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.

Purpose: Combinations of immune checkpoint inhibitors (ICIs) and chemotherapy have become the standard first-line treatment for human epidermal growth factor receptor 2 (HER-2)-negative advanced gastric cancer. However, primary resistance remains a challenge, with no effective biomarkers available for its prediction. This retrospective study explores the relationship between the baseline inflammatory burden index (IBI) and primary resistance in such context. Materials and Methods: We analyzed 62 patients with HER-2-negative advanced gastric cancer who received ICIs and chemotherapy as their first-line treatment. The IBI was calculated as follows: C-reactive protein (mg/L) × neutrophil count (10 3 /mm 3 )/lymphocyte count (10 3 /mm 3 ). Based on disease progression within 6 months, patients were categorized into the primary resistant or the control group. We compared baseline characteristics and IBI scores between the groups and assessed the predictive value of the IBI using the receiver operating characteristic curve. Both univariate and multivariate binary logistic regression analyses were conducted to identify factors influencing primary resistance. Results: Nineteen patients were included in the primary resistance group, and forty-three patients were included in the control group. The IBI was significantly higher in the resistant group compared to the control group (P<0.01). The area under the curve for the IBI was 0.82, indicating a strong predictive value. Multivariate analysis identified the IBI as an independent predictor of primary resistance (P=0.014). Conclusions The baseline IBI holds promise as a predictor of primary resistance to combined ICIs and chemotherapy in patients with HER-2-negative advanced gastric cancer.

Objective To explore the neuroprotective effects and mechanisms of the sesquiterpene lactone compound ACT001 on rotenone(ROT)-induced Parkinson's disease(PD)model mouse.Methods SPF C57BL/6 mice were randomly divided into 6 groups,including control group,solvent control group,ROT model group,ACT001 5 mg/kg group(ROT+ACT001-5),ACT001 20 mg/kg group(ROT+ACT001-20),and levodopa(L-dopa)positive control group(ROT+L-dopa),with 9 mice in each group.The control group received an equivalent amount of intraperitoneal injection of saline,the solvent control group received an equivalent amount of rotenone solvent without rotenone,the remaining groups of mice were used to establish a PD mouse model by intraperitoneal injection of rotenone.Mice in different ACT001 dosage groups received intraperitoneal injections of high and low doses of ACT001,while the positive control group received levodopa intraperitoneally for 15 consecutive days.Behavioral changes in mice were assessed using open field,rotarod,pole-climbing,and balance beam tests.Immunofluorescence(IF)assay to detect the expression of tyrosine hydroxylase(TH)neurons,content of TH-positive fibers in the striatum and to detect the activation status of nigrostriatal microglia in the mouse midbrain;Real-time PCR was employed to measure the levels of interleukin(IL)-6,IL-1β,and tumor necrosis factor-α(TNF-α)in the substantia nigra of the mouse brain.Western blotting was used to measure the protein levels of TH,nuclear factor-κB(NF-κB)p65,NF-κB inhibitor α(IκBα),and phosphorylated IκBα(p-IκBα)in the substantia nigra of the mouse brain.Results Compared to the control group and the solvent control group,the rotenone-induced PD model group exhibited motor impairments in behavioral tests,a decrease in the number of TH positive neurons in the substantia nigra(P＜0.0001),decreased levels of TH-positive fibers in the striatum,activation of midbrain substantia microglia,and elevated levels of IL-6,IL-1β,TNF-α,p-IκBα,and NF-κB p65 expression.ACT001 significantly improved the behavioral impairments and substantia nigra damage in PD mice,increased the number of TH-positive neurons in the substantia nigra,increased levels of TH-positive fibers in the striatum,inhibition of microglial cell activation in the midbrain substantia nigra,and elevated the protein expression levels of IκBα while reducing the levels of IL-6,IL-1β,TNF-α,p-IκBα,and NF-κB p65 in the substantia nigra(P＜0.05).At a dose of 5 mg/kg,ACT001 significantly improved behavioral impairments in rotenone-induced PD mice,reduced the loss of dopaminergic neurons,and its mechanism may be related to the inhibition of the NF-κB signaling pathway and the suppression of inflammation.In summary,the intervention of ACT001 in the rotenone-induced PD mouse model inhibited the inflammatory response in the midbrain,increased the number of TH-positive neurons,and augmented the population of dopaminergic neurons in the substantia nigra,exerting a protective effect on neurons.Conclusion ACT001 significantly improves behavioral deficits in ROT-induced PD mice,ameliorates of dopaminergic neuron loss from the midbrain substantia nigra and striatum,inhibits the activation of nigrostriatal microglia in the midbrain,and suppresses inflammatory responses by inhibiting the activation of the NF-κB signaling pathway.

