Skeletal muscle atrophy refers to a pathological condition characterized by muscle fiber atrophy as well as decreased muscle mass and muscle strength induced by various predisposing factors. It falls under the category of “flaccidity syndrome” in traditional Chinese medicine， and its pathogenesis is mainly associated with disturbed protein homeostasis， mitochondrial dysfunction and oxidative stress injury. Active ingredients of traditional Chinese medicine exerts synergistic regulatory effects via multiple pathways， thus possessing unique advantages in the clinical prevention and treatment of skeletal muscle atrophy. This paper reviews the mechanisms by which active ingredients of traditional Chinese medicine alleviate skeletal muscle atrophy. Existing studies have demonstrated that such active ingredients can ameliorate skeletal muscle atrophy through multiple approaches： regulating protein metabolic balance （geniposide， matrine， schisandrin A， etc.） and oxidative stress （astragaloside Ⅳ， Gastrodia elata polysaccharide， Angelica sinensis polysaccharide， etc.）， improving mitochondrial function （parthenolide， berberine， curcumin， etc.）， facilitating myogenesis and myogenic differentiation （cucurbitacin Ⅱb， saikosaponin A， saikosaponin D， etc.）， suppressing inflammatory response （ursolic acid， triptolide， emodin， etc.）， ameliorating insulin resistance （akebiasaponin D， etc.）. In the future， active ingredients of traditional Chinese medicine are expected to achieve breakthroughs in clinical treatment for skeletal muscle atrophy， providing novel ideas and strategies for the prevention and treatment of degenerative disorders.

Objective To explore the effect of electromyographic perception-assisted robotic training combined with paired associa-tion stimulation on upper limb function in hemiplegic patients after stroke.Methods From December,2023 to December,2024,120 hemiplegic patients after stroke in Nanjing Pukou People's Hos-pital(Liangjiang Hospital,Southeast University)were randomly assigned to control group(n=60)and experi-mental group(n=60)using random envelope method.Both groups received medication and routine rehabilita-tion training,the control group received traditional muscle strength training combined with paired associative stimulation,and the experimental group received electromyographic perception robot-assisted training combined with paired association stimulation.Fugl-Meyer Assessment-Upper Extremities(FMA-UE),modified Barthel In-dex(MBI),and modified Ashworth Scale(MAS)were conducted before and four weeks after treatment.The sur-face electromyography(sEMG)was used to detect the root mean square(RMS)and integrated electromyography(iEMG)of the biceps and triceps brachii,and to calculate the corresponding co-activation ratio(CR).Results Nine cases in the control group and four cases in the experimental group dropped down.After treatment,RMS of triceps,CR of flexion elbow,the scores of FMA-UE and MBI increased in both groups(|t|>2.219,P<0.001),and were better in the experimental group than in the control group(|t|>2.084,P<0.05);the biceps RMS and CR of elbow extension significantly increased in experimental group(|t|>3.863,P<0.001),and were better in the experimental group than in the control group(|t|>2.498,P<0.05).The MAS score of biceps improved in experi-mental group after treatment(Z=-4.097,P<0.001),and was better in the experimental group than in the con-trol group(Z=-3.459,P<0.01).Conclusion Electromyographic perception robot-assisted training combined with paired association stimulation can im-prove the upper limb motor function and the ability of daily living in hemiplegic patients after stroke.

Objective:To evaluate the short-term efficacy of surgical treatment for severe pulmonary stenosis(PS) in infants and young children, and to clarify the impact of different surgical timings on the efficacy of PS treatment.Methods:A retrospective analysis was conducted on 24 infants and young children who underwent surgical treatment for severe PS at the General Hospital of Northern Theater Command, PLA, from January 1, 2020, to October 1, 2024. Among them, 13 were males and 11 were females. The average weight of the patients was(9.2±3.6) kg, the average gestational age was(39.3±1.7) weeks, and the average age was(15.0±13.5) months. Preoperative clinical symptoms and signs(e.g., cyanosis, shortness of breath), transpulmonary valve pressure gradient(TPVPG), right ventricular systolic pressure(RVSP), and Em/Am were recorded. The patients were divided into two groups based on surgical timing: the infant group(under 1 year old, n=12) and the toddler group(1-3 years old, n=12).Results:There were no deaths among all patients. The postoperative ICU stay was significantly longer in the infant group compared to the toddler group( P<0.05). Compared to preoperative values, surgical treatment significantly improved TPVPG, reduced RVSP, and enhanced right ventricular diastolic function, which stabilized by 3 months postoperatively( P<0.05). Intergroup comparisons revealed that the infant group had significantly lower TPVPG at 6 months postoperatively compared to the toddler group. Additionally, right ventricular diastolic function improved significantly in the infant group postoperatively, while no significant improvement was observed in the toddler group. Younger age and reduced right ventricular diastolic function were identified as major risk factors for prolonged mechanical ventilation(>24 hours). Conclusion:Surgical treatment for PS during infancy and early childhood is safe and effective. Comprehensive preoperative evaluation is crucial, and early surgical intervention is recommended for patients with impaired right ventricular function to improve prognosis.

