Post-stroke cognitive impairment(PSCI)is a prevalent and debilitating complication of stroke that significantly hinders recovery and diminishes patients'quality of life.Repetitive transcranial magnetic stimulation(rTMS),a non-invasive neuromodulation technique,has garnered growing interest for its potential to enhance cognitive function in individuals with PSCI.Concurrently,resting-state functional magnetic resonance imaging(rs-fMRI),as a non-invasive neuroimaging technique,has emerged as a valuable tool for assessing spontaneous neural activity and functional connectivity in the brain.By offering in-sights into the neurobiological mechanisms underlying PSCI and the modulatory effects of rTMS,rs-fMRI provides a foundation for advancing precision-targeted interventions.This review aims to highlight recent progress in applying rs-fMRI to evaluate the efficacy and underlying mechanisms of rTMS in the treatment of PSCI.

Objective:To evaluate the clinical utility of machine learning model based radiomics in predicting high-risk molecular subtypes of lower-grade gliomas(LrGGs).Methods:This was a cross-sectional study. A total of 287 patients diagnosed with LrGGs in the First Hospital of Shanxi Medical University, Shanxi Provincial People′s Hospital, and the Third Hospital of Shanxi Medical University from January 2011 to September 2023 were retrospectively collected, including 166 males and 121 females; 114 cases of high-risk molecular subtypes and 173 cases of non-high-risk molecular subtypes. All patients were divided into 201 cases in the training set and 86 cases in the test set according to 7∶3 in simple randomized grouping method. All patients underwent contrast-enhanced T 1WI (CE-T 1WI) and T 2-weighted fluid-attenuated inversion recovery sequence imaging (T 2-FLAIR), and the imaging features of high-risk and non-high-risk molecular subtypes were analyzed. Analysis of variance, recursive feature elimination, and Kruskal-Wallis were used for radiomics feature screening, and a support vector machine (SVM) classifier was used to construct a radiomics-based classifier model. Univariate and multivariate logistic regression were used to analyze clinical variables independently influencing high-risk molecular subtypes of LrGGs to construct a clinical model; a combined model was developed by integrating radiomics labels and clinical variables. Receiver operating characteristic curve and area under the curve (AUC), calibration curve, and decision curve were used to compare the predictive performance of different models. Results:The patient′s age ( OR=1.042, 95% CI 1.018-1.068, P=0.001), pathological grade ( OR=2.270, 95% CI 1.212-4.311, P=0.011), MGMT methylation status ( OR=0.456, 95% CI 0.238-0.866, P=0.017), and ependymal involvement ( OR=7.335, 95% CI 2.929-18.370, P<0.001) were independent influencing factors for the high-risk molecular subtype of LrGGs, and a clinical model was developed based on these factors. An SVM model was constructed based on 12 radiomics features (3 radiomics features based on CE-T 1WI and 9 radiomics features based on T 2-FLAIR). The radiomics score of the probability output by the SVM model was combined with age, pathological grade, MGMT methylation status, and ependymal involvement to develop a combined model. The AUC values of the SVM model for predicting the high-risk molecular subtype of LrGGs were 0.824 and 0.859 in the training set and test set, respectively; the AUC values of the clinical model in the training set and test set were 0.759 and 0.721, respectively; and the AUC values of the combined model in the training set and test set were 0.823 and 0.815, respectively. The combined model had a high clinical net benefit. Conclusion:The machine learning MRI radiomics model can preoperatively predict high risk molecular subtypes of LGGrs, assist in individualized treatment decisions.

Objective:To investigate the clinical-epidemiological characteristics of connective tissue diseases (CTD) complicated with pulmonary hypertension in Shanxi province from 2018 to 2021.Methods:This was a cross-sectional study. Data of CTD patients with pulmonary hypertension from 2018 to 2021 were collected from the Shanxi Provincial Health Statistics Direct Reporting System based on inpatient medical records. The demographic and clinical data of patients with different CTD types were analyzed.Results:A total of 1 697 CTD patients with pulmonary hypertension were included, among whom there were 451 cases (26.58%) of Sj?gren′s syndrome, 392 cases (23.10%) of systemic lupus erythematosus, 289 cases(17.03%) of systemic sclerosis, 109 cases (6.42%) of mixed CTD, 69 cases (4.07%) of Takayasu arteritis, and 387 cases (22.80%) of other CTD. The majority of patients were female (1 410 (83.09%)), and 783 cases (46.14%) were aged between 41 and 65 years, and 6 cases (0.35%) were performed right heart catheterization. The prevalence of CTD with pulmonary hypertension increased from 0.06/10 4 in 2018 to 0.20/10 4 in 2021. There were significant differences in the severity of pulmonary hypertension, New York Heart Association (NYHA) functional class, length of hospital stay, medical costs, and clinical outcomes among patients with different CTD subtypes (all P<0.001). Patients with systemic sclerosis had the highest proportion of NYHA functional class Ⅲ/Ⅳ(65.1%(188/289)), the longest length of hospital stays (13 (9, 18) days), the highest average medical costs (13 622.67 (8 636.38, 20 597.75) ￥(RMB)), and the lowest rate of improvement and discharge (51.90%(150/289)). Conclusions:Between 2018 and 2021, Shanxi province, where CTD is more common in Sj?gren′s syndrome, has a high proportion of women, a high proportion of people aged 41-65 years, and a low prevalence of right ventricular catheterization in patients with CTD complicated with pulmonary hypertension. The prevalence of CTD complicated with pulmonary hypertension shows a rising trend in Shanxi province from 2018 to 2021, while patients with systemic sclerosis exhibit the most severe cardiac impairment and poorer clinical outcomes compared to other subtypes.

