Objective We aimed to evaluate the clinical efficacy of promoting blood circulation and eliminating phlegm method in preventing and treating patients with hydrocephalus after acute intracerebral hemorrhage.Methods This study included 139 patients with acute intracerebral hemorrhage who visited Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Guangyuan Hospital of Traditional Chinese Medicine,Affiliated Hospital of North Sichuan Medical College,Meishan Hospital of Traditional Chinese Medicine,and Xuyong Hospital of Traditional Chinese Medicine from September 2019 to June 2023.Patients who met the exposure factors of"using the method of promoting blood circulation and eliminating phlegm"were classified into the integrated Chinese and Western medicine cohort,while those who did not meet the exposure factors were classified into the Western medicine cohort.Clinical efficacy,incidence of hydrocephalus after intracerebral hemorrhage,sum of maximum distance between the anterior horn of the lateral ventricle and the head of the caudate nucleus(Huckman value),size of the hematoma,incidence of endpoint events,National Institutes of Health Stroke Scale(NIHSS)score,Modified Rankin Scale(mRS)score,and Barthel index score between two cohorts were compared.Results Total clinical effective rates for patients with hydrocephalus in the two cohorts were 60.0%and 75.0%,respectively.The total effective rate of the integrated Chinese and Western medicine cohort was higher than that of the Western medicine cohort(P<0.05).After 28 days of treatment,the incidence of hydrocephalus in patients in the integrated Chinese and Western medicine cohort was lower than that of the Western medicine cohort,and the Huckman value decreased compared with the Western medicine cohort(P<0.05).Compared with 24 hours after onset,both cohorts showed a reduction in hematoma size after 28 days of treatment;compared with the Western medicine cohort,patients in the integrated Chinese and Western medicine cohort had reduced hematoma size(P<0.05).After 6 months of onset,the number of deaths in the integrated Chinese and Western medicine cohort decreased compared with the Western medicine cohort(P<0.05).Compared with 28 days of treatment,the NIHSS and mRS scores of the patients in both cohorts decreased after 6 months,while the Barthel index score increased;compared with the Western medicine cohort,patients in the integrated Chinese and Western medicine cohort showed a decrease in the NIHSS and mRS scores after both 28 days of treatment and 6 months,while the Barthel index score increased(P<0.05).Conclusion Promoting blood circulation and eliminating phlegm can effectively prevent and treat hydrocephalus after intracerebral hemorrhage and does not increase the risk of bleeding within 24 hours.

Objective:To explore the manifestations of magnetic resonance imaging(MRI)on acute traumatic lateral patellar dislocation of children and adolescents.Methods:MRI images of the affected side and healthy side of 110 children and adolescents with acute traumatic lateral patellar dislocation who were treated in the Second Hospital of Tangshan from July 2016 to April 2022 were retrospectively analyzed.The correlation of the medial patellofemoral ligament(MPFL)on the affected side between the tear location and tear degree was compared and analyzed.According to the cartilage injury grading system of international cartilage repair society(ICRS),the articular cartilage injury of affected side was divided into 4 grades,and the correlation between the articular cartilage injury grading and the articular cartilage injury location was compared and analyzed.Three methods of measuring patellar height,which included Insall-Salvati index(ISI),patellotrocheal index(PTI)and Caton-Deschamps index(CDI),were used to compare and analyze the differences of MRI data of patellar height between the affected side of knee joint and the healthy knee joint of pediatric children.Results:In 110 patients with MPFL injury,73 cases were partial tears and 37 cases were complete tears.There was significant difference in the injury at MPFL patellar attachment location between complete tears(22 cases)and partial tears(19 cases)(x2=11.740,P<0.05),and there was significant difference in MPFL multiple injury between partial tear(40 cases)and complete tear(8 cases)(x2=10.990,P<0.05).There were no significant differences in the injuries of MPFL middle segment and the origin of femur between partial tears and complete tears.There were 162 lesions in 110 cases with osteochondral injury,which included 55 lesions on the patellar side,33 lesions on the femur side and 74 multiple lesions according to the part of injury.There was significant difference between the location of osteochondral injury and injury grading(x2=38.153,P<0.05).The ISI,PTI and CDI on the affected side were significantly lower than those on the healthy side in pediatric patients with acute traumatic lateral patellar dislocation of children and adolescents(x2=30.853,12.586,19.656,P<0.05),respectively.Conclusion:The complete tears are more likely to occur in the injury of MPFL patellar attachment location of pediatric patients with acute traumatic lateral patellar dislocation of children and adolescents,while multiple injuries are more likely to be in partial tears.There is correlation between the articular cartilage injury grading and the articular cartilage injury location in pediatric patients.MRI is an important method to diagnose MPFL injury,which can provide more evidence for clinical treatment.

