Objective:To observe the characteristics of multi-muscle surface electromyography (sEMG) network indices during static standing among hemiplegic stroke survivors, and to evaluate the value of the indices in assessing neuromuscular dysfunction.Methods:Ten male stroke survivors with hemiplegia were recruited into the hemiplegia group, and 10 age-matched healthy males were chosen as the control group. Both groups were required to perform 30s static standing tasks with their eyes open and closed. The sEMG signals from the bilateral gluteus maximus (GM), rectus femoris (RF) and biceps femoris (BF) muscles were synchronously collected. Linear time-frequency domain indices were then calculated from the sEMG signals, including the root mean square (RMS) and median frequency (MF). Network indices were extracted from the multiplex recurrence network and weighted networks were constructed from the sEMG signals, including the average interlayer mutual information (I), average edge overlap (ω), clustering coefficient (C), average shortest path length (L) and degree of centrality (DC).Results:With the eyes closed, the RMS values of the bilateral GMs of the hemiplegia group, as well as the values for the RF and BF on the unaffected side were significantly higher than the control group′s values. In the hemiplegia group, the RMS values of the RF and BF muscles on the unaffected side were significantly higher than on the affected side during standing with the eyes closed. For the RF muscles the RMS values on the unaffected side were, on average, significantly higher than with the eyes open. The MF of the GM muscles on the unaffected side in the hemiplegia group was significantly lower than the average MF values of the bilateral GM muscles in the control group with the eyes open or closed. With the eyes closed, the MF of the unaffected-side GM was significantly lower than that of the affected-side GM in the hemiplegia group. Compared with the control group, the hemiplegia group showed a significant increase in I and ω values, but a significant decrease in L values with the eyes open or closed. The DC values of the bilateral GM, RF and BF muscles in the hemiplegia group were significantly higher than among the control group with the eyes open, which was also true of the bilateral GM and RF muscles with the eyes closed. With the BF muscles it was true only of the unaffected side. In the hemiplegia group, the DC values of the unaffected-side GM with the eyes open or closed, and of the unaffected-side BF with the eyes closed.Conclusions:When standing still, hemiplegic stroke survivors exhibit increased overall synchronous muscle adjustment with involvement of unaffected-side muscles, especially the GM. sEMG network indices such as I, ω, L and DC can assess multi-muscle synchronous adaptability and the involvement of single muscles. sEMG network algorithms thus have potential as a new method for localizing and quantitatively assessing neuromuscular dysfunction among such patients.

Objective:To compare the efficacy and safety of crisaborole ointment 2% versus pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged 2 years or older.Methods:A multicenter, randomized, open-label, controlled clinical trial was conducted. A total of 120 pediatric patients aged 2 - 17 years with mild to moderate atopic dermatitis were enrolled from departments of dermatology of 8 hospitals in China between March 2022 and February 2023. The participants were randomly assigned in a 1∶1 ratio to the crisaborole group and the pimecrolimus group, and received the treatment with crisaborole ointment 2% and pimecrolimus cream 1% respectively, twice a day for 4 weeks. Visits were scheduled at baseline/on day 1, as well as on days 8, 15, and 29. The primary efficacy outcome was the percentage of patients achieving the Investigator's Static Global Assessment (ISGA) success (defined as clear [0] or almost clear [1] on the ISGA scale, combined with ≥ 2‐grade improvement from baseline) on day 29. The secondary efficacy outcomes included changes in the Eczema Area and Severity Index (EASI) total scores from baseline to day 29, percentages of patients achieving ISGA improvement (defined as clear [0] or almost clear [1] on the ISGA scale), as well as changes in the Peak Pruritus Numerical Rating Scale (NRS) scores, Dermatology Life Quality Index (DLQI) /Infants' Dermatology Life Quality Index (IDLQI) /Children's Dermatology Life Quality Index (CDLQI) scores, and in the Dermatitis Family Impact (DFI) scores. Drug safety was evaluated according to the incidence of adverse events. Categorical data were compared using the chi-square test. Since measurement data did not follow a normal distribution, the rank sum test was used for comparisons of measurement data between groups.Results:A total of 106 children with mild to moderate atopic dermatitis were included in the per-protocol analysis set, with 52 in the crisaborole group (26 males and 26 females) and 54 in the pimecrolimus group (27 males and 27 females). There were no significant differences in age, disease duration, ISGA and EASI scores at baseline between the two groups (all P > 0.05). On day 29, 22 patients (42.31%) in the crisaborole group and 25 (46.30%) in the pimecrolimus group achieved ISGA success, with no significant difference between the two groups ( χ2 = 0.17, P = 0.68) ; 35 patients (67.31%) in the crisaborole group and 45 (83.33%) in the pimecrolimus group achieved ISGA improvement, also with no significant difference between the two groups ( χ2 = 3.68, P = 0.06) ; additionally, there were no significant differences in the EASI, pruritus NRS, DLQI/IDLQI/CDLQI, or DFI scores between the two groups (all P > 0.05). Adverse reactions to the two topical agents were mainly local reactions such as mild to moderate pain, itching, or worsening of itching, and no obvious systemic adverse reactions occurred. The incidence of drug-related adverse reactions was 46.15% (24 cases) in the crisaborole group and 37.04% (20 cases) in the pimecrolimus group, with no significant difference between the two groups ( χ2 = 0.91, P = 0.34) . Conclusion:The efficacy of crisaborole ointment 2% was comparable to that of pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged ≥ 2 years, and it yielded early and rapid improvement in the quality of life of patients and their families, with good safety and tolerability profiles.

