Drawing on recent advances in modern fascial anatomy and biomechanics， this paper interprets the biomechanical implications of yin-yang balance at the physical level from the perspective of holistic force lines. It posits that holistic force lines represent the functional expression of mechanical load transmission and integration within the myofascial network； the channel sinews system and myofascial chains exhibit significant similarities in terms of their distribution， functional attributes， and principles of holistic regulation， and can thus be understood as structural-functional carriers of yin-yang balance. Accordingly， this paper provides a biomechanical interpretation of the yin-yang relationship from four aspects， including interdependence， mutual restriction， dynamic balance through waxing and waning， and mutual transformation， proposing that in a healthy state， the body relies on the continuous integration， distribution， and readjustment of the myofascial tension network to maintain overall coordination， whereas disease states are often associated with compensatory transmission of local tension abnormalities along holistic force lines， the accumulation of imbalances， and structural rigidity. The holistic force-line perspective provides a biomechanical explanatory framework for the theory of yin-yang balance and offers a new theoretical basis for clinical diagnosis and treatment to shift from empirical holistic balancing toward holistic force-line balancing based on posture， function， and tension transmission pathways.

Objective To investigate the in vitro antiviral effects of Blumea balsamifera(L.)DC.extract against Coxsackievirus B5(CVB5).Methods A series of dilutions of Coxsackievirus were prepared and co-cultured with RD cells to determine the TCID50 value.Subsequently,different concentrations of the extract were added to a 96-well plate containing RD cells to evaluate their impact on cell viability.The ability of Blumea balsamifera extract to inhibit Coxsackievirus was further observed in the 96-well plate containing RD cells and the extract.Results The TCID50 value of Coxsackie virus solution was 10-7.67.The inhibition rate of Blumea balsamifera extract against Coxsackievirus increased with concentration,with an IC50 value of 7.26 mg/L.At a concen-tration of 50 mg/L,the extract caused a decrease in RD cell viability(P＜0.05),but within the concentration range of 6.25 to 50 mg/L,it increased the viability of virus-infected RD cells(P＜0.05),with a selectivity index(SI)exceeding 6.89.Conclusion Blumea balsamifera(L.)DC.extract exhibits in vitro activity against Coxsackievirus.

Objective To compare the distribution characteristics of retinal capillary non-perfusion areas(NPAs)across different layers and regions in patients with neovascular glaucoma(NVG)secondary to proliferative diabetic retinop-athy(PDR)versus those with PDR alone through wide-field swept-source optical coherence tomography angiography(SS-OCTA)and to analyze the impacts of NPAs on the development of NVG.Methods This prospective cross-sectional study enrolled 33 patients with PDR(33 eyes,the PDR group)and 30 patients with NVG(30 eyes,the PDR+NVG group)diag-nosed at Affiliated Hospital of Shandong Second Medical University(formerly Weifang Medical University)from January 2022 to June 2023.The fundus examination was performed using SS-OCTA,and the NPA boundaries of the superficial capil-lary plexus(SCP)and deep capillary plexus(DCP)of the retina were manually delimited with the aid of ImageJ.The reti-na was divided based on two methods.Specifically,according to different concentric circles,the retina could be divided in-to the foveal area,parafoveal area,perifoveal area,annulus6-9,annulus9-12,annulus12-retinal boundary;besides,the ret-ina could also be divided into four quadrants(supratemporal,infratemporal,supranasal,and infranasal quadrants)based on the horizontal and vertical lines centered on the macular fovea.Based on that,the NPA area and ischemia index(ISI)in each layer and subdivision of the two groups of patients were counted.Additionally,the NPA and ISI in different concentric circles and different quadrants of the SCP and DCP were compared between the two groups.Moreover,the distribution characteristics of NPAs as well as the effect of NPAs on NVG were analyzed.Results(1)The NPA area and ISI in the DCP were larger than those in the SCP in both groups(all P＜0.001);the NPA area and ISI in the SCP and DCP of patients in the PDR+NVG group were larger than those in the PDR group(all P＜0.001).(2)In the supratemporal,infratemporal,supranasal,and infranasal quadrants,the NPA area and ISI in the SCP and DCP of patients in the PDR+NVG group were larger than those in the PDR group(all P＜0.01).The NPA area in the inferotemporal quadrant was the largest in the SCP and DCP,respectively,within each group(all P＜0.01).(3)The differences in the NPA area and ISI between the two groups were statistically significant in the annulus6-9,annulus9-12,and annulus12-retinal boundary in the SCP and DCP(all P＜0.01).The differences in the NPA area and ISI were statistically significant between different annular subdivisions in the SCP and DCP within each group(all P＜0.001).The multiple comparison results showed that the NPA area and ISI of the annulus12-retinal boundary in the SCP and DCP were larger than those in other annuli in both groups(all P＜0.05).The NPA area and ISI of the annulus9-12 were larger than those of the parafoveal and perifoveal areas;the NPA area and ISI of the annulus6-9 were larger than those of the parafoveal area(all P＜0.05).There was no statistically significant differ-ence in the NPA area and ISI in the remaining annuli(all P＞0.05).(4)The multivariate logistic regression analysis showed that the NPA area and ISI in the subnasal quadrant of the SCP were negatively correlated with the risk of NVG sec-ondary to PDR(P=0.036 and 0.038).The increased NPA area and ISI in the subnasal quadrant of the DCP were risk fac-tors for NVG secondary to PDR,and they may increase the risk of NVG(P=0.029 and 0.028).Conclusion The in-creased NPA area and ISI in the subnasal quadrant of the DCP were risk factors for secondary NVG in patients in the PDR group.

