Objective:To analyse the effect of ultrasound-guided percutaneous liver biopsy and the coaxial biopsy needle tract radiofrequency ablation on patients diagnosed with hepatocellular carcinoma who are considered to be at risk of bleeding.Methods:The data of 117 patients with hepatocellular carcinoma who underwent coaxial biopsy needle tract radiofrequency ablation after ultrasound-guided percutaneous liver biopsy in Peking University First Hospital from March 2019 to April 2023 were retrospectively analysed. There were 95 males and 22 females, with the age of (62.0±11.8) years. A comprehensive analysis was conducted on the following variables: the pre-puncture platelet count, the international standardised ratio, anticoagulation therapy, the haemoglobin (Hb) level, the success rate of the liver puncture, the qualified rate of liver puncture specimens, the number of puncture samples, the length of hospital stay, the Hb level after puncture, bleeding within 10 days post-operation, and complications after ablation, including biliary fistula, hemothorax and organ perforation.Results:Among the 117 patients, 60 cases (51.3%) had an international normalized ratio >1.1, 40 cases (34.2%) had thrombocytopenia, that is, <150×10 9/L, and 17 cases (14.5%) received continuous anticoagulation therapy before the operation. It is evident that all 117 patients successfully completed the ultrasound-guided percutaneous liver biopsy, and that all liver biopsy specimens were qualified. The absence of biliary fistula, hemothorax, organ perforation or death in the patients post-ablation was noted. According to the adverse event evaluation criteria, version 5.0, 113 cases (96.6%) were classified as grade 1 and 4 cases (3.4%) were classified as grade 3. The Hb concentration of patients with minor bleeding (grade 1) prior to puncture was (119.7±22.2) g/L, which was significantly higher than the Hb concentration of patients with severe bleeding (grade 3), (76.0±10.4) g/L ( t=3.92, P=0.010). A meticulous examination of the data revealed that there were no statistically significant differences between the two groups with regard to pre-puncture platelet count, pre-puncture international standardised ratio, pre-puncture proportion of receiving anticoagulant drugs, length of hospital stay and number of puncture samples (all P>0.05). Conclusion:For patients with hepatocellular carcinoma who are at risk of bleeding, ultrasound-guided percutaneous liver biopsy followed by coaxial biopsy needle tract radiofrequency ablation can obtain satisfactory liver tissue samples and is relatively safe. There were differences in hemoglobin levels before puncture among patients with different bleeding after puncture.

Objective:To construct a predictive model for mortality in patients with multiple trauma combined with thoracic injuries and evaluate its predictive value.Methods:A retrospective cohort study was conducted to analyze the clinical data of 184 patients with multiple trauma combined with thoracic injuries admitted to the International Zhuang Medicine Hospital Affiliated to Guangxi University of Chinese Medicine from April 2019 to December 2023, including 129 males and 55 females, aged 19-85 years [(46.1±13.7)years]. According to the prognostic outcomes at 3-month follow-up after discharge, the patients were divided into survival group ( n=145) and death group ( n=39). Data were recorded in both groups at admission, including gender, age, and cause of injury, laboratory tests such as systolic blood pressure, oxygen saturation (SaO 2), hemoglobin (Hb), neutrophil-to-lymphocyte ratio (NLR), and lactate, combined injuries such as the number of combined injuries, number of rib fracture, bilateral rib fracture, first-rib fracture, sternum fracture, thoracic vertebral fracture, bilateral pulmonary contusion, bilateral pneumothorax, subarachnoid hemorrhage, subdural hematoma, epidural hematoma, skull fracture, skull base fracture, cervical vertebral fracture, brain herniation, cerebral contusion, lumbar vertebral fracture, pelvic and abdominal cavity hematoma, liver injury, kidney injury, spleen injury, clavicle fracture, scapular fracture, femoral fracture, and pelvic fracture, and injury scores such as shock index (SI), modified shock index (MSI), injury severity score (ISS), revised trauma score (RTS), Glasgow coma score (GCS), and thoracic trauma severity (TTS) score. Univariate binary logistic regression analysis was used to screen for risk factors of death in patients with multiple trauma combined with thoracic injuries. LASSO regression and multivariate logistic regression analysis were employed to identify predictive variables and independent risk factors for mortality in those patients and to construct a regression equation. A nomogram prediction model based on the regression equation was developed using R language. Receiver operating characteristic (ROC) curves were plotted to evaluate the discrimination of the model. The ROC curves were internally validated using the Bootstrap method with 1 000 resamples. The calibration of the model was assessed using the Hosmer-Lemeshow (H-L) goodness-of-fit test. The clinical application value of the model was evaluated using decision curve analysis (DCA) and clinical impact curve (CIC) analysis. Results:There were statistically significant differences between the survival group and the death group in systolic blood pressure, SaO 2, NLR, lactate, number of combined injuries, subarachnoid hemorrhage, subdural hematoma, skull fracture, skull base fracture, brain herniation, liver injury, SI, MSI, ISS, RTS, GCS, and TTS ( P<0.05 or 0.01). The results of the univariate binary logistic regression analysis showed that the above-mentioned related variables except for systolic blood pressure were all significantly associated with death in patients with multiple trauma combined with thoracic injuries ( P<0.05 or 0.01). Five predictive variables, TTS, GCS, brain herniation, ISS, and lactate were obtained in LASSO regression analysis. The results of the multivariate logistic regression analysis showed that GCS ( OR=0.70, 95% CI 0.58, 0.83), brain herniation ( OR=46.18, 95% CI 4.27, 499.26), TTS ( OR=1.71, 95% CI 1.30, 2.24), and lactate ( OR=1.35, 95% CI 1.01, 1.80) were independent risk factors for death in patients with multiple trauma combined with thoracic injuries ( P<0.05 or 0.01). Based on the aforementioned independent risk factors, a regression formula was constructed as follows: P=e x/(1+e x), with the x=-0.36×"GCS"+3.83×"brain herniation"+0.53×"TTS"+0.30×"lactate levels"-11.03. The area under the ROC curve (AUC) of the predictive model for mortality in patients with multiple trauma combined with thoracic injuries based on the equation was 0.97 (95% CI 0.93, 1.00). The AUC was internally validated using the Bootstrap method with 1 000 samples, resulting in an AUC of 0.97 (95% CI 0.91, 1.00). The results of the H-L goodness-of-fit test showed that the bias-corrected calibration curve of the model was in good consistence with the actual curve and both of them were close to the ideal curve. In the evaluation of the clinical application value of the predictive model, the DCA results showed that the predictive model could achieve good clinical net benefit. The CIC results showed that when the threshold probability was greater than 0.7, the model-identified high-risk patients for death highly matched the patients who actually died. Conclusion:The predictive model for mortality in patients with multiple trauma combined with thoracic injuries based on GCS, brain herniation, TTS, and lactate has good predictive performance and clinical application value.

