Objective A scoping review of domestically and internationally published studies on finite element analysis(FEA)based on three-dimensional(3D)human body model in preventing pressure ulcer(PU)was conducted,aiming to provide new directions for improving the prevention strategies of pressure ulcer.Methods We conducted a systematic search in both Chinese and English medical databases,including PubMed,Embase,CINAHL,Web of Science,Cochrane Library,Sinomed,CNKI,Wanfang and VIP,and engineering database(Engineering Village Compen-dex).The search period was from the inception of each database to July 29,2024.The information was extracted,and the results were analyzed and standardized for reporting.Results A total of 30 studies were included.The general methods of FEA based on 3D human body model include establishing geometric model,meshing,defining material properties,loading and setting boundary conditions,and solving equations.According to the contents of studies,they could be categorized into 4 distinct application domains,including identification of risk groups(n=9),position management(n=9),preventive dressings(n=10)and supportive surfaces(n=7).Conclusion FEA based on 3D human body model provides a foundation to PU biomechanical mechanism research and a scientific basis to the supplement and optimization of clinical prevention.Future studies should integrate clinical problems with simulations and further optimize simulations techniques and protocols.

Objective:To use machine learning to predict the efficacy of accelerated corneal collagen cross-linking (A-CXL) surgery, identify prognostic factors, and construct models to predict postoperative disease progression.Methods:A single-center retrospective study was conducted.A total of 82 keratoconus patients (112 eyes) who underwent A-CXL surgery at the West China Hospital of Sichuan University between March and December 2021 were enrolled.Preoperative and follow-up examinations included anterior segment evaluation by slit-lamp microscopy, corneal topography using Pentacam, and corneal biomechanical indices using Corvis ST.Disease progression was defined as an increase in maximum keratometry (Kmax) of ≥1 D from the preoperative level at the last follow-up.Various machine learning algorithms were employed to analyze corneal topography, biomechanical parameters and corneal densitometry values to identify prognostic factors and construct models for predicting postoperative disease progression.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of West China Hospital, Sichuan University (No.2023496).Written informed consent was obtained from each subject.Results:During follow-up, 15.1% (17/112) of the eyes showed progression after A-CXL.The preoperative astigmatism and stress-strain index (SSI) in the progression group were (-5.41±2.72)D and 1.41±0.78, respectively, which were significantly higher than (-3.30±2.54)D and 0.95±0.98 in the non-progression group ( t=2.80, 2.03; both P<0.05).Cox regression analysis identified preoperative astigmatism (hazard ratio [HR]=1.20), SSI (HR=1.10), and anterior corneal densitometry of 2-6 mm (CDA6) (HR=2.10) as significant risk factors for post-A-CXL progression.Among various machine learning models developed and validated, the area under the curve (AUC) values for logistic regression, multilayer perceptron (MLP) model, and random forest (RF) exceeded 0.700.For F1-score, the AUC values for logistic regression, MLP, and RF were 0.870, 0.880, and 0.880, respectively.The network structure of the visualized MLP was a single-layer, 24-neurons neural network with 80% accuracy in predicting whether progression occurred after A-CXL.The clinical nomogram developed in conjunction with astigmatism, SSI, and CDA6 predicted the cumulative probability of progression at 0.5, 1, and 2 years postoperatively based on the sum of the specified values for each variable, and based on the optimal cutoff value, keratoconus corneas could be classified into high-, intermediate-, and low-risk groups, respectively.The time-dependent subject operating characteristic curves of the nomogram showed AUCs of 0.734, 0.685, and 0.935 at 0.5, 1, and 2 years postoperatively, respectively, all of which performed well in predicting progression. Conclusions:Preoperative astigmatism, SSI, and CDA6 are significant risk factors for post-A-CXL progression in keratoconus.The MLP model can accurately predict postoperative disease progression, and the clinical nomogram combining preoperative astigmatism, SSI, and CDA6 can effectively differentiate between low-, medium-, and high-risk postoperative progression outcomes.

