Objective To investigate the global burden of visceral leishmaniasis (VL) from 1990 to 2021 and predict the trends in the burden of VL from 2022 to 2035, so as to provide insights into global VL prevention and control. Methods The global age-standardized incidence, prevalence, mortality and disability-adjusted life years (DALYs) rates of VL and their 95% uncertainty intervals (UI) were captured from the Global Burden of Disease Study 2021 (GBD 2021) data resources. The trends in the global burden of VL were evaluated with average annual percent change (AAPC) and 95% confidence interval (CI) from 1990 to 2021, and gender-, age-, country-, geographical area- and socio-demographic index (SDI)-stratified burdens of VL were analyzed. The trends in the global burden of VL were projected with a Bayesian age-period-cohort (BAPC) model from 2022 to 2035, and the associations of age-standardized incidence, prevalence, mortality, and DALYs rates of VL with SDI levels were examined with a smoothing spline model. Results The global age-standardized incidence [AAPC = -0.25%, 95% CI: (-0.25%, -0.24%)], prevalence [AAPC = -0.06%, 95% CI: (-0.06%, -0.06%)], mortality [AAPC = -0.25%, 95% CI: (-0.25%, -0.24%)] and DALYs rates of VL [AAPC = -2.38%, 95% CI: (-2.44%, -2.33%)] all appeared a tendency towards a decline from 1990 to 2021, and the highest age-standardized incidence [2.55/10⁵, 95% UI: (1.49/10⁵, 4.07/10⁵)], prevalence [0.64/10⁵, 95% UI: (0.37/10⁵, 1.02/10⁵)], mortality [0.51/10⁵, 95% UI: (0, 1.80/10⁵)] and DALYs rates of VL [33.81/10⁵, 95% UI: (0.06/10⁵, 124.09/10⁵)] were seen in tropical Latin America in 2021. The global age-standardized incidence and prevalence of VL were both higher among men [0.57/10⁵, 95% UI: (0.45/10⁵, 0.72/10⁵); 0.14/10⁵, 95% UI: (0.11/10⁵, 0.18/10⁵)] than among women [0.27/10⁵, 95% UI: (0.21/10⁵, 0.33/10⁵); 0.06/10⁵, 95% UI: (0.05/10⁵, 0.08/10⁵)], and the highest mortality of VL was found among children under 5 years of age [0.24/10⁵, 95% UI: (0.08/10⁵, 0.66/10⁵)]. The age-standardized incidence (r = -0.483, P < 0.001), prevalence (r = -0.483, P < 0.001), mortality (r = -0.511, P < 0.001) and DALYs rates of VL (r = -0.514, P < 0.001) correlated negatively with SDI levels from 1990 to 2021. In addition, the global burden of VL was projected with the BAPC model to appear a tendency towards a decline from 2022 to 2035, and the age-standardized incidence, prevalence, mortality and DALYs rates were projected to be reduced to 0.11/10⁵, 0.03/10⁵, 0.02/10⁵ and 1.44/10⁵ in 2035, respectively. Conclusions Although the global burden of VL appeared an overall tendency towards a decline from 1990 to 2021, the burden of VL showed a tendency towards a rise in Central Asia and western sub-Saharan African areas. The age-standardized incidence and prevalence rates of VL were relatively higher among men, and the age-standardized mortality of VL was relatively higher among children under 5 years of age. The global burden of VL was projected to continue to decline from 2022 to 2035.

In the era of big data, neuroimaging and algorithmic analyses have propelled brain science research and brain mapping. Acupuncture, widely recognized as an effective surface stimulation therapy, has demonstrated therapeutic efficacy for various brain conditions such as stroke and depression. However, the mechanisms linking acupuncture to brain function and its modulatory effects on brain activity require systematic exploration. Additionally, there is an urgent need to scientifically reinterpret traditional meridian theory and enhance its clinical applicability. Therefore, we propose the initiative of constructing a "brain mapping atlas of meridian, collateral and body surface stimulation" to explore the patterns linking the therapeutic effects of stimulating the twelve meridians, eight extraordinary vessels, divergent channels, collateral channels, sinew channels, and skin regions to brain function. This initiative aims to provide a scientific interpretation of traditional Chinese medicine meridian theory and enhance its practical applicability. This paper begins by reviewing the current state of brain mapping. It then summarizes existing research on the relationship between acupuncture and the brain, highlighting the necessity of constructing this atlas. The paper further analyzes the methodologies and technical challenges involved. Finally, the potential applications of the brain mapping atlas of meridian, collateral and body surface stimulation, and its main significance in advancing traditional meridian theory to keep pace with the times are prospected.
Humans ; Acupuncture Therapy ; Meridians ; Big Data ; Brain/physiology* ; Brain Mapping