Objective:To investigate factors influencing frequent episodes (≥ 4 episodes within 1 year) in children with moderate-to-severe atopic dermatitis (AD) in China.Methods:A national multicenter cross-sectional study was conducted. Patients under the age of 18 years diagnosed with moderate-to-severe AD were enrolled at dermatology clinics in 18 medical institutions across 12 provinces and municipalities in China between June 12 and August 8, 2023. At the time of the visit, their guardians completed a structured questionnaire covering demographic characteristics, clinical features of AD, personal and family history, factors associated with frequent episodes of moderate-to-severe AD, compliance with treatment, and disease awareness. Statistical analyses included t tests, one-way analysis of variance, rank-sum tests, and chi-square tests, with multiple-response analysis applied for multiple-choice questions. Results:A total of 965 valid questionnaires were collected, and 965 children with moderate-to-severe AD were included. Among them, there were 531 males and 434 females, 678 (70.3%) were aged 2 - < 12 years, 837 (86.7%) were from urban areas, the age at onset was 2.47 ± 3.03 years, and the median frequency of AD episodes in the past year was 4 times. These children were divided into 2 groups based on the median episode frequency: < 4-episode group (439 cases, 45.5%) and ≥ 4-episode group (526 cases, 54.5%). Compared with the < 4-episode group, children in the ≥ 4-episode group showed younger ages at onset (2.22 ± 2.98 years vs. 2.76 ± 3.06 years, P = 0.006) and higher proportions of patients with comorbid allergic diseases in both the children themselves (82.9% [436/526] vs. 69.7% [306/439], χ2 = 23.42, P < 0.001) and their relatives (66.0% [347/526] vs. 57.4% [252/439], χ2 = 7.46, P = 0.006). Children in the ≥ 4- episode group also had higher monthly usage of moisturizers (150 [30, 300] g vs. 60 [6, 200] g) and daily frequency of moisturizer use, greater disease awareness, but more severe fear of medication use (all P < 0.05). The region and the human development index level were both significantly associated with the episode frequency (both P < 0.001), with the highest proportion of children from South China in the ≥ 4- episode group (36.3%, 191/526). Children in the ≥ 4-episode group also had a longer duration of topical glucocorticoid use than those in the < 4-episode group ( Z = -2.21, P = 0.027). External triggers associated with AD episodes mainly included heat exposure (50.36%, 486/965), hot water bathing (40.73%, 393/965), seafood (23.52%, 227/965), and dust mites (33.37%, 322/965) . Conclusion:In children with moderate-to-severe AD in China, factors influencing frequent episodes may include residence in southern or economically developed regions, earlier age at onset, having a personal or family history of allergic diseases, and fear of medication use.

Objective:To explore the current status and influencing factors of quality of life in patients with thyroid-associated ophthalmopathy (TAO) .Methods:From January to July 2024, convenience sampling was used to select TAO patients of the Department of Ophthalmology of Peking University Third Hospital as research subjects. The patients were surveyed using the General Information Questionnaire, Graves' Ophthalmopathy Quality of Life Questionnaire (GO-QOL), Negative Physical Self Scale-Appearance (NPSS-A), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Perceived Social Support Scale (PSSS). Spearman correlation analysis was used to explore the correlation between GO-QOL scores and NPSS-A, SAS, SDS, and PSSS scores. Multiple linear regression was used to analyze the factors influencing the quality of life of TAO patients.Results:A total of 234 questionnaires were distributed, and 203 valid questionnaires were collected, with a valid response rate of 86.75%. The GO-QOL visual function and social function dimensions scores of 203 TAO patients were [78.57 (50.00, 100.00) ] and [43.75 (18.75, 62.50) ], respectively. Multiple linear regression analysis showed that age, eye movement disorders, eyelid retraction, and disease grading, were the influencing factors of the visual function dimension of GO-QOL ( P<0.05). Age, social support, and body image were the influencing factors on the social function dimension of GO-QOL ( P<0.05) . Conclusions:The quality of life of TAO patients is poor. Healthcare professionals should develop coping strategies based on factors affecting different dimensions of quality of life, so as to improve patients' quality of life.

