Objective:To determine whether spinal cord injury (SCI) triggers secondary neuroinflammation and neuronal injury in remote brain regions by impairing the drainage function of the meningeal lymphatic vessels (MLVs).Methods:Fifty-two female C57BL/6 mice were assigned with the random number table into four groups ( n=13 per group): sham group, SCI group, adeno-associated virus negative control group (negative control group), and adeno-associated virus overexpressing VEGF-C group (VEGF-C group). The sham group underwent laminectomy without spinal cord injury. In the SCI group, negative control group and VEGF-C group, T 9 contusion was made to establish the SCI models using a modified Allen′s impactor. At 4 weeks before SCI modeling, the negative control group and VEGF-C group were injected via the cisterna magna with 3 μl adeno-associated virus for negative control or adeno-associated virus for VEGF-C overexpression. At 56 days after injury, Alexa Fluor? 647 ovalbumin conjugate (OVA-647) was injected via the cisterna magna as a tracer. Two hours later, the proportion of OVA-647 in the deep cervical lymph nodes (dCLN) was detected. Immunofluorescence was performed to assess the proportion of MLVs marker lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) and expression levels of microglial marker ionized calcium-binding adaptor molecule 1 (Iba1) in the cerebral cortex, hippocampus, midbrain, and thalamus across the experimental groups. ELISA was employed to quantify the levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) and Nissl staining was used to assess neuronal counts in these regions. Results:At 56 days after injury, the OVA-647 proportion in the dCLN was higher in the sham group than that in the SCI group and negative control group ( P<0.01), whereas the SCI group and negative control group showed a lower OVA-647 proportion in the dCLN than the VEGF-C group ( P<0.05). At 56 days after injury, the dural LYVE-1 proportion was higher in the sham group than that in the SCI group and negative control group ( P<0.01), whereas it was lower in the SCI group and negative control group than that in the VEGF-C group ( P<0.05). At 56 days after injury, the count of Iba1-positive microglia across all the above-mentioned regions was increased in the SCI group and negative control group ( P<0.01), compared with that in the sham group, whereas it was reduced in these regions in the VEGF-C group, compared with that in the SCI group and negative control group ( P<0.01). At 56 days after injury, TNF-α and IL-1β levels in these regions were both elevated in the SCI group and negative control group when compared with those in the sham group ( P<0.05), whereas they were reduced in the VEGF-C group, compared with those in the SCI group and negative control group ( P<0.05). At 56 days after injury, neuronal survival in the regions was decreased in the SCI group and negative control group, compared with that in the sham group ( P<0.05), whereas it was increased in the VEGF-C group, compared with that in the SCI group and negative control group ( P<0.05). Conclusion:SCI can induce secondary neuroinflammation and neuronal damage in remote brain regions by impairing the drainage function of MLVs.

Objective To exploring the drug rules for treating children's night cough based on the theory of"Shaoyang as the pivot".Methods 189 cases of children with night cough were included,and 224 prescriptions.Used the Traditional Chinese Medicine Inheritance Assistance Platform to analyze the time distribution,syndrome types,and four nature,five flavors,and channel tropism of diseases.Used frequency statistics,association rule analysis,and cluster analysis to extract drug patterns for pediatric night cough.Results Coughing occured most frequently during the Yin period.The syndrome type was mainly Shaoyang syndrome.The high-frequency core drugs were Chaihu,Huangqin,and Banxia,etc..The prescription characteristics were Xiaochaihu decoction without Renshen,Shengjiang,and Dazao,and added Wuweizi,Danggui and Xingren.The drugs were used flexibly according to the syndromes:Maxing Er San decoction was added to the phlegm and drink syndrome,Qumai Er Chen decoction was added to the food stagnation syndrome,Sijunzi decoction was added to the qi deficiency syndrome,Maiwei Dihuang decoction was added to the yin deficiency syndrome,and Weijing decoction was added to the phlegm and heat syndrome.Conclusion Based on the basic principle of harmonizing Shaoyang,and according to the disease mechanism,the classical prescription is flexibly used,forming a night cough treatment system based on the"Shaoyang as the pivot"theory,with distinct clinical characteristics.

