OBJECTIVE To preliminarily investigate the antiasthmatic effect and mechanism of Ephedrae Herba-Armeniacae Semen Amarum herb pair on the respiratory center. METHODS Male SD rats were randomly divided into blank group， model group， dexamethasone group （positive control）， and Ephedrae Herba-Armeniacae Semen Amarum 2∶1， 1∶1 and 1∶2 groups. Rats in each group were administered different ratios of the herb pair decoction [all at 18 g （crude drug）/kg]， dexamethasone suspension （0.5 mg/kg）， or normal saline intragastrically twice daily for seven consecutive days. Forty minutes after the last administration， medicated cerebrospinal fluid was collected to determine the content of effective components entering the brain. One and a half hours after the last administration， the nucleus tractus solitarius （NTS） was located using a stereotaxic apparatus. Histamine phosphate （1 μL） was injected into the NTS region at a constant rate of 1 μL/min using a 10 μL microsyringe to induce excitation of the respiratory center in rats； the blank group was injected with normal saline. The contents of neurotransmitters [nerve growth factor （NGF）， substance P （SP）， norepinephrine （NA）， 5-hydroxytryptamine （5-HT） and acetylcholine （Ach）] in the medulla oblongata brain tissue were detected. The mRNA expressions of neurokinin-1 receptor （NK-1R）， p38 mitogen-activated protein kinase （MAPK）， and c-fos in the medulla oblongata， as well as the protein expressions of NK-1R， p38 MAPK， and c-fos in the NTS region， were determined. RESULTS The main active components of Ephedrae Herba-Armeniacae Semen Amarum herb pair entering the brain were ephedrine， pseudoephedrine， and methylephedrine. Compared with blank group， the contents of NGF， SP， NA， 5-HT and Ach， and the relative expression levels of NK-1R， p38 MAPK， and c-fos mRNA and protein were significantly increased in the model group （ P ＜0.01）. Compared with model group， Ephedrae Herba-Armeniacae Semen Amarum herb pair groups with different ratios significantly reduced the neurotransmitter contents and the relative expression levels of NK-1R， p38 MAPK， and c-fos mRNA and protein （ P ＜0.01）， with the 2∶1 Ephedrae Herba-Armeniacae Semen Amarum herb pair and 1∶1 mass ratios showing relatively better effects. CONCLUSIONS Ephedrae Herba alkaloids are the main active components in affecting the function of the respiratory center. The herb pair groups with a larger proportion of Ephedrae Herba exhibit stronger effects. Ephedrae Herba-Armeniacae Semen Amarum herb pair can reduce the excitability of the respiratory center by down-regulating the expression of the NK-1R/MAPK/c-fos pathway in the NTS and decreasing the abnormal release of neurotransmitters such as NGF and SP.

Objective: This prospective study evaluated the feasibility of chemical exchange saturation transfer (CEST) MRI for assessing disease activity in thyroid-associated ophthalmopathy (TAO). Materials and Methods: A total of 88 patients with active TAO, 76 with inactive TAO, and 30 healthy controls were enrolled. CEST MRI-derived magnetization transfer ratio (MTR) and MTR asymmetry (MTRasym) at 1 ppm, 2 ppm, and 3.5 ppm were calculated. Clinical data, MTR, and MTRasym values for the extraocular muscles (one representative muscle per eye, yielding two measurements per participant) were compared among the groups. Spearman’s correlation was used to examine associations between imaging parameters and the clinical activity score (CAS) in patients with TAO. Logistic regression analysis was used to identify independent associations between imaging parameters and disease activity in patients with TAO (active vs. inactive). Receiver operating characteristic (ROC) analysis was conducted to evaluate the diagnostic performance for discriminating active from inactive TAO. Results: Patients with active TAO showed lower MTR values (P < 0.001) and higher MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) (all P < 0.001) compared with those with inactive TAO. MTR was negatively correlated with CAS (r = -0.402; P < 0.001), while MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) were positively correlated with CAS (r = 0.369, 0.350, and 0.349, respectively;all P < 0.001). MTR and MTRasym (1 ppm) were independently associated with TAO activity. The areas under the ROC curve (AUCs) for MTR and MTRasym (1 ppm) in discriminating active from inactive TAO were 0.772 and 0.730, respectively. Combining MTR with MTRasym (1 ppm) significantly improved diagnostic performance compared with either parameter alone, achieving an AUC of 0.805 (P = 0.029 and 0.001). Conclusion MTR and MTRasym (1 ppm) were independently associated with TAO activity. Their combination further enhanced diagnostic performance in distinguishing active from inactive TAO, suggesting their potential as quantitative imaging biomarkers to guide treatment in patients with TAO.

