Objective:To explore the changes in the functional connectivity (FC) of hippocampal subregions in nicotine addicts after repetitive transcranial magnetic stimulation (rTMS) using resting-state FC.Methods:This study was a cross-sectional study. The clinical and imaging data from 20 male nicotine addicts at Zhejiang Hospital between 2022 and 2024 were analyzed prospectively. All participants received rTMS treatment and were assessed with nicotine-related clinical scales and resting-state FC analysis before and after treatment. The clinical scale evaluations included the Fagerstr?m test for nicotine dependence (FTND), smoking severity index, Minnesota nicotine withdrawal scale (MNWS), short tobacco craving questionnaire (sTCQ), and visual analog scale (VAS). Paired t-tests and Wilcoxon signed-rank tests were used to compare the differences in clinical scale scores before and after treatment. Ten subregions of the bilateral hippocampus (including the hippocampus, dentate gyrus, entorhinal cortex, hippocampus-amygdala transition area, and subiculum) were used as seed points, and paired t-tests were conducted to compare the FC differences in these subregions before and after treatment. Pearson and Spearman correlation analyses were used to assess the correlation between changes in resting-state FC in the rTMS group and clinical scale scores. Results:Compared to pre-treatment, the scores on the FTND, smoking severity index, MNWS, sTCQ, and VAS all significantly decreased after rTMS treatment in nicotine addicts (all P<0.05). Compared to pre-treatment, post-treatment FC was reduced between the left dentate gyrus subregion and the bilateral supplementary motor area and left middle cingulate gyrus, while it increased between the left entorhinal cortex subregion and the right middle and superior temporal gyri, and between the left hippocampus-amygdala transition area subregion and the bilateral calcarine cortex and cuneus (Gaussian random field correction, voxel-level P<0.01, cluster-level P<0.05). Negative correlations were observed between the FC difference in the left hippocampus-amygdala transition area subregion and the right calcarine cortex and the difference in sTCQ-impulse score before and after treatment ( r=-0.447, P=0.048). Negative correlations were observed between the FC difference in the left hippocampus-amygdala transition area subregion and the right cuneus and the difference in the sTCQ-expectation score ( r=-0.559, P=0.010). Negative correlations were observed between the FC difference in the left hippocampus-amygdala transition area subregion and the left calcarine cortex and the differences in sTCQ-emotion and sTCQ-expectation scores ( r=-0.516, P=0.020; r=-0.466, P=0.038, respectively). Negative correlations were observed between the FC difference in the left hippocampus-amygdala transition area subregion and the left cuneus and the differences in sTCQ-emotion and sTCQ-expectation scores ( r=-0.459, P=0.042; r=-0.501, P=0.024, respectively). Conclusion:Changes in FC in certain hippocampal regions are observed in nicotine addicts following rTMS treatment, suggesting that hippocampal subregions may serve as potential biomarkers for nicotine addiction withdrawal to some extent.

To investigate the clinical assessment of dual-enhanced antiplatelet therapy after cerebrovascular intervention to reduce the risk of cerebral infarction recurrence, and to provide a reference for the prevention and treatment of cerebral infarction recurrence risk. 202 patients with cerebral infarction who underwent cerebrovascular intervention in Tianjin Fifth Central Hospital from January 2018 to October 2022 were selected as study subjects. The patients were divided into a treatment group ( n=104) based on randomized controlled single-blind method with 61 males and 43 females with a mean age of (62.33±2.57) years old and a control group ( n=98) with 56 males and 42 females with a mean age of (62.49±2.36) years old. The control group was given aspirin mono-antiplatelet therapy, and the treatment group was given clopidogrel doublet augmented antiplatelet therapy on the basis of the control group, and both groups continued the treatment for 2 months. Platelet counts, coagulation indexes and inflammatory factors were compared between the two groups before and after treatment, and the America National Institutes of Health Stroke Scale (NIHSS) score was used to assess the neurological functions of the two groups before and after treatment, and the recurrence of cerebral infarction in the two groups was counted within 6 months after treatment. In addition, the patients in the treatment group were divided into the cerebral infarction recurrence group and the cerebral infarction non-recurrence group according to whether they had cerebral infarction recurrence within 6 months after treatment, and the clinical data of the patients in the treatment group were collected to analyze the influencing factors of the dual-enhancement antiplatelet therapy for the recurrence of cerebral infarction in patients with cerebral infarction after cerebral vascular intervention by multifactorial logistic regression. The results showed that after treatment, patients in the treatment group had an international normalized ratio (INR) of (1.76±0.38), a platelet activation rate of (39.52±4.79)%, a platelet aggregation rate of (48.54±5.21)%, a tumor necrosis factor-alpha (TNF-alpha) of (28.37±4.47)ng/L, an interleukin 6 (IL-6) of (24.77±3.52)ng/L, a high-sensitivity C-reactive protein (hs-CRP) of (7.39±1.53)mg/L and an NIHSS score of (6.11±1.39) were lower than those of the control group (2.32±0.41), (44.81±6.37)%, (51.39±5.58)%, (39.66±4.51) ng/L, (29.25±4.04) ng/L, (9.03±1.78) mg/L and (9.93±1.46) points (all P<0.05). At 6-month follow-up of all patients, cerebral infarction recurred in 16 (15.38%) patients in the treatment group and in 33 (33.67%) patients in the control group ( χ2=9.185, P<0.05). Kaplan-Meier results showed a statistically significant difference in the rate of recurrence without cerebral infarction in the treatment group compared with the control group(LogRank χ2=4.595, P<0.05). Logistic regression analysis showed that smoking history, cervical vascular plaque, post-treatment NIHSS score, post-treatment stenosis score, post-treatment INR, post-treatment hs-CRP and CYP2C19 gene polymorphism were independent influences on the recurrence of cerebral infarction in cerebral infarction patients with cerebral vascular interventions followed by doublet augmentation of antiplatelet therapy (all P<0.05). In conclusion, dual-enhanced antiplatelet therapy may be an effective measure to reduce the risk of cerebral infarction recurrence after cerebrovascular intervention in patients with cerebral infarction, but it is still influenced by more factors.

