Purpose/Significance To sort out the literature in the field of traditional Chinese medicine(TCM)in China in the past decade,and to expound the hot topics and development trends in this field.Method/Process Literature in the field of TCM in Wanfang Data from 2013 to 2022 is searched.The abstracts are taken as the research objects,the topics are extracted by BERTopic model,and CiteSpace is used for visualization and analysis.Result/Conclusion 12 683 papers in Chinese are included,and the 5 topics are found:clinical trials and efficacy,research on pathogenesis and pharmacology,the development of the field of TCM,treatment of chronic dis-ease,drug analysis and literature research.The paper makes an in-depth analysis of the topic of the development of traditional Chinese medicine,which continues to grow in popularity,and puts forward that the deep integration of artificial intelligence(AI)and TCM is the future trend.

Purpose/Significance The paper discusses the construction of the current elderly health policy system by using policy text min-ing and quantitative evaluation,and provides references for future policy adjustment and optimization.Method/Process Policies on elderly health issued by the relative departments from 2019 to 2023 are analyzed.The ROST text data mining tool is used to extract high-frequency words and build semantic networks.Gephi is utilized to visualize social network relationships for text analysis.Quantitative analysis of these policies is conducted using the PMC index model.Results/Conclusion The high-frequency words such as"national","society","knowl-edge","resources",and"guarantee"are identified as key areas in elderly health policies,which are interconnected within the social network.The overall trend of the elderly health policy formulation is positive.It is suggested to improve the accuracy and adaptability of the policy,clari-fy the time node and core elements of the policy,and enhance the strategic analysis of the function and content of the policy.

Purpose: The human epidermal growth factor receptor 2 (HER2) is an established therapeutic target for various kinds of solid tumors. HER2 amplification occurs in approximately 1% to 6% of colorectal cancer. In this study, we aimed to assess the efficacy and safety of trastuzumab in combination with chemotherapy in HER2-positive metastatic colorectal cancer (mCRC). Materials and Methods: An open-label, phase II trial (Clinicaltrials.gov: NCT03185988) was designed to evaluate the antitumor activity of trastuzumab and chemotherapy in HER2-positive digestive cancers excluding gastric cancer in 2017. Patients from this trial with HER2-positive, KRAS/BRAF wild-type, unresectable mCRC were analyzed in this manuscript. Eligible patients were treated with trastuzumab (8 mg/kg loading dose and then 6 mg/kg every 3 weeks) and irinotecan (120 mg/m2 days 1 and 8 every 3 weeks). The primary endpoint was the objective response rate. Results: Twenty-one HER2-positive mCRC patients were enrolled in this study. Seven patients (33.3%) achieved an objective res-ponse, and 11 patients (52.4%) had stable disease as their best response. The median progression-free survival (PFS) was 4.3 months (95% confidence interval, 2.7 to 5.9). Four of the 21 patients (19.0%) had grade 3 adverse events, including leukopenia, neutropenia, urinary tract infection, and diarrhea. No treatment-related death was reported. Exploratory analyses revealed that high tumor tissue HER2 copy number was associated with better therapeutic response and PFS. Alterations in the mitogen-activated protein kinase pathway, HER2 gene, phosphoinositide 3-kinase/AKT pathway, and cell cycle control genes were potential drivers of trastuzumab resistance in mCRC. Conclusion Trastuzumab combined with chemotherapy is a potentially effective and well-tolerated therapeutic regimen in mCRC with a high HER2 copy number.

