Objective To investigate the predictive value of preoperative combined detection of neutrophil-to-lymphocyte ratio (NLR) and prothrombin time-international normalized ratio to albumin ratio (PTAR) for early abdominal infection after liver transplantation. Methods Clinical data of 287 recipients who underwent liver transplantation at the Liver Transplant Center of Beijing Friendship Hospital, Affiliated to Capital Medical University, from January 2020 to April 2024 were retrospectively analyzed. The patients were divided into infection group (n=60) and non-infection group (n=227) based on whether abdominal infection occurred within 30 days after surgery. The distribution characteristics of pathogens and infection time in infected patients were analyzed. Spearman correlation analysis was used to assess the correlation between NLR, PTAR, Child-Pugh score and preoperative model for end-stage liver disease (MELD) score. Univariate and multivariate logistic regression analyses were performed to identify risk factors for abdominal infection. Receiver operating characteristic (ROC) curves were plotted for NLR, PTAR, and the combined prediction model to evaluate their predictive efficacy for abdominal infection after liver transplantation. Based on the cutoff value of the combined model, recipients were divided into low-risk and high-risk groups, and Kaplan-Meier analysis was used to compare the cumulative incidence of abdominal infection within 30 days after surgery between the two groups. Results Among the 287 recipients who underwent liver transplantation, 60 developed bacterial or fungal abdominal infections postoperatively. A total of 86 strains were isolated from infected patients, with Gram-negative bacteria accounting for 58%, Gram-positive bacteria for 36%, and fungi for 5%. Preoperative NLR and PTAR were positively correlated with Child-Pugh and MELD scores (all 1 > r > 0, P < 0.05). Logistic regression analysis showed that preoperative NLR, preoperative PTAR, postoperative ICU stay duration and postoperative biliary leakage were risk factors for abdominal infection within 30 days after surgery. The area under the curve (AUC) for NLR, PTAR, Child-Pugh score and MELD score were 0.771, 0.735, 0.650 and 0.741, respectively. The AUC for the combined NLR and PTAR prediction model was 0.824 (95% confidence interval: 0.763-0.885, P < 0.001), with a cutoff value of 0.168. Kaplan-Meier analysis showed that the cumulative incidence of abdominal infection within 30 days after surgery was lower in the low-risk group than in the high-risk group, with statistically significant difference (P < 0.001). Conclusions Preoperative NLR and PTAR are independent risk factors for abdominal infection within 30 days after liver transplantation. The combined prediction model of NLR and PTAR may effectively identify high-risk recipients for early abdominal infection after liver transplantation, providing basis for early intervention.

Education is a crucial element in the development of acupuncture as a discipline, providing essential talent support for its future advancement. A structured interview was conducted with renowned acupuncture expert Professor ZHAO Jiping, focusing on key topics such as the core of acupuncture education, the connotation and development of acupuncture textbooks, and acupuncture teaching models. Through in-depth discussion, the current problems in acupuncture education were analyzed, and possible solutions were explored, aiming to offer ideas for the innovative development of acupuncture education.
Acupuncture/trends* ; Humans ; Acupuncture Therapy ; China

Objective:To analyze the relationship between health belief and the stages of parental decision-making on childhood 13-valent pneumococcal conjugate vaccine (PCV13) immunization in China.Methods:Cross-sectional multistage survey sampling method was used to select study subjects. The study subjects were parents who were aged 20-45 years and had one and more children ≤5 years old in three cities in China. A self-administered questionnaire designed based on health belief model was used to collect the information. Multinomial logistic regression analysis was used to assess the relationships between perceived susceptibility, perceived severity of illness, perceived effect of PCV13 and stages of parental decision-making on childhood PCV13 immunization.Results:A total of 1 716 valid questionnaires were returned (89.33%). The average age of the study subjects was (35.33±4.95) years, and 79.60% of them were women. In the study subjects, 48.31% had in action, 21.79% were in contemplation and 29.90% were in pre-contemplation. The multinominal logistic regression analysis indicated that high perceived susceptibility ( OR=0.14, 95% CI:0.09-0.22; OR=0.54, 95% CI:0.39-0.76), high perceived severity of illness ( OR=0.55, 95% CI:0.42-0.73), and high perceived effect of PCV13 ( OR=0.27, 95% CI:0.18-0.40; OR=0.51, 95% CI:0.32-0.81) were significantly lower in those who were in contemplation or pre-compared with those who had in action. For study subjects with low perceived susceptibility, high perceived effect of PCV13 might decrease the probabilities of contemplation ( OR=0.53, 95% CI:0.32-0.87) and pre-contemplation ( OR=0.27, 95% CI:0.18-0.41). For those with high perceived susceptibility, perceived severity of illness might decrease the probability of contemplation ( OR=0.43, 95% CI:0.23-0.82). Conclusions:Childhood PCV13 vaccination willingness and level is low in China. It is important to pay greater attention to the intervention on health belief in child parents, such as perceived effect of PCV13, perceived severity of illness, and perceived susceptibility, in health policy development and health promotion.

