ObjectiveTo evaluate the clinical efficacy and safety of the traditional Chinese medicine （TCM） compound Chaiqin Xiaoyong Decoction （柴芩消痈饮， CXD） combined with Jinhuang Ointment （金黄膏， JO） in treating the nodular stage of acne mastitis of liver meridian heat accumulation type. MethodsA randomized， double-blind， placebo-controlled clinical trial was conducted. A total of 108 patients with liver meridian heat accumulation type acne mastitis in the nodular stage were randomly assigned to a treatment group and a control group， with 54 patients in each group. Both groups received topical application of JO once daily at a thickness of 3~5 mm for 8 hours， along with standard nursing care. On this basis， the treatment group received oral CXD granules， while the control group received placebo granules， administered twice daily， 3 sachets per dose， for 14 consecutive days. Clinical efficacy， TCM symptom scores， nodule size， visual analogue scale （VAS） pain scores， white blood cell （WBC） count， C-reactive protein （CRP） level， and systemic immune-inflammation index （SII） were compared. At the end of treatment， efficacy and safety indicators were evaluated. A 6-month follow-up was conducted to compare the proportion of patients undergoing surgical treatment. ResultsThe total clinical efficacy rate in the treatment group was 90.38% （47/52）， significantly higher than 32.00% （16/50） in the control group （P＜0.01）. The treatment group also showed significantly lower TCM symptom scores， VAS scores， nodule size， WBC count， CRP level， and SII （P＜0.05 or P＜0.01）. During follow-up， the surgical intervention rate in the treatment group was 5.77% （3/52）， lower than 14.00% （7/50） in the control group， with a statistically significant difference （P＜0.01）. No significant abnormalities were observed in safety indicators before and after treatment in either group. ConclusionCXD effectively reduces nodule size and alleviates symptoms such as redness and pain in patients with acne mastitis of liver meridian heat accumulation type， improves TCM symptom scores， enhances overall clinical efficacy， and demonstrates good safety.

Objective To compare the clinical efficacy of typeⅡhybrid surgery versus Sun’s surgery in treating acute Stanford A aortic dissection. Methods A retrospective analysis was conducted on the clinical data of patients with acute Stanford A aortic dissection who were treated at the Central Hospital of Wuhan affiliated to Tongji Medical College, Huazhong University of Science and Technology from 2016 to 2022. According to the surgical method, patients were divided into a typeⅡhybrid group and a Sun’s surgery group, and the clinical efficacy of the two groups was compared. Results A total of 52 patients were included, with 22 in the typeⅡhybrid surgery group and 30 in the Sun’s surgery group. The typeⅡhybrid group consisted of 18 males and 4 females, with an average age of (58.18±6.00) years, while the Sun’s surgery group consisted of 22 males and 8 females, with an average age of (53.03±11.89) years. All surgeries were successfully completed. There were 4 (13.3%) perioperative deaths in the Sun’s surgery group, including 2 patients of multiple organ failure, 1 patient of paraplegia, and 1 patient of uncontrollable postoperative bleeding. There was 1 (4.5%) perioperative death in the typeⅡhybrid surgery group, who was suspected of acute coronary syndrome and took a loading dose of dual antiplatelet drugs preoperatively. The patient underwent secondary thoracotomy for hemostasis, was re-cannulated during the operation, and finally died of circulatory failure after implantation of intra-aortic balloon pumping. There was no statistical difference in perioperative mortality between the two groups (P=0.381). Compared with the Sun’s surgery group, the typeⅡhybrid surgery group had shorter cardiopulmonary bypass time [153.00 (135.00, 185.25) min vs. 182.50 (166.50, 196.75) min, P=0.013], aortic cross-clamping time [77.00 (70.50, 92.00) min vs. 102.50 (93.50, 109.75) min, P<0.001], postoperative ICU stay [4.00 (2.83, 6.00) days vs. 8.00 (6.38, 11.78) days, P<0.001], postoperative ventilator support time [72.00 (29.50, 93.25) h vs. 87.65 (39.13, 139.13) h, P=0.138], less intraoperative blood loss [(1586.82±209.41) mL vs. (1 806.00±292.62) mL, P=0.004], postoperative 24 h drainage volume [612.50 (507.50, 762.50) mL vs. 687.50 (518.75, 993.75) mL, P=0.409], and shorter postoperative hospital stay [18.00 (13.00, 20.25) days vs. 22.00 (17.00, 29.25) days, P=0.013]. There was no statistically significant difference in the incidence of other early postoperative complications such as secondary thoracotomy for hemostasis, tracheotomy, renal dysfunction requiring dialysis, stroke, and paraplegia between the two groups (P>0.05). Conclusion For patients with acute Stanford A aortic dissection, typeⅡhybrid surgery is safe and effective; compared with traditional Sun’s surgery, typeⅡhybrid surgery has relatively less trauma, lower incidence of complications, satisfactory short-term results, and further research is needed on long-term prognosis.