The end of the COVID-19 infection peak in 2022 prompts a backlog of cardiovascular surgical patients to gradually return to the hospital, resulting in a surge in cardiovascular surgeries. However, against the backdrop of the COVID-19 pandemic, the clinical practice of cardiovascular surgery faces many problems. Therefore, organized by Beijing Anzhen Hospital, experts in cardiovascular surgery and related fields have formulated hospital expert experience on perioperative treatment principles of cardiovascular surgery for patients infected with COVID-19. This article summarizes the clinical decision-making of patients requiring cardiovascular surgery after COVID-19 infection, and advises on the corresponding recommendations according to the existing evidence-based medical evidence as well as the actual clinical practice experience of relevant experts. The main content of the article includes special requirements for cardiovascular surgical treatment indications in patients with COVID-19 infection, selection of surgical timing, special requirements of preoperative, intraoperative and postoperative management, etc., which aims to provide COVID-19-infected patients with guidance on rational decision-making when receiving cardiovascular surgery.

Background Subways are typical congregate settings and may facilitate aerosol transmission of viruses. However, quantified transmission probability estimates are lacking. Purpose To model spread and diffusion of respiratory aerosols in subways by simulation and calculation of infection probabilities. Methods The internal environment of carriages of Shanghai Metro Line 10 was used to establish a study scene. The movement of tiny particles was simulated using the turbulent model. Trend analysis of infection probabilities and viral quantum doses was conducted in a closed subway carriage scene by a quantum emission-infection probability model. Results Under a typical twelve-vent air conditioning configuration, respiratory droplet aerosols within a subway carriage dispersed rapidly throughout various regions due to airflow, with limited short-term diffusion to other carriages. Concurrently, owing to the uncertainty of airflow patterns, the airflow might circulate and converge within carriages, causing delayed outward dispersion or hindered dispersion of droplet aerosols upon entry into these zones. Passengers boarding the carriage could exacerbate the formation of these zones. When the air conditioning system functioned adequately (air exchange rate=23.21 h⁻¹), the probability of a virus carrier transmitting the virus to other passengers within the same carriage via aerosol transmission was approximately 3.8%. However, in the event of air conditioning system failure (air exchange rate=0.5 h⁻¹), this probability escalated dramatically to 30%. Furthermore, a super-spreader (with virus spreading exceeding 90% of the average) elevated the infection probability to 14.9%. Additionally, due to the complexity of turbulence within the carriage, if local diffusion occurred in 1/2 zones of a carriage, the anticipated infection probability would increase to 8.9%, or during the morning or evening rush hours leading to elevated aerosol concentrations, the infection probability would rise to 4.7%. The subway transmission probability for common coronaviruses diminished to as low as 0.9%. Conclusion Combined computational fluid dynamics and infection probability analysis reveals that in the prevalent twelve-vent air conditioning configurations, despite being a major transportation hub with substantial spatial-temporal overlap, the internal space of subway carriages exhibits a certain level of resistance to virus aerosol transmission owing to built-in ventilation capabilities. However, turbulence and passenger positioning may lead to localized hovering of droplet aerosols, thereby increase the risk of virus transmission. Furthermore, super-spreaders, poor operational status of built-in air conditioning system, and high passenger volume at morning or evening peak hours exert profound effects on virus transmission and infection probability.

PURPOSE: A large number of studies have suggested the practicability and predictability of immediate implant function, but few studies have reported marginal bone level changes during sequential loading periods. The purpose of this study was to evaluate the marginal bone remodeling of immediately loaded self-tapping implants both at each time point and during each loading period between two time points. MATERIALS AND METHODS: The patients included in this retrospective study were treated with immediately loaded NobelSpeedy Replace implants between August 2008 and July 2009. Differences in the marginal bone level (MBL) at each time point and the marginal bone level change (ΔMBL) between two time points were analyzed with Bonferroni correction (P < .05). RESULTS: Overall, 24 patients (mean age, 47.3 ± 12.8 years) with 42 immediately loaded implants and a median follow-up of 6.5 years (IQR, 67.8 months) were included. The cumulative survival rate after 10 - 12 years was 95.2%. Continuous but slow marginal bone loss was observed during long-term follow-up. MBL at both 7.5 years and 11 years was significantly lower than that at loading, 6 months, 2 years and 4 years (P < .05). No bone loss difference was found in any period before 4 years of follow up (P > .05). The loading period of 4 years to 7.5 years showed the largest ΔMBL compared to those of other time periods (P < .05). CONCLUSION Slight bone loss occurred continuously, and more radical changes of marginal bone can be observed during the period of 4-7.5 years. Thus, long-term effective follow-up of immediately loaded implants is needed.