To investigate the clinical assessment of dual-enhanced antiplatelet therapy after cerebrovascular intervention to reduce the risk of cerebral infarction recurrence, and to provide a reference for the prevention and treatment of cerebral infarction recurrence risk. 202 patients with cerebral infarction who underwent cerebrovascular intervention in Tianjin Fifth Central Hospital from January 2018 to October 2022 were selected as study subjects. The patients were divided into a treatment group ( n=104) based on randomized controlled single-blind method with 61 males and 43 females with a mean age of (62.33±2.57) years old and a control group ( n=98) with 56 males and 42 females with a mean age of (62.49±2.36) years old. The control group was given aspirin mono-antiplatelet therapy, and the treatment group was given clopidogrel doublet augmented antiplatelet therapy on the basis of the control group, and both groups continued the treatment for 2 months. Platelet counts, coagulation indexes and inflammatory factors were compared between the two groups before and after treatment, and the America National Institutes of Health Stroke Scale (NIHSS) score was used to assess the neurological functions of the two groups before and after treatment, and the recurrence of cerebral infarction in the two groups was counted within 6 months after treatment. In addition, the patients in the treatment group were divided into the cerebral infarction recurrence group and the cerebral infarction non-recurrence group according to whether they had cerebral infarction recurrence within 6 months after treatment, and the clinical data of the patients in the treatment group were collected to analyze the influencing factors of the dual-enhancement antiplatelet therapy for the recurrence of cerebral infarction in patients with cerebral infarction after cerebral vascular intervention by multifactorial logistic regression. The results showed that after treatment, patients in the treatment group had an international normalized ratio (INR) of (1.76±0.38), a platelet activation rate of (39.52±4.79)%, a platelet aggregation rate of (48.54±5.21)%, a tumor necrosis factor-alpha (TNF-alpha) of (28.37±4.47)ng/L, an interleukin 6 (IL-6) of (24.77±3.52)ng/L, a high-sensitivity C-reactive protein (hs-CRP) of (7.39±1.53)mg/L and an NIHSS score of (6.11±1.39) were lower than those of the control group (2.32±0.41), (44.81±6.37)%, (51.39±5.58)%, (39.66±4.51) ng/L, (29.25±4.04) ng/L, (9.03±1.78) mg/L and (9.93±1.46) points (all P<0.05). At 6-month follow-up of all patients, cerebral infarction recurred in 16 (15.38%) patients in the treatment group and in 33 (33.67%) patients in the control group ( χ2=9.185, P<0.05). Kaplan-Meier results showed a statistically significant difference in the rate of recurrence without cerebral infarction in the treatment group compared with the control group(LogRank χ2=4.595, P<0.05). Logistic regression analysis showed that smoking history, cervical vascular plaque, post-treatment NIHSS score, post-treatment stenosis score, post-treatment INR, post-treatment hs-CRP and CYP2C19 gene polymorphism were independent influences on the recurrence of cerebral infarction in cerebral infarction patients with cerebral vascular interventions followed by doublet augmentation of antiplatelet therapy (all P<0.05). In conclusion, dual-enhanced antiplatelet therapy may be an effective measure to reduce the risk of cerebral infarction recurrence after cerebrovascular intervention in patients with cerebral infarction, but it is still influenced by more factors.

