Objective: To evaluate repeated testing on blood screening platforms in confirmation of non-discriminatory reactive (NDR) samples in nucleic acid testing (NAT). Methods: A total of 102 HBsAg-negative/NAT NDR samples were collected from voluntary blood donors at Dalian Blood Center between January 2021 and December 2023. Repeated testing was performed using two NAT platforms (Cobas s201 and Panther). For the first round of repeated testing, all samples were tested 12 times on each system; for the second round, the samples which were non-reactive or only reactive once in the first round were tested an additional 8 times. Anti-HBc and anti-HBs was detected using electrochemiluminescence assay (ECA). Meanwhile, blood donors were followed up. Results: The proportion of anti-HBc+ in 102 NDR samples was 88.2%. Forty-one samples (40.2%, 41/102) and 7 samples were confirmed HBV DNA+ in first-round and second-round repeated testing, respectively. The cumulative confirmation rate of HBV DNA+ was 47.1% (48/102) after repeated testing. Extra five blood donors detected HBV DNA+ in follow-up were identified as anti-HBc+ occult hepatitis B virus infection (OBI), while no window period infection was observed. Ultimately, there were 53 HBV infected donors confirmed, 46 HBV infection-unconfirmed, and 3 HBV uninfected. No significant difference was observed between the confirmation rate of the first-round testing and the cumulative confirmation rate after the second-round testing (P>0.05). The proportion of anti-HBc+ donors was quite high in both HBV infection-confirmed (98.1%) and unconfirmed group (82.6%), and donors with seronegative and anti-HBs-only occupied a high proportion in the latter (P<0.05). Conclusion: Numerous repeated testing of NDR samples using NAT platforms cannot achieve complete confirmation of HBV infection. Supplementary anti-HBc testing can minimize potential OBI risk among NDR donors, and is low-cost and efficient.

ObjectiveTo investigate the distribution characteristics and correlation of paired oral and esophageal microbiota in patients with esophageal squamous cell carcinoma （ESCC）. MethodsA total of 46 pathologically confirmed ESCC patients were enrolled， and oral swabs and cancerous tissue samples were collected. The microbial composition was analyzed using 16S rRNA gene sequencing， and bioinformatics methods were employed to compare the microbiota diversity， compositional differences， and correlations between the two sites. ResultsThe Alpha diversity of the oral microbiota in ESCC patients was significantly higher than that of their esophageal microbiota， though the overall community structure was similar between the two sites. LEfSe analysis revealed that Spirochaetes， Prevotella， Catonella， Enterococcus， Fusobacterium periodonticum， Veillonella parvula， Capnocytophaga sputigena， and Neisseria subflava were significantly enriched in ESCC tumor tissues. In contrast， Actinobacteria， Proteobacteria， Streptococcus， Neisseria， Haemophilus， Streptococcus mitis， Haemophilus parainfluenzae， Porphyromonas gingivalis， Haemophilus haemolyticus， and Prevotella tannerae were significantly enriched in the oral cavity. Correlation analysis demonstrated significant associations between the two sites at taxonomic levels such as Spirochaetes， Treponema， Granulicatella elegans， Neisseria macacae， Treponema amylovorum， Fusobacterium periodonticum， and Neisseria meningitidis （P<0.05）. ConclusionThe oral and esophageal microbiota in ESCC patients exhibit both distinct differences and similarities. Oral microbiota may influence the esophageal microenvironment through migration or local immune modulation.

