ObjectiveTo systematically compare the effects of diverse electromagnetic stimulation protocols on hand function and activities of daily living (ADL) in stroke patients using network meta-analysis (NMA), and screen the optimal stimulation strategy for post-stroke hand dysfunction rehabilitation. MethodsNMA was performed in accordance with the PRISMA-NMA statement. Databases of CNKI, Wanfang data, VIP, CBM, PubMed, Web of Science and Embase were searched from database inception to April, 2026 for eligible randomized controlled trials (RCTs) comparing different electromagnetic stimulation protocols for post-stroke hand impairment. The Cochrane Risk of Bias tool and PEDro scale were used to assess methodological quality of included studies, while the GRADE system was adopted to grade evidence quality of primary outcomes of Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI). After literature screening, data extraction and bias evaluation, RevMan 5.4 and Stata 17.0 were used for meta-analysis and NMA. ResultsA total of 22 RCT involving 17 electromagnetic stimulation protocols were finally included. The PEDro scores ranged from six to ten. The top five protocols for improving FMA-UE score were repetitive peripheral magnetic stimulation (rPMS) + repetitive transcranial magnetic stimulation (rTMS), intermittent theta-burst stimulation (iTBS) + rPMS, iTBS + transcranial direct current stimulation (tDCS), transcutaneous electrical acupoint stimulation (TEAS) and contralaterally controlled functional electrical stimulation (CCFES). tDCS was the most effective on MBI, followed by TEAS and iTBS+rPMS. Evidence quality for FMA-UE and MBI was moderate. Funnel plots suggested low risk of publication bias, and consistency tests verified good coherence between direct and indirect comparisons in network models. ConclusionElectromagnetic stimulation significantly facilitates upper limb and hand functional recovery, and improves ADL in stroke patients. The combined central-peripheral magnetic stimulation protocol may be the most effective on motor rehabilitation, whereas tDCS on ADL.

Objective:To retrospectively analyse the clinical data of patients after NUSS procedure for pectus excavatum, and summary of surgical techniques for NUSS bar removal.Methods:Retrospectively collected the clinical data of 276 patients undergoing NUSS bar removal from January 2024 to September 2024 in Beijing Children's Hospital affiliated to Capital Medical University. The age of the patients ranged from 6 to 20 years old, 211 males and 65 females. The average time the bar was in place in the body was 36 months.Results:All 276 patients successfully completed the NUSS bar removal. The average operative time was 22.6 min, with an average blood loss of 3.3 ml. 90 patients with bone scabs, 104 patients with wire breakage were successfully removed. 2 cases of postoperative wound infection, no other intraoperative and postoperative complications. The average hospitalization time after surgery was 1.2 days. Follow up for 3 months after surgery, and no abnormalities were found on the chest X-ray.Conclusion:Mastering the surgical techniques for pectus excavatum bar removal enhances the safety and efficiency of the procedure. It effectively reduces the incidence of intraoperative and postoperative complications, shortens operative time, and alleviates postoperative pain in patients.

Objective To explore the association between plasma fibrinogen(FBG)levels and the risk of in-hospital mortality among patients with septic shock.Methods The clinical data of 563 patients diagnosed with septic shock in the Intensive Care Unit(ICU)of Shenzhen Second People's Hospital from August 1,2018,to December 31,2020,were collected.Patient demographic information,basic vital signs,and blood routine and biochemical indices upon admission were gathered.Moreover,the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHEⅡ)scores were calculated.Binary logistic regression analysis was conducted to explore the correlation between plasma fibrinogen levels and in-hospital mortality in patients with septic shock.Additionally,a generalized additive model(GAM)and smoothed curve fitting were employed to investigate the nonlinear relationship between plasma fibrinogen and in-hospital mortality.Receiver operating characteristic(ROC)curves were constructed for FBG and APACHEⅡ scores to predict in-hospital mortality in septic shock patients.The area under the curve(AUC)was computed to compare the predictive efficacies of the two.Furthermore,a segmented linear regression model was utilized for quantification.Results Binary logistic regression analysis demonstrated a significant negative correlation between plasma fibrinogen levels and in-hospital mortality among patients with septic shock(P<0.05).GAM modeling and smoothed curve fitting disclosed a nonlinear association between plasma fibrinogen levels and in-hospital mortality,with an inflection point at 5.54 g/L.The segmented linear regression model indicated that,to the left of the inflection point(FBG≤5.54 g/L),for every 1 g/L decrease in plasma fibrinogen,the risk of death increased by 24.5%(OR=0.755,P=0.003).Conversely,to the right of the inflection point(FBG>5.54 g/L),the relationship was not statistically significant(OR=1.049,P=0.685).The findings of the subgroup analyses indicated that the characteristics of the subgroups did not alter the relationship between blood fibrinogen levels and in-hospital mortality.Conclusion There is a nonlinear relationship between FBG levels and in-hospital mortality in patients with septic shock,which has predictive value for evaluating the risk of in-hospital mortality in this patient cohort.

