Objective To investigate the therapeutic effects of combined magnetic and electrical stimulation with an"intelligent exercise prescription"and novel matrix radiofrequency therapy in patients with pelvic organ prolapse(POP).Methods A total of 158 patients with POP who received treatment at the Gynecological Pelvic Floor Rehabilitation Center of the Eighth Affiliated Hospital of Southern Medical University between October 2022 and July 2025 were retrospectively enrolled and divided into an observation group(n=64)and a control group(n=94)based on their treatment plans.The control group underwent magnetic and electrical stimulation combined with an"intelligent exercise prescription"regimen.Specifically,patients received 10 sessions of electrical stimulation,5 sessions of magnetic stimulation,and performed 15～20 minutes of daily home exercise training guided by the"intelligent exercise prescription."The observation group received,in addition to the aforementioned treatments,four sessions of novel matrix radiofrequency therapy.Changes in the muscle strength grades of type Ⅰ and type Ⅱ pelvic floor muscles,Glazer surface electromyography(EMG)values,and POP-Q staging were compared between the two groups before and after treatment.Results After treatment,both groups demonstrated significant improvements in type Ⅰ and type Ⅱ muscle fiber strength compared to baseline(all P<0.05),with the observation group showing greater improvement in type Ⅰ muscle fiber strength than the control group(P<0.05).The muscle potential values of the observation group during rapid contraction,tense contraction,and endurance contraction stages were markedly increased compared to pre-treatment levels.Moreover,the muscle potential values during the pre-resting stage were significantly reduced after treatment(P<0.05).In the observation group,POP-Q grades of the anterior vaginal wall,uterus,and posterior vaginal wall were all significantly lower post-treatment than pre-treatment(all P<0.05).However,no statistically significant differences were observed between the observation group and the control group in these parameters(P>0.05).Both groups exhibited relatively high compliance rates(both≥75.0%),with no significant difference between them(P>0.05).The treatment cost for the observation group was significantly higher than that for the control group(P<0.05).Conclusions The combination of magneto-electrical stimulation,an"intelligent exercise prescription,"and novel matrix radiofrequency therapy can significantly improve pelvic floor muscle strength and muscle potential values in the short term,compared to pre-treatment levels.This integrated approach also effectively alleviates the prolapse of the anterior vaginal wall,uterus,and posterior vaginal wall.Furthermore,the combination of magnetic and electrical stimulation,"intelligent exercise prescription,"and matrix radiofrequency therapy demonstrates superior efficacy in enhancing type Ⅰ pelvic floor muscle fiber strength when compared to the combination of magnetic and electrical stimulation with"intelligent exercise prescription"alone.However,this treatment protocol entails a relatively high economic burden,and its clinical application should be carefully evaluated in consideration of patients'functional needs and financial conditions.

Background: Psoralea corylifolia L. (Buguzhi, BGZ), known for its efficacy in supporting pregnancy and preventing miscarriage, has been used in China for over 1000 years. Recently, BGZ has been identified as a potential cause of drug-induced liver injury. However, its safety during pregnancy remains unclear, which significantly hinders its routine clinical application. Objective: To investigate the effects of BGZ administration during pregnancy on the liver of mouse mothers and their weaned 21-day-old offspring. Methods: Mice were orally administered BGZ at doses of 2.5 and 10 g/kg during pregnancy, with BGZ withdrawal during the lactation period. Liver histopathology (hematoxylin-eosin staining), biochemical analysis, and evaluation of liver bile acid metabolism were performed after the lactation period. Results: BGZ administration at doses of 2.5 and 10 g/kg during pregnancy, followed by withdrawal during the lactation period, caused mild liver damage in both mothers and their 21-day-old offspring. Serum total bile acid (TBA) levels were elevated compared with those in the control group. Additionally, changes were observed in the levels and proportions of various bile acids (BAs) in the liver, suggesting mild effects on BA metabolism. Conclusion: BGZ administration during pregnancy caused mild liver damage and increased serum TBA levels in both mouse mothers and their 21-day-old offspring. This phenomenon may be associated with imbalanced BA metabolism in the liver. Based on the present study and the limited toxicological research on BGZ, pregnant women should avoid prolonged use of BGZ. If BGZ is administered during pregnancy, serum TBA levels should be monitored, and if elevated, BGZ should be discontinued.

