Objective: To assess the association between the metabolic score for insulin resistance index (METS-IR) and overactive bladder (OAB) in the US population，so as to explore the potential of METS-IR as a predictive tool for OAB risk and to provide insights for early screening and intervention strategies. Methods: Based on the data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018，a cross-sectional design was employed，and multivariate logistic regression models were used to analyze the association between METS-IR and OAB. METS-IR was analyzed both as a continuous variable and categorized into quartiles. To further validate the association between METS-IR and OAB across diverse populations，subgroup analyses were conducted in participants stratified by clinical characteristics. Smooth curve fitting was employed to test the linearity of the METS-IR-OAB relationship. Results: Elevated METS-IR was associated with an increased risk of OAB (P<0.001)，and this positive correlation remained stable when METS-IR was categorized into quartiles (P<0.001). Subgroup analyses revealed that the association between METS-IR and OAB was more pronounced in females，participants younger than 55 years，and non-diabetic individuals (P<0.05). Furthermore，smooth curve fitting confirmed a linear positive correlation between METS-IR and OAB，with this linear relationship observed in both diabetic and non-diabetic groups. Conclusion: This study，based on the NHANES 2005-2018 database，found a linear positive correlation between METS-IR and OAB.

Objective To investigate the expression and clinical significance of B7-H5 in patients with chro-nic hepatitis B and hepatitis B virus(HBV)-related hepatocellular carcinoma.Methods Enzyme-linked immu-nosorbent assay(ELISA)was used to detect the serum levels of B7-H5 in 104 patients with chronic hepatitis B,28 patients with HBV-related hepatocellular carcinoma and 35 healthy controls.And statistical methods were used to analyze the difference,correlation and diagnostic value of the results.Results The serum levels of B7-H5 in patients with HBV-related hepatocellular carcinoma,patients with chronic hepatitis B and healthy subjects were statistically different(P＜0.05),and the level from high to low was HBV-related liver cancer patients,chronic hepatitis B patients,healthy subjects.The serum level of B7-H5 in chronic hepatitis B pa-tients with negative HBV-DNA was significantly higher than that in healthy subjects(P＜0.01).The level of B7-H5 in patients with chronic hepatitis B was positively correlated with HBV-DNA load(P＜0.05).And the level of B7-H5 in patients with HBV-related hepatocellular carcinoma was positively correlated with HBsAg,HBeAg and AFP levels(P＜0.05).In addition,B7-H5 had diagnostic value for chronic hepatitis B and HBV-related hepatocellular carcinoma(P＜0.01),and the diagnostic value for HBV-related hepatocellular carcino-ma was higher than that for chronic hepatitis B.The level of B7-H5 in patients with HBV-related hepatocellu-lar carcinoma after surgery was significantly lower than that before surgery(P＜0.05).Conclusion Serum levels of B7-H5 is related to the progression of CHB and HBV-related hepatocellular carcinoma,and can be considered as an effective detection index for the auxiliary diagnosis and the judgment of postoperative condi-tion of CHB and HBV-related hepatocellular carcinoma.

