Objective To introduce the causes of accidents and the diagnosis and treatment of two patients with radiation-induced skin injury admitted to our hospital in 2023, and to provide a reference for the clinical treatment of subsequent radiation-induced skin injury. Methods The clinical treatment process of two patients with acute skin injury caused by external radiation exposure were summarized and analyzed. Results The exposure history of the two patients was reconstructed, the flaw detection scenario was simulated, the biological dose and hand skin exposure dose were estimated, and the infrared thermal imaging device was used for dynamic monitoring. A comprehensive analysis was conducted based on clinical manifestations and other data. The diagnosis of “Xie” was excessive exposure combined with acute radiation-induced skin injury on both hands (Grade IV for the right hand palm, index finger, and middle finger and Grade II for the left hand little finger). The diagnosis of “Hao” was acute radiation-induced skin injury on both hands (Grade I). The two patients received different clinical treatment measures: “Xie” was treated with both local and systemic therapies, while “Hao” was mainly treated with systemic therapy. Conclusion After systematic and effective treatment, the radiation-induced skin injuries healed in both patients.

Objective To compare multiple models and analyze SHAP feature contributions to construct a machine learning risk prediction model for post-reperfusion syndrome (PRS) during adult living donor liver transplantation (LDLT). Methods Clinical data of 390 patients who underwent LDLT due to end-stage liver disease at the First Affiliated Hospital of Anhui Medical University from May 2023 to April 2025 were collected. Five machine learning models, including random forest, logistic regression, XGBoost, decision tree, and AdaBoost, were compared. Feature selection was performed using Lasso regression, and the training set was divided into five folds for stratified cross-validation. The generalization ability of the model was evaluated on the independent test set. The models were comprehensively compared based on key evaluation indicators such as recall rate, accuracy rate, precision rate, area under the curve (AUC) and F1 value, to determine the optimal model. Results Eight potential factors for predicting PRS were selected. The random forest model demonstrated the best prediction performance in both the training set and the test set. Its accuracy rate was as high as 84.2% (AUC = 0.894, 95% confidence interval 0.808-0.964) in the test set. The importance ranking of PRS predictors was determined through SHAP value analysis. Cold ischemia time, K⁺ during the anhepatic period and the model for end-stage liver disease (MELD) score were all identified as the most significant predictors. Conclusions Based on eight key indicators including cold ischemia time, portal vein occlusion time, pre-reperfusion body temperature, alkaline reserve during the anhepatic period, K⁺ during the anhepatic period, MELD score, left ventricular end-diastolic diameter and graft volume to standard liver volume ratio, the PRS prediction model constructed using the random forest algorithm demonstrates the best prediction performance in the test set, providing certain assistance for subsequent clinical predictions.

OBJECTIVE To investigate the clinical efficacy and mechanism of Gongliuxiao capsule combined with dienogest （DNG） in the treatment of refractory/recurrent endometriosis （EMT）. METHODS A retrospective analysis was conducted on the clinical data of 94 patients with refractory/recurrent EMT admitted to Qingdao TCM Hospital from January 2022 to January 2025. According to different treatment methods， they were divided into a monotherapy group （47 cases， receiving DNG monotherapy） and a combination group （47 cases， receiving Gongliuxiao capsule combined with DNG）. The cl inical efficacy， symptom and sign scores [Visual Analog Scale （VAS） and Pictorial Blood Loss Assessment Chart （PBAC） scores ] ， vascular endothelial function indicators [serum transforming growth factor-β 1 （TGF-β 1 ）， vascular endothelial growth factor （VEGF）， matrix metalloproteinase-2 （MMP-2）， MMP-9， basic fibroblast growth factor （bFGF） ] ， serum pathological factors [carbohydrate antigen 125 （CA125）， CA199， anti-endometrial antibody （EMAb） ] ， and Th1/Th2 drift indicators [interferon-γ （IFN-γ）， interleukin-4 （IL-4） ] were compared between the two groups before and after 6 months of treatment. RESULTS After treatment， the VAS and PBAC scores， serum levels of TGF-β 1 ， VEGF， MMP-2， MMP-9， bFGF， CA125， CA199， EMAb， and IL-4 in both groups were significantly lower than those before treatment， while IFN-γ levels were significantly higher than those before treatment （ P ＜0.05）. Moreover， the magnitude of increase or decrease in the combination group was significantly greater than that in the monotherapy group （ P ＜0.05）. The total effective rate in the combination group was significantly higher than that in the monotherapy group （93.62% vs. 76.60%， P ＜0.05）. CONCLUSIONS The combination of Gongliuxiao capsule and DNG is effective in treating refractory/recurrent EMT， and can effectively improve the degree of dysmenorrhea and abnormal menstrual volume in patients. The mechanism may be related to improving vascular endothelial function， inhibiting the expression of tumor pathological factors， and correcting Th1/Th2 drift.