Objective:To explore the aerobic exercise tolerance and ventilatory efficiency during cardiopulmonary exercise testing (CPET) of persons with non-small cell lung cancer (NSCLC) complicated by type 2 diabetes mellitus (T2DM).Methods:Forty-eight persons with NSCLC and T2DM formed an NSCLC-T2DM group while another 48 persons with NSCLC but not T2DM formed an NSCLC-non T2DM group. Another 24 healthy counterparts were enrolled into the control group. All completed CPET before pneumonectomies were performed on those with NSCLC. Indexes of static pulmonary function, exercise tolerance, heart rate recovery, ventilation efficiency and gas exchange were computed.Results:Compared with the control group, both NSCLC groups had, on average, lower peak oxygen uptake (VO 2peak), lower anaerobic thresholds (ATs) and lower peak O 2 pulse rates. They also had higher average VE/VCO 2 slopes and VE/VCO 2 nadirs. Compared with the NSCLC-non T2DM group, those with T2DM had a significantly lower average VO 2peak and WRpeak, as well as significantly higher average VE/VCO 2 slope and VE/VCO 2 nadir. Compared with the control group, the average VO 2 and VCO 2 of both NSCLC groups was lower at the AT and during peak exercise, with the NSCLC-T2DM group′s averages significantly lower than those of the NSCLC-non T2DM group during peak exercise. During warm-up and at the AT, the NSCLC groups had a significantly higher average heart rate than the control group. Then, compared with the control group and the NSCLC-non T2DM group, the average heart rate in the NSCLC-T2DM group decreased significantly more slowly during the first three minutes of the recovery period. Compared with the control group, the VE/VCO 2 values of the NSCLC groups were significantly higher at the AT and during peak exercise. During the warm-up and at the AT, the average partial pressures of end-tidal carbon dioxide in the NSCLC groups were significantly lower than among control group, and during peak exercise the NSCLC-T2DM group′s average value was significantly lower than the control group′s. Compared with the control group and the NSCLC-non T2DM group, the NSCLC-T2DM group′s average forced expiratory volume in one second, forced vital capacity, peak expiratory flow rate and maximum voluntary ventilation were all significantly lower. Conclusions:Diabetes impairs the exercise tolerance and ventilation efficiency of persons with NSCLC. Without diabetes their exercise tolerance and ventilation efficiency would be impaired only slightly. CPET can provide a basis for risk assessment before pneumonectomy.

Objective:To investigate the current situation of cardiopulmonary bypass(CPB) in China and analyze the causes, to guide the formulation and implementation of technology standard.Methods:The survey task force sent out a nationwide survey to obtain up-to-date information on perfusion practice by ChSECC(Chinese Society of Extracorporeal Circulation). The unit of analysis for the survey was the medical center performs CPB. The survey consisted 48 questions covering four topics of qualifications, including certification and education, policies and practices, device and equipment, techniques used.Results:There were 540 of the 714 centers for an overall response rate of 76%. According to the annual number of CPB, they were divided into 4 groups: group A(≤50 cases/year), group B(50-100 cases/year), group C(100-500 cases/year) and group D(≥500 cases/year). The response rate of center with more than group D last year was 100%. Most of the perfusionists had certification issued by ChSECC. Although there were more than 80% of group D performed regular training and assessment of perfusionist, the result was still not ideal enough. Low utilization of safety equipment was not depend on the annual operation volume in most of responding centers. Ultrafiltration and blood protection technology had high application rate in group D compared with group A and B.Conclusion:The certification rate of perfusionists are high. Lower the number of annual CPB cases, lower the proportion of regular evaluation and training, and lower rate of standards performance. No matter the amount of CPB, the application rate of safety equipment is not ideal. Higher the number of CPB cases, higher the utilization rate of CPB related technologies.