Objective We aimed to study the distribution of traditional Chinese medicine(TCM)constitution and related influencing factors in patients with impaired glucose tolerance(IGT).Methods A cross-sectional study method was used to enroll IGT patients who attended one of eight collaborating units across China between January and August 2021.Basic information was recorded,physical and laboratory examinations were completed,and the data on TCM constitution were collected according to the"classification and determination table of TCM constitution."Finally,patient information was entered into an Excel table,and the data were analyzed using SPSS 26.0.Results Among the 450 patients,a balanced constitution accounted for 37.3%,yang-deficiency constitution for 15.6%,phlegm-dampness constitution for 14.4%,and dampness-heat constitution for 10.9%.Among the biased constitutions,the proportion of men with dampness-heat constitution was higher than that of women,and the proportion of women with yang-deficiency constitution and blood stasis constitution was significantly higher than that of men(P<0.05).The triglyceride level of patients with phlegm-dampness constitution was higher than that of patients with yang-deficiency constitution(P<0.05);the HDL-cholestrol level of patients with yang-deficiency constitution was higher than that of patients with phlegm-dampness constitution(P<0.05);and the uric acid level of patients with phlegm-dampness constitution,dampness-heat constitution,or yin-deficiency constitution was higher than that of patients with yang-deficiency constitution,and the UA level was the highest in patients with dampness-heat constitution(P<0.05).Conclusion The distribution of TCM constitution in IGT patients was dominated by balanced constitution,followed by yang-deficiency constitution,phlegm-dampness constitution,and dampness-heat constitution.Gender,blood lipid levels,and UA levels were the main factors affecting the constitution status of IGT patients.

Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.

Objective:To study the influencing factors of the effort level and incentive coefficient of doctors in public hospitals under different fairness preferences,and provide suggestions for the design of the incentive mechanism for doctors in public hospi-tals.Methods:The equity preference theory,principal-agent theory and Matlab Software were used for analysis.Results:The doc-tor's effort level was negatively correlated with the cost coefficient,positively correlated with the fairness preference level,and the promotion effect of vertical fairness preference on the effort level was higher than that of horizontal fairness preference;the incentive coefficient was positively correlated with the doctor's vertical fairness preference and negatively correlated with the horizontal equity preference.Conclusion:The government and hospital managers should reduce the effort cost of doctors,fully understand the fair-ness preference of doctors,strengthen the supervision of doctors'work,adopt a comprehensive incentive strategy to intervene in the fairness preference of doctors,and transform the negative utility of doctors'equity preference into the enthusiasm for working hard.

Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.

Objective:To study the influencing factors of the effort level and incentive coefficient of doctors in public hospitals under different fairness preferences,and provide suggestions for the design of the incentive mechanism for doctors in public hospi-tals.Methods:The equity preference theory,principal-agent theory and Matlab Software were used for analysis.Results:The doc-tor's effort level was negatively correlated with the cost coefficient,positively correlated with the fairness preference level,and the promotion effect of vertical fairness preference on the effort level was higher than that of horizontal fairness preference;the incentive coefficient was positively correlated with the doctor's vertical fairness preference and negatively correlated with the horizontal equity preference.Conclusion:The government and hospital managers should reduce the effort cost of doctors,fully understand the fair-ness preference of doctors,strengthen the supervision of doctors'work,adopt a comprehensive incentive strategy to intervene in the fairness preference of doctors,and transform the negative utility of doctors'equity preference into the enthusiasm for working hard.

Objective:To explore the influencing factors of the incentives contract of the government for physicians in public hospitals to complete economic and public welfare tasks,and provide corresponding incentive strategies.Methods:Modeling method of multi task principal-agent theory are applied.Results:The optimal incentive coefficient of the government are negatively associated with the cost coefficient of physicians'efforts,physicians'risk attitudes and cost relevance.The uncertainty of the external environment has different effects.Conclusion:The realization of the incentive contract for physicians in public hospitals requires the government to timely adjust the corresponding incentive strategies according to the changes of parameters,so as to ensure the public welfare of medical services and the acquisition of long-term profits.

Objective:To study the influencing factors of the effort level and incentive coefficient of doctors in public hospitals under different fairness preferences,and provide suggestions for the design of the incentive mechanism for doctors in public hospi-tals.Methods:The equity preference theory,principal-agent theory and Matlab Software were used for analysis.Results:The doc-tor's effort level was negatively correlated with the cost coefficient,positively correlated with the fairness preference level,and the promotion effect of vertical fairness preference on the effort level was higher than that of horizontal fairness preference;the incentive coefficient was positively correlated with the doctor's vertical fairness preference and negatively correlated with the horizontal equity preference.Conclusion:The government and hospital managers should reduce the effort cost of doctors,fully understand the fair-ness preference of doctors,strengthen the supervision of doctors'work,adopt a comprehensive incentive strategy to intervene in the fairness preference of doctors,and transform the negative utility of doctors'equity preference into the enthusiasm for working hard.