Guided by the theories of yin-yang and collateral disease， this paper identifies the dysregulation of yang qi ascent and descent as the core pathomechanism of hypertension. Based on clinical experience， a treatment approach centered on the method of raising yang and promoting descent was proposed. Clinically， three major syndrome types were identified. Firstly， deficiency of zong qi （ancestral qi） with blood stasis， obstruction of phlegm-turbidity and blood stasis， and hyperactivity of liver yang. Corresponding empirical formulation， Yizong Huoxue Decoction （益宗活血汤） was applied to tonify zong qi， invigorate blood， and raise yang. Secondly， Lizong Huoxue Decoction （理宗活血汤） was used to resolve phlegm， promote yang qi circulation， and regulate qi and blood. Thirdly， Qinggan Tongluo Decoction （清肝通络饮） was used to clear the liver， dredge collaterals， and subdue hyperactive yang. For special types such as non-dipper hypertension， time-specific syndrome differentiation and treatment can be applied based on a thorough understanding of the underlying pathomechanism， aiming to provide new insights into clinical diagnosis and treatment of hypertension.

Chronic heart failure （CHF） is a complex clinical syndrome that the cardiac output is not enough to meet the metabolic needs of the body， or depends on the increase of filling pressure to compensate. Its high morbidity and mortality pose a serious threat to human health， necessitating attention and active intervention. At present， western medicine treatment of CHF is mainly based on diuretics， intravenous vasodilators， intravenous positive inotropic drugs， etc.， which， however， have problems such as long medication cycles， serious side effects， and limited applicable population. Recent studies have shown that traditional Chinese medicine can act in a multi-pathway， multi-component， and multi-target manner， showing unique advantages in the prevention and treatment of CHF. Buyang Huanwutang has the effects of tonifying Qi， activating blood， and dredging collaterals. Clinical and mechanism studies have confirmed that this prescription is effective in treating CHF and its syndromes. The clinical studies can be classified into two categories. Studies of the first category use simple modern medical diagnostic criteria as the inclusion criteria for CHF patients， which can improve the scientificity and objectivity. Studies of the second category uses modern medicine combined with traditional Chinese medicine disease diagnostic criteria for the screening of CHF patients， which helps to improve the accuracy of efficacy evaluation. However， there are problems such as the lack of unified research standards and the insufficiency of mechanism research. In addition， the available studies remain to be classified or summarized. This study systematically sorted out the clinical and mechanism studies of Buyang Huanwutang in the treatment of CHF in recent years to review the research status. In clinical treatment， Buyang Huanwutang can be used alone， or modified， or combined with other prescriptions or Western medicine. The mechanism studies predict that Buyang Huanwutang can ameliorate CHF by regulating the calcium balance， protecting the mitochondrial structure and function， and regulating intestinal flora. This review aims to provide a theoretical basis and practical guidance for the clinical application and optimization and subsequent in-depth study of Buyang Huanwutang in the treatment of CHF.

Objective To explore the prevention effectiveness of a mode,conducting targeted corrective training based on motor dysfunction detected by military joint function screening,on military training injuries in new recruits during recruit basic training in order to cope with the high incidence of military training injuries among them.Method A military personnel joint function screening was conducted on the new recruits in a training base of Joint Logistics Support Force.Based on the results of screening,the new recruits with a single action score of 1 and a total score of<10 were subjected and served as corrective training participants.Through cluster sampling,the new recruits were randomly divided into an experimental group(n=223)and a control group(n=223).The control group were trained according to the regular training plan,while the experimental group completed their designated training tasks and a 2-month corrective training for motor dysfunction at the same time.The entire corrective training process was carried out by our key personnel who had received relevant training.Medical records of the medical security department of the experimental unit were collected and evaluated for the injury situation.The score of joint function screening was analyzed using independent sample t test.The incidence of training injuries was analyzed using Chi-square test or Fisher's exact test.Result After corrective training,the score of joint function was higher in the experimental group than the score before training(15.12±2.13 vs 10.58±2.83),and the score was also higher than that of the control group(15.12±2.13 vs 14.19±1.97,P<0.05).During the recruit basic training period,the incidence of training injuries was notably lower in the experimental group than the control group(12.5％vs 34.5％,Chi-square=5.469,P=0.001).Only for those who were injured during the training,11 people(39.2％)in the experimental group scored less than 10,which was obviously lower than the 49 people(63.6％)in the control group(Chi-square=4.972,P=0.026).Conclusion Our mode,corrective training based on the results of military personnel joint function screening,can effectively reduce the incidence of military training injuries in new recruits during recruit basic training,and exerts a good preventive effect against military training injuries.