ObjectiveTo investigate the effect of Hezhongxiaopi granules （HZXPG） on methylnitronitrosoguanidine （MNNG）-mediated gastric mucosal cell apoptosis and the regulatory effects on the Nicalin （Ncln）-C/EBP homologous protein （CHOP） axis and endoplasmic reticulum stress （ERS）. MethodsThe cell counting kit-8 （CCK-8） assay was employed to examine the inhibitory effect of MNNG on the proliferation of GES-1 cells， and the optimal effective dose of MNNG was selected. Human gastric mucosal GES-1 cells were allocated into the control， model （MNNG， 1.562 5 mmol·L^-1）， and low/high-dose HZXPG （5% and 10% HZXPG-containing serum） groups. Phalloidin staining was employed to detect MNNG-induced morphological changes in human gastric mucosal cells. Terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） assay was adopted to assess cell apoptosis. Annexin Ⅴ/propidium iodide （Annexin Ⅴ/PI） flow cytometry was utilized to measure the alterations in the apoptotic cycle of human gastric mucosal cells. Western blot was performed to determine the expression levels of proteins related to apoptosis， ERS， and the Ncln/CHOP axis. ResultsCompared with the control group， the model group exhibited a reduction in the surface area of GES-1 cells， endoplasmic reticulum （ER） dilation， increased early and late apoptosis rates of gastric mucosal cells， upregulated protein levels of truncated Bid （tBid）， Bcl-2-associated X protein （Bax）， cleaved-cysteinyl aspartate-specific proteinase （Caspase）-3， and cleaved-Caspase-8， and downregulated protein level of B-cell lymphoma-2 （Bcl-2） （P<0.01）. In addition， the expression levels of binding immunoglobulin protein （BiP）， Ncln， and CHOP were upregulated （P<0.01）， with enhanced Ncln expression in the ER and elevated CHOP expression in the nucleus. Compared with the model group， the high-dose HZXPG group showed a significant increase in the surface area of gastric mucosal cells. Both dose groups exhibited inhibited ER dilation and reduced early and late apoptosis rates of gastric mucosal cells （P<0.01）. Low-dose HZXPG decreased the expression of tBid and Bax （P<0.05， P<0.01） and promoted Bcl-2 expression （P<0.01）. High-dose HZXPG reduced the expression levels of tBid， Bax， cleaved-Caspase-3， and cleaved-Caspase-8 （P<0.05， P<0.01） and increased the Bcl-2 expression level （P<0.05）. Furthermore， high-dose HZXPG downregulated the expression levels of BiP， Ncln， and CHOP （P<0.05， P<0.01）， while decreasing the nuclear translocation of CHOP. ConclusionHZXPG alleviates MNNG-induced ERR-mediated apoptosis of gastric mucosal cells by inhibiting the Ncln-CHOP axis， thereby relieving gastric mucosal cell damage caused by precancerous gastric lesions.

The current classification methods for traditional Chinese medicine （TCM） visceral syndrome differentiation suffer from excessive generalization， which hinders their clinical application. Based on the analysis of the pattern of "one syndrome corresponding to multiple formulas"， this paper focused on the principle of syndrome-formula correspondence， and proposed that formula-syndromes are the smallest units for refining visceral syndromes. By establishing the correspondence between formula-syndromes and visceral syndromes， this study aims to further clarify the refined categories of syndromes and their treatment patterns， providing a new perspective for the standardization and objectification of TCM syndromes.

A brain-computer interface (BCI) based on motor imagery (MI) provides additional control pathways by decoding the intentions of the brain. MI ability has great intra-individual variability, and the majority of MI-BCI systems are unable to adapt to this variability, leading to poor training effects. Therefore, prediction of MI ability is needed. In this study, we propose an MI ability predictor based on multi-frequency EEG features. To validate the performance of the predictor, a video-guided paradigm and a traditional MI paradigm are designed, and the predictor is applied to both paradigms. The results demonstrate that all subjects achieved > 85% prediction precision in both applications, with a maximum of 96%. This study indicates that the predictor can accurately predict the individuals' MI ability in different states, provide the scientific basis for personalized training, and enhance the effect of MI-BCI training.
Humans ; Imagination/physiology* ; Electroencephalography/methods* ; Brain-Computer Interfaces ; Male ; Female ; Adult ; Young Adult ; Brain/physiology* ; Movement/physiology* ; Motor Activity/physiology* ; Psychomotor Performance/physiology*

