The incidence,disability and mortality of nervous system diseases have risen sharply worldwide.At present,the pathogenesis and mechanism of nervous system diseases have not been clarified.Tongqiao Huoxue Decoction in Yi Lin Gai Cuo has the effects of promoting blood circulation and removing blood stasis,dredging orifices and activating collaterals.This article reviewed the clinical trials and basic research of Tongluo Huoxue Decoction and its modified prescriptions in the treatment of neurological diseases in recent years.It showed that this prescription is often used in the treatment of blood stasis syndrome at the brain orifices,which has a significant effect on improving brain function and treating a variety of intractable diseases related to brain nerves;its pharmacological mechanisms involve regulating neurotransmitters,restoring nerve function,inhibiting oxidative stress along with inflammatory responses,optimizing hemodynamics and blood rheology retarding vascular remodeling,and promoting angiogenesis.

Objective To establish a pose estimation model for recognizing instruments in intraluminal aortic intervention and to evaluate its efficiency as well as clinical applicability.Methods Forty-eight digital subtraction angiography(DSA)video clips of 45 patients who underwent intraluminal aortic intervention by physician or robot-assisted physician were collected and preprocessed into one video with totally 10 220 frames.The frames were categorized into 5 levels of background complexity.A key dataset of 5 110 frames was selected from 10 220 frames after intermittent frame extraction and divided into training set(n=4 599)and validation set(n=511).The accumulative numbers of guidewires,catheters,guidewire tips and catheter tips with manual labels in training set were recorded.Feature extraction was performed via a backbone network of this model,and an optical flow tracking algorithm was combined to achieve key point tracking between consecutive frames.After frame-by-frame inference across all 10 220 frames,the confusion results in training set were calculated,while the accuracy was calculated in validation set,the inference speeds were record in all sets,and the results were compared with those of U-Net.Results In validation set,the mean accuracy of the model for recognizing guidewires and catheters was 0.832 and 0.808,respectively,better than those of U-Net(0.767 and 0.793).For physician-operated procedures,the average accuracy of this model for recognizing guidewires and catheters within chest aorta was 0.787 and 0.756,which within abdominal aortic was 0.826 and 0.806,respectively.For robot-assisted procedures,the average accuracy of this model for recognizing guidewires and catheters in validation set was 0.855 and 0.834,respectively.Under 5 descending levels of background complexity,the model achieved recognizing accuracies of 0.594,0.865,0.817,0.793 and 0.764 for guidewires,and of 0.626,0.847,0.795,0.739 and 0.694 for catheters.In training set,this model accumulatively correctly classified guidewires,catheters,guidewire tips and catheter tips in 7 971,7 026,7 551 and 7 533 ones,accumulatively missed classified guidewires,catheters,guidewire tips and catheter tips in 1 271,1 357,812 and 863 ones,respectively.For all 10 220 frames,the inference frame rate of this model was 20.66 frames per second.Conclusion The obtained pose estimation model demonstrated excellent accuracies for recognizing instruments in intraluminal aortic intervention with real-time processing capability,which was able for clinical application.

BACKGROUND:Studies have shown that immune cells are involved in all processes of ischemic stroke,in which cuproptosis also plays a key role.OBJECTIVE:To screen diagnostic biomarkers related to the progression of ischemic stroke through bioinformatics,and analyze and validate cuproptosis-related genes closely related to the occurrence and development of ischemic stroke.METHODS:The GSE16561 microarray was obtained from the GEO database,containing data from 39 cases of ischemic stroke(ischemic stroke group)and 24 controls(control group).Differentially expressed genes from the ischemic stroke microarray data were analyzed.Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed.By using LASSO and Random Forest methods,key genes affecting the occurrence and development of ischemic stroke were screened,and a diagnostic model was established and validated.Differential gene analysis was performed through immune cell infiltration and weighted gene co expression network.The differentially expressed immune-related genes were intersected with cuproptosis genes to obtain the hub genes related to cuproptosis immunity.In vitro cell experiments were conducted to divide rat hippocampal neurons into a normal group and an ischemic stroke group,and qPCR experiments were performed to verify the results.RESULTS AND CONCLUSION:(1)573 differentially expressed genes were obtained by differential analysis.Differentially expressed genes were mainly enriched in biological processes,such as positive regulation of immune response,and signaling pathways such as lipid and atherosclerosis.(2)Machine learning methods were used to screen diagnostic genes such as MFN2,PKM2,CREG1,and FOXO3A,which may have some diagnostic value for ischemic stroke.(3)Immune infiltration analysis revealed resting plasma cells,NK cells,macrophages,etc.,indicating that immune cells play a certain role in the pathogenesis of ischemic stroke.(4)Weighted gene co-expression network analysis combined with immune infiltration analysis obtained 118 key module genes,which were intersected with cuproptosis genes to obtain 2 cuproptosis and immune characteristic genes.The correlation analysis between four diagnostic genes and Hub genes showed that the expression of FOXO3A and MFN2,PKM2 and BCL2L1,MTF1 and MFN2,ATP7B and BCL2L1 were correlated.(5)The qPCR results showed significant differences in the genes MTF1 and ATP7B between the ischemic stroke group and the blank group.To conclude,ATP7B and MTF1 can serve as characteristic genes for cuproptosis in ischemic stroke.It is possible to improve ischemic stroke by intervening in ATP7B and MTF1 to regulate cuproptosis.