Objective To identify recruit movement dysfunction based on military joint function screening and assessment,implement targeted corrective training,explore the impact of this assessment-correction system on knowledge-attitude-belief-practice(KABP)related factors,and scientifically evaluate its efficacy in preventing recruit military training injuries within the knowledge-attitude-belief-practice theoretical framework.Methods A cluster randomized controlled trial was conducted at a recruit training base of the Joint Logistics Support Force from March to May 2025,enrolling 446 recruits.Participants were randomly assigned to an experimental group(n=223)or control group(n=223)using a random number table.The control group followed the routine training program,while the experimental group additionally received a 2-month targeted corrective training for movement dysfunction alongside the established training tasks.Knowledge-attitude-belief-practice questionnaires were administered to both groups at the initial,intermediate,and advanced stages of the corrective training.Univariate logistic regression was used to preliminarily screen KABP-related factors,and a multivariate logistic regression model was further constructed to analyze the role of KABP factors in the corrective training.Results The experimental group had a cumulative training injury incidence of 40 cases(17.9%),which was significantly lower than that of the control group(83 cases,37.2%;χ2=20.757,P<0.001).The experimental group showed varying degrees of improvement in knowledge,attitude and belief,and practice dimensions(P<0.05),while the control group exhibited no significant changes in the three KABP dimensions across the three surveys.Logistic regression analysis revealed:In the first round,total practice score was significantly negatively associated with training injury incidence rate(OR=0.863,95%CI:0.822～0.906,P<0.001),whereas knowledge and attitude-belief dimensions showed no significant association;In the second round,both total knowledge score(OR=0.925,95%CI:0.903～0.946,P<0.001)and total practice score(OR=0.906,95%CI:0.874～0.940,P<0.001)significantly reduced the risk of military training injuries,with attitude-belief dimension still showing no significant effect;In the third round,all three KABP dimensions were significantly negatively associated with military training injury incidence rate(knowledge:OR=0.905,95%CI:0.884～0.926,P<0.001;attitude and belief:OR=0.942,95%CI:0.899～0.988,P=0.013;behavior:OR=0.882,95%CI:0.841～0.924,P<0.001).Conclusion Joint function screening and corrective training can significantly reduce the incidence of recruit training injuries,primarily by optimizing knowledge mastery and movement behavior;belief cultivation,however,requires long-term practical accumulation.

Abstract OBJECTIVE To develop a vancomycin individualized dosing-assisted decision platform suitable for practical clinical application scenarios and provide individualized dosing recommendations for the rational use of vancomycin. METHODS Based on the vancomycin population pharmacokinetic model that had been constructed and verified to be feasible, the vancomycin individualized assisted decision-making platform was developed by using Idea2019, JDK1.8, ETL and other software tools. The platform development had gone through three main stages, included ①requirement analysis; ②design stage; ③software testing and optimization. RESULTS The vancomycin individualized assisted decision-making platform, which was successfully developed and applied, had the advantages of simple page, perfect function and convenient operation, and was divided into four main modules according to functions, namely retrieval module, information module, concentration prediction module and reporting module. The platform could connect to the hospital intranet platform to automatically obtain patient information, medication information and blood concentration test results, and calculate individual pharmacokinetic parameters for subsequent concentration prediction based on the embedded population pharmacokinetic model, combined with individual parameters. The concentration prediction module incorporated the Bayesian feedback method with patient medication information, drug concentration measurement results and relevant covariate parameter values, took the guideline-recommended trough concentration and AUC range as the target value, calculated the individualized drug administration scheme that met the target concentration range, and set up custom simulation functions considering the actual clinical application scenarios, which was of more popularization and application value. CONCLUSION Based on the vancomycin population pharmacokinetic model that has been successfully constructed in the previous stage, with the assistance of Idea2019, JDK1.8, ETL and other software tools, a vancomycin individualized dosing-assisted decision platform has successfully constructed, which can more efficiently and conveniently assist monitoring pharmacists to provide individualized dosing advice for clinical use of vancomycin.