Objective:To investigate the current status of treatment inertia in patients with chronic heart failure who were readmitted to hospitals, and to explore the influencing factors of treatment inertia in patients with chronic heart failure, so as to provide a basis for patients to provide effective and timely rehabilitation treatment.Methods:Using the phenomenological research method, 16 readmitted chronic heart failure patients from Shandong Provincial Hospital Affiliated to Shandong First Medical University, Qilu Hospital of Shandong University and the First Affiliated Hospital of Shandong First Medical University were selected by purpose sampling method from May to July 2024 for semi-structured interview; the interview data were analyzed and summarized by Colaizzi seven-step analysis method.Results:There were 12 males and 4 females, aged (60.63 ± 9.39) years old. There were three themes: behavioral characteristics of treatment inertia (including delayed initiation of treatment, refusal to upgrade treatment, poor treatment compliance); internal barriers of treatment inertia (including insufficient symptom perception, multiple pressures of patients, insufficient confidence in treatment); external influences of treatment inertia (including insufficient family support and limited medical resources).Conclusions:Treatment inertia is common in patients with chronic heart failure who are readmitted to the hospital, which leads to the diversification of influencing factors of treatment inertia and negatively affects the treatment effect of patients. Medical staff should conduct targeted analysis and treatment according to the specific situation of the patient, reduce the inertia of the patient′s treatment, promote the timely treatment of patients with chronic heart failure, actively cooperate with the treatment, and improve the patient′s recovery effect.

Objective To explore the medication rules and mechanism of Xin'an physicians in the treatment of diabetes mellitus.Methods The prescriptions for the treatment of diabetes mellitus in Xin'an medical writings were collected.The core drug prescriptions were obtained by using IBM SPSS Modeler 18.0 for dispensing association rules as well as complex network analysis,and the cluster analysis of high-frequency traditional Chinese medicines was carried out by using IBM SPSS Statistics 25.0.The active ingredients and targets of the core drugs were extracted from the BATMAN-TCM database.The GeneCards database was used to search for diabetes gene targets,and after obtaining the intersecting targets,the STRING online platform was imported to construct the protein interactions network,and screened the core genes by using the Cytoscape 3.9.1 software,and imported into the DAVID database for GO function and KEGG pathway enrichment analysis.Results A total of 135 valid prescriptions were included,involving 184 flavors of traditional Chinese medicines,with cold and mild properties.Sweet,bitter and pungent flavors,and the main attributes of lung,spleen,kidney,stomach and heart meridians.The association rules mined 14 pairs of commonly used medicine pairs.Cluster analysis clustered the top 20 traditional Chinese medicines into five cluster groups.Complex network visualization analysis formed a core prescription consisting of honey-fried licorice root,ginseng,rhizoma anemarrhenae,ophiopogon japonicus,poria cocos.The core prescription drugs were screened for 164 effective active ingredients,1,498 action targets,1,995 diabetes gene targets,404 intersecting targets,10 core targets were extracted,and a total of 1,363 items covering BP were obtained from GO functional enrichment analysis,129 items involving CC,264 items containing MF,and 206 items of KEGG signaling pathway.Conclusion The prescriptions and medicines used by Xin'an doctors in the treatment of diabetes mellitus reflect the academic idea of"treating both the symptoms and the root cause"as well as the therapeutic thought of"using cold and warmth,supplementing with sweetness and warmth,opening up and lowering with bitterness,cultivating the earth and generating gold,and consolidating the root and cultivating the elements",which provide references for the treatment of diabetes mellitus in today's clinics.

Objective To explore the medication rules and mechanism of Xin'an physicians in the treatment of diabetes mellitus.Methods The prescriptions for the treatment of diabetes mellitus in Xin'an medical writings were collected.The core drug prescriptions were obtained by using IBM SPSS Modeler 18.0 for dispensing association rules as well as complex network analysis,and the cluster analysis of high-frequency traditional Chinese medicines was carried out by using IBM SPSS Statistics 25.0.The active ingredients and targets of the core drugs were extracted from the BATMAN-TCM database.The GeneCards database was used to search for diabetes gene targets,and after obtaining the intersecting targets,the STRING online platform was imported to construct the protein interactions network,and screened the core genes by using the Cytoscape 3.9.1 software,and imported into the DAVID database for GO function and KEGG pathway enrichment analysis.Results A total of 135 valid prescriptions were included,involving 184 flavors of traditional Chinese medicines,with cold and mild properties.Sweet,bitter and pungent flavors,and the main attributes of lung,spleen,kidney,stomach and heart meridians.The association rules mined 14 pairs of commonly used medicine pairs.Cluster analysis clustered the top 20 traditional Chinese medicines into five cluster groups.Complex network visualization analysis formed a core prescription consisting of honey-fried licorice root,ginseng,rhizoma anemarrhenae,ophiopogon japonicus,poria cocos.The core prescription drugs were screened for 164 effective active ingredients,1,498 action targets,1,995 diabetes gene targets,404 intersecting targets,10 core targets were extracted,and a total of 1,363 items covering BP were obtained from GO functional enrichment analysis,129 items involving CC,264 items containing MF,and 206 items of KEGG signaling pathway.Conclusion The prescriptions and medicines used by Xin'an doctors in the treatment of diabetes mellitus reflect the academic idea of"treating both the symptoms and the root cause"as well as the therapeutic thought of"using cold and warmth,supplementing with sweetness and warmth,opening up and lowering with bitterness,cultivating the earth and generating gold,and consolidating the root and cultivating the elements",which provide references for the treatment of diabetes mellitus in today's clinics.

