Cerebral small vessel disease （CSVD） is a spectrum of pathological conditions affecting intracranial small blood vessels and is associated with a variety of clinical manifestations， including cognitive impairment， gait abnormalities， and sleep disorders. In recent years， the association between CSVD and sleep disorders has attracted increasing attention. This article reviews the association of CSVD with various sleep disorders such as obstructive/central sleep apnea hypoventilation syndrome， restless legs syndrome， and insomnia， analyzes the mechanisms by which sleep disorders cause CSVD， and proposes potential directions for future research.

Phantom limb pain (PLP) is a form of neuropathic pain occurring after limb amputation, and its underlying mechanisms remain unclear, posing significant challenges for clinical management. Spinal cord stimulation (SCS), a neuromodulation technique, has shown potential in relieving chronic pain, though its long-term efficacy and safety in treating PLP require further validation. This report presents a case of a 42-year-old male experiencing persistent radiating, lightning-like pain [Visual Analog Scale (VAS) score 8-9], following right upper limb amputation. Preoperative imaging revealed signal loss in the right nerve roots at C₆-T₁. A percutaneous electrode was implanted surgically to achieve full coverage of the painful region. Five days postoperatively, the VAS score dropped to 2-3, and after 1 year of follow-up, the patient continued to experience significant pain relief (VAS 1-2), with complete resolution of depressive symptoms and cessation of analgesic medication. Existing studies suggest that the long-term outcomes of SCS may fluctuate, and attention should be paid to potential complications such as infection and electrode displacement.
Humans ; Phantom Limb/therapy* ; Male ; Adult ; Spinal Cord Stimulation/methods* ; Electrodes, Implanted ; Amputation, Surgical/adverse effects*

Allergen-specific immunotherapy（AIT） remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis（AR）. Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group（CRRCG） convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans ; Allergens/immunology* ; China ; Consensus ; Desensitization, Immunologic ; Immunoglobulin E ; Quality of Life ; Rhinitis, Allergic/therapy* ; Treatment Outcome ; East Asian People

Objective:To examine the influence of sarcopenia on the mid-term clinical outcomes of percutaneous vertebroplasty(PVP) in the management of osteoporotic vertebral compression fractures(OVCF).Methods:A retrospective case analysis method was adopted to analyze the clinical data of 102 patients with OVCF who underwent PVP in Beijing Daxing District Hospital of Integrated Chinese and Western Medicine from September 2020 to September 2022. Among them, there were 19 males and 83 females; the patients was (74.31±6.99) years, aged from 61 to 89 years. Using the skeletal muscle index (SMI) at the L3 vertebral level as the basis for grouping, with the diagnostic criteria of SMI<24.4 cm 2/m 2 for males and SMI<23.3 cm 2/m 2 for females. The 102 patients were divided into the sarcopenia group ( n=42) and the non-sarcopenia group ( n=60). The visual analog scale(VAS) scores for low back pain were recorded before surgery and at 3 days, 6 months, 1 year, 3 years after surgery; The oswestry disability index(ODI) was recorded at 6 months, 1 year, and 3 years after surgery; Bone mineral density (BMD) T-scores were recorded at 1 year and 3 years after surgery, and complications such as adjacent vertebral fractures were recorded. Measurement data with normal distribution were expressed as mean±standard deviation( ± s), and comparisons between groups were performed using the t-test. Count data were expressed as case and percentage (%), and comparisons between groups were performed using the chi-square test or Fisher′s exact test. Results:All patients in this study successfully completed the surgery and were followed up for 3 years. Compared with the preoperative baseline levels, the VAS for low back pain and ODI of patients in both groups decreased significantly at all postoperative time points, with statistically significant differences ( P<0.05). For patients in the sarcopenia group, the VAS for low back pain at 3 days, 6 months, 1 year, and 3 years after surgery were (2.50±1.04), (2.45±0.80), (2.17±0.79), (1.90±0.76) points, respectively. Those in the non-sarcopenia group were(2.02±0.68), (1.85±0.80), (1.78±0.61), (1.57±0.62) points, respectively, with a statistically significant difference between the two groups ( P<0.05). The ODI scores of the sarcopenia group at 6 months, 1 year, and 3 years postoperatively were (23.76±3.88)%, (23.05±4.33)%, (22.51±4.49)%, while those of the non-sarcopenia group were (21.68±4.51)%, (20.78±4.60)%, (20.30±4.44)%. The difference between the two groups was statistically significant ( P<0.05). The T-scores of femoral neck bone mineral density in the sarcopenia group at 1 year and 3 years after surgery were (-2.78±0.38), (-2.71±0.41), and those in the non-sarcopenia group were (-2.63±0.35), (-2.53±0.34), with a statistically significant intergroup difference ( P<0.05). For the T-scores of lumbar spine bone mineral density, the sarcopenia group had (-3.36±0.58), (-3.47±0.68) at 1 year and 3 years postoperatively, compared with (-3.12±0.59), (-2.91±0.53) in the non-sarcopenia group. The difference between the two groups was statistically significant ( P<0.05). Regarding the incidence of postoperative complications such as adjacent vertebral fractures, the sarcopenia group had a significantly higher incidence (19.0%) than the non-sarcopenia group (3.3%), with a statistically significant difference between the groups ( P<0.05). Conclusions:OVCF patients with sarcopenia who undergo PVP have poorer mid-term postoperative efficacy than those without sarcopenia, and they also face an increased risk of postoperative complications. Early screening and active intervention for patients with sarcopenia will help improve their clinical efficacy.

