It is believed that "deficiency qi retention and stagnation" is the fundamental pathogenesis of coronary microvascular dysfunction （CMD） after percutaneous coronary intervention （PCI）. Patients often have severe coronary vessel congestion before PCI， leading to emptiness in the heart's collaterals， which results in deficiency of healthy qi， poor movement of blood and body fluids， so the heart collaterals are susceptible to stagnation and stasis，then phlegm and stasis generate； after PCI， it is easy to damage the healthy qi then lead to qi deficiency， causing qi， blood， and body fluids fail to transport， thereby leading to blood stasis and phlegm turbidity retention， generating heat and wind to damage the heart and body. It is proposed that the prevention before PCI should replenish qi and collaterals， expel blood stasis and resolve phlegm， to support "deficient qi" in heart collaterals and prevent "stagnation" after PCI. Postoperative management should focus on replenishing qi and protecting the collaterals， eliminating pathogen and controlling development， so as to avoid exacerbating deficiency and stagnation by damaging healthy qi， and eliminate pathogen and unblock the collaterals to interrupt the pathogenesis， which prevent "retention and stagnation" from changes.

ObjectiveTo investigate the changes in cerebral blood perfusion in patients with acute cerebral infarction after taking Tongnaoyin， a traditional Chinese medicine， based on head and neck computed tomography （CT） angiography （CTA） combined with brain CT perfusion imaging （CTP）. MethodA total of 240 patients with cerebral infarction of phlegm and blood stasis syndrome treated in Jiangsu Province Hospital of Traditional Chinese Medicine from March 2018 to September 2023 were randomly divided into a control group （99 cases） and a Tongnaoyin group （141 cases）. Based on the guidelines， the control group was treated with conventional treatment such as anti-aggregation， anticoagulation， lipid-lowering and plaque stabilization， brain protection， and supportive treatment. The Tongnaoyin group was treated with Tongnaoyin of 200 mL in warm conditions in the morning and evening on the basis of the control group. Both groups underwent CTA combined with CTP within 24 hours after admission， and they were reexamined by CTA and CTP in the sixth month after admission. The degree of intracranial artery stenosis was determined according to the North American Symptomatic Carotid Endarterectomy Trial （NASCET） method. The relative cerebral blood volume （rCBV）， relative cerebral blood flow （rCBF）， mean transit time （MTT）， and time to peak （TTP） of the lesion area before and after treatment were compared. The adverse outcomes of the two groups within six months after discharge were compared. ResultCompared with the group before treatment， the degree of vascular stenosis in the Tongnaoyin group was significantly reduced， and the difference was statistically significant （Z=105.369，P<0.05）. Compared with the control group after treatment， the improvement rate of vascular stenosis in the Tongnaoyin group was higher （χ²=84.179，P<0.01）， and the curative effect was better.After treatment， the rCBV and rCBF of patients in the Tongnaoyin group were significantly increased， and the difference was statistically significant （P<0.01）. MTT and TTP showed a trend of shortening， but the difference was not statistically significant. There was no statistically significant difference in rCBV， rCBF， MTT， and TTP in the control group. Compared with those in the control group after treatment， the rCBV and rCBF in the Tongnaoyin group were significantly increased， while MTT and TTP were significantly reduced （P<0.01）. After six months of discharge， the risk of poor prognosis in the Tongnaoyin group was significantly reduced compared with the control group （P<0.05）. ConclusionTongnaoyin has a good effect on improving cerebral blood perfusion in patients with acute cerebral infarction. It can be used as an effective supplement for the conventional treatment of ischemic stroke to improve clinical efficacy.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

