By systematically combing ancient and modern literature， this paper examined Tribuli Fructus and Astragali Complanati Semen（ACS） used in the famous classical formulas from the aspects of name， origin， production area， harvesting and processing， clinical efficacy， so as to provide a basis for the development of famous classical formulas containing such medicinal materials. The results showed that the names of Tribuli Fructus in the past dynasties were mostly derived from its morphology， and there were nicknames such as Baijili， Cijili and Dujili. The name of ACS in the past dynasties were mostly originated from its production areas， and there were nicknames such as Baijili， Shayuan Jili and Tongjili. Because both of them had the name of Baijili， confusion began to appear in the Song dynasty. In ancient and modern times， the main origin of Tribuli Fructus were Tribulus terrestris， and ancient literature recorded the genuine producing areas of Tribuli Fructus was Dali in Shaanxi and Tianshui in Gansu， but today it is mainly cultivated in Anhui and Shandong. The fruit is the medicinal part， harvested in autumn throughout history. There is no description of the quality of Tribuli Fructus in ancient times， and the plump， firm texture， grayish-white color is the best in modern times. Traditional processing methods for Tribuli Fructus included stir-frying and wine processing， while modern commonly used is purified， fried and salt-processed. The ancient records of Tribuli Fructus were spicy， bitter， and warm in nature， with modern research adding that it is slightly toxic. The main effects of ancient and modern times include treating wind disorders， improving vision， promoting muscle growth， and treating vitiligo. The mainstream base of ACS used throughout history is Astragalus complanatus. Ancient texts indicated ACS primarily originated from Shaanxi province. Today， the finest varieties come from Tongguan and Dali in Shaanxi. The medicinal part is the seed， traditionally harvested in autumn. Modern harvesting occurs in late autumn or early winter， followed by sun-drying. Ancient texts valued seeds with a fragrant aroma as superior， while modern standards prioritize plump， uniform and free of impurities. Traditional processing methods for ACS included frying until blackened and wine-frying， while modern practice commonly employs purification methods. In terms of medicinal properties， the ancient and modern records are sweet and warm in nature. Due to originally classified under Tribuli Fructus， its effects were thus regarded as equivalent to those of Tribuli Fructus， serving as the medicine for treating wind disorders， additional functions included tonifying the kidneys and treating vitiligo. The present record of its efficacy is to tonify the kidney and promote Yang， solidify sperm and reduce urine， nourish the liver and brighten the eye， etc. Based on the textual research results， it is suggested that when developing the famous classical formulas of Tribuli Fructus medicinal materials， we should pay attention to the specific reference object of Baijili， T. terrestris and A. complanatus should be identified and selected， and the processing method should be in accordance with the requirements of the formulas.

Objective To explore the predictive value of CT radiomics and morphological features for the prognosis and survival in non-small cell lung cancer(NSCLC)patients.Methods The clinic data of 300 NSCLC patients(300 lesions)were downloaded from the Cancer Imaging Archive,with 210 randomly selected as the training set and 90 as the test set.According to the prognosis and survival,the patients were divided into two groups with survival period≤3 and＞3 years.3D Slicer software was used to delineate the regions of interest layer by layer in CT images,and the radiomics features were extracted from each region of interest.Both t-test and least absolute shrinkage and selection operator were utilized for radiomics feature screening.Three types of prediction models,namely radiomics model,morphological model and combined model,were constructed with Logistic regression,whose performances were evaluated using the receiver operating characteristic(ROC)curve.Results The differences in radiomics labels and mediastinal lymph node metastasis between the training set and the test set were statistically significant.For radiomics model,morphological model and combined model,the area under the ROC curve was 0.784(95%CI:0.722-0.847),0.734(95%CI:0.664-0.804)and 0.748(95%CI:0.680-0.815)in the training set,and 0.737(95%CI:0.630-0.844),0.665(95%CI:0.554-0.777)and 0.687(95%CI:0.578-0.797)in the test set,which demonstrated that radiomics model had the best diagnostic performance.Conclusion The CT radiomics model can effectively predict the prognosis and survival in NSCLC patients.