Objective To explore the independent influencing factors of kinesiophobia in pa-tients after total knee arthroplasty and analyze the effect of rehabilitation training under the informa-tion-motivation-behavioral skills(IMB)model.Methods A total of 385 patients undergoing primary unilateral total knee arthroplasty were selected,and the independent influencing factors of kinesiopho-bia in these patients after total knee arthroplasty were analyzed.Eighty-nine patients with kinesiopho-bia were divided into control group(n=44)and observation group(n=45)according to random number table method.The control group received routine rehabilitation intervention,while the obser-vation group received rehabilitation intervention under the IMB model.The application effect of reha-bilitation intervention under the IMB model in patients with kinesiophobia after total knee arthroplasty was analyzed.Results Multivariate Logistic regression analysis showed that the analgesic effect,ad-verse reactions to anesthetics,preoperative anxiety level,preoperative depression level,postoperative self-efficacy,and postoperative family care level were all independent influencing factors of kinesio-phobia in patients after total knee arthroplasty(P＜0.05).Compared with before intervention,at 1 month and 3 months after intervention,the Tampa Scale of Kinesiophobia(TSK)scores and Numeri-cal Rating Scale(NRS)scores of both groups decreased,while the Knee Society Score(KSS)and rehabilitation exercise compliance scores increased(P＜0.05).Compared with the control group,at 1 month and 3 months after intervention,the TSK scores and NRS scores of the observation group were significantly lower,while the KSS and rehabilitation exercise compliance scores were signifi-cantly higher(P＜0.05).Conclusion There are multiple influencing factors for kinesiophobia in patients after total knee arthroplasty.Clinically,the implementation of rehabilitation training pro-gram under the IMB model is conducive to changing postoperative rehabilitation behaviors,impro-ving kinesiophobia and pain levels after total knee arthroplasty,and enhancing knee function and re-habilitation training compliance.

Objective To compare the clinical effects of single-puncture and double-puncture subcutaneous tunneling techniques for PICC placement in cancer patients,and to provide references for nurses in selecting appropriate catheterization methods.Methods A continuous sampling method was adopted to select cancer patients who underwent PICC placement in the Department of Oncology at a tertiary general hospital in Nanning from June 2022 to December 2023.According to the actual catheterization technique received by patients,they were assigned to either the single-puncture or double-puncture subcutaneous tunneling group.After 1:1 propensity score matching(PSM),the 2 groups were compared in terms of catheter-related complication rates,pain scores and total catheterization time.Results After propensity score matching,79 patients were included in each group.The results showed that the incidence of catheter-related thrombosis,pain scores,and total catheterization time in the one-needle subcutaneous tunneling group were significantly lower than those in the two-needle subcutaneous tunneling group,with statistically significant differences(P＜0.05).Conclusion The one-needle subcutaneous tunneling method can effectively reduce the incidence of catheter-related thrombosis and pain during catheterization in cancer patients,while also shortening the total catheterization time.

Objective By comparing the prevalence and mortality of dementia among rural people in Xi'an in 1997 and 2014 to clarify the epidemiological changes of dementia among rural people in the city over 17 years.Methods In 1997 and 2014,people aged 55 and above in villages in Xi'an were selected by random cluster sampling method,and face-to-face questionnaire survey was conducted by combining centralized and home visits.Dementia and its subtypes were diagnosed by"the three-step method";the changes of dementia prevalence and mortality were compared between the two surveys.Results The prevalence of dementia among rural residents aged 55 and above in Xi'an was 3.49％in 1997,with age-gender standardized prevalence of 2.08％.In 2014,the prevalence of dementia was 4.25％,with age-gender standardized prevalence of 2.78％.Over the 17 years,the prevalence of dementia increased by 1.79 times(OR=1.79,95％CI:1.20-2.65,P=0.004),with a 1.9-fold increase in females and a 1.67-fold increase in males.The mortality of dementia patients was 61.76‰ and age-gender standardized mortality was 60.20‰ in 1997,while the mortality was 35.71‰ and age-gender standardized mortality was 34.18‰ in 2014.The mortality of dementia decreased by 33％over the 17 years(HR=0.33,95％CI:0.15-0.74,P=0.007).Conclusion The prevalence of dementia in rural areas of Xi'an increased significantly over the 17 years,but the mortality rate decreased,and this trend was more obvious in women.

Objective To exploring the drug rules for treating children's night cough based on the theory of"Shaoyang as the pivot".Methods 189 cases of children with night cough were included,and 224 prescriptions.Used the Traditional Chinese Medicine Inheritance Assistance Platform to analyze the time distribution,syndrome types,and four nature,five flavors,and channel tropism of diseases.Used frequency statistics,association rule analysis,and cluster analysis to extract drug patterns for pediatric night cough.Results Coughing occured most frequently during the Yin period.The syndrome type was mainly Shaoyang syndrome.The high-frequency core drugs were Chaihu,Huangqin,and Banxia,etc..The prescription characteristics were Xiaochaihu decoction without Renshen,Shengjiang,and Dazao,and added Wuweizi,Danggui and Xingren.The drugs were used flexibly according to the syndromes:Maxing Er San decoction was added to the phlegm and drink syndrome,Qumai Er Chen decoction was added to the food stagnation syndrome,Sijunzi decoction was added to the qi deficiency syndrome,Maiwei Dihuang decoction was added to the yin deficiency syndrome,and Weijing decoction was added to the phlegm and heat syndrome.Conclusion Based on the basic principle of harmonizing Shaoyang,and according to the disease mechanism,the classical prescription is flexibly used,forming a night cough treatment system based on the"Shaoyang as the pivot"theory,with distinct clinical characteristics.

