Rheumatoid arthritis （RA） is a common autoimmune disease characterised clinically by symmetrical joint pain， swelling， and stiffness. Long-term chronic synovial inflammation can lead to severe joint damage and even disability， thereby affecting quality of life for patients. Current clinical treatment of RA emphasises an integrated approach combining traditional Chinese and Western medicine， with traditional Chinese medicine offering certain advantages in reducing disease activity of RA， preventing relapses， and other aspects. Modern clinical evidence confirms that Guizhi Shaoyao Zhimutang （GSZT） is effective in improving symptoms such as immune metabolism， joint stiffness， and joint pain in RA patients. Pharmacological studies have revealed that GSZT primarily contains components such as cinnamaldehyde， total glucosides of paeony， total alkaloids of Aconiti Lateralis Radix Praeparata， glycyrrhetinic acid， zingiberone， isoimperatorin， ephedra polysaccharides， and cedrol. It improves RA symptoms via multiple mechanisms and targets， including enhancing immune responses， exerting anti-inflammatory and analgesic effects， regulating relevant signalling pathways， inhibiting cell apoptosis， and suppressing bone destruction. This paper reviewed the syndrome patterns and pharmacological basis of GSZT in the treatment of RA， as well as its clinical applications and related mechanisms， thereby providing a theoretical basis and reference for the further development and utilisation of GSZT in the treatment of RA.

Rheumatoid arthritis （RA） is a common autoimmune disease characterised clinically by symmetrical joint pain， swelling， and stiffness. Long-term chronic synovial inflammation can lead to severe joint damage and even disability， thereby affecting quality of life for patients. Current clinical treatment of RA emphasises an integrated approach combining traditional Chinese and Western medicine， with traditional Chinese medicine offering certain advantages in reducing disease activity of RA， preventing relapses， and other aspects. Modern clinical evidence confirms that Guizhi Shaoyao Zhimutang （GSZT） is effective in improving symptoms such as immune metabolism， joint stiffness， and joint pain in RA patients. Pharmacological studies have revealed that GSZT primarily contains components such as cinnamaldehyde， total glucosides of paeony， total alkaloids of Aconiti Lateralis Radix Praeparata， glycyrrhetinic acid， zingiberone， isoimperatorin， ephedra polysaccharides， and cedrol. It improves RA symptoms via multiple mechanisms and targets， including enhancing immune responses， exerting anti-inflammatory and analgesic effects， regulating relevant signalling pathways， inhibiting cell apoptosis， and suppressing bone destruction. This paper reviewed the syndrome patterns and pharmacological basis of GSZT in the treatment of RA， as well as its clinical applications and related mechanisms， thereby providing a theoretical basis and reference for the further development and utilisation of GSZT in the treatment of RA.

Within the prefrontal-cingulate cortex, abnormalities in coupling between neuronal networks can disturb the emotion-cognition interactions, contributing to the development of mental disorders such as depression. Despite this understanding, the neural circuit mechanisms underlying this phenomenon remain elusive. In this study, we present a biophysical computational model encompassing three crucial regions, including the dorsolateral prefrontal cortex, subgenual anterior cingulate cortex, and ventromedial prefrontal cortex. The objective is to investigate the role of coupling relationships within the prefrontal-cingulate cortex networks in balancing emotions and cognitive processes. The numerical results confirm that coupled weights play a crucial role in the balance of emotional cognitive networks. Furthermore, our model predicts the pathogenic mechanism of depression resulting from abnormalities in the subgenual cortex, and network functionality was restored through intervention in the dorsolateral prefrontal cortex. This study utilizes computational modeling techniques to provide an insight explanation for the diagnosis and treatment of depression.
Prefrontal Cortex/physiology* ; Humans ; Emotions/physiology* ; Cognition/physiology* ; Gyrus Cinguli/physiology* ; Computer Simulation ; Models, Neurological ; Neural Pathways/physiology* ; Nerve Net/physiology*