Objective:To systematically evaluate and synthesize qualitative studies on the illness experience of patients with heart failure, in order to inform the development of targeted health management and care strategies to improve patients' quality of life.Methods:A comprehensive literature search was conducted in PubMed, Web of Science, Embase, Cochrane Library, Wanfang Database, China National Knowledge Infrastructure, VIP Database, and China Biology Medicine disc from inception to January 31, 2025. Relevant qualitative studies on the illness experience of patients with heart failure were retrieved. Quality appraisal and data extraction were performed, and Meta-synthesis methods were used to integrate the findings.Results:A total of 12 studies were included, all of which were rated as grade B in quality appraisal. From these studies, 52 distinct findings were extracted and grouped into 10 new categories. These were further synthesized into 4 integrated themes: multidimensional decline in physical, psychological, and social functioning; increased need for support systems; negative experiences with disease perception and self-management; diverse strategies for disease acceptance and coping.Conclusions:The illness experience of heart failure patients is multidimensional. Medical staff should pay close attention to their physical, psychological, and social needs and adopt a patient-centered care model to deliver personalized and dynamic healthcare, thereby improving quality of life and clinical outcomes.

Objective:To develop and validate a nomogram prediction model for major adverse cardiovascular events (MACE) in elderly patients with chronic heart failure (CHF) based on the ratio of homocysteine to free triiodothyronine (HCY/FT3).Methods:This research was a prognostic study. A total of 1 301 elderly patients with CHF admitted to the Department of General Practice of Shanghai Fifth People′s Hospital Affiliated to Fudan University from January 2018 to January 2023 were enrolled and divided into MACE group ( n=564) and non-MACE group ( n=737) according to whether MACE occurred at the end of the follow-up. Baseline clinical data was collected. The follow-up period was 18 months, with the follow-up deadline being June 30, 2024. The primary endpoint was the occurrence of MACE, including death from any cause or re-hospitalization due to heart failure. Multivariate logistic regression analysis was used to determine the independent risk factors for MACE of elderly patients with CHF ( P<0.05). All patients included were randomly allocated into a training cohort ( n=913) and a validation cohort ( n=388) in a 7∶3 ratio. A nomogram prediction model was developed. The model was internally validated by bootstrapping. The discriminative ability of the model was assessed by calibration curves and receiver operating characteristic (ROC) curves. Results:Multivariable logistic regression analysis demonstrated that atrial fibrillation history, lower diastolic blood pressure, elevated uric acid, elevated free thyroxine (FT4), higher HCY/FT3 ratio, and lower left ventricular ejection fraction (LVEF) were independent predictors of MACE in elderly CHF patients ( P<0.05). A nomogram model incorporating these factors was developed. Internal validation using bootstrapping showed good calibration, as both training and validation cohort calibration curves closely approximated the ideal line. ROC curve analysis indicated an area under the curve of 0.721 (95% CI: 0.661-0.782) for the nomogram in predicting MACE. Conclusions:We developed and internally validated a nomogram incorporating the HCY/FT3 ratio to predict MACE risk in elderly CHF patients. This model demonstrated acceptable discrimination and good calibration, suggesting potential clinical utility for risk stratification.