OBJECTIVE: To compare the protective effects of electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS) during pregnancy on maternal immune activation (MIA)-induced adverse pregnancy outcomes, fetal developmental defects, and neuropsychological behavior abnormalities in offspring mice. METHODS: Eighty pregnant C57BL/6 mice were randomly divided into 5 groups: control, model, EA, TEAS, and sham-stimulation groups, 16 mice in each group. MIA models were replicated on the day 12.5 of pregnancy via tail intravenous injection with polyinosinic-polycytidylic acid. On the second day of modeling success, in the EA and TEAS groups, the interventions were delivered at bilateral "Zusanli" (ST36), with a frequency of 2 Hz, a current of 0.5 mA, and for 20 min each day in the pregnant mice; and the interventions lasted 6 days. Body mass and fertility indexes of pregnant mice, and the development indexes of offspring mice were recorded. Liquid phase suspension chip technology was used to detect the levels of cytokines and chemotactic factors in the serum of pregnant mice and and fetal brain of offspring mice. Flow cytometry was adopted to detect the proportion of the subgroups and subtypes of spleen T lymphocytes and macrophages in pregnant mice. Using the open field test, prepulse inhibition (PPI) test and Morris water maze, the spatial learning and memory were assessed in offspring mice. Immunofluorescence staining was used to detect microglial count in the medial prefrontal cortex (mPFC) in offspring mice. RESULTS: Compared with the control group, the model group showed a reduced body mass of pregnancy mice (P<0.01), smaller litter size and fewer live births (P<0.01, P<0.05), the increase in dead birth and the decrease in offspring survival rate (P<0.05, P<0.01). When compared with model group, in the EA group and the TEAS group, the body mass of pregnancy mice rose (P<0.05), litter size and live births increased (P<0.05, P<0.01), the dead birth was reduced and the offspring survival rate higher (P<0.05). In comparison with the control group, the model group showed the increase in the levels of monocyte chemotactic protein-1 (MCP-1), interleukin-6 (IL-6), γ-interferon (IFN-γ) in the serum of pregnant mice, and spleen M1 macrophage proportion (P<0.01, P<0.05), and the decrease in spleen M2 macrophages of pregnant mice (P<0.01); and the increase in MCP-1 and IL-6 in fetal brain of offspring mice (P<0.05). Compared with the model group, the EA group and the TEAS group showed the decrease in MCP-1, IL-6 and IFN-γ, and spleen M1 macrophage proportion (P<0.01, P<0.05), and the increase in spleen M2 macrophages of pregnant mice (P<0.01, P<0.05) ; and the decrease in MCP-1 and IL-6 in fetal brain of offspring mice (P<0.05). Compared with the control group, in the model group, the total movement distance, escape incubation were extended (P<0.05, P<0.01), the frequency of entering the central area and crossing the platform decreased, and the activity duration in central area was shortened (P<0.05, P<0.01), the average speed rose (P<0.05), PPI%, the percentage of target quadrant swimming time in the total time and that of target quadrant swimming distance in the total distance were reduced (P<0.05, P<0.01) in offspring mice. When compared with the model group, in the EA group and TEAS group, the total movement distance and escape incubation were shortened, the average speed was reduced (P<0.05), PPI% and the frequency of crossing the platform increased (P<0.05, P<0.01); the percentage of target quadrant swimming time in the total time and that of target quadrant swimming distance in the total distance rose (P<0.05, P<0.01) in the offspring mice. In the EA group, the frequency of entering the central area and the activity duration in central area were higher (P<0.05, P<0.01); and in the the TEAS group, the activity duration in central area were longer (P<0.05). When compared with the control group, in the model group, microglial count in mPFC was elevated in offspring mice (P<0.05). In comparison with the model group, the EA group and the TEAS group showed the decrease of microglial count in mPFC (P<0.05). CONCLUSION EA and TEAS at "Zusanli" (ST36) during pregnancy effectively improve in the pregnancy outcomes and fetal brain developmental abnormalities induced by infection, and attenuate neurodevelopmental defects and mental disorders of offspring mice through inhibiting inflammatory activation of microglia in mPFC.
Animals ; Female ; Pregnancy ; Electroacupuncture ; Acupuncture Points ; Mice ; Mice, Inbred C57BL ; Humans ; Male