Objective To observe the effects of ginkgolides drops on anginal attacks and peripheral blood levels of microRNA-29 a(miR-29a)and intercellular adhesion molecule-1(ICAM-1)in patients with stable angina pectoris.Methods 78 patients with stable angina pectoris patients,who had visited the cardiology department of our hospital during the period of January 2022 to December 2023,were selected.The patients were divided in a Chinese medicine group or a conventional group by using the random number table method,39 in each group.The conventional group received conventional Western medicine treatment,while the Chinese medicine received ginkgo ketone ester drip pills on the basis of conventional Western medicine therapies.Occurrence of angina attack,treadmill electrocardiogram test indexes,blood rheology,6-minute walking distance,TCM symptom scores and changes in peripheral blood miR-29a and ICAM-1 were observed in the two groups.The rate of nitroglycerin discontinuation or reduction and the incidence of adverse reactions were counted.Results Before treatment,there was no statistically significant difference in occurrence of angina attacks between the two groups(P＞0.05).After treatment,the number of attacks per week,weekly glyceryl trinitrate uses,and duration of each attack decreased in both groups,with a greater decline in the Chinese medicine group than in the conventional group(P＜0.05).Before treatment,there was no statistically significant difference in the indicators of treadmill electrocardiogram test between the two groups(P＞0.05).After treatment,induction positive time,exercise termination time,and maximum ST depression time increased in both groups,with longer induction positive time and maximum ST depression time in the Chinese medi-cine group than in the conventional group,while exercise termination time,as compared with the baseline,did not differ statistically(P＞0.05).Maximum ST depression amplitude and ST recovery time decreased in both groups,with a greater decrease in the Chinese medicine group than in the conventional group(P＜0.05).Before treatment,there were no statistically significant differences in miR-29a,ICAM-1,and rheology between the two groups(P＞0.05).After treatment,ICAM-1 and whole blood high/low shear viscosity,FIB,platelet aggregation rate,and plasma viscosity decreased in both groups,with a bigger drop in the Chinese medicine group than in the conventional group(P＜0.05).As compared with the baseline,miR-29a did not differ statistically between the two groups(P＞0.05).Before treatment,there were no statistically significant differences in 6min walking distance and Chinese medicine symptom scores between the two groups.After treatment,6 min walking distance increased in both groups,with a greater increase in the Chinese medicine group than in the conventional group(P＜0.05);Chinese medicine symptom scores decreased in both groups,with a greater decrease in the Chinese medicine group than in the conven-tional group(P＜0.05).The glyceryl trinitrate reduction rate was higher in the Chinese medicine group(79.49%,31/39 cases)than in the conventional group(56.41%,22/39 cases),and the incidence of adverse reactions did not differ statistically between the Chinese medicine group and the conventional group(7.69%vs.5.13%,3/39 vs.2/39 cases;P＞0.05).Conclusions Ginkgolides drops for stable angina improve the degree of myocardial ischaemia and blood rheology,reduce angina attacks,lower ICAM-1 levels,and increase the rate of nitroglycerin discontinua-tion or reduction.

Objective:To investigate the clinicopathological characteristics, diagnosis and differential diagnosis of intravascular large B-cell lymphoma (IVLBCL) and its collision tumors.Methods:Five cases of IVLBCL were collected, including 2 cases of collision tumors, and 1 case complicated with liver cirrhosis. The morphology and immunophenotype were analyzed. The related literature was reviewed.Results:There were 2 females and 3 males, aged from 53 to 73 years, with a median age of 65 years. The tumors were located in the lower extremities, right cerebellar hemisphere, left kidney, bilateral nasal cavity, and liver, respectively. Cases 2 and 3 were incidentally found in meningioma and renal cell carcinoma tissues, respectively. Case 5 had a background of liver cirrhosis. Morphologically, atypical large lymphoid cells were located in small blood vessels and capillary lumen, with little cytoplasm, hyperchromasia, prominent nucleoli, and obvious mitotic figures. Immunohistochemically, the IVLBCL tumor cells expressed CD20 and PAX5; 2 cases were CD5 positive. One of the 5 cases was GCB phenotype, and 4 cases were non-GCB phenotype. All cases expressed C-MYC (positive rate was 10%-40%). PD-L1 was positive in 4 cases (positive rate was 60%-90%). Ki-67 proliferation index was 70%-90%. CKpan, CD3, TDT, and CD34 were negative. In case 2, meningioma cells were positive for PR, EMA, and vimentin, but negative for CKpan and PD-L1. In case 3, renal carcinoma cells were positive for CKpan, PAX8, EMA, vimentin, CAⅨ and CD10, while PD-L1 was negative. No EBER expression (by in situ hybridization) or C-MYC gene translocation (FISH, break-apart probe) was detected in any of the 5 cases. Three patients were followed up, and all died within 1-13 months.Conclusions:IVLBCL is a highly aggressive lymphoma, with occult clinical manifestations and poor prognosis. Collision tumors of IVLBCL are extremely rare. A better understanding of IVLBCL would help pathologists avoid misdiagnoses.