Pulpitis is a prevalent inflammatory disease in dentistry, and root canal therapy remains the primary clinical treatment for it. However, pulp removal leads to reduced tooth fracture resistance and complications such as secondary infection and tooth fracture. As a potential alternative, vital pulp therapy (VPT) relies on precise assessment of pulp status; yet current clinical diagnostic methods lack specificity. The establishment of appropriate animal models for pulpitis is crucial for investigating its pathogenesis, developing specific diagnostic biomarkers, and optimizing VPT strategies. This review systematically summarizes experimental animals selection based on anatomical compatibility and pathological similarity, as well as model construction methods and multimodal evaluation systems for pulpitis animal models, aiming to provide insights for related researches.

Objective:To analyze the situation of rodents carrying Hantavirus and the genetic and evolutionary characteristics of the virus in Zibo city, Shandong province in 2022, and provide reference for the scientific prevention and control of hemorrhagic fever with renal syndrome (HFRS).Methods:Real-time quantitative PCR (RT-qPCR) was used to detect hantavirus (HV) nucleic acids in rodent lung tissues and identify HV genotypes. Each nucleic acid fragment was designed to amplify various gene fragments by segment, and the whole genome of Hantavirus was sequenced by second generation sequencing. Sequence assembly was performed using SeqMan 7.1.0.44, a subprogram of DNAStar. Sequence alignment and evolutionary analysis were conducted using MEGA 7.0 and BioEdit software.Results:A total of 270 host animals were captured in this survey. Among them, 13 rodent lung samples tested positive for Hantavirus, resulting in a virus-positive rate of 4.8%. The full-genome sequences of four hantavirus strains were successfully obtained, all identified as Seoul virus (SEOV) genotype. Four Hantavirus-positive samples showed high nucleotide sequence homology in the M gene and belonged to the SEOV S3 subtype. These strains exhibited high similarity with those from Hebei, Liaoning, and Beijing. The amino acid sequences of the nucleoprotein and glycoprotein immunogenic epitopes were identical to those of the vaccine strain Z37.Conclusions:This study successfully determined the full genome sequences of four hantavirus strains from Zibo city, Shandong province. The genotypes are primarily SEOV, with the subtype being S3. The homology of genes within the same subtype is high, with no significant variations observed. The alignment of immune epitopes in key proteins suggests that the current vaccine may provide protection against locally circulating strains, but further in-depth research is still required.