Objective To explore the impact of suture configuration and fixation type on the biome-chanical strength of rotator cuff repair,using a factorial design study.Methods Sixteen fresh-frozen porcine shoulder samples were randomized into an anchorless double-row suture bridge transosseous su-tures(DS)group,an anchored double-row suture bridge transosseous-equivalent(DE)group,an an-chorless X-BOX construct transosseous sutures(XS)group,and an anchored X-BOX construct transos-seous-equivalent(XE)group,each of four,according to suture configuration(double-row suture bridge,traditional X-BOX construct)and fixation type(suture anchors,transosseous sutures).Then,their fatigue resistance(first-cycle excursion,gap length difference ratio,and the percentage of ex-posed footprints)and the failure strength(the maximum failure load and the re-tear type)were mea-sured using a biomechanical material testing machine.Results Different suture configurations affected failure strength(F=39.559,P<0.001),with the double-row suture bridge groups(693.07±58.35 N,746.76±138.57 N)showing significantly higher failure strength,compared to the traditional X-BOX groups(462.90±18.91 N,421.43±90.76 N).However,the fixation type did not significantly im-pact failure strength(F=1.161,P=0.302).Moreover,the suture configuration influenced the gap differ-ence ratio(F=7.781,P=0.016),but had no significant correlation with other fatigue resistance indica-tors(P>0.05).Meanwhile,failure strength and fatigue resistance were not correlated with fixation type,and the interaction between suture and fixation type(P>0.05).The incidence of failure types for the four suture configurations was as follows:Type I tendon tear:XS>XE>DS=DE;type II tendon tear:DS>XE>XS=DE;fixing material-related failure:DE>DS=XE=XS.Conclusion The failure strength and gap formation ratio in rotator cuff repair under fatigue loading are influenced by suture configuration,whereas no significant association has been observed with respect to fixation method,whether using transosseous sutures or suture anchors.

Objective:To examine the clinical effects of the SCERTS model-based peer-mediated intervention (PMI) on the social skills of children with autism spectrum disorder (ASD) and provide new approaches to the rehabilitation treatment of ASD children.Methods:A randomized controlled study.A total of 120 children with mild-to-moderate ASD diagnosed Xi′an Traditional Chinese Medicine Hospital of Encephalopathy between April 2023 and April 2024 were selected.They were assigned to either the experimental or control group using the random number table method, with 60 cases in each group.The experimental group was treated with the SCERTS model-based PMI, whereas the control group underwent conventional rehabilitation training, comprising cognitive, language and behavioural interventions, acupuncture and other techniques.Changes in Social Responsiveness Scale (SRS), Autism Social Skills Scale (ASSS) and Autism Treatment Evaluation Checklist (ATEC) scores were observed in the 2 groups of children before and after treatment.The statistical analyses were performed using a paired-samples t-test for intra-group comparisons and an independent-samples t-test for inter-group comparisons. Results:Following 12 weeks of intervention, the SRS and ATEC scores decreased while the ASSS scores increased after treatment in both groups.The differences were statistically significant (all P<0.05).The SRS [(83.25±14.56) points] and ATEC [(79.41±15.36) points] of the experimental group were lower than those of the control group [SRS(89.80±12.69) points, ATEC(85.95±16.13) points].The ASSS score of the experimental group was higher than that of the control group [(112.77±22.42) points vs.(103.80±24.13) points] ( t=2.627, 2.274, -2.109; all P<0.05). Conclusions:The SCERTS model-based PMI is an efficacious approach for the improvement of social skills in ASD children, and thus merits further investigation and application.

Objective To explore the impact of suture configuration and fixation type on the biome-chanical strength of rotator cuff repair,using a factorial design study.Methods Sixteen fresh-frozen porcine shoulder samples were randomized into an anchorless double-row suture bridge transosseous su-tures(DS)group,an anchored double-row suture bridge transosseous-equivalent(DE)group,an an-chorless X-BOX construct transosseous sutures(XS)group,and an anchored X-BOX construct transos-seous-equivalent(XE)group,each of four,according to suture configuration(double-row suture bridge,traditional X-BOX construct)and fixation type(suture anchors,transosseous sutures).Then,their fatigue resistance(first-cycle excursion,gap length difference ratio,and the percentage of ex-posed footprints)and the failure strength(the maximum failure load and the re-tear type)were mea-sured using a biomechanical material testing machine.Results Different suture configurations affected failure strength(F=39.559,P<0.001),with the double-row suture bridge groups(693.07±58.35 N,746.76±138.57 N)showing significantly higher failure strength,compared to the traditional X-BOX groups(462.90±18.91 N,421.43±90.76 N).However,the fixation type did not significantly im-pact failure strength(F=1.161,P=0.302).Moreover,the suture configuration influenced the gap differ-ence ratio(F=7.781,P=0.016),but had no significant correlation with other fatigue resistance indica-tors(P>0.05).Meanwhile,failure strength and fatigue resistance were not correlated with fixation type,and the interaction between suture and fixation type(P>0.05).The incidence of failure types for the four suture configurations was as follows:Type I tendon tear:XS>XE>DS=DE;type II tendon tear:DS>XE>XS=DE;fixing material-related failure:DE>DS=XE=XS.Conclusion The failure strength and gap formation ratio in rotator cuff repair under fatigue loading are influenced by suture configuration,whereas no significant association has been observed with respect to fixation method,whether using transosseous sutures or suture anchors.

