Objective: To develop a depression recognition model by integrating the spirit-expression diagnostic framework of traditional Chinese medicine (TCM) with machine learning algorithms. The proposed model seeks to establish a TCM-informed tool for early depression screening, thereby bridging traditional diagnostic principles with modern computational approaches. Methods: The study included patients with depression who visited the Shanghai Pudong New Area Mental Health Center from October 1, 2022 to October 1, 2023, as well as students and teachers from Shanghai University of Traditional Chinese Medicine during the same period as the healthy control group. Videos of 3 – 10 s were captured using a Xiaomi Pad 5, and the TCM spirit and expressions were determined by TCM experts (at least 3 out of 5 experts agreed to determine the category of TCM spirit and expressions). Basic information, facial images, and interview information were collected through a portable TCM intelligent analysis and diagnosis device, and facial diagnosis features were extracted using the Open CV computer vision library technology. Statistical analysis methods such as parametric and non-parametric tests were used to analyze the baseline data, TCM spirit and expression features, and facial diagnosis feature parameters of the two groups, to compare the differences in TCM spirit and expression and facial features. Five machine learning algorithms, including extreme gradient boosting (XGBoost), decision tree (DT), Bernoulli naive Bayes (BernoulliNB), support vector machine (SVM), and k-nearest neighbor (KNN) classification, were used to construct a depression recognition model based on the fusion of TCM spirit and expression features. The performance of the model was evaluated using metrics such as accuracy, precision, and the area under the receiver operating characteristic (ROC) curve (AUC). The model results were explained using the Shapley Additive exPlanations (SHAP). Results: A total of 93 depression patients and 87 healthy individuals were ultimately included in this study. There was no statistically significant difference in the baseline characteristics between the two groups (P > 0.05). The differences in the characteristics of the spirit and expressions in TCM and facial features between the two groups were shown as follows. (i) Quantispirit facial analysis revealed that depression patients exhibited significantly reduced facial spirit and luminance compared with healthy controls (P < 0.05), with characteristic features such as sad expressions, facial erythema, and changes in the lip color ranging from erythematous to cyanotic. (ii) Depressed patients exhibited significantly lower values in facial complexion L, lip L, and a values, and gloss index, but higher values in facial complexion a and b, lip b, low gloss index, and matte index (all P < 0.05). (iii) The results of multiple models show that the XGBoost-based depression recognition model, integrating the TCM “spirit-expression” diagnostic framework, achieved an accuracy of 98.61% and significantly outperformed four benchmark algorithms—DT, BernoulliNB, SVM, and KNN (P < 0.01). (iv) The SHAP visualization results show that in the recognition model constructed by the XGBoost algorithm, the complexion b value, categories of facial spirit, high gloss index, low gloss index, categories of facial expression and texture features have significant contribution to the model. Conclusion This study demonstrates that integrating TCM spirit-expression diagnostic features with machine learning enables the construction of a high-precision depression detection model, offering a novel paradigm for objective depression diagnosis.

ObjectiveTo investigate the epidemiological and clinical characteristics of human bocavirus (HBoV) in hospitalized children with acute lower respiratory tract infection (ALRTI) at a single-center children’s hospital in Shanghai, thereby providing evidence for the diagnosis, treatment, and prevention of HBoV infection. MethodsA retrospective study was conducted on 19 537 hospitalized children with ALRTI at Shanghai Children’s Hospital from January 2021 to December 2023. Multiplex polymerase chain reaction (PCR) combined with capillary electrophoresis was used to detect HBoV and 12 other common respiratory viruses /atypical pathogens. The positive detection rate, demographic characteristics (sex, age), temporal distribution (year, season) of HBoV, as well as the clinical characteristics of severe and non-severe pneumonia were analyzed. ResultsThe overall HBoV-positive rate was 2.57% (503/19 537), with 59.44% (299/503) being single infections and 40.56% (204/503) being co-infections. The positive detection rate was significantly higher in boys than that in girls (2.78% vs 2.33%, χ²=3.88, P=0.049). The highest infection rate was observed in toddlers, followed by infants (χ²=379.57, P<0.001). The positive rate peaked in 2021 and reached its lowest point in 2023 (χ²=45.49, P<0.001), with epidemics mainly prevalent in summer and autumn. The main clinical symptoms were cough (90.06%, 453/503), fever (75.94%, 382/503), and wheezing (39.96%, 201/503). Children with severe pneumonia showed a higher incidence of wheezing compared with the non-severe group (P<0.001), while underlying diseases and co-infections had no significant association with disease severity (P>0.05). ConclusionHBoV was an important pathogen of ALRTI in children, predominantly affecting infants and toddlers, with higher susceptibility in boys and seasonal peaks in autumn and summer. The main clinical manifestations included cough, fever, and wheezing, with wheezing being more prevalent in children with severe pneumonia.

