Professor Wu Mianhua,a renowned national traditional Chinese medicine(TCM)practitioner,proposed the"deficient qi and Kenang"theory based on the doctrines of"deficient qi"and"Kenang".This theory is applied to the pathogenesis analysis and clinical syndrome differentiation and treatment of brain tumors.It posits that the fundamental pathogenesis of brain tumors involves orig-inal qi deficiency,internal generation of deficient qi,intermingling of phlegm and blood stasis,and conglomeration of toxins into nest-like foci.The treatment strategy emphasizes reinforcing healthy qi,regulating qi,resolving phlegm,dispelling stasis,attacking toxins,dispersing nodules,and adjusting treatment according to disease stages.In the early stage,it is to support healthy qi and regulate qi to remove qi deficiency;in the middle stage,it is to dissipate phlegm and expel blood stasis to resolve pathological nests;in the late stage,it is to attack toxins and resolve masses to break up nest sac.Throughout the treatment,strictly adhere to the principle of"rein-forcing healthy qi without retaining pathogens,and breaking accumulations without impairing healthy qi".

Objective To observe the effects of transcranial direct current stimulation(tDCS)combined with music therapy on cognitive function and activities of daily living in patients with post-stroke cognitive impairment(PSCI).Methods This prospective study enrolled subacute stroke(2 weeks to 6 months after onset)patients with cognitive impairment admitted to the Rehabilitation Department of the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital)from January 2023 to December 2024.Using the random number table,patients in the subacute early stage(2 weeks to＜3 months after stroke)and subacute late stage(3 months to 6 months after stroke)were respectively assigned to the experimental group and the control group.Baseline clinical data were collected,including gender,age,stroke type(intracerebral hemorrhage,cerebral infarction),lesion side(left,right),disease course,educational attainment,history of smoking and alcohol consumption,stroke area(basal ganglia,temporal lobe,frontal lobe),and National Institutes of Health stroke scale(NIHSS)score at admission.Both groups received conventional rehabilitation treatment.The experimental group additionally received tDCS treatment combined with music therapy intervention,which included active and passive music therapy.In contrast,the control group received only tDCS treatment in conjunction of conventional rehabilitation intervention.Both groups received treatment for 2 weeks.The Montreal cognitive assessment scale(MoCA),Rivermead behavioural memory test(RBMT),and digit span test(DST)were used to evaluate the overall cognitive function,memory,and attention of PSCI patients before and after treatment.The modified Barthel index(MBI)was used to evaluate the daily living activity ability of PSCI patients 2 weeks post-treatment.Results A total of 40 PSCI patients were included in this study,with 20 cases in each group.Among the participants,17 in the experimental group and 18 in the control group were in early stage of subacute stroke,while 3 in the experimental group and 2 in the control group were in the late stage of subacute stroke.(1)There were no statistically significant differences in the baseline clinical data of the two groups(all P＞0.05).(2)Before treatment,the MoCA,RBMT,and DST scores in the experimental group were(15.00±3.71),(2.90±1.07),and(4.05±1.47)points,respectively,while the corresponding scores in the control group were(13.45±2.61),(2.75±0.77),and(3.35±0.99)points.There were no statistically significant differences in the MoCA,RBMT,and DST scores between the two groups before treatment(all P＞0.05).Two weeks after treatment,the MoCA,RBMT,and DST scores in the experimental group were(19.05±4.35),(5.15±1.50),and(5.85±1.66)points,respectively,compared to(15.90±2.73),(3.45±1.15),and(4.35±1.18)points in the control group.The interaction effect of time and group(Ftime×group)was 15.716,45.762 and 14.140,respectively,all of which were statistically significant(all P＜0.01);the group main effect(Fgroup)was 4.876,7.140,and 7.074,respectively,all of which were statistically significant(all P＜0.05);the time main effect(Ftime)was 259.370,165.762,and 173.209,respectively,all of which were statistically significant(all P＜0.01).(3)Before treatment,the MBI scores of the experimental group and control group were(56.00±7.18)and(55.25±5.73)points,respectively,with no statistically significant difference between the two groups(P＞0.05).Two weeks after the treatment,the MBI scores of the experimental group and control group were(63.00±6.77)and(60.50±5.36)points,respectively.No statistically significant differences were observed in the interaction effect of time and group,or the main effect of group between the two groups after treatment(Ftime ×group=1.677,P＞0.05;Fgroup=0.751,P＞0.05).While a statistically significant difference was found in the main effect of time on the MBI scores between the experimental group and control group(Ftime=82.196,P＜0.01).Conclusion The combination of tDCS and music therapy can improve the cognitive function and daily living activity ability in patients with PSCI,and offering superior outcomes compared to tDCS treatment alone.

