Objective: To construct a deep learning model based on convolutional neural network(CNN)-long short term memory network(LSTM)-Attention to explore the correlation between meteorological and clinical factors and the incidence of ischemic stroke. Methods: A fusion model CNN-LSTM-Attention based on CNN, LSTM, and Attention was constructed by incorporating clinical data and meteorological data of ischemic stroke inpatients. The predictive performance of the model was evaluated by maximum prediction error and root mean square error(RMSE). The impact of different lag days on prediction performance was investigated by selecting lag periods ranging from 1 to 7 days. Results: In both short-term and long-term predictions, the CNN-LSTM-Attention fusion model(short-term: 1.5 and 0.6; long-term: 8.3 and 2.5) showed superior maximum prediction bias and RMSE compared to the LSTM model(short-term: 2.8 and 1.2; long-term: 19.5 and 5.5) and the CNN-LSTM model(short-term: 2.0 and 0.8; long-term: 11.2 and 3.3). After incorporating lag days, the maximum prediction deviation and RMSE for lags of 3 days(short-term: 0.7 and 0.4; long-term: 5.5 and 1.9) and 5 days(short-term: 0.8 and 0.3; long-term: 6.5 and 2.0) in both short-term and long-term forecasts were smaller than lags of 0 days(short-term: 1.5 and 0.6; long-term: 8.3 and 2.5). The maximum prediction deviation and RMSE in the short-term forecast were greater than lag 0 days for both lag 1 days(1.5 and 0.8) and lag 7 days(1.9 and 0.9). In the long-term forecast, the two indicators for lag 1 days(6.8 and 2.4) were lower than those for lag 0 days but higher than those for lag 3 days and 5 days. The maximum prediction deviation for lag 7 days(7.5) was lower than that for lag 0 days, but the RMSE(2.7) is higher than that for lag 0 days. Conclusion The established CNN-LSTM-Attention model demonstrates significant predictive value for the onset of ischemic stroke and can provide reference for the rational allocation of medical resources.

Objective To evaluate the clinical efficacy of Zhuanggu Kangsong Soft Extract combined with percutaneous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods A total of 90 eligible OVCF patients admitted to Guangzhou Integrated Chinese and Western Medicine Hospital between January 2023 and May 2024 were enrolled and randomly divided into an observation group(n=45)and a control group(n=45)using a random number table.Both groups underwent PVP.After treatment,the control group received conventional western medication orally(calcium carbonate D3 tablets+calcitriol soft capsules),while the observation group received additional Zhuanggu Kangsong Soft Extract treatment orally.Western medication was administered for 6 months,and herbal treatment lasted 3 months.Changes in Visual Analogue Scale(VAS)scores for pain,Oswestry Disability Index(ODI)scores for low back function,bone mineral density(BMD)T-values,and serum bone metabolism markers were observed before and after treatment.Results(1)At postoperative day 3,3 months,and 6 months,both groups showed significant improvements in VAS and ODI scores compared to those before treatment(P＜0.05).The observation group demonstrated superior improvements in VAS and ODI scores at 3 and 6 months compared to the control group(P＜0.05).(2)At 3,6,and 12 months postoperatively,BMD T-values were improved in both groups(P＜0.05),with the observation group exhibiting greater improvements at 6 and 12 months(P＜0.05).(3)Serum N-terminal osteocalcin and 25-hydroxyvitamin D3[25(OH)D3]levels increased in both groups at 1,3,and 6 months(P＜0.05).The observation group showed more pronounced elevations in these markers at 3 and 6 months(P＜0.05).Conclusion The combination of Zhuanggu Kangsong Soft Extract and PVP demonstrates significant therapeutic benefits for OVCF by effectively alleviating pain,enhancing BMD,and improving activities of daily living,which highlights its high clinical value.