Objective To evaluate the effectiveness,safety and economy of generic venlafaxine sustained-release capsules and the original drug in clinical practice based on real world clinical data.Methods This is a multicenter,retrospective real-world study.The information of outpatients who used venlafaxine sustained-release capsules in 7 hospitals from October 2021 to October 2022 was collected,including prescription data and laboratory data.They were divided into generic drug group and original drug group.After the baseline level was corrected by propensity score match method,the prescription daily dose,plasma concentration,medication possession ratio,the continuous medication rate for 3,6 and 9 months,dressing change rate,the incidence of adverse reactions,the frequency of drug use,the average daily cost,the annual cost per capita and the proportion of the average annual cost of drugs were compared between the two groups.Results After the baseline level was corrected by propensity score matching method,the prescription daily dose and medication possession ratio(MPR≥0.8)in the generic drug group were higher than that of the original drug group(P＜0.05).There was no statistically difference in plasma concentration between the two groups(P=0.294).The continuous medication rate for 3,6 and 9 months in the generic drug group were statistically higher than those in the original drug group(P＜0.01).The single dressing change rate of the generic drug group was lower than that of the original drug group(P=0.032).There was no significant difference in the rate of secondary dressing change between the two groups(P=1.000).There were no significant differences in the incidence of abnormal ALT,AST,TC,Na,APTT,and PLC between two groups(P＞0.05).The average daily cost of the generic drug group was lower than that of the original drug group.The per capita annual cost of drugs and the proportion of average annual cost of drugs in the generic drug group were significantly lower than those in the original drug group(P＜0.01).Conclusion In the actual clinical diagnosis and treatment,no clinically significant differences in effectiveness and safety were found between the generic venlafaxine sustained-release capsule and the original-patented,while the economic advantages of the generic drug were better than that of the original-patented drug.

Objective To explore the predictive value of quantitative parameters of dual-layer detector spectral CT(DLCT)for Ki-67 expression in solid lung adenocarcinoma.Methods The data of 103 patients were retrospectively collected,and the patients were divided into Ki-67 high expression and Ki-67 low expression groups according to Ki-67 proliferation index.The quantitative parame-ters of DLCT were measured and calculated,and the differences in these parameters between the two groups were compared.The parameters with statistically significant differences were assessed for correlation with Ki-67 expression.The efficacy of DLCT param-eters and combined parameters in predicting Ki-67 expression in solid lung adenocarcinoma were evaluated by receiver operating character-istic(ROC)curve and compared by DeLong test.Results Long diameter,short diameter and smoking history were positively corre-lated with the Ki-67 expression in solid lung adenocarcinoma(r>0,P<0.05).Gender and quantitative parameters of DLCT were nega-tively correlated with the Ki-67 expression in solid lung adenocarcinoma(r<0,P<0.05).The combined parameters of convention and spectral CT had the highest prediction efficiency.Conclusion The quantitative parameters of DLCT can be used to evaluate the Ki-67 expres-sion in solid lung adenocarcinoma.