Objective:To examine the clinical effects of the SCERTS model-based peer-mediated intervention (PMI) on the social skills of children with autism spectrum disorder (ASD) and provide new approaches to the rehabilitation treatment of ASD children.Methods:A randomized controlled study.A total of 120 children with mild-to-moderate ASD diagnosed Xi′an Traditional Chinese Medicine Hospital of Encephalopathy between April 2023 and April 2024 were selected.They were assigned to either the experimental or control group using the random number table method, with 60 cases in each group.The experimental group was treated with the SCERTS model-based PMI, whereas the control group underwent conventional rehabilitation training, comprising cognitive, language and behavioural interventions, acupuncture and other techniques.Changes in Social Responsiveness Scale (SRS), Autism Social Skills Scale (ASSS) and Autism Treatment Evaluation Checklist (ATEC) scores were observed in the 2 groups of children before and after treatment.The statistical analyses were performed using a paired-samples t-test for intra-group comparisons and an independent-samples t-test for inter-group comparisons. Results:Following 12 weeks of intervention, the SRS and ATEC scores decreased while the ASSS scores increased after treatment in both groups.The differences were statistically significant (all P<0.05).The SRS [(83.25±14.56) points] and ATEC [(79.41±15.36) points] of the experimental group were lower than those of the control group [SRS(89.80±12.69) points, ATEC(85.95±16.13) points].The ASSS score of the experimental group was higher than that of the control group [(112.77±22.42) points vs.(103.80±24.13) points] ( t=2.627, 2.274, -2.109; all P<0.05). Conclusions:The SCERTS model-based PMI is an efficacious approach for the improvement of social skills in ASD children, and thus merits further investigation and application.

Objective:To evaluate the effects of antibiotics alone and combined with Longqing tablets and antibiotics on stent-related symptoms (SRS), urinary tract infection (UTI), and quality of life in patients who underwent ureteroscopic lithotripsy (URL) with indwelling ureteral stents.Methods:The clinical data of 160 patients who underwent URL with indwelling ureteral stents in the Department of Urology, Xuanwu Hospital, Capital Medical University from January 2022 to December 2023 were retrospectively analyzed. According to the postoperative application of antibiotics and Longqing tablets, they were divided into two groups: control group and observation group, with 80 cases in each group. The control group took Levofloxacin tablets orally, and the observation group took Longqing tablets combined with Levofloxacin tablets orally. The SRS of the two groups was compared according to the degree of urinary tract irritation symptoms, low back pain, and dysuria. UTI was evaluated by the incidence of fever, hematuria, pyuria, positive rate of urine culture, and specific bacterial classes. The Chinese version of the ureteral stent symptom questionnaire (USSQ) and the quality of life score were evaluated in the two groups. Normally distributed quantitative data were expressed as mean ± standard deviation ( ± s), and the t-test was used for comparison between groups; non-normally distributed quantitative data were expressed as median (interquartile range) [ M( Q1, Q3)], and the non-parametric test was used for comparison between groups. Count data were expressed as the number of cases and percentage, and the Chi-square test was used for comparison between groups. Results:Among the 160 patients, 141 (88.13%) developed SRS, including 71 cases (88.75%) in the control group, and 70 cases (87.50%) in the observation group, there was no significant difference between the two groups ( P=0.724). In terms of SRS, the urinary tract irritation symptom scores [3.0 (1.0, 5.0) points vs 5.0 (3.0, 7.0) points], low back pain scores [1.5 (1.0, 2.0) points vs 2.5 (2.0, 3.0) points] and dysuria scores [1.5 (1.0, 2.0) points vs 3.5 (2.5, 4.0) points] of the observation group were significantly lower than those of the control group, the differences were statistically significant ( P<0.05). The Chinese version of USSQ showed that the urinary tract symptoms of the observation group were significantly relieved compared with the control group [15(12, 19) points vs 22 (15, 28) points], and the difference was statistically significant ( P=0.037). In terms of UTI, the incidence of fever (6.25% vs 7.50%), the incidence of hematuria (20.00% vs 22.50%), the incidence of pyuria (30.00% vs 33.75%), and positive rate of urine culture (11.25% vs 15.00%) between the two groups were not statistically significant ( P> 0.05), but the number was reduced to a certain extent. There was no statistically significant difference in the scores of physiological function, emotional function and social function between the two groups before surgery ( P> 0.05); however, the scores of the above three items in both groups were improved 2 weeks after surgery, and the improvement of the observation group was significantly higher than that of the control group, with statistical significance ( P<0.01). Conclusion:Longqing tablets combined with antibiotics are more effective in improving SRS in patients who receive URL and have indwelling ureteral stents than antibiotics alone, and can prevent UTI and improve the quality of life to a certain extent.