Background/Aims: Cancer stem cells (CSCs) are believed to drive tumor development and metastasis. Activin and hepatocyte growth factor (HGF) are important cytokines with the ability to induce cancer stemness. However, the effect of activin and HGF combination treatment on CSCs is still unclear. Methods: In this study, we sequentially treated colorectal cancer cells with activin and HGF and examined CSC marker expression, self-renewal, tumorigenesis, and metastasis. The roles of forkhead box M1 (FOXM1) and sex-determining region Y-box 2 (SOX2), two stemness-related transcription factors, in activin/HGF-induced aggressive phenotype were explored. Results: Activin and HGF treatment increased the expression of CSC markers and enhanced sphere formation in colorectal cancer cells. The tumorigenic and metastatic capacities of colorectal cancer cells were enhanced upon activin and HGF treatment. Activin and HGF treatment preferentially promoted stemness and metastasis of CD133 + subpopulations sorted from colorectal cancer cells. FOXM1 was upregulated by activin and HGF treatment, and the knockdown of FOXM1 blocked activin/HGF-induced stemness, tumorigenesis, and metastasis of colorectal cancer cells.Similarly, SOX2 was silencing impaired sphere formation of activin/HGF-treated colorectal cancers. Overexpression of SOX2 rescued the stem cell-like phenotype in FOXM1-depleted colorectal cancer cells with activin and HGF treatment. Additionally, the inhibition of FOXM1 via thiostrepton suppressed activin/HGF-induced stemness, tumorigenesis and metastasis. Conclusions Sequential treatment with activin and HGF promotes colorectal cancer stemness and metastasis through activation of the FOXM1/SOX2 signaling. FOXM1 could be a potential target for the treatment of colorectal cancer metastasis.

Background The correlation between noise exposure and negative emotions of noise-exposed workers has received increasing attention and related studies have been reported. However, there is a lack of research on the path and effect analysis of the relationship between noise exposure and negative emotions, which will contribute to a more comprehensive understanding of the health damage characteristics of noise in addition to hearing loss. Objective To explore the path and effects of cumulative noise exposure, tested hearing thresholds, and conscious hearing level of noise-exposed workers on negative emotions. Methods Using stratified random sampling, 312 noise-exposed workers from a machinery and equipment manufacturing enterprise were selected. Occupational history, negative emotions (including the feelings of stress, anxiety, and depression), and conscious hearing level of the workers were investigated using the Depression-Anxiety-Stress Scale (DASS-21) and a self-made questionnaire. The hearing threshold of the workers was measured by pure tone air conduction audiometry. Sound level meter was used to measure noise equivalent sound level at selected work sites. Individual cumulative noise exposure was estimated based on work site noise level and personal noise exposure history. Path analysis was used to analyze potential mediating effects of workers' hearing thresholds and conscious hearing levels on the relationship between noise exposure and negative emotions (including stress, anxiety, and depression). Results The positive rates of negative emotions among the 312 noise-exposed workers were 18.27% (57/312) for stress, 46.79% (146/312) for anxiety, and 28.53% (89/312) for depression; the cumulative noise exposure ranged from 101.0 to 136.1 dB(A)·d, with an average of 125.69 dB(A)·d. The distributions of tested hearing thresholds and conscious hearing levels among the workers exposed to noise were significantly inconsistent (P<0.001), with both unweighted and weighted Kappa values less than 0.4. The percentage of workers with conscious hearing levels higher than their hearing threshold levels was 16.0%, and the percentage of workers with conscious hearing levels lower than conscious hearing levels was 38.7%. The path analysis results showed that tested hearing thresholds had no mediating effect on the relationship between cumulative noise exposure and negative emotions. There was a partial mediating effect of conscious hearing level on the relationship between cumulative noise exposure and negative emotions, with a mediating effect value of 0.06 (95%CI: 0.03, 0.11) and a mediating effect ratio of 28.57%. Conclusion Conscious hearing plays a partial mediating role in the relationship between cumulative noise exposure and negative emotions of noise-exposed workers, while tested hearing thresholds do not.