The incidence,disability and mortality of nervous system diseases have risen sharply worldwide.At present,the pathogenesis and mechanism of nervous system diseases have not been clarified.Tongqiao Huoxue Decoction in Yi Lin Gai Cuo has the effects of promoting blood circulation and removing blood stasis,dredging orifices and activating collaterals.This article reviewed the clinical trials and basic research of Tongluo Huoxue Decoction and its modified prescriptions in the treatment of neurological diseases in recent years.It showed that this prescription is often used in the treatment of blood stasis syndrome at the brain orifices,which has a significant effect on improving brain function and treating a variety of intractable diseases related to brain nerves;its pharmacological mechanisms involve regulating neurotransmitters,restoring nerve function,inhibiting oxidative stress along with inflammatory responses,optimizing hemodynamics and blood rheology retarding vascular remodeling,and promoting angiogenesis.

Objective To establish a pose estimation model for recognizing instruments in intraluminal aortic intervention and to evaluate its efficiency as well as clinical applicability.Methods Forty-eight digital subtraction angiography(DSA)video clips of 45 patients who underwent intraluminal aortic intervention by physician or robot-assisted physician were collected and preprocessed into one video with totally 10 220 frames.The frames were categorized into 5 levels of background complexity.A key dataset of 5 110 frames was selected from 10 220 frames after intermittent frame extraction and divided into training set(n=4 599)and validation set(n=511).The accumulative numbers of guidewires,catheters,guidewire tips and catheter tips with manual labels in training set were recorded.Feature extraction was performed via a backbone network of this model,and an optical flow tracking algorithm was combined to achieve key point tracking between consecutive frames.After frame-by-frame inference across all 10 220 frames,the confusion results in training set were calculated,while the accuracy was calculated in validation set,the inference speeds were record in all sets,and the results were compared with those of U-Net.Results In validation set,the mean accuracy of the model for recognizing guidewires and catheters was 0.832 and 0.808,respectively,better than those of U-Net(0.767 and 0.793).For physician-operated procedures,the average accuracy of this model for recognizing guidewires and catheters within chest aorta was 0.787 and 0.756,which within abdominal aortic was 0.826 and 0.806,respectively.For robot-assisted procedures,the average accuracy of this model for recognizing guidewires and catheters in validation set was 0.855 and 0.834,respectively.Under 5 descending levels of background complexity,the model achieved recognizing accuracies of 0.594,0.865,0.817,0.793 and 0.764 for guidewires,and of 0.626,0.847,0.795,0.739 and 0.694 for catheters.In training set,this model accumulatively correctly classified guidewires,catheters,guidewire tips and catheter tips in 7 971,7 026,7 551 and 7 533 ones,accumulatively missed classified guidewires,catheters,guidewire tips and catheter tips in 1 271,1 357,812 and 863 ones,respectively.For all 10 220 frames,the inference frame rate of this model was 20.66 frames per second.Conclusion The obtained pose estimation model demonstrated excellent accuracies for recognizing instruments in intraluminal aortic intervention with real-time processing capability,which was able for clinical application.

