Background: and Purpose In patients with large vessel occlusion (LVO), intravenous thrombolysis (IVT) frequently alters thrombus location; however, the clinical impact of this phenomenon remains unclear. We aimed to compare post-IVT thrombus dynamics between tenecteplase and alteplase and to evaluate the association between thrombus dynamics and 3-month outcomes. Methods: This retrospective study analyzed prospectively collected, multicenter data from consecutive patients with LVO who underwent bridging therapy between January 2022 and December 2024. Thrombus dynamics were classified as resolution, migration, or stability. Analyses incorporated propensity score matching with weighting to balance baseline characteristics. Results: Of the 806 initially included patients, 746 were included after matching (373 treated with tenecteplase and 373 treated with alteplase). The incidence of thrombus migration was significantly higher in the tenecteplase group than in the alteplase group (19.3% vs. 11.3%; odds ratio [OR]: 1.92; 95% confidence interval [CI] 1.27–2.91). The advantage of tenecteplase over alteplase was restricted to patients with an IVT-to-puncture time of <60 minutes (18.6% vs. 6.2%; p=0.001) and was no longer significant when the interval ≥60 minutes (19.7% vs. 15.0%; p=0.204; pinteraction=0.043). Additionally, thrombus migration was associated with a better functional outcome (OR: 1.62; 95% CI 1.04–2.53). Finally, tenecteplase was associated with improved functional independence compared with alteplase (OR: 1.43; 95% CI 1.04–1.95). Conclusions Tenecteplase demonstrated superior efficacy in inducing thrombus migration compared with alteplase, particularly within 60 minutes of IVT administration. Thrombus migration independently predicted improved functional independence. These findings support the preferential use of tenecteplase for bridging therapy in patients with LVO.

Objective: To optimize the technology and process for recovering immune cells from discarded leukocyte filter through reverse flushing, and to investigate the effects of different reverse flushing solutions and physical conditions (temperature, soaking, and ultrasound) on the cell recovery rate. Additionally, to evaluate the feasibility and quality of isolating and culturing NK cells from the recovered cells. Methods: Normal saline, PBS, and PBS-EDTA were used as reverse flushing solutions to backwash the filter, and the white blood cell recovery rates were compared. The reverse flushing efficiency was optimized by adjusting the temperature of the reverse flushing solution, filter soaking treatment and ultrasonic treatment. The Ficoll separation method was employed to isolate peripheral blood mononuclear cells (PBMCs) from the elution solution and conduct in vitro expansion and culture. Lymphocyte subsets were identified and quantified using flow cytometry. Results: The physiological saline served as the backflush fluid was the most stable. The reverse temperature had a significant impact on the recovery rate of white blood cell subgroups. The recovery rates of lymphocytes and monocytes at 37℃ were significantly higher than those at 4℃ [(35.56±5.55)% vs (22.88±0.31)%, (32.42±4.82)% vs (8.00±1.6)%, t=5.581 and 5.758, respectively, both P<0.001)], and at 25℃ [(35.56±5.55)% vs (22.42±6.13)%, t=5.904, P<0.001; (32.4±4.82)% vs (21.11±1.23)%, t=2.629, P=0.030)]. The recovery rates of white blood cell subgroups after 37℃ immersion were higher than those after direct reverse flow at 37℃, but the difference was not statistically significant (P>0.05). The recovery rate of cells after ultrasonic immersion at 25℃ was further increased compared to that after immersion at 25℃, but the difference was not statistically significant (P>0.05). The purity of the NK cells obtained through sorting reached (94.2±4.5)%, and the viability was (94.8±0.9)%. After 15 days of culture, the cell count was expanded approximately 450 times, yielding more than 10 /mL highly active NK cells. Conclusion: By optimizing the backflushing process, immune cells can be efficiently recovered from discarded filters. The 37℃ backflow liquid has the best backflow effect; soaking and ultrasonic treatment can be used as auxiliary methods to improve recovery rates. The NK cells from this source have high purity, good activity, and strong expansion ability, and can be used as a reliable cell source for immunotherapy research, and in line with the circular economy concept of resource reuse.

