Objective To investigate the acoustic characteristics of speech in Parkinson's disease(PD)pa-tients compared to healthy individuals using smartphone-recorded speech,laying the foundation for future intelligent cloud-based PD detection.Methods A total of 81 PD patients and 63 healthy controls were randomly selected to re-cord their speech using Huawei,Xiao mi,and Apple smartphones through the"Active Health"screening app from the National Key R&D Program.Using the Praat library in Python,parameters such as mean fundamental frequen-cy(Mean F0),minimum fundamental frequency(Min F0),maximum fundamental frequency(Max F0),formants(F1,F2,F3,F4),shimmer,noise-to-harmonics ratio(NHR),and jitter were extracted and compared.Results In PD patients,jitter and shimmer were significantly higher in the/ba/,/bi/,/bu/,and/bo/vowels compared to the control group,while Mean F0 and Max F0 was significantly lower in/bi/and/bo/.Min F0 was significantly higher in/bi/and/bu/for PD patients.No significant differences were found in F1,F2,F3,or F4 between PD pa-tients and controls in/ba/,/bi/,/bo/and/bu/.Conclusion Quantitative analysis of smartphone-recorded speech can detect speech changes in PD patients,providing a solid foundation for the development of a cloud-based PD de-tection system.

AIM To investigate the effects of Changpu Yujin Decoction(CPYJD)on striatal mitophagy and PINK1/Parkin signaling pathway in a rat model of Tourette syndrome(TS).METHODS Thirty-six SPF male SD rats were randomly assigned to the control group(n=9)and the TS modeling group(n=27).Rats in the modeling group received daily intraperitoneal injections of 3,3'-iminodipropionitrile(IDPN)(300 mg/kg)for 7 consecutive days to establish the TS model.Post-modeling,successfully induced TS rats were re-randomized into model group(no treatment),tiapride group(47.91 mg/kg)and CPYJD group(77.28 g/kg).All groups received their respective interventions via intragastric administration daily for 28 days.Following drug administration,behavioral scores were assessed in each group.Pathological alterations in the striatum were examined using HE staining,while ultrastructural changes were evaluated by transmission electron microscopy(TEM).Neuronal apoptosis was quantified via TUNEL staining,and ROS levels in striatum were measured by ELISA.Co-localization of PINK1 and LC3B was assessed using immunofluorescence(IF).Finally,mRNA and protein expressions of PINK1,Parkin,Beclin-1,P62 and LC3B(LC3B-Ⅱ/Ⅰ ratio)were analyzed by RT-qPCR and Western blot.RESULTS Compared to the control group,the model group demonstrated significantly increased behavioral scores(P＜0.01),elevated neuronal apoptosis rate and higher ROS levels in the striatum(P＜0.01);severe neuronal and mitochondrial damage in the striatum;significantly reduced mRNA and protein expressions of PINK1,Parkin,Beclin-1 and LC3B(LC3B-Ⅱ/Ⅰ ratio)in the striatum(P＜0.01);markedly upregulated P62 mRNA and protein expressions(P＜0.01).Compared to the model group,both the tiapride and CPYJD intervention groups exhibited significantly reduced behavioral scores(P＜0.01);decreased neuronal apoptosis rate and lower ROS levels(P＜0.01);improved pathological alterations in the striatal neurons and mitochondria;increased mRNA and protein expressions of PINK1,Parkin and Beclin-1 in the striatum(P＜0.05,P＜0.01);and decreased P62 mRNA and protein expressions(P＜0.01).Furthermore,the rats in the CPYJD group specifically showed elevated LC3B mRNA level and LC3B-Ⅱ/Ⅰ protein ratio in striatum(P＜0.05,P＜0.01).CONCLUSION The effect of CPYJD intervention in TS rats may involve activation of mitophagy through regulation of the PINK1/Parkin signaling pathway,improving mitochondrial function,reducing ROS levels,and thereby protecting neurons.