Objective:To investigate expression and clinical significance of T cell activation related membrane molecules in infertility patients with polycystic ovary syndrome(PCOS).Methods:A total of 80 PCOS infertility patients who visited Second Affiliated Hospital of Hainan Medical College from January 2020 to June 2021 were selected as observation group,and 80 cases of women who underwent physical examination at same time were selected as control group.Expressions of membrane molecules related to T cell acti-vation in peripheral blood of patients between two groups were compared.Patients with PCOS infertility were divided into pregnant group[66(82.5％)]and non pregnant group[14(17.5％)]according to different prognosis.General clinical data,peripheral blood inflammatory factors and T cell activation related membrane molecules expressions were compared between two groups,focusing on correlation between T cell activation related membrane molecules expressions and prognosis of PCOS infertility patients,ROC curve and decision-making curve of T cell activation related membrane molecule expressions were drawn to predict prognosis of PCOS infer-tility patients,whose prediction efficiency and net profitability were further analyzed.Pearson correlation analysis was used to explore correlation between T cell activation related membrane molecules expressions and clinical characteristics of PCOS infertility patients.Results:CD4+CD45+T and CD4+CD63+T cells expressions in peripheral blood of patients in observation group were significantly higher than control group(P<0.05).Total testosterone(T),TNF-α,IFN-γ,CD4+CD45+T and CD4+CD63+T cells expressions of patients in non pregnancy group were significantly higher than pregnancy group(P<0.05).Multivariate Logistic regression analysis showed that CD4+CD45+T and CD4+CD63+T cells were independent predictors of prognosis of PCOS infertility patients(P<0.05),ROC analysis showed that AUC of CD4+CD45+T cells predicting prognosis of PCOS infertility patients was 0.756(0.721～0.826),and the best diag-nostic cut-off point was 48.1％,AUC of CD4+CD63+T cells was 0.746(0.711～0.834),and the best cut-off point for diagnosis was 31.2％,while AUC of CD4+CD45+T and CD4+CD63+T cells combination was 0.948(0.897～0.986).Decision curve analysis showed that combined prediction of CD4+CD45+T and CD4+CD63+T cells was higher than a single indicator.Correlation analysis showed that CD4+CD45+T and CD4+CD63+T cells expressions in peripheral blood of patients with PCOS infertility was related to T,TNF-α,insulin resistance index(HOMA-IR),IFN-γ,IL-2 and IL-10(P<0.05).Conclusion:The higher the CD4+CD45+T and CD4+CD63+T cells expressions in peripheral blood,the worse the prognosis of patients with PCOS infertility.

OBJECTIVE To prepare vancomycin hydrochloride(VH)-loaded polydopamine(PDA)nanoparticles(VH@PDA nanoparticles),and study their antimicrobial effect in combination with photothermal therapy.METHODS Using PDA as the carrier,VH was loaded to prepare VH@PDA nanoparticles(PDA nanoparticles were prepared using the same method).The nanoparticles were characterized with laser particle size analyzer,transmission electron microscope,and UV visible absorption spectrometer;the drug loading capacity and encapsulation efficiency of the nanoparticles were determined.The near-infrared laser irradiation was adopted to determine their photothermal ability.Taking Staphylococcus aureus as the research object,the bactericidal properties of the nanoparticles in combination with photothermal therapy in vitro were clarified through plate colony coating method,live/dead staining analysis,crystal violet staining.Using L929 cells as the research object,the effects of VH@PDA nanoparticles at different mass concentrations(0,3.125,6.25,12.5,25,50 and 100 μg/mL)on cell viability were investigated to assess their biocompatibility.RESULTS VH@PDA nanoparticles were successfully loaded with VH,exhibiting uniform particle size(approximately 300 nm),distinct pore size,and a spherical structure.The drug loading capacity was 11.34%,the encapsulation efficiency was 32.00%,the photothermal conversion efficiency reached 23.55%,and they demonstrated stable photothermal performance.The antibacterial effect results of the combined photothermal therapy demonstrated that without near-infrared laser irradiation,the antibacterial effects of VH,PDA nanoparticles,and VH@PDA nanoparticles were not significant.However,when subjected to near-infrared laser irradiation,VH@PDA nanoparticles exhibited a pronounced antibacterial effect.The results of the cell experiments revealed that after treatment with VH@PDA nanoparticles at various mass concentrations,the cell viability rates remained above 80%.CONCLUSIONS VH@PDA nanoparticles are successfully prepared,which exhibit stable photothermal properties,significant antibacterial effects when combined with photothermal therapy,and good biocompatibility.