ObjectiveTo investigate the intervention effects and mechanisms of the flavonoid hyperoside （Hyp） on lipopolysaccharide （LPS）-induced inflammation in the zebrafish model. MethodsZebrafish larvae were either microinjected with 0.5 g·L^-1 LPS or immersed in 1 g·L^-1 LPS for the modeling of inflammation. The larvae were then treated with Hyp at 25， 50， and 100 mg·L^-1 through immersion for four consecutive days. The inflammatory phenotypes were assessed by analyzing the mortality rate， malformation rate， body length， and yolk sac area ratio. Behavioral tests were conducted to evaluate the inflammatory stress responses， and macrophage migration was observed by fluorescence microscopy. Additionally， the mRNA levels of inflammation-related genes， including interleukin-1β （IL-1β）， interleukin-6 （IL-6）， chemokine C-C motif ligand 2 （CCL2）， chemokine C-X3-C motif receptor 1 （CX3CR1）， chemokine C-C motif receptor 2 （CCR2）， and genes associated with the Toll-like receptor 4 （TLR4）/myeloid differentiation factor 88 （MyD88）/nuclear factor-kappa B （NF-κB） signaling pathway， were measured by Real-time quantitative polymerase chain reaction（Real-time PCR）. ResultsCompared with the pure water injection group， the model group exhibited increased mortality， malformation rates and yolk sac area ratio （P0.01）， reduced body length （P0.01）， increased total swimming distance and high-speed swimming duration （P0.01）， and up-regulated mRNA levels of TLR4， MyD88， NF-κB， IL-1β， IL-6， CCL2， CX3CR1， and CCR2 （P0.01）. Hyp at low， medium and high doses， as well as aspirin， reduced the mortality and malformation rates （P0.05，P0.01）， increased the body length （P0.05，P0.01）， decreased the yolk sac area ratio （P0.01）， reduced the high-speed swimming duration （P0.01）， and down-regulated the mRNA levels of TLR4， MyD88， NF-κB， IL-1β， IL-6， CCL2， CX3CR1， and CCR2 （P0.05，P0.01） compared with the model group. ConclusionHyp may modulate the TLR4/MyD88/NF-κB pathway to ameliorate inflammatory phenotypes and alleviate stress conditions in zebrafish， thereby exerting the anti-inflammatory effect.

Objective:To investigate the co-infection and phylogenetic analysis of human rhinovirus (HRV) in 2019 novel coronavirus (2019-nCoV) positive samples.Methods:Ten common respiratory viruses, including HRV were detected by real-time fluorescence quantitative polymerase chain reaction (qPCR) in 7 213 samples of 2019-nCoV positive cases and the co-infection characteristics were analyzed. The VP4/VP2 gene fragment of HRV was amplified and sequenced.Phylogenetic trees were constructed.Results:HRV accounted for 1.34% of the 2019-nCoV positive samples (97/7 213), followed by common coronavirus (0.50%, 36/7 213). The co-infection rate of HRV in 2019-nCoV positive samples was significantly different from that of other viruses ( χ2=318.09, P<0.001). There was significant difference in HRV co-infection rate among different age groups ( χ2=36.77, P<0.001), the peak was in<18 years age group. The co-infection rate of HRV had no significant difference in different seasons. The VP4/VP2 gene fragments of 39 HRV strains (40.21%, 39/97) were successfully sequenced and made phylogenetic analysis. There were 10 strains of HRV-A, 9 strains of HRV-B and 20 strains of HRV-C. Seventeen subtypes were identified, of which B6 (66.67%, 6/9) and C15 (70%, 14/20) were the most prevalent and other subtypes were scattered. Conclusions:The co-infection rate of HRV in patients with 2019-nCoV infection was the highest. The highest co-infection rate was in<18 years age group. Group A, B, and C of HRV were found in 2019-nCoV positive samples, and serotypes present diversity.