Aim To verify the therapeutic effect of the Qushi Huoxue decoction(QSHXF)on a mouse model of non-alcoholic fatty liver disease(NAFLD)using network pharmacology and experimental approaches,to examine the changes in the PI3K-AKT-lipid metabo-lism signaling pathway,and to elucidate its molecular mechanisms.Methods The potential active ingredi-ents and targets of the QSHXF were identified using the TCMSP platform.NAFLD-related genes were sourced from the GeneCards,PharmGkb,TTD,and OMIM data-bases.The intersection of drug targets and NAFLD treatment targets was analyzed to identify the key tar-gets of the QSHXF in treating NAFLD.The STRING database and Cytoscape 3.9.1 software were utilized to construct networks linking traditional Chinese medicine active ingredients to disease targets and PPI networks,allowing for the screening of key active ingredients and core targets.GO and KEGG enrichment analyses of the intersecting targets were conducted using R version 4.2.2.The NAFLD model was established by feeding mice a methionine-choline deficient diet for a duration of five weeks.Following successful modeling,low,me-dium,and high doses of the QSHXF were administered for intervention over a period of six weeks.The efficacy was verified and the underlying mechanisms were ex-plored using methods such as HE staining,Oil Red O staining,and Western blot analysis.Results The net-work pharmacology prediction indicated that QSHXF might effectively treat NAFLD through key components such as quercetin and kaempferol,as well as core tar-gets including STAT3,AKT1,and HIF1A.KEGG en-richment analysis further suggested that QSHXF might exert its therapeutic effects on NAFLD via signaling pathways such as AGE-RAGE and PI3K-AKT.Verifi-cation through animal experiments demonstrated that QSHXF could significantly reduce hepatic steatosis and lipid droplet accumulation in NAFLD mice.Specifical-ly,it markedly decreased serum levels of TC,TG,ALT,AST,and LDL,while increasing HDL levels.Addition-ally,the treatment significantly reduced the protein ex-pression levels of p-PI3K,p-AKT,SREBP-1c,FASN,and ACC1 in the liver.Conclusions QSHXF can sig-nificantly enhance liver function,improve blood lipid levels,and alleviate hepatic steatosis in NAFLD mice,with its mechanism potentially linked to the inhibition of the PI3K-AKT-lipid metabolism signaling pathway.

Objective To determine whether an intelligerct cloud platform follow-up model demonstrates superiority over conventional methods in enhancing follow-up quality,reducing costs,and improving functional recovery following total knee arthroplasty(TKA).Methods A retrospective cohort study was conducted on 260 patients undergoing TKA at our hospital from October 2022 to September 2023.According to the different postoperative follow-up methods,they were divided int a cloud platform group(n=130)and a traditional group(n=130).The baseline data,pre-and postoperative knee function scores,and follow-up costs were collected and compared between the 2 groups.Results The cloud platform group exhibited significantly higher rate of follow-up satisfaction,reduced resource utilization,shorter per-follow-up duration,fewer accompanying persons per visit,lower total follow-up expenditures,and decreased cumulative follow-up time when compared with the traditional group(P<0.05).At 6 weeks,3,6,and 12 months postoperatively,better range of motion(ROM)was observed in the cloud-based group than the traditional group(P<0.05),but no intergroup differences were seen in other knee function scores.Conclusion Cloud platform follow-up enhances early postoperative ROM(6 weeks to 12 months)and demonstrates marked cost-effectiveness when compared to the conventional mode.It represents a viable alternative for post-TKA rehabilitation surveillance.

Neuroscience,a cutting-edge field in interdisciplinary research,consistently draws considerable research interest,of which quantitatively probing the neurochemical dynamics is essential for brain science research.In vivoelectrochemical analysis,featuring with high sensitivity,high spatiotemporal resolution,free from transfection,and designable electrode/solution interfaces,provides important tools for in vivo neurochemicals sensing.Fast scan cyclic voltammetry combined with microelectrodes can not only enable precise detection of dopamine but also is compatible with existing neurosurgical equipment.This offers new opportunities for the clinical application of in vivo electrochemical analysis and paves new avenues for the diagnosis and treatment of neurological diseases.This review summarized recent progress of in vivo electrochemical techniques for brain neurochemistry and addressed key clinical challenges and their potential solutions.

Objective To explore the clinical significance and to investigate the expression of TOMM40L in the tis-sue of triple-negative breast cancer(TNBC).Methods The expression of TOMM40L in TNBC tissues and normal tissues was analyzed with TCGA and UALCAN databases.Univariate and multivariate Cox regression analysis and Nomogram model were used to evaluate the prognostic value of TOMM40L in TNBC patients.Furthermore,the ex-pression of TOMM40L in breast cancer cell lines was evaluated using Western blot analysis and quantitative real-time PCR.Specific siRNA knockdown was performed to evaluate the migration,and cell proliferation of TOMM40L.The potential signaling pathways of TOMM40L were identified by GO and KEGG and GSEA.Results TOMM40L was highly expressed in the TNBC compared to non-TNBC tumor tissues(P＜0.001).TOMM40L levels were en-hanced in TNBC cell lines as compared to other non-TNBC cell lines.CCK-8 and Transwell assay demonstrated that TOMM40L knockdown reduced the proliferation and migration of TNBCcell lines.Functional enrichment analysis showed that TOMM40L was involved in glucose metabolism-related pathways.Conclusions The expression of TOMM40L is increased in TNBC and is correlated with poor prognosis.TOMM40L may promote TNBC migration and proliferation.