Objective To explore the effects of ultrasound-guided intercostal nerve block(INB)and thoracic paravertebral nerve block(TPVB)on the dosage of anesthetics and the efficacy of analgesia in video-assisted thoracoscopic lobectomy.Methods From October 2019 to October 2023,90 patients undergoing video-assisted thoracoscopic lobectomy at the People's Hospital of Tongling City,Anhui,were selected.They were divided into the INB group(42 cases)and the TPVB group(48 cases).The INB group received ultrasound-guided intercostal nerve block,while the TPVB group was administered ultrasound-guided thoracic paravertebral nerve block.The two groups were compared before anesthesia induction(T0),15 minutes of anesthesia(T1),30 minutes of anesthesia(T2),45 minutes of anesthesia(T3),and after extubation(T4),vita4 signs,anesthetic dosage,analgesic effect,pain stress index and adverse reactions.Results In the TPVB group,systolic blood pressure(SBP)of T1,T2,T3 and T4 were(115.88±9.29)mmHg,(113.58±9.72)mmHg,(117.33±9.17)mmHg and(121.15±10.51)mmHg,respectively;diastolic blood pressure(DBP)were(86.74±7.35)mmHg,(90.83±8.82)mmHg,(90.83±8.82)mmHg and(91.05±8.73)mmHg,respectively;Heart rate(HR)were(79.94±7.46)times/min,(81.97±7.28)times/min,(82.36±7.41)times/min and(85.83±8.32)times/min,respectively.Which were all higher than the INB group[(103.53±8.28)mmHg,(105.40±8.66)mmHg,(109.03±8.13)mmHg,(114.64±9.65)mmHg.(77.68±6.57)mmHg,(79.27±6.69)mmHg,(83.21±7.37)mmHg,(85.83±8.21)mmHg,(71.17±6.21)times/min,(75.18±6.47)times/min,(74.82±6.12)times/min and(79.35±7.12)times/min,respectively],there were statistical significance between the two groups(P＜0.05).Postoperatively,the TPVB group had lower 24-hour sufentanil consumption[(27.68±2.64)μg]and fewer presses of the analgesia pump[(5.16±0.38)times]compared to the INB group[(36.22±3.36)μg and(6.87±0.42)times,(P＜0.05)].Visual analogue scale(VAS)scores for pain at rest and during coughing at 2,24,and 48 hours in group TPVB were 2.44±0.27,3.55±0.42,2.81±0.34 and 3.36±0.23,4.13±0.33,3.80±0.25,respectively,which were also lower than the INB group(2.83±0.44,3.98±0.55,3.33±0.46 and 3.87±0.30,4.59±0.47,4.17±0.29,respectively)(P＜0.05).Levels of prostaglandin E2(PGE2)(1.53±0.28 μg/L),norepinephrine(NE)(362.25±33.85 ng/L),and cortisol(Cor)(278.72±25.13 ng/L)in the TPVB group were lower than those in the INB group(2.71±0.32 μg/L,425.67±38.37 ng/L,315.68±29.21 ng/L)(P＜0.05).Adverse reactions such as nausea and vomiting,and dizziness were less frequent in the TPVB group[1(2.1％),1(2.1％)]compared to the INB group[6(12.5％),5(10.4％)](P＜0.05).Conclusion Ultrasound-guided thoracic paravertebral nerve block is superior to intercostal nerve block in terms of anesthetic dosage and analgesic efficacy in video-assisted thoracoscopic lobectomy.