Objective To compare the application value of different nutritional assessment tools for peritoneal dialysis patients.Methods A total of 147 patients who were hospitalized for peritoneal dialysis in The Second Affiliated Hospital of Naval Medical University between Oct.2022 and Oct.2023 were enrolled by convenience sampling method.The nutritional assessment was carried out by using 3 assessment tools,including 7-point subjective global assessment(7-SGA),malnutrition inflammation score(MIS)and controlling nutritional status(CONUT).Correlation analyses were conducted between the nutritional assessment results and anthropometric measurements and blood biochemical indexes.Results The incidence of malnutrition assessed by 7-SGA,MIS,and CONUT were 53.74%(79/147),48.30%(71/147),and 76.19%(112/147),respectively.Both 7-SGA and MIS assessment revealed that the incidence of malnutrition in peritoneal dialysis patients＞60 years old was significantly higher than that in patients≤60 years old(both P＜0.01).Grouped by 7-SGA results,the body mass index(BMI),skeletal muscle mass,skeletal muscle mass index,phase angle,grip strength,upper arm circumference,upper arm muscle circumference,skinfold thickness,albumin and prealbumin levels in malnourished peritoneal dialysis patients were significantly lower than those in well-nourished peritoneal dialysis patients(all P＜0.05).The 7-SGA score was negatively correlated with age(P＜0.05),and was positively correlated with BMI,skeletal muscle mass,skeletal muscle mass index,phase angle,grip strength,upper arm circumference,upper arm muscle circumference,skinfold thickness,albumin,prealbumin,total protein,creatinine,and hemoglobin(all P＜0.05).Conclusion The incidence of malnutrition in peritoneal dialysis patients varies with the assessment tools used.7-SGA score has high correlation with anthropometric and blood biochemical indexes,and is effective,reliable,and practical.It is a good tool for nutritional assessment in patients undergoing peritoneal dialysis.

Lumbar disc (LD) herniation and aging are prevalent conditions that can result in substantial morbidity. This study aimed to clarify the mechanisms connecting the LD aging and herniation, particularly focusing on cellular senescence and molecular alterations in the nucleus pulposus (NP). We performed a detailed analysis of NP samples from a diverse cohort, including individuals of varying ages and those with diagnosed LD herniation. Our methodology combined histological assessments with single-nucleus RNA sequencing to identify phenotypic and molecular changes related to NP aging and herniation. We discovered that cellular senescence and a decrease in nucleus pulposus progenitor cells (NPPCs) are central to both processes. Additionally, we found an age-related increase in NFAT1 expression that promotes NPPC senescence and contributes to both aging and herniation of LD. This research offers fresh insights into LD aging and its associated pathologies, potentially guiding the development of new therapeutic strategies to target the root causes of LD herniation and aging.
Intervertebral Disc Displacement/metabolism* ; Humans ; Aging/pathology* ; Nucleus Pulposus/pathology* ; Male ; Female ; Transcriptome ; Middle Aged ; Lumbar Vertebrae/pathology* ; Adult ; Cellular Senescence ; Stem Cells/pathology* ; Aged ; Intervertebral Disc Degeneration/metabolism*

OBJECTIVE To explore the pharmacokinetic characteristics of 3 blood-absorbed components of Xiangshao sanjie oral liquid in rats with hyperplasia of mammary gland （HMG）. METHODS Female SD rats were divided into control group and HMG group according to body weight， with 6 rats in each group. The HMG group was given estrogen+progesterone to construct HMG model. After modeling， two groups were given 1.485 g/kg of Xiangshao sanjie oral liquid （calculated by crude drug） intragastrically， once a day， for 7 consecutive days. Blood samples were collected before the first administration （0 h）， and at 5， 15， 30 minutes and 1， 2， 4， 8， 12， 24 hours after the last administration， respectively. Using chlorzoxazone as the internal standard， the plasma concentrations of ferulic acid， paeoniflorin and rosmarinic acid in rats were detected by UPLC-Q/TOF-MS. The pharmacokinetic parameters [area under the drug time curve （AUC0－24 h， AUC0－∞）， mean residence time （MRT0－∞）， half-life （t1/2）， peak time （tmax）， peak concentration （cmax）] were calculated by the non-atrioventricular model using Phoenix WinNonlin 8.1 software. RESULTS Compared with the control group， the AUC0－24 h， AUC0－∞ and cmax of ferulic acid in the HMG group were significantly increased （P＜0.05）； the AUC0－24 h， AUC0－∞ ， MRT0－∞ ， t1/2 and cmax of paeoniflorin increased， but there was no significant difference between 2 groups （P＞0.05）； the AUC0－24 h and MRT0-∞ of rosmarinic acid were significantly increased or prolonged （P＜0.05）. C ONCLUSIONS In HMG model rats， the exposure of ferulic acid， paeoniflorin and rosmarinic acid in Xiangshao sanjie oral liquid all increase， and the retention time of rosmarinic acid is significantly prolonged.

