[Objective]Childhood trauma(CT)is considered one of the major risk factors for developing major depres-sive disorder(MDD)in adulthood.However,the neural basis of MDD patients with CT(CT-MDD)remains poorly under-stood.Therefore,the objective of our study is to explore the resting-state global brain functional connectivity(FC)in CT-MDD.[Methods]A total of 34 CT-MDD and 34 healthy controls performed resting-state fMRI.Whole-brain voxel-level degree centrality(DC)analysis was performed,and the brain regions with significant differences between the two groups were selected as region of interest(ROI)for further estimating the global brain FC.Subsequently,correlation analysis was performed between DC values,FC values in abnormal brain areas and clinical characteristics.[Results]The CT-MDD group showed increased DC value of the right middle frontal gyrus(MFG)compared with the healthy controls.Seed-based FC revealed that the CT-MDD group showed increased connections between the left precuneus and the right MFG or the right medial prefrontal cortex,relative to healthy controls(threshold at P<0.05).Additionally,the DC value of the right MFG was correlated with the severity of CT.[Conclusion]Our results show the increased FC between the left precuneus and the ROI(right MFG)as well as the right medial prefrontal cortex,which are two important brain regions within the de-fault mode network(DMN),and might suggest increased synchronism between the cognitive executive networks and DMN in CT-MDD.These findings may provide insights into the pathophysiological mechanisms underlying CT-MDD.

Objective To investigate the current postoperative physical activity levels of lung cancer patients after a month and to analyze the influencing factors.Methods From January to December 2023,a total of 1,195 lung cancer patients from 16 hospitals in eastem,central and westem China were selected as the survey subjects by the convenient sampling method.A cross-sectional survey was conducted by General Information Questionnaires,Health-Related Physical Fitness Surveys,MD Anderson Symptom Inventory,Hospital Anxiety and Depression Scale,Social Support Rating Scale,Self-Rated Abilities for Health Practices Scale,and the International Physical Activity Questionnaire.Results 36 questionnaires with missing data exceeding 10％and 13 duplicate questionnaires were excluded,resulting in the analysis of 1,146 questionnaires.After a month postoperatively,lung cancer patients with moderate and low levels of physical activity were 732(63.9％)and 204(17.8％),respectively.Multivariate regression analysis showed that the influencing factors included residence,average monthly family income,regional lymph node staging,family history of lung cancer,grip strength,hemoglobin,and depression score(P＜0.05).Conclusion The physical activity level of lung cancer patients a month after surgery is influenced by a combination of sociodemographic,disease-related,health-related physical fitness,and psychological factors.Clinical healthcare professionals should accurately assess the physical activity levels of lung cancer patients,identify those with insufficient physical activity,and develop and implement personalized intervention strategies based on their physical condition and potential influencing factors to enhance their physical activity levels and improve their quality of life.

Objective To investigate the effectiveness of applying the CIPP(Context,Input,Process,and Product)model in the training of general workers in a disinfection supply center.Methods From January to March 2023,a total of 24 general workers in our hospital's disinfection supply center underwent traditional training as the pre-management phase.Subse-quently,from July to September 2023,a training system centered on the CIPP model was implemented as the post-management phase.After the training,the examination results and training evaluations were analyzed using SPSS 13.0 statistical software.Results The technical training of the general workers resulted in improved learning outcomes compared to before the training.Conclusion By applying the CIPP model in the training of general workers in a disinfection supply center,their grasp of basic knowledge and professional skills can be enhanced.This can reduce technical errors during operations,improve the quality of sterile items,and reduce the risk of nosocomial infections,thereby ensuring patient safety.