Objective: To investigate the effect of auricular therapy on sleep improvement and the GABAergic system pathway in a rat model of insomnia and to explore its possible mechanism. Methods: According to the random number table, 60 male SD rats were randomly divided into blank control, model, auricular point sticking, auricular bloodletting, and auricular bloodletting combined with sticking groups, with 12 rats per group. Insomnia was induced by intraperitoneal injection of p-chlorophenylalanine. After establishing the insomnia model, 36 rats were treated once a day with auricular point sticking or bloodletting for 5 consecutive days. After the intervention, the general condition and body weight of rats were observed; the righting reflex test was used to detect the sleep latency and duration; HE staining was used to observe the morphology of hypothalamic neuron cells; and an enzyme-linked immunosorbent assay was used to detect the GABA and glutamate content in rat serum. Immunohistochemistry(IHC) and real-time fluorescence quantitative PCR were used to detect GABA ARα1 and GABA ARγ2 protein and mRNA expression in the hypothalamus of rats, and Western blotting(WB) was used to detect GABA ARα1, GABA ARγ2, GAD65/67, GAT-1, and GABA-T protein expression in the hypothalamus of rats. Results: Compared with the blank control group, the model group had a lower body weight, a significantly shorter sleep duration (P<0.05), severe damage to the morphological structure of hypothalamic neurons with disordered cell arrangement, larger intercellular gaps, enlarged cell bodies, and a vacuolated appearance. All the intervention groups had significantly higher body weight and longer sleep duration than the model group (P<0.05). Compared with the other intervention groups, the auricular point sticking group had a longer sleep duration (P<0.05), and the hypothalamic neuron cells in all intervention groups improved, with the auricular point sticking group showing more apparent improvement. The model group had a lower GABA and higher glutamate contents, and GABA ARα1, GABA ARγ2, and GAD65/67 protein expression in the hypothalamus were lower than in the blank control group. In contrast, GAT-1 and GABA-T protein expression was higher, and GABA ARα1 and GABA ARγ2 mRNA expression was lower (P<0.05). The serum GABA content in the auricular point sticking and auricular bloodletting groups was higher, and the serum glutamate content in the auricular point sticking and auricular bloodletting combined sticking groups was lower than in the model group. GABA ARα1 mRNA expression in the hypothalamus of each intervention group was significantly increased, and GABA ARγ2 mRNA expression in the hypothalamus of the auricular point sticking and auricular bloodletting combined sticking groups increased. GABA ARα1(IHC, WB), GABA ARγ2(WB), and GAD65/67 protein expression in the hypothalamus of the auricular point sticking group increased, whereas GAT-1 and GABA-T protein expression decreased. GABA ARα1 and GABA ARγ2 protein expression(IHC, WB) in the hypothalamus of the auricular bloodletting group increased, whereas GABA-T protein expression decreased. GABA ARγ1(IHC) and GABA ARγ2(WB) protein expression in the hypothalamus of the auricular bloodletting combined sticking group increased, whereas GAT-1 and GABA-T protein expression decreased (P<0.05). Compared with in the inventation groups, the serum GABA content in the auricular point sticking group increased, the serum glutamate content decreased, GABA ARα1 and GABA ARγ2 mRNA expression in the hypothalamus increased, and GABA ARα1(IHC), GAD65/67 protein expression increased. In contrast, GABA-T protein expression decreased (P<0.05), and GABA ARγ2 protein expression(IHC) in the hypothalamus of the auricular bloodletting group increased (P<0.05). Conclusion Auricular therapy, particularly auricular point sticking, may have modulated the GABAergic system pathway by upregulating hypothalamic GABA ARα1, GABA ARγ2, and GAD65/67 protein expression while downregulating GAT-1 and GABA-T protein expression to alleviate symptoms in an insomnia rat model.