Objective:To investigate the application value of risk prediction model for acute kidney injury (AKI) after donation of cardiac death (DCD) liver transplantation based on machine learning algorithm.Methods:The retrospective cohort study was conducted. The clinicopathological data of 1 001 pairs of DCD liver transplant donors and recipients at five hospitals, including The First Affiliated Hospital of Zhejiang University School of Medicine et al, in the Chinese Liver Transplan-tation Registry from January 2015 to December 2023 were collected. Of the donors, there were 825 males and 176 females. Of the recipients, there were 806 males and 195 females, aged 52 (range, 18-75)years. There were 281 recipients included using oversampling technique, and all 1 282 recipients were divided to the training set of 897 recipients and the validation set of 385 recipients by a ratio of 7∶3 using computer-generated random numbers. Seven prediction models, including Random Forest (RF), Extreme Gradient Boosting (XGBoost), Support Vector Machine (SVM), Logistic Regression (LR), Decision Tree (DT), K-Nearest Neighbors (KNN), and Categorical Boosting (CatBoost), were constructed for AKI after liver transplantation based on machine learning algorithm. Observation indicators: (1) comparison of clinicopathological characteristics between recipients with and without AKI and donors; (2) follow-up and survival of recipients with and without AKI; (3) construction and validation of nomogram prediction model of AKI after liver transplantation; (4) construction and validation of machine learning prediction model of AKI after liver transplantation. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test, and comparison among groups was conducted using the Kruskal-Wallis H test. Comparison of count data between groups was conducted using the chi-square test or corrected chi-square test. Kaplan-Meier method was used to calculate survival rates and plot survival curves. Logistic regression model was performed for univariate and multivariate analyses. The receiver operating characteristic (ROC) curve was plotted to calculate area under curve (AUC) and 95% confidence interval ( CI). The performance of prediction model was evaluated using DeLong test, accuracy, sensitivity, specificity. The calibration curve was plotted to evaluate the performance of predicted probability and actual probability. The interpretability analysis of machine learning algorithm and SHapley Additive exPlanations was used to explain the model decision separately. Results:(1) Comparison of clinicopathological characteristics between recipients with and without AKI and donors. Of 1 001 recipients, there were 360 cases with AKI and 641 cases without AKI after liver transplantation. There were significant differences in body mass index (BMI), hepatic encepha-lopathy, hepatitis B surfact antigen (HBsAg), hepatorenal syndrome (HRS) and donor diabetes, donor blood urea nitrogen, donor alanine aminotransferase, donor aspartate aminotransferase, mass of graft, volume of blood loss during liver transplantation, warm ischema time of donor liver, and operation time between recipients with and without AKI ( Z=-4.337, χ2=9.751, 9.088, H=11.142, χ2=5.286, Z=-3.360, -2.539, -3.084, -1.730, -3.497, -1.996, -2.644, P<0.05). (2) Follow-up and survival of recipients with and without AKI. All the 1 001 recipients received follow-up. The recipients with AKI after liver transplantation were followed up for 18.6(range, 0-102.3)months, and recipients without AKI after liver transplantation were followed up for 31.9(range, 0.1-105.5)months. The 1-, 3-, and 5-year overall survival rates were 72.1%, 63.5%, and 59.3% of recipients with AKI, versus 86.7%, 76.7%, and 72.5% of recipients without AKI, respectively, showing a significant difference in overall survival between them ( χ2=26.028, P<0.05). (3) Construction and validation of nomogram predic-tion model of AKI after liver transplantation. Results of multivariate analysis showed that recipient BMI, recipient creatinine, recipient HBsAg, recipient HRS, donor blood urea nitrogen, donor crea-tinine, anhepatic phase and volume of blood loss during liver transplantation were independent risk factors for AKI of recipients after liver transplantation ( odds ratio=1.113, 0.998, 0.605, 1.580, 1.047, 0.998, 1.006, 1.157, 95% CI as 1.070-1.157, 0.996-1.000, 0.450-0.812, 1.021-2.070, 1.021-1.074, 0.996-0.999, 1.000-1.012, 1.045-1.281, P<0.05). The nomogram prediction model of AKI after liver transplantation was constructed based on the results of multivariate analysis. Results of ROC curve showed that the AUC of 0.666 (95% CI as 0.637-0.696). (4) Construction and validation of machine learning prediction model of AKI after liver transplantation. Based on the Lasso regression analysis, seven machine learning algorithm prediction models, including RF, XGBoost, SVM, LR, DT, KNN, and CatBoost, were constructed, with ROC curves of the validation set plotted. The AUC of above models were 0.863, 0.841, 0.721, 0.637, 0.620, 0.708, 0.731, accuracies were 0.764, 0.782, 0.701, 0.592, 0.605, 0.605, 0.681, sensitivities were 0.764, 0.789, 0.719, 0.588, 0.694, 0.694, 0.704, specificities were 0.763, 0.774, 0.683, 0.597, 0.511, 0.511, 0.656, respectively. Delong test showed that the RF model with the highest AUC of 0.863(95% CI as 0.828-0.899). Calibration curve analysis showed the predicted probability closest to the actual probability of RF model, indicating the model with a good validation value. Further sorting of SHAP of different clinical factors based on RF model showed that recipient BMI, donor blood urea nitrogen, volume of blood loss during liver transplantation, donor age had large effects on the output outcomes. Conclusion:The nomogram prediction model and seven machine learning algorithm prediction models for AKI after DCD liver transplantation are constructed, and the RF model based on machine learning has a better predictive performance.