Objective To explore the effects of ultrasound-guided intercostal nerve block(INB)and thoracic paravertebral nerve block(TPVB)on the dosage of anesthetics and the efficacy of analgesia in video-assisted thoracoscopic lobectomy.Methods From October 2019 to October 2023,90 patients undergoing video-assisted thoracoscopic lobectomy at the People's Hospital of Tongling City,Anhui,were selected.They were divided into the INB group(42 cases)and the TPVB group(48 cases).The INB group received ultrasound-guided intercostal nerve block,while the TPVB group was administered ultrasound-guided thoracic paravertebral nerve block.The two groups were compared before anesthesia induction(T0),15 minutes of anesthesia(T1),30 minutes of anesthesia(T2),45 minutes of anesthesia(T3),and after extubation(T4),vita4 signs,anesthetic dosage,analgesic effect,pain stress index and adverse reactions.Results In the TPVB group,systolic blood pressure(SBP)of T1,T2,T3 and T4 were(115.88±9.29)mmHg,(113.58±9.72)mmHg,(117.33±9.17)mmHg and(121.15±10.51)mmHg,respectively;diastolic blood pressure(DBP)were(86.74±7.35)mmHg,(90.83±8.82)mmHg,(90.83±8.82)mmHg and(91.05±8.73)mmHg,respectively;Heart rate(HR)were(79.94±7.46)times/min,(81.97±7.28)times/min,(82.36±7.41)times/min and(85.83±8.32)times/min,respectively.Which were all higher than the INB group[(103.53±8.28)mmHg,(105.40±8.66)mmHg,(109.03±8.13)mmHg,(114.64±9.65)mmHg.(77.68±6.57)mmHg,(79.27±6.69)mmHg,(83.21±7.37)mmHg,(85.83±8.21)mmHg,(71.17±6.21)times/min,(75.18±6.47)times/min,(74.82±6.12)times/min and(79.35±7.12)times/min,respectively],there were statistical significance between the two groups(P＜0.05).Postoperatively,the TPVB group had lower 24-hour sufentanil consumption[(27.68±2.64)μg]and fewer presses of the analgesia pump[(5.16±0.38)times]compared to the INB group[(36.22±3.36)μg and(6.87±0.42)times,(P＜0.05)].Visual analogue scale(VAS)scores for pain at rest and during coughing at 2,24,and 48 hours in group TPVB were 2.44±0.27,3.55±0.42,2.81±0.34 and 3.36±0.23,4.13±0.33,3.80±0.25,respectively,which were also lower than the INB group(2.83±0.44,3.98±0.55,3.33±0.46 and 3.87±0.30,4.59±0.47,4.17±0.29,respectively)(P＜0.05).Levels of prostaglandin E2(PGE2)(1.53±0.28 μg/L),norepinephrine(NE)(362.25±33.85 ng/L),and cortisol(Cor)(278.72±25.13 ng/L)in the TPVB group were lower than those in the INB group(2.71±0.32 μg/L,425.67±38.37 ng/L,315.68±29.21 ng/L)(P＜0.05).Adverse reactions such as nausea and vomiting,and dizziness were less frequent in the TPVB group[1(2.1％),1(2.1％)]compared to the INB group[6(12.5％),5(10.4％)](P＜0.05).Conclusion Ultrasound-guided thoracic paravertebral nerve block is superior to intercostal nerve block in terms of anesthetic dosage and analgesic efficacy in video-assisted thoracoscopic lobectomy.

Purpose This study aims to analyze the clinical,pathological,and molecular genetic characteristics of nodal follicular helper T-cell lymphoma,follicular type(nTFHL-F).Methods 7 cases of nTFHL-F were re-viewed.Clinical data were collected,tissue morphology was summarized,and immunohistochemical staining and mo-lecular testing were performed.Results The median age of patients was 62 years with a male-to-female ratio of 6:1.The initial symptoms included neck lymphadenectasis in 6 cases and abdominal discomfort in one.Six cases were in ad-vanced stages,while 1 case was in the localized stage.The tumors exhibited a vague,irregular follicular nodular pat-tern,without significant polymorphic inflammatory background or high endothelial vascular proliferation.Five cases showed a progressive transformation resembling germinal center pattern,and two cases exhibited a follicular lymphoma-like growth pattern.Tumor cells presented three distinct morphologies:centrocyte-like appearance,monocytoid B cell-like appearance,and atypical cells with abundant,transparent cytoplasm.Tumor cells expressed at least three follicu-lar T-cell markers.Testing for ITK::SYK gene fusion was negative in all cases(0/7).Next generation sequencing i-dentified mutations in TET2 gene in two cases(2/2),the RHOA gene in one case(1/2),and VAV1 gene in one case(1/2).The follow-up duration ranged from 2 to 64 months,with three deaths(3/7),and a median survival time of 37 months.Conclusion nTFHL-F predominantly occurs in middle-aged to elderly males,presenting with advanced clinical stages,and has a poor prognosis.nTFHL-F is closely associated with nodal follicular helper T-cell lymphoma,angioimmunoblastic type,and mya coexist within the same individual.