Migraine is one of the most prevalent and disabling neurological disease, but the current pharmacotherapies show limited efficacy and often accompanied by adverse effects. Acupuncture is a promising complementary therapy, but further clinical evidence is needed. The influence of acupuncture on migraine is not an immediate effect, and its mechanism remains unclear. This study aims to provide further clinical evidence for the anti-migraine effects of acupuncture and explore the mechanism involved. A randomized controlled trial was performed among 10 normal controls and 38 migraineurs. The migraineurs were divided into blank control, sham acupuncture, and acupuncture groups. Patients were subjected to two courses of treatment, and each treatment lasted for 5 days, with an interval of 1 day between the two courses. The effectiveness of treatment was evaluated using pain questionnaire. The functional magnetic resonance imaging (fMRI) data were analyzed for investigating brain changes induced by treatments. Blood plasma was collected for metabolomics and proteomics studies. Correlation and mediation analyses were performed to investigate the interaction between clinical, fMRI and omics changes. Results showed that acupuncture effectively relieved migraine symptoms in a way different from sham acupuncture in terms of curative effect, affected brain regions, and signaling pathways. The anti-migraine mechanism involves a complex network related to the regulation of the response to hypoxic stress, reversal of brain energy imbalance, and regulation of inflammation. The brain regions of migraineurs affected by acupuncture include the lingual gyrus, default mode network, and cerebellum. The effect of acupuncture on patients' metabolites/proteins may precede that of the brain.
Humans ; Migraine Disorders/etiology* ; Brain/diagnostic imaging* ; Acupuncture Therapy/methods* ; Magnetic Resonance Imaging

Objective:To explore the effect of case-based learning (CBL) guided by ICF (International Classification of Functioning, Disability and Health) in rehabilitation practice teaching.Methods:Fifty-eight rehabilitation undergraduates who had practiced in the Department of Rehabilitation Medicine in The First Affiliated Hospital of Chongqing Medical University from February 2019 to December 2019 were randomized into observation group and control group. The observation group adopted ICF-guided CBL method for practice teaching, while the control group adopted traditional teaching methods. At the end of the internship, all the students were assessed in terms of their theoretical knowledge, case analysis and clinical practice ability. At the same time, questionnaires were used to conduct a satisfaction survey on the teaching method, and the results of the two groups were compared and analyzed by ttest and rank-sum test through SPSS 25.0. Results:The scores of the observation group were higher than those of the control group, with statistical significance ( P<0.05) . In the satisfaction survey, the observation group was superior to the traditional teaching method in terms of self-thinking ability and learning initiative, with statistical significance ( P<0.05). Conclusion:ICF-guided CBL method can strengthen students' independent thinking ability and learning initiative, and improve the students' clinical comprehensive ability of rehabilitation treatment.

Objective:To study the effect of MYD88 L265P mutation on the expression of PD-L1 in tumor cells and tumor microenvironment in diffuse large B-cell lymphoma (DLBCL), and to provide theoretical basis for immunotherapy for patients.Methods:Multiplex ligation-dependent probe amplification (MLPA) was used to detect the frequency of MYD88 L265P mutation in 72 cases of DLBCL diagnosed by pathologists in Cancer Hospital of Chinese Academy of Medical Sciences from August 2008 to May 2010. Expression of PD-L1 in tumor cells and tumor microenvironment in all samples was evaluated using PD-L1 (22C3) and PD-L1 (SP142) with Ventana automatic immunohistochemical (IHC) platform. The relationship between MYD88 L265P mutation and the expression of PD-L1 in DLBCL tumor cells and tumor microenvironment was assessed.Results:Of the 72 cases of DLBCL, MYD88 L265P mutation was detected in 15 (20.8%) cases. Nine cases with JAK2 amplification were excluded, and the remaining 63 cases of DLBCL were divided into MYD88 L265P mutant group ( n=14) and MYD88 L265P wild-type group ( n=49). IHC results showed that among the 14 cases of MYD88 L265P mutant groups, PD-L1 (22C3) was positive in 7 cases (7/14) of tumor cells and PD-L1 (SP142) was positive in 4 cases (4/14) of tumor microenvironment. Among the 49 cases of MYD88 L265P wild-type group, 9 cases (18.4%) were positive for PD-L1 (22C3) in tumor cells, and 38 cases (77.6%) were positive for PD-L1(SP142) in tumor microenvironment. In addition, among the 16 cases with PD-L1(22C3) expression in tumor cells, only 2 of the 7 cases with MYD88 L265P mutation were positive for PD-L1 (SP142) in tumor microenvironment. All 9 cases with wild-type MYD88 L265P were positive for PD-L1 (SP142) in tumor microenvironment. Statistical analysis showed that the expression level of PD-L1 (22C3) in tumor cells in the MYD88 L265P mutant group was significantly higher than that in the MYD88 L265P wild-type group ( P=0.017). The expression level of PD-L1 (SP142) in tumor microenvironment in the MYD88 L265P mutant group was significantly lower than that in the MYD88 L265P wild-type group ( P=0.001). Conclusions:MYD88 L265P mutation may play an important role in the regulation of PD-L1 expression in DLBCL tumor cells and tumor microenvironment. Further studies will provide a theoretical basis for immunotherapy of DLBCL patients with MYD88 L265P mutation.