In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands of deaths and chronic physical disabilities every year.This guideline aims to provide practical information to help clinical professionals evaluate and treat snakebite victims.These recommendations are based on clinical experience and clinical research evidence.This guideline focuses on the following topics:snake venom,clinical manifestations,auxiliary examination,diagnosis,treatments,and prevention.

Objective To investigate the efficacy of continuous saline bladder irrigation(CSBI)after a single immediate instillation of chemotherapy(SIIC)in patients with low-and immediate-risk non-muscle-invasive bladder cancer(NMIBC)undergoing transurethral resection of bladder tumor(TURBT).Methods Clinical data of 211 patients with with low-and immediate-risk NMIBC,who underwent TURBT in our hospital during Jan.2004 and Dec.2019 were collected.The patients were divided into two groups according to whether CSBI was conducted after SIIC.The recurrence rate,progression rate,recurrence-free survival and progression-free survival of the two groups were compared.Cox univariate and multivariate regression analyses were used to investigate whether CSBI was a risk factor for recurrence and progression.Results There were no significant differences in baseline data,recurrence rate and progression rate between the two groups(P＞0.05).There was no significant difference in recurrence-free survival between the two groups,but the progression-free survival was shorter in CSBI group(x2=8.270,P=0.004).Multivariate Cox regression analysis indicated that diabetes(HR:2.240,95％CI:1.066-4.704,P=0.033)and multiple tumors(HR:3.060,95％CI:1.639-5.711,P＜0.001)were independent risk factors for recurrence and CSBI(HR:7.914,95％CI:1.710-36.632,P=0.008)was an independent risk factor for progression.Conclusion CSBI after SIIC may increase the risk of progression in patients with low-and immediate-risk NMIBC,but a larger sample size is needed for validation.

Inflammation is associated with the occurrence and recurrence of ischemic stroke, and patients with coronary artery disease who receive colchicine treatment have a lower incidence of vascular events. However, the efficacy and safety of anti-inflammatory therapy with colchicine in preventing recurrent stroke is unclear. This article reviews the relevant mechanisms of action of colchicine and its role in the prevention of ischemic stroke, aiming to provide reference for the secondary prevention of ischemic stroke.

Gravity is one of the most widespread mechanomechanical signals affecting surface organisms and plays a key role in maintaining normal cardiovascular structure and function.The absence of gravity in the space environment leads to changes in the physiological-mechanical environment of the cardiovascular system,potentially causing adaptive changes or remodelling of the cardiovascular system in terms of structure and function.However,how the cardiovascular system senses,transduces,and responds to altered mechanical stress in the microgravity environment remains poorly understood by humans.In this paper,we reviewed the research findings on mechanoreceptors and mechano-transduction of cardiovascular system in recent years,analyzed the mechanisms of mechanical perception and response to microgravity in cardiovascular system,and predicted the novel mechanoreceptors,key signaling pathways,and potential targets for intervention in space microgravity.This article aims to provide new ideas for combating adaptive changes in the cardiovascular system due to space microgravity.

Objective:To explore the surgical treatment of lateral condylar fracture of the humerus combined with lateral dislocation of the elbow in adults.Methods:A retrospective study was conducted to analyze the 8 patients who had been treated at Department of Orthopaedic Trauma, Zhengzhou Orthopaedic Hospital for lateral condylar fracture of the humerus combined with lateral dislocation of the elbow from June 2020 to June 2023. There were 3 males and 5 females, with an age of (50.1±12.3) years. All the lateral condylar fractures of the humerus combined with lateral dislocations were treated by open reduction and internal fixation after swelling subsided. Flexion and extension of the elbow and rotation of the forearm were recorded at the last follow-up. Mayo elbow function score (MEPS) was used to evaluate the functional recovery of the elbow.Results:Elbow dislocation was corrected in 2 patients after rectification, but the elbow subluxation still existed because the displacement of the humeral lateral condyle was not reduced. The elbow dislocation still existed in 6 patients because it was difficult to maintain the correction of the dislocation after manual reduction. Follow-ups were conducted for 12.0 (12.0, 18.8) months. At the last follow-up, the flexion-extension was 85.6°±20.3°, rotation 133.1°±24.0°, and MEPS (91.9±8.0) points. The joint stability was significantly improved in the 8 patients compared with that before operation. Obvious pain was reported in none of the patients, and their joint limitation was acceptable.Conclusions:In adults, lateral condylar fracture of the humerus combined with lateral dislocation of the elbow is rare in clinic. Surgical treatment of the condition can achieve satisfactory clinical outcomes, but elbow dysfunction and limited rotation of the forearm may occur in the affected limb.

