ObjectiveTo analyze the research status and development trends of non-pharmacological therapies for post-stroke spasticity (PSS) over the past two decades. MethodsRelevant literatures on non-pharmacological rehabilitation of PSS published from January, 2004 to June, 2024 were retrieved from Web of Science Core Collection. CiteSpace 6.3.R6 and VOSviewer 1.6.18 were used for visualization analysis. ResultsA total of 780 publications were included. The annual number of publications showed an overall upward trend. China, the USA, and Italy contributed the highest number of publications. The Hong Kong Polytechnic University and researcher Noureddin Nakhostin Ansari were identified as the most influential institution and author, respectively. High-frequency keywords and cluster labels included electric stimulation, transcranial magnetic stimulation, robot and acupuncture. ConclusionOver the past 20 years, researches on non-pharmacological therapies for PSS have remained active, with hotspots focusing on diverse interventions such as electrical stimulation, magnetic stimulation and robot-assisted therapy.

Among chronic hepatitis B patients undergoing long-term treatment with nucleos（t）ide analogues （NAs）， approximately 10%—20% can achieve a low level of <100 IU/mL for hepatitis B surface antigen （HBsAg）. These patients have the advantage to achieve clinical cure （HBsAg clearance） and are currently a key focus for treatment discontinuation and combination treatment strategies. As for the selection of clinical management strategies， the NAs discontinuation strategy， based on the “immune reactivation” hypothesis， may lead to HBsAg clearance in some patients， especially among Caucasians， but the risk of recurrence after discontinuation cannot be neglected. The treatment strategies based on pegylated interferon-α exhibit a higher potential for active HBsAg clearance， and some novel immunomodulators have also shown preliminary efficacy. Overall， for patients with HBsAg <100 IU/mL previously treated with NAs， treatment discontinuation or active combination treatment should be carefully assessed based on individual risk-benefit profiles. In the future， it is essential to incorporate more refined biomarkers for precise stratification and explore novel combination regimens with finite treatment courses that are safe and highly effective， in order to help more patients achieve clinical cure and reduce long-term risks of liver disease.

Severe acute pancreatitis （SAP） is closely related to dysfunction of the spleen-stomach ascent and descent. Due to the influence of modern lifestyle and dietary factors， Qi deficiency in the spleen and stomach has become the pathological basis of SAP. Its pathogenesis is characterized by dampness， heat， pathogenic factors， stasis， stagnation， obstruction， Fu-organs Qi obstruction， pathogenic excess， and healthy Qi deficiency. At different stages of the disease course of SAP， there is a focus on both pathogenic excess and healthy Qi deficiency. It is specifically manifested as Fu-organs stagnation and heat accumulation， as well as pathogenic excess and healthy Qi deficiency， during the systemic inflammatory response phase， intermingling of blood stasis and pathogenic factors， as well as Qi deficiency and blood stasis， during the infection period， and weakness of the spleen and stomach， as well as healthy Qi deficiency and lingering pathogenic factors， during the residual infection period. Based on the theory that "the spleen and stomach are the acquired foundation"， a staged treatment method centered on the core principle of "strengthening healthy Qi to eliminate pathogenic factors" was developed. The staged treatment method included "clearing the Fu-organs to expel turbidity， replenishing Qi to harmonize the stomach， activating blood circulation to expel pathogenic factors， replenishing Qi to relieve pain， promoting digestion to stimulate appetite， and replenishing Qi to invigorate the spleen". In clinical practice， Hewei Tongxie mixture， Yikang mixture， and Shiwei Jianpi Xiaoshi powder were selected for staged treatment of SAP. This article systematically summarized the theoretical basis of traditional Chinese medicine， Western medicine foundation， modern pharmacological mechanisms， and clinical application experience of the staged treatment of SAP with "strengthening the healthy Qi to eliminate pathogenic factors"， providing new ideas for the treatment of SAP with traditional Chinese medicine.

ObjectiveTo avoid stress responses in experimental monkeys caused by direct capture, and to improve the adaptability and experimental efficiency of marmosets in behavioral, two-photon imaging, and electrophysiological experiments, a device for immobilizing marmosets without the need for capture is developed. MethodsA set of compatible transport cage and monkey chair was produced through 3D graphic design and printing. First, the transport cage was aligned with the feeding outlet of the experimental housing cage, and the marmoset was gently guided into the transport cage. Then, the transport cage was connected to the monkey chair, and the marmoset was gently guided into the chair for immobilization. Subsequent experiments were carried out afterward. The effectiveness was evaluated by observing the efficiency of transport and immobilization, the marmoset cooperation level, and stress responses. ResultsAfter testing and improvements, the device successfully completed immobilization of marmosets without the need for capture, significantly improving the fluency and efficiency of the experiment. As the number of operations increased, the marmosets became more cooperative, and the operation speed was significantly enhanced. After using the device, the stress responses were noticeably reduced, with marmosets showing lower stress levels. In particular, compared to traditional capture methods, the use of this device significantly reduced marmoset anxiety and discomfort, increasing their cooperation levels during the experiment. ConclusionThe monkey chair device designed allows for restraint of marmosets without the need for capture, ensuring smooth progress of subsequent experiments while also safeguarding animal welfare. This device is easy to operate, highly practical, cost-effective, and has great potential for widespread application.