Objective To explore the professionalization model of nursing management team in an international medical center in a provincial public tertiary hospital.Methods Through literature research and Delphi method,a three-person nursing management team was established respectively in three nursing units:outpatient,first-ward,and second-ward of the center,and then trained professionally to define management boundaries and responsibilities.The training effect was verified by applying the professionalization management in the international medical center.The three nursing teams(nine nurses totally)were compared in terms of leadership,patient satisfaction,and nursing discipline construction before and after the training.Results Following the training,the three teams all exhibited a significant improvement in leadership as well as its dimensions(P＜0.05),and pa-tient satisfaction(P＜0.05).Additionally,care quality,scientific research capacity,and innovation ability were all elevated across the three groups.Conclusion The establishment of a nursing management team and performance of professional training can effectively promote the concept of professionalization management,improve the leadership of nurses,cultivate talent eche-lons,drive the overall development of disciplines and teams,and expand the connotation of nursing culture.For all these bene-fits,this model is suitable for promotion and application among clinical departments.

Objective To investigate the clinical efficacy of multidisciplinary team (MDT) model combined with Da Vinci robot-assisted thoracic surgery in the treatment of early non-small cell lung cancer (NSCLC). Methods From July 2020 to December 2021, the patients with NSCLC who received Da Vinci robot-assisted thoracic surgery in the Department of Thoracic Surgery, General Hospital of Northern Theater Command were collected. According to whether MDT were performed before hospitalization, the patients were divided into an MDT group and a common group. The recovery and clinical efficacy were compared between the two groups. Results A total of 187 patients were enrolled, including 81 males and 106 females, aged 63 (56, 67) years. There were 85 patients in the MDT group, and 102 patients in the common group. Compared with the common group, the MDT group had lower incidence of postoperative complications (9.4% vs. 29.4%, P=0.017), shorter intraoperative operation time [55 (45, 61) min vs. 79 (65, 90) min, P<0.001], and less intraoperative blood loss [25 (20, 30) mL vs. 30 (20, 50) mL, P=0.029] in the same operation mode. In addition, the drainage volume on the second postoperative day [270 (200, 350) mL vs. 215 (190, 300) mL, P=0.004], the number of dissected lymph nodes groups [6 (5, 6) groups vs. 5 (3, 6) groups, P=0.004] and the number of dissected lymph nodes [16 (13, 21) vs. 13 (9, 20), P=0.005] in the MDT group were significantly better than those in the common group. The differences in the postoperative intubation time and postoperative hospital stay between the two groups were not statistically significant (P>0.05). Conclusion MDT combined with Da Vinci robot-assisted thoracic surgery can further reduce the risk of surgery, improve the clinical treatment effect, reduce the incidence of postoperative complications, and accelerate the rehabilitation of patients.