Objective:To study the risk factors for combined bacterial/fungal infections in patients with severe fever with thrombocytopenia syndrome (SFTS) and to develop a novel and validated prediction model.Methods:The basic data and the results of the first laboratory examination after admission were retrospectively collected from patients diagnosed with SFTS who were hospitalized in the First Affiliated Hospital, Nanjing Medical University from January 2018 to December 2022. The patients were categorized into co-infected and non-co-infected groups according to whether they had co-infections with bacterial/fungal infections or not.Independent risk factors were screened by multivariate logistic regression analyses. A novel prediction model was constructed, and the predictive value of the model was assessed using receiver operating characteristic curve. Non-parametric tests and chi-square test were used for statistical analysis.Results:A total of 294 patients were included, and 62 cases were in the combined infection group including 39 cases of simple respiratory tract infections, 11 cases of simple bloodstream infections, four cases of simple urinary tract infections, four cases of respiratory tract combined with bloodstream infection, and four cases of respiratory tract combined with urinary tract infection. Acinetobacter baumannii was mostly found in bacterial infections, with a total of 19 strains, followed by Escherichia coli and Pseudomonas aeruginosa, both with seven strains. Aspergillus were mostly common in fungi, with a total of 16 strains which were all collected from patients with pulmonary infections. Compared with the non-co-infected group, patients in the co-infected group had longer hospital stays, with statistically significant differences ( Z=-6.18, P<0.001). The patients also had higher frequencies of bleeding symptoms, neurological symptoms, severe illness, and death, with statistically significant differences ( χ2=23.91, 16.37, 15.51 and 15.58, respectively, all P<0.001). The aspartate transaminase-to-platelet ratio index (APRI) was also higher in patients with coinfection, with a statistically significant difference ( Z=-4.64, P<0.001). Multivariate binary logistic regression showed that severe illness (odds ratio ( OR)=2.567, 95% confidence interval ( CI) 1.344 to 4.904, P=0.004), blood glucose level higher than 7.782 mmol/L ( OR=4.766, 95% CI 2.493 to 9.109, P<0.001), procalcitonin level higher than 0.228 μg/L ( OR=2.487, 95% CI 1.289 to 4.799, P=0.007), and APRI value higher than 6.268 ( OR=3.032, 95% CI 1.404 to 6.548, P=0.005) were the independent risk factors for co-infections in SFTS patients. Disease severity, blood glucose, procalcitonin, and APRI were combined to construct a novel predictive model: Infect-risk score=-3.331+ 0.654×severity (severe=1, non-severe=0)+ 0.160×blood glucose+ 0.066×procalcitonin+ 0.013×APRI. The AUC for this score was 0.764 (95% CI 0.698 to 0.830, P<0.001), with Youden index of 0.416, sensitivity of 0.839, and specificity of 0.578. Conclusions:Severe illness, blood glucose levels higher than 7.782 mmol/L, procalcitonin levels above 0.228 μg/L, and APRI values above 6.268 are independent risk factors for bacterial/fungal coinfection in SFTS patients. The constructed Infect-risk score model has good predictive value for bacterial/fungal coinfection in SFTS patients.