Intravascular large B-cell lymphoma (IVLBCL), a rare subtype of non-Hodgkin lymphoma, is classified as an independent subtype of extranodal diffuse large B-cell lymphoma (DLBCL) in the 2008 World Health Organization (WHO) Classification (Turner et al., 2010). The 5th edition of the World Health Organization (WHO 2022) classification of hematolymphoid tumors retains this subtype (Alaggio et al., 2022). IVLBCL, which is characterized by neoplastic lymphocyte proliferation within the lumen of small blood vessels, tends to invade organs, such as the nervous system, skin, bone marrow (BM), and lung (D'Angelo et al., 2019; Satoh et al., 2019; Vásquez et al., 2019; Fukami et al., 2020).
Humans ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; Vascular Neoplasms/therapy*

Booster vaccinations are highly recommended in combating the SARS-CoV-2 Omicron variant and its subvariants. However, the optimal booster vaccination strategies and related immune mechanisms with different prior vaccinations are under-revealed. In this study, we systematically evaluated the immune responses in mice and hamsters with different prime-boost regimens before their protective efficacies against Omicron were detected. We found that boosting with Ad5-nCoV, S_WT-2P or S_Omicron-6P induced significantly higher levels of neutralization activities against Omicron variants than CoronaVac and ZF2001 by eliciting stronger germinal center (GC) responses. Specifically, S_Omicron-6P induced even stronger antibody responses against Omicron variants in CoronaVac and Ad5-nCoV-primed animals than non-Omicron-specific vaccines but with limited differences as compared to Ad5-nCoV and S_WT-2P. In addition, boosting with a specific vaccine has the potential to remodel the existing immune profiles. These findings indicated that adenovirus-vectored vaccines and mRNA vaccines would be more effective than other types of vaccines as booster shots in combating Omicron infections. Moreover, the protective efficacies of the vaccines in booster vaccinations are highly related to GC reactions in secondary lymphatic organs. In summary, these findings provide timely important information on prime-boost regimens and future vaccine design.

BACKGROUND:Acupotomy is an effective method for the treatment of cervical spondylosis with definite clinical efficacy,but its key molecular mechanism is still unclear.OBJECTIVE:To observe the effect of acupotomy intervention on the expression of fibroblast growth factor family and kinase insert domain protein receptor in the splenius capitis muscles of rats with cervical spondylosis,and to study the therapeutic mechanism of acupotomy in cervical spondylosis.METHODS:The Genomics Expression Omnibus Database was searched to obtain the microarray dataset GSE153761,which was compatible with the study,and a bioinformatics approach was used for the initial screening of targets,followed by animal experiments.Twenty-four 6-month-old SPF grade Sprague-Dawley rats were randomly divided into four groups.The model of cervical spondylosis was established by unbalanced dynamic and static forces in the model and acupotomy groups.The muscles and ligaments were not cut in the sham operation group.After successful modeling,acupotomy intervention was performed in the acupotomy group,once a week,3 times in total.Normal rats were selected as controls.The posteroanterior and lateral X-rays of the cervical spine were taken for modeling verification;the open-field tests were performed in all rats to observe behavioral changes;the pathological structure of the splenius capitis muscles was observed by hematoxylin-eosin staining;the mRNA and protein expression of fibroblast growth factor family and kinase insert domain protein receptor in the splenius capitis muscles was detected by fluorescent quantitative PCR and immunohistochemical method,respectively.RESULTS AND CONCLUSION:Bioinformatics results indicated that fibroblast growth factor family/kinase insert domain protein receptor is an important signal axis for activating the phosphatidylinositol 3-kinase/protein kinase B signaling pathway.After modeling,the intervertebral space of the rats was narrowed,and the anterior and posterior borders of the vertebral body and the articular process were hyperosteogenous.In the open-field tests,the total distance and average speed in the model group were decreased after modeling(P<0.05),while the total rest time in the model group was increased(P<0.05).After treatment,the total distance and average speed in the acupotomy group were greater than those in the model group(P<0.05),while the total rest time in the acupotomy group was shorter than that in the model group(P<0.05).The pathological changes of the splenius capitis muscles indicated damage to the cervical muscle,and acupotomy improved cervical muscle strain.Compared with the normal group,The mRNA and protein expressions of fibroblast growth factor 7,fibroblast growth factor 9,fibroblast growth factor 10,fibroblast growth factor 18,and kinase insert domain protein receptor in the splenius capitis muscles were increased in the model group compared with the normal group(P<0.05).In contrast,acupotomy treatment could downregulate the above indicators(P<0.05).Thus,acupotomy may repair cervical muscle strain by regulating the expression of fibroblast growth factor 7,fibroblast growth factor 9,fibroblast growth factor 10,fibroblast growth factor 18,and kinase insert domain protein receptor,thereby improving intervertebral disc degeneration,which may be the key target for acupotomy treatment of cervical spondylosis.