OBJECTIVE To analyze the bacterial spectrum characteristics and drug resistance of midstream urine culture-positive cases in patients with urinary tract infection(UTI),and to provide reference for rational use of antibiotics.METHODS A retrospective analysis was conducted on 6 029 patients with urinary tract infections who had positive midstream urine cultures at the First Affiliated Hospital of Guangzhou Medical University from 2013 to 2023,with a total of 8 495 infectious bacterial detected,and the characteristics of the pathogens,antimicrobial susceptibility tests and the epidemiological features were analyzed.RESULTS There were 2 086 males and 3 943 fe-males.A total of 8 495 pathogens were isolated,of which 1 492 stains of gram-positive bacteria accounted for 17.56％,5 850 strains of gram-negative bacteria accounted for 68.86％,1 150 strains of fungi accounted for 13.54％,with Escherichia coli(42.30％),Klebsiella pneumoniae(7.59％),and Enterococcus faecalis(6.19％)being predominated.The major gram-negative bacteria had low resistance rates to meropenem,imipen-em and ertapenem(＜20％),and high resistance rates to ampicillin and cefazolin(＞34％).The major gram-posi-tive bacteria had low resistance rates to teicoplanin and quinupristin/dalfopristin(＜12％),very low resistance to linezolid(＜1％),and high resistance rates to erythromycin(＞40％).The main fungi had low resistance rates to flucytosine and amphotericin B(＜3％),while Candida tropicalis had high resistance rates to itraconazole,flu-conazole,and voriconazole(37.93％-42.18％).CONCLUSION The three most frequently isolated pathogens in the midstream urine cultures of patients with UTI are Escherichia coli,Klebsiella pneumoniae,and Group D En-terococcus faecalis,which show low resistance to tigecycline and high resistance to ciprofloxacin,ampicillin and levofloxacin,and these findings provide important references for clinical treatment of urinary tract infections.

OBJECTIVE To analyze the bacterial spectrum characteristics and drug resistance of midstream urine culture-positive cases in patients with urinary tract infection(UTI),and to provide reference for rational use of antibiotics.METHODS A retrospective analysis was conducted on 6 029 patients with urinary tract infections who had positive midstream urine cultures at the First Affiliated Hospital of Guangzhou Medical University from 2013 to 2023,with a total of 8 495 infectious bacterial detected,and the characteristics of the pathogens,antimicrobial susceptibility tests and the epidemiological features were analyzed.RESULTS There were 2 086 males and 3 943 fe-males.A total of 8 495 pathogens were isolated,of which 1 492 stains of gram-positive bacteria accounted for 17.56％,5 850 strains of gram-negative bacteria accounted for 68.86％,1 150 strains of fungi accounted for 13.54％,with Escherichia coli(42.30％),Klebsiella pneumoniae(7.59％),and Enterococcus faecalis(6.19％)being predominated.The major gram-negative bacteria had low resistance rates to meropenem,imipen-em and ertapenem(＜20％),and high resistance rates to ampicillin and cefazolin(＞34％).The major gram-posi-tive bacteria had low resistance rates to teicoplanin and quinupristin/dalfopristin(＜12％),very low resistance to linezolid(＜1％),and high resistance rates to erythromycin(＞40％).The main fungi had low resistance rates to flucytosine and amphotericin B(＜3％),while Candida tropicalis had high resistance rates to itraconazole,flu-conazole,and voriconazole(37.93％-42.18％).CONCLUSION The three most frequently isolated pathogens in the midstream urine cultures of patients with UTI are Escherichia coli,Klebsiella pneumoniae,and Group D En-terococcus faecalis,which show low resistance to tigecycline and high resistance to ciprofloxacin,ampicillin and levofloxacin,and these findings provide important references for clinical treatment of urinary tract infections.

Electrocardiogram (ECG) signal is an important basis for the diagnosis of arrhythmia and myocardial infarction. In order to further improve the classification effect of arrhythmia and myocardial infarction, an ECG classification algorithm based on Convolutional vision Transformer (CvT) and multimodal image fusion was proposed. Through Gramian summation angular field (GASF), Gramian difference angular field (GADF) and recurrence plot (RP), the one-dimensional ECG signal was converted into three different modes of two-dimensional images, and fused into a multimodal fusion image containing more features. The CvT-13 model could take into account local and global information when processing the fused image, thus effectively improving the classification performance. On the MIT-BIH arrhythmia dataset and the PTB myocardial infarction dataset, the algorithm achieved a combined accuracy of 99.9% for the classification of five arrhythmias and 99.8% for the classification of myocardial infarction. The experiments show that the high-precision computer-assisted intelligent classification method is superior and can effectively improve the diagnostic efficiency of arrhythmia as well as myocardial infarction and other cardiac diseases.
Humans ; Electrocardiography ; Heart Diseases ; Myocardial Infarction/diagnostic imaging* ; Algorithms ; Electric Power Supplies

Objective To explore the prognostic factors of the pathological complete response of internal mammary lymph node (ipCR) after neoadjuvant chemotherapy and its effect on breast cancer prognosis. Methods We retrospectively analyzed the clinical data of 70 patients with primary breast cancer with internal mammary lymph node metastasis who received neoadjuvant chemotherapy. Patients were divided into the ipCR group and non-ipCR group based on their postoperative pathology. χ² test, Fisher, and Logistic regression were used for univariate and multivariate analysis. Meanwhile, the Kaplan-Meier curve and Cox regression were used for prognostic analysis. Results Of 70 patients, 31 obtained ipCR (44.3%). Univariate analysis showed that the expression levels of apCR, HR, and HER2 status were related to ipCR (P < 0.05). Multivariate analysis showed that age, apCR, and HER2 status were independent predictors of ipCR (P < 0.05). The average DFS of ipCR group was better than non-ipCR group (96.0 vs. 67.1 months, P < 0.05). The risk of recurrence and metastasis was 87% lower in the ipCR group than in the non-ipCR group (HR=0.13, 95%CI: 0.04-0.44, P < 0.01). ipCR, Ki67 expression level, and breast pCR (bpCR) were independent factors affecting patients' prognosis. Conclusion There is a correlation between clinico pathological factors and ipCR after neoadjuvant chemotherapy. ipCR can be used to predict the prognosis of patients with internal mammary lymph node metastasis.