Objective To identify determinants of subtherapeutic voriconazole(VRCZ)concentrations in allogeneic hematopoietic stem cell transplantation(allo-HSCT)recipients and to develop/validate a nomogram-based risk prediction model.Methods This study retrospectively analyzed 310 VRCZ therapeutic drug monitoring(TDM)measurements from allo-HSCT recipients at 310 patients who under went allo-HSCT surgery at Hebei Yanda Ludaopei Hospital from October 2022 to October 2024 and received VRCZ for the prevention and treatment of invasive fungal infections before transplantion were selected as the study subjects.Cases were stratified into target-concentration group(0.5～5.0μg/ml)and subtherapeutic group(<0.5μg/ml).Through single factor and multiple factor Logistic regression analysis,indeipendent predictive factors forvecz plasma concentration non-compliance were screened,and a column chart prediction model(NPM)was constructed.The performance of the model was evaluateding area under the receiver operating characteristic curve(AUC),Hosmer-Lemeshow(H-L)goodness-of-fit test,and decision curve analysis(DCA).Results Among 310 VRCZ-TDM measurements,71.61%(222/310)achieved target concentrations.Multivariate analysis showed that CYP2C19 intermediate metabolite,daily dose of cyclosporine A(CSA),daily dose of VRCZ,creatinine(Cr)>97 μmol/L,albumin(Alb)and C-reactive protein(CRP)were independent influencing factors for VRCZ blood drug concentration non-compliance(Wald χ2=4.046～13.221,all P＜0.05).The nomogram demonstrated excellent discrimination,calibration(H-L goodness of fit test χ2=2.663,P=0.954),and clinical utility with net benefit across 0.05～0.96 risk thresholds.Conclusion The nomogram incorporating CYP2C19 gene phenotype,daily CSA dosing,daily VRCZ dosing,Cr levels,Alb and CRP provides a validated tool for optimizing VRCZ therapy in allo-HSCT recipients,enabling precision dosing strategies.

Objective: To preliminarily develop a multidimensional blood donor role scale based on role theory and systematically compare the psychosocial characteristic differences between award-winning donors and first-time donors in Guangzhou, and to provide an empirical reference for formulating differentiated donor retention strategies. Methods: A cross-sectional survey design was adopted. A random sample of award-winning donors and concurrently sampled first-time donors yielding 1 361 valid responses collected (721 from the award group, 640 from the first-time group). Exploratory factor analysis was used to assess the scale structure. Data were post-stratified and weighted according to the gender and age distributions of the general donor population. Independent samples t-tests, multivariate analysis of covariance (MANCOVA), and generalized linear models were employed to compare dimensional scores between the two groups. A paired t-test was conducted to analyze the annual donation frequency of award-winning donors before and after receiving the award. Results: Exploratory factor analysis yielded a 5-factor structure, including Role Identity and Expectations, Role Adaptation and Maintenance, Role Environment and Experience, Role Relationships and Conflict, and Role Incentives and Rewards, with a cumulative variance contribution rate of 56.43%. The scale demonstrated good internal consistency reliability (Cronbach's α=0.906). Known-group validity test showed that award-winning donors scored significantly higher than first-time donors on Role Identity and Expectations (t=4.366, P<0.001, d=0.240), Role Adaptation and Maintenance (t=5.436, P<0.001, d=0.500), and Role Relationships and Conflict (t=4.844, P<0.001, d=0.220). These differences remained significant after controlling for selected demographic variables (MANCOVA, Wilks' λ=0.943, P<0.001). Generalized linear models suggested that donation frequency was an independent predictor for these dimensions. Additionally, the annual donation frequency of award-winning donors was slightly higher after receiving the award than before (t=2.007, P=0.045). Conclusion: The preliminary blood donor role scale demonstrates acceptable reliability and validity and can effectively distinguish groups with different donation behavior characteristics. The study reveals that award-winning donors exhibit more positive psychological characteristics across multiple role identity dimensions and maintain their donation behavior after receiving an award. External incentives and internal role identity may jointly contribute to behavioral persistence. The findings provide a preliminary reference for further exploring the formation pathways of donor role identity and developing differentiated donor retention strategies.