BACKGROUND:Studies have shown that immune cells are involved in all processes of ischemic stroke,in which cuproptosis also plays a key role.OBJECTIVE:To screen diagnostic biomarkers related to the progression of ischemic stroke through bioinformatics,and analyze and validate cuproptosis-related genes closely related to the occurrence and development of ischemic stroke.METHODS:The GSE16561 microarray was obtained from the GEO database,containing data from 39 cases of ischemic stroke(ischemic stroke group)and 24 controls(control group).Differentially expressed genes from the ischemic stroke microarray data were analyzed.Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed.By using LASSO and Random Forest methods,key genes affecting the occurrence and development of ischemic stroke were screened,and a diagnostic model was established and validated.Differential gene analysis was performed through immune cell infiltration and weighted gene co expression network.The differentially expressed immune-related genes were intersected with cuproptosis genes to obtain the hub genes related to cuproptosis immunity.In vitro cell experiments were conducted to divide rat hippocampal neurons into a normal group and an ischemic stroke group,and qPCR experiments were performed to verify the results.RESULTS AND CONCLUSION:(1)573 differentially expressed genes were obtained by differential analysis.Differentially expressed genes were mainly enriched in biological processes,such as positive regulation of immune response,and signaling pathways such as lipid and atherosclerosis.(2)Machine learning methods were used to screen diagnostic genes such as MFN2,PKM2,CREG1,and FOXO3A,which may have some diagnostic value for ischemic stroke.(3)Immune infiltration analysis revealed resting plasma cells,NK cells,macrophages,etc.,indicating that immune cells play a certain role in the pathogenesis of ischemic stroke.(4)Weighted gene co-expression network analysis combined with immune infiltration analysis obtained 118 key module genes,which were intersected with cuproptosis genes to obtain 2 cuproptosis and immune characteristic genes.The correlation analysis between four diagnostic genes and Hub genes showed that the expression of FOXO3A and MFN2,PKM2 and BCL2L1,MTF1 and MFN2,ATP7B and BCL2L1 were correlated.(5)The qPCR results showed significant differences in the genes MTF1 and ATP7B between the ischemic stroke group and the blank group.To conclude,ATP7B and MTF1 can serve as characteristic genes for cuproptosis in ischemic stroke.It is possible to improve ischemic stroke by intervening in ATP7B and MTF1 to regulate cuproptosis.

Transbronchoscopic freezing technology has made remarkable achievements in the treatment of respiratory diseases. Transbronchoscopic freezing technology uses the principle of low temperature freezing to treat pathological tissue. This technique has been widely used in the diagnosis and treatment of various respiratory pathological，including freeze-thaw and freeze-cutting techniques. With the development of bronchoscopic intervention technology，the application range of refrigeration technology has gradually expanded，and its safety and effectiveness have also been improved. This review systematically introduced the technique of transbronchoscopic freezing and its application in pediatric interventionarespiratory medicine，aiming to maket more pediatric peers aware of this technology,and apply it more effectively in respiratory intervention treatment.