BACKGROUND:There are many problems to completely transform clinical diseases into animal models,but the ideal animal model is the premise of the mechanism research of cervical spondylosis,and it is very important to select the appropriate animal model of cervical spondylosis.OBJECTIVE:To analyze the species,sex,age,type of cervical spondylosis model and its internal molecular mechanism of animal models of cervical spondylosis in detail so as to explore how to select suitable animal models for experimental research of cervical spondylosis.METHODS:PubMed,Medline,Embase,Web of Science,WanFang,VIP,and CNKI databases were searched with Chinese and English search terms"cervical spondylosis,cervical spondylotic myelopathy,cervical spondylotic radiculopathy,cervical spondylosis of vertebral artery type,neck type cervical spondylosis,unbalanced dynamic and static forces,joint injury,neck pain,animal model."According to the inclusion and exclusion criteria,the literature was screened,and finally 61 articles were included for review and analysis.RESULTS AND CONCLUSION:Rats are the most commonly used animals,and males seem to be more popular.It is recommended to use young adult animals.According to the characteristics of molding,cervical spondylosis models were divided into cervical spondylotic myelopath,cervical spondylotic radiculopathy,neck type cervical spondylosis,and other type cervical spondylosis.The advantages and disadvantages of various modeling methods were evaluated.Based on the studies of existing animal models,the molecular mechanism of cervical spondylosis was summarized.Therapeutic signals mediate nuclear factor-κB,phosphatidylinositol-3 kinase/protein kinase B,mitogen-activated protein kinase,and other pathways to regulate the biological processes of inflammation,apoptosis and autophagy of spinal cord,nerve root,intervertebral disc,muscle and other tissues,and ultimately delay the progression of cervical spondylosis.The quality of some studies is poor,and the clinical compatibility is not high.In the future,it is necessary to further standardize the animal model of cervical spondylosis,formulate relevant guidelines,improve the credibility of the research results,and lay a solid foundation for further human clinical trials.

Objective:To investigate the dosimetric impact of dwell position spacing in the design of three-dimensional (3D) interstitial brachytherapy plans for cervical cancer, and to provide a reference for selecting dwell spacing in clinical planning.Methods:A total of 15 patients with cervical cancer who underwent 3D interstitial brachytherapy at Tianjin Medical University Cancer Institute & Hospital between March 2022 and March 2024 were selected using simple random sampling. For each patient, 10 brachytherapy plans were generated with different dwell position spacings set at 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10 mm, respectively. Key parameters among different dwell spacings compared included D 90%, V 100%, V 200%, and V 300% for the high-risk clinical target volume (HRCTV); D 90% for the intermediate-risk clinical target volume (IRCTV); D 2 cm3 for organs at risk (OARs) (bladder, small intestine, colon, and rectum); and the total dwell time. Statistical analyses were performed using repeated measurement ANOVA or the Friedman test. Results:Among different dwell spacings, there were no statistically significant differences in HRCTV D 90%, HRCTV V 100%, bladder D 2 cm3, and rectum D 2 cm3 among different dwell spacings ( P=0.075, 0.061, 0.480, 0.639). All plans with dwell spacings ≤ 3 mm met clinical dose requirements. When the dwell spacing was set to 1 mm, HRCTV V 200% and V 300% had the smallest mean values, while IRCTV D 90% and total dwell time had the largest mean values; all differences were statistically significant ( P<0.05). When the dwell spacing was ≥6 mm, an increase in spacing led to a decrease in mean small intestine D 2 cm3, and total dwell time, but an increase in HRCTV V 200% and a decrease in IRCTV D 90%, with statistically significant differences compared to spacings of 1-4 mm ( P<0.05). When the dwell spacing was ≥8 mm, the median colon D 2 cm3 decreased, with statistically significant differences compared to spacings of 1-3 mm ( P<0.05). Conclusions:For 3D interstitial brachytherapy planning in cervical cancer, dwell position spacings ≤ 3 mm can meet clinical dose requirements, with 1 mm providing optimal target coverage. Spacings ≥6 mm / ≥8 mm can reduce radiation dose to the small intestine and colon, respectively, while also shortening dwell time.