Green analytical chemistry (GAC) focuses on mitigating the adverse effects of analytical activities on human safety, human health, and environment. In addition to the 12 principles of GAC, proper GAC tools should be developed and employed to assess the greenness of different analytical assays. The 15 widely used GAC metrics, i.e., national environmental methods index (NEMI), advanced NEMI, assessment of green profile (AGP), chloroform-oriented toxicity estimation scale (ChlorTox Scale), Analytical Eco-Scale, Green Certificate Modified Eco-Scale, analytical method greenness score (AMGS), green analytical procedure index (GAPI), ComplexGAPI, red-green-blue (RGB) additive color model, RGB 12 algorithm, analytical greenness calculator (AGREE), AGREE preparation (AGREEprep), HEXAGON, and blue applicability grade index (BAGI), are selected as the typical tools. This article comprehensively presents and elucidates the principles, characteristics, merits, and demerits of 15 widely used GAC tools. This review is helpful for researchers to use the current GAC metrics to assess the environmental sustainability of analytical assays.

Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.

Green analytical chemistry(GAC)focuses on mitigating the adverse effects of analytical activities on human safety,human health,and environment.In addition to the 12 principles of GAC,proper GAC tools should be developed and employed to assess the greenness of different analytical assays.The 15 widely used GAC metrics,i.e.,national environmental methods index(NEMI),advanced NEMI,assessment of green profile(AGP),chloroform-oriented toxicity estimation scale(ChlorTox Scale),Analytical Eco-Scale,Green Certificate Modified Eco-Scale,analytical method greenness score(AMGS),green analytical pro-cedure index(GAPI),ComplexGAPI,red-green-blue(RGB)additive color model,RGB 12 algorithm,analytical greenness calculator(AGREE),AGREE preparation(AGREEprep),HEXAGON,and blue appli-cability grade index(BAGI),are selected as the typical tools.This article comprehensively presents and elucidates the principles,characteristics,merits,and demerits of 15 widely used GAC tools.This review is helpful for researchers to use the current GAC metrics to assess the environmental sustainability of analytical assays.

Objective: To understand the trends and associated factors of tuberculosis knowledge and behavior among freshmen from Jiangsu Province, 2019 to 2022, so as to provide theoretical support for the popularization of tuberculosis knowledge and the prevention and control of tuberculosis in universities. Methods: From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were selected by stratified random sampling, and tuberculosis knowledge and behavior were surveyed online using a selfdesigned questionnaire. Oneway variance trend test and multiple linear regression analysis were used to analyze the trend of knowledge and behavior levels, and a multiple linear regression model was used to analyze the influencing factors. Results: The overall awareness rate of tuberculosis among freshmen from Jiangsu Province was 90.6%, and the overall awareness rates from 2019 to 2022 were 88.4%, 90.4%, 91.7%, and 91.8%, respectively. The overall behavioral accuracy rate was 92.3%, with the annual rates from 2019 to 2022 being 91.8%, 92.3%, 92.7%, and 92.4%, respectively. Both the awareness rate and accuracy behavior rate increased annually (F=216.67, 11.75, P<0.01). The multiple linear regression analysis showed that school type, ethnicity, fathers educational level, mothers educational level, mothers occupation, family per capita monthly income, and living arrangement in high school affected both personal knowledge awareness rate and personal behavioral accuracy rate (β=-0.047-0.035, P<0.01), while region, gender, family residence, and being an only child only affected behavioral accuracy rate (β=-0.003-0.032, P<0.05). Conclusions The tuberculosis knowledge and behavior levels of freshmen from Jiangsu Province have been increasing by year. Targeted health education should be carried out based on the relevant influencing factors to further enhance the tuberculosis prevention and control literacy.

Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.

Objective:This study investigates the difference in the detection rate and symptomatology between ICD-10 and DSM-5 diagnostic criteria for bipolar disorder with mixed states.Methods:Based on the Phase Ⅰ (2012) and Phase Ⅱ (2021) databases of National Bipolar Mania Pathway Survey (BIPAS), patients with bipolar disorder were included. General demographic data, clinical characteristics, symptomatic phenotypes, and mixed characteristics were retrieved. The detection rates and symptomatic performances of patients with or without mixed states in Phase Ⅰ and Ⅱ were compared using the chi-square test.Results:For patients with mixed states, the detection rate during Phase Ⅱ (2021) using DSM-5 (18.79%, 199/1 059) criteria was significantly higher than that during Phase Ⅰ (2012) using ICD-10 (6.78%, 199/2 934; χ 2=125.05, P<0.001). Whether using ICD-10 or DSM-5 criteria, patients with mixed states had a significantly higher frequency of multiple symptomatic manifestations. Conclusion:The DSM-5 diagnostic criteria generate a high detection rate for bipolar disorder with mixed states. The clinical phenotypes of bipolar disorder with mixed states vary significantly using different diagnostic tools.