Objective:To investigate the value of serum miR-143 level combined with MRI in predicting the early response to concurrent chemoradiotherapy (CCRT) in cervical cancer.Methods:A total of 85 patients with pathologically confirmed cervical cancer underwent conventional MRI, intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), and dynamic contrast-enhanced MRI (DCE-MRI) before CCRT. The biopsy tissues and serum samples were collected. The differential expression of miRNA in the biopsy tissues was determined by microarray chip. The expression level of miR-143 in the serum samples was analyzed by qRT-PCR. All patients were divided into the non-residual and residual tumor groups according to post-treatment MRI. Pre-treatment clinical factors, MRI parameters and miR-143 between two groups were statistically analyzed by the univariate and multivariate analyses. The optimal thresholds and predictive performance for post-treatment incidence of residual tumors were estimated by drawing the ROC curve.Results:At one month after CCRT, there were 52 patients in the non-residual tumor group and 33 patients in the residual tumor group. In the residual tumor group, pre-treatment FIGO staging, apparent diffusion coefficient (ADC), D and V e were significantly higher (all P<0.05), whereas K trans value was significantly lower ( P<0.001) when compared to those in the non-residual tumor group. The miRNA array analysis showed that there were 16 miRNAs with differential expression levels between two groups (all P<0.05). Among them, the increase of miR-143 was the most significant in the residual tumor group. Compared with the residual tumor group, the expression level of serum miR-143 was significantly down-regulated in the non-residual tumor group ( P=0.002). Compared with the SiHa cells, the expression level of miR-143 in the SiHa-R cells was significantly up-regulated ( P<0.05). Multivariate analysis showed that only miR-143, D, K trans and V e were the independent prognostic factors. The combination of multi-parametric MRI and miR-143 exhibited the highest predictive performance (AUC=0.975), with a sensitivity of 84.8% and a specificity of 96.2%. Conclusion:The combination of multi-parametric MRI with miR-143 further improves the predictive performance for residual tumors after CCRT, which contributes to the personalized treatment of cervical cancer.

Objective:To deeply understand the reason and inner experience of day surgery patients canceling surgery through qualitative research, so as to strengthen the management of day surgery patients.Methods:This research adopted phenomenological research method. From June to December 2019, purpose sampling was used to select 12 patients who had canceled the day surgery at Ningbo First Hospital in Zhejiang Province for a semi-structured interview. The Colaizzi 7-step analysis method was used for data analysis.Results:Through repeated refining, analysis and extraction of interview data, the reasons and inner experience of day surgery patients who canceled surgery were finally summarized into 5 themes. Those themes included fear of day surgery, distrust of day doctors, affected by basic diseases and physiological factors, lack of confidence in community medical care, insufficient preparation before surgery.Conclusions:The reasons for day surgery patients to cancel surgery include fear of surgery, distrust of doctors, basic diseases and physiological factors, lack of confidence in community medical care, and insufficient preparation before surgery. It is recommended that day surgery medical and nursing staff strengthen day ward management, improve their professional level and ability to communicate with patients, and at the same time promote the construction of hospital-community integration to ensure the medical safety of patients after discharge from the hospital, and further reduce the cancellation rate of day surgery.

Objective:To explore the application effect of evidence-based clinical practice of enhanced recovery after surgery multiple discrepancies theory (ERAS-MDT) in perioperative nursing of patients with hepatectomy.Methods:From January to December 2018, 62 patients with hepatectomy who received perioperative care of ERAS-MDT in the Department of Hepatobiliary and Pancreatic Surgery of Ningbo First Hospital of Zhejiang Province were selected as the control group. We reviewed the implementation effect, searched the clinical practice guidelines, systematic reviews and evidence summary related to ERAS-MDT, carried out field investigation and expert consultation, summarized the obstacle factors, formulated countermeasures, and built a standardized operation mode of ERAS-MDT. From January to December 2019, a total of 66 patients with hepatectomy who received standardized ERAS-MDT perioperative nursing were selected as the observation group. The first exhaust time, defecation time, first ambulation time, first oral feeding time, hospitalization time, nutritional status and pain score were compared between the two groups.Results:The first exhaust time, defecation time, first ambulation time, first oral feeding time, hospitalization time of the observation group were earlier than those of the control group, and the differences were statistically significant ( P<0.05) . The albumin level of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . The pain scores of the observation group on the operation day was lower than those of the control group, and the difference between the two groups was statistically significant ( P<0.05) . Conclusions:A standardized management model of ERSA-MDT based on evidence-based clinical practice exhibits positive effect on the perioperative recovery of hepatectomy patients, which can further improve the clinical outcome of patients.