ObjectiveTo investigate the effect of Ziziphi Spinosae Semen-Albiziae Flos on the nucleotide-binding oligomerization domain，NOD-like receptor thermal protein domain associated protein 1 （NLRP1）/chemokine ligand 1 （CXCL1）/chemokine receptor 2 （CXCR2） pathway in the hippocampus of the rat model of chronic unpredictable mild stress （CUMS）-induced depression. MethodA total of 120 male SD rats were randomized into blank，CUMS，CUMS + low-，medium-，and high-dose （4，8，16 g·kg^-1） Ziziphi Spinosae Semen-Albiziae Flos，and CUMS + venlafaxine hydrochloride （0.008 g·kg^-1） groups，with 20 rats in each group.The rat model of depression was established by solitary feeding combined with CUMS.The behaviors and spatial learning and memory abilities of rats were examined by sugar water consumption test，tail suspension test，forced swimming test，and Morris water maze test.Quantitative real-time PCR （Real-time PCR） and Western blot were employed to determine the expression of factors associated with the NLRP1/CXCL1/CXCR2 pathway in the hippocampus.Enzyme-linked immunosorbent assay was employed to determine the levels of tumor necrosis factor-α （TNF-α），interleukin （IL）-18，IL-1β，and IL-6 in the hippocampus.The immunofluorescence assay was used to measure the levels of reactive oxygen species （ROS） in the hippocampus. ResultCompared with the blank group，the CUMS group showed decreased preference to sugar water and times of crossing the platform （P<0.01），and increased immobility time of tail suspension，forced swimming floating time，and escape latency （P<0.01）.Compared with the CUMS group，the administration of Ziziphi Spinosae Semen-Albiziae Flos and venlafaxine hydrochloride alleviated the effects of CUMS on the above-mentioned behaviors and spatial learning and memory abilities of the rats （P<0.05，P<0.01）.Compared with the blank group，the CUMS group showed up-regulated protein levels of NLRP1，CXCL1，and CXCR2 （P<0.01） and elevated levels of IL-18，IL-1β，TNF-α，and IL-6 （P<0.01） in the hippocampus.The treatment with Ziziphi Spinosae Semen-Albiziae Flos and venlafaxine hydrochloride attenuated the activation of NLRP1/CXCL1/CXCR2 signaling pathway and lowered the levels of inflammatory cytokines in the hippocampus of CUMS rats （P<0.05，P<0.01）.In addition，Ziziphi Spinosae Semen-Albiziae Flos lowered the level of ROS in the hippocampus （P<0.05，P<0.01）. ConclusionZiziphi Spinosae Semen-Albiziae Flos can mitigate the depressive behaviors of the rat model of CUMS-induced depression by inhibiting the activation of NLRP1/CXCL1/CXCR2 signaling pathway.

OBJECTIVE To analyze the current status and research hot spots of traditional Chinese medicine （TCM）in the prevention and treatment of myocardial ischemia -reperfusion injury （MIRI），and to provide reference for developing relevant studies. METHODS A bibliometric analysis was performed with the literature on TCM treatments for MIRI included in the Web of Science as the data source . RESULTS A total of 972 literatures were included in this study . The research on TCM for prevention and treatment of MIRI in recent 10 years showed an increasing trend year by year ，and the literature published in 2021 were cited most frequently ；most research scholars focused in China ；Peking Union Medical College ，Chinese Academy of Medical Sciences had the most papers in this field ，and a lot of collaboration with other institutions ，which had a large influence in the field ；Sun Guibo and Sun Xiaobo were high -yielding authors in the field ，but the global authorship was not very close and had not formed cooperative teams of some scale ；Molecular Medicine Reports was perhaps the most popular journal in the field . Co-citation analysis found that the research direction in this field was mostly focused on exploring the pathogenesis of MIRI and finding intervention targets . Key words analysis revealed that TCM regulated apoptosis ， pyroptosis， mitochondrial dysfunction ， miRNA and other pathways to improve MIRI research was a hot spot in the field ，and more studies had focused on the Nrf 2 pathway，NF-κB pathway ，NLRP3 inflammasomepathway， TNF pathway ， SIRT3 pathway， JNK pathway ，PI3K/Akt pathway and AMPK pathway . CONCLUSIONS Much attention has been paid to the prevention and treatment of MIRI by TCM in the past 10 years，and the current hot spots in this field are mostly focused on the studies about the intervention mechanism of TCM ’s active ingredients and Chinese patent medicines on MIRI . Moreover，the research about TCM in the treatment of MIRI is mostly focused on the field of basic experiments at present ，and it is recommended that many large -scale，high-quality， multicenter，randomized controlled clinical studies should be carried out in the future ，to provide high -grade evidence -based evidence for the application of TCM in clinic .

Pre-testing preparation is the basis and starting point of genetic testing.The process includes collection of clinical information,formulation of testing scheme,genetic counseling before testing,and completion of informed consent and testing authorization.To effectively identify genetic diseases in clinics can greatly improve the diagnostic rate of next generation sequencing (NGS),thereby reducing medical cost and improving clinical efficacy.The analysis of NGS results relies,to a large extent,on the understanding of genotype-phenotype correlations,therefore it is particularly important to collect and evaluate clinical phenotypes and describe them in uniform standard terms.Different types of genetic diseases or mutations may require specific testing techniques,which can yield twice the result with half the effort.Pre-testing genetic counseling can help patients and their families to understand the significance of relevant genetic testing,formulate individualized testing strategies,and lay a foundation for follow-up.