Purpose To explore the feasibility of artificial intelligence compressed sensing(ACS)technique in ankle joint MRI.Materials and Methods From September to October 2023,32 healthy volunteers who underwent ankle joint scanning in Beijing Friendship Hospital,Capital Medical University were prospectively collected.MRI of the ankle joint based on ACS and parallel imaging(PI)technology was performed on 3.0T MR.The sagittal proton density weighted imaging(PDWI),coronary PDWI,transverse PDWI and sagittal T1WI were acquired,and all data were divided into test group and control group,with ACS to accelerate the multiples of 5(ACS 5.0)in test group,whereas PI speed ratio of 2(PI 2.0)in control group,respectively.The signal intensity of talus,achilles tendon and cartilage were measured,the signal intensity and standard deviation of the long hallux flexor were obtained,and the signal noise ratio(SNR)and contrast to noise ratio(CNR)were calculated via long hallux flexor as background noise.The data of objective and subjective evaluation of the two sequences were statistically analyzed,and the image quality of each sequence was evaluated via the standard reference of PI 2.0.Results SNR and CNR in ACS group were higher than those in PI group,and the anatomical structure of sagittal PDWI sequence between the two groups had statistical significance(t=-2.937,-1.981,-4.058,-3.879,P<0.05).There were significant differences in cartilage SNR and talus CNR in coronal PDWI sequence(t=-3.310,-3.567;P=0.002,P<0.001).In terms of axial PDWI sequence,there were statistically significant differences in talus CNR and cartilage CNR between ACS and PI groups(t=-4.270,-4.382,P<0.05).The subjective evaluation of the image quality scores of the two groups by the two diagnostic imaging doctors showed a strong observer consistency(Kappa=0.977,P=0.009).There was no significant difference in image quality scores between the two groups(Z=-0.248,-0.747,<0.001,-0.071,P>0.05).The total collection time of ACS group and PI group was 337 s and 610 s,respectively.Compared with PI group,the total scanning time of ACS group was shortened by 44.8%.Conclusion ACS based MRI of the ankle joint can not only shorten the scan time,but also ensure and further improve the image quality,with feasibility.

Objective To investigate the relationship between nestin expression and microvessel density(MVD)and its value as a potential prognostic marker of glioblastoma(GBM).Methods A retrospective trial was conducted on 50 GBM patients undergoing craniotomy under general an-esthesia in the Third Affiliated Hospital of Chongqing Medical University from March 2020 to March 2023.According to the median nestin H score(Nestin staining intensity × percentage of positive cells),they were divided into H score ≥80.0 group(28 cases)and H score＜80.0 group(22 cases).After 2 years of follow-up,they were also divided into a death group(23 cases)and a survival group(27 cases).The expression of nestin was determined by immunohistochemical staining,and MVD was quantified by von Willebrand factor(vWF)and CD105 immunohistochem-ical staining.Spearman rank test was used to analyze the correlation between nestin expression level and MVD formation,multivariate Cox proportional hazards regression analysis was em-ployed to identify the influencing factors for overall survival in the GBM patients,and Kaplan-Meier survival curve was plotted to analyze the 2-year survival rate of the patients.Results The nestin H score was positively correlated with vWF-MVD(Rho=0.701,P＜0.01)and CD105-MVD(Rho=0.753,P＜0.01).There were no significant differences between the H score ≥80.0 group and the H score＜80.0 group in terms of gender,age,isocitric dehydrogenase-1 mutation,tumor site,tumor location,brain necrosis,tumor volume,edema volume,preoperative Karnofsky Performance Status score,and extent of tumor resection(P＞0.05).The survival group had larger proportions of isocitrate dehydrogenase-1 mutation and maximal resection,and lower nestin H score than the death group(P＜0.05,P＜0.01).Cox proportional hazards regression showed that partial resection/biopsy(HR=4.781,95％CI:2.066-11.060,P=0.001)and increased nestin H score(HR=1.007,95％CI:1.001-1.013,P=0.032)were independent influencing factors for worsening overall survival in the GBM patients.Kaplan-Meier survival curve analysis indicated that the cumulative survival rate was lower in the H score ≥80.0 group than the H score＜80.0 group(log rank x2=8.147,P=0.004).Conclusion Nestin overexpression is associated with poor prognosis in GBM patients,indicating more microangiogenesis,which may be a therapeutic target for GBM patients.