Objective:This multicenter retrospective study aimed to analyze the clinicopathological features of duodenal adenocarcinoma (DA) and identify prognostic factors for postoperative survival.Methods:Demographic characteristics, clinicopathological features, treatment outcomes and survival of DA patients undergoing surgical treatment at 18 Chinese medical centers from January 2012 to December 2023 were retrospectively analyzed.Results:Among the 2 056 DA patients included, 46.8% (963) had extra-ampullary DA (EA-DA), and 53.2% (1 093) had peri-ampullary DA (PA-DA). The 1-, 3-, and 5-year overall survival (OS) rates for patients who underwent radical surgery were 93.2%, 71.0%, and 57.2%, respectively. The median overall survival was 76 months, and the median progression-free survival (PFS) was 65 months. No differences in survival were observed between the laparotomy group and minimally invasive surgery (MIS) group either before or after propensity score matching (OS: 76 vs. 75 months before PSM, P=0.986; OS: 75 vs. 75 months after PSM, P=0.602). Furthermore, there were no significant differences between-group in operation time and postoperative complications ( P＞0.05). The MIS group experienced less intraoperative blood loss and shorter hospital stays. The multivariate Cox regression analysis revealed that advanced age ( HR=1.43,95% CI:1.18-1.73), elevated carbohydrate antigen 19-9 levels ( HR=1.24,95% CI:1.02-1.51), perineural invasion ( HR=1.44,95% CI:1.14-1.81), vascular invasion ( HR=1.35,95% CI:1.07-1.71), advanced T stage (T3-4 vs. T1-2: HR=1.86,95% CI:1.49-2.31), regional lymph node metastasis ( HR=1.93,95% CI:1.58-2.36), preoperative biliary drainage ( HR=1.26,95% CI:1.04-1.53), intraoperative blood loss ( HR=1.34,95% CI:1.11-1.62), clinically significant postoperative pancreatic fistulas ( HR=1.53,95% CI:1.12-2.09), and postoperative hemorrhage ( HR=1.62,95% CI:1.14-2.29) were independent risk factors for poor prognosis after surgery (all P＜0.05). Conclusions:Radical surgery is associated with favorable overall survival among DA patients, and no difference in survival is observed between EA-DA and PA-DA patients. MIS is a reliable alternative for DA treatment.

Objective:To observe the influence of Jiegu Qili Tablets combined with percutaneous vertebroplasty(PVP)on bone metabolism markers and bone morphogenetic protein-2(BMP-2)and bone morphogenetic protein-7(BMP-7)in patients with osteoporotie vertebral compression fractures(OVCF).Methods:This study was a prospective study,150 patients with OVCF due to qi stagnation and blood stasis syndrome who were admitted to our hospital from April 2022 to April 2024 were divided into control group(received PVP treatment,n=75)and observation group(received Jiegu Qili Tablets on the basis of the control group,n=75)according to the random number table method.Visual analogue scale(VAS),TCM syndrome score and Oswestry dysfunction index(ODI)vertebro-related indicators(anterior compression rate of the injured vertebrae,Cobb's Angle of the injured vertebrae),disappearance time of major symptoms and fracture healing time,bone metabolism markers[bone gla protein(BGP),Beta C-terminal cross-linked telopeptides of type Ⅰ collagen(β-CTX),bone alkaline phosphatase(BALP)]and BMP-2,BMP-71evels before treatment and one month after treatment were compared between the two groups.Results:One month after treatment,the main symptoms,secondary symptoms,total score,VAS,ODI scores,serum β-CTX,BALP levels,anterior compression rate of the injured vertebrae,and Cobb's Angle of the injured vertebrae in the observation group were lower than those in the control group.The disappearance time of the main symptoms and fracture healing time in the observation group were shorter than those in the control group,BGP,BMP-2 and BMP-7 were higher than those in the control group(P＜0.05).Conclusion:Jiegu Qili Tablets combined with PVP in the treatment of patients with OVCF,can effectively promote fracture healing in patients by improving bone metabolism markers and BMP-2 and BMP-7 levels,and is conducive to postoperative recovery of patients.

With the rapid development of generative artificial intelligence(GAI),its application in TCM research has attracted increasing attention.This article explored the application prospects of GAI in TCM research,analyzed its specific application scenarios in TCM clinical research,intelligent device development,and herbal medicine research,and identified the main challenges currently faced,including insufficient logical rigor,lack of high-quality clinical data,and shortage of interdisciplinary talents.This article proposed solutions such as constructing TCM knowledge graphs,standardizing TCM data collection,enhancing objective measurement and evaluation,and cultivating artificial intelligence talents with a background in TCM,in order to o provide references for the objective and intelligent research and application of TCM based on GAI,and further improve the clinical efficacy and quality of TCM.