Morinda officinalis is one of the “Four Great Southern Medicines” and is commonly used in clinical practice to treat erectile dysfunction and nocturnal emissions caused by kidney yang deficiency， uterine cold infertility， menstrual disorders， low abdominal pain， rheumatism， and muscle and bone weakness. Based on the principle of “treating raw and cooked differently”， this article summarizes the effects of different processing methods on the chemical constituents and pharmacological effects of M. officinalis . Research has found that processing can affect the content and structure of sugars， iridoids， and anthraquinones in M. officinalis ， thereby regulating its pharmacological effects such as anti-osteoporosis， immune regulation， anti-fatigue， and anti-depression. Among them， salt M. officinalis shows outstanding performance in anti-osteoporosis and enhancing immunity. Although previous studies have preliminarily elucidated the major chemical constituents of M. officinalis and their pharmacological characteristics， the dynamic transformation paths of constituents during the processing remain to be further clarified， especially the es tablishment of a quality marker system associated with the processing technology， to achieve the precision and intelligent development of the processing.

ObjectiveTo measure the distance from the surface of Fengfu （GV 16） to the deep important bony structures in children aged 4 to 8 years based on CT three-dimensional reconstruction technology， thereby providing imaging reference data for clinical acupuncture safe operations in terms of different age groups and needle insertion angles. MethodsCervical CT image data were collected from healthy children aged 4 to 8 years with five age groups （4-， 5-， 6-， 7-， 8-year-old groups）， 20 cases in each group. The images were imported into Mimics 21.0 software for three-dimensional reconstruction. The straight-line distances from the skin model surface of the Fengfu （GV 16） to the first underlying bony barrier （such as the lower edge of the occipital bone， the posterior arch of the atlas vertebra） were measured at intervals of 5° on both the transverse section （0° ± 35°） and the sagittal section （40° upward to 40° downward on the diagonal）. The correlation between the measured distance， age， and angle was analyzed. ResultsIn the transverse and sagittal sections， the measured distance from the skin surface to the underlying bone of Fengfu （GV 16） at each angle increased with age. In the transverse section， the increase was relatively small within the 0° to 20° angle range， whereas a more pronounced increase was observed when the angle exceeded 20°； at measurement angles of 30° to 35°， the distance of the skin surface to the bone at Fengfu （GV 16） in the 7- and 8-year-old groups was significantly greater than that in the 4-year-old group （P＜0.05）. In the sagittal section， the measured distance from the skin surface to the bone at Fengfu （GV 16） was shortest and changed greatly at oblique upward angles of 15° to 40° within each age group， and increased markedly at near-vertical angles of 0° to 10°； it was longest at oblique downward angles of -40° to -5° and showed relatively gradual changes. ConclusionThis study obtained the imaging distance data from Fengfu （GV 16） to the surrounding bony structures in children aged 4 to 8 years through three-dimensional modeling， finding that this distance has clear age and angle dependence， which can provide quantitative evidence for developing individualized and precise safe acupuncture schemes at Fengfu （GV 16） in pediatric clinical practice.

ObjectiveTo measure the distance from the surface of Fengfu （GV 16） to the deep important bony structures in children aged 4 to 8 years based on CT three-dimensional reconstruction technology， thereby providing imaging reference data for clinical acupuncture safe operations in terms of different age groups and needle insertion angles. MethodsCervical CT image data were collected from healthy children aged 4 to 8 years with five age groups （4-， 5-， 6-， 7-， 8-year-old groups）， 20 cases in each group. The images were imported into Mimics 21.0 software for three-dimensional reconstruction. The straight-line distances from the skin model surface of the Fengfu （GV 16） to the first underlying bony barrier （such as the lower edge of the occipital bone， the posterior arch of the atlas vertebra） were measured at intervals of 5° on both the transverse section （0° ± 35°） and the sagittal section （40° upward to 40° downward on the diagonal）. The correlation between the measured distance， age， and angle was analyzed. ResultsIn the transverse and sagittal sections， the measured distance from the skin surface to the underlying bone of Fengfu （GV 16） at each angle increased with age. In the transverse section， the increase was relatively small within the 0° to 20° angle range， whereas a more pronounced increase was observed when the angle exceeded 20°； at measurement angles of 30° to 35°， the distance of the skin surface to the bone at Fengfu （GV 16） in the 7- and 8-year-old groups was significantly greater than that in the 4-year-old group （P＜0.05）. In the sagittal section， the measured distance from the skin surface to the bone at Fengfu （GV 16） was shortest and changed greatly at oblique upward angles of 15° to 40° within each age group， and increased markedly at near-vertical angles of 0° to 10°； it was longest at oblique downward angles of -40° to -5° and showed relatively gradual changes. ConclusionThis study obtained the imaging distance data from Fengfu （GV 16） to the surrounding bony structures in children aged 4 to 8 years through three-dimensional modeling， finding that this distance has clear age and angle dependence， which can provide quantitative evidence for developing individualized and precise safe acupuncture schemes at Fengfu （GV 16） in pediatric clinical practice.