Objective To investigate the risk factors of in-hospital mortality and establish a risk prediction model for patients receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO).Methods We retrospectively collected the data of 302 patients receiving VA-ECMO in ICU of 3 hospitals in Guangdong Province between January,2015 and January,2022 using a convenience sampling method.The patients were divided into a derivation cohort(201 cases)and a validation cohort(101 cases).Univariate and multivariate logistic regression analyses were used to analyze the risk factors for in-hospital death of these patients,based on which a risk prediction model was established in the form of a nomogram.The receiver operator characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the discrimination ability,calibration and clinical validity of this model.Results The in-hospital mortality risk prediction model was established based the risk factors including hypertension(OR=3.694,95%CI:1.582-8.621),continuous renal replacement therapy(OR=9.661,95%CI:4.103-22.745),elevated Na2+ level(OR=1.048,95%CI:1.003-1.095)and increased hemoglobin level(OR=0.987,95%CI:0.977-0.998).In the derivation cohort,the area under the ROC curve(AUC)of this model was 0.829(95%CI:0.770-0.889),greater than those of the 4 single factors(all AUC<0.800),APACHE Ⅱ Score(AUC=0.777,95%CI:0.714-0.840)and the SOFA Score(AUC=0.721,95%CI:0.647-0.796).The results of internal validation showed that the AUC of the model was 0.774(95%CI:0.679-0.869),and the goodness of fit test showed a good fitting of this model(χ2=4.629,P>0.05).Conclusion The risk prediction model for in-hospital mortality of patients on VA-ECMO has good differentiation,calibration and clinical effectiveness and outperforms the commonly used disease severity scoring system,and thus can be used for assessing disease severity and prognostic risk level in critically ill patients.

Objective To propose a dual-domain CBCT reconstruction framework(DualSFR-Net)based on generative projection interpolation to reduce artifacts in sparse-view cone beam computed tomography(CBCT)reconstruction.Methods The proposed method DualSFR-Net consists of a generative projection interpolation module,a domain transformation module,and an image restoration module.The generative projection interpolation module includes a sparse projection interpolation network(SPINet)based on a generative adversarial network and a full-view projection restoration network(FPRNet).SPINet performs projection interpolation to synthesize full-view projection data from the sparse-view projection data,while FPRNet further restores the synthesized full-view projection data.The domain transformation module introduces the FDK reconstruction and forward projection operators to complete the forward and gradient backpropagation processes.The image restoration module includes an image restoration network FIRNet that fine-tunes the domain-transformed images to eliminate residual artifacts and noise.Results Validation experiments conducted on a dental CT dataset demonstrated that DualSFR-Net was capable to reconstruct high-quality CBCT images under sparse-view sampling protocols.Quantitatively,compared to the current best methods,the DualSFR-Net method improved the PSNR by 0.6615 and 0.7658 and increased the SSIM by 0.0053 and 0.0134 under 2-fold and 4-fold sparse protocols,respectively.Conclusion The proposed generative projection interpolation-based dual-domain CBCT sparse-view reconstruction method can effectively reduce stripe artifacts to improve image quality and enables efficient joint training for dual-domain imaging networks in sparse-view CBCT reconstruction.