ObjectiveTo investigate the therapeutic effect of Dayuanyin on acute lung injury induced by H1N1 infection and decipher the potential mechanism. MethodThe constituents in Dayuanyin were analyzed by ultra-high performance liquid chromatography-quadrupole-exactive orbitrap mass spectrometry （UHPLC-Q-Exactive Orbitrap MS）. Forty-eight female BALB/c mice were randomized into normal， model， oseltamivir （19.5 mg·kg^-1）， and low-， medium-， and high-dose （2.73， 5.46， 10.92 g·kg^-1） Dayuanyin groups. The normal and model groups were administrated with deionized water by gavage， and the other groups were administrated with the corresponding drugs by gavage. On day 3 of drug administration， the normal group received nasal inhalation of normal saline， and the other groups were inoculated intranasally with A/RP/8/34 （H1N1） for the modeling of influenza virus infection. Mice were administrated with drugs continuously for 7 days and weighed daily. Sampling was performed 12 h after the last administration， and the lung tissue was weighed to calculate the lung index. Hematoxylin-eosin staining was performed to observe the pathological and morphological changes of the lung tissue and bronchi. The cytometric bead array （CBA） was used to measure the serum levels of interferon-gamma （IFN-γ）， C-X-C motif ligand 1 （CXCL1）， tumor necrosis factor-alpha （TNF-α）， chemokine ligand 2 （CCL2）， interleukin-12p70 （IL-12p70）， chemokine ligand 5 （CCL5）， interleukin-1β （IL-1β）， chemokine （C-X-C motif） ligand 10 （CXCL10）， granulocyte-macrophage colony-stimulating factor （GM-CSF）， interleukin-10 （IL-10）， interferon-beta （IFN-β）， interferon-alpha （IFN-α）， and interleukin-6 （IL-6）. According to the results of mass spectrometry and network pharmacology， we analyzed the mechanism of Dayuanyin in treating acute lung injury caused by H1N1. The protein levels of extracellular signal-regulated kinase 1/2 （ERK1/2）， p38 mitogen-activated protein kinase （p38 MAPK）， nuclear factor-kappa B （NF-κB）， and their phosphorylated forms were determined by Western blot. The mRNA levels of myeloid differentiation factor 88 （MyD88）， Toll-like receptor 3 （TLR3）， Toll-like receptor 7 （TLR7）， and Toll-like receptor 8 （TLR8） in the lung tissue were measured by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultA total of 57 compounds， including paeoniflorin and baicalein， were detected in Dayuanyin. Compared with the normal group， the model group showed decreased body weight （P<0.01）， lung edema and hemorrhage， increased lung index （P<0.01）， and elevated levels of IFN-γ， IL-12p70， CCL5， IL-1β， CXCL10， GM-CSF， IFN-β， and IL-6 （P<0.01）. Compared with the model group， Dayuanyin attenuated alveolar wall thickening， capillary congestion， and immune cell infiltration， reduced the alterations in body weight and lung index （P<0.01）， and down-regulated the protein levels of IFN-γ， IL-12p70， CCL5， IL-1β， CXCL10， GM-CSF， IFN-β， and IL-6 （P<0.01）. A total of 57 key genes were predicted by network pharmacological analysis， of which the MAPK signaling pathway was the main target signaling pathway. Compared with the normal group， the model group showed up-regulation in the protein levels of phosphorylation （p）-ERK1/2， p-p38 MAPK， and p-NF-κB （P<0.01） and the mRNA levels of TLR7， TLR8， MyD88， and TLR3 （P<0.05， P<0.01）. Compared with the model group， Dayuanyin lowered the phosphorylation levels of ERK1/2， p38 MAPK， and NF-κB p65 in a dose-dependent manner （P<0.01） and down-regulated the mRNA levels of TLR3， TLR7， TLR8， and MyD88 （P<0.01）. ConclusionDayuanyin can prevent and control H1N1 infection-induced acute lung injury by inhibiting the TLR/MAPK/NF-κB signaling pathway.