Background: Aristolochic acid II (AAII), a major nephrotoxic and carcinogenic component of aristolochic acids (AAs), has been less studied compared with its well-characterized analog, aristolochic acid I (AAI). Although AAs are known to induce carcinogenesis via DNA adduct formation, the toxicity mechanisms, environmental prevalence, and long-term health impacts of AAII remain poorly understood. Objective: This study aimed to systematically evaluate AAII’s acute and chronic toxicity, carcinogenic mechanisms, and environmental exposure patterns using integrated murine models and phytochemical analyses to clarify its toxicological profile and associated health risks. Methods: C57BL/6J mice were used in the following experiments: (1) determination of AAII content in 3 commonly used Aristolochia medicinal materials via liquid chromatography-mass spectrometry/mass spectrometry; (2) acute toxicity testing with single doses of 10, 20, or 40 mg/kg; and (3) chronic exposure with 1 or 10 mg/kg administered every other day for 24 weeks, followed by 21 to 40 weeks of postexposure monitoring. Histopathological examination, whole-exome sequencing, biochemical assays, and micronucleus tests were performed to assess multi-organ damage, tumorigenesis, genomic mutation signatures, and direct clastogenicity. Phytochemical analyses were used to evaluate environmental distribution. Results: (1) A single 40 mg/kg dose of AAII induced dose-dependent renal tubular degeneration without hepatotoxicity; (2) the 10 mg/kg group showed significant mortality (20%), tumor incidence (33.3%, primarily forestomach and bladder transitional cell carcinomas), persistent renal interstitial fibrosis, and subclinical hepatic injury. Chronic exposure to 1 mg/kg still induced 13.3% mortality and 15.5% tumor incidence over a 64-week period; (3) whole-exome sequencing revealed a predominance of C>T mutations and pathway enrichment in chemical carcinogenesis and cytochrome P450-mediated metabolism, indicating reactive metabolite-driven mechanisms distinct from classical AA-DNA adducts; and (4) no histopathological changes were observed in nontarget organs (brain, heart, and testes), and micronucleus assays confirmed the absence of direct clastogenicity. Conclusion: This study highlights the delayed carcinogenic risks of low-dose chronic AAII exposure and emphasizes the need to update regulatory frameworks to ensure the safe use of aristolochiaceae-containing herbal products.