ObjectiveTo elucidate the chemical composition of Danshenyin and its blood components in rats after oral administration. MethodsUltra performance liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry（UPLC-Q-TOF-MS/MS） coupled with PeakView 1.2 software was used to systematically characterize and identify the components of Danshenyin aqueous extract and its migratory components in rat blood after oral administration based on the retention time， quasi-molecular ion peaks， secondary fragmentation ions， and literature reports， and a preliminary compounds identification of Salviae Miltiorrhizae Radix et Rhizoma aqueous extract， the co-decoction of Santali Albi Lignum and Amomi Fructus was carried out to attribute the chemical constituents of the aqueous extract of Danshenyin. ResultsA total of 73 compounds， including 21 phenolic acids， 23 diterpenes， 6 flavonoids， 7 organic acids， 3 volatile oils and 13 others， were identified from the aqueous extract of Danshenyin. And 36 prototypes and 15 metabolites were identified in rat plasma， the major metabolic pathways included reduction， hydration， hydroxylation， demethylation， methylation， sulfation and others， these metabolites were mainly derived from tanshinones and salvianolic acids. ConclusionThe main blood components of the aqueous extract of Danshenyin are salvianolic acids and tanshinones， which may be the material basis of the efficacy. This study can provide reference for pharmacological research， quality control， and clinical application of Danshenyin.

Objective To explore the attentional network function in sub-healthy individuals with spleen qi deficiency syndrome.Methods Twenty-seven individuals in the sub-healthy spleen qi deficiency syndrome group were recruited from September 2022 to August 2024 in communities and colleges.Twenty-five healthy controls were also recruited according to the principle of matching age,gender,and years of education components.Attention network tests were performed on subjects in both groups.Results Compared with the control group,the executive control network function value of the spleen qi deficiency syndrome group was significantly decreased(P=0.012).The differences in correct rate,overall reaction time,alert network and orientation network between the two groups were not statistically significant(P＞0.05).The results of correlation analysis showed a significant negative correlation between Health Evaluating Questionnaire H20 V2009 scores and executive control network efficiency of the subjects in the spleen qi deficiency syndrome(P＜0.001),and a positive correlation between the spleen qi deficiency syndrome score and executive control network efficiency(P=0.038).Conclusions Abnormal changes in the executive control of attention in sub-healthy subjects with spleen qi deficiency syndrome were closely related to the severity of the symptoms of spleen qi deficiency,which provided further scientific evidence for the cognitive psychological connotation of the theory of"spleen stores Yi".

