ObjectiveTo evaluate the effects of Tongnaoyin on the blood-brain barrier status and neurological impairment in acute ischemic stroke （AIS） patients with the syndrome of phlegm-stasis blocking collaterals by dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI）. MethodsA total of 63 patients diagnosed with AIS in the Jiangsu Province Hospital of Chinese Medicine from October 2022 to December 2023 were enrolled in this study. According to random number table method，the patients were assigned into a control group （32 cases） and an observation group （31 cases）. The control group received conventional Western medical treatment，and the observation group took 200 mL Tongnaoyin after meals，twice a day from day 2 of admission on the basis of the treatment in the control group. After 7 days of treatment，the patients were examined by DCE-MRI. The baseline data for two groups of patients before treatment were compared. The National Institute of Health Stroke Scale （NIHSS） score and modified Rankin Scale （mRS） score were recorded before treatment and after 90 days of treatment for both groups. The rKtrans，rKep，and rVe values were obtained from the region of interest （ROI） of the infarct zone/mirror area and compared between the two groups. ResultsThere was no significant difference in the NIHSS or mRS score between the two groups before treatment. After 90 days of treatment，the NIHSS and mRS scores declined in both groups，and the observation group had lower scores than the control group （P<0.05）. After treatment，the rKtrans and rVe in the observation group were lower than those in the control group （P<0.01）. ConclusionCompared with conventional Western medical treatment alone，conventional Western medical treatment combined with Tongnaoyin accelerates the repair of the blood-brain barrier in AIS patients，thereby ameliorating neurological impairment after AIS to improve the prognosis.

Objective Emergency response to public health emergencies constitutes a vital component of the modernization of national governance systems and capacities, directly impacting national security, social stability, and public health. This study aims to analyze the key issues and research hotspots in the field of emergency response to public health emergencies, providing theoretical foundations and practical guidance for formulating scientific and effective emergency strategies and policies. Ultimately, it seeks to enhance the nation’s capability to respond to public health emergencies and safeguard public health. Methods Using core journals indexed in the China National Knowledge Infrastructure (CNKI) database as the data source, 1094 journal articles in the field of emergency response to public health emergencies in China from 2003 to September 2024 were selected as the research sample. Citespace visualization software was employed to organize and analyze the research process in the field of emergency response to public health emergencies. Results The current research in this field predominantly involves small-scale cooperation, and the research process can be divided into four stages. The research in the emerging stage mainly focuses on the themes of emergency mechanism and emergency management, the development stage mainly centers on the themes of emergency capacity improvement and system exploration, the outbreak stage emphasizes the themes of COVID-19 and epidemic prevention and control, and the sustainable development stage highlights collaborative governance and informatization. Conclusion The COVID-19 pandemic has accelerated the development of research in this field. Currently, the field shows a continuous growth, with an increasing volume of publications. The focus of current research has shifted towards collaborative governance and the study of assessment tools, aiming to enhance the efficiency and effectiveness in responding to public health emergencies. Moreover, the field is advancing toward more systematic and comprehensive research. However, there is still a need to strengthen scientific communication and collaboration.

Objective: To analyze the relationship between cumulative ecological risks and physical activity behaviors of junior high school students, so as to provide theoretical support for promoting the physical and mental health development of junior high school students. Methods: From March to April 2023, a multistage random cluster sampling method was used to conduct an online survey of 3 502 middle school students in Henan Province. Physical activity levels and cumulative ecological risk were measured using the Physical Activity Rating Scale-3 and the Cumulative Ecological Risk Scale. Chisquare test and multiple Logistic regression were employed to examine the distribution and influencing factors of physical exercise behaviors among different student groups. Results: Slight physical exercise had the highest proportion of physical activity in tensity among junior high school students (48.5%), with 80.4% engaging in low levels of physical activity. Only 16.8% of students exercised ≥1 time daily, and the most common frequency was 1-2 times per week (44.1%). Gender, residential area, parental education, and peer support were all significantly associated with physical activity levels among junior high school students (χ2=122.53, 6.49, 7.49, 10.17, P<0.05). Logistic regression analysis showed that higher cumulative ecological risk scores were associated with a greater likelihood of engaging in low levels of physical activity compared to high levels (OR=1.12, 95%CI=1.02-1.23, P<0.05), but no significant association was found for moderate physical activity (OR=1.08, 95%CI=0.97-1.21, P>0.05). Conclusions Junior high school students in Henan Province generally engage in insufficient physical exercise. Cumulative ecological risk negatively predicts their physical activity behaviors.