Atopic dermatitis （AD） is a common pruritic and chronic inflammatory dermatosis in clinical practice and is one of the diseases responding specifically to traditional Chinese medicine （TCM）. With the launch of biological agents and small molecule drugs and the development and implementation of guidelines of diagnosis and treatment， clinical pathways of treatment of moderate to severe AD， and consensus on the whole-process management of AD， the clinical efficacy of moderate to severe AD has been significantly improved. However， there are still many unmet clinical needs that require more effective methods to meet. In response to the Opinions of the CPC Central Committee and the State Council on Facilitating the Inheritance， Innovation， and Development of Traditional Chinese Medicine and the spirit of the National Conference on TCM， the China Association of Chinese Medicine organized more than 20 experts in TCM dermatology， Western medicine dermatology， interdisciplinary fields， and industries to discuss the difficulties and advantages of TCM in the treatment of AD. TCM treatment for AD can not only improve rash and relieve itching but also solve many concomitant syndromes. The abundant external treatment methods of TCM have advantages for different special populations and rash characteristics. The concept of treating disease before its onset in TCM is in line with the chronic disease management mode of prevention and treatment of atopic march and prevention of recurrence. In addition， TCM therapy can reduce the use of topical glucocorticoids and has good safety. Regarding the comorbidity of AD， equal emphasis on TCM and Western medicine and multidisciplinary joint treatment should be advocated to achieve maximum benefit for patients. The exchange of TCM and Western medicine has clarified the positioning and advantages of TCM intervention in AD， providing guidance for clinical and scientific research.

Objective:To explore the application effect of 3D technology-assisted teaching based on "four-in-one" flipped classroom in clinical teaching of neurosurgery, and provide a basis for optimizing the medical education mode.Methods:A total of 50 students from the Second Clinical College were selected between June 2020 and June 2024, including eight-year program medical students and postgraduate neurosurgery students. The control group ( n=25) received the conventional teaching mode. The experimental group ( n=25) was taught using the "four-in-one" flipped classroom combined with 3D technology, including characteristic textbooks with 3D model drawings, Internet platforms (video libraries and virtual simulation modules), mobile interactive terminals (real-time question and answer), and virtual simulation technology. Effectiveness was evaluated through theoretical assessment (e.g., neuroanatomy and clinical application ability, with a total score of 100 points), operational assessment (e.g., surgical design and aseptic concept, with a total score of 100 points), and a teaching quality questionnaire. Independent samples t-test was conducted using SPSS 22.0. Results:The total score of theoretical assessment was higher in the experimental group than that in the control group [(86.52±5.21) vs. (73.56±6.32), P<0.001], with the largest difference observed in case analysis questions [(26.03±3.65) vs. (22.22±3.50), P=0.001]. In the operational assessment, the experimental group performed better in "surgical process design" [(26.30±4.14) vs. (21.44±3.45), P<0.001] and "aseptic concept" [(8.18±0.98) vs. (6.64±0.79), P<0.001]. The teaching quality questionnaire showed that the experimental group scored higher in "clinical practice skill enhancement" [(23.13±1.39) vs. (21.45±1.86), P=0.001] and "self-directed learning motivation" [(21.84±1.60) vs. (19.75±1.45), P<0.001]. Conclusions:The combination of "four-in-one" flipped classroom and 3D technology can significantly improve the teaching effectiveness of neurosurgery, especially in the cultivation of clinical thinking and practical abilities. This approach is worth promoting.

Objective To investigate the underlying mechanisms contributing to the limited therapeutic efficacy of endocrine therapy combined with CDK4/6 inhibitors in HR+/HER2-low breast cancer,and to develop a breast cancer organoid model as a tool for the precise identification of HR+/HER2-low patients who are responsive to pan-TKI treatment.Methods Transcriptomics was employed to identify differentially expressed genes in HR+/HER2-0 and HR+/HER2-low breast cancer samples and to perform functional enrichment analysis.Tumor organoid models were established using breast cancer tissues obtained from clinical sources,and the differential sensitivity of these samples to therapeutic agents was assessed using Calcein-AM/PI cell viability staining and EdU-based cell proliferation assays.Results The results of transcriptomic enrichment analysis indicated that EGFR was signifi-cantly activated in HR+/HER2-low breast cancer and exhibited characteristics of resistance to TKIs.Breast cancer organoids were successfully established.Drug sensitivity testing revealed that the therapeutic efficacy of ET combined with CDK4/6 inhibitors was suboptimal in certain cases of HR+/HER2-low breast cancer,while the addition of TKIs effectively restored sensitivity to the ET+CDK4/6 inhibitor regimen(P<0.05).Conclusions TKI can restore the reduced sensitivity of HR+/HER2-low breast cancer to endocrine therapy combined with CDK4/6 inhibitors.Breast cancer organoids hold promise as screening tools for assessing drug sensitivity in clinical settings for patients with HR+/HER2-low breast cancer.