Objective To investigate the therapeutic effects of combined magnetic and electrical stimulation with an"intelligent exercise prescription"and novel matrix radiofrequency therapy in patients with pelvic organ prolapse(POP).Methods A total of 158 patients with POP who received treatment at the Gynecological Pelvic Floor Rehabilitation Center of the Eighth Affiliated Hospital of Southern Medical University between October 2022 and July 2025 were retrospectively enrolled and divided into an observation group(n=64)and a control group(n=94)based on their treatment plans.The control group underwent magnetic and electrical stimulation combined with an"intelligent exercise prescription"regimen.Specifically,patients received 10 sessions of electrical stimulation,5 sessions of magnetic stimulation,and performed 15～20 minutes of daily home exercise training guided by the"intelligent exercise prescription."The observation group received,in addition to the aforementioned treatments,four sessions of novel matrix radiofrequency therapy.Changes in the muscle strength grades of type Ⅰ and type Ⅱ pelvic floor muscles,Glazer surface electromyography(EMG)values,and POP-Q staging were compared between the two groups before and after treatment.Results After treatment,both groups demonstrated significant improvements in type Ⅰ and type Ⅱ muscle fiber strength compared to baseline(all P<0.05),with the observation group showing greater improvement in type Ⅰ muscle fiber strength than the control group(P<0.05).The muscle potential values of the observation group during rapid contraction,tense contraction,and endurance contraction stages were markedly increased compared to pre-treatment levels.Moreover,the muscle potential values during the pre-resting stage were significantly reduced after treatment(P<0.05).In the observation group,POP-Q grades of the anterior vaginal wall,uterus,and posterior vaginal wall were all significantly lower post-treatment than pre-treatment(all P<0.05).However,no statistically significant differences were observed between the observation group and the control group in these parameters(P>0.05).Both groups exhibited relatively high compliance rates(both≥75.0%),with no significant difference between them(P>0.05).The treatment cost for the observation group was significantly higher than that for the control group(P<0.05).Conclusions The combination of magneto-electrical stimulation,an"intelligent exercise prescription,"and novel matrix radiofrequency therapy can significantly improve pelvic floor muscle strength and muscle potential values in the short term,compared to pre-treatment levels.This integrated approach also effectively alleviates the prolapse of the anterior vaginal wall,uterus,and posterior vaginal wall.Furthermore,the combination of magnetic and electrical stimulation,"intelligent exercise prescription,"and matrix radiofrequency therapy demonstrates superior efficacy in enhancing type Ⅰ pelvic floor muscle fiber strength when compared to the combination of magnetic and electrical stimulation with"intelligent exercise prescription"alone.However,this treatment protocol entails a relatively high economic burden,and its clinical application should be carefully evaluated in consideration of patients'functional needs and financial conditions.

Objective To noninvasively predict isocitrate dehydrogenase(IDH)status of glioma via combining imaging and clini-cal features before surgery,so as to provide basis for individualized clinical treatment decision.Methods A total of 47 patients with glioma confirmed by pathological and molecular genetic tests were included,including 20 with IDH mutant type and 27 with IDH wild type.After diffusion tensor imaging(DTI)scanning,fractional anisotropy(FA)and mean diffusivity(MD)values of tumor paren-chyma were calculated.Combining DTI parameters with MRI morphological features of tumor,blood neutrophil/lymphocyte ratio(NLR)and patient's age,binary logistic regression model was established to effectively predict IDH status of glioma patients before surgery.Results There were significant differences in FAmean/FANAWM,MDmin,NLR,tumor location and age between IDH mutant type and IDH wild type groups(P<0.05).The binary logistic regression model concluding,FAmean/FANAWM,MDmin,cystic degeneration,NLR and age,predicted IDH status of glioma with area under the curve(AUC)of 0.961 and 95%confidence interval(CI)of 0.914-1.00.Conclusion The regression model established via combining DTI,MRI morphological features and blood NLR has great performance in classifying IDH status of glioma,and can help predict IDH status noninvasively before surgery,so as to assist clinical individualized treatment.