The risk of colorectal cancer is substantially higher in patients with long-term colorectal inflammation than in the general population.Prolonged inflammation is an essential factor that triggers colorectal cancer.The dynamic pathological evolution process of the classic"inflammation-mediated carcinogenesis"in the colorectum is proctocolitis→dysplasia→cancer.Traditional Chinese medicine lacks a systematic consensus on the pathogenesis of colorectal"inflammation-mediated carcinogenesis".This article proposes the theory of"pathogenic factors lurk intestinal collaterals"to explain the development law of pathogenesis in the dynamic evolution of colorectal"inflammation-mediated carcinogenesis".Internal and external factors can trigger the movement of the latent pathogenic factors,thereby damaging the intestinal tissues,when latent pathogenic factors are hidden in the intestinal collaterals,and the healthy qi is unable to expel them.The prolonged course of the disease further weakens the healthy qi,allowing the latent pathogenic factors to accumulate in the intestinal collaterals,intertwine with phlegm-dampness and blood stasis,accelerate accumulation,and lead to cancer."Latent pathogens trapped in the intestinal collaterals"is the core pathogenesis during inflammation-mediated carcinogenesis.Thus,to prevent colorectal inflammation-mediated carcinogenesis,consideration should be given to the principle of driving away pathogenic factors and dredging the collaterals in clinical practice.The theory regarding"latent pathogens trapped in the intestinal collaterals"can provide a theoretical reference for syndrome differentiation and treating colorectal inflammation-mediated carcinogenesis and offer novel ideas for clinical treatment.

Objective To evaluate the performance of a clinical-radiomics model for differentiating focal organizing pneumonia(FOP)and lung adenocarcinoma(LUAD).Methods We retrospectively analyzed the data of 60 patients with FOP confirmed by postoperative pathology at the First Medical Center of the Chinese PLA General Hospital from January,2019 to December,2022,who were matched with 120 LUAD patients using propensity score matching in a 1∶2 ratio.The independent risk factors for FOP were identified by logistic regression analysis of the patients'clinical data.The cohort was divided into a training set(144 patients)and a test set(36 patients)by random sampling.Python 3.7 was used for extracting 1835 features from CT image data of the patients.The radiographic features and clinical data were used to construct the model,whose performance was validated using ROC curves in both the training and test sets.The diagnostic efficacy of the model for FOP and LUAD was evaluated and a diagnostic nomogram was constructed.Results Statistical analysis revealed that an history of was an independent risk factor for FOP(P=0.016),which was correlated with none of the hematological findings(P>0.05).Feature extraction and dimensionality reduction in radiomics yielded 30 significant labels for distinguishing the two diseases.The top 3 most discriminative radiomics labels were GraylevelNonUniformity,SizeZoneNonUniformity and shape-Sphericity.The clinical-radiomics model achieved an AUC of 0.909(95%CI:0.855-0.963)in the training set and 0.901(95%CI:0.803-0.999)in the test set.The model showed a sensitivity of 85.4%,a specificity of 83.5%,and an accuracy of 84.0%in the training set,as compared with 94.7%,70.6%,and 83.3%in the test set,respectively.Conclusion The clinical-radiomics nomogram model shows a good performance for differential diagnosis of FOP and LUAD and may help to minimize misdiagnosis-related overtreatment and improve the patients'outcomes.

Objective: To determine the efficacy and safety of the Yinmei Kuijie decoction combined with 5-aminosalicylic acid (5-ASA) in treating mildly to moderately active ulcerative colitis (UC) under real-world conditions. Methods: This multicenter, prospective, non-randomized, observational study will be conducted in real-world settings. A total of 204 eligible patients will be consecutively enrolled in the study. Patients in the combination treatment group will receive Yinmei Kuijie decoction in combination with 5-ASA, whereas those in the control group will be treated with 5-ASA alone. The primary endpoint will be a clinical response at week 12, defined as a ≥3 point and ≥30% reduction from baseline in the Mayo total score with ≥1 reduction in rectal bleeding or rectal bleeding score = 0 or 1. Secondary efficacy endpoints at week 12 will include health-related quality of life, mucosal healing, and inflammation indicators. Conclusion The results of this study may provide evidence of the efficacy and safety of Yinmei Kuijie decoction combined with 5-ASA in treating patients with mildly to moderately active UC under real-world principles. The results will provide a basis for further confirmatory studies on the efficacy of Yinmei Kuijie decoction.