Cholera toxin B subunit(CTB)can enhance antigen presentation and promote T cell pro-liferation,B cell differentiation and B cell isotype conversion.Moreover,woodchuck hepatitis virus post transcriptional regulatory element(WPRE)can enhance gene expression efficiency by optimi-zing RNA polyadenylation,denuclearization and/or translation.In order to construct porcine epi-demic diarrhea virus like particles(VLPs)chimerized with CTB and WPRE and evaluate their im-munogenicity,the G Ⅱ type PEDV S gene,combined with the elements promoting the protein ex-pression and enhancing immune effects,was synthesized by the company and cloned into pET32a(+).Af-ter double enzyme digestion and gel recovery,the gene named as TSCW was cloned into pFastBacl to construct the recombinant plasmid pFastBac-TSCW.pFastBac-TSCW was further transformed into DH10Bac competent cells to obtain recombinant bacmid Bacmid-TSCW.Subsequently,the Bacmid-TSCW was transfected into sf9 cells to obtain recombinant baculovirus BV-TSCW.After co-infection of BV-TSCW and BV-M into sf9 cells,viral like particles VLP-TSCW was obtained and used to immunize mice to evaluate its immunogenicity.The results showed that the recombi-nant plasmid pFastBac-TSCW and bacmid Bacmid-TSCW were successfully constructed.After transfection of sf9 cells with recombinant baculovirus,significant cytopathic effects were observed.PCR and Western blot results showed that the recombinant baculoviruses existed stably in sf9 cells and the target proteins was also expressed stably.In addition,the electron microscopy results showed that BV-TSCW and BV-M successfully assembled into viral like particles VLP-TSCW.Furthermore,ELISA results indicated that VLP-TSCW induced high level specific antibodies.The above results laid the foundation for further optimization,design and development of PEDV VLPs subunit vaccines.

Objective To develop an ion-pairing reversed-phase high performance liquid chromatography(IP-RP-HPLC)method for the determination of L-methionine sulphoximine(MSX) residues in recombinant protein therapeutics, and to verify and preliminarily apply it, so as to provide a reference for the quality control of related products.Methods A chromatographic analysis method was screened and the mobile phase conditions such as ion-pairing reagent, pH and salt concentration were optimized to develop an IP-RP-HPLC method for the determination of MSX residues in recombinant protein therapeutics. The method was verified for specificity, system applicability, linearity, limit of detection(LOD) and limit of quantitation(LOQ), precision, accuracy and solution stability, by which the residual MSX contents in multiple batches of in-process sample and bulk of recombinant protein therapeutics were determined.Results The chromatographic conditions were determined as follows: using Hypersil GOLDTMC18 column(4. 6 mm × 250 mm, 5 μm) at column temperature of 25 ℃; 50 mmol/L sodium dihydrogen phosphate(containing 5 mmol/L sodium 1-octane sulfonate, pH 2. 0)-acetonitrile(volume fraction of 85 ∶ 15) as mobile phase for isocratic elution at a flow rate of 0. 6 mL/min; detection wavelength of 200 nm; injection volume of 50 μL. The method exhibited good specificity and system applicability. The control substance showed good linearity in the concentration range of 10-100 μg/mL, with a correlation coefficient(R) of 0. 999 95. The LOD and LOQ were 5 and 0. 5 μg/mL, respectively. MSX was not detected in either recombinant protein A or B, and the relative standard deviations(RSDs) of the measured concentrations of six parallel spiked samples were 1. 3% and 1. 1%, respectively, with the recovery rates ranged from 94% to 103%. For recombinant protein A spiked test sample placed at 10 ℃, the RSD of the measured concentrations at 0 h and 12 h were 2. 1%. MSX was not detected in the in-process samples and bulk of recombinant protein A test samples and three batches of recombinant protein B samples.Conclusion The developed IP-RP-HPLC method has the characteristics of simple operation and high sensitivity, and can be used for the quality control of MSX residues in recombinant protein therapeutics.

