ObjectiveThis study aimed to establish a monocrotaline （MCT）-induced pulmonary arterial hypertension （PAH） rat model to systematically evaluate the protective effect of Xiao Qinglongtang （XQLT） on right cardiac function in model rats and further elucidate the underlying regulatory mechanism. MethodsSixty male SD rats were randomly assigned to the normal group， model group， XQLT low-， medium-， and high-dose groups （XQLT-L/M/H）， and the beraprost sodium tablet group （BST）. Except for the normal group， rats in all other groups were given a single subcutaneous injection of MCT （60 mg·kg^-1） to induce PAH. Three weeks after injection， rats in the XQLT-L/M/H groups were administered XQLT intragastrically at 3.07， 6.14， 12.28 g·kg^-1·d^-1， respectively. Rats in the BST group received beraprost sodium at 12.6 μg·kg^-1·d^-1， and rats in the model group received an equal volume of saline. All treatments lasted for 3 weeks. Right ventricular systolic pressure （RVSP） was measured by right ventricular catheterization. Cardiac function was assessed by echocardiography. The right ventricle was weighed to calculate the right ventricular hypertrophy index （RVHI）. Hematoxylin-eosin （HE） staining， Masson staining， and transmission electron microscopy were used to observe myocardial morphology. Serum metabolomic changes were analyzed using ultra-performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS）. Data-independent acquisition （DIA） proteomics was used to detect differentially expressed （DE） proteins in the right ventricle， and Western blot was used to measure the expression of uncoupling protein 3 （UCP3）， phosphatidylinositol 3-kinase catalytic subunit p110α （PIK3CA）， L1 cell adhesion molecule （L1CAM）， and quinone oxidoreductase （CRYZ）. UPLC-MS/MS was used to analyze the chemical components of XQLT. ResultsCompared with the normal group， the model group showed significantly increased RVSP and RVHI （P<0.05）， along with pathological changes in myocardial morphology. Compared with the model group， all XQLT-treated groups exhibited reductions in RVSP and RVHI as well as significant improvements in cardiac function and myocardial morphology. Among the XQLT groups， XQLT-M showed the most pronounced effects （P<0.05）， comparable to the BST group. Serum metabolomics revealed 105 differential metabolites in the XQLT groups versus the model group ［variable importance in projection （VIP） >1， P<0.05］， including 58 upregulated and 47 downregulated metabolites. KEGG enrichment analysis indicated that XQLT intervention downregulated phenylalanine metabolism （P<0.01） and upregulated unsaturated fatty acid biosynthesis （P<0.05）. Proteomics analysis showed that 982 DE proteins were identified in the MCT groups versus the normal group， including 455 upregulated and 527 downregulated proteins （|fold change （FC）| >1.3， P<0.05）. Compared with the model group， 237 DE proteins were identified in the XQLT groups， including 124 upregulated and 113 downregulated proteins （|FC| >1.3， P<0.05）， with 57 overlapping DE proteins. KEGG enrichment suggested that XQLT mainly modulated pathways related to mineral absorption， ribosomal biogenesis， peroxisomes， glycolysis/gluconeogenesis， spliceosomes， and thyroid hormone signaling. Western blot analysis showed that， compared with the model group， XQLT increased the expression of UCP3， PIK3CA， and L1CAM， while decreasing the expression of CRYZ （P<0.05）. ConclusionXQLT exerts a protective effect on right heart function in MCT-induced PAH rats， and its mechanism is associated with maintaining myocardial homeostasis and alleviating right ventricular remodeling.

Objective: To explore the management of blood donors tested reactive to HCV in blood screening based on confirmation of HCV infection. Methods: Multiple HCV antibody assays, repeating HCV RNA testing, follow-up of blood donors and retesting of archive samples were performed to confirm HCV infection, identify infection status, and exclude false positives in blood donors reactive to HCV in blood screening. Results: From 2011 to 2024, the unqualified rate of HCV detection in blood screening was 2.45‰(2 751/1 122 026). Among these, anti-HCV+-&NAT-accounted for 1.85‰, followed by anti-HCV++ at 0.60‰. The proportion of anti-HCV+-&NAT-and HCV RNA yields was extremely low (0.007‰). The positive rate of anti-HCV+-&NAT-samples tested by electrochemiluminescence method (ELCIA) was approximately 7.5%, differing among reagents (P<0.05). The follow-up of anti-HCV+-&NAT-donors showed that 96.2% (202/210) were false positives, but 51.4% of donors remained anti-HCV+-&NAT-during follow-up. Among them, 8 donors (3.8%) could not be ruled out from HCV infection due to positive retesting by ELCIA. Of the anti-HCV+-&NAT-donors who were reactive at the first follow-up, 86.8% remained anti-HCV+-&NAT-at the second follow-up. The sampling confirmation data showed that all of 260 anti-HCV++ donors were confirmed as anti-HCV positive, and the proportion of false positives or missed detections by NAT was very low. Two occult HBV infections (OBIs) and one HBsAg carrier were identified among the 3 anti-HCV +-&NAT+ donors, and no HCV infection was confirmed in 5 anti-HCV--&HCV RNA + donors. Conclusion: The prevalence of HCV among blood donors in Dalian was about 0.06%, with extremely low proportion of window-period infection and slightly higher proportion of resolved infections than that of current infections. The majority of anti-HCV+-&NAT-were false positive. Blood donors confirmed as false positive should be qualified in blood screening 3 months later before next donation. In order to reduce the false positive results, it was advisable to avoid the same type of supplementary reagents as the initial reagents when performing confirmation.