The anti-inflammatory phytochemical investigation of the leaves of Illicium dunnianum (I. dunnianum) resulted in the isolation of five pairs of new lignans (1-5), and 7 known analogs (6-12). The separation of enantiomer mixtures 1-5 to 1a/1b-5a/5b was achieved using a chiral column with acetonitrile-water mixtures as eluents. The planar structures of 1-2 were previously undescribed, and the chiral separation and absolute configurations of 3-5 were reported for the first time. Their structures were determined through comprehensive spectroscopic data analysis [nuclear magnetic resonance (NMR), high-resolution electrospray ionization mass (HR-ESI-MS), infrared (IR), and ultraviolet (UV)] and quantum chemistry calculations (ECD). The new isolates were evaluated by measuring their inhibitory effect on NO in lipopolysaccharide (LPS)-stimulated BV-2 cells. Compounds 1a, 3a, 3b, and 5a demonstrated partial inhibition of NO production in a concentration-dependent manner. Western blot and real-time polymerase chain reaction (PCR) assays revealed that 1a down-regulated the messenger ribonucleic acid (mRNA) levels of tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), COX-2, and iNOS and the protein expressions of COX-2 and iNOS. This research provides guidance and evidence for the further development and utilization of I. dunnianum.
Lignans/isolation & purification* ; Plant Leaves/chemistry* ; Anti-Inflammatory Agents/isolation & purification* ; Mice ; Animals ; Molecular Structure ; Plant Extracts/pharmacology* ; Illicium/chemistry* ; Cyclooxygenase 2/immunology* ; Interleukin-6/immunology* ; Nitric Oxide/metabolism* ; Cell Line ; Tumor Necrosis Factor-alpha/immunology* ; Nitric Oxide Synthase Type II/immunology* ; Lipopolysaccharides

OBJECTIVE: To explore and quantify the association of hot night exposure during the sperm development period (0-90 lag days) with semen quality. METHODS: A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014-2020 were recruited in this multicenter study. Two indices (i.e., hot night excess [HNE] and hot night duration [HND]) were used to estimate the heat intensity and duration during nighttime. Linear mixed models were used to examine the association between hot nights and semen quality parameters. RESULTS: The exposure-response relationship revealed that HNE and HND during 0-90 days before semen collection had a significantly inverse association with sperm motility. Specifically, a 1 °C increase in HNE was associated with decreased sperm progressive motility of 0.0090 (95% confidence interval [ CI]: -0.0147, -0.0033) and decreased total motility of 0.0094 (95% CI: -0.0160, -0.0029). HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021 (95% CI: -0.0040, -0.0003) and 0.0023 (95% CI: -0.0043, -0.0002), respectively. Consistent results were observed at different temperature thresholds on hot nights. CONCLUSION Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
Humans ; Male ; Semen Analysis ; Adult ; Sperm Motility ; Hot Temperature/adverse effects* ; China ; Middle Aged ; Spermatozoa/physiology* ; Young Adult

Objective To investigate the expression pattern of IQGAP2 in renal cell carcinoma tissues and cell lines,and to analyze its effects on the proliferation and migration of renal cell carcinoma cells.Methods Firstly,GEO database was used to screen differentially expressed genes between renal cell carcinoma tissues,and GEPIA,TIMER2.0 were used to analyze the expression level of IQGAP2 in renal cell carcinoma tissue.Subse-quently,knockdown(siRNA)and overexpression plasmids of IQGAP2 were constructed and transfected into ACHN and 786-O cell lines to perform a series of functional experiments to evaluate the effect of IQGAP2 on the malignant biological behavior of renal carcinoma cells.qRT-PCR and Western Blot were used to detect the expres-sion of EMT(epithelial-mesenchymal transition)related proteins after knockdown and overexpression of IQGAP2.Results In renal cell carcinoma tissues,the relative expression of IQGAP2 was significantly lower than in adja-cent normal tissues(P<0.001).Transfection of si-IQGAP2 in ACHN and 786-O cells effectively downregulated the mRNA and protein expression levels of IQGAP2(P<0.01),while transfection with an overexpression plasmid significantly upregulated its mRNA and protein expression(P<0.001).Further studies revealed that overexpression of IQGAP2 significantly inhibited the proliferation(P<0.05)and migration(P<0.01)of ACHN and 786-O cells,whereas knockdown of IQGAP2 enhanced their proliferation(P<0.05,P<0.001)and migration(P<0.01).Through qRT-PCR and Western blot analyses of EMT-related proteins,it was found that reduced expression of IQGAP2 promoted the epithelial-mesenchymal transition(EMT)process in renal cancer cells.Conclusions The expression of IQGAP2 is low in renal cell carcinoma tissues and cells,and the decrease of the expression level can promote the EMT process of renal cell carcinoma cells,and then enhance the proliferation and migration of renal cell carcinoma cells.IQGAP2 plays an important tumor suppressor role in renal cell carcinoma.