Objective To investigate the current level of public awareness regarding nuclear emergency evacuation around a nuclear power plant, analyze the influencing factors, and propose suggestions and countermeasures based on the results. Methods In July 2024, according to the survey protocol and questionnaire developed by the National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, a field-based centralized online questionnaire was administered. A total of 854 residents living near the nuclear power plant were included as survey participants. An analysis of variance was used to compare the impact of different factors on the public knowledge of nuclear radiation and awareness of nuclear emergency evacuation, while the chi-square test was employed to compare differences between groups. Results A total of 854 questionnaires were collected in this study. The survey revealed that the levels of public knowledge about nuclear radiation and awareness of nuclear emergency evacuation around the power plant were relatively low, with average objective awareness rates of 51% and 47%, respectively. In terms of age, the 30-45 years old group had the highest average score, while the group aged 60 and above had the lowest. Regarding education level, the group with primary school education or below had the lowest average score, whereas those with junior college or undergraduate education scored the highest. The internet (73.7%) was the primary source of emergency information for the public, followed by television (61.7%). The majority of the public (85.0%) expressed trust in the government during evacuation and were willing to follow governmental evacuation arrangements. The main reason for this willingness was the belief that the government could provide sufficient emergency supplies. Conclusion The surveyed population exhibited low levels of knowledge regarding nuclear radiation and awareness of nuclear emergency evacuation, with generally low awareness rates. Awareness levels were influenced by factors such as sex, age, educational background, and distance from the nuclear power plant. To enhance public awareness, it is necessary to strengthen science communication related to nuclear radiation and public protective actions in nuclear emergencies. Targeted dissemination strategies with high communication effectiveness, accessibility, and public acceptance should be adopted to gradually enhance public awareness of nuclear radiation and nuclear emergency protective actions.

The 20th National Congress of the Communist Party of China emphasized the expansion of international scientific and technological exchanges and cooperation. Against this backdrop, the radiological health research institutions bear important responsibilities in the field of international radiological health. As a key institution in the industry, the National Institute for Radiological Protection (NIRP), Chinese Center for Disease Control and Prevention shoulders the important mission of promoting international exchanges in radiation health in China. A case study was conducted on the NIRP using data of official overseas visits from 2010 to 2024. The SWOT analysis was used to comprehensively and systematically examine the strengths, weaknesses, opportunities, and challenges of NIRP in international cooperation and exchanges. To effectively enhance the depth and scope of international exchanges, this article proposes a series of innovative optimization strategies such as establishing dedicated personnel positions to ensure efficient handling of affairs, implementing stringent approval procedures to guarantee the rationality and compliance of overseas visits, strengthening pre-departure training to improve the professionalism of outbound personnel, conducting follow-up evaluations to continuously refine management practices, and centralizing the management of official passports to ensure their secure use. This article aims to provide practical optimization strategies for the management of official overseas visits for NIRP and other similar institutions, promote international exchanges and cooperation in the field of radiation health, and help China play a more important role in the global radiation health field.

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.

Objective To discuss the value of clinical radiomic nomogram(CRN)and deep convolutional neural network(DCNN)in distinguishing atypical pulmonary hamartoma(APH)from atypical lung adenocarcinoma(ALA).Methods A total of 307 patients were retrospectively recruited from two institutions.Patients in institu-tion 1 were randomly divided into the training(n=184:APH=97,ALA=87)and internal validation sets(n=79:APH=41,ALA=38)in a ratio of 7∶3,and patients in institution 2 were assigned as the external validation set(n=44:APH=23,ALA=21).A CRN model and a DCNN model were established,respectively,and the performances of two models were compared by delong test and receiver operating characteristic(ROC)curves.A human-machine competition was conducted to evaluate the value of AI in the Lung-RADS classification.Results The areas under the curve(AUCs)of DCNN model were higher than those of CRN model in the training,internal and external validation sets(0.983 vs 0.968,0.973 vs 0.953,and 0.942 vs 0.932,respectively),however,the differences were not statistically significant(p=0.23,0.31 and 0.34,respectively).With a radiologist-AI com-petition experiment,AI tended to downgrade more Lung-RADS categories in APH and affirm more Lung-RADS cat-egories in ALA than radiologists.Conclusion Both DCNN and CRN have higher value in distinguishing APH from ALA,with the former performing better.AI is superior to radiologists in evaluating the Lung-RADS classification of pulmonary nodules.