Objective To analyze the hotspots and frontiers of researches related to exercise intervention for spinal curvature abnor-malities in children and adolescents. Methods Articles related to exercise intervention for spinal curvature abnormalities in children and adolescents were re-trieved from CNKI and Web of Science Core Collection,from January,2014 to December,2023.The literatures were analyzed wtih CiteSapce 6.2.R3 in terms of disciplines,countries,institutes and keywords. Results A total of 233 articles were retrived,including 71 articles in Chinese and 162 articles in English.The annual pub-lication volume was on the rise.China was the country with the highest number of publications.South Korea was seen a sudden increase in recent literature.For Chinese,the institutions with the largest number of publication were the Department of Health and Exercise Science in Tianjin University of Sport and Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital).While the institutions with the largest number of publication in English were Marmara University and Hong Kong Polytechnic University.The English literatures covered a wide range of disciplines,including clinical medicine,sports medicine,neurolo-gy and psychology.Common high-frequency keywords in both Chinese and English literatures were idiopathic scoliosis,Cobb's angle and Schroth exercise.The latest bursting words included physical health in Chinese,and health-related quality of life and respiratory muscle strength in English. Conclusion The research popularity related to exercise intervention for spinal curvature abnormality in children and ado-lescents is generally on the rise.The research hotspots focus on four main areas:disease,quality of life,research advances and clinical treatment.More attention should be paid to the effect and dosage of exercise intervention on the respiratory function,as well as the effect of Chinese medicine exercise therapy on pediatric patients with abnormal spinal curvature diseases.Future work should focus on constructing an evidence-based Chinese/West-ern medicine exercise prevention and treatment system in the context of China's national conditions,advancing high-quality randomized controlled trials,strengthening interdisciplinary and international collaborations,and fo-cusing on the development and evaluation of personalized exercise intervention programs.

ObjectiveTo investigate the prevalence of stroke in Songjiang District from 2017 to 2022, to analyze the epidemiological characteristics of stroke incidence, so as to provide a scientific basis for the formulation of stroke prevention and control policies. MethodsData of new stroke incidence from 2017 to 2022 in Songjiang District were obtained from the Shanghai Stroke and Acute Myocardial Infarction Registration and Reporting Information System. In addition, different classifications such as time of onset, gender, age group and types of stroke, were statistically analyzed. Statistical indicators, such as the number of incidence, crude incidence rate, standardized incidence rate and average age of incidence were calculated simultaneously. Joinpoint software were used to calculate the annual change percentage (APC) and the trend of stroke incidence in Songjiang District. ResultsFrom 2017 to 2022, the newly reported cases of stroke were 12 988 in Songjiang District, the crude incidence rate was 325.76/10⁵, and the standardized incidence rate was 127.58/10⁵. The crude incidence rate and standardized incidence rate in males were 363.45/10⁵ and 157.17/10⁵, respectively, but 288.68/10⁵ and 99.02/10⁵ in females. The mean age of onset was (73.12±11.75) years, of which the mean age of onset was (70.86±11.96) years for men and (75.91±10.85) years for women. The incidence of stroke increased with age, rising rapidly after 60 years and reaching a peak in the age group of ≥ 80 years old. The crude incidence rate and standardized incidence rate of stroke in Songjiang District showed a downward trend from 2017 to 2022, with an APC of -6.20% and -8.01%, respectively (P=0.018, 0.007). The newly reported stroke was dominated by ischemic stroke, accounting for 82.81% of the total cases, with a crude incidence rate of 269.77/10⁵ and a standardized rate of 103.84/10⁵. The incidence of stroke presented seasonal characteristics, with the highest incidence in winter, accounting for 26.11% of the whole year. ConclusionThe incidence rate of stroke in Songjiang District shows a declined trend, but the overall incidence is still at a high level. The situation of prevention and control is still serious, with a heavy disease burden. It is necessary to strengthen health education and disease management for the elderly.

The incidence and mortality rate of heart failure (HF) are increasing annually, resulting in a huge medical and economic burden worldwide. B-type natriuretic peptide (BNP) is the gold standard biomarker of HF recommended by national and international guidelines for the diagnosis and prognosis evaluation of HF. Recent studies suggest that BNP can be truncated in multiple forms by different enzymes rather than complete fragments in circulation, which can be contributing to the diagnosis and classification of HF. The immunoassay mostly used in clinics are unable to distinguish different truncated BNP forms due to cross-reactivity of antibody, while mass spectrometry is more accurate because it can easily distinguish through their mass-to-charge ratios. With the maturation of ambient ionization mass spectrometry and ion mobility mass spectrometry, it can help to simplify sample pre-treatment and improve the separation efficiency, in order to explore the clinical value of the heterogeneity of BNP truncated forms.

