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 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.

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 analyze and explore the health response capability construction in the long-term recovery phase of nuclear or radiological emergencies. Methods By evaluating China’s participation in an international nuclear emergency exercise organized by Organization for Economic Co-operation and Development’s Nuclear Energy Agency, and considering the relevant guidelines published by international organizations such as the International Atomic Energy Agency, the sections that need to be strengthened in the health response during the long-term recovery phase of nuclear or radiological emergencies were analyzed. The related issues such as health monitoring and medical follow-up were explored. Results The tasks in the long-term recovery phase mainly include monitoring the affected population and information management, medical follow-up, and psychological assistance. In response to potential nuclear or radiological emergencies, 22 nuclear emergency medical rescue bases have been established in China, with a geographical distribution that includes key regions. Relevant institutions have basic capabilities of health response to nuclear or radiological emergencies. However, the exercise shows that strategy and capacity construction in long-term recovery phase are weak points in health response to nuclear or radiological emergencies. China should further strengthen strategies in major public protection actions and information management of affected populations in nuclear or radiological emergencies. Conclusion It is recommended to develop standard operating procedures for major public protection actions, long-term health monitoring and evaluation of affected populations, medical follow-up, and psychological assistance in the future. A unified health registration system for affected populations in nuclear or radiological emergencies should be established to further enhance China’s health response capabilities during the long-term recovery phase of nuclear or radiological emergencies.

After the Three Mile Island, Chernobyl, and Fukushima nuclear accidents, numerous issues were exposed during the emergency evacuation process, such as insufficiently detailed emergency plans, lack of specific evacuation route schemes, inadequate preparation of emergency protective materials, and delays in emergency response decision-making. Additionally, these accidents revealed serious issues with the emergency evacuation of vulnerable populations. In particular, during the Fukushima nuclear accident, the lack of resource support led to deteriorating health and fatalities among hospital patients and elderly residents in nursing homes near the nuclear power plant during emergency evacuation. To learn from the experiences and lessons of public protection actions in emergency evacuations during major nuclear accidents, the government should enhance the guidance of nuclear emergency evacuation plans, increase the quality of emergency training and exercises, and improve their specificity and continuity, as well as establish an efficient nuclear emergency rescue response and decision-making mechanism. For vulnerable populations in nuclear emergency evacuations, the government should consider updating the nuclear emergency plans and disaster preparedness material reserves of medical facilities (such as designated treatment hospitals) and elderly facilities (such as nursing homes) within the emergency protection action areas of nuclear power plants in a timely manner. This will ensure that these institutions have the capacity to provide initial evacuation and necessary support for vulnerable populations in disaster situations.

Objective To analyze and explore the health response capability construction in the long-term recovery phase of nuclear or radiological emergencies. Methods By evaluating China’s participation in an international nuclear emergency exercise organized by Organization for Economic Co-operation and Development’s Nuclear Energy Agency, and considering the relevant guidelines published by international organizations such as the International Atomic Energy Agency, the sections that need to be strengthened in the health response during the long-term recovery phase of nuclear or radiological emergencies were analyzed. The related issues such as health monitoring and medical follow-up were explored. Results The tasks in the long-term recovery phase mainly include monitoring the affected population and information management, medical follow-up, and psychological assistance. In response to potential nuclear or radiological emergencies, 22 nuclear emergency medical rescue bases have been established in China, with a geographical distribution that includes key regions. Relevant institutions have basic capabilities of health response to nuclear or radiological emergencies. However, the exercise shows that strategy and capacity construction in long-term recovery phase are weak points in health response to nuclear or radiological emergencies. China should further strengthen strategies in major public protection actions and information management of affected populations in nuclear or radiological emergencies. Conclusion It is recommended to develop standard operating procedures for major public protection actions, long-term health monitoring and evaluation of affected populations, medical follow-up, and psychological assistance in the future. A unified health registration system for affected populations in nuclear or radiological emergencies should be established to further enhance China’s health response capabilities during the long-term recovery phase of nuclear or radiological emergencies.

Objective:To systematically evaluate the impact of the three major nuclear accidents at Three Mile Island, Chernobyl and Fukushima on the mental health status of emergency responders.Methods:MeSH and Entry Terms were searched. Relevant literature on the mental health consequences of the emergency responders to the Three Mile Island, Chernobyl, and Fukushima nuclear accidents were retrieved from PubMed, Web of Science, and APA PsycINFO databases, and screened and reviewed.Results:Totally 37 studies were included. General psychological distress, depression, anxiety, post-traumatic stress disorder and other abnormal psychological problems are prevalent among emergency responders following nuclear accidents. The psychological impact of the Chernobyl nuclear accident was most profound, causing serious mental disorders such as organic mental disorder and personality disorder among the clean-up workers. The mental health condition of emergency responders was associated with disaster-related emergency response tasks and the social factors brought in nuclear accidents.Conclusions:General psychological distress, anxiety, depression, post-traumatic stress reaction/disorder, severe mental disorder and other long-term abnormal psychological problems are common among first responders after nuclear accidents, and baseline mental health and psychological interventions require further study.

Flavonoid glycosides are the main active constituents of Epimedii Folium and its related plants. They can be divided into polyglycosides and low glycosides according to the number of glycosyl group. The polyglycosides of Epimedii Folium can be transformed into low glycosides after biotransformation ；pharmacological activities of low glycosides in anti-tumor ，tonifying kidney yang and anti-osteoporosis are stronger than those of polyglycosides. In this paper ， the research progress about biotransformation technology of flavonoid glycosides of Epimedii Folium was reviewed. It was found that the main biotransformation pathway of flavonoid glycosides of Epimedii Folium was to obtain low glycosides by removing glycosyl group ； related methods were mainly enzymatic hydrolysis and microbial transformation ，and also included plant cell transformation ，acid hydrolysis method and synthesis method.

Objective:To estimate the mental health status and personality traits of the nuclear radiation emergency rescuers, allowing to provide reference basis for improving their mental health.Methods:Totally 52 nuclear radiation emergency rescuers were selected as the subjects. The symptom checklist 90 (SCL-90) and Cattell′s 16 personality factor scale (16PF) were used to assess their mental health status and personality traits. The results obtained from the survey of these rescuers were compared with those obtained using Students′ t-test, One-Way ANOVA and Pearson correlation analysis. Results:The average scores of multiple factors and positive items of the SCL-90 were significantly lower in the rescuers than in the norm ( t=-4.77 to -2.04, P<0.05), and the positive rate was 21.15%. The symptom checklist 90 subscales such as somatization, obsessive-compulsive and depression were found in the rescuers. Rescuers received high scores in the following components among the 16 factors of Cattell: less intelligent-more intelligent, emotionally stable. Rescuers also received low scores in the following components among the 16 factors of Cattell: tough-minded-tender-minded, trusting-suspicious. Life satisfaction, educational degree and Cattell′s 16 PF were significantly associated with the factors of SCL-90( r=-0.569 to 0.627, P<0.05). Conclusions:The rescuers are better than ordinary Chinese people in psychological health. Mental health-related factors such as literacy, life satisfaction, and personality traits should be taken into account when selecting team members and conducting psychological interventions.