Objective By comparing the prevalence and mortality of dementia among rural people in Xi'an in 1997 and 2014 to clarify the epidemiological changes of dementia among rural people in the city over 17 years.Methods In 1997 and 2014,people aged 55 and above in villages in Xi'an were selected by random cluster sampling method,and face-to-face questionnaire survey was conducted by combining centralized and home visits.Dementia and its subtypes were diagnosed by"the three-step method";the changes of dementia prevalence and mortality were compared between the two surveys.Results The prevalence of dementia among rural residents aged 55 and above in Xi'an was 3.49％in 1997,with age-gender standardized prevalence of 2.08％.In 2014,the prevalence of dementia was 4.25％,with age-gender standardized prevalence of 2.78％.Over the 17 years,the prevalence of dementia increased by 1.79 times(OR=1.79,95％CI:1.20-2.65,P=0.004),with a 1.9-fold increase in females and a 1.67-fold increase in males.The mortality of dementia patients was 61.76‰ and age-gender standardized mortality was 60.20‰ in 1997,while the mortality was 35.71‰ and age-gender standardized mortality was 34.18‰ in 2014.The mortality of dementia decreased by 33％over the 17 years(HR=0.33,95％CI:0.15-0.74,P=0.007).Conclusion The prevalence of dementia in rural areas of Xi'an increased significantly over the 17 years,but the mortality rate decreased,and this trend was more obvious in women.

Objective To compare the clinical effects of single-puncture and double-puncture subcutaneous tunneling techniques for PICC placement in cancer patients,and to provide references for nurses in selecting appropriate catheterization methods.Methods A continuous sampling method was adopted to select cancer patients who underwent PICC placement in the Department of Oncology at a tertiary general hospital in Nanning from June 2022 to December 2023.According to the actual catheterization technique received by patients,they were assigned to either the single-puncture or double-puncture subcutaneous tunneling group.After 1:1 propensity score matching(PSM),the 2 groups were compared in terms of catheter-related complication rates,pain scores and total catheterization time.Results After propensity score matching,79 patients were included in each group.The results showed that the incidence of catheter-related thrombosis,pain scores,and total catheterization time in the one-needle subcutaneous tunneling group were significantly lower than those in the two-needle subcutaneous tunneling group,with statistically significant differences(P＜0.05).Conclusion The one-needle subcutaneous tunneling method can effectively reduce the incidence of catheter-related thrombosis and pain during catheterization in cancer patients,while also shortening the total catheterization time.

Objective:To determine whether spinal cord injury (SCI) triggers secondary neuroinflammation and neuronal injury in remote brain regions by impairing the drainage function of the meningeal lymphatic vessels (MLVs).Methods:Fifty-two female C57BL/6 mice were assigned with the random number table into four groups ( n=13 per group): sham group, SCI group, adeno-associated virus negative control group (negative control group), and adeno-associated virus overexpressing VEGF-C group (VEGF-C group). The sham group underwent laminectomy without spinal cord injury. In the SCI group, negative control group and VEGF-C group, T 9 contusion was made to establish the SCI models using a modified Allen′s impactor. At 4 weeks before SCI modeling, the negative control group and VEGF-C group were injected via the cisterna magna with 3 μl adeno-associated virus for negative control or adeno-associated virus for VEGF-C overexpression. At 56 days after injury, Alexa Fluor? 647 ovalbumin conjugate (OVA-647) was injected via the cisterna magna as a tracer. Two hours later, the proportion of OVA-647 in the deep cervical lymph nodes (dCLN) was detected. Immunofluorescence was performed to assess the proportion of MLVs marker lymphatic vessel endothelial hyaluronan receptor-1 (LYVE-1) and expression levels of microglial marker ionized calcium-binding adaptor molecule 1 (Iba1) in the cerebral cortex, hippocampus, midbrain, and thalamus across the experimental groups. ELISA was employed to quantify the levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) and Nissl staining was used to assess neuronal counts in these regions. Results:At 56 days after injury, the OVA-647 proportion in the dCLN was higher in the sham group than that in the SCI group and negative control group ( P<0.01), whereas the SCI group and negative control group showed a lower OVA-647 proportion in the dCLN than the VEGF-C group ( P<0.05). At 56 days after injury, the dural LYVE-1 proportion was higher in the sham group than that in the SCI group and negative control group ( P<0.01), whereas it was lower in the SCI group and negative control group than that in the VEGF-C group ( P<0.05). At 56 days after injury, the count of Iba1-positive microglia across all the above-mentioned regions was increased in the SCI group and negative control group ( P<0.01), compared with that in the sham group, whereas it was reduced in these regions in the VEGF-C group, compared with that in the SCI group and negative control group ( P<0.01). At 56 days after injury, TNF-α and IL-1β levels in these regions were both elevated in the SCI group and negative control group when compared with those in the sham group ( P<0.05), whereas they were reduced in the VEGF-C group, compared with those in the SCI group and negative control group ( P<0.05). At 56 days after injury, neuronal survival in the regions was decreased in the SCI group and negative control group, compared with that in the sham group ( P<0.05), whereas it was increased in the VEGF-C group, compared with that in the SCI group and negative control group ( P<0.05). Conclusion:SCI can induce secondary neuroinflammation and neuronal damage in remote brain regions by impairing the drainage function of MLVs.

