of EGF,bFGF,TGF-β and the scores of QLQ-C30 increased in both groups,and those of the observation group were significantly higher than the control group(P＜0.05).Conclusion Combining rhGM-CSF with Kangfuxin liquid can effectively prevent radiation dermatitis in breast cancer patients by reducing incidence and severity,delaying onset time,accelerating healing,and improving quality of life.

Objective To investigate the application effect of biofeedback electrical stimulation combined with Kegel exercises using vaginal dumbbell in pelvic floor muscle strength rehabilitation of patients with postpartum pelvic floor dysfunction(PFD).Methods A prospective study was conducted on 70 PFD patients who were divided into control group(n=34)and combined group(n=36)according to random numbers generated by Excel.Control group received Kegel exercises using vaginal dumbbell,while combined group was given biofeedback electrical stimulation on this basis.Both groups underwent 3 months of continuous treatment.GRRUG method was adopted to assess pelvic floor muscle strength after treatment;a low-frequency neuromuscular stimulation therapy device was used to detect the pelvic floor muscle fiber electromyography value and fatigue value;and female sexual function index(FSFI)was utilized to evaluate the quality of sexual life.The pelvic floor function impairments in two groups were also recorded and compared.Results After treatment,compared with control group,combined group had greater proportions of above grade Ⅲ muscle strength of class Ⅰ and class Ⅱ muscle fibers(P<0.05),higher mean pelvic floor electromyography values of class Ⅰ and class Ⅱ muscle fibers(P<0.05),and lower fatigue value of pelvic floor muscle(P<0.05).In addition,combined group had higher FSFI scores for sexual desire,sexual arousal,vaginal lubrication,orgasm,satisfaction and dyspareunia,and the total score than control group(P<0.05),and the incidence rates of frequent and urgent urination,lumbosacral pain,and vaginal relaxation were lower in combined group as compared with control group(P<0.05).Conclusion The combination of biofeedback electrical stimulation and Kegel exercises using vaginal dumbbell in the treatment of patients with postpartum PFD can significantly improve pelvic floor muscle strength,alleviate symptoms such as frequent and urgent urination,lumbosacral pain and vaginal relaxation,and improve the quality of sexual life.

Objective:To investigate the clinical features and predictive indicators of children with recurrent simple febrile seizures, providing theoretical guidance for the early identification of such patients in clinical practice.Methods:This study is a single-center, retrospective analysis. It included 152 children with febrile seizures who were admitted to Department of Emergency, Hangzhou Children's Hospital from January 2021 to December 2023. Based on whether multiple episodes of simple febrile seizures occurred within 24 hours, the children were divided into a recurrent simple febrile seizure group ( n = 44) and a simple febrile seizure group ( n = 108). Demographic characteristics, clinical data, and laboratory test results were collected. Statistical analysis was performed using univariate and multivariate logistic regression, correlation analysis, and receiver operating characteristic curves. Results:Among the 152 children with febrile seizures included in this study, 44 (28.95%) were diagnosed with recurrent simple febrile seizures. Children with recurrent simple febrile seizures had lower temperatures upon admission, were younger at the time of their first febrile seizure, and had a higher proportion of cases where the time interval from fever to seizure was < 12 hours ( t = 2.84, 4.25, 8.45, all P < 0.05). Pearson correlation analysis showed that recurrent simple febrile seizures were negatively correlated with admission temperature and age at first febrile seizure ( r = -0.599, -0.609, both P < 0.001) and positively correlated with the time interval from fever to seizure ( r = 0.568, P = 0.004). Logistic regression analysis indicated that age at first febrile seizure and a time interval from fever to seizure of ≥ 12 hours were influential factors of recurrent simple febrile seizures ( OR = 2.864, 2.145, P = 0.004, 0.007). Receiver operating characteristic curve analysis revealed that admission temperature, age at first febrile seizure, a time interval from fever to seizure of ≥ 12 hours, and their combination were all effective in detecting recurrent simple febrile seizures. However, the combined assessment had higher sensitivity and specificity than any single assessment, with a sensitivity of 88.60%, specificity of 89.80%, a cutoff value of 0.840, and an area under the curve of 0.886. Conclusions:Lower admission temperatures, younger age at the time of the first febrile seizure, and a time interval of < 12 hours from fever to seizure are associated with an increased likelihood of simple febrile seizures developing into recurrent simple febrile seizures.