Objective:To explore the trajectories of breastfeeding social support and postpartum depression from childbirth through 6 months postpartum in postpartum women.Methods:A longitudinal survey method was adopted. Using convenience sampling method, postpartum women who were hospitalized and delivered in the First Affiliated Hospital of University of Science and Technology of China from June to July 2023 were selected. The Hughes Breastfeeding Support Scale (HBSS) and Edinburgh Postpartum Depression Scale (EPDS) were used to collect data at three times including departure (T1), 42 days postpartum (T2), and 6 months postpartum (T3). Repeated analysis of variance was used to explore the trajectories of breastfeeding social support and postpartum depression at different times, and LSD test was used for pairwise comparison. Pearson correlation analysis was used to analyze the relationship between the HBSS and EPDS.Results:Finally, 435 postpartum women completed the survey. There were 171 cases aged 20-29 years old, 237 cases aged 30-39 years old, and 27 cases aged ≥ 40 years old.The rate of exclusive breastfeeding for 6 months after delivery was 41.1%(179/435). The total score of HBSS in parturients was at a high level at T1, with a score of (84.08 ± 14.14) points, but at T2 and T3, it was at a moderate level with scores of (77.45 ± 15.29), (78.42 ± 15.97) points, respectively, and the difference was statistically significant at different time points ( F=36.59, P<0.01). The total score of EPDS in parturients at T1, T2, and T3, were (8.53 ± 4.81), (8.29 ± 5.52), (7.71 ± 5.02) points, respectively, and the difference was statistically significant at different time points ( F=6.44, P<0.01). The scores of HBSS were negatively correlated with the scores of EPDS at three times ( r=-0.345, -0.458, -0.578, all P<0.01). Conclusions:The level of breastfeeding social support and postpartum depression showed a dynamic change trend, and these two variables were negatively related. Nursing staff should strengthen the construction of social support network for breastfeeding, and implement personalized intervention measures according to the psychological characteristics of postpartum women in different stages to improve the current situation of breastfeeding.

Objective:To investigate the extent and characteristics of parenting stress experienced by fathers of children aged 0-6 in three provinces of Eastern China, and to compare the quality of their marital relationships within each latent class, in order to provide reference for developing intervention strategies for different categories of fathers.Methods:Using cross-sectional survey methods, fathers with children aged 0-6 years were recruited using convenience sampling from December 2020 to March 2021 from Anhui province, Zhejiang province and Jiangsu province in Eastern China. Data were collected through a general information questionnaire, the Parenting Stress Index-Short Form, and the Locke-Wallace Marital Adjustment Scale.Latent profile analysis was used to determine the classification, Kruskal-Wallis H test was used to compare the difference of marital quality. Results:A total of 657 questionnaires were distributed and 604 valid questionnaires were recovered. The age of 604 fathers was (32.50 ± 6.26) years, the score of parenting stress was (89.70 ± 17.87) and the score of marriage quality was (108.36 ± 22.28). The characteristics of parenting stress among fathers of young children were categorized into three latent profile types: "high stress-negative parenting group" (88 people accounting for 14.6%), " medium stress- poor interaction group" (329 people accounting for 54.5%), and " low stress-positive parenting group" (187 people accounting for 30.9%). The scores of marriage quality were (99.94 ± 23.81), (106.52 ± 19.84), (115.56 ± 23.70) points among these three latent classes with significant differences ( H=35.89, P<0.05). Conclusions:The study identifies three latent classes of parenting stress among fathers of children aged 0-6, each associated with varying levels of marriage quality. Therefore, targeted interventions aimed at improving fathers′ parenting stress and marriage quality, and helping create family environments where children can grow up healthy.