Objective:To summary the clinical and electrophysiological characteristics of temporal lobe epilepsy (TLE) originating from the temporal pole (TP), and to conduct brain network analysis based on stereo-electroencephalogram (SEEG) and head positron emission tomography- computed tomography (PET-CT).Methods:A retrospective analysis was conducted on patients with TLE who underwent SEEG implantation from January 1, 2019 to September 1, 2023 in Guangdong Sanjiu Brain Hospital. Based on anatomical-electrical-clinical analysis and SEEG findings, patients with seizures originating from the TP were selected. The clinical data, head magnetic resonance imaging (MRI), PET-CT, scalp electroencephalogram were reviewed, and the seizure-induced network was analyzed based on SEEG and head PET-CT.Results:A total of 108 cases of TLE were analyzed, of whom 13 cases had an epileptogenic zone located at the TP, accounting for 12% (13/108) of all TLE patients. Among them, 8 were males and 5 were females, and age of onset was (11.6±7.8) years. All of them were drug-resistant epilepsy patients, of whom 6 cases had normal cognitive function, 4 had mild cognitive abnormalities, and 3 had severe cognitive decline. A total of 59 seizures were recorded, and the occurrence rate of generalized tonic-clonic seizures (GTCS) was 42% (25/59). Seizure symptoms were classified into 3 types: the first type was hypermotor, seen in 9 patients; the second type was complex motor, seen in 2 patients; and the third type was automotor, seen in 2 patients. Head MRI showed that 9 cases had a blurring of the TP on one side, with or without hippocampal sclerosis; 2 cases had a mass at the TP without hippocampal sclerosis; 2 cases were negative on head MRI. Head PET-CT showed that 13 cases had TP hypometabolism on the lesion side, of whom 11 cases had hypometabolism involving the medial temporal lobe (mTL), posterior orbital gyrus (POG), anterior cingulate gyrus (ACG) and insular lobe at the same time, the other 2 cases combined with ipsilateral hypometabolism of the medial temporal lobe. Pathology showed that 7 cases had microcortical dysplasia of the TP; 3 had focal cortical dysplasia Ⅰ or focal cortical dysplasia Ⅱ; 2 had benign tumors. Scalp electroencephalogram showed that interictal phase was divided into 3 discharge patterns: bilateral temporal regions with prominent lesion side; bilateral anterior regions with prominent lesion side; lesion-side hemisphere with prominent temporal region. Ictal period showed 4 initial patterns: lesion-side hemispheric rhythmic spikes-slow waves or polyspikes-slow waves; lesion-side anterior region rhythmic slow waves; lesion-side anterior region low voltage fast (LVF) activities, and diffuse LVF with prominent lesion-side hemisphere. SEEG showed that 13 patients received electrode implantation with (9±2) electrodes per patient, divided into 3 seizure patterns: type 1: TP?adjacent temporal neocortex?POG, ACG and insula?mTL; type 2: TP?para hippocampal gyrus and the base of temporal lobe?ACG ,POG and insula?mTL; type 3: TP?mTL?insular lobe?POG.Conclusions:TLE originating from the TP is relatively rare, with hypermotor or complex motor as the main manifestations, and automotor being relatively less common, which is more likely to be followed by GTCS. The epileptogenic network analysis displays a tendency to spread from the TP to the frontal and insular lobes, as well as to the mTL, with the former pattern being more common. Common etiologies are cortical dysplasia and benign tumors of the TP without hippocampal sclerosis.