Objective:To analyze the clinical features of patients with traumatic optic neuropathy (TON) and to explore its clinical patterns and treatment outcomes.Methods:A retrospective analysis was conducted on data from 323 patients (334 eyes) with TON, who were treated in the Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Qingdao University from April 1999 to October 2024. Among these patients, 288 were male and 35 were female, with ages ranging from 4 to 70 years. All patients were followed up for a period of 6 to 24 months, with the final follow-up visual acuity recorded as the ultimate visual outcome. The visual acuity evaluation criteria were classified into five levels: no light perception, light perception, hand movement in front of the eye, counting fingers at 1 meter, and "chart-visible acuity". A treatment outcome was deemed effective if the post-treatment visual acuity improved by one level or more compared to pre-treatment, or if the chart-visible acuity improved by two lines or more on the logMAR chart. The clinical characteristics of patients, causes of injury, complications, treatment methods, and changes in visual acuity before and after treatment were summarized. Logistic regression analyses were performed to identify the influencing factors affecting treatment efficacy.Results:TON occurred mostly in young (215/323, 66.56%) males (288/323, 89.16%), the majority of patients came from villages and towns (236/323, 73.07%). Traffic accidents (232/323, 71.83%) remained the main etiology. Most patients had craniofacial injuries and other bodily injuries. The effective rate of vision improvement was 50.30% (168/334). Multiple logistic regression analyses identified that residual vision (light perception or better) at presentation ( OR=3.26, P<0.001) and receiving treatment within 7 days after injury ( OR=2.04, P=0.008) were protective factors on visual acuity recovery, while the presence of orbital wall fracture was a risk factor for visual acuity recovery ( OR=0.26, P<0.001). Additionally, undergoing surgical treatment was a protective factor for visual improvement in patients with no light perception ( OR=2.94, P=0.007). For patients with residual vision at presentation, orbital wall fracture was a significant risk factor ( OR=0.28, P=0.009). Conclusions:TON is more prevalent in young males and is primarily caused by traffic accidents, leading to a poor prognosis. Timely medical intervention following injury significantly influences prognostic outcomes. Early surgical intervention (within 7 days) is recommended, particularly for patients with no light perception at presentation.

To assess the cross-contamination risk and genetic evolution ofStaphylococcus aureus(S.aureus)at various stages in a swine slaughterhouse,and to provide a reference for risk evalua-tion and control measures of S.aureus contamination during swine slaughtering,we conducted whole-genome sequencing on 31 isolates of S.aureus collected and preserved from the slaughter-house.Bioinformatics analyses were performed to investigate the genomic characteristics and genet-ic relationships of these isolates.Results revealed cross-contamination across different slaughter-house stages,predominantly with ST398-t1451 strains.Additionally,highly virulent ST9-t899 strains and ST398-t11 strains with numerous resistance genes were detected at various stages.The strains predominantly carried virulence genes such as hlgA,hlgB,and hlgC,with varying num-bers of resistance genes.Notably,two strains carried the optrA gene and three strains carried the cfr gene;the presence of the optrA gene is relatively rare among S.aureus.These genes confer re-sistance to novel synthetic antibiotics such as oxazolidinones and florfenicol and have the potential for horizontal gene transfer,increasing the risk of dissemination both within and beyond the slaughterhouse.Importantly,the study also detected a LA-MRSA-ST9 strain in water samples from the slaughterhouse,which could potentially infect humans.This strain exhibits zoonotic char-acteristics,highlighting the need for stricter protective measures for slaughterhouse workers to mitigate occupational exposure and infection risks.

Objective:To translate the quality of life tool for patients with aplastic anaemia and paroxysmal nocturnal haemoglobinuria (QLQ-AA/PNH) into Chinese, and to test its reliability and validity.Methods:According to the scale translation principle, the Chinese version of QLQ-AA/PNH was formed through translation, back translation and cross-cultural adaptation. A cross-sectional survey method was used to conveniently select 58 patients with aplastic anemia who were treated in the hematology department of the Second Affiliated Hospital of Dalian Medical University from January 2018 to September 2023 for investigation, and to evaluate the reliability and validity of the scale.Results:The Chinese version of QLQ-AA/PNH retains 36 items, and 5 common factors (psychological status dimension, life burden dimension, physical condition dimension, illness anxiety dimension and other symptom dimension) were extracted through exploratory factor analysis. The cumulative variance contribution rate reached 71.33%, and the factor load of each entry was greater than 0.5 on corresponding common factors. The Cronbach α coefficient of the scale as a whole was 0.971, the broken half reliability coefficient was 0.985, the Cronbach α coefficient of each common factor was 0.637 to 0.954, and the broken half reliability coefficient was 0.637 to 0.930. Conclusions:The Chinese version of QLQ-AA/PNH has been proved to be valid and reliable. It is a valuable tool for evaluating the quality of life among patients with aplastic anaemia.