Objective To explore the effect of external attentional focus strategy on walking function after stroke.Methods From July to December 2024,40 stroke patients admitted in Beijing Bo'ai Hospital were randomly divided into control group(n=20)and experimental group(n=20).Both groups underwent conventional rehabilitation.On this basis,the control group received conventional walking training,while the experimental group received walk-ing training based on external attentional focus strategy,for three weeks.Before and after training,they were as-sessed with Gait Watch 3D gait analysis,Timed Up and Go Test(TUGT),Berg Balance Scale(BBS)and Fugl-Meyer Assessment-Lower Extremities(FMA-LE).Results After training,the step speed,step frequency,walking cycle,time of TUGT,and the scores of BBS and FMA-LE improved in both groups(|t|>3.098,P<0.01),and the step speed,step frequency,walking cycle and the score of FMA-LE improved more in the experimental group than in the control group(|t|>2.572,P<0.05).Conclusion External attentional focus strategy can improve the walking function of patients with stroke.

Objective:To systematically evaluate studies validating the performance of the Global Leadership Initiative on Malnutrition (GLIM) in diagnosing malnutrition.Methods:Seven Chinese and English databases including Embase, Web of Science (WOS), PubMed, CINAHL, Cochrane Library, SinoMed, CNKI, Wanfang Data, and VIP Database were searched for articles on the validation of GLIM criteria published between September 2018 and September 2024. Two researchers independently performed literature screening and data extraction. The concurrent and predictive validity of the criteria was analyzed.Results:A total of 136 papers were included for analysis. The GLIM criteria for diagnosing malnutrition had a sensitivity of 77%, a specificity of 87%, and an area under the curve (AUC) of 0.90. Malnutrition diagnosed by the GLIM criteria predicted prolonged hospital and intensive care unit (ICU) stays, increased readmission and complication rates (both overall and infectious), reduced survivals (median, overall, and disease-free), and increased in-hospital and follow-up mortalities. Both moderate and severe malnutrition predicted decreased overall survival. However, only three studies analyzed the impact of nutritional therapy on the clinical outcomes of malnourished patients.Conclusions:The GLIM criteria accurately differentiate malnutrition and are a valid predictive tool of clinical outcomes. However, the validity criteria in these validation studies were questionable, along with high methodological heterogeneity. Furthermore, there is a lack of studies validating the role of nutritional therapy in improving the clinical outcomes of malnourished patients.

Obese type 2 diabetes belongs to the category of"consumptive thirst"in traditional Chinese medicine,and obesity is its main cause.This paper summarizes the pathogenesis of obese type 2 diabetes from three aspects:thirst caused by fat evil,deficiency caused by fat evil,and fat evil causing various pathogens.That is to say,the congestion of fat evil produces heat and hurts Yin,lead-ing to consumptive thirst.The accumulation of ointment and fat will damage Yang in the middle energizer and hinder spleen transport.Phlegm and dampness originate from spleen deficiency,which gather in veins and generate blood stasis and heat.The com-plicated combination of phlegm,blood stasis and heat leads to the relapse or development of consumptive thirst.Based on the theory of"maintaining the sweet and restoring the body fluids",this paper skillfully uses sweet herbs and cooperates with other nature and flavors to treat the pathogenesis of"thirst,deficiency and blood stasis"caused by fat evil injuring body fluids,to achieve the purposes of clear-ing away heat and nourishing Yin,strengthening spleen and protecting middle energizer,removing turbidity and blood stasis.Finally,the body fluid is continuously produced,transported smoothly,and the consumptive thirst is relieved.