Objective To evaluate the effectiveness of active screening in improving the detection rate of carbape-nem-resistant Enterobacterales(CRE)in the intensive care units(ICUs).Methods From July 2023 to June 2024,active screening of rectal swab CRE was conducted on ICU patients in 10 hospitals.ICU patients who underwent ac-tive screening from July 2023 to June 2024 were selected as the study group,while those who did not undergo active screening from July 2022 to June 2023 were selected as the control group.Difference in CRE detection rates between the two groups of patients was compared.Results A total of 7 803 ICU patients were included in the study group,744 CRE strains were detected,with a detection rate of 9.53％,out of which 304 CRE strains were detected through routine detection(detection rate 3.90％),3 707 patients underwent active screen,440 CRE strains were detected(detection rate 11.87％).7 561 ICU patients were included in the control group,out of which 250 CRE strains were detected through routine detection,with a detection rate of 3.31％.There was a statistically significant difference in the overall detection rate of CRE between two groups of patients(x2=246.18,P＜0.001).In the study group,CRE detection rate of active screening(11.87％)was higher than that of routine detection(3.90％),with statistically significant difference(x2=264.26,P＜0.001).A total of 17 CRE strains were detected from the study group.The proportions of Klebsiella pneumoniae(80.92％vs 73.41％)and Serratia marcescens(2.30％vs0.23％)in the routine detection group were both higher than in the active screening group,while the proportion of Escherichia coli in the routine detection group was lower(8.22％vs 19.55％),all with statistically significant differences(all P＜0.05).Conclusion The prevalence of CRE in ICUs is relatively high,with a wide range of bac-terial species.Active screening can improve the detection rate of CRE.

Objectives:To analyze the cardiac involvement of patients with Fabry disease(FD)in Anhui region.Methods:This retrospective analysis included 48 previously and currently diagnosed FD patients(25 males)in Anhui region,overall patient and gender specific cardiac involvement was analyzed.Results:The median age of FD patients is 28.0(19.0,46.0)years.The cardiac manifestations of patients with FD were most commonly characterized by palpitations/arrhythmias(13/42 cases)and exertional dyspnea(11/42 cases),electrocardiographic changes were most commonly characterized by T-wave inversion(22/42 cases),ST-segment depression(16/42 cases),and left ventricular hypervoltage(18/42 cases),cardiac structural and functional changes were most common in papillary muscle hypertrophy(29/36 cases),bilateral sign(22/37 cases)and left ventricular hypertrophy(21/46 cases),as well as reduced left ventricular global longitudinal strain(26/39 cases).Neuropathic pain(28/43 cases)was the most common extracardiac manifestation of FD patients.FD patients of different gender differed in age at diagnosis(P=0.018),alpha galactosidase A activity(P<0.001),globotriaosylsphingosine(lyso-GL3)levels(P<0.001),enzyme replacement therapy rate(P=0.043),dyshidrosis(P<0.01),and the incidence of angiokeratoma(P=0.004).Correlation analysis showed that genotype was not correlated with enzyme activity or Lyso-GL-3 levels,whereas the Sokolow-Lyon index was positively correlated with Lyso-GL-3 levels(ρ=0.423,P=0.008),and the Sokolow-Lyon indices(septal thickness:ρ=0.562,P<0.001;left ventricle posterior wall thickness:ρ=0.569,P<0.001)and QRS duration(septal thickness:ρ=0.543,P<0.001;left ventricle posterior wall thickness:ρ=0.557,P<0.001)were positively correlated with left ventricular wall thickness.Conclusions:Cardiac involvement in patients with FD in the Anhui region is characterised by palpitations or arrhythmias,accompanied by nonspecific electrocardiographic changes.Echocardiography frequently reveals papillary muscle hypertrophy.The manifestation of cardiac involvement in patients of different genders is similar.

Objective:To establish a three-dimensional culture and stress-loaded model of human periodontal ligament cells(hP-DLCs)in vitro and to determine the effect of static pressure on autophagy.Methods:Periodontal tissue was scraped from fresh ex-tracted tooth surfaces for culture and hPDLCs were obtained.Type Ⅰ rat tail collagen was extracted to prepare collagen-sodium algi-nate composite hydrogel,in which third-generation hPDLCs were embedded.After 72 h of culture,gene expression of autophagy-related proteins LC3,Atg-5 and Beclin-1 was detected by quantitative real-time polymerase chain reaction(qRT-PCR),and the expression of Atg-5,Beclin-1 and LC3 was detected by Western blotting.Results:Cells grew well in collagen-alginate hydrogels.After 15 min of compressive stress loading,the level of autophagy of hPDLCs increased significantly and then gradually decreased to the baseline level.Conclusion:Collagen-alginate hydrogel has good biocompatibility and safety,and can be used as an excellent scaffold for three-dimensional cell culture in vitro.Static compressive stress can accelevate autophagy,and this acceleration is rapid and short-lived.