Morinda officinalis is one of the “Four Great Southern Medicines” and is commonly used in clinical practice to treat erectile dysfunction and nocturnal emissions caused by kidney yang deficiency， uterine cold infertility， menstrual disorders， low abdominal pain， rheumatism， and muscle and bone weakness. Based on the principle of “treating raw and cooked differently”， this article summarizes the effects of different processing methods on the chemical constituents and pharmacological effects of M. officinalis . Research has found that processing can affect the content and structure of sugars， iridoids， and anthraquinones in M. officinalis ， thereby regulating its pharmacological effects such as anti-osteoporosis， immune regulation， anti-fatigue， and anti-depression. Among them， salt M. officinalis shows outstanding performance in anti-osteoporosis and enhancing immunity. Although previous studies have preliminarily elucidated the major chemical constituents of M. officinalis and their pharmacological characteristics， the dynamic transformation paths of constituents during the processing remain to be further clarified， especially the es tablishment of a quality marker system associated with the processing technology， to achieve the precision and intelligent development of the processing.

ObjectiveTo examine the influencing mechanisms and regional differences in accessible facility utilization behavior among residents in eastern and central-western China. MethodsData were collected through the online questionnaire administered to residents across China using snowball sampling. Descriptive analysis and chi-square tests were conducted to compare the basic characteristics of respondents between the two regions. Welch's t test was used to compare accessible facility utilization behavior and its influencing factors. Multigroup structural equation modeling (SEM) was applied to compare the influencing mechanisms of accessible facility utilization behavior between eastern and central-western China. ResultsA total of 1 039 valid responses were obtained, including 604 from the eastern region and 435 from the central-western region. Residents in eastern regions scored significantly higher than those in central-western regions on both facility-seeking (t = 4.057, P < 0.001) and actual-using (t = 4.551, P < 0.001) behavior. The structural equation models for both regions showed identical and satisfactory goodness-of-fit indices (GFI = 0.950, AGFI = 0.932, IFI = 0.947, CFI = 0.947, RMSEA = 0.028), and all measurement and structural invariance tests met the recommended criteria. Facility configuration showed no significant direct effect on utilization behavior in eastern China, whereas a negative direct effect was observed in central-western China (β = -0.171, P = 0.047), with its influence mainly exerted indirectly through social cognition and user experience. Social cognition and user experience had significant positive effects on utilization behavior (P < 0.001). Meanwhile, social cognition indirectly influences utilization behavior through the mediating path of usage experience. The direct effects of social cognition (β = 0.406) and user experience (β = 0.510) in central-western China were greater than those in eastern China (β = 0.369 and β = 0.335, respectively). The chain mediation effect of "configuration-cognition-experience-behavior" was statistically significant in both regions (P < 0.05), with larger indirect effects observed in central-western China. ConclusionFacility configuration has a limited direct effect on accessible facility utilization, whereas social cognition and user experience play a central role, particularly in central-western China. It is recommended that the construction and renovation of accessible facility be guided by population needs, accompanied by strengthened promotion of accessibility concepts and policies, and that a transition from hardware-oriented construction to service- and management-oriented governance of accessible environments should be promoted in central-western China.

Antibody humanization is critical to reduce immunogenicity and enhance efficacy in the preclinical phase of the development of therapeutic antibodies originated from animal models.Computational suggestions have long been desired,but available tools focused on immunogenicity calculation of whole antibody sequences and sequence segments,missing the individual residue sites.This study introduces Site-specific Immunogenicity for Therapeutic Antibody(SITA),a novel computational framework that predicts B-cell immunogenicity score for not only the overall antibody,but also individual residues,based on a comprehensive set of amino acid descriptors characterizing physicochemical and spatial features for antibody structures.A transfer-learning-inspired framework was purposely adopted to overcome the scarcity of Antibody-Antibody structural complexes.On an independent testing dataset derived from 13 Antibody-Antibody structural complexes,SITA successfully predicted the epitope sites for Antibody-Antibody structures with a receiver operating characteristic(ROC)-area unver the ROC curve(AUC)of 0.85 and a precision-recall(PR)-AUC of 0.305 at the residue level.Furthermore,the SITA score can significantly distinguish immunogenicity levels of whole human antibodies,therapeutic antibodies and non-human-derived antibodies.More importantly,analysis of an additional 25 thera-peutic antibodies revealed that over 70％of them were detected with decreased immunogenicity after modification compared to their parent variants.Among these,nearly 66％antibodies successfully iden-tified actual modification sites from the top five sites with the highest SITA scores,suggesting the ability of SITA scores for guide the humanization of antibody.Overall,these findings highlight the potential of SITA in optimizing immunogenicity assessments during the process of therapeutic antibody design.