Objective To develop the volume adjustable vegetable facilities and meet the demands of research on the growing technique of vegetables.Methods Three series of adjustable volume vegetable facilities were developed with light and ventilation module,growth module,cultivation tray module and measurement module.Telescopic structure was adopted in the facilities and the performance testing and characteristics analyses were carried out.Results The facilities could be adjusted at the height range of 250-700 mm.Three kinds of LED lights and replaceable cultivation tray and matrix were installed in the facilities.The parameters including water content,electric conductivity and temperature in the matrix,CO2 concentration in the atmosphere of facilities were monitored.The test results showed that the performances and the indexes of facilities met the subsequent experimental demands.Conclusion Light weight,small volume,and adjustable volume vegetable facilities were developed.The production efficiency of lettuce(12 plants/0.12 m2)grown in the facilities was 49.7 g(FW)plant-1.The development of facilities laid the foundation of construction of on-orbit vegetable facility.

Objective Rinse the common bile duct with 100 mL of 0.9%sodium chloride injection after choledocholithotomy to observe if it can improve the clearance rate of residual stones.Methods A study enrolled patients receiving endoscopic retrograde cholangiopancreatography(ERCP)and mechanical lithotripsy for calculus of common bile duct(≥12 mm)were conducted.After occlusion cholangiography confirmed common bile duct stone clearance,intraductal ultrasonography(IDUS)was performed to determine clearance scores based on the number of residual stones.The amounts of residual stones spotted via IDUS were graded,a large amount of stone fragments scored 1,a small amount of stone fragments scored 2,completely cleared common bile duct without any biliary sludge scored 3.After clearing calculus of common bile duct in ERCP and rinsing with 50 mL and 100 mL 0.9%sodium chloride injection,IDUS examination was performed and scored.Results No patient had common bile duct clearance scores of reached 3 without saline irrigation,45(40.18%)patients reached 3 with 50 mL 0.9%sodium chloride injection irrigation,and 99(88.39%)patients reached 3 with 100 mL irrigation.Multivariate Logistic regression analysis showed that common bile duct diameter>15 mm[odds ratio(O＾R)=4.90,95%confidence interval(CI):1.19～22.57,P=0.013],angulation of the distal common bile duct(the angle between the axis of the common bile duct and the ampulla axis of the common bile duct in cholangiography)≤140°(O＾R=6.92,95%CI:1.83～38.98,P=0.047)and duodenal diverticulum(O＾R=4.10,95%CI:1.14～16.90,P=0.041)were independent risk factors for failure to rinse with 100 mL 0.9%sodium chloride injection.Conclusion Irrigation with 100 mL 0.9%sodium chloride injection can effectively remove the residual calculus of common bile duct after lithotripsy.

Objective To evaluate the performance of a clinical-radiomics model for differentiating focal organizing pneumonia(FOP)and lung adenocarcinoma(LUAD).Methods We retrospectively analyzed the data of 60 patients with FOP confirmed by postoperative pathology at the First Medical Center of the Chinese PLA General Hospital from January,2019 to December,2022,who were matched with 120 LUAD patients using propensity score matching in a 1∶2 ratio.The independent risk factors for FOP were identified by logistic regression analysis of the patients'clinical data.The cohort was divided into a training set(144 patients)and a test set(36 patients)by random sampling.Python 3.7 was used for extracting 1835 features from CT image data of the patients.The radiographic features and clinical data were used to construct the model,whose performance was validated using ROC curves in both the training and test sets.The diagnostic efficacy of the model for FOP and LUAD was evaluated and a diagnostic nomogram was constructed.Results Statistical analysis revealed that an history of was an independent risk factor for FOP(P=0.016),which was correlated with none of the hematological findings(P>0.05).Feature extraction and dimensionality reduction in radiomics yielded 30 significant labels for distinguishing the two diseases.The top 3 most discriminative radiomics labels were GraylevelNonUniformity,SizeZoneNonUniformity and shape-Sphericity.The clinical-radiomics model achieved an AUC of 0.909(95%CI:0.855-0.963)in the training set and 0.901(95%CI:0.803-0.999)in the test set.The model showed a sensitivity of 85.4%,a specificity of 83.5%,and an accuracy of 84.0%in the training set,as compared with 94.7%,70.6%,and 83.3%in the test set,respectively.Conclusion The clinical-radiomics nomogram model shows a good performance for differential diagnosis of FOP and LUAD and may help to minimize misdiagnosis-related overtreatment and improve the patients'outcomes.