With the aging of the global population， osteoporosis （OP） is becoming a major public health concern worldwide. Currently， the commonly used anti-osteoporosis drugs in clinical practice have limited application due to many side effects. Therefore， developing more effective and safer strategies for the prevention and treatment of OP has become a research focus in this field. In recent years， the clinical efficacy and advantages of traditional Chinese medicine （TCM） in treating OP have been gradually recognized. With the deepening pharmacological research on TCM for OP prevention and treatment， it is found that the active ingredients of Scutellaria baicalensis can promote bone formation or inhibit bone resorption by regulating signaling pathways， including Wnt/β-catenin， osteoprotegerin （OB）/receptor activator of nuclear factor-κB ligand （RANKL）/RANK （OPG/RANKL/RANK）， and bone morphogenetic protein 2 （BMP-2）/Smad， mitogen-activated protein kinase （MAPK）， and mammalian target of rapamycin （mTOR）. However， existing research on active ingredients of S. baicalensis for OP treatment is scattered， making it difficult for scholars to gain a systematic understanding of its research and application. This review summarized the literature on the active ingredients of S. baicalensis in OP treatment worldwide， clarified their mechanisms of action， and explored some issues， providing references for the integration of TCM in OP prevention and treatment.

With the aging of the global population， osteoporosis （OP） is becoming a major public health concern worldwide. Currently， the commonly used anti-osteoporosis drugs in clinical practice have limited application due to many side effects. Therefore， developing more effective and safer strategies for the prevention and treatment of OP has become a research focus in this field. In recent years， the clinical efficacy and advantages of traditional Chinese medicine （TCM） in treating OP have been gradually recognized. With the deepening pharmacological research on TCM for OP prevention and treatment， it is found that the active ingredients of Scutellaria baicalensis can promote bone formation or inhibit bone resorption by regulating signaling pathways， including Wnt/β-catenin， osteoprotegerin （OB）/receptor activator of nuclear factor-κB ligand （RANKL）/RANK （OPG/RANKL/RANK）， and bone morphogenetic protein 2 （BMP-2）/Smad， mitogen-activated protein kinase （MAPK）， and mammalian target of rapamycin （mTOR）. However， existing research on active ingredients of S. baicalensis for OP treatment is scattered， making it difficult for scholars to gain a systematic understanding of its research and application. This review summarized the literature on the active ingredients of S. baicalensis in OP treatment worldwide， clarified their mechanisms of action， and explored some issues， providing references for the integration of TCM in OP prevention and treatment.

Objective: To assess the dynamic changes of microcirculation at acupoints in patients with primary dysmenorrhea and cold congelation and blood stasis syndrome using laser speckle blood flow imaging. Methods: Patients with primary dysmenorrhea and cold coagulation and blood stasis syndrome (primary dysmenorrhea group, n=53) and healthy female college students(control group, n=57) who met the inclusion and exclusion criteria from October 2020 to July 2022 were enrolled at Hebei University of Chinese Medicine. On the premenstrual and first day of menstruation, a laser speckle blood flow imaging system was used to measure the microcirculation blood flow perfusion on the surface of acupoints related to the conception, thoroughfare, and governor vessels, and stomach, spleen, and bladder meridians in the abdomen and lumbosacral regions. The dynamic changes in microcirculation were calculated based on the difference in average blood flow perfusion at each acupoint before and after menstruation. Receiver operating curve (ROC) analysis was used to analyze the diagnostic efficacy of dynamic changes in microcirculation on the surface of each acupoint. The microcirculation sensitization rate of acupoints was calculated. Results: Compared with the control group, the dynamic changes in microcirculation at the following acupoints in the primary dysmenorrhea group were increased (P<0.05): conception vessel (Yinjiao[CV7], Qihai[CV6], Shimen[CV5], Guanyuan[CV4]); left thoroughfare