Objective:To explore the application value of artificial intelligence-assisted diagnosis system for TBS report in cervical cancer screening.Methods:A total of 16 317 clinical samples and related data of cervical liquid-based thin-layer cell smears, which were obtained from July 2020 to September 2020, were collected from Southern Hospital, Guangzhou Huayin Medical Inspection Center, Shenzhen Bao′an People′s Hospital(Group) and Changsha Yuan′an Biotechnology Co., Ltd. The TBS report artificial intelligence-assisted diagnosis system of cervical liquid-based thin-layer cytology jointly developed by Southern Medical University and Guangzhou F. Q. PATHOTECH Co., Ltd. based on deep learning convolution neural network was used to diagnose all clinical samples. The sensitivity,specificity and accuracy of both artificial intelligence-assisted diagnosis system and cytologists using artificial intelligence-assisted diagnosis system were analyzed based on the evaluation standard(2014 TBS). The time spent by the two methods was also compared.Results:The sensitivity of artificial intelligence-assisted diagnosis system in predicting cervical intraepithelial lesions and other lesions (including endometrial cells detected in women over 45 years old and infectious lesions) under different production methods, different cytoplasmic staining and different scanning instruments was 92.90% and 83.55% respectively, and the specificity of negative samples was 87.02%, while that of cytologists using artificial intelligence-assisted diagnosis system was 99.34%, 97.79% and 99.10%, respectively. Moreover, cytologists using artificial intelligence-assisted diagnosis system could save about 6 times of reading time than manual.Conclusions:Artificial intelligence-assisted diagnosis system for TBS report of cervical liquid-based thin-layer cytology has the advantages of high sensitivity, high specificity and strong generalization. Cytologists can significantly improve the accuracy and work efficiency of reading smears by using artificial intelligence-assisted diagnosis system.

Objective:To investigate the protective effect and mechanisms of umbilical cord tissue transplantation on radiation-induced learning and memory impairment in rats.Methods:Sixty SD rats were randomly divided into three groups with 20 in each group: control group, model group (whole brain X-ray irradiation, dose 20 Gy) and treatment group (whole brain X-ray irradiation, dose 20 Gy + umbilical cord tissue transplantation). The changes of body mass were observed, and the learning and memory of rats were observed by water maze test on the 14th and 28th day after irradiation, the neuron state of hippocampus was observed by HE staining, and the expressions of NF-κB pathway related proteins and IL-6 in hippocampus were detected by Western blot.Descriptive analysis and hypothesis testing were processed by SPSS 17.0.Results:(1) On the 28th day, the escaping latency in the water maze experiment of the treatment group was significantly higher than that of the control group and lower than that of the model group (control group: (11.77±3.02) s, model group: (23.75±3.27)s, treatment group: (18.49±2.32)s; t=3.940, -2.943, both P<0.05); the number of crossing platform in the treatment group was significantly lower than that in the control group and higher than that in the model group (control group: (7.20±0.84), model group (3.60±1.14 ), treatment group (5.00±1.00); t=-3.773, 2.064, both P<0.05). (2)HE staining showed that the neurons in the control group were arranged orderly and the cytoplasm was transparent.The neurons in the model group were arranged disorderly and the contraction of the cell body was triangular or irregular.The number of neurons in the treatment group was less than that in the model group. (3) On the 14th day, the relative expression of TLR4 in the treatment group was significantly higher than that in the control group and lower than that in the model group (control group: (0.69±0.03), model group: (1.06±0.11), treatment group: (0.90±0.04); t=7.275, -2.368, both P<0.05). The relative expression of NF-κB p65 in the treatment group was significantly higher than that in the control group and lower than that in the model group (control group: (1.67±0.12), model group: (2.08 ±0.06), treatment group: (1.93±0.08); t=3.236, -2.684, both P<0.05). The relative expression of IL-6 in the treatment group was significantly higher than that in the control group and lower than that in the model group (control group: (0.77±0.08), model group: (1.12±0.07), treatment group: (0.95±0.06); t=3.274, -3.495, both P<0.05). The relative expression of Bcl-2 / Bax in the treatment group was significantly lower than that in the control group and higher than that in the model group (control group: (1.40±0.52), model group: (0.48±0.06), treatment group: (0.72±0.0 3); t=-2.263, 6.350, both P<0.05). The expression trend of IL-6 and Bcl-2 / Bax protein on the 28th day was the same as that on the 14th day. Conclusion:Cord tissue transplantation can improve the learning and memory impairment caused by radiotherapy, which may be related with the inhibition of inflammation caused by radiotherapy.