Objective:To explore the short-term clinical effects of deep cervical lymph node-venous anastomosis in the treatment of Alzheimer’s disease (AD).Methods:A prospective exploratory study was conducted on the treatment of AD patients using the cervical deep lymph node-venous anastomosis technique in Scar and Wound Treatment Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from September to October 2024. The patients underwent high-frequency ultrasound to locate deep cervical lymph nodes and the external jugular vein. Under general anesthesia, bilateral deep cervical lymph node-venous anastomoses were performed. Indocyanine green (ICG) lymphography was conducted via subcutaneous injection behind the ear to visualize lymph nodes in levels Ⅱ and Ⅲ. After making a skin incision along the posterior margin of the sternocleidomastoid muscle, the external jugular vein, internal jugular veins, and associated lymph nodes were exposed. Adjacent veins were selected for anastomosis of lymph node. Using microsurgical techniques, end-to-side or end-to-end anastomosis was completed for lymph nodes in levels Ⅱ and Ⅲ. Preoperative assessments included the mini-mental state examination (MMSE, a higher score indicates better cognitive function), Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog, a higher score indicates greater impairment of cognitive function), Alzheimer’s disease cooperative study scale for activities of daily living (ADCS-ADL, a higher score indicates better ability to perform daily activity), and neuropsychiatric inventory (NPI, a higher score indicates more severe behavioral and emotional symptom). Postoperative follow-up included the same scales to observe changes in cognitive function, activities of daily living, and emotional communication.Results:Four patients (1 male, 3 females, aged 58-79 years) with AD were included. All were diagnosed based on cerebrospinal fluid biomarkers. All patients successfully underwent bilateral deep cervical lymph node-venous anastomoses. On average, 4.3 (2-7 per person) anastomoses were performed per patient. Surgical procedures lasted an average of 6.5 h (5.5-8.5 h) with minimal blood loss (less than 50 ml). Patients resumed normal activity within 6 hours postoperatively and were discharged after an average of 4.1 d (3.5-5.0 d). Postoperative complications included one case each of aspiration pneumonia, lower limb venous thrombosis, and transient delirium, all of whom resolved without long-term effects. Clinical symptoms, including memory decline, mood swings, and anxiety, showed varying degrees of improvement. Patients reported enhanced quality of life, emotional stability, and social engagement, confirming the procedure’s safety and potential cognitive benefits. At one month postoperatively, the MMSE scores of the four patients increased by an average of 0.8 points compared to preoperative levels. Additionally, the two patients who completed the ADAS-Cog assessments showed a decrease in their scores (reduced by 1.0 points and 11.3 points, respectively, compared to preoperative scores), indicating a certain degree of improvement in cognitive function during this period. The ADCS-ADL and NPI scores of four patients varied significantly, without showing any clear pattern.Conclusion:Lymphovenous anastomosis of the deep cervical lymph node-venous anastomosis may provide a new surgical intervention approach for AD, but further large-scale studies and long-term follow-up are needed to validate its safety and effectiveness.

Menstrual migraine is a specific subtype of migraine unique to women,closely related to the menstrual cycle,characterized by periodic and intractable headaches,often accompanied by nausea,vomiting or photophobia and phonophobia,which seriously affects life and has a high degree of disability.Its pathogenesis is complex,involving multi-dimensional regulation such as estrogen fluctuations,neurovascular responses and genetic and environmental factors,but the specific mechanism has not been fully clarified.In recent years,with the increasing social attention to women's health,the clinical research demand for menstrual migraine has become increasingly urgent.Currently,modern medicine can alleviate symptoms through acute drug intervention(such as non-steroidal anti-inflammatory drugs,triptans)and preventive treatment(such as beta-blockers,CGRP antagonists),but there are problems such as drug dependence and insufficient individualization.Traditional Chinese medicine,based on the"holistic concept"and"syndrome differentiation and treatment"theory,regulates the balance of qi,blood,yin and yang through therapies such as traditional Chinese medicine and acupuncture,showing unique advantages in improving symptoms and preventing recurrence.The combination of traditional Chinese and Western medicine can optimize the therapeutic effect and reduce side effects through synergistic effects,but the full-cycle prevention and treatment strategy still needs further exploration.This article systematically reviews the pathogenesis and research progress of treatment of menstrual migraine in traditional Chinese and Western medicine,emphasizes the interaction between hormone fluctuations and neurovascular responses,and proposes an individualized intervention plan based on the menstrual cycle,providing new ideas for clinical practice and reference directions for future research.

Objective A scoping review of domestically and internationally published studies on finite element analysis(FEA)based on three-dimensional(3D)human body model in preventing pressure ulcer(PU)was conducted,aiming to provide new directions for improving the prevention strategies of pressure ulcer.Methods We conducted a systematic search in both Chinese and English medical databases,including PubMed,Embase,CINAHL,Web of Science,Cochrane Library,Sinomed,CNKI,Wanfang and VIP,and engineering database(Engineering Village Compen-dex).The search period was from the inception of each database to July 29,2024.The information was extracted,and the results were analyzed and standardized for reporting.Results A total of 30 studies were included.The general methods of FEA based on 3D human body model include establishing geometric model,meshing,defining material properties,loading and setting boundary conditions,and solving equations.According to the contents of studies,they could be categorized into 4 distinct application domains,including identification of risk groups(n=9),position management(n=9),preventive dressings(n=10)and supportive surfaces(n=7).Conclusion FEA based on 3D human body model provides a foundation to PU biomechanical mechanism research and a scientific basis to the supplement and optimization of clinical prevention.Future studies should integrate clinical problems with simulations and further optimize simulations techniques and protocols.