Objectives:To develop and validate predictive models for esophageal squamous cell carcinoma (ESCC) using circulating cell-free DNA (cfDNA) terminal motif analysis. The goal was to improve the non-invasive detection of early-stage ESCC and its precancerous lesions.Methods:Between August 2021 and November 2022, we prospectively collected plasma samples from 448 individuals at the Department of Endoscopy, Cancer Hospital, Chinese Academy of Medical Sciences for cfDNA extraction, library construction, and sequencing. We analyzed 201 cases of ESCC, 46 high-grade intraepithelial neoplasia (HGIN), 46 low-grade intraepithelial neoplasia (LGIN), 176 benign esophageal lesions, and 29 healthy controls. Participants, including ESCC patients and control subjects, were randomly assigned to a training set ( n=284) and a validation set ( n=122). The training cohort underwent z-score normalization of cfDNA terminal motif matrices and a selection of distinctive features differentiated ESCC cases from controls. The random forest classifier, Motif-1 (M1), was then developed through principal component analysis, ten-fold cross-validation, and recursive feature elimination. M1's efficacy was then validated in the validation and precancerous lesion sets. Subsequently, individuals with precancerous lesions were included in the dataset and participants were randomly allocated to newly formed training ( n=243), validation ( n=105), and test ( n=150) cohorts. Using the same procedure as M1, we trained the Motif-2 (M2) random forest model with the training cohort. The M2 model's accuracy was then confirmed in the validation cohort to establish the optimal threshold and further tested by performing validation in the test cohort. Results:We developed two cfDNA terminal motif-based predictive models for ESCC and associated precancerous conditions. The first model, M1, achieved a sensitivity of 90.0%, a specificity of 77.4%, and an area under the curve (AUC) of 0.884 in the validation cohort. For LGIN, HGIN, and T1aN0 stage ESCC, M1's sensitivities were 76.1%, 80.4%, and 91.2% respectively. Notably, the sensitivity for jointly predicting HGIN and T1aN0 ESCC reached 85.0%. Both the predictive accuracy and sensitivity increased in line with the cancer's progression ( P＜0.001). The second model, M2, exhibited a sensitivity of 87.5%, a specificity of 77.4%, and an AUC of 0.857 in the test cohort. M2's sensitivities for detecting precancerous lesions and ESCC were 80.0% and 89.7%, respectively, and it showed a combined sensitivity of 89.4% for HGIN and T1aN0 stage ESCC. Conclusions:Two predictive models based on cfDNA terminal motif analysis for ESCC and its precancerous lesions are developed. They both show high sensitivity and specificity in identifying ESCC and its precancerous stages, indicating its potential for early ESCC detection.

