ObjectiveThis paper aims to clarify the material basis of Gualou Niubangtang and establish a quantitative analysis method for its main constituents， providing a reference for the overall quality control of this preparation. MethodsThe constituents in the formula were systematically characterized based on ultra-performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry （UPLC-Q-TOF-MS/MS）. Identification was performed by matching with the UNIFI 9.6 software and utilizing database platforms such as PubChem， ChemicalBook， and ChemSpider， combined with relevant literature reports. A quantitative analysis method for the seven main constituents in Gualou Niubangtang was established by using high performance liquid chromatography （HPLC）. ResultsUPLC-Q-TOF-MS/MS analysis identified 155 constituents， including 69 flavonoids， 36 terpenoids， 23 phenylpropanoids， 8 phenylethanoid glycosides， and 19 other types of constituents. In the established quantitative analysis method， the seven main constituents showed good linearity within their respective linear ranges. The precision， repeatability， stability， and spike recovery all met the required standards. The results showed that the content ranges of geniposide， liquiritin， hesperidin， arctiin， baicalin， oroxylin A-7-O-β-D-glucuronide， and wogonoside in 15 batches of Gualou Niubangtang were 13.67-21.25， 1.20-7.64， 5.45-7.45， 22.97-33.51， 29.95-39.07， 2.58-4.80， and 6.56-9.31 mg·g^-1， respectively. ConclusionThis study successfully characterizes and attributes multi-category constituents in Gualou Niubangtang， clarifying that its material basis is primarily composed of flavonoids， terpenoids， phenylethanoid glycosides， and phenylpropanoids. Furthermore， it enables the quantification of seven constituents within the formula. This work lays a foundation for research on the quality control， action mechanism， and clinical application of this formula.

OBJECTIVE To analyze the reasons for the outbreak of suspected carbapenem-resistant Acinetobacter baumannii(CRAB)infections in the neurosurgical intensive care unit to take comprehensive prevention and con-trol measures to control the spread of infections,and to provide a reference for the control of multidrug-resistant organisms(MDRO)infections in intensive care units.METHODS Epidemiological data were collected from five patients with CRAB infections in the neurosurgical intensive care unit of Gansu Provincial People's Hospital in Mar.2024,and environmental hygiene monitoring and comprehensive infection prevention and control measures were conducted.RESULTS A total of five cases of lower respiratory tract infections occurred,all of which were hospital-acquired infections,and all patients had consistent spatial-temporal distribution.A.baumannii was detec-ted in the sputum cultures of all patients,and all were resistant to carbapenems,aminoglycosides and some β-lac-tam drugs.Before the implementation of comprehensive prevention and control measures,a total of 25 samples from the surfaces and the hands of health workers were collected,with a pass rate of 52.00％;CRAB was detected on the surface of treatment carts and the wall of sputum suction bottles in the treatment room,with a detection rate of 8.00％.After the implementation,a total of 24 samples were collected,with a pass rate of 100.00％,and the difference was statistically significant when compared with the pre-implementation period(χ2=16.987,P<0.001).Through the implementation of comprehensive measures such as isolation,standardization of the ward cleaning and disinfection process,strengthening hand hygiene,standardization of sterile operations and personnel management,the indicators such as hand hygiene compliance rate,the execution rate of multi-drug-resistant bac-terial preventive and control measures and the fluorescent marker removal rate were all improved,and the suspec-ted CRAB infection outbreak was timely controlled.CONCLUSION This suspected CRAB hospital-acquired infec-tion outbreak may be related to a variety of factors,and timely environmental hygiene monitoring and comprehen-sive infection prevention and control measures can effectively control the spread of CRAB infection.