Based on his extensive clinical experience and the team's mechanistic research, Professor XU Nenggui has proposed the academic concept that "the governor vessel governs the brain and treats cerebral viscus diseases", and established a novel acupuncture approach for encephalopathy treatment centered on the integrated theory of "governor vessel-brain-mind", and developed a staged acupuncture protocol of "governor vessel regulating spirit" for ischemic stroke. This article introduces the academic features of this method in treating post-stroke dysphagia from four aspects: theoretical framework, treatment principles and point selection, mechanistic research, and clinical case studies. In clinical application, the method emphasizes syndrome differentiation based on meridians, harmonization between the conception and governor vessels; precise acupoint selection to treat both form and spirit; stage-specific differentiation with targeted needling. Furthermore, Professor XU integrates basic research with clinical practice, focusing on the neurobiological mechanisms underlying the efficacy of acupuncture in treating post-stroke dysphagia.
Acupuncture Therapy/methods* ; Humans ; Deglutition Disorders/psychology* ; Stroke/complications* ; Meridians ; Acupuncture Points

To address the challenges of complex digital model management and difficulties in model interoperability during the development of sophisticated products,this paper proposes an intelligent cloud architecture-based method for MBSE(model-based systems engineering)model microservice aggregation and adaptive integration.By introducing ontology semantic annotation and hash encoding mechanisms,we achieve unified encapsulation and service-oriented management of heterogeneous modeling tool resources.Combined with model virtual execution modes and dynamic resource orchestration technology,we design a task-oriented of Model-Based Microservice Deployment Framework,significantly improving model service scheduling efficiency and resource utilization.Leveraging a service-cluster-based model aggregation approach,we employ Hamming distance to calculate model capability compatibility,optimizing model discovery and orchestration processes.The prototype implementation and multi-phase experimental validation conducted in a domestic private cloud environment demonstrate that the proposed method effectively supports digital development across the entire lifecycle of aerospace products,enhancing model resource sharing and system integration efficiency.

Objective:To explore the intimal injury of two kinds of hemostatic clips under different clamping forces, and to optimize and verify the calculation formula of minimum occlusion force (MOF), so as to provide theoretical basis for selecting appropriate hemostatic clips to reduce vascular injury.Methods:A total of 96 male SD rats with body weight ranging from 280 to 300 g (Animal Experimental Center of Shanxi Medical University) were randomly assigned to metal hemostatic clip group ( n=48) and disposable hemostatic clip group ( n=48) by random number table method. Each group was further divided into four subgroups with clamping forces of 0.3, 0.6, 0.9 and 1.2 N for abdominal aortic injury experiments. The damage to the vascular intima was observed under a scanning electron microscope. A vascular closure model was established for mathematical analysis to derive the theoretical calculation formula of the arterial blood management factor (MOF). According to blood pressure (BP), blood vessel diameter (D) and hemostatic clamp width (W), the average values of theoretical and actual MOF data were analyzed by paired t test to verify the accuracy of the formula. From January 2021 to December 2022, six patients (with 12 branch arteries) who presented with oral and maxillofacial malignancies at the Department of Oral and Maxillofacial Surgery, Shanxi Medical University School and Hospital of Stomatology, were included to validate the accuracy of the MOF formula. Results:Under electron microscopy, when the clamping force was 0.3 N, the one-time hemostatic clip caused very little damage to the vascular intima (grade 1 injury), with only a few folds being flattened. When the clamping force was 0.6 N, both types of hemostatic clips caused partial peeling of the intima surface (grade 2-3 injury). However, when the clamping force was adjusted to 0.9 and 1.2 N, the damage caused by both types of hemostatic clips was more severe (grade 3-4 injury), with large areas of intima peeling or even disappearance. In some specimens of the metal hemostatic clip group, the damage even reached the muscular layer. Vascular closure model analysis showed that MOF=2×(1/2×π×D×W×BP), the mean diameter of abdominal aorta of 24 SD rats was (1.41±0.07) mm, the blood pressure was (83.29±11.56) mmHg (1 mmHg=0.133 kPa). The theoretical MOF value was (0.096±0.015) N, the actual clamping force (ACF) was (0.095±0.012) N, there was no statistical significance between the two groups ( t=-0.35, P=0.725). In clinical application, the MOF calculation formula was used to select the appropriate hemostatic clip for 12 arteries, successfully blocking the blood flow, verifying the accuracy of the formula. Conclusions:Hemostatic clips can cause damage to the inner membrane of blood vessels, and the greater the clamping force, the more severe the damage. Disposable hemostatic clips have certain advantages in avoiding excessive damage to the inner membrane of blood vessels. The theoretical MOF calculation formula has a certain degree of reliability and can be used as a reference to select the appropriate hemostatic clip with low damage.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.