Transarterial radioembolization (TARE) is a widely utilized therapeutic approach for hepatocellular carcinoma (HCC), however, the clinical implementation is constrained by the stringent preparation conditions of radioembolization agents. Herein, we incorporated the superstable homogeneous iodinated formulation technology (SHIFT), simultaneously utilizing an enhanced solvent form in a carbon dioxide supercritical fluid environment, to encapsulate radionuclides (such as ¹³¹I,¹⁷⁷Lu, or ¹⁸F) with lipiodol for the preparation of radiolipiodol. The resulting radiolipiodol exhibited exceptional stability and ultra-high labeling efficiency (≥99%) and displayed notable intratumoral radionuclide retention and in vivo stability more than 2 weeks following locoregional injection in subcutaneous tumors in mice and orthotopic liver tumors in rats and rabbits. Given these encouraging findings, ¹⁸F was authorized as a radiotracer in radiolipiodol for clinical trials in HCC patients, and showed a favorable tumor accumulation, with a tumor-to-liver uptake ratio of ≥50 and minimal radionuclide leakage, confirming the feasibility of SHIFT for TARE applications. In the context of transforming from preclinical to clinical screening, the preparation of radiolipiodol by SHIFT represents an innovative physical strategy for radionuclide encapsulation. Hence, this work offers a reliable and efficient approach for TARE in HCC, showing considerable promise for clinical application (ChiCTR2400087731).

At present,in medical academic circle there is no consensus on the optimal diameter of the stent used in transjugular intrahepatic portosystemic shunt(TIPS).In 2021,the Advancing Liver Therapeutic Approaches Consortium(ALTAC)recommended the use of controllable diameter TIPS covered stent system in the performance of TIPS,the stent diameter of this system can be adjusted within the range of 8 mm to 10 mm,and its stability can be maintained for a long time.This system carries several advantages such as accurately regulating portal venous pressure gradient(PPG),optimizing hemodynamic target,protecting liver blood perfusion,reducing shunt-related complications,etc.,indicating that this system has a promising clinical application prospect.Through reviewing the relevant literature,this paper summarizes the research progress of controllable diameter TIPS covered stent system,aiming to better help clinicians engaged in related fields to gain a further understanding of this new technology.

Objective:To construct an assessment tool for laparoscopic left lateral sectionectomy skills.Methods:From November 2023 to January 2024, 22 clinical experts in hepatopancreatobiliary surgery from different regions of China were selected for this study. A preliminary indicator system was established through literature review, and the indicators and their weights at each level were determined using the Delphi method and analytic hierarchy process (AHP).Results:In the two rounds of consultation, the expert positive coefficients were 100.00% and 90.91%, authority coefficients were 0.984 and 0.985, Kendall coefficients were 0.231 and 0.193 ( P<0.001), and Cronbach's α coefficients were 0.905 and 0.865, respectively. A skill assessment tool for laparoscopic left lateral sectionectomy skills was constructed consisting of 5 primary indicators and 23 secondary indicators. AHP analysis showed that the concordance rate of each matrix of the secondary indicators was <0.1, meeting the consistency test requirements. Conclusions:The assessment tool for laparoscopic left lateral sectionectomy skills developed in this study is objective and reliable for evaluating the surgical skills of novice surgeons.

Mesenchymal stem cell (MSC) has been shown to attenuate injuries in a variety of radiation animal models and has been explored for the treatment of radiation-induced patients, due to its potent immunomodulatory and tissue repair capabilities. Based on its high safety and multiple biological functions, MSC is expected to be used for the treatment of radiation sickness. In this review, the research progress of MSC and its secretions in the treatment of radiation-induced injuries was summarized, such as skin injury, intestinal injury, brain injury, acute radiation syndrome of the hematopoietic system, lung injury, liver injury, and cardiac injury.