Objective To investigate the characteristics of imaging signs of giant cell tumor(GCT)of the hand and foot bones.Methods The clinical,X-ray,CT and MRI images of 18 cases of GCT of hand and foot bones diagnosed by pathology were analyzed retrospectively.And compared with 54 cases of long bone GCT imaging manifestations.Results Among the 18 GCT cases of hand and foot bones,there were 8 cases of hand,10 cases of foot,including 12 cases of short tubular bone and 6 cases of tarsal bone.All lesions were dilatant osteolytic bone destruction involving the joint surface,in which the short tubular bone GCT showed central growth,the tumor occupied the entire wide diameter of the bone,the lesion range was long,consistent with the bone axis,easy to invade the surrounding soft tissue,sclerotic edge,bone ridge,lobed and periosteal reaction were rare,and prone to recurrence after surgery.The GCT of tarsal bone and short tubular bone showed eccentric growth,and there was statistical difference(P<0.05).The probability of pathological fracture in GCT of long bone was significantly greater than that of short tubular bone.There was no significant difference between the two groups in swelling growth,involvement of bone end and ethmoid sign of bone cortex.Conclusion Compared with long bone GCT,hand and foot bones are rare occurrence site of GCT,which is more aggressive than long bone GCT and prone to recurrence after surgery.Full attention should be paid to its imaging characteristics to provide more accurate image information for clinical treatment strategies.

Objective:To systematically evaluate and integrate the qualitative research of nursing students participating in hospice care practice experience, to provide a basis for the better development of hospice care education.Methods:A computer search was conducted on the China national knowledge infrastructure, Chinese Biomedical Literature Database, VIP database, Wanfang Medical Database, Cochrane Library, Embase, Web of Science, and PubMed for qualitative research on nursing students' participation in hospice care practices. The search period was from the establishment of the database to February 2023. The quality of the included literature was evaluated using the qualitative research quality evaluation criteria of the Australian JBI Evidence Based Health Care Center. A aggregative integration method was used for result integration.Results:A total of 16 articles were included, and 46 major research results were extracted and summarized into 9 new categories, forming 4 integrated results: providing hospice care services for patients and their families; emotional experience of nursing dying patients; coping with negative experience and harvesting personal growth; needs and difficulties.Conclusions:Nursing students experience multiple emotional experiences in hospice care practice, and are eager to help and support in various aspects. It is suggested for managers to pay attention to the inner experience and needs of nursing students, improve hospice care education in China, and improve the end-of-life care ability of nursing students.

AIM: To compare the binocular and monocular accommodation among normal group, premyopia group and mild myopia group, and to study the characteristics of accommodation in the premyopia group, thus providing clinical evidence for the delay/prevention of myopia and the effective decrease of the incidence of myopia.METHODS: Cross-sectional descriptive study. A total of 179 children who had abnormal/high-risk visual acuity indicated by the vision screening in school from October 2021 to February 2023 were selected, including 92 males and 87 females, aged from 6 to 12(mean 8.55±1.66)years old, then they were referred to the Juvenile Myopia Prevention and Control Center in Cuizu Community Health Service Center. They were divided into normal group(+0.75 D<SE≤+2.00 D), the premyopia group(-0.50 D<SE≤+0.75 D)and the mild myopia group(-3.00 D≤SE≤-0.50 D)according to the diopters after cycloplegia, and binocular myopia grouping is defined by the eye with lower diopter. Binocular positive relative accommodation(PRA), negative relative accommodation(NRA), accommodative facility(AF), and monocular AF and amplitude of accommodation(AA)were examined. The age, binocular and monocular accommodation of different groups were compared.RESULTS: There were no difference in the sex ratio of different groups(χ2=0.167, P=0.920). There was no difference in age between the normal group and the premyopia group(P=0.310), but there were differences between the mild myopia group and the normal group and premyopia group(P=0.018, <0.01); Binocular NRA, PRA, and AF had significance between the normal group and the premyopia group(P<0.01), while there was no significance between the premyopia group and the mild myopia(P>0.05). Monocular AF had significance between the normal group and the premyopia group(P<0.01), while there was no significance between the premyopia group and the mild myopia group(P>0.05); The monocular AA had significance among the three groups(P<0.05).CONCLUSION: Although the diopters was normal, binocular NRA, PRA, monocular and binocular AF had significantly decreased in the premyopia group, and there was no significant difference compared with mild myopia group; monocular AA had decreased in the premyopia group and it was also significantly different from the mild myopia group. The accommodation function should be examined in premyopic children. Recovering the abnormal visual function through visual training may be a way to prevent and control premyopia from progressing to myopia.