Objective To explore the effect and possible mechanism of berberine on the macro-phage polarization of human myeloid leukemia monocytic cell line THP-1 induced by oxidized low-density lipoprotein(ox-LDL).Methods THP-1 cells were induced into macrophages by PMA,and then according to different concentrations of berberine,the cells were divided into con-trol group,and 5,10,20,40 and 50 μmol/L berberine groups.After intervention for 24 or 48 h,CCK8 assay was used to detect cell viability for optimal concentration and time of berberine treat-ment.PMA-induced THP-1 macrophages were assigned into blank group,model group(ox-LDL),berberine group,inhibitor group(phosphatidyl inositol 3-kinase(PI3K)inhibitor LY294002)and berberine+inhibitor group(berberine+LY294002).The contents of inducible nitric oxide syn-thase(iNOS)and TGF-β1 were detected by ELISA.qPCR was employed to measure the mRNA expression of TNF-α,arginase 1(Arg1),PI3K and protein kinase B Akt1,and Western blotting was applied to detect the protein levels of Akt1 and phosphorylated protein kinase B antibody(p-Akt1).Results In 24 h after intervention,the macrophage activity was significantly lower in the 40 and 50 μmol/L berberine groups than the control group(P＜0.05),and after 48 h,the ac-tivity in all the 5 doses of berberine groups was obviously lower than that in the control group[(0.89±0.02)％,(0.82±0.03)％,(0.71±0.02)％,(0.62±0.03)％and(0.53±0.02)％vs(1.01±0.01)％,P＜0.05].Berberine treatment of 20 μmol/L for 24 h had little effect on cell viability,and the dose and the time were regarded as the best concentration and time.Compared with the blank group,iNOS content and TNF-α mRNA level were increased in the model group,while TGF-β1 content,mRNA levels of Arg1,PI3K and Akt1,and p-Akt1/Akt1 protein levels were de-creased(P＜0.05).iNOS content and TNF-α mRNA level were decreased,while TGF-β1 content,mRNA levels of Arg1,PI3K and Akt1 and protein levels of p-Akt1/Akt1s were increased in the berberine group than the model group(P＜0.05).Compared with the berberine group,iNOS con-tent and TNF-α mRNA level were increased,while mRNA levels of Arg1,PI3K and Akt1 and protein levels of p-Akt1/Akt1 were decreased in the berberine+inhibitor group(P＜0.05).Con-clusion Berberine can inhibit the inflammatory response of THP-1 macrophages induced by ox-LDL by activating PI3K/Akt1 pathway,and inhibit the M1 polarization and promote the M2 polarization of macrophages.

ObjectiveBased on ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS^E） technique， we identified qualitatively the metabolites of aristolochic acid（AAs） in rat in order to analyze the metabolic differences between water extract of Aristolochiae fructus（AFE） and Aristolochic acid Ⅰ（AAⅠ）. MethodSD rats were selected and administered AFE（110 g·kg^-1·d^-1） or AAⅠ（5 mg·kg^-1·d^-1） by oral for 5 days， respectively. Serum， urine and feces were collected after administration. Through sample pretreatment， ACQUITY UPLC BEH C₁₈ column（2.1 mm×100 mm， 1.7 μm） was used with the mobile phase of 0.01% formic acid methanol（A）-0.01% formic acid water（B， containing 5 mmol·L^-1 ammonium acetate） for gradient elution（0-1 min， 10%B； 1-7 min， 10%-75%B； 7-7.2 min， 75%-95%B； 7.2-10.2 min， 95%B； 10.2-10.3 min， 95%-10%B； 10.3-12 min， 10%B） at a flow rate of 0.3 mL·min^-1. Positive ion mode of electrospray ionization（ESI⁺） was performed in the scanning range of m/z 100-1 200. In combination with UNIFI 1.9.4.053 system， the Pathway-MS^E was used to qualitatively analyze and identify the AAs prototype and related metabolites in biological samples（serum， urine and feces）， and to compare the similarities and differences of metabolites in rats in the subacute toxicity test between AFE group and AAⅠ group. ResultCompared with AAⅠ group， 6， 10， 13 common metabolites and 14， 20， 30 unique metabolites were identified in biological samples（serum， urine and feces） of AFE group， respectively. Moreover， the main AAs components always followed the metabolic processes of demethylation， nitrate reduction and conjugation. Compared with common metabolites in AAⅠ group， prototype components of AAⅠ in serum and most metabolic derivatives of AAⅠ［AAⅠa， aristolochic lactam Ⅰ（ALⅠ）a， 7-OHALⅠ and its conjugated derivatives］ in biological samples were significantly increased in AFE group（P<0.05， P<0.01）， except that the metabolic amount of ALⅠ in feces of AFE group was remarkably lowed than that of AAⅠ group（P<0.01）. In addition， a variety of special ALⅠ efflux derivatives were also identified in the urine and feces of the AFE group. ConclusionAlthough major AAs components in AFE all show similar metabolic rules as AAⅠ components in vivo， the coexistence of multiple AAs components in Aristolochiae Fructus may affect the metabolism of AAⅠ， and achieve the attenuating effect by increasing the metabolic effection of AAⅠ and ALⅠ.