BACKGROUND:Seed cells are seeded on three-dimensional scaffold materials,and three-dimensional culture in bioreactors is a common in vitro tissue engineering culture method,but the changes in cell proliferation and metabolic patterns in bioengineered blood vessel construction are still unclear. OBJECTIVE:To explore the metabolic changes of cells such as oxygen consumption and their causes during the whole process of biological vascular tissue construction by in vitro bioreactor. METHODS:The self-built vascular bioreactor system was used as the platform;bovine vascular smooth muscle cells were used as the seed cells,and a conventional CO2 incubator provided the external gas environment for the cultivation process.Seed cells were seeded on a tubular porous polyglycolic acid scaffold material for three-dimensional culture,and the whole process included a one-week resting period and a seven-week pulsating tensile stress stimulation loading period.A non-invasive monitoring system was built,and the optical dissolved oxygen patch method was used to monitor the changes of dissolved oxygen in the culture solution in the reactor,and the glucose consumption and lactic acid production were measured by regular sampling.CCK-8 assay was used to determine the proliferation of smooth muscle cells on polyglycolic acid three-dimensional scaffold materials.Nicotinamide adenine dinucleotide oxidation state and reduction state ratio(NAD+/NADH)was utilized to understand cell proliferation and metabolism in the early stage of culture.RT-qPCR and western blot assay were applied to detect the expression of proliferation-related genes(Ki67)and glycolysis-related genes(GLUT-1,LDHA). RESULTS AND CONCLUSION:(1)The dissolved oxygen level in the culture solution was(4.314±0.380)mg/L from the cell injection to the end of the resting period(the first week),and gradually stabilized at(1.960±0.866)mg/L after the tensile stress stimulation(the last seven weeks);the two had significant changes(P<0.05).(2)The ratio of glucose consumption to lactic acid production in the cell culture medium YL/G increased rapidly after the cells were injected,and the highest value was above 1 on the fifth day,and then slow down to 0.5(The mean value of YL/G in the resting period was 0.89 and the mean value in the pressurized period was 0.57,P<0.05).(3)CCK-8 assay results showed that A450 value gradually increased after the cells were injected,and reached the highest value on the fifth day,reaching 3.17,and then slowly decreased.At the same time,it was found that Ki67 mRNA was up-regulated on the third day of culture,and then declined.The expression level of Ki67 protein was higher from the third day to the fifth day.(4)The detection of NAD+/NADH showed that the increase was obvious from the fifth to the seventh day after the injection of cells,and the expression of glycolysis-related genes(GLUT-1 and LDHA)was up-regulated and changed synchronously,and the relative expression was higher in the first five days.(5)The results showed that the tissue-engineered blood vessels were constructed using the vascular bioreactor and the smooth muscle cells in the early stage mainly proliferated and exhibited a metabolic feature of low oxygen consumption.The metabolic characteristics of high oxygen consumption were observed during the pulsatile tensile stress stimulation stage.

BACKGROUND:Osteoarthritis is a common chronic inflammation of joints caused by degenerative changes of articular cartilage.More and more studies have shown that mechanical stress is closely related to the development of osteoarthritis.The Hippo pathway is not only involved in the development of tissue cells,but also an effecting factor of mechanical stress,which is involved in the regulation of bone metabolism and cartilage metabolism. OBJECTIVE:Regulation of the Hippo pathway may become one of the new targets for intervention in osteoarthritis.Therefore,this paper reviewed the research on the effect of mechanical stress regulation of the Hippo pathway on osteoarthritis to provide ideas for the pathogenesis of osteoarthritis and provide a new theoretical basis for the treatment of osteoarthritis. METHODS:PubMed,Web of Science,Embase,CNKI,VIP,and WanFang databases were used for a literature search for articles published from inception to 2023 concerning the influence of mechanical stress on osteoarthritis and mechanical stress,Hippo pathway,and osteoarthritis.A total of 75 articles were finally reviewed. RESULTS AND CONCLUSION:(1)Different mechanical stresses may play different roles in cell proliferation,apoptosis and differentiation,osteoarthritis inflammation,and vascular homeostasis in osteoarthritis.(2)Hard extracellular matrix,low cell density,medium shear force,medium tensile force,and compression force can achieve cell proliferation,osteogenic differentiation,and vascular homeostasis,and inhibit inflammatory response by activating YAP/TAZ.(3)Soft extracellular matrix,high cell density,excessive shear force,excessive tensile force,and compressive force inhibit cell proliferation,enhance cartilage differentiation,disrupt vascular homeostasis,and promote inflammation through inactivation of YAP/TAZ,thus promoting the process of osteoarthritis.