Objective To identify the mutation in pathogenic genes by analyzing the clinical features and genotype of a family with Al-port syndrome,in order to provide a theoretical basis in genetic counseling for guidance on the future pregnancies in this couple.Meth-ods Based on closely combined thorough re-examination for the report of previous whole-exome sequencing of the proband and the mu-tation site information,Sanger sequencing verification was conducted in the proband's family members.Additionally,a comprehensive assessment of the proband's clinical manifestations and family history was performed,and the previous whole-exome sequencing report was reanalyzed accordingly.Results In terms of the heterozygous mutation(NM_0000924:c.3289+1G＞A)in intron 35 of COL4A4 gene carried by the proband,this mutation was identified in the proband's father(Ⅲ7),grandmother(Ⅱ6),aunt(Ⅲ6),and two great-uncle(Ⅱ2 and Ⅱ5).All of them exhibited clinical manifestations carried the COL4A4:c.3289+1G＞A heterozygous mutation.However,no mutation was detected in the proband's mother(Ⅲ8),great-grandmother(Ⅰ2),great-aunt(Ⅱ3),and great-uncle(Ⅱ4),grandfather(Ⅱ7)who were clinically unaffected.Additionally,a heterozygous mutation(COL4A3:NM_000914:c.1956A＞G)was identified in ex-on 27 of the COL4A3 gene in the proband.Her mother(Ⅲ 8),the other grandmother(Ⅱ9)and aunt(Ⅲ9)all carried the mutation of COL4A3 but had no clinical manifestation.However,her father(Ⅲ7)did not carry this mutation.Conclusion The splicing site muta-tion COL4A4:NM_0000924:c.3289+1G＞A should be confirmed as the pathogenic cause of Alport syndrome in this family.The combi-nation of whole-exome high-throughput sequencing and Sanger sequencing can effectively diagnose Alport syndrome and provide genetic counseling for the couple's next pregnancy.

Objective This study aims to establish a hidden curriculum-based medical humanities teaching pathway within surgical internship education and evaluate its effectiveness in enhancing students' humanistic care competence.Methods A single-group pre-test and post-test design was adopted.A total of 76 interns from a tertiary teaching hospital in 2024 were in-cluded.A five-dimensional hidden curriculum framework—material,spiritual,behavioral,faculty,and institutional—was con-structed.Humanistic competence was assessed before and after the intervention using the Humanistic Professional Awareness Scale for Healthcare Students and Providers(HPAS-HSP).Results Post-intervention scores significantly improved compared to pre-intervention across the total scale in the three dimensions:personal integrity and responsibility,sensitivity to others,and pro-fessional competence(P＜0.05),with the greatest improvement observed in sensitivity to others.Conclusion The structured hidden curriculum is effective in enhancing medical students' humanistic qualities,especially in fostering emotional resonance and professional identity.Future work should focus on verifying behavioral transformation and developing multi-source evaluation sys-tems to improve effectiveness and applicability.

Spinal muscular atrophy (SMA), a hereditary neuromuscular disease, may lead to progressive muscle weakness and atrophy in the proximal limbs resulting from decreased survival motor neuron (SMN) protein expression caused by SMN1 gene mutation. Currently, drugs clinically used for SMA gene therapy include nusinersen, sofosbuvir, and risdiplam, whic have limited scopes of application. Some drugs need to be used for a long time, and none of them can achieve a complete cure. Intrathecal injection of supplemented SMN1 gene has entered clinical trials, showing good curative effect. At the same time, basic researches indicate that CRISPR/Cas9 gene editing technology shows good prospect in correcting the mutant genes in SMA. This article reviews the clinical characteristics of SMA and research progress of gene therapy, aiming to provide a new perspective for diagnosis and treatment of SMA.