Objective To investigate the activity concentrations of natural radionuclides in drinking water (tap water and well water) in urban and rural areas of Hohhot, assess the safety of drinking water, and to provide data support for local drinking water radioactivity monitoring and management. Methods Representative samples of well water and tap water were collected from nine banners/counties/districts in Hohhot. Activity concentrations were measured using a low-background gross α/β counter, an α spectrometer, inductively coupled plasma mass spectrometry, and a radium/radon analyzer. Results A total of nine tap water samples and nine well water samples were analyzed. For the tap water samples, gross α activity concentrations ranged from 0.093 to 0.193 Bq/L, gross β from 0.091 to 0.225 Bq/L, uranium mass concentrations from 2.32 to 10.36 μg/L, thorium mass concentrations from 0.09 to 0.20 μg/L,²¹⁰Po activity concentrations from below the minimum detectable limit to 0.41 mBq/L, and ²²⁶Ra activity concentrations from 8.70 to 13.35 mBq/L. For the well water samples, gross α activity concentrations ranged from 0.111 to 0.203 Bq/L, gross β from 0.111 to 0.270 Bq/L, uranium mass concentrations from 2.31 to 13.28 μg/L, thorium mass concentrations from 0.17 to 0.26 μg/L,²¹⁰Po activity concentrations from 1.03 to 2.12 mBq/L, and ²²⁶Ra activity concentrations from 15.38 to 23.63 mBq/L. Conclusion The activity concentrations of natural radionuclides in both well water and tap water in the Hohhot region were at environmental background levels and met national drinking water hygiene standards.

Objective Investigating the effect and mechanism of resveratrol on cardiac function in exercise-induced fatigue rats by regulating mitochondrial energy metabolism.Methods Forty-eight healthy male Sprague Dawley rats(6～8 weeks old)were selected and divided randomly into a blank control(C)group,resveratrol administration(R)group,exercise-induced fatigue(E)group,and exercise-induced fatigue+resveratrol administration group(ER)(n=12 rats per group).Rats in the E and ER groups were subjected to weight-bearing 5％of their body weight for 60 minutes each day and exercise for 6 days per week for 6 weeks.Rats in the R and ER groups received resveratrol 50 mg/kg by gavage,1 hour after exercise.The biochemical kit was used to detect the indicators of motor fatigue,myocardial injury and mitochondrial energy metabolism enzymes in rat myocardium.The mRNA expression levels of myocardial energy metabolism related regulatory factors were detected by real-time fluorescent quantitative PCR(RT-qPCR).Results Plasma levels of blood urea nitrogen(BUN)and creatine kinase(CK)were significantly increased in rats in group E compared with group C(P＜0.05,P＜0.05),CK-MB and cTnI activity were also significantly increased(P＜0.01,P＜0.05),while activity levels of myocardial cytochrome C oxidase(COX)and succinate dehydrogenase(SDH)were significantly reduced(P＜0.01,P＜0.05).mRNA expression levels of the mitochondrial energy metabolism-related genes silent information regulator 1(SIRT1),peroxisome proliferator-activated receptor γ coactivator 1-α(PGC-1α),and estrogen receptor-related receptor α(ERRα)were also significantly reduced(P＜0.01,P＜0.01,P＜0.01).Serum levels of BUN and CK were significantly decreased in the ER group compared with group E(P＜0.05,P＜0.05),while CK-MB and cTnI activities were significantly decreased(P＜0.05,P＜0.05),myocardial COX and SDH activities were significantly increased(P＜0.01,P＜0.05),and SIRT1,PGC-1α and ERRα mRNA levels were also significantly increased(P＜0.05,P＜0.01,P＜0.01).Conclusions Resveratrol can effectively activate the sirtuin 1/peroxisome proliferator-activated receptor γ coactivator 1α/estrogen-related receptor α signaling pathway,improve myocardial energy metabolism in exercise-fatigued rats,and protect against myocardial injury.