vessel (left Huangshu[KI16], left Zhongzhu[KI15], left Siman[KI14], left Qixue[KI13], left Dahe[KI12], left Henggu[KI11]); left stomach meridian (left Tianshu[ST25], left Wailing[ST26], left Qichong[ST30]); left spleen meridian (left Daheng[SP15], left Fujie[SP14]); right thoroughfare vessel (right Huangshu[KI16], right Zhongzhu[KI15], right Siman[KI14], right Qixue[KI13], right Dahe[KI12], right Henggu[KI11]); right stomach meridian (right Wailing[ST26], right Daju[ST27], right Shuidao[ST28], right Guilai[ST29], right Qichong[ST30]); and right spleen meridian (right Fujie[SP14]). The area under the ROC curve of conception vessel (Yinjiao[CV7], Qihai[CV6], Shimen[CV5], Guanyuan[CV4]), thoroughfare vessel (right Siman[KI14], left Huangshu[KI16], right Qixue[KI13], right Zhongzhu[KI15], right Dahe[KI12], left Zhongzhu[KI15], left Siman[KI14], right Huangshu[KI16], left Qixue[KI13], right Henggu[KI11], left Henggu[KI11], left Dahe[KI12]); stomach meridian (left Tianshu[ST25], right Guilai[ST29], left Wailing[ST26], right Shuidao[ST28], right Daju[ST27], right Wailing[ST26], right Qichong[ST30], left Qichong[ST30]), and spleen meridian (left Daheng[SP15], left Fujie[SP14], right Fujie[SP14]) was 0.610-0.682 (P<0.05). Compared with the control group, the sensitization rate of some acupoints in the primary dysmenorrhea group increased (P<0.05). Conclusion With the onset of menstruation, the blood flow perfusion of some acupoints in the abdomen (thoroughfare, and conception vessels, and stomach and spleen meridians) of patients with primary dysmenorrhea and cold blood coagulation and blood stasis syndrome increased, and the status of acupoints changed from a resting state to an active state. These acupoints are sensitive in patients with primary dysmenorrhea and cold blood coagulation and blood stasis syndrome and have a certain diagnostic efficacy, providing a basis for further analyzing the efficacy and mechanism of acupuncture and moxibustion to treat primary dysmenorrhea with cold blood coagulation and blood stasis syndrome.

Objective: To construct a scientific and perfect evaluation index system of infectious disease prevention and control ability in colleges and universities, so as to provide reference tools for colleges and universities to effectively respond to infectious disease. Methods: The initial framework of the evaluation index system of infectious disease prevention and control ability in colleges and universities was constructed by using literature analysis method. Experts familiar with infectious disease prevention and control or school health work were selected to conduct two rounds( n =16，18) of Delphi expert consultation for determining the evaluation index system. Analytical hierarchy process was used to calculate the index weights and combined weights. About 198 prevention and control personnel were conveniently selected from 3 universities in Inner Mongolia Autonomous Region to comprehensively evaluate the evaluation indicators by using fuzzy comprehensive evaluation method. Results: After two rounds of Delphi consultation questionnaire, the effective recovery rates were 80.0% and 90.0%, the expert authority levels were 0.89 and 0.86, the expert harmony coefficients for Kendall W were 0.166 and 0.310, and the variation coefficient of each index was <0.25. Finally, the evaluation index system of infectious disease prevention and control ability of colleges and universities included 4 first level indicators, 14 second level indicators and 75 third level indicators. The weights of prevention and monitoring and early warning, organizational system guarantee, emergency management, rehabilitation and summary were 0.176, 0.476, 0.268 and 0.080, respectively. The top 3 weights of the secondary indexes were 0.623 for infectious disease surveillance and early warning, 0.595 for loss assessment and 0.370 for emergency response. The score of fuzzy comprehensive evaluation of the index system of infectious disease prevention and control ability in colleges and universities was 79.148, suggesting a high level. Conclusion The established evaluation index system of infectious disease prevention and control ability in colleges and universities is scientific and reasonable, which is conducive to provide tool reference for the evaluation of infectious disease prevention and control ability in colleges and universities.

