Objective To explore the feasibility of using high-definition thoracoscopy to identify sympathetic ganglia during thoracic sympathicotomy for primary palmar hyperhidrosis. Methods The clinical data of patients with primary palmar hyperhidrosis who underwent high-definition thoracoscopic sympathicotomy in Taikang Xianlin Drum Tower Hospital from June to July 2023 were retrospectively analyzed. Intraoperative visualization rates and anatomical variations of sympathetic ganglia were recorded, and the consistency between white-light thoracoscopy and near-infrared fluorescence imaging was compared. Additionally, surgical videos from previous fluorescence-guided procedures were reviewed. Results Finally 100 patients were collected, including 54 females and 46 males, with an average age of (21.92±6.56) years. All patients underwent endoscopic thoracic sympathicotomy at R3 level. The overall intraoperative ganglion visualization rate was 92.5% (740/800), with G2-G5 rates of 95.5% (191/200), 94.0% (188/200), 94.0% (188/200), and 86.5% (173/200), respectively. Ganglion variations occurred in 32.0% (237/740), predominantly at G3 (29.8%) and G4 (42.6%). In 5 indocyanine green-enhanced patients, the concordance rate between white-light and near-infrared fluorescence imaging was 100.0% (38/38). Video analysis of 14 near-infrared fluorescence-guided surgeries demonstrated a 99.1% (107/108) consistency rate. Postoperative palmar hyperhidrosis improvement reached 100.0% (100/100) with no Horner’s syndrome. Conclusion With the wide clinical application of high-definition thoracoscopy, accurate thoracic sympathicotomy has the feasibility of clinical application.

Factorial design is an important method for optimizing complex strategies in implementation science. This paper systematically elucidates the origin, types, and core concepts of the factorial design, and then use a brief smoking cessation intervention project as an example to illustrate its specific applications in identifying key factors and testing interactions. Factorial design has the following typical advantages: it can test synergistic and antagonistic effects between factors, provide effect estimates that are broadly valid across the experimental conditions, and offer high statistical efficiency. At the same time, it also has certain limitations, including that its complexity is positively correlated with the number of factors, the need for large sample sizes to detect interactions, the potential for insufficient acceptability of some strategy combinations due to ethical concerns or participant burden, and the complexity of the analytical methods required. In future research, its application should be further optimized by appropriately controlling the number of factors, clearly defining research objectives, and evaluating intervention acceptability, in order to promote the development of precision implementation science.

ObjectiveThis study aims to enhance of the farnesyl pyrophosphate（FPP） pool in Saccharomyces cerevisiae by heterologously expressing different farnesyl diphosphate synthases（FPSs） from various plants， thereby increasing the production of terpenoid compounds by the engineered yeast. MethodsRNA from mixed samples of roots， stems， and leaves of seven plants including Arabidopsis thaliana， Rosa rugosa， Artemisia annua， Centella asiatica， Humulus lupulus， Medicago sativa， and Panax ginseng was extracted by column chromatography and reverse transcribed into the first strand of complementary DNA（cDNA）， and based on the transcriptome data of the seven species of plants， sequence-specific primers were designed for CaFPS， RrFPS， MsFPS， HiFPS， PgFPS， AtFPS， and AaFPS， the full-length of the genes was cloned， and the genes were analyzed for bioinformatics in order to construct a pESC yeast shuttle vector. These seven plant-derived FPSs were further heterologously expressed in the previous constructed β-elemene-producing yeast， and the yield of β-elemene was indicated for their catalytic acivities. ResultsThe coding sequences of CaFPS， RrFPS， MsFPS， HiFPS， PgFPS， AtFPS， and AaFPS were all of 1 021 bp in length and encoding 301 amino acids， all of which were similarly related to the endogenous FPS-encoding gene（ERG20） in S. cerevisiae. After heterologous expression， RrFPS was identified as the most effective in catalyzing the synthesis of FPP from isopentenyl pyrophosphate（IPP） and dimethylallyl pyrophosphate（DMAPP）. Compared to the control strains， the RrFPS overexpressed yeast strains YB-1-Rr and YB-3-Rr increased the production of β-elemene by 231.25% and 189.3%， respectively. ConclusionBy comparing the functions of FPS-encoding genes from seven different plant sources， it is determined that the protein encoded by the RrFPS from R. rugosa has the best catalytic ability， which can provide key genetic elements for the construction of engineered yeast strain constructs with high terpenoid production.