Working memory is an executive memory process that includes encoding, maintenance, and retrieval. These processes can be modulated by transcranial alternating current stimulation (tACS) with sinusoidal waves. However, little is known about the impact of the rate of current change on working memory. In this study, we aimed to investigate the effects of two types of tACS with different rates of current change on working memory performance and brain activity. We applied a randomized, single-blind design and divided 81 young participants who received triangular wave tACS, sinusoidal wave tACS, or sham stimulation into three groups. Participants performed n-back tasks, and electroencephalograms were recorded before, during, and after active or sham stimulation. Compared to the baseline, working memory performance (accuracy and response time) improved after stimulation under all stimulation conditions. According to drift-diffusion model analysis, triangular wave tACS significantly increased the efficiency of non-target information processing. In addition, compared with sham conditions, triangular wave tACS reduced alpha power oscillations in the occipital lobe throughout the encoding period, while sinusoidal wave tACS increased theta power in the central frontal region only during the later encoding period. The brain network connectivity results showed that triangular wave tACS improved the clustering coefficient, local efficiency, and node degree intensity in the early encoding stage, and these parameters were positively correlated with the non-target drift rate and decision starting point. Our findings on how tACS modulates working memory indicate that triangular wave tACS significantly enhances brain network connectivity during the early encoding stage, demonstrating an improvement in the efficiency of working memory processing. In contrast, sinusoidal wave tACS increased the theta power during the later encoding stage, suggesting its potential critical role in late-stage information processing. These findings provide valuable insights into the potential mechanisms by which tACS modulates working memory.
Humans ; Memory, Short-Term/physiology* ; Male ; Female ; Young Adult ; Transcranial Direct Current Stimulation/methods* ; Brain/physiology* ; Adult ; Electroencephalography ; Single-Blind Method

Objective To develop the Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre and provide a scientific and practical guidance for improving the quality of nursing in operating theatre.Methods The writing team established by the Operating Room Nursing Professional Committee of Guangdong Nursing Association conducted systematic literature retrieval and screening,and used the updated clinical Guidelines for Research and Evaluation Ⅱ in UK 2017.AGREE Ⅱ and the evidence evaluation system of the Australian JBI(Joanna Briggs Institute,JBI)Evidence-Based Health Care Center evidence level system(2016 Edition)comprehensively analyzed the evidence related to the sensitive indicators for evaluating the quality of operating room nursing and the suggestions of the writing group members.The first draft was formed based on the three-dimensional quality evaluation theoretical framework of"structure-process-result".Through the Delphi method,after two rounds of expert consultations and members'votes,the first draft was deeply revised and improved.Results Based on the three-dimensional quality evaluation theoretical framework of"structure-process-outcome"proposed by American scholar Donabedian,the expert consensus finally included five primary indicators:basic nursing quality,quality indicators of patient safety,quality indicators of hospital infection control,quality indicators of medication and safety management,and quality indicators of specialised nursing in operating theatre.The secondary indicators consisted of one structural indicator(management of commonly used instrument and equipment in operating theatre)and 17 process indicators(e.g.,infusion and blood transfusion management,body temperature management,etc.).The tertiary indicators included 26 process indicators and 11 outcome indicators(e.g.,incidence of adverse reactions of infusion during surgery,incidence of intra-operative hypothermia,etc.).Conclusion The evidence-and guideline-based Expert Consensus on Sensitive Indicators for Assessment of the Quality of Nursing in Operating Theatre based on eviclence and guidelines was established through rigorous evidence-based methods.It is operational and practical,and offers theoretical support and practical guidance for the managers of operating theatre to improve the quality of nursing.