BACKGROUND:Tissue flossing is a new injury prevention tool and auxiliary exercise training strategy.Tissue flossing can increase joint range of motion,improve athletic performance,and relieve pain,and is increasingly widely used in the field of sports and rehabilitation. OBJECTIVE:To review the mechanism of tissue flossing and its application in sports and rehabilitation to provide a reference for follow-up research. METHODS:"Tissue flossing;compression tissue flossing;floss band;voodoo flossband;blood flow restriction;shearing of fascia;musculoskeletal rehabilitation;sport injury"were used as Chinese and English search terms to search on the databases of CNKI,WanFang,VIP,PubMed and EBSCO databases.Relevant articles from January 2000 to October 2022 were retrieved,and 86 articles were finally included according to inclusion and exclusion criteria. RESULTS AND CONCLUSION:Tissue flossing intervention can improve lower limb joint motion,improve sprint and jump performance,promote joint injury rehabilitation,and relieve pain subjectively.However,tissue flossing intervention did not improve the range of motion of the upper limb.There is still controversy on the acute enhancement of lower limb muscle strength.It has a good tendency to improve lower limb balance and stability and improve mental state,but more studies are needed to confirm.The possible mechanisms of tissue flossing intervention are mainly fascia shear,pain gating,blood flow restriction and reperfusion,and compression.Tissue flossing is a useful treatment option that can provide important contributions in the future in the areas of sports training,sports injury prevention and rehabilitation,but more long-term in-depth studies are needed.

BACKGROUND:The specific mechanism of Gushukang,as a Chinese traditional patent medicine for the treatment of postmenopausal osteoporosis of kidney deficiency and blood stasis,needs further studies. OBJECTIVE:To investigate the effect of Gushukang on serum sex hormones,bone microstructure and estrogen receptor in postmenopausal osteoporosis. METHODS:Firstly,network pharmacological analysis was performed.The active ingredients and action targets of Gushukang and the targets of postmenopausal osteoporosis were obtained respectively.Cytoscape was used to construct the active ingredient-target network.STRING database and Cytoscape were used for protein-protein interaction analysis and screening of core targets.DAVID database was used for Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses of intersection targets.Then the ovariectomized Sprague-Dawley rats were used in the animal experiment.Gushukang was administered by gavage for 3 months.The serum estrogen level was detected by ELISA,the bone microstructure was detected by microCT,and the protein expression of estrogen receptor α and estrogen receptor β in bone tiusse was detected by western blot. RESULTS AND CONCLUSION:The network pharmacological research results identified 132 active ingredients and 150 targets of Gushukang and 1155 targets of postmenopausal osteoporosis.After intersections with 1155 postmenopausal osteoporosis targets,87 targets of active ingredients of Gushukang against postmenopausal osteoporosis were obtained.By constructing the active ingredient-target network,it was found that the active ingredients at the core were quercetin,kaempferol,luteolin,naringin and isorhamnetin,and the targets at the core were NCOA2,ESR2,AR,F2,ESR1 and PTGS1.The final targets obtained after the protein-protein interaction analysis and screening included MAPK8,ESR1,JUN,R3C1,RELA and FOS,of which ESR1 was the common core target obtained from the two analyses.KEGG enrichment analysis showed estrogen,tumor necrosis factor,apoptosis and other signaling pathways.Therefore,animal experiments focused on the effect of Gushukang on different subtypes of estrogen receptors in the estrogen signaling pathway.The results showed that in the Gushukang group,bone microstructure was significantly improved,serum estrogen level had no significant change,but the protein expression of estrogen receptor α and β in bone tissue was significantly increased.All the findings indicate that the mechanism of Gushukang in the treatment of postmenopausal osteoporosis may be related to its hormone-like effect and the enhancement of estrogen receptor expression.