Objective To characterize working memory performance in patients with chronic fatigue syndrome(CFS)and spleen-deficiency syndrome and to examine its associations with clinical symptoms by Sternberg working memory task(SWMT).Methods 31 CFS patients meeting both CDC-1994 criteria and consensus criteria for spleen-deficiency pattern were recruited from outpatient clinics and universities from September 2022 and June 2025.31 healthy controls were also recruited based on age,sex,and education.All subjects completed the SWMT.Group differences were analyzed.Within the CFS cohort,reaction time(RT)was correlated with scores on the checklist individual strength(CIS),36-item short-form health survey(sf-36),and fatigue scale-14(FS-14).Mediation was examined.Results RT lengthened with increasing memory load in both groups.CFS patients displayed slower RTs than controls in the baseline and 6-digit set(P<0.05).The 3-digit RT difference,though not significant(P>0.05),yielded a medium effect size(r=0.36).Accuracy did not differ between two groups.Among CFS patients,3-digit RT correlated positively with CIS total and the 4 sub-scale scores.6-digit RT correlated with the SF-36 health-transition dimension(r=0.396,P=0.027).CIS and FS-14 scores directly impaired SF-36 social functioning without working-memory mediating.Conclusion CFS patients with spleen-deficiency exhibit slowed processing speed rather than capacity loss.The close link between working-memory slowing and fatigue suggests a distinct neural basis.These results support the traditional concept"the spleen stores Yi"and integrate TCM pattern differentiation with modern cognitive neuroscience in CFS.

Objective To build the machine learning classification model for sub-health patients with spleen qi deficiency syndrome and kidney qi deficiency syndrome based on degree centrality characteristics.Methods A total of 80 sub-healthy subjects were included,including 40 subhealth patients with spleen qi de ficiency syndrome and 40 subhealth patients with kidney qi deficiency syndrome were enrolled and underwent resting-state functional magnetic resonance imaging scans.The DPABI software was used to extract the degree centrality characteristics of all subjects,and a random forest model was used for classification.Results Between the sub-health spleen qi deficiency syndrome group and the sub-health kidney qi deficiency syndrome group,after feature selection,10 degree centrality features were finally obtained:The supplementary eye field,posterior cingulate gyrus,MT+area,pre-supramarginal sulcus,ventromedial visual area,secondary visual cortex,supramarginal sulcus,precuneus,ventral supramarginal gyrus complex and dorsolateral prefrontal cortex.Following hyperparameter optimization and leave-one-out cross-validation,a random forest classification model was obtained with an accuracy rate of 0.71.Conclusion The significant changes in the centrality of brain regions such as the supplementary eye field and posterior cingulate gyrus may be key brain regions underlying the neural mechanism differences between subhealth spleen qi deficiency syndrome and kidney qi deficiency syndrome,providing neuroimaging evidence for the cognitive neural basis differences in traditional Chinese medicine theories of"spleen in storing idea"and"kidney storing will".

Objective To explore the neuroimaging mechanisms of sub-health patients with spleen qi deficiency syndrome based on large-scale brain network resting-state functional connectivity.Methods Thirty-seven sub-health patients with spleen qi deficiency syndrome and 37 healthy controls were enrolled.All subjects underwent resting-state functional magnetic resonance imaging(fMRI)scans.Functional connectivity within and between large-scale brain networks was analyzed and compared between the two groups.The correlation between abnormal changes in brain network functional connectivity in the sub-health spleen qi deficiency syndrome group and spleen qi deficiency syndrome scores was also analyzed.Results Compared with the healthy control group,the sub-health spleen deficiency syndrome group showed significantly reduced functional connectivity within and between brain networks,including the visual network,sensorimotor network,dorsal attention network,frontoparietal network,and default mode network(P<0.05,NBS correction,5000 permutations).Among these,the functional connectivity between the sensorimotor network and the frontoparietal network(r=-0.357,P=0.030)and between the dorsal attention network and the frontoparietal network(r=-0.360,P=0.029)showed a significant negative correlation with the spleen qi deficiency syndrome score.Conclusion Abnormal changes in functional connectivity within and between large-scale brain networks in sub-health patients with spleen deficiency syndrome provide further neuroimaging evidence for the cognitive psychological connotation of the"spleen in storing idea"theory.