Objective: To explore the characteristics and relationship between physical activity and self-efficacy of college students during the COVID-19 epidemic, so as to provide evidence for the orderly development of physical education and curriculum reform of college students after their return to school. Methods: A total of 6 227 college students were collected from 8 districts of China by using convenient sampling method and snowball sampling method, and the physical activity and self-efficacy of all participants were assessed used by the International Physical Activity Questionnaire Short Form (IPAQ-S) and the General Self-Efficacy Scale(GSES). Results: In the terms of general self-efficacy, the score of male students was significantly higher than that of female students, the score of freshman was significantly higher than that of other grades(t/F=7.32, 5.56, P<0.01). In terms of physical activity, the middle and high level physical activity of girls was significantly higher than that of boys, but the proportion of boys meeting the recommended amount was higher(P<0.01). Low level physical activity was the highest in junior college students(31.75%), medium level physical activity was the highest in freshmen (46.75%) and sophomore student (48.13%), and high level physical activity was the highest senior college students (30.40%). The moderate level of physical activity was the highest in all BMI groups, while the lean group had the lowest level of low level physical activity (15.70%) and the highest level of high level physical activity(37.31%), and the lowest proportion meeting the recommended amount(P<0.05). Self-efficacy had a positive predictive effect on physical activity(OR=1.04, 95%CI=1.03-1.05). Conclusion During the COVID-19 epidemic, there are significant differences in general self-efficacy and physical activity among college students by gender, grade and BMI. The general self-efficacy has a positive impact on physical activity, suggesting that college physical education should pay attention to students- self-efficacy, while considering individual and group differences, and promote physical activity level through self-efficacy improvement.

Objective To systematically evaluate the risk of primary lung cancer in breast cancer patients. Methods A computer-based search was conducted for the English literatures about the risk of primary lung cancer in breast cancer patients in Medline, Scopus and Embase databases. Two researchers independently screened the literatures, extracted the data and assessed the risk of bias. The statistical analysis was performed using the Stata 15.5 software. Results A total of 7 references were included, and the overall risk of primary lung cancer in female breast cancer patients was slightly higher than that in the general population (SIR: 1.18, 95%CI: 1.09-1.27). Subgroup analysis showed that the risk of lung cancer was significantly increased in women aged < 50 years after diagnosis of breast cancer (SIR: 1.99, 95%CI: 1.48-2.69). Conclusion Compared with the general population, the risk of primary lung cancer is increased in female breast cancer patients, especially in young women with breast cancer.

Objective:To evaluate the incidence intensity of hand, foot, and mouth disease (HFMD) in 2018/2019 season in southern China by Moving Epidemic Method (MEM), and compare the intensity among provinces, so as to provide basis for optimizing the allocation of public health resources.Methods:The weekly incidence data of HFMD of children under 5 years old in 15 provinces of southern China from March 1, 2012 to February 28, 2019 were collected from Disease Surveillance Reporting System of Chinese Center for Disease Control and Prevention, and the epidemic intensity threshold of each province in southern China during this period was calculated and evaluated by MEM.Results:In the first incidence peak of 2018/2019 HFMD season, in 15 provinces in the south China, 6 provinces (Jiangsu, Zhejiang, Jiangxi, Chongqing, Sichuan and Yunnan) reported very high incidence rates in children under 5 years old while Guangdong, Guangxi and Hainan provinces had low incidence level. In the second incidence peak, the incidences in 6 provinces (Shanghai, Jiangsu, Zhejiang, Chongqing, Sichuan and Yunnan) reached very high levels. The incidences in remaining provinces also reached medium or high levels. In most provinces, the thresholds in the first incidence peak were higher than those in the second incidence peak, but Chongqing and Sichuan were different. The results of model validation showed that the sensitivity and specificity of MEM were higher than 70% except for Hainan, Chongqing and Yunnan.Conclusions:For southern provinces with two incidence peaks in HFMD season, MEM can be used to determine the epidemic intensity thresholds of different incidence peaks by dividing the disease season to analyze the incidence intensity of HFMD in different stages. The epidemic intensity threshold established by MEM integrates the historical data, and the province (city) with extremely high epidemic level identified represents that the province (city) has an abnormal increase compared with the historical incidence level, which requires more attention from all areas and timely implementation of prevention and control measures.