Selective occlusion of tumor vasculature has proven to be an effective strategy for cancer therapy. Among vascular coagulation agents, the extracellular domain of coagulation-inducing protein tissue factor, truncated tissue factor (tTF), is the most widely used. Since the truncated protein exhibits no coagulation activity and is rapidly cleared in the circulation, free tTF cannot be used for cancer treatment on its own but must be combined with other moieties. We here developed a novel, tumor-specific tTF delivery system through coupling tTF with the DNA aptamer, AS1411, which selectively binds to nucleolin receptors overexpressing on the surface of tumor vascular endothelial cells and is specifically cytotoxic to target cells. Systemic administration of the tTF-AS1411 conjugates into tumor-bearing animals induced intravascular thrombosis solely in tumors, thus reducing tumor blood supply and inducing tumor necrosis without apparent side effects. This conjugate represents a uniquely attractive candidate for the clinical translation of vessel occlusion agent for cancer therapy.

Objective To evaluate the pathological stage,the presence of detrusor muscle and the clinical significance for standardized examination of specimens for en bloc transurethral resection technique with Hybrid Knife to treat NMIBC (ERBT) compared with conventional TURBT.Methods This was prospective randomized controlled study.This study was approved by the Ethics Committee of Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology (TJ-IRB20180604),and patients all signed informed consent.The clinical study registration number of this study:NCT03221062.The margin of the tumor was recognized and marked by with Hybrid Knife (0.5 cm away from the normal mucosa).Then water was injected into the submucosa and form a water pad,with a circular cutting layer by layer (0.5 cm away from the marked position),reaching the detrusor muscle in depth.After complete resection,the tumor was removed by specimen bag.Specimens for ERBT cohort were given standard handling.Resected specimen of ERBT stretched with pins on foam and its margin was stained.The basement of specimen was also stained.Total specimen sectioned into appropriate pieces for histological assessment in the department of pathology.TURBT cohort performed traditional surgical methods and pathological examination.All patients received postoperative intravesical instillation according to their pathology.Imaging and cystoscopy were performed every 3 months.The primary study end-point was the quality of resection,including the pathological stage and the presence of DM.Secondary outcomes were:short-term tumour recurrence rate (18 month),feasibility,and safety.Results From January 2017 to October 2017,109 patients were enrolled.51 patients underwent ERBT,and 58 patients underwent TURBT.The clinical characteristics of the patients in each cohort,such as average age,gender,average BMI,smoking history,the mean number of lesions and tumour size had no significant differences (P ＞ 0.05).The operation of 109 cases was completed successfully.There was no statistical difference between the operative time and the postoperative bladder irrigation time.Major intraoperative or postoperative complications (Clavien ≥ Ⅱ) did not occur in all of the patients.The percentage of T1 staging was higher in the ERBT cohort vs.TURBT cohort [21/51 (41.2％) vs.13/58 (22.4％),P =0.035],of which ERBT cohort accurately detected 9 cases (42.8％) of T1b patients,significantly higher than TURBT cohort (2 cases,15.4％) (P =0.096).All the ERBT samples showed the presence of DM (100.0％),while there was only 77.4％ in TURBT cohort (P ＜ 0.05).Mean follow-up (20.3 ± 3.1) months (ranged from 18 to 24 months).Recurrence rate were 8.9％ (4/45) in ERBT cohort vs.22.2％ (12/54) in TURBT cohort (P=0.059).Conclusions ERBT with Hybrid Knife for treatment NMIBC is a safe,effective,and provides high-quality specimens compared to TURBT.More high-risk NMIBC patients,especially T1 b patients,can be detected obviously by pathologist with the standardized treatment of specimens.