Purpose To investigate the sex differences of white matter damage in Alzheimer's disease(AD)and their association with cognitive impairment.Materials and Methods This retrospective study included 88 AD patients(48 females),71 amnestic mild cognitive impairment(aMCI)patients(39 females),and 95 healthy controls(63 females)recruited from the Memory Disorder Clinic at the First Affiliated Hospital of Anhui Medical University from September 2017 to July 2024.High-resolution three-dimensional T1 structure images and diffusion tensor imaging images were all obtained from each participant.The mean diffusivity(MD)and fractional anisotropy(FA)values of each white matter region were obtained,and the two-way ANOVA analysis was conducted to investigate brain regions with interaction effects between groups and sexes,those brain regions were then chosen as regions of interest for further correlation analysis with a series of cognitive scale scores.Results In terms of FA values,the right posterior corona radiata,right anterior limb of the internal capsule and left corticospinal tract showed interaction between sexes and cognitive groups(F=4.764,3.812,5.937,all P<0.05).The FA value of AD group was significantly lower than that of healthy control and aMCI group(all P<0.05),but there was no significant difference between healthy control and aMCI group(except the right anterior limb of the internal capsule,P=0.018).In AD group,FA values were significantly higher in women than in men in the previously described brain regions(all P<0.05),while there was no significant difference in FA values between male and female in healthy control and aMCI groups(except the left corticospinal tract,P<0.001).In terms of MD values,the right anterior limb of the internal capsule,right superior corona radiata and left external capsule showed interaction effect between sexes and cognitive groups(F=8.581,3.680,7.218,all P<0.05).The MD value of AD group was significantly higher than that of aMCI group(P<0.001),and aMCI group was higher than that of healthy control group(all P<0.05).In AD group,the MD values in the above brain regions were significantly higher in males than those in females(all P<0.01),while no significant difference was found between males and females in healthy control and aMCI groups(except for the left external capsule,P<0.05).For correlation analysis,the AD group was dimidiated into two groups by sex,the scores of the Montreal cognitive assessment,the Mini Mental state examination and the verbal fluency test of the female patient group were positively correlated with the FA values of the right posterior corona radiate(r=0.372,P=0.009;r=0.345,P=0.016;r=0.383,P=0.007),while the Mini Mental state examination and the verbal fluency test scores of female AD patient group were negatively correlated with the MD values of the right superior corona radiata(r=-0.360,P=0.012;r=-0.360,P=0.003).Conclusion Compared to the healthy control and MCI groups,white matter damage in AD patients shows sex differences and is associated with general cognitive and language functions impairment in female AD patients.

Objective To preliminarily investigate the safety and efficacy of percutaneous microwave ab-lation(MWA)in patients with advanced breast cancer involving the skin or nipple-areola complex(NAC).Methods This study included breast cancer patients with skin or NAC involvement treated at the Fifth Medical Center of the Chinese PLA General Hospital from January 2011 to August 2024.Patients underwent percutaneous MWA with water isolation technique to protect surrounding tissues.Clinical data were retrospectively collected,and the technical success rate,complications,prognosis,patient satisfaction with breast aesthetics,and quality of life improvement were analyzed.Results A total of 19 patients(24 lesions)meeting the inclusion and ex-clusion criteria were analyzed.The cases included 4 with T4N0M0,2 with T4N1M0,3 with T4N2M0,1 with T4N3M0,1 with T4N2M1,and 8 with T4N3M1.The average diameter of the 24 lesions was(4.9±3.4)cm,with an average of(1.6±0.6)ablation sessions per lesion.The median ablation time was 36.9(26.1,61.7)minutes,and the median ablation energy was 84.2(45.6,149.2)kJ.The technical success rate was 100%.Postoperatively,7 patients(7/19,36.8%)experienced skin burns around the lesion or nipple shedding,all of which healed naturally.The median overall survival was 35.0(17.0,45.5)months,and the median recur-rence-free survival was 17.0(11.0,38.5)months.Patient satisfaction with post-treatment breast aesthetics was 89.5%,and all patients reported significant improvement in their quality of life.Conclusions Percutane-ous microwave ablation for breast cancer involving the skin or NAC was preliminary demonstrates to be safe and effective,suggesting its potential as a viable treatment option for patients with inoperable breast cancer.

Insufficient future liver remnant volume remains a critical limitation for single-stage resection in patients with hepatic malignancies. The techniques for promoting future liver remnant hypertrophy to realize two-stage hepatectomy include portal vein embolization， associating liver partition and portal vein ligation for staged hepatectomy， and portal vein ligation. In recent years， the application of auxiliary liver transplantation has further facilitated two-stage total hepatectomy. This article systematically reviews the clinical applications of these techniques and analyzes their advantages and limitations， so as to provide a reference for optimizing clinical decision-making.