Objective To investigate the effect of two treatment regimens combining Tacrolimus(TAC)with different Rituximab(RTX)dosages,and to provide clinical reference for treatment strategies.Methods A retrospective analysis was conducted on patients diagnosed with idiopathic membranous nephropathy(IMN)and treated with RTX combined with TAC regimen(RTX+TAC group and low-dose RTX+TAC group)in The First Affiliated Hospital of Xinxiang Medical University.Propensity score matching(PSM)was performed at a 1:1 ratio,and a total of 60 patients were enrolled,with 30 in each group.In low-dose RTX(375 mg/m2 at the first and fifteenth day respectively)+TAC group,if circulating B cells(CD19?)exceeded 5 cells/μL after 3 months,a 200 mg RTX infusion was administered.In RTX(1g at the first and fifteenth day respectively)+TAC group,if complete remission(CR)was not achieved by 6 months,an additional 1000 mg RTX infusion was administered.The incidence of CR,partial remission,and adverse events were followed up for 12 months after medication in both groups.Results(1)Both groups showed significant reductions in 24-hour proteinuria,with the RTX+TAC group demonstrating a notably higher decrease compared to the low-dose RTX+TAC group.Statistical differences were observed between the two groups at the 1st and 3rd months of treatment(P<0.05).Albumin levels gradually increased,and there were differ-ences between the two groups at both the 1st and 3rd months(P<0.05).The anti-phospholipase A2 antibody levels decreased significantly after one month of treatment[3.45(1.90,22.10)vs.3.28(8.30,23.08)RU/mL],P>0.05.At 3 months of treatment,the overall clinical remission rate was 63.3％for the RTX+TAC group compared to 36.7％for the low-dose RTX+TAC group(P<0.05).At 12 months,the RTX+TAC group achieved an overall remission rate of 86.7％,while the low-dose RTX+TAC group reached 83.3％,showing no statistical significance(P>0.05).After one month of treatment,the RTX+TAC group achieved a complete serological immunological remission rate of 33.3％,significantly higher than the 3.3％in the low-dose RTX+TAC group(P<0.05).(2)The cumulative remission rate of the RTX+TAC group was higher than that of the low-dose RTX+TAC group during the first 6 months of follow-up.The remission rate in the low-dose RTX+TAC group increased significantly after 6 months.Log-rank test showed no statistical difference between the survival curves of the two groups(P=0.37).(3)Based on a multifactorial COX regression analysis of factors related to remission in patients with IMN,for every unit increase in serum immunological remission time,the risk of patients achieving remission decreased by 13.5％(HR=0.87,P=0.016).The risk of remission for patients with high titers of anti-PLA2R antibodies decreased by 60.2％(HR=0.39,P=0.018).Conclusions Different RTX dosages yielded comparable overall clinical remission rates without significantly increasing adverse events.RTX+TAC regimen achieves higher early CR rate.Serological remission time and high titer anti-PLA2R antibodies are associated with clinical outcomes.

Objective:To investigate the effect of orbital suspension training on muscle thickness,balance and walking ability in stroke patients with hemiplegia.Method:From October 2023 to January 2025,40 stroke patients with hemiplegia,having a Holden walking function grade of ≥1 and＜3 were randomly divided into a treatment group and a control group,with 20 pa-tients in each group.Both groups received conventional physiotherapy,while the treatment group was received orbital suspension training on this basis for 4 weeks.The Berg balance scale(BBS)and Holden walking func-tion grading were used for efficacy evaluation before and after treatment.Muscle thickness of the bilateral ab-dominal muscle thickness,rectus femoral,tibialis anterior,biceps long head,and medial head thickness of gastrocnemius was measured using musculoskeletal ultrasound.Result:After treatment,the thickness of the external oblique muscles on both sides,the thickness of the rec-tus femoris muscle on the affected side,BBS score,and Holden walking function grading score improved in both groups(P＜0.05).The treatment group showed significant improvement compared to the control group in the thickness of the extemal oblique muscles on both sides,the internal oblique muscle on the affected side,the rectus femoris muscle on the affected side,the tibialis anterior muscle on the unaffected side,and the thickness of rectus femoris muscle to the long head of the biceps femoris muscle(P＜0.05).There was a mod-erate correlation between the difference in thickness of the rectus femoris muscle and the BBS score in both two groups(r:0.592,0.552).In the treatment group,the difference in thickness between the external oblique muscle and the healthy anterior tibialis muscle was related to the difference in BBS score(r:0.467,0.592).In the control group,the difference in thickness both the bilateral transverse abdominis muscles was related to the difference in BBS scores(r:0.581,0.499).Conclusion:Orbital suspension training can effectively improve balance and walking function.It also enhances the thickness of bilateral lateral oblique muscle,rectus femoris on the affected side,tibialis anterior muscle and thickness ratio of the rectus femoris to the biceps femoris on both sides.The change in thickness of rec-tus femoris muscle is related to the improvement of balance function.

