OBJECTIVE: To observe the clinical efficacy of Daoqi (directing qi flowing) acupuncture technique in Huangdi Neijing (Yellow Emperor's Inner Classic) for moderate-to-severe obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: Sixty patients with moderate-to-severe OSAHS were randomly divided into a Daoqi acupuncture group (30 cases) and a conventional acupuncture group (30 cases, 1 case dropped out). In the Daoqi acupuncture group, Daoqi acupuncture technique in Huangdi Neijing was applied at Shanglianquan (Extra), Fengfu (GV16), and bilateral Lieque (LU7), Zhaohai (KI6); in the conventional acupuncture group, conventional acupuncture was applied at Shanglianquan (Extra), Fengfu (GV16), Yamen (GV15), and bilateral Lieque (LU7), Zhaohai (KI6), Zusanli (ST36), Fenglong (ST40). The treatment was adopted once every other day, 3 times a week, 4 weeks as one course and 3 courses were required totally in both groups. Before and after treatment, the polysomnography (PSG) indexes [apnea-hypopnea index (AHI), hypopnea index (HI), apnea index (AI), longest apnea duration, lowest nocturnal SaO₂ (LSaO₂)], and scores of Epworth sleepiness scale (ESS), Pittsburgh sleep quality index (PSQI), World Health Organization quality of life-BREF (WHOQOL-BREF) were observed, and the clinical efficacy was evaluated after treatment in the two groups. RESULTS: After treatment, the AHI, HI, AI and longest apnea duration were reduced compared with those before treatment in the two groups (P<0.01), the LSaO₂ was increased in the Daoqi acupuncture group (P<0.01); in the Daoqi acupuncture group, the AHI, HI, AI and longest apnea duration were lower than those in the conventional acupuncture group (P<0.05), and the LSaO₂ was higher than that in the conventional acupuncture group (P<0.05). After treatment, the ESS and PSQI scores were decreased compared with those before treatment (P<0.01), while the WHOQOL-BREF scores were increased compared with those before treatment (P<0.01) in the two groups; in the Daoqi acupuncture group, the ESS and PSQI scores were lower than those in the conventional acupuncture group (P<0.05, P<0.01), and the WHOQOL-BREF score was higher than that in the conventional acupuncture group (P<0.05). The total effective rate was 93.3% (28/30) in the Daoqi acupuncture group, which was higher than 82.8% (24/29) in the conventional acupuncture group (P<0.01). CONCLUSION Daoqi acupuncture technique in Huangdi Neijing can effectively treat moderate-to-severe OSAHS patients, improve the clinical symptoms and quality of life, and has the advantages i.e. simpler acupoints selection and gentler stimulation.
Humans ; Sleep Apnea, Obstructive/physiopathology* ; Male ; Female ; Middle Aged ; Acupuncture Therapy ; Adult ; Acupuncture Points ; Treatment Outcome ; Aged ; Quality of Life