Objective:To establish a predictive model for the risk of cognitive impairment in patients with hypertension.Methods:Data were obtained from the China Health and Retirement Longitudinal Study(CHARLS),and 17 indicators were analyzed,including demographic features,behavioral factors,and health status.The study cohort was randomly divided into a training set(n=2 918)and an internal validation set(n=1 249)at a ratio of 7∶3,and 1 457 patients with hypertension who were treated in Chongqing Traditional Chinese Medicine Hospital from January to December 2024 were included as an external validation set.The least absolute shrinkage and selection operator regression analysis was used to identify predictive variables,and 10-fold cross-validation was used to determine the optimal model.A logistic regression model was used to investigate the risk factors for cognitive impairment in patients with hypertension,and then a nomogram prediction model was established.The calibration curve was used to assess the accuracy of the model,and the area under the ROC curve(AUC)and the decision curve analysis were used to assess the predictive performance of the model.Results:A total of 4167 hypertensive patients aged≥45 years were included from the CHARLS database,among whom 668 had cognitive impairment.The multivariate logistic regression analysis showed that age(odds ratio[OR]=1.408,95%CI=1.040-1.056),sex(OR=0.570,95%CI=0.492-0.660),body mass index(OR=0.931,95%CI=0.914-0.948),educational level(OR=0.235,95%CI=0.200-0.277),place of residence(OR=1.674,95%CI=1.447-1.936),physi-cal activity(OR=0.459,95%CI=0.373-0.562),depression(OR=1.386,95%CI=1.198-1.604),and total cholesterol level(OR=0.997,95%CI=0.995-0.999)were predictive variables.The ROC curve analysis showed that the nomogram model had good performance,with an AUC of 0.814(95%CI=0.802-0.826)in the training set,0.817(95%CI=0.788-0.846)in the internal validation set,and 0.725(95%CI=0.699-0.752)in the external validation set.Conclusion:The nomogram model developed in this study can effectively predict the risk of cognitive impairment in Chinese patients with hyperten-sion and has a good application value.

An end-to-end auxiliary diagnosis method for pneumonia based on DCL-Net with dual-path of different convolutional kernels is proposed,in which no feature engineering is required,and the original lung sound signal is directly input into the model.The dual-path convolutional network with kernel sizes of 1*3 and 1*5,with each path containing 3 residual blocks,allows the model to automatically learn features of lung sounds at different scales while avoiding model degradation.The performance of the end-to-end method is validated through the comparisons with 3 commonly used feature extraction methods in signal analysis,namely Mel-spectrogram,short-time Fourier transform,and wavelet transform.The results show that the proposed method has a diagnostic accuracy of 61.4%for the 4-class classification task(normal,moderate,severe,critical),which is 1.6%,5.0%,and 3.7%higher than the other 3 feature extraction methods,and the diagnostic accuracy is 89.7%for the binary classification task(normal or abnormal),which is 11.0%,5.1%,and 11.2%higher than the other 3 feature engineering methods,demonstrating that it can serve as an effective diagnostic tool for pneumonia.

The traditional Chinese medicine （TCM） myocardial infarction （MI） unit is a standardized， regulated， and continuous integrated care unit guided by TCM theory and built upon existing chest pain centers or emergency care units. This unit emphasizes multidisciplinary collaboration and forms a restructured clinical entity without altering current departmental settings， offering comprehensive diagnostic and therapeutic services with full participation of TCM in the treatment of MI. Its core medical model is patient-centered and disease-focused， providing horizontally integrated TCM-based care across multiple specialties and vertically constructing a full-cycle treatment unit for MI， delivering prevention， treatment， and rehabilitation during the acute， stable， and recovery phases. Additionally， the unit establishes a TCM-featured education and prevention mechanism for MI to guide patients in proactive health management， reduce the incidence of myocardial infarction， and improve quality of life.

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.

BACKGROUND: The contraction behaviors of cardiomyocytes (CMs), especially contraction synchrony, are crucial factors reflecting their maturity and response to drugs. A wider field of view helps to observe more pronounced synchrony differences, but the accompanied greater computational load, requiring more computing power or longer computational time. METHODS: We proposed a method that directly correlates variations in optical field brightness with cardiac tissue contraction status (CVB method), based on principles from physics and photometry, for rapid video analysis in wide field of view to obtain contraction parameters, such as period and contraction propagation direction and speed. RESULTS: Through video analysis of human induced pluripotent stem cell (hiPSC)-derived CMs labeled with green fluorescent protein (GFP) cultured on aligned and random nanofiber scaffolds, the CVB method was demonstrated to obtain contraction parameters and quantify the direction and speed of contraction within regions of interest (ROIs) in wide field of view. The CVB method required less computation time compared to one of the contour tracking methods, the LucasKanade (LK) optical flow method, and provided better stability and accuracy in the results. CONCLUSION This method has a smaller computational load, is less affected by motion blur and out-of-focus conditions, and provides a potential tool for accurate and rapid analysis of cardiac tissue contraction synchrony in wide field of view without the need for more powerful hardware.