Objective:To investigate the application value of intraoperative sliding rail computed tomography （CT） in complicated and difficult cochlear implantation by analyzing the cases of complicated and difficult cochlear implantation. Methods:The clinical data of patients with complicated and difficult cochlear implantation assisted by sliding rail CT were retrospectively analyzed, the intraoperative complications and the number of electrode adjustments were summarized, and the patients were followed up. Results:A total of 51 subjects were included in this study, including 46 patients with inner ear malformation, 2 patients with cochlear ossification, there were 7 patients underwent secondary scanning to adjust the electrode and achieved satisfactory implantation position. Conclusion:Intraoperative CT scanning is a reliable adjunctive tool for determining the placement of complex cochlear implantation, and it improves the accuracy of difficult cochlear implantation surgeries.
Humans ; Cochlear Implantation/methods* ; Retrospective Studies ; Tomography, X-Ray Computed ; Cochlear Implants ; Male ; Female ; Child, Preschool ; Child ; Cochlea ; Electrodes, Implanted ; Infant

Objective To explore the effects of mental fatigue on attention maintenance function by electroencephalogram(EEG)signal characteristics and cortical source analysis.Methods A total of 25 healthy males were recruited as subjects and contingent negative variation(CNV)auditory paradigm was used to assess the differences in EEG characteristics before and after mental fatigue,with the average amplitude of CNV at different processing stages as the analysis indices.Then,the 3-dimensional distribution of cortical current density changes of CNV after mental fatigue were calculated by standardized low-resolution electromagnetic tomography analysis(sLORETA).Results The reaction time of the CNV signal remained unchanged following mental fatigue(P＞0.05),while the lapse rate exhibited a significant increase(P＜0.05).Besides,mental fatigue was related to a notable decrease in the amplitude of CNV early components(500-1 000 ms after warning stimulus)at the central and central parietal electrodes,and a significant reduction in the amplitude of CNV late components(2 550-3 050 ms after warning stimulus)at the prefrontal,frontal,central,and central parietal electrodes(all P＜0.05).The results of sLORETA source analysis showed that the brain activity in the left posterior insular cortex decreased after mental fatigue during the late component of CNV(P＜0.05).Conclusion The decreased activation of the posterior insula,which plays a crucial role in sensorimotor information integration,could potentially serve as a neural mechanism for the reduction of CNV amplitude and the impairment of attention maintenance function following mental fatigue.

Objective To investigate the relationship between cerebral perfusion status,blood pressure variability,and prognosis in patients with moyamoya disease following cerebral revascularization.Methods A retrospective analysis was conducted on 108 patients who underwent their first combined cerebral revascularization between January 2019 and July 2022 at the Department of Neurosurgery,First Affiliated Hospital of Henan University,and Henan Provincial People's Hospital.Based on postoperative cerebral perfusion improvement,patients were categorized into a"good"group and a"general"group.Baseline characteristics,key imaging parameters,blood pressure variability,and symptom scores were compared and analyzed between the two groups.Results In this study,there were 55 cases in the good group and 53 cases in the general group.According to the comparative analysis of the postoperative indicators between the good group and the general group,Statistically significant differences were observed in symptom improvement[42(79.25%)vs.52(94.55%)],TIA[22(41.51%)vs.11(20.00%)],and cerebral infarction[6(11.32%)vs.0(0.00%)],mRS score and the Matsushima classification(P<0.05).However,there was no statistically significant difference in the BPV-related index between the two groups of patients before the operation(all P>0.05).When comparing nine blood pressure variability(BPV)-related indices including the mean of 24-hour,daytime,and nighttime systolic blood pressure,coefficient of variability(CV),and average real variability(ARV)between the two groups,no significant differences were observed in the BPV-related indices before surgery between the two groups(P>0.05).The differences in the BPV-related indices before and after surgery(postoperative index-preoperative index)between the two groups were statistically significant(P<0.05).Postoperative cerebral perfusion status was positively correlated with prognosis and negatively correlated with BPV.Conclusion Patients with good improvement in cerebral perfusion status after combined revascularization for moyamoya disease have less blood pressure variability and better prognosis.