In response to the high risk of recurrence and metastasis after breast cancer surgery， this paper proposes a six-dimensional integrated preventive and therapeutic model， namely the "disease-syndrome-constitution-trend-strategy-efficacy" framework， including disease identification， syndrome differentiation， constitution differentiation， trend assessment， strategy implementation， and effect evaluation. This model builds upon the traditional three-dimensional approach of disease identification， syndrome differentiation and constitution differentiation， and introduces "trend" to dynamically capture the evolving tendencies of disease progression and the transformation of syndrome and constitution， thereby operationalizing the concept of "treating before disease onset". The "strategy" dimension enables the organic integration and individualized regulation of TCM and western medical interventions， while the "efficacy" dimension establishes a multidimensional evaluation system integrating TCM and western medicine to assess the efficacy of the "strategy"， so as to promote the systematic， dynamic， and precise development of treating before disease onset in TCM.

Objectives: . This study aimed to investigate the regulatory functions of gamma-aminobutyric acid (GABA)ergic neural circuits from the inferior colliculus (IC) to the medial geniculate body (MGB) in salicylate-induced tinnitus. Methods: . Mice were treated with salicylate to induce tinnitus, and tinnitus-like behaviors were evaluated via gap prepulse inhibition of acoustic startle. Using combined viral tracing methodologies, we identified and mapped the pathways and connections from the IC to the MGB. Furthermore, we employed Gq-coupled human M3 designer receptors exclusively activated by designer drugs (DREADDs) and Gi-coupled human M4 DREADDs to achieve targeted excitation or suppression of GABAergic neurons in the IC and MGB. Following the administration of clozapine N-oxide, which binds to these receptors, we modulated these neural circuits to assess their impact on tinnitus severity in a mouse model. Results: . Our findings demonstrated that mice exposed to salicylate exhibited tinnitus-like behaviors. GABAergic neurons projecting retrogradely from the MGB to the IC were primarily concentrated in the external nucleus of the IC. After clozapine N-oxide administration, chemogenetic activation of IC-MGB GABAergic neurons aggravated salicylate-induced tinnitus. Additionally, activation of GABAergic neurons between the IC and MGB induced the perception of tinnitus even without salicylate. However, chemogenetic inhibition of the IC-MGB GABAergic circuit did not reverse salicylate-induced tinnitus. Conclusion . These findings suggest that activation of the IC-MGB GABAergic neural circuit may contribute to tinnitus generation through a mechanism distinct from that of salicylate-induced tinnitus. This study provides novel insights into the mechanisms underlying tinnitus.

ObjectiveTo analyze the correlation between family nurturing care environment and children with autism spectrum disorder (ASD) or at high risk, and to provide scientific evidence for the tertiary prevention of ASD in children at high risk. MethodsA case-control study, enrolling 30 children with ASD or at high risk for ASD as the case group, and 113 normal children who underwent routine physical examinations at the community health service centers and district maternal and child health care hospital during the same period as the control group, was conducted. The information for maternal pregnancy and childbirth, children, and family nurturing care was collected through the child healthcare system and a self-designed questionnaire survey. Multivariate logistic regression analyses were used to identify the relevant factors for ASD or high-risk status in children. ResultsMultivariate logistic regression analyses showed that among maternal and child factors, maternal adverse conditions during the3 months before pregnancy and throughout pregnancy (OR=6.026, 95%CI: 1.575‒23.062), and male gender (OR=4.064, 95%CI: 1.046‒15.784) were positively correlated with ASD or high risk status in children (P<0.05). Among family nurturing care factors, unbalanced dietary structure (OR=7.281, 95%CI: 1.819‒29.148) was positively correlated with ASD or high-risk status in children (P<0.05), while paternal companionship >2 h·d^-1 (OR=0.025, 95%CI: 0.001‒0.426) and parent-child interaction with responsive care (OR=0.824, 95%CI: 0.704‒0.963) were negatively correlated with ASD or high-risk status in children (P<0.05). ConclusionFactors positively correlated with ASD or high-risk status in children include maternal adverse conditions during the 3 months before pregnancy and throughout pregnancy, male gender, and unbalanced dietary structure. Factors negatively correlated with it include paternal companionship and parent-child interaction with responsive care. Clinically, comprehensively management of maternal pre-pregnancy and prenatal health, children’s diet and family nurturing care, along with focused developmental monitoring of boys, and efforts toward early detection, early diagnosis and early intervention should be strengthened.