Mental disorders are characterized by disturbances in behavior,volition,emotion,and cognition and are considered emotional diseases in traditional Chinese medicine.Acupuncture is one of the most widely used complementary alternative therapies for the treatment of mental disorders.Recently,there has been growing interest in the use of the Tong Du Tiao Shen(Dredging Du meridian to regulate the spirit)as a primary treatment.However,a comprehensive summary of the establishment and related acupuncture methods of Tong Du Tiao Shen is lacking.This paper aims to address this gap by exploring the origin and development of Tong Du Tiao Shen,its application in treating mental disorders,and the modern biological mechanisms involved.Ultimately,this paper seeks to expand the clinical application of Tong Du Tiao Shen acupuncture and provide a scientific basis for future research in this field.

【Objective】 To investigate the level of serum bone metabolism and biochemical markers and bone density of plasmapheresis donors, and to provide scientific basis for ensuring the health and safety of plasmapheresis donors in China. 【Methods】 A total of 437 plasmapheresis donors from Linwu plasmapheresis station in Hunan Province from July 1 to September 30, 2022 were recruited to determine the levels of total serum calcium, albumin, serum 25-hydroxyvitamin D (25OHD), serum type I procollagen N-terminal propeptide (P1NP), and collagen type 1 crosslinked carboxyl-terminal peptide (β-CTX). Dual-energy X-ray method was used to measure the bone density of the anteroposterior lumbar spine (L1-L4) and bilateral femoral neck bone density of plasmapheresis donors. Plasmapheresis donors were grouped according to the type of plasma donation (first-time and repeat plasmapheresis donors) and the total number of plasma donations to assess the differences in bone density and serum bone metabolism biochemical markers between groups. The dose-response relationship between the total number of plasmapheresis donations and biochemical indexes was analyzed by limiting cubic spline, and the influencing factors of different indexes were explored by multiple linear regression. 【Results】 A total of 437 plasmapheresis donors were included in this study, including 187 first-time plasmapheresis donors and 250 repeat plasmapheresis donors. There were no significant differences in bone density and prevalence of osteoporosis between first-time donors and repeat donors (P>0.05). There was also no significant difference in bone density levels between groups of total number of plasmapheresis donations. The levels of albumin and 25OHD decreased with the increase of the total number of plasma donations, while the serum P1NP level was positively correlated with the total number of plasma donations. The results of the restriction cubic spline showed that the total number of plasmapheresis donations had a nonlinear dose-response relationship with 25OH and P1NP (P<0.05). The results of multiple linear regression showed that the frequency of plasmapheresis donation was the influencing factor of 25OHD, and the total number of plasmapheresis donation was the influencing factor of P1NP. 【Conclusion】 Plasmapheresis donation does not affect the bone health of donors and increase the risk of osteoporosis due to the use of long-term anticoagulants, but it will increase the osteogenic activity of plasmapheresis donors. It is recommended that middle-aged and elderly plasmapheresis donors supplement vitamin D appropriately.

Objective:To explore the differential diagnostic value of abdominal diffusion-weighted imaging (DWI) combined with serum alpha fetoprotein (AFP), des-gamma-carboxyprothrombin (DCP), and the ratio of γ-glutamyl transpeptidase to alanine transaminase (GTP/ALT) in the diagnosis of benign and malignant liver tumors.Methods:Ninety liver tumor patients admitted to the Chenzhou First People′s Hospital from February 2020 to May 2022 were selected, including 48 malignant tumors and 42 benign tumors, and were divided into malignant group and benign group. The imaging findings of routine magnetic resonance imaging (MRI) and DWI examination were analyzed for two groups of patients. We compared the apparent diffusion coefficient (ADC) values, serum AFP, DCP levels, and GTP/ALT between two groups of patients. The diagnostic value of DWI, individual and combined detection of various serological indicators for malignant tumors was analyzed using receiver operating characteristic (ROC) curves.Results:There were significant differences in MRI and DWI imaging manifestations between the malignant and benign groups of patients. The ADC values and ADC index of patients in the malignant group at different b values of 50, 400, and 800 s/mm 2 were lower than those in the benign group, and the differences were statistically significant (all P<0.05). The serum AFP, DCP, and GTP/ALT of patients in the malignant group were higher than those in the benign group, and the differences were statistically significant (all P<0.05). The ROC curve analysis results showed that the sensitivity and specificity of DWI combined with serum AFP, DCP, and GTP/ALT in diagnosing liver malignant tumors were higher than those of DWI alone and each serological indicator alone. Conclusions:The combination of DWI, serum AFP, DCP, and GTP/ALT has high sensitivity and specificity in diagnosing liver malignant tumors, and has certain clinical value in distinguishing between benign and malignant liver tumors.