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 construct a classification management model on the basis of Kraljic matrix for electrocardiogram(ECG)monitoring equipment in emergency intensive care unit(ICU),so as to explore its application value in the management for ECG monitoring equipment in emergency ICU.Methods:The classification management model on the basis of index for ECG monitoring equipment in emergency ICU was constructed.According to two classification dimensions included the market supply risk and the self-value,an indicator system of classification management,which aimed at strategic materials with high value and high risk,leverage materials with high value and low risk,bottleneck materials with low value and high risk,and conventional materials with low value and low risk,was constructed.A total of fifty-one ECG monitoring equipment in the emergency ICU of The People's Hospital of Longhua of Shenzhen from January to December 2023 were selected,and they were managed respectively by conventional management mode(25 sets)and classification management mode(26 sets)according to different management modes.The standardization level of operation management for equipment,the occurrence of safety risk and the level of management for equipment of the two management modes were compared,and the satisfaction of 30 relative personnel,who used and managed these equipment,for classification management of equipment also were compared.Results:The average values of the percentage of standardization level of normality of equipment operation,disinfection and sterilization,maintenance and fault repair of using classification management mode were respectively(91.58±4.33)%,(92.1±3.28)%,(91.49±3.54)%and(92.58±3.32)%,all of which were higher than those of conventional management mode,and the differences were statistically significant(t=12.537,15.706,14.196,18.946,P<0.05),repsectively.The average incidences of the risk of pressure injury,electrical injury and body fluid extravasation of adopting classification management mode were respectively(2.54±0.87)%,(3.02±0.82)%and(1.29±0.65)%,all of which were lower than those of adopting conventional management mode,and the differences were statistically significant(t=22.825,17.453,24.424,P<0.05),respectively.The satisfaction scores of 30 relative management personnel,who used equipment on the process rationality,system standardization and quality effectiveness,of adopting classification management mode were respectively(94.26±3.54),(92.57±4.36)and(91.87±3.69),all of which were higher than those of conventional management mode,and the differences were statistically significant(t=14.052,13.991,13.551,P<0.05),respectively.The reasonable placement rate,recording rate of standardization,and intact rate of equipment in the 26 equipment by adopting classification management mode were respectively 92.31%,92.31%and 88.46%,all of which were significantly higher than those by adopting conventional management mode,and the differences were statistical significant(x2=12.052,10.398,11.338,P<0.05).Conclusion:The classification management model of ECG monitoring equipment in emergency ICU can increase the management efficiency for the equipment in operating room of hospital,and improve the operation quality of equipment,and enhance the safety of equipment in clinical use,and the standardization of operation management for equipment.

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.

Purpose To explore the value of 5.0T MRI arterial spin labeling and morphological indexes for staging chronic kidney disease(CKD).Materials and Methods Ninety-five patients with CKD in Chongqing University Three Gorges Hospital from January to August 2024 were collected prospectively,all of whom underwent 5.0T MRI routine and arterial spin labeling examination with calculation of renal blood flow(RBF)and morphological evaluation.According to the estimated glomerular filtration rate(eGFR),the patients were categorized into early CKD group[eGFR 60-89 ml/(min?1.73 m2)]and intermediate-late CKD group[eGFR<59 ml/(min?1.73 m2)]and were further divided into stage 1-5.The differences in RBF between early and intermediate-late CKD patients were compared,and the differences in morphological indexes among different stages of CKD were also analyzed.Binary Logistic regression analysis was used to screen for independent influences on early or intermediate-late CKD staging.Receiver operating characteristic curve was used to evaluate the diagnostic efficacy of RBF values and morphological indexes for early CKD.RBF in CKD stages 1-5 were compared,with Bonferroni pairwise comparisons.The correlation between RBF values and both clinical and morphological indexes were also assessed.Results Whether in CKD stage 2 or 5,morphological factors affecting CKD staging were renal parenchymal signal,renal corticomedullary demarcation,renal volume and renal envelope(χ2=53.715,73.368,36.488,56.688,35.630,39.499,28.520,32.632,all P<0.001).In CKD stage 2,the independent influences screened by multivariate binary Logistic regression analysis were renal parenchymal signal(P<0.001)and renal corticomedullary demarcation(P=0.021).Both renal RBF values in early CKD were significantly higher than that in intermediate-late CKD(Z=-5.975,-5.885,both P<0.001).The areas under the curve for diagnosing early CKD using mean RBF of both kidneys,morphological indexes,and the combination of mean RBF with renal morphological indexes were 0.854,0.932 and 0.951,respectively.RBF values for both kidneys showed statistically significant differences among the five CKD stages(left:H=48.738;right:H=48.102,both P<0.001)and between non-adjacent stages(all P<0.05).Both kidneys RBF values showed a positive correlation with renal parenchymal signal and renal corticomedullary demarcation(left:r=0.600,0.503;right:r=0.550,0.504,both P<0.001).Conclusion The integration of arterial spin labeling and morphological assessment on 5.0T MRI enables a noninvasive and precise functional and morphological evaluation of early renal damage in CKD patients,providing a foundation for subsequent clinical CKD staging.