Objective To explore the active components,therapeutic targets,and molecular mechanisms of Shaoyao Decoction in the treatment of ulcerative colitis(UC)using network pharmacology techniques,bioinformatics methods,and experimental approaches.Methods Screening active components of Shaoyao Decoction and predicting their targets using databases such as PubChem,screening HCC-related disease targets through the NCBI database,constructing a PPI network,conducting GO functional enrichment and KEGG pathway analysis to identify potential biological processes and signaling pathways involved,and validating with molecular docking using AutoDock Tools.Forty male C57BL/6J mice were randomly divided into normal,model,Mesalazine,and Shaoyao Tang groups based on body weight.Except for the normal group,all other groups were induced with ulcerative colitis(UC)by providing 2.5%dextran sulfate sodium(DSS)in drinking water for 5 days.After continuous intragastric administration for 7 days,the mice were sacrificed.The levels of cytokines such as IL-2,IL-1β,IL-6,and TNF-α in colon tissues were measured by ELISA,and pathological sections of colon tissue samples were observed.Results The study identified 20 active components and 945 targets of Shaoyao Tang,among which 609 were related to UC.Through PPI network analysis,22 key targets including VEGFA,AKT1,PTGS2,and STAT3 were determined.GO analysis revealed 409 enriched terms,involving negative regulation of inflammatory response to antigenic stimulus,positive regulation of inflammatory response,etc.KEGG analysis discovered 136 significantly enriched pathways,including the NF-κB signaling pathway,Toll-like receptor signaling pathway(related to inflammation and immunity),VEGF signaling pathway,and ErbB signaling pathway(related to cell proliferation and apoptosis).Molecular docking revealed that the active ingredients exhibited strong affinity with target proteins such as IL-6,TNF,TLR4,IL-2,IL-1B,and PTGS2,forming stable conformations.The final ELISA results demonstrated that the levels of multiple inflammatory cytokines in the colon tissue of DSS-induced ulcerative colitis(UC)mouse models were significantly elevated,with notable upregulation of IL-2,IL-1β,IL-6,and TNF-α compared to the normal group(P<0.05).Following drug intervention,both the Mesalazine group and the Shaoyao Decoction group exhibited significant anti-inflammatory effects,effectively reducing the expression levels of the aforementioned inflammatory cytokines in the colon tissue(P<0.05).Notably,compared to the Mesalazine group,Shaoyao Decoction demonstrated a more pronounced regulatory effect on inflammatory cytokines(P<0.05).Conclusion In this study,the innovative integration of network pharmacology prediction,molecular docking validation and key inflammatory factor assay systematically elucidated the"multi-component-multi-target-multi-pathway"anti-inflammatory mode of Paeonia lactiflora broth in the treatment of UC.The experiments demonstrated that Paeonia lactiflora broth could regulate the release of pro-inflammatory cytokines by regulating the levels of IL-2,IL-1β,IL-6,TNF-α cytokines and other related cytokines to reduce the inflammation of the colon and improve the damage of colon tissues in mice with UC.

Objectives:To study the influence on stability and stress of posterior atlantoccipital transarticu-lar-clivus screw(TACL)in occipitocervical fixation using the finite element analysis method.Methods:Finite element models were established using the occipitocervical CT data of a volunteer,including an intact model,an unstable model,and six models of occipitocervical fixations:occipital screw(OS)+C1 lateral mass screw(C1LMS)+C2 pedicle screw(C2PS),OS+atlantoccipital transarticular screw(TA)+C2PS,OS+atlantoccipital transar-ticular-clivus screw(TACL)+C2PS,Occipital condyles screw(OcC)+C1LMS+C2PS,TA+C2PS,and TACL+C2PS.Material parameters were assigned to the models,and a vertical downward force of 40 N was applied to the upper surface of the occipital bone to simulate the weight of head.A torque of 1.5N·m was applied to in-duce flexion,lateral bending,and rotational movements.The stability,implant stress distribution,and bone stress distribution of each occipitocervical fixation model under different conditions were compared.Results:The range of motion(ROM)of the intact model under physiological conditions was similar to those reported in the literatures,and the ROMs under flexion,extension,lateral bending and rotation conditions was 19.53°,17.37°,10.44° and 38.74°,respectively.The ROMs of the unstable model under flexion,extension,lateral bending and rotation conditions were 26.17°,18.90°,10.99° and 42.30°,respectively,which were 34.00％,8.82％,5.34％and 9.20％higher than those of the intact model,respectively.The ROMs of the six fixation models were reduced under the same working conditions.Compared to the unstable model,TACL+C2PS cut 97.43％,94.06％,96.68％,and 99.01％of the ROM under the four working conditions.The peak internal fix-ation stresses were 241.00MPa,241.20MPa,166.94MPa,and 168.80MPa for TACL+C2PS,and 295.00MPa,295.00MPa,73.54MPa,and 81.40MPa for OS+TACL+C2PS in the same working conditions;The internal fixa-tion stresses were concentrated in the middle of the connecting rod and the tail of the TACL,and both mod-els applying the TACL fixation technique had less cutting stress on the bone,which had a more reasonable stress distribution than other occipital fixation techniques.Conclusions:Posterior TACL as a technique for occipital fixation can meet the mechanical strength requirements for occipitocervical fixation and has superior stability and stress distribution compared with other occipital fixation techniques applied alone,and its combined application with posterior occipital screws provides greater mechanical stability.