Objective To observe the effect of preoperative exercise on consciousness,lung function and recovery efficiency of patients undergoing ventriculoperitoneal shunt.Methods A total of 54 patients undergoing elective ventriculoperitoneal shunt in Beijing Bo'ai Hospital from October,2024 to March,2025 were randomly divided into control group(n=27)and prerehabilitation group(n=27).The control group received routine preoperative treatment and nursing,while the prerehabilitation group additionally received exercise for two weeks.They were assessed with Coma Recovery Scale-Revised(CRS-R),and observed diaphragm mobility with sonography,before and three days after operation;and the time to first ambulation after surgery and length of stay in hospital were compared between two groups.Results CRS-R scores improved in both groups after operation(|t|>5.451,P<0.001),and it was greater in the prehabilitation group than in the control group(t=2.812,P<0.01).CRS-R subscale scores improved in auditory and motor functions in the control group(|Z|>2.000,P<0.05),and they were improved in auditory,visual,motor,verbal and arousal functions in the prehabilitation group(|Z|>2.282,P<0.01).CRS-R subscale scores were greater in motor and arousal in the prehabilitation group than in the control group(|Z|>2.320,P<0.05).Diaphragmatic mobility improved in the prehabilitation group(t=-7.782,P<0.001),and it was better than in the control group(t=2.044,P<0.05).The time to first ambulation after surgery and length of stay in hospital were shorter in the prehabilitation group than in the control group(|t|>3.654,P<0.01).Conclusion Preoperative exercise for patients undergoing elective ventriculoperitoneal shunt can improve the consciousness after operation,especially the level of motor and arousal,as well as the lung function,and accelerate the recovery process.

Objective To explore the effect of external attentional focus strategy on walking function after stroke.Methods From July to December 2024,40 stroke patients admitted in Beijing Bo'ai Hospital were randomly divided into control group(n=20)and experimental group(n=20).Both groups underwent conventional rehabilitation.On this basis,the control group received conventional walking training,while the experimental group received walk-ing training based on external attentional focus strategy,for three weeks.Before and after training,they were as-sessed with Gait Watch 3D gait analysis,Timed Up and Go Test(TUGT),Berg Balance Scale(BBS)and Fugl-Meyer Assessment-Lower Extremities(FMA-LE).Results After training,the step speed,step frequency,walking cycle,time of TUGT,and the scores of BBS and FMA-LE improved in both groups(|t|>3.098,P<0.01),and the step speed,step frequency,walking cycle and the score of FMA-LE improved more in the experimental group than in the control group(|t|>2.572,P<0.05).Conclusion External attentional focus strategy can improve the walking function of patients with stroke.

From the perspective of Chinese medicine classics and traditional theories,this paper discusses the pathways of acu-puncture-moxibustion treatment for brain diseases,providing a reference for constructing an acupuncture-moxibustion diagnosis and treatment system for brain diseases that aligns with the characteristics of Chinese medicine.First,it reviews the understanding of the brain and brain diseases by physicians throughout history,classifies the conditions included in modern Chinese medicine's scope of brain diseases,and defines the category of brain diseases in Chinese medicine.Based on Chinese medicine classics and the theories and practices of physicians from ancient to modern times,it elaborates on the meridian pathways,viscus pathways and body structure pathways for acupuncture-moxibustion treatment of brain diseases,which includes treatment based on the Governor Vessel,the Foot-Taiyang Bladder Meridian,the Foot-Yangming Stomach Meridian,and other meridians,treatment based on the heart,kidney,intes-tines,and other viscera related to the brain,and treatment based on the characteristics of the body structure related to the cranium and brain and the brain-orifice connection.Finally,it emphasizes the significance of these pathways in enriching the clinical methods of acupuncture-moxibustion for treating brain diseases and highlights the importance of establishing a syndrome differentiation and treat-ment system for brain diseases that reflects the unique features of acupuncture-moxibustion.