ObjectiveTo observe the effect of Huayu Mingmu prescription on retinal angiogenesis and phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR）-hypoxia inducible factor-1α/vascular endothelial growth factor A （HIF-1α/VEGFA） signaling pathway in diabetic retinopathy （DR） rats. MethodsSixty-four SPF-grade male SD rats were used in the study. Eleven rats were randomly selected as the normal group， while the remaining 53 rats were fed a high-sugar， high-fat diet combined with low-dose streptozotocin （STZ） intraperitoneal injection to establish a type 2 diabetes mellitus （T2DM） rat model. DR model evaluation was performed after 12 weeks of diabetes. The rats were then divided into model， low-dose， medium-dose， and high-dose groups of Huayu Mingmu prescription （9.29， 18.57， 37.14 g·kg^-1）， and a calcium dobesilate group （0.16 g·kg^-1）， with 10 rats in each group. The rats were orally administered the corresponding doses of Huayu Mingmu prescription and calcium dobesilate. The normal and model groups received equal volumes of physiological saline via gavage for 8 consecutive weeks. Retinal vascular changes were observed through fundus photography， and pathological changes in retinal tissue were evaluated using hematoxylin-eosin （HE） staining. Retinal microvascular pathological changes were examined through retinal vascular network preparation and periodic acid-Schiff （PAS） staining. Immunofluorescence （IF） was used to detect the expression of VEGFA and angiopoietin-2 （Ang-2） in retinal tissue. Western blot was employed to detect the protein expression of PI3K， Akt， mTOR， HIF-1α， VEGFA， and VEGFR2 in retinal tissue. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to assess the mRNA expression of PI3K， Akt， mTOR， HIF-1α， VEGFA， and VEGFR2 in retinal tissue. ResultsCompared with the normal group， the model group exhibited significant pathological changes in retinal tissue， including the appearance of acellular capillaries， as well as significant endothelial cell （E） proliferation and pericyte （P） loss （P<0.01）. The E/P was significantly elevated （P<0.01）. Protein and mRNA expression levels of PI3K， Akt， mTOR， HIF-1α， VEGFA， and VEGFR2 in retinal tissue were significantly increased （P<0.01）， and the expression of Ang-2 protein was significantly elevated （P<0.01）. In contrast， retinal tissue in the treatment groups showed alleviated pathological changes， with reduced endothelial cell proliferation and pericyte loss （P<0.05， P<0.01）. Among the treatment groups， the high-dose Huayu Mingmu prescription and the calcium dobesilate group exhibited a decreased E/P （P<0.01）. Protein and mRNA expression levels of PI3K， Akt， mTOR， HIF-1α， VEGFA， and VEGFR2 in retinal tissue were significantly reduced （P<0.05， P<0.01）， and the expression of Ang-2 protein was significantly decreased （P<0.01）. ConclusionHuayu Mingmu prescription can intervene in retinal neovascularization in DR rats， delay the progression of DR， and its mechanism may be related to antagonizing the PI3K/Akt/mTOR-HIF-1α/VEGFA signaling pathway.

OBJECTIVES: Injuries are the leading cause of death among children and adolescents. Although numerous risk assessment tools for unintentional injuries in children have been developed and published both domestically and internationally, there is currently no global consensus on standardized use. This study aims to systematically characterize existing unintentional injury risk assessment tools for children aged 0-6 years, with the goal of informing scientific tool selection and optimization. METHODS: Relevant literature published up to January 2025 was retrieved from CNKI, Wanfang, PubMed, and Web of Science. An information extraction form was developed to gather data on the basic features of each assessment tool, assessment format, scoring methods and criteria, dimensions assessed, reliability and validity, and types of unintentional injuries covered. RESULTS: A total of 50 risk assessment tools for unintentional injuries among children aged 0-6 years were included. Among them, 35 tools assessed two or more types of unintentional injuries. Regarding assessment format, 38 tools relied on caregiver self-report, 2 on investigator interviews, 3 on direct observation by investigators, and 7 used multiple methods. The tools covered four major dimensions: knowledge, attitude, behavior, and environment. Eleven tools covered 3 dimensions, while only one tool addressed all 4. Nineteen tools provided clear scoring methods, 14 included criteria for risk determination, and only 11 had both scoring methods and risk criteria. Twenty-eight tools lacked both. Twenty-two tools had been evaluated for reliability and/or validity. Among the 25 English-language tools, only 3 had been translated into Chinese. CONCLUSIONS Currently, no existing tool comprehensively assesses all major types of unintentional injuries for children under six years of age. It is recommended that practitioners select appropriate tools based on specific needs. In addition, improvements should be pursued, such as translating and validating English-language tools, developing quantitative scoring methods and criteria for tools tailored to Chinese children for important but underrepresented injury types (e.g., road traffic injuries, drowning).
Humans ; Infant ; Child, Preschool ; Child ; Risk Assessment/methods* ; Accidental Injuries/prevention & control* ; Infant, Newborn ; Wounds and Injuries/epidemiology* ; Reproducibility of Results