Objective:To explore the application effect of interventional teaching in undergraduate nursing internship in operating rooms.Methods:A total of 98 undergraduate nursing students who worked as interns in the operating room during the two school years from June 2022 to February 2024 were selected as research subjects. Students who entered the program from June 2022 to February 2023 were enrolled into control group (50 students), and those who entered from June 2023 to February 2024 were enrolled into experimental group (48 students). The students conducted their internships in batches (with 4 to 5 students per subgroup) following a departmental rotation mechanism. The control group received routine teaching, while the experimental group received interventional teaching. At the end of the internship, the two groups were compared for their performance, including basic and specialized knowledge, skills, theory, and operation; patient reception, tripartite verification, and intraoperative cooperation for planned video-assisted thoracoscopic bullectomy; and their degrees of satisfaction with the teaching. The t-test was performed using SPSS 26.0. Results:The experimental group achieved significantly higher theoretical scores than the control group [(91.69±4.51) vs. (74.52±6.06)]. Meanwhile, the experimental group was significantly superior to the control group in operational performance, including surgical hand disinfection [(96.08±1.93) vs. (92.14±3.07)] and wearing and removing sterile surgical gowns and sterile gloves [(97.00±1.75) vs. (94.10±3.48)). In terms of specialized knowledge and skills, specifically, patient reception and third-party verification in simulated surgical nursing, the experimental group achieved higher scores than the control group [(98.77±0.69) vs. (94.04±2.56); (98.54±0.65) vs. (94.64±2.65)]. In terms of intraoperative cooperation, the experimental group showed a slight advantage over the control group. The experimental group had higher degrees of satisfaction with teaching than the control group, including course design, implementation methods, course arrangement, teaching attitude, teaching methods, degree of participation, gains, and assistance.Conclusions:After adopting interventional teaching, the teaching effect for nursing internship in operating rooms is better. It improves the various assessment scores of nursing students, enhances their comprehensive abilities and degrees of satisfaction with teaching, and reinforces the teaching abilities in operating rooms.

Objective:To investigate the management options for loop plate cutting of the tibial cortex during reconstruction of the anterior cruciate ligament (ACL) by the all-inside technique.Methods:From January 2022 to December 2024, a total of 13 patients with ACL injury who underwent all-inside reconstruction with tibial lateral loop plate cutting of the cortex and immediate revision for ACL injuries at Department of Sports Medicine, the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed (cut group). There were 5 males and 8 females with an average age of 28.7±9.1 years (range, 17-39 years). During the revision, a transverse tunnel was drilled at the distal end of the tibial tunnel, and the loop plate was fixed to the lateral tibial cortex through the transverse tunnel. Matched by gender, age, and side, the patients who underwent ACL reconstruction with all-inside loop steel without cutting the tibial cortex during the same period (the uncut group) were selected as the control group at a ratio of 1∶2, including 10 males and 16 females, aged 29.1±9.3 years (range, 17-39 years). The visual analogue scale (VAS), Tegner score, International Knee Documentation Committee (IKDC) and Lysholm score for knee pain before and after surgery were compared between the two groups, and bone tunnel enlargement was assessed using the Peyrache grading scale.Results:All patients were successfully operated and followed up for 13.1±2.5 months and 13.3±2.6 months, respectively. The Lysholm scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 35.44±15.69, 75.21±16.77, and 93.47±18.56 respectively, while those of the uncut group were 37.81±17.33, 71.45±15.82, and 91.05±19.54. The Lysholm scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the Lysholm scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the Lysholm scores between the two groups before and after surgery ( P>0.05). The IKDC scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 39.12±14.28, 69.52±15.36, and 84.24±17.91 respectively, while those of the uncut group were 37.46±11.55, 72.81±17.73, and 87.62±18.52. The IKDC scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the IKDC scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the IKDC scores between the two groups before and after surgery ( P>0.05). The Tegner scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 1.61±1.11, 3.59±1.66, and 5.59±1.79 respectively, while those of the non-cutting group were 1.57±1.05, 3.47±1.51, and 5.41±1.63. The Tegner scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the Tegner scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the Tegner scores between the two groups before and after surgery ( P>0.05). According to Peyrache's grading criteria, 7 cases in the cutting group had femoral side bone tunnel enlargement and 8 cases had tibial side bone tunnel enlargement; 12 cases in the non-cutting group had femoral side bone tunnel enlargement and 15 cases had tibial side bone tunnel enlargement, with no statistically significant differences (χ 2=0.205, P=0.650; χ 2=0.053, P=0.818). At the last follow-up, there were 2 cases of Lachman grade I in the cutting group and 3 cases in the non-cutting group, 1 case of joint stiffness in the cutting group and 2 cases in the non-cutting group. None of the patients in the two groups had vascular nerve injury, deep vein thrombosis, or intra-articular infection. Conclusion:The method of drilling a transverse tunnel at the distal end of the outer opening of the tibial tunnel and fixing the loop plate to the lateral tibial cortex through the transverse tunnel, along with cutting the tibial cortex, can improve the knee joint function.