Objective:To investigate expression and clinical significance of T cell activation related membrane molecules in infertility patients with polycystic ovary syndrome(PCOS).Methods:A total of 80 PCOS infertility patients who visited Second Affiliated Hospital of Hainan Medical College from January 2020 to June 2021 were selected as observation group,and 80 cases of women who underwent physical examination at same time were selected as control group.Expressions of membrane molecules related to T cell acti-vation in peripheral blood of patients between two groups were compared.Patients with PCOS infertility were divided into pregnant group[66(82.5％)]and non pregnant group[14(17.5％)]according to different prognosis.General clinical data,peripheral blood inflammatory factors and T cell activation related membrane molecules expressions were compared between two groups,focusing on correlation between T cell activation related membrane molecules expressions and prognosis of PCOS infertility patients,ROC curve and decision-making curve of T cell activation related membrane molecule expressions were drawn to predict prognosis of PCOS infer-tility patients,whose prediction efficiency and net profitability were further analyzed.Pearson correlation analysis was used to explore correlation between T cell activation related membrane molecules expressions and clinical characteristics of PCOS infertility patients.Results:CD4+CD45+T and CD4+CD63+T cells expressions in peripheral blood of patients in observation group were significantly higher than control group(P<0.05).Total testosterone(T),TNF-α,IFN-γ,CD4+CD45+T and CD4+CD63+T cells expressions of patients in non pregnancy group were significantly higher than pregnancy group(P<0.05).Multivariate Logistic regression analysis showed that CD4+CD45+T and CD4+CD63+T cells were independent predictors of prognosis of PCOS infertility patients(P<0.05),ROC analysis showed that AUC of CD4+CD45+T cells predicting prognosis of PCOS infertility patients was 0.756(0.721～0.826),and the best diag-nostic cut-off point was 48.1％,AUC of CD4+CD63+T cells was 0.746(0.711～0.834),and the best cut-off point for diagnosis was 31.2％,while AUC of CD4+CD45+T and CD4+CD63+T cells combination was 0.948(0.897～0.986).Decision curve analysis showed that combined prediction of CD4+CD45+T and CD4+CD63+T cells was higher than a single indicator.Correlation analysis showed that CD4+CD45+T and CD4+CD63+T cells expressions in peripheral blood of patients with PCOS infertility was related to T,TNF-α,insulin resistance index(HOMA-IR),IFN-γ,IL-2 and IL-10(P<0.05).Conclusion:The higher the CD4+CD45+T and CD4+CD63+T cells expressions in peripheral blood,the worse the prognosis of patients with PCOS infertility.

Objective:To explore the effect of non-invasive intervention on preventing maternal breast tenderness, and to provide references for clinicians to select the optimal non-invasive intervention for the prevention of maternal breast tenderness.Methods:Literature focused on the effect of different non-invasive interventions to prevent maternal breast tenderness by randomized controlled trials design was searched in the databases, including China National Knowledge Infrastructure, VIP, Wanfang, SinoMed, PubMed, Web of Science, Embase and Cochrane Library, from inception to April 8, 2024. Two researchers independently screened the literature, extracted the data and evaluated the quality of the literature. Stata 16.0 was used to conduct a network Meta-analysis.Results:A total of 21 studies involving 2 298 women, covering 5 non-invasive interventions (low-frequency pulse electrotherapy, breast massage combined with low-frequency pulse electrotherapy, breast massage and acupoint massage, breast massage and acupoint massage combined with ear point pressure bean, breast massage and acupoint massage combined with external application of Chinese medicine). The network meta-analysis results showed that, compared with routine care, five non-invasive interventions had statistically significant differences in reducing the incidence of maternal breast tenderness ( OR values ranging from 0.20 to 0.39, all P<0.05). Breast massage combined with low-frequency pulse electrotherapy ranked first in terms of effectiveness on preventing of breast tenderness. Conclusions:All five non-invasive interventions are effective on preventing maternal breast tenderness, with breast massage combined with low-frequency pulse electrotherapy being the most effective.

Metering unit is important component of medical service items and also serve as significant bases for scientifically estimating the costs of medical services.National Technical Specification of Medical Service Items(2023 Edition)has set up elements such as"metering unit"and"adjustment coefficient for resource consumption in special circumstances",which clearly stipulate the metering units of each medical service item and the multiples for discretionary increases or decreases in the overall resource consumption when special circumstances occur.These two elements are important references for the cost accounting in medical institutions.The project team has elaborated on the definitions,establishment principles and special circumstances of these two types of elements,namely"metering units"and"adjustment coefficient for resource consumption in special circumstances",providing references for the application of relevant governments and healthcare institutions.