Objective To integrate and optimize the hospital adverse event reporting system,and to enhance the repor-ting rate of medical safety adverse events by using PDCA cycle management method.Achieve closed-loop management of adverse events,improve the efficiency of adverse event management in the hospital,assist in hospital grading review and-quality develop-ment,and reduce the mortality rate of low-risk groups in the hospital.Methods Based on the SPO theory,the quality control circle,PDCA management,flow chart and description method were used,and combined with the previous adverse event manage-ment experience,the adverse event reporting and tracking process was simplified,and adverse event management information platform was optimized and restructured.The period from January to December 2023(control group)and the period from January to 2024(observation group)were compared and analyzed for the number of adverse event reports per 100 discharges and the mor-tality rate of the low-risk group before and after the implementation of PDCA cycle management.Results The application of PDCA cycle management effectively improved the reporting rate of medical safety adverse events and reduced the mortality rate of the hospital's low-risk group.Conclusion The integrated and designed adverse event management system has good applicability and can be promoted for use in hospital management.

Objective:To investigate the changes of serum complement C1q/tumor necrosis factor-associated protein 3 (CTRP3) in patients with rheumatoid arthritis (RA) and its clinical significance.Methods:A total of 60 RA patients admitted to Chongming Hospital affiliated to Shanghai University of Medicine & Health Sciences (Chongming Branch of Xinhua Hospital) from January 2023 to February 2024 were collected.They were divided into a plaque group (38 cases) and a plaque free group (22 cases) according to the results of carotid intima-media thickness (cIMT) by carotid artery ultrasonography. ESR, CRP, blood lipid, HOMA-IR, RF, CCP antibody and CTRP3 levels were detected, and the relationship between CTRP3 levels and disease activity and atherosclerosis in RA patients was analyzed. The statistical analysis was carried out with independent t-test, analysis of variance, Pearson correlation analysis and logistic regression. Results:Serum CTRP3 level in RA patients was lower than that in healthy control group [(116±44)ng/ml and (184±63)ng/ml, t=-6.54, P=0.004]. The CTRP3 level in RA group with plaque was lower than that in RA group without plaque [(98±28) ng/ml and (123±38)ng/ml, t=-5.57, P=0.008]. Serum CTRP3 levels in RA patients were correlated with LDL-C ( r=-0.68, P=0.011), HOMA-IR ( r=-0.74, P=0.001), RF ( r=-0.46, P=0.042), anti-CCP antibody( r=-0.54, P=0.037), DAS28 ( r=-0.66, P=0.024) were negatively correlated with cIMT ( r=-0.76, P=0.001), and positively correlated with DMARDs duration ( r=0.51, P=0.040) and flow-mediated di latatiton ( r=0.70, P=0.004). The CTRP3 level [( OR(95% CI)=0.683(0.355, 0.807), P=0.023] was an independent correlation factor affecting cIMT. Conclusion:CTRP3 level in RA patients is significantly lower than that in healthy control group, and is negatively correlated with insulin resistance, autoantibody level and disease activity, and has a protective effect on early atherosclerosis in RA patients.

[Purpose]To analyze the causes of death and potential life loss of malignant tumors in Sichuan Province from 2017 to 2022.[Methods]Data were collected from the death information registration and management system of China Disease Prevention and Control Information System,and national cause of death monitoring sites in Sichuan Province from 2017 to 2022.SAS 9.4 and Joinpoint 4.9.1.0 software were used to calculate crude cancer mortality rate,age-standardized mortality rate by Chinese standerd population(ASMRC),annual percentage change and potential years of life lost(PYLL)and potential years of life lost rate(PYLLR).[Results]From 2017 to 2022,the crude cancer mortality rate in Sichuan Province was 169.32/105,and the ASMRC was 111.26/105.The cancer mortality rate in the general population and that stratified by sex showed an increasing trend(all P＜0.05).The top 5 causes of cancer death were lung cancer,liver cancer,esophageal cancer,gastric cancer and colorectum cancer.The mortality rates of lung cancer,colorectum can-cer,female breast cancer,pancreatic cancer,lip,oral and pharyngeal malignancies all increased(all P＜0.05).From 2017 to 2022,the PYLL caused by malignant tumors in Sichuan Province was 1 520 175.00 person-year,the PYLLR was 13.98‰.[Conclusion]In Sichuan Province,the mortali-ty rate of malignant tumors is on the rise.Lung cancer and gastrointestinal cancers are the main malignancies causing life loss.Early diagnosis and treatment of key cancers should be strengthened to reduce cancer mortality.

Reninoma is a rare renal secretory tumor，prevalent in the young population. This disease is mostly surgically resected，and the use of microwave ablation to treat reninoma in children is scarce. A case of reninoma in a child was reported in this paper. The patient presented with refractory hypertension，hypokalemia，hyperreninemia and hyperaldosteronemia. Enhanced CT and contrast-enhanced ultrasound showed mass in the lower pole of the right kidney，which was considered as reninoma and microwave ablation was performed. The renin concentration decreased to 68.42 pg/ml at 4 hours after surgery. After 1 year of postoperative follow-up，there was no recurrence of hypertension and hypokalemia，and no signs of tumor recurrence were seen on repeated ultrasound examinations.