Objective To investigate the optimal target and prognostic significance of SBP in hospi-talized octogenarian male patients with heart failure with preserved ejection fraction(HFpEF).Methods A total of 952 male HFpEF inpatients aged ≥80 years admitted in Department of Car-diovascular Diseases of Second Medical Center of Chinese PLA General Hospital from July 2012 to June 2023 were recruited.According to their SBP value at discharge(1 mm Hg=0.133 kPa),they were divided into＜100 mm Hg group(29 cases),100-150 mm Hg group(677 cases),and＞150 mm Hg group(246 cases).General clinical data of all patients were collected,and all-cause mortality rate was regarded as the endpoint event.Results The mortality rate was 82.8％(24/29),63.5％(430/677)and 55.7％(137/246)in the SBP＜100,100-150 and＞150 mm Hg groups,respectively,and statistical difference was observed in the rate among the three groups(P=0.006).The mortality rate of patients with SBP＜100 mm Hg was significantly higher than that of the other two groups(x2=22.70,Plog-rank＜0.01).The patients with SBP 100-150 and＞150 mm Hg had notably lower risk for mortality than those with SBP＜100 mm Hg(P=0.015).Conclusion SBP＜100 mm Hg is closely associated with an increased risk of all-cause mortality in octogenarian male HFpEF inpatients.

Dura mater is a tough collagen connective tissue attached to inner surface of skull and wrapped around brain.As a buffer bridge between brain tissue and skull,its physiological function and role in skull development and repair have always been a focus of research.Recent studies have found that dura mater not only directly participates in skull development during skull growth,but also secretes a variety of cytokines that control the development of central nervous system.There are abundant material exchange and cell communication between the two.This article reviews the role of dura in development and repair of skull,and provides clues for further discovery of the relevant mechanisms of dura in development and repair of skull.

Objective To develop a rapid and accurate Monte Carlo program(simplified code for dosimetry of carbon ions,SPEEDO)for carbon ion therapy.Methods For electromagnetic process,type Ⅱ condensed history simulation scheme and continuous slowing down approximation were used to simulate energy straggling,range straggling,multiple scattering,and ionization processes.For nuclear interaction,5 types of target nuclei were considered,including hydrogen,carbon,nitrogen,oxygen,and calcium.The produced secondary charged particles followed the same condensed history framework.The study simulated the transport of carbon ions in 4 materials(water,soft tissues,lung,and bone),and the calculated doses were validated against TOPAS(a Monte Carlo simulation software for radiotherapy physics),followed by a comparison with dose measurements in a water phantom from the HIMM-WW(a medical heavy-ion accelerator facility in Wuwei).Results SPEEDO's simulation results showed good consistency with TOPAS.For each material,in the voxel region where the physical dose was greater than 10％of the maximum dose point,the relative maximum dose error of both was less than 2％.At treatment energy of 400 MeV/u,SPEEDO's computation time was significantly less than that of TOPAS(13.8 min vs 105.0 min).SPEEDO's calculation results also showed good agreement with HIMM-WW measurements in terms of lateral dose distribution and integrated dose depth curve.Conclusion SPEEDO program can accurately and rapidly perform Monte Carlo dose calculations for carbon-ion therapy.