Objective:To compare the efficacy and safety of crisaborole ointment 2% versus pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged 2 years or older.Methods:A multicenter, randomized, open-label, controlled clinical trial was conducted. A total of 120 pediatric patients aged 2 - 17 years with mild to moderate atopic dermatitis were enrolled from departments of dermatology of 8 hospitals in China between March 2022 and February 2023. The participants were randomly assigned in a 1∶1 ratio to the crisaborole group and the pimecrolimus group, and received the treatment with crisaborole ointment 2% and pimecrolimus cream 1% respectively, twice a day for 4 weeks. Visits were scheduled at baseline/on day 1, as well as on days 8, 15, and 29. The primary efficacy outcome was the percentage of patients achieving the Investigator's Static Global Assessment (ISGA) success (defined as clear [0] or almost clear [1] on the ISGA scale, combined with ≥ 2‐grade improvement from baseline) on day 29. The secondary efficacy outcomes included changes in the Eczema Area and Severity Index (EASI) total scores from baseline to day 29, percentages of patients achieving ISGA improvement (defined as clear [0] or almost clear [1] on the ISGA scale), as well as changes in the Peak Pruritus Numerical Rating Scale (NRS) scores, Dermatology Life Quality Index (DLQI) /Infants' Dermatology Life Quality Index (IDLQI) /Children's Dermatology Life Quality Index (CDLQI) scores, and in the Dermatitis Family Impact (DFI) scores. Drug safety was evaluated according to the incidence of adverse events. Categorical data were compared using the chi-square test. Since measurement data did not follow a normal distribution, the rank sum test was used for comparisons of measurement data between groups.Results:A total of 106 children with mild to moderate atopic dermatitis were included in the per-protocol analysis set, with 52 in the crisaborole group (26 males and 26 females) and 54 in the pimecrolimus group (27 males and 27 females). There were no significant differences in age, disease duration, ISGA and EASI scores at baseline between the two groups (all P > 0.05). On day 29, 22 patients (42.31%) in the crisaborole group and 25 (46.30%) in the pimecrolimus group achieved ISGA success, with no significant difference between the two groups ( χ2 = 0.17, P = 0.68) ; 35 patients (67.31%) in the crisaborole group and 45 (83.33%) in the pimecrolimus group achieved ISGA improvement, also with no significant difference between the two groups ( χ2 = 3.68, P = 0.06) ; additionally, there were no significant differences in the EASI, pruritus NRS, DLQI/IDLQI/CDLQI, or DFI scores between the two groups (all P > 0.05). Adverse reactions to the two topical agents were mainly local reactions such as mild to moderate pain, itching, or worsening of itching, and no obvious systemic adverse reactions occurred. The incidence of drug-related adverse reactions was 46.15% (24 cases) in the crisaborole group and 37.04% (20 cases) in the pimecrolimus group, with no significant difference between the two groups ( χ2 = 0.91, P = 0.34) . Conclusion:The efficacy of crisaborole ointment 2% was comparable to that of pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged ≥ 2 years, and it yielded early and rapid improvement in the quality of life of patients and their families, with good safety and tolerability profiles.

Objective:To analyze the correlation between respiratory event duration and nocturnal oxygen saturation (SpO 2) in adults with obstructive sleep apnea (OSA), and to explore its significance in assessing nocturnal hypoxemia and OSA severity. Methods:A prospective study was conducted on adult OSA patients diagnosed via overnight standard polysomnography (PSG) at the Department of Otolaryngology, First Affiliated Hospital of Sun Yat-sen University from June 2019 to December 2023. Data collected included demographic information, PSG reports, scale scores, and comorbidities. Patients were first stratified by apnea-hypopnea index (AHI) severity. Relationships between respiratory event duration parameters,including total apnea-hypopnea time (TAHT), percentage of total sleep time with apnea-hypopnea (AHT%), total apnea time (TAT), total hypopnea time (THT), and mean apnea-hypopnea time (MAHT), and nocturnal SpO? parameters, including average SpO? (aSpO?), minimal SpO? (mSpO?), mean oxygen desaturation (MOD), and percentage of total sleep time with SpO?<90% (CT90), were analyzed. Patients were then divided into two groups based on the median MAHT (27.6 s) for SpO? comparison. Finally, severe OSA patients were further subclassified using an AHI inflection point (50 events/h) identified via scatter plot analysis to compare nocturnal SpO?. Statistical analysis was performed using SPSS 27.0.Results:Among the 250 study subjects, there were 201 males and 49 females, with ages ranging from 18 to 76 years (mean age: 41.6 ± 11.9 years).TAHT, AHT%, and TAT in OSA patients demonstrated significant negative correlations with aSpO?( r=-0.698, -0.718, -0.646)and mSpO?( r=-0.746, -0.746, -0.748), while showing positive correlations with MOD ( r=0.783, 0.791, 0.823)and CT90 ( r=0.868, 0.866, 0.852), P<0.05. When stratified by MAHT median ( M=27.6 s), the "long-event" subgroup ( n=125) displayed significantly lower mSpO 2 and higher MOD and CT90 compared to the "short-event" subgroup ( n=125), Z=-3.319, 3.288, 2.242; P<0.05. No significant difference in aSpO 2 was observed ( P>0.05). Subgrouping severe OSA patients at AHI=50 events/hour revealed significant differences in aSpO 2, mSpO 2, MOD, and CT90 between groups ( Z=-5.011, -4.787, 5.142, 6.117, P<0.05). Conclusions:TAHT, AHT%, and TAT significantly correlate with nocturnal SpO? parameters in OSA patients and can supplement AHI in assessing OSA severity. MAHT independently reflects nocturnal oxygenation status beyond AHI.