Objective:To investigate the correlation between the expression levels of breast cancer metastasis-like transcriptional repressor (BRMS1L), keratin 19 (KRT19), microRNA-101 (miR-101) in surgical resection specimens and postoperative recurrence and metastasis of differentiated thyroid cancer (DTC) .Methods:A total of 186 DTC patients were selected in Shanxi Province Cancer Hospital from Jan. 2021 to Jan. 2023. Their recurrence and metastasis status were assessed in 2 years after surgery, and they were categorized into the recurrence and metastasis group and the non-recurrence and metastasis group. The clinical data of the two groups, as well as the expression levels of BRMS1L, KRT19, and miR-101 in the surgical resection specimens, were compared. Logistic regression analysis was used to investigate the relationship between BRMS1L, KRT19, miR-101 in the surgical resection specimens and postoperative recurrence and metastasis of DTC. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were used to evaluate the predictive value of BRMS1L, KRT19, and miR-101 in the surgical resection specimens for postoperative recurrence and metastasis of DTC, as well as their gain value in constructing predictive models.Results:Among 186 DTC patients were followed up for 2 years postoperatively, 4 were lost to follow-up. Of these, 137 did not experience recurrence or metastasis, while 45 did, resulting in a recurrence and metastasis rate of 24.73% (45/182). The tumor diameter, proportion of stage Ⅲ-Ⅳ, proportion of multiple lesions, and proportion of lymph node metastasis in the recurrent and metastatic group were all higher than those in the non-recurrent and non-metastatic group, while the proportion of postoperative 131I therapy was lower ( P<0.001, P=0.002, P=0.008, P<0.001). The KRT19 mRNA level in the recurrent and metastatic group was higher than that in the non-recurrent and non-metastatic group, while the BRMS1L mRNA and miR-101 levels were lower (both P<0.001). Logistic regression analysis showed that, before and after adjusting for other factors, BRMS1L, KRT19, and miR-101 were independent factors influencing postoperative recurrence and metastasis of DTC (both P<0.001). ROC curves showed that the AUCs of BRMS1L, KRT19, and miR-101 for predicting recurrent metastasis after DTC were 0.776, 0.802, 0.812, with sensitivities of 84.44%, 73.33%, and 84.44%, and specificities of 62.04%, 72.26%, and 79.56%; the R language package was used to construct a conventional prediction model consisting of clinical factors such as tumor diameter, clinical stage, lesion type, lymph node metastasis, and postoperative 131I treatment, and a new prediction model consisting of tumor diameter, clinical stage, lesion type, lymph node metastasis, postoperative 131I treatment, BRMS1L, KRT19, and miR-101. The test results indicated that both prediction models exhibited good fit ( P>0.05). The ROC curve analysis revealed that the AUCs for predicting postoperative recurrence and metastasis in DTC were 0.928 and 0.854 for the new and conventional prediction models, respectively. The sensitivity was 91.11% and 80.00%, and the specificity was 83.94% and 78.83%, respectively. The predictive value of the new prediction model was significantly better than that of the conventional prediction model ( Z=2.011, P=0.044) . Conclusions:The expression levels of BRMS1L, KRT19, and miR-101 in surgically resected specimens are closely correlated with postoperative recurrence and metastasis of DTC, serving as independent influencing factors with good predictive value. Furthermore, they exhibit significant gain value in constructing predictive models.