Objective:To analyze the current situation and hotspots of medication literacy research at home and abroad, and provide references for medication literacy research in China.Methods:The literature related to medication literacy in the Web of Science Core Collection Database, Scopus and China National Knowledge Infrastructure Database were retrieved (up to May 31, 2024). The CiteSpace software was used to analyze the number of published papers, countries, institutions, journals, authors and keywords, etc.Results:A total of 604 literature were included (361 in Chinese and 243 in English). The literature related to medication literacy were first seen in 2000, and the number grew slowly, which showed rapid growth after 2016, and reached a peak in 2023. The country with the largest number of published English literature was China (69 articles), followed by the United States (66 articles). The literature from the United States were cited 3 623 times, and those from China were cited 2 523 times. Central South University and the Third Xiangya Hospital of Central South University were tied for the first place in terms of the number of published articles as institutions (both 15 articles). The top 5 institutions in terms of the number of Chinese publications were Xiangya Third Hospital of Central South University, Central South University, Yanbian University, Affiliated Hospital of Yanbian University, and Tianjin Chest Hospital. The discipline with the largest number of published English literature was pharmacology/pharmacy (107 articles), followed by public environmental occupational health (88 articles) and general internal medicine (39 articles); the discipline with the largest number of Chinese published articles was clinical medicine (124 articles), followed by research on medical and health policies and regulations (56 articles), and medical education and marginal medical disciplines (34 articles). Keyword cluster analysis showed that the top 3 keywords in the English literature were medication errors, health education, and community pharmacy, while those in the Chinese literature were health literacy, self-management, and health education.Conclusions:Research on medication literacy has rapidly developed in recent years. China and the United States are the main countries for research related to medication literacy. Health education and medication errors are the mainstream of the research. Future research can focus on personalized assessment and intervention measures of medication literacy, so as to develop high-quality assessment tools for medication literacy.

Objective To investigate the relationship between cerebral perfusion status,blood pressure variability,and prognosis in patients with moyamoya disease following cerebral revascularization.Methods A retrospective analysis was conducted on 108 patients who underwent their first combined cerebral revascularization between January 2019 and July 2022 at the Department of Neurosurgery,First Affiliated Hospital of Henan University,and Henan Provincial People's Hospital.Based on postoperative cerebral perfusion improvement,patients were categorized into a"good"group and a"general"group.Baseline characteristics,key imaging parameters,blood pressure variability,and symptom scores were compared and analyzed between the two groups.Results In this study,there were 55 cases in the good group and 53 cases in the general group.According to the comparative analysis of the postoperative indicators between the good group and the general group,Statistically significant differences were observed in symptom improvement[42(79.25%)vs.52(94.55%)],TIA[22(41.51%)vs.11(20.00%)],and cerebral infarction[6(11.32%)vs.0(0.00%)],mRS score and the Matsushima classification(P<0.05).However,there was no statistically significant difference in the BPV-related index between the two groups of patients before the operation(all P>0.05).When comparing nine blood pressure variability(BPV)-related indices including the mean of 24-hour,daytime,and nighttime systolic blood pressure,coefficient of variability(CV),and average real variability(ARV)between the two groups,no significant differences were observed in the BPV-related indices before surgery between the two groups(P>0.05).The differences in the BPV-related indices before and after surgery(postoperative index-preoperative index)between the two groups were statistically significant(P<0.05).Postoperative cerebral perfusion status was positively correlated with prognosis and negatively correlated with BPV.Conclusion Patients with good improvement in cerebral perfusion status after combined revascularization for moyamoya disease have less blood pressure variability and better prognosis.