The classical latent structure method does not consider the influence of primary and secondary symptoms,syndromes and symptoms in the analysis and modeling of syndromes.In this paper,based on the data of damp-heat in intestine and stomach syndrome involving 1087 diabetic patients,the classical latent structure analysis was used to obtain the quantitative syndrome diagnostic rules.Then,using Constrained Latent Tree Analysis(CLTA),the quantitative syndrome diagnostic rules containing primary and secondary symptoms were obtained as follows,primary symptoms include halitosis(2.3),yellow tongue coating(2),abdominal distension(2.3),greasy tongue coating(2.1),loose stool or loose stool(1.5),red tongue(1.3),smooth pulse(1.4).Secondary symptoms include epigastric distension(1.1).Compared with the traditional latent structure analysis method,the rules established by CLTA are more compatible with the concept of differentiating primary and secondary symptoms and the common practice of TCM.The quantitative syndrome diagnostic rules of damp-heat in intestine and stomach syndrome constructed by the CLTA method have considerable objectivity in the modeling process.The diagnostic rules established were also compatible with the qualitative concept of TCM theory in stratifying primary and secondary symptoms.Finally,the diagnostic rules are obtained by logistic regression analysis,and the accuracy of the three rules is compared.The results show that the rule recognition accuracy obtained by CLTA is the highest.Therefore,the syndrome diagnostic rules of damp-heat in intestine and stomach obtained from the analysis of CLTA are in line with the constraint semantics of primary and secondary diseases and the theory of traditional Chinese medicine.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Objective Investigating the effect and mechanism of resveratrol on cardiac function in exercise-induced fatigue rats by regulating mitochondrial energy metabolism.Methods Forty-eight healthy male Sprague Dawley rats(6～8 weeks old)were selected and divided randomly into a blank control(C)group,resveratrol administration(R)group,exercise-induced fatigue(E)group,and exercise-induced fatigue+resveratrol administration group(ER)(n=12 rats per group).Rats in the E and ER groups were subjected to weight-bearing 5％of their body weight for 60 minutes each day and exercise for 6 days per week for 6 weeks.Rats in the R and ER groups received resveratrol 50 mg/kg by gavage,1 hour after exercise.The biochemical kit was used to detect the indicators of motor fatigue,myocardial injury and mitochondrial energy metabolism enzymes in rat myocardium.The mRNA expression levels of myocardial energy metabolism related regulatory factors were detected by real-time fluorescent quantitative PCR(RT-qPCR).Results Plasma levels of blood urea nitrogen(BUN)and creatine kinase(CK)were significantly increased in rats in group E compared with group C(P＜0.05,P＜0.05),CK-MB and cTnI activity were also significantly increased(P＜0.01,P＜0.05),while activity levels of myocardial cytochrome C oxidase(COX)and succinate dehydrogenase(SDH)were significantly reduced(P＜0.01,P＜0.05).mRNA expression levels of the mitochondrial energy metabolism-related genes silent information regulator 1(SIRT1),peroxisome proliferator-activated receptor γ coactivator 1-α(PGC-1α),and estrogen receptor-related receptor α(ERRα)were also significantly reduced(P＜0.01,P＜0.01,P＜0.01).Serum levels of BUN and CK were significantly decreased in the ER group compared with group E(P＜0.05,P＜0.05),while CK-MB and cTnI activities were significantly decreased(P＜0.05,P＜0.05),myocardial COX and SDH activities were significantly increased(P＜0.01,P＜0.05),and SIRT1,PGC-1α and ERRα mRNA levels were also significantly increased(P＜0.05,P＜0.01,P＜0.01).Conclusions Resveratrol can effectively activate the sirtuin 1/peroxisome proliferator-activated receptor γ coactivator 1α/estrogen-related receptor α signaling pathway,improve myocardial energy metabolism in exercise-fatigued rats,and protect against myocardial injury.

Objective To analyze the research status,hotspots and development trends in the field of central post-stroke pain(CPSP).Methods Relevant literatures up to April 8,2025 were retrieved from the Web of Science Core Collection database.CiteSpace 6.4.R1 advanced version was used for bibliometric and visualization analysis of publication trends,country/institution/author collaboration networks,keywords and burst terms.Results A total of 119 publications were included.Researches on CPSP have shown an overall upward trend since 2002,which could be divided into a slow development period(from 2002 to 2015)and a rapid growth period(from 2016 onwards).The number of published papers reached its peak in 2024.China and the United States led in pub-lication volume.Harvard University was the most productive institution,and Asian institutions contributed a sig-nificant number of publications.The most prolific author was Gao Ju.The top five keywords by co-occurrence frequency were central post-stroke pain,neuropathic pain,pathophysiology,transcranial magnetic stimulation and motor cortex stimulation.Keyword clustering analysis generated ten clusters,which were integrated into four core research areas:pain types,clinical characteristics and diagnostic techniques,pathophysiological mecha-nisms,and treatment strategies.The bursting words included spinal cord and molecular expression in recent years;pathophysiology was the most bursting word.Conclusion In recent years,researches on CPSP are significantly increasing,focusing on pathophysiological mecha-nisms and intervention strategies.Future studies should strengthen the integration of basic and clinical research,promote multidisciplinary collaboration,and enhance research quality.

Objective To analyze the research status,hotspots and development trends in the field of central post-stroke pain(CPSP).Methods Relevant literatures up to April 8,2025 were retrieved from the Web of Science Core Collection database.CiteSpace 6.4.R1 advanced version was used for bibliometric and visualization analysis of publication trends,country/institution/author collaboration networks,keywords and burst terms.Results A total of 119 publications were included.Researches on CPSP have shown an overall upward trend since 2002,which could be divided into a slow development period(from 2002 to 2015)and a rapid growth period(from 2016 onwards).The number of published papers reached its peak in 2024.China and the United States led in pub-lication volume.Harvard University was the most productive institution,and Asian institutions contributed a sig-nificant number of publications.The most prolific author was Gao Ju.The top five keywords by co-occurrence frequency were central post-stroke pain,neuropathic pain,pathophysiology,transcranial magnetic stimulation and motor cortex stimulation.Keyword clustering analysis generated ten clusters,which were integrated into four core research areas:pain types,clinical characteristics and diagnostic techniques,pathophysiological mecha-nisms,and treatment strategies.The bursting words included spinal cord and molecular expression in recent years;pathophysiology was the most bursting word.Conclusion In recent years,researches on CPSP are significantly increasing,focusing on pathophysiological mecha-nisms and intervention strategies.Future studies should strengthen the integration of basic and clinical research,promote multidisciplinary collaboration,and enhance research quality.