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Objective To explore the association and diagnostic performance of liver imaging reporting and data system(LI-RADS)CT signs with hepatocellular carcinoma(HCC)both in the LI-RADS target population and patients without LI-RADS-defined HCC risk factors.Methods A retrospective analysis was conducted on the data of 435 patients with 482 hepatic lesions confirmed by pathology.Of these,306 cases were assigned to the HCC group(327 HCC lesions),and other 129 cases were assigned to the non-HCC group(77 malignancies and 78 benign lesions).Receiver operating characteristic(ROC)curve analysis assessed the diagnostic performance of LI-RADS v2018 CT signs for HCC,and logistic regression analyses determined the association of CT signs with HCC.Results The asso-ciation of CT signs with all HCC lesions was statistically significant for non-peripheral washout[odds ratio(OR)15.1;95％ confi-dence interval(CI)5.6-40.4;P＜0.01]and non-rim arterial phase hyperenhancement(APHE)(OR 12.4;95％ CI 7.5-20.5;P＜0.01)higher than enhanced capsule(OR 9.9;95％ CI 2.8-34.8;P＜0.01;OR 2.4;95％ CI 1.4-3.8;P=0.01).The sensitivity,specificity,positive predictive value(PPV),and area under the curve(AUC)for diagnosing HCC were 85％,83％,91％,and 0.84,respectively for non-peripheral washout;82％,77％,88％ and 0.79,respectively for non-rim APHE;and 31％,98％,97％ and 0.65,respectively for enhanced capsule.Sensitivity(88％ vs 87％),specificity(83％ vs 82％),PPV(92％ vs 91％)and AUC(0.90 vs 0.87)were all slightly higher when non-peripheral washout,non-rim APHE,enhanced capsule,and ancillary features were combined for the diagnosis of HCC compared to combining the three major features.Enhanced capsule(OR 13.3;95％ CI 3.6-48.9;P＜0.01),blood products in mass(OR 20.3;95％ CI 2.4-171.4;P＜0.01),and mosaic appearance(OR 37.7;95％ CI 4.2-340.0;P＜0.01)were associations with HCC presenting with atypical imaging features and provided high specificity from 98％ to 99％.Conclusion In theLI-RADS target population and patients without LI-RADS-defined HCC risk factors,LI-RADS v2018 CT signs show excellent diag-nostic performance for HCC.Two ancillary features,blood products in mass and mosaic appearance,show good specificity for HCC with atypical imaging features.

RNA binding motif protein 8A(RBM8A)is an RNA binding protein,which is mainly in-volved in translation and cell cycle regulation.In addition,RBM8A is a core factor of the exon-junc-tion complex(EJC),which is highly expressed in cells,especially in cancer cells,and abnormally expressed in cytoplasm and nucleus.Studies have shown that RBM8A plays a key regulatory role in the replication process of some viruses,such as Flaviviridae viruses.Therefore,whether RBM8A is involved in the replication of pseudorabies virus(PRV)is unknown.Therefore,this study proved whether RBM8A is involved in the replication of PRV.In order to study the effect of RBM8A pro-tein on PRV replication,the eukaryotic expression plasmid pCAGGS-HA-RBM8A was designed and constructed to express RBM8A,and sh-RBM8A was simultaneously designed and constructed to overexpress and inhibit RBM8A.qRT-PCR and Western blot were used to detect the effect of RBM8A on PRV replication.At the same time,PRV-GB standard plasmid was constructed to make PRV proliferation standard curve.After overexpression and inhibition of RBM8A,DNA was ex-tracted.Virus copy number was calculated by qRT-PCR to further detect the effect of RBM8A on PRV replication.The results showed that overexpression of RBM8A inhibited PRV replication and decreased the copy number of the virus,while overexpression of shRBM8A promoted PRV replication and increased the copy number of the virus.This study shows that RBM8A can inhibit PRV replication,which provides reference for the functional study of RBM8A and lays a founda-tion for the mechanism of anti-PRV replication.