Objective To explore the neuroimaging mechanisms of cognitive impairment in sub-health patients with spleen qi deficiency syndrome and kidney qi deficiency syndrome using independent component analysis.Methods 40 sub-health patients with spleen qi deficiency syndrome and 40 kidney qi deficiency syndrome were recruited.All subjects underwent repeated neuropsychological testing and resting-state functional magnetic resonance imaging(fMRI)scans.Independent component analysis was used to compare functional connectivity differences between the two groups of subjects in the default mode network(DMN),frontoparietal network(FPN),dorsal attention network(DAN),and executive control network(ECN).The relationship between the differences in functional connectivity and cognitive function in the two groups of patients was also analyzed.Results In sub-health patients with spleen deficiency syndrome,the DMN included six brain regions,including the bilateral superior parietal lobule,left inferior occipital gyrus,and left lingual gyrus.The FPN included four brain regions,including the left superior parietal gyrus and the left caudate nucleus,the DAN included two brain regions,including the right superior temporal gyrus and the left medial frontal gyrus,and the ECN included the left central parietal lobule.The functional connectivity between the spleen qi deficiency syndrome symptom score and the left middle temporal gyrus and right superior temporal gyrus showed a significant positive correlation(r=0.371,P=0.028).In sub-health kidney qi deficiency syndrome patients,the DMN included six brain regions,including the left superior temporal gyrus,left precuneus,and right angular gyrus,the FPN included three brain regions,including the right middle temporal gyrus and right superior temporal gyrus,the DAN included four brain regions,including the right wedge lobe and the left medial frontal superior gyrus,and the ECN included the left central paracentral lobule and the right central posterior gyrus.Among these,the functional connectivity between the left wedge lobe and the left frontal middle gyrus showed a significant positive correlation with the syndrome score of kidney qi deficiency(r=0.404,P=0.016).Conclusion Sub-health patients with spleen qi deficiency syndrome and kidney qi deficiency syndrome exhibit different neuroimaging bases for cognitive impairment,providing neuroimaging evidence to elucidate the differences in the cognitive psychological connotation of the theories of"spleen in storing idea"and"kidney storing will".

Objective To investigate their potential differences in brain functional characteristics from a neuroimaging perspective,functional magnetic resonance imaging(fMRI)was employed.Methods Twenty chronic fatigue syndrome(CFS)patients were recruited and underwent assessments of traditional Chinese medicine(TCM)syndrome patterns,fatigue severity scores,and resting-state fMRI scans.First,correlation analysis was performed between fatigue scores and TCM symptom scores.Symptom clusters significantly associated with fatigue were categorized into spleen deficiency and liver stagnation groups.Principal component analysis(PCA)was then applied to identify the dominant symptom components for each group.These components were subsequently mapped onto whole-brain functional activity to compare the neural signatures between the two syndromes.Finally,the brain functional profiles of spleen deficiency and liver stagnation were compared with publicly available neurotransmitter receptor maps to explore their distinct neurochemical substrates.Results Symptoms correlated with fatigue severity included exhaustion,dizziness,chest tightness,bitter taste in the mouth,epigastric fullness,poor appetite,irritability,lumbar soreness,sallow complexion,dry eyes,and five-center-heat.The brain mapping results revealed that spleen deficiency-related symptoms(poor appetite,sallow complexion,reduced food intake,dizziness)were primarily associated with the left thalamus and left parahippocampal gyrus.Liver stagnation-related symptoms(dry eyes,chest tightness,irritability,bitter taste)were linked to the left parahippocampal gyrus and right middle occipital gyrus(lingual region).The functional brain spectrum of the two syndromes showed significant negative correlations.Moreover,the spleen deficiency spectrum was closely associated with vesicular acetylcholine transporter(VAChT)receptor density.The liver stagnation spectrum correlated with D2 dopamine receptor density.Both spectrums were significantly related to glucose metabolic density but exhibited opposing directional trends.Conclusion CFS patients with spleen deficiency and liver stagnation demonstrate distinct central functional activities and neurochemical substrates,along with opposing brain activity patterns.Clinically,differentiating between these two syndrome patterns is critical for applying targeted TCM interventions.

Objective To explore the attentional network function in sub-healthy individuals with spleen qi deficiency syndrome.Methods Twenty-seven individuals in the sub-healthy spleen qi deficiency syndrome group were recruited from September 2022 to August 2024 in communities and colleges.Twenty-five healthy controls were also recruited according to the principle of matching age,gender,and years of education components.Attention network tests were performed on subjects in both groups.Results Compared with the control group,the executive control network function value of the spleen qi deficiency syndrome group was significantly decreased(P=0.012).The differences in correct rate,overall reaction time,alert network and orientation network between the two groups were not statistically significant(P＞0.05).The results of correlation analysis showed a significant negative correlation between Health Evaluating Questionnaire H20 V2009 scores and executive control network efficiency of the subjects in the spleen qi deficiency syndrome(P＜0.001),and a positive correlation between the spleen qi deficiency syndrome score and executive control network efficiency(P=0.038).Conclusions Abnormal changes in the executive control of attention in sub-healthy subjects with spleen qi deficiency syndrome were closely related to the severity of the symptoms of spleen qi deficiency,which provided further scientific evidence for the cognitive psychological connotation of the theory of"spleen stores Yi".