In order to improve the disaster response ability of resident physicians under standardized training, this study designed a disaster medicine curriculum of traditional Chinese and Western medicine with reference to domestic and foreign experience. The curriculum consisted of 8 modules with a total of 26 class hours. The definition and classification of disasters and the status of traditional Chinese medicine in disaster medicine were introduced. This study evaluated the teaching effect of disaster medicine curriculum of traditional Chinese and Western medicine carried out by the Emergency Trauma Center of the Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine in 84 resident physicians under standardized training. The results showed that the objective test scores of resident physicians under standardized training before and after the course were (45.00±2.51) and (76.25±2.76), respectively ( P<0.001). A questionnaire survey on the subjective understanding of knowledge related to disaster medicine of traditional Chinese and Western medicine was conducted among resident physicians under standardized training before and after the course. The results showed that the test scores before and after the course were (50.88±1.41) and (64.64±1.80), respectively ( P<0.001). This study showed that the theoretical knowledge, skills, and comprehensive ability of resident physicians under standardized training in disaster relief have been greatly improved through the disaster medicine-related curriculum, providing a reference for the establishment of disaster medical education-related curriculum of integrated traditional Chinese and Western medicine.

This study investigates the application effect of bisection combined with flipped classroom in the teaching of the course Introduction to Hearing and Speech Rehabilitation. A total of 74 students majoring in hearing and speech rehabilitation in the classes of 2019 and 2020 were selected as research subjects, and flipped classroom was applied in the teaching of the course Introduction to Hearing and Speech Rehabilitation. A questionnaire survey was conducted to compare the difference between traditional teaching model and flipped classroom in improving the comprehensive abilities of students. Research findings show that the teaching model of bisection combined with flipped classroom can significantly improve the abilities of self-expression, creative thinking, teamwork, and interpersonal communication among students, and there was no significant difference in improving learning enthusiasm between the two teaching models.

Objective To observe the value of preoperative CT enterography(CTE)for predicting the necessity of enterectomy in ovarian cancer(OC)patients for achieving optimal debulking surgery(ODS).Methods Preoperative CTE data of 49 patients with pathologically confirmed OC were retrospectively analyzed,including 13 cases received neoadjuvant chemotherapy(NACT)and 36 cases did not.The length(L)and circumference(C)of muscular involvement shown on CTE were taken as criteria for judging the necessity of enterectomy in OC patients([degree 0:no muscular involvement,degree 1:L＜3.0 cm and C＜1/3,degree 2:L≥3.0 cm[A]or C≥1/3[B]).The patients were followed up for at least 1 year after surgery,and the actual operation results were recorded to estimate the ideal surgical strategy.The consistency of CTE evaluated necessity of enterectomy and the ideal surgical strategy was analyzed.Results For patients not undergoing NACT,according to degree 2 A or B showed on CTE,predicted results had excellent agreement with the ideal surgical strategy(Kappa=0.852,P＜0.001),while those according to degree 1 or 2,2 A,2 B were all in good agreement with the ideal surgical strategy(Kappa=0.684-0.771,all P＜0.001).For patients undergoing NACT,the predicted results of degree 2 muscular involvement showed on CTE before NACT had excellent consistencies with the ideal surgical strategy(all Kappa=0.806,all P=0.003).The predicted results of degree 2 muscular involvement showed on CTE after NACT had moderate consistencies with the ideal surgical strategy(all Kappa=0.581,all P=0.021).Conclusion Preoperative CTE could be used to predict the necessity of enterectomy in OC patients for achieving ODS.

Objective To explore the impact of temperature and environmental factors on the risk of deaths from cardiovascular and cerebrovascular diseases (CVD) in Wuhan during the course of high temperature. Methods The daily CVD death data and meteorological and atmospheric pollutant concentration data during the high temperature process in Wuhan from 2014 to 2019 were collected. The generalized additive models (GAM) were used to obtain the characteristics of meteorological factors, atmospheric pollutant concentrations, high impact factors and thresholds affecting the relative risk of CVD death. Results The analysis results showed that: (1) When the maximum temperature reached 36.7°C and the lowest temperature reached 25.3°C, the relative risk of CVD death increased significantly; (2) The risk of CVD death during the first high temperature process was the largest, and the average CVD excess mortality rate during the first high temperature process from 2014 to 2019 reached 21.7%; and (3) The average temperature, maximum temperature and PM₁₀ during the course of high temperature were important environmental factors that increased the risk of CVD deaths, and the relative risks were 1.14 (95% confidence interval (95% CI): 1.11-1.17), 1.11 (95% confidence interval (95% CI): 1.08-1.15, and 1.06 (95% confidence interval (95% CI): 1.02-1.09), respectively. Conclusion Temperature and PM₁₀ are important environmental factors that increase the risk of death from CVD during the high temperature process in Wuhan from 2014 to 2019, with the first annual high temperature process having the greatest impact on the risk of CVD death.