Objective:To investigate the safety and efficacy of haplo-identical hematopoietic stem cell transplantation (haplo-HSCT) conditioning with the same dosage form of antithymoglobulin (ATG) in patients with severe aplastic anemia (SAA) failure to ATG.Methods:This was a retrospective cohort study. A total of 65 patients with SAA who failed ATG treatment and received haplo-HSCT conditioning with the same dosage of ATG at the Institute of Hematology, Peking University People′s Hospital between July 2008 and October 2020 were included as the ATG treatment failure group. An additional 65 SAA patients who applied ATG for the first time during haplo-HSCT were randomly selected by stratified sampling as the first-line haplo-HSCT group. Baseline clinical data and follow-up data of the two groups were collected. Conditioning-related toxicity within 10 days after ATG application and long-term prognosis were analyzed. The Kaplan-Meier was used to calculate the overall survival rate, and the Log-rank test was applied to compare the rates of the two groups.Results:In the ATG treatment failure group, there were 36 males and 29 females, and the age at the time of transplantation [ M ( Q1, Q3)] was 16 (8, 25) years. In the first-line haplo-HSCT group, there were 35 males and 30 females, with a median age of 17 (7, 26) years. Within 10 days of ATG application, the incidence of noninfectious fever, noninfectious diarrhea, and liver injury in the ATG treatment failure group was 78% (51 cases), 45% (29 cases), and 28% (18 cases), respectively, and in the first-line haplo-HSCT group was 74% (48 cases), 54% (35 cases), and 25% (16 cases), respectively; the difference between the two groups was not statistically significant for any of these three parameters (all P>0.05). For graft-versus-host disease (GVHD), there was no significant difference between the ATG treatment failure group and the first-line haplo-HSCT group in the development of 100 day Ⅱ to Ⅳ acute GVHD (29.51%±0.35% vs. 25.42%±0.33%), Ⅲ to Ⅳ acute GVHD (6.56%±0.10% vs. 6.78%±0.11%), and 3-year chronic GVHD (26.73%±0.36% vs. 21.15%±0.30%) (all P>0.05). Three-year overall survival (79.6%±5.1% vs. 84.6%±4.5%) and 3-year failure-free survival (79.6%±5.1% vs. 81.5%±4.8%) were also comparable between these two groups (both P>0.05). Conclusions:Compared with no exposure to ATG before HSCT, similar early adverse effects and comparable survival outcomes were achieved in patients with SAA who failed previous ATG treatment and received haplo-HSCT conditioning with the same dosage form of ATG. This might indicate that previous failure of ATG treatment does not significantly impact the efficacy and safety of salvaging haplo-HSCT in patients with SAA.

Objective:To investigate the epidemic characteristics of influenza in children and the features of severe influenza.Methods:From January 2016 to September 2022, 1 600 samples from hospitalized cases of severe acute respiratory tract infection and 7 660 samples from outpatients with influenza-like illness were collected. Influenza virus was detected by real-time RT-PCR. Other respiratory viruses in the samples of severe hospitalized cases and some samples of outpatients were detected. Clinical features of influenza virus infection and co-infection were analyzed.Results:The positive rate of influenza virus in the 1 600 hospitalized cases of severe acute respiratory infection was 6.63% (106 cases). H1N1, H3N2, BV and BY were deteted in 49.06% (52 cases), 17.92% (19 cases), 29.25% (31 cases) and 3.77% (4 cases) of the 106 cases, respectively. The positive rate of influenza virus in the 7 660 out-patient cases was 15.01% (1 150 cases), and H1N1, H3N2, BV and BY were detected in 22.17% (255 cases), 30.96% (356 cases), 41.39% (476 cases) and 5.48% (63 cases) of the infected cases, respectively. Influenza A (H1N1) virus was more likely to cause severe influenza in children (χ 2=37.978, P<0.001), while seasonal H3N2 and BV strains were less likely to cause severe influenza in children (χ 2=7.871, P=0.005; χ 2=5.948, P=0.015). There was no statistically significant difference in the positive rates of BY lineage in the two groups. Severe influenza mainly occured in the peak season of influenza epidemic. There was no significant difference in the clinical manifestations between the children infected with the four different influenza viruses. In the 106 severe cases of influenza, the co-infection rate of influenza virus with other respiratory viruses was 17.92% (19 cases), while the co-infection rate reached 34.81% (47 cases) in 135 outpatient cases of influenza. The difference in the co-infection rates was statistically significant between outpatient and hospitalized cases (χ 2=10.734, P=0.001). Conclusions:Influenza A (H1N1) virus was more likely to cause severe influenza in infants and young children in comparison with seasonal H3N2 and BV. There was no significant difference in the clinical features of influenza caused by H1N1, H3N2, BV and BY. Co-infection of influenza virus with other respiratory viruses is not a major risk factor for severe influenza in infants.