This article briefly describes the imaging performance standards of the kilovolt X-ray image guidance system used in radiotherapy, analyzes the main aspects that should be considered in the image quality of X-IGRT system, and focuses on parameters that should be considered in the imaging performance evaluation criteria of the CBCT X-IGRT. The purpose is to sort out the imaging performance evaluation standards of kilovolt X-IGRT system, clarify the image quality requirements of X-IGRT equipment, and reach a consensus when evaluating the imaging performance of X-IGRT system.
Radiotherapy Planning, Computer-Assisted/methods* ; Cone-Beam Computed Tomography/methods* ; Spiral Cone-Beam Computed Tomography ; Radiotherapy, Intensity-Modulated/methods* ; Radiotherapy, Image-Guided/methods*

ObjectiveTo analyze the effect of standardized training on post competency of rehabilitation therapists, based on World Health Organization rehabilitation competency framework (RCF), and combined with the characteristics of rehabilitation and the requirements of standardized training in China. MethodsFrom 2018 to 2022, a total of 30 rehabilitation therapists who participated in the standardized training were selected. Before and after the standardized training, the closed-book theoretical assessment and Mini-clinical Evaluation Exercise (Mini-CEX) assessment were carried out, and a 360-Degree Evaluation scale was distributed to their teachers, peers and patients. Through multi-dimensional post competency analysis, the data obtained from the scales were combined with the five dimensions of basic theoretical knowledge, clinical practice ability, medical humanities literacy, scientific research and teaching ability, and organizational management ability to analyze the effect of standardized training on post competency of rehabilitation therapists. ResultsAfter training, the therapists improved in theory and case analysis (Z > 2.716, P < 0.05). They also improved in medical interview skills, physical examination, humane care/professionalism, clinical judgment ability and overall clinical level (Z > 2.162, P < 0.05) according to Mini-CEX. The medical ethics, daily work, management ability, social ability, interpersonal communication ability, basic professional ability and operation ability improved (Z > 1.978, P < 0.05) according to the 360-Degree Evaluation scale. The effect of standardized training was significant in basic theoretical knowledge, clinical practice ability and medical humanities literacy by the post competency analysis model. ConclusionThe effect of standardized training of rehabilitation therapists is significant, and the therapists can be competent for daily work in diagnosis and treatment after training.

Realgar is an arsenic-containing Chinese medicine known for its toxin-removing, phlegm-dispelling, and malaria-intercepting effects. It has proven to be effective in the treatment of acute promyelocytic leukemia. However, because of the harmful nature of arsenic to human health, realgar is considered a “poison” in many countries, raising concerns about the toxicity and safety of realgar and its preparations. The Shuifei process (grinding with water) of realgar plays a crucial role in ensuring its safety as a Chinese medicine. The major ingredient of realgar, As S , is water insoluble and poorly absorbed by the human body. Therefore, it is important to note that the toxicity and health risks of realgar to humans are overestimated by solely considering the amount of arsenic. Realgar processing is an indispensable method to ensure the quality of medicinal realgar, involving purification, powdering, detoxification, and synergism. This article not only highlights possible mechanisms through which realgar exerts pharmacological effects but also reviews the literature regarding its toxic features and potential mechanisms. Currently, realgar toxicity research primarily relies on animal experiments, and clinical data on its adverse reactions are relatively limited. The toxicity of arsenic is closely related to the form and valence of its major metabolites in the body. Animal studies have confirmed that, when realgar enters the body, the major form of arsenic metabolized is dimethylarsenic acid; therefore, it was considered that the toxicity of realgar induced by high doses might be associated with the accumulation of dimethylarsenic acid produced in the methylation pathway of inorganic arsenic. Realgar is generally less toxic when used in safe doses, but prolonged use may pose a significant risk. It is rarely used alone and is often combined with other Chinese medicines in an attempt to reduce toxicity. Scientifically and reasonably limiting the arsenic content of realgar-containing Chinese patent medicines is an effective way to improve the safety of realgar in clinical medication.