OBJECTIVE To investigate the effect and underlying mechanism of hydroxytyrosol(HT)on mouse chondrocyte injury induced by oxidative stress.METHODS Mouse chondrocytes were incubated with varying concentrations of HT 0-400 μmol L-1 for 24 h,and the viability of the mouse chondrocytes was assessed using CCK-8 kit.An oxidative stress model of chondrocytes was estab-lished by the addition of H2O2 200 μmol L-1.The experimental groups included the cell control group,H2O2 group,and H2O2+HT 10,50 and 250 μmol·L-1 groups.After 24 h,the mRNA expression levels of interleukin-6(IL-6),cyclooxygenase-2(COX-2),prostaglandin E2(PGE2),inducible nitric oxide synthase(iNOS),matrix metalloproteinase-3(MMP-3),MMP-13,a disintegrin and metalloproteinase with throm-bospondin motifs-4(ADAMTS-4),ADAMTS-5,SRY-box transcription factor-9(SOX-9)and aggrecan(ACAN)in mouse chondrocytes were detected by real-time quantitative PCR,the intracellular reactive oxygen species(ROS)level in chondrocytes was measured with 2,7-dichlorodihydrofluorescein diace-tate(DCFH-DA)staining,while the mitochondrial membrane potential was evaluated using JC-1 staining.After 48 h,the protein expression levels of iNOS,COX-2,MMP-13,and type Ⅱ collagen(Col-2)in mouse chondrocytes were detected using Western blotting.RESULTS HT at concentrations≤350 μmol·L-1 had no significant effect on the survival of mouse chondrocytes.Compared with the cell control group,after 24 h,the mRNA expression levels of IL-6,COX-2,PGE2,iNOS,MMP-3,MMP-13,ADAMTS-4 and ADAMTS-5 in the chondrocytes of mice in the H2O2 group were increased,while the mRNA expression levels of SOX-9 and ACAN were decreased.Additionally,there was an elevation in the ROS level and a significant loss of mitochondrial membrane potential in the chondrocytes of mice.Compared with the H2O2 group,after treatment with HT 10,50 and 250 μmol·L-1,there were significant decreases in mRNA expression levels of IL-6,COX-2,PGE2,iNOS,MM P-3,MMP-13,ADAMTS-4 and ADAMTS-5,the mRNA expressions of SOX-9 and ACAN were increased,the ROS level was lowered.After treatment with HT 50 and 250 μmol L-1,the loss of mitochondrial membrane potential was ameliorated.Compared to the cell control group,the protein expressions of iNOS,COX-2 and MMP-13 were upregulated in the H2O2 group,while the protein expression of Col-2 was downregulated after 48 h.Compared to the H2O2 group,treatment with HT at concentrations of 10,50 and 250 μmol·L-1 resulted in decreased protein expressions of iNOS,COX-2 and MMP-13 in mouse chondrocytes,but the protein expression of Col-2 increased following treatment with HT 50 and 250 μmol L-1.CONCLUSION HT can ameliorate H2O2-induced chondrocyte injury by reducing intracellular ROS levels and alleviating the loss of mitochondrial membrane potential,suppressing the release of inflammatory cytokines,inhibiting catabolic processes,and promoting anabolic activities.

Objective To explore the association between knee torsion and multiple bony abnormali-ties of the lower limb in patients with recurrent patellar dislocation(RPD).Methods The preoperative imaging data of RPD patients treated in our institution between May 2020 and October 2024 were col-lected retrospectively.A total of 238 patients were included in this study,with 83.6%being females.All patients underwent standard hip-knee-ankle CT scans,and lower limb bony structural parameters were reconstructed and measured using Mimics 20.0,focusing on variables such as knee torsion,femo-ral anteversion(FAA),femoral distal torsion angle(DFTA),supratrochlear spur,tibial tuberosity to trochlear groove distance(TT-TG),Caton-Deschamps index,and tibial torsion.Bony abnormalities were categorized based on previously established risk thresholds.Moreover,chi-square tests were em-ployed to compare the composition ratio differences between knee torsion and multiple lower limb osse-ous abnormalities.Results Among all affected knees,the proportion of excessive knee torsion was 33.6%,while in cases with osseous abnormalities,the value was over 40%.Compared with cases of low knee torsion,patients with excessive knee torsion showed significantly higher proportions of FAA(41.3%vs.27.2%,P=0.028),excessive DFTA(60%vs.32.9%,P<0.001),supratrochlear spur(55%vs.38.6%,P=0.016),trochlear dysplasia(93.8%vs.73.4%,P<0.001),excessive TT-TG(68.8%vs.43.7%,P<0.001),and patella alta(50%vs.22.2%,P<0.001).Additionally,95%of knees with excessive torsion exhibited two or more bony risk factors,whereas 55%had four or more bony structural abnormalities,which was significantly higher than those of low knee torsion(55%vs.21.5%,P<0.001).Conclusion In RPD patients,excessive knee torsion is associated with multiple low-er limb bony abnormalities.Moreover,patients with high knee torsion(>12°)are significantly more likely to have multiple bony abnormalities than those with low torsion.Therefore,in surgical decision-making for such patients,lower limb bony abnormalities should be assessed comprehensively.