ObjectiveTo analyze the "compatibility" relationship of sugars and glycosides and the heat-clearing and blood-cooling effect of the roots of four varieties of Rehmannia glutinosa and provide a basis for research on the pharmacodynamic material basis and quality control of R. glutinosa. MethodsThe content of sugars and glycosides in the roots of four varieties of R. glutinosa was determined during the growth period. The principal component analysis （PCA）， orthogonal partial least squares-discriminant analysis （OPLS-DA）， and the "compatibility" relationship of active components were employed to screen out the differential samples. A rat model of bleeding due to blood heat was used to verify the pharmacodynamic differences and the potential active components of differential samples. ResultsThe content and proportion characteristics of various components in roots of the four varieties of R. glutinosa during the expansion stage and the maturity stage had obvious differences. The proportion of phenylethanoid glycosides at the maturity stage was higher than that at the expansion stage. The R. glutinosa variety 85-5 had special quality characteristics among the tested varieties. All the samples alleviated the symptoms in the rat model. The effect of clearing heat and cooling blood was different between the maturity stage and the expansion stage， as well as between 85-5 samples at the maturity stage and other samples. The effect of clearing heat and cooling blood of R. glutinosa roots was the result of the combined action of multiple components in R. glutinosa roots and might be related to the high proportions of polysaccharides， iridoid glycosides， and phenylethanoid glycosides. ConclusionThe growth stage and variety affect the quality of R. glutinosa roots. The effect of clearing heat and cooling blood of R. glutinosa roots was related to the content and proportions of various components. The study can provide a basis for the basic research on the active components and quality control of R. glutinosa.

ObjectiveTo analyze the "compatibility" relationship of sugars and glycosides and the heat-clearing and blood-cooling effect of the roots of four varieties of Rehmannia glutinosa and provide a basis for research on the pharmacodynamic material basis and quality control of R. glutinosa. MethodsThe content of sugars and glycosides in the roots of four varieties of R. glutinosa was determined during the growth period. The principal component analysis （PCA）， orthogonal partial least squares-discriminant analysis （OPLS-DA）， and the "compatibility" relationship of active components were employed to screen out the differential samples. A rat model of bleeding due to blood heat was used to verify the pharmacodynamic differences and the potential active components of differential samples. ResultsThe content and proportion characteristics of various components in roots of the four varieties of R. glutinosa during the expansion stage and the maturity stage had obvious differences. The proportion of phenylethanoid glycosides at the maturity stage was higher than that at the expansion stage. The R. glutinosa variety 85-5 had special quality characteristics among the tested varieties. All the samples alleviated the symptoms in the rat model. The effect of clearing heat and cooling blood was different between the maturity stage and the expansion stage， as well as between 85-5 samples at the maturity stage and other samples. The effect of clearing heat and cooling blood of R. glutinosa roots was the result of the combined action of multiple components in R. glutinosa roots and might be related to the high proportions of polysaccharides， iridoid glycosides， and phenylethanoid glycosides. ConclusionThe growth stage and variety affect the quality of R. glutinosa roots. The effect of clearing heat and cooling blood of R. glutinosa roots was related to the content and proportions of various components. The study can provide a basis for the basic research on the active components and quality control of R. glutinosa.

BACKGROUND:In recent years,brain-computer interface technology has emerged as a transformative approach in human-computer interaction by recognizing movement intentions to control external devices.This technology has been utilized in the treatment of lower limb functions after stroke,offering new hope for the rehabilitation of stroke patients.OBJECTIVE:To analyze and summarize the application of brain-computer interface technology in the rehabilitation of lower limb motor functions in stroke patients in recent years,and to explore the clinical application value of brain-computer interface technology in the functional rehabilitation of the lower limbs in stroke patients.METHODS:A literature search in CNKI and PubMed was conducted using"stroke,brain-computer interfaces,lower extremity"as search terms in Chinese and English,respectively,with the search time range set from January 2014 to June 2024.RESULTS AND CONCLUSION:Brain-computer interfaces hold promising prospects for the recovery of lower limb motor function in stroke patients,and their application in the field of rehabilitation medicine is continuously expanding.However,the underlying mechanisms have not yet been fully elucidated.Moreover,there are certain limitations in the acquisition of electroencephalogram signals from patients,resulting in reduced precision for brain-computer interface systems in recognizing limb movements.Current decoding methods also exhibit constraints in identifying the gait cycle and fail to accurately locate voluntary movements of the various joints and muscles of the lower limbs,impeding the application of brain-computer interface technology.Subsequent research should focus on elucidating the neural mechanisms by which brain-computer interface technology facilitates the recovery of lower limb motor functions in stroke patients,refining the technologies and devices for extracting brain motor signals,and formulating multimodal feedback for individual patients to realize more effective motor rehabilitation.These advances could propel the development of brain-computer interface technology in the field of lower limb motor function recovery,ameliorate patient rehabilitation outcomes,and elevate the quality of life.