Objective:To analyze the molecular characteristics of prevalent Bordetella pertussis (Bp) isolates in Liaocheng City, Shandong Province in 2024. Methods:From March to August 2024, oropharyngeal swabs were collected from suspected pertussis cases at Liaocheng People′s Hospital in Shandong Province for Bp isolation. A total of 99 Bp isolates were obtained. Whole-genome sequencing was performed on all isolates, followed by Multilocus Sequence Typing (MLST), vaccine antigen-related gene typing (including ptxP, ptxA, ptxB, ptxC, ptxD, ptxE, fhaB, fim2, fim3, and prn), 23S rRNA gene typing, and phylogenetic analysis. To capture the differences between Bp isolates and vaccine strains in Liaocheng City, the international vaccine strain Tohama I and the Chinese vaccine strain CS were included in the analysis. Antimicrobial resistance testing against 11 agents was performed on 52 isolates. Results:The throat swabs of 99 Bp isolates were collected from patients aged 44 days to 42 years, and the median age of the patients was 7 (5, 8) years. All isolates ptxP were ptxP3 type. 74 isolates (74.75%) carried the prn150, while 21 isolates (21.21%) were prn-deficient. The predominant antigenic profile was ptxP3/ ptxA1/ ptxB1/ ptxC4/ ptxD1/ ptxE4/ fhaB1/ fim2-1/ fim3-1/ prn150, found in 72 isolates (72.73%). All 99 isolates carried the A2047G mutation in the 23S rRNA gene. Antimicrobial susceptibility testing showed that the MICs of macrolides and clindamycin for all 52 Bp isolates were all >256 mg/L. However, the isolates showed low MIC for seven other antimicrobials tested, including trimethoprim-sulfamethoxazole, amoxicillin, and levofloxacin. MLST typing revealed that 94 isolates (94.95%) were identified as ST-2, while 5 isolates (5.05%) belonged to a novel sequence type (ST-118). Phylogenetic analysis demonstrated that all 99 Bp isolates were highly homologous but clustered in evolutionary branches distinct from vaccine strains. Conclusion:In 2024, Bordetella pertussis isolates in Liaocheng City exhibit distinct clonal epidemic characteristics, with the predominant antigenic genotype being ptxP3/ ptxA1/ ptxB1/ ptxC4/ ptxD1/ ptxE4/ fhaB1/ fim2-1/ fim3-1/ prn150. All isolates are resistant to macrolide antibiotics.

This study aimed to identify mutations in the human insulin receptor gene (INSR) and investigate their role in the pathogenesis of severe insulin resistance syndrome. Sanger sequencing of the INSR gene was performed on a patient clinically suspected of having type A insulin resistance syndrome admitted to the Department of Endocrinology, the First Medical Center of Chinese PLA General Hospital. Upon identifying mutations, relevant exons were sequenced in her first-degree relatives. Additionally, control groups consisting of individuals with type 2 diabetes and those with normal glucose tolerance were screened for the mutation detected in the patient. Functional predictions of the INSR protein were made using MutationTaster, SIFT, and PolyPhen2 software. A previously unreported heterozygous missense mutation, c.3652G/A (Asp1218Asn), in exon 20 was identified in both the proband and her father. This mutation was not present in any of the control individuals. Multiple prediction tools indicate that this mutation likely disrupts gene/protein structure or function. The c.3652G/A (Asp1218Asn) heterozygous mutation in INSR is a novel variant that plays a significant role in the pathogenesis of severe insulin resistance in this Chinese family.

Diseases caused by animal virus infection seriously restricts the healthy development of animal husbandry.In-depth study of the molecular mechanism of viral replication and pathogenesis will provide theoretical basis for screening vaccine and drug targets.N6-methyladenosine(m6 A)modification occurs extensively in viral and host transcriptomes and affects viral replication and pathogenicity by regulating gene expression,which acts as a novel regulator of gene expression in addition to DNA and protein modifications.Insight into the regulatory molecular mechanism of m6 A modification in virus infection is the research hotspots and frontiers.In recent years,there are re-ports of alternation of the m6 A modification-associated epitranscriptomes and related function a-nalysis during virus infection.Here,we summarize the alternation of the epitranscriptomes induced by African swine fever virus(ASFV),porcine reproductive and respiratory syndrome virus(PRRSV),porcine epidemic diarrhoea virus(PEDV),cestode virus(CSFV),porcine pseudorabies virus(PRV),Marek's disease virus(MDV),Newcastle disease virus(NDV),avian leukaemia virus(ALV)and duck hepatitis A virus(DHAV)infection,and the subsequent effects on viral replica-tion and pathogenicity.We also discuss the potential role and molecular mechanism of m6 A modification in animal virus replication and pathogenesis,which will contributes to the prevention and control for animal disease.