Objective:To summarize the technical experience of using a contralateral free gracilis myocutaneous flap combined with an adductor magnus perforator flap for salvaging failure of breast reconstruction after transplantation with the free adductor magnus perforator flap.Methods:A retrospective analysis was conducted on patients with breast cancer who received contralateral posteromedial thigh flap (gracilis myocutaneous flap combined with adductor magnus perforator flap) transplantation for immediate unilateral breast reconstruction developed vascular crisis and caused flap necrosis at the Department of Oncology Plastic Surgery, Hunan Cancer Hospital, between December 2016 to December 2022. All patients with early-stage breast cancer received modified radical mastectomy. All patients were selected to undergo the immediate breast reconstruction surgery with unilateral free adductor magnus perforator flap transplantation. The proximal end of internal mammary vessels were used as the recipient vessels in all cases. After the emergency exploration confirmed the necrosis of the flap, a contralateral free gracilis myocutaneous flap combined with adductor magnus perforator flap were immediately harvested for salvage breast reconstruction. The vascular pedicle of the gracilis muscular branch and the adductor magnus perforator branch were anastomosed with the proximal and distal ends of the internal mammary vessels, respectively. Postoperative patient monitoring was conducted intensively, with follow-up assessments focusing on breast contour and donor site recovery.Results:A total of 5 patients were included, aged 26 to 42 years, with an average of (31.5±1.8) years. All salvaged breast reconstruction surgeries were successful, the salvaged flap measured 15.0 cm×6.0 cm×4.0 cm-17.0 cm×7.5 cm×5.5 cm. All the transplanted flaps survived after the operation, with satisfactory breast contour, good flap elasticity, and no contracture or deformation. The donor sites of both thigh flaps healed well, leaving only linear scars and no significant functional impairment to the lower limbs. Follow-up ranged from 9 to 24 months, with an average of 15.7 months. The breast shape was satisfactory, and there was no recurrence of breast cancer.Conclusion:The donor site morbidity of the posteromedial thigh flap is relatively small. When unilateral flap transplantation fails, immediate transfer of the contralateral flap can be chosen for salvage reconstruction. This approach ensures symmetrical donor site outcomes and is generally well-accepted by patients.

Objective:To explore the effects of perceived stress on ego depletion of college students, as well as the mediating role of emotional eating and the moderating role of peer relationship.Methods:A cross-sectional survey of 1 088 college students was conducted using the perceived stress scale, the Dutch eating behavior questionnaire, the self-control resource depletion scale, and the peer relationship measurement from December 2023 to April 2024.PROCESS Macro program in SPSS 25.0 software was used to test the mediating effect of emotional eating and the moderating effect of peer relationship.Results:(1)The score of perceived stress, emotional eating, peer relationship and ego depletion were 39.26±8.35, 39.19±12.15, 2.00(1.00), and 18.19±7.15, respectively.(2)Perceived stress was positively correlated with emotional eating, ego depletion, and peer relationship( r=0.36, 0.61, 0.25, all P<0.01). Emotional eating was positively correlated with ego depletion and peer relationship( r=0.40, 0.19, both P<0.01). And ego depletion was positively correlated with peer relationship( r=0.23, P<0.01).(3)Emotional eating played a partial mediating role in the effect of perceived stress on ego depletion( β=0.077, 95% CI=0.053-0.104), and the mediating effect accounted for 12.38%(0.077/0.622) of the total effect.(4)Peer relationship played a moderating role between perceived stress and emotional eating. Under low peer relationship, perceived stress had a significant positive predictive effect on emotional eating( βsimple=0.46, P<0.01), and under high peer relationship, the predictive effect of perceived stress on emotional eating was significantly weaker( βsimple=0.26, P<0.01). Conclusions:Perceived stress not only directly affects ego depletion, but also indirectly affects ego depletion through emotional eating in college students.High levels of peer relationship can weaken the impact of perceived stress and high emotional eating on ego depletion.