Objective:To study the alternation of plasma ghrelin in patients with acute pancreatitis (AP) and to evaluate the efficacy of gastric slow wave analysis in predicting the severity of AP.Methods:Clinical data and blood samples of 129 patients with AP and 16 individuals for normal physical examination in the Department of Gastroenterology, Jiangnan University Affiliated Central Hospital (Wuxi No.2 People's Hospital) from September 2018 to August 2024 were prospectively collected. Individuals with normal physical examinations were included in the normal control group, including 9 males and 7 females, aged (50.9±14.2) years. The finally enrolled 125 patients with AP included 82 males and 43 females, aged (49.5±15.6) years, which were grouped according to disease severity. Mild AP (MAP) was included in the MAP group ( n=84), while moderate to severe and severe acute AP were included in the non-MAP group ( n=41). The surface gastrogram of all AP patients was detected on the 2nd and 4th day after admission. The slow waves of gastric electricity were recorded, and gastric growth hormone-releasing hormone, C-reactive protein (CRP), etc. were detected simultaneously. Univariate and multivariate logistic regression analyses were conducted to analyze the influencing factors of AP severity (MAP or non-MAP). Receiver operating characteristic (ROC) curve was used to evaluate the indicators in predicting the severity of AP. Results:The levels of gastric growth hormone-releasing hormone in both the non-MAP group and MAP group on the 2nd and 4th day after admission were lower than those in normal control group (all P<0.05). The percentages of normal gastric electrical slow waves in the first and fourth leads, the mean percentages of normal gastric electrical slow waves in the four leads, and the main frequency on the 2nd day of admission in the non-MAP group were lower than those in the normal control group, and the main power and C-reactive protein were higher than those in the MAP group, the differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed the percentage of normal gastric electrical slow wave in the first lead on the 2nd day of admission ( OR=0.914, 95% CI: 0.869-0.961, P=0.001) and CRP ( OR=1.008, 95% CI: 1.002-1.013, P=0.012) were the influencing factors of the severity of AP. The area under the ROC curve of the percentage of normal gastric electrical slow wave in the first lead on the 2nd day of admission in predicting the severity of AP was 0.705, with a sensitivity of 97.6% and a specificity of 35.7%. Conclusion:The plasma gastric growth hormone-releasing hormone in patients with AP decreases in the early stage. The low percentage of normal slow waves in the first lead of gastric electrocardiogram on the 2nd day of admission is a risk factor for the severity of AP and can be used for the early prediction of the severity.

Objective:To analyze the clinical characteristics and treatment outcomes of children with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) antibody-mediated necrotizing myopathy, and to explore early identification and management strategies to provide reference for clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the clinical data and treatment outcomes of 10 pediatric patients with anti-HMGCR antibody-mediated necrotizing myopathy admitted to the Department of Rheumatology, Children′s Hospital of Fudan University from December 2020 to December 2024. Statistical description was performed using SPSS 22.0.Results:Among the 10 patients, the male-to-female ratio was 1:4, the age of onset was (7.2±4.0) years, and the disease duration at diagnosis was (22.2±19.6) months. None had a history of statin exposure. Six patients presented with muscle weakness, and4 were diagnosed due to asymptomatic elevation of creatine kinase (CK); 4 had dermatomyositis-like rashes. All patients showed significantly elevated CK levels [median 3 291(1 969, 8 776)U/L] and underwent muscle biopsy. Histopathological findings revealed myofiber degeneration, necrosis, and regeneration in all cases, with inflammatory infiltration in 9 cases, MHC-Ⅰ positivity in all, and C5b-9 positivity in 9 cases. The median follow-up duration was (15.7±6.3) months. At the last follow-up, muscle strength was normal or nearly normal, and the CK median value had decreased to 977.5 (211.0, 3 536.0) U/L.Conclusion:For patients with suspected idiopathic inflammatory myopathy and significantly elevated CK, muscle-specific antibody testing-including anti-HMGCR-and muscle biopsy should be performed promptly regardless of the presence of skin rash, to ensure accurate diagnosis and guide treatment, thereby avoiding misdiagnosis or missed diagnosis.