Objective To observe the effects of transcranial direct current stimulation(tDCS)combined with music therapy on cognitive function and activities of daily living in patients with post-stroke cognitive impairment(PSCI).Methods This prospective study enrolled subacute stroke(2 weeks to 6 months after onset)patients with cognitive impairment admitted to the Rehabilitation Department of the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital)from January 2023 to December 2024.Using the random number table,patients in the subacute early stage(2 weeks to＜3 months after stroke)and subacute late stage(3 months to 6 months after stroke)were respectively assigned to the experimental group and the control group.Baseline clinical data were collected,including gender,age,stroke type(intracerebral hemorrhage,cerebral infarction),lesion side(left,right),disease course,educational attainment,history of smoking and alcohol consumption,stroke area(basal ganglia,temporal lobe,frontal lobe),and National Institutes of Health stroke scale(NIHSS)score at admission.Both groups received conventional rehabilitation treatment.The experimental group additionally received tDCS treatment combined with music therapy intervention,which included active and passive music therapy.In contrast,the control group received only tDCS treatment in conjunction of conventional rehabilitation intervention.Both groups received treatment for 2 weeks.The Montreal cognitive assessment scale(MoCA),Rivermead behavioural memory test(RBMT),and digit span test(DST)were used to evaluate the overall cognitive function,memory,and attention of PSCI patients before and after treatment.The modified Barthel index(MBI)was used to evaluate the daily living activity ability of PSCI patients 2 weeks post-treatment.Results A total of 40 PSCI patients were included in this study,with 20 cases in each group.Among the participants,17 in the experimental group and 18 in the control group were in early stage of subacute stroke,while 3 in the experimental group and 2 in the control group were in the late stage of subacute stroke.(1)There were no statistically significant differences in the baseline clinical data of the two groups(all P＞0.05).(2)Before treatment,the MoCA,RBMT,and DST scores in the experimental group were(15.00±3.71),(2.90±1.07),and(4.05±1.47)points,respectively,while the corresponding scores in the control group were(13.45±2.61),(2.75±0.77),and(3.35±0.99)points.There were no statistically significant differences in the MoCA,RBMT,and DST scores between the two groups before treatment(all P＞0.05).Two weeks after treatment,the MoCA,RBMT,and DST scores in the experimental group were(19.05±4.35),(5.15±1.50),and(5.85±1.66)points,respectively,compared to(15.90±2.73),(3.45±1.15),and(4.35±1.18)points in the control group.The interaction effect of time and group(Ftime×group)was 15.716,45.762 and 14.140,respectively,all of which were statistically significant(all P＜0.01);the group main effect(Fgroup)was 4.876,7.140,and 7.074,respectively,all of which were statistically significant(all P＜0.05);the time main effect(Ftime)was 259.370,165.762,and 173.209,respectively,all of which were statistically significant(all P＜0.01).(3)Before treatment,the MBI scores of the experimental group and control group were(56.00±7.18)and(55.25±5.73)points,respectively,with no statistically significant difference between the two groups(P＞0.05).Two weeks after the treatment,the MBI scores of the experimental group and control group were(63.00±6.77)and(60.50±5.36)points,respectively.No statistically significant differences were observed in the interaction effect of time and group,or the main effect of group between the two groups after treatment(Ftime ×group=1.677,P＞0.05;Fgroup=0.751,P＞0.05).While a statistically significant difference was found in the main effect of time on the MBI scores between the experimental group and control group(Ftime=82.196,P＜0.01).Conclusion The combination of tDCS and music therapy can improve the cognitive function and daily living activity ability in patients with PSCI,and offering superior outcomes compared to tDCS treatment alone.

Objective To investigate the impacts of intervertebral foramen endoscopic surgery combined with silver needle hyperthermia therapy on lumbar spine function and local tenderness in patients with lumbar disc herniation(LDH).Methods From April 2020 to March 2023,100 LDH patients were randomly devided into a control group(50 cases)and an observation group(50 cases)through random number table method.The control group was treated with intervertebral foramen endoscopic surgery combined with conventional lumbar and dorsal muscle training,while observed group was treated with intervertebral foramen endoscopic surgery combined with silver needle warm therapy.The lumbar function,local tenderness,laboratory indicators,and adverse reactions were compared.Results The Japanese Orthopaedic Association(JOA)score increased in both groups after treatment,and observed group had obviously higher scores,the differences were statistically significant(P<0.05);After treatment,both groups showed a decrease in pain visual analogue scale(VAS)score,and observed group had obviously lower scores,the differences were statistically significant(P<0.05);The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),prostaglandin E2(PGE2),and 5-hydroxytryptamine(5-HT)in both groups decreased after treatment,and the observed group showed a more obvious decrease in all indicators,the differences were statistically significant(P<0.05);The incidence of adverse reactions was 4.00%(2/50)in observed group and 20.00%(10/50)in the control group,adverse reactions in observed group were obviously fewer,the difference was statistically significant(P<0.05).Conclusion The combination of intervertebral foramen endoscopic surgery and silver needle hyperthermia therapy can effectively improve lumbar spine function and alleviate local tenderness symptoms in patients with LDH.It is worthy clinical application.