Objective:To explore the clinical efficacy of curcumin-mediated photodynamic therapy (PDT) for the treatment of cervical intraepithelial neoplasia (CIN) combined with human papillomavirus (HPV) infection.Methods:A prospective randomized controlled study was conducted. Eighty patients with CIN combined with HPV infection in Dingzhou People's Hospital from January 2022 to January 2023 were selected and divided into the observation group and the control group using the randomized numerical table method, with 40 cases in each group. The observation group was treated with curcumin-mediated PDT, and the control group was treated with recombinant human interferon α-2b suppository for topical application. The efficacy, HPV-DNA conversion rate, high-risk human papillomavirus (HR-HPV) load, recovery status, inflammatory cytokine level, expression of Ki-67, expression of Survivin, and occurrence of adverse reactions were compared between the two groups.Results:Eighty patients aged (35±4) years old. The age, disease duration, age of first sexual experience, CIN grading, HPV typing and other general data of the two groups were compared, and the differences were not statistically significant (all P > 0.05). The total effective rate of the observation group was higher than that of the control group [95.0% (38/40) vs. 75.0% (30/40)], and the difference was statistically significant ( χ2 = 6.28, P = 0.012). The HPV-DNA conversion rates in the observation group were higher than those in the control group at 1, 3 and 6 months after treatment [1 month: 65.0% (26/40) vs. 42.5% (17/40); 3 months: 87.5% (35/40) vs. 67.5% (27/40); 6 months: 95.0% (38/40) vs. 80.0% (32/40)], and the differences were statistically significant ( χ2 values were 4.07, 4.59 and 4.11, respectively, all P < 0.05). HR-HPV loads in the observation group were lower than those in the control group at 1, 3 and 6 months after treatment (1 month: 42.4±5.8 vs. 56.7±6.7; 3 months: 31.0±4.5 vs. 40.3±3.7; 6 months: 14.5±2.4 vs. 28.8±2.4), and the differences were statistically significant ( t values were 10.24, 10.17 and 26.77, respectively, all P < 0.001). The healing time of cervical wound in the observation group was shorter than that in the control group [(30±3) d vs. (39±5) d, t = 9.37, P < 0.001]. The levels of interleukin 4, interleukin 6, interleukin 10 and relative expressions of Ki-67 and Survivin in the observation group were lower than those in the control group at 6 months after treatment (all P < 0.001). The difference in the incidence of adverse reactions between the observation and control groups was not statistically significant [12.50% (5/40) vs. 7.50% (3/40), χ2 = 0.56, P = 0.456]. Conclusions:Curcumin-mediated PDT for the treatment of patients with CIN combined with HPV infection has a high total effective rate; it can reduce the HR-HPV load and inflammatory cytokine levels, and improve the HPV-DNA conversion rate.

Objective:To analyze the clinical significance of high risk human papillomavirus (HR-HPV) positive female cervical lesion screening HR-HPVE6/E7 mRNA detection.Methods:A total of 80 HR-HPV-positive female patients with cervical lesions were retrospectively selected in Dingzhou People′s Hospital from August 2021 to August 2023. According to the pathological examination results, the patients were divided into inflammatory response group (16 cases), cervical intraepithelial neoplasia (CIN) Ⅰ group (15 cases), CINⅡ group (22 cases), CINⅢ group (17 cases) and cervical cancer group (10 cases). The viral load and positive rate of HR-HPVE6/E7 mRNA in the five groups were compared. Receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic efficacy of HR-HPVE6/E7 mRNA in cervical lesions.Results:The viral load of HR-HPVE6/E7 mRNA in the cervical cancer group, CINⅢ group, CINⅡ group, CINⅠ group and inflammatory response group was gradually decreased: 3 152.62(894.26, 21 986.24), 812.62(465.05, 3 945.06), 481.64(215.62, 2 451.49), 38.62(0, 612.47), 0(0, 316.28) × 10 3 copy/L, there was statistical difference among the five groups ( P<0.05). The positive rate of HR-HPVE6/E7 mRNA in cervical cancer group (10/10) was higher than that in CINⅢ group (10/17), CINⅡ group [27.27%(6/22)], CINⅠ group (2/15) and inflammatory response group (0), and there were statistical differences ( P<0.05). ROC curve analysis results showed that the area under the curve of HR-HPVE6/E7 mRNA for diagnosis of cervical lesions was 0.901(95% CI 0.837 - 0.942), sensitivity was 92.53%, specificity was 89.12%. Conclusions:Quantitative detection of HR-HPVE6/E7 mRNA viral load has high sensitivity and specificity in the diagnosis of cervical lesions.