Objective: This paper analyzed the present clinical researches of traditional Chinese medicine (TCM) in the treatment of heart failure caused by coronary heart disease and discusses the ideas and methods of evidence-based optimization. Methods: PubMed, EMBASE, Cochrane Library, CNKI, WanFang, VIP and CBM were searched to screen the clinical studies of TCM for treating heart failure caused by coronary heart disease. The problems and solutions were discussed by evaluating the risk of bias of the studies and analyzing the outcomes compared with the Cochrane systematic reviews of chronic heart failure. Results: A total of 32 clinical researches were included and the methodological quality of the studies was generally low. In addition, few studies assessed the endpoint events, mortality and readmission, as the primary outcomes in their trials, which is significantly different from the outcomes concerned in the Cochrane systematic reviews. Conclusion: It is really critical to improve the methodological quality of the trials and to choose the endpoint events as the primary outcomes in the evidence-based optimization of the prevention and treatment of TCM for heart failure caused by coronary heart disease Chinese medicine.

Objective To analyze the relationship of neurocognitive impairments and 1 H MRS changes of the thalamus in patients with chronic hepatitis B virus related cirrhosis (HBV-RC).Methods Totally 28 patients with HBV-RC (cirrhosis group) and 28 well-matched healthy subjects (control group) were enrolled.All subjects underwent number connection test A (NCT-A) and the digit symbol test (DST) before MRS scanning.The ratios of peak area to each metabolite,including N-acetylaminosuccinic acid (NAA),choline (Cho),glutamine and glutamate (Glx),myoinositol (mI) and creatine (Cr) were calculated,respectively.Results Compared with control group,patients in cirrhosis group showed lower Cho/Cr and mI/Cr,higher Glx/Cr,prolonged NCT-A time and decreased DST scores (all P＜0.001).NCT-A completion time was negatively correlated with Cho/Cr and mI/Cr (r=-0.477,P =0.001;r=-0.695,P＜0.001) and positively correlated with Glx/Cr (r=0.665,P＜0.001).DST scores were positively correlated with Cho/Cr and mI/Cr (r =0.478,P =0.001;r=0.632,P＜0.001),and negatively correlated with Glx/Cr (r=-0.572,P＜0.001).Conclusion The neurocognitive impairments may be related to metabolic changes of the thalamus in patients with HBV RC.

Objective To evaluate the effectiveness and safety of percutaneous micro-invasive release therapy by using push-cut knife on stenosal tendosynovitis. Methods The patients with stenosal tendosy-novitis were chosen according to inclusion criteria,and then divided,based on random digital table and 1:1 of random concealmert,into push-cut knife group and needle-knife group. The push-cut knife group was given push-cut knife therapy one time, and was given traditional needle-knife one time. The main outcome index was cure rate on the 27thweek after treatment, and secondary indexes included pain scores,joint range of motion (ROM) and trigger indications. The safety indexes included complications and adverse events. Results There were totally 120 patients were chosen,but one quitted due to serious disease in needle-knife group,and 119 patients completed the study and were brought into the statistical analysis of outcome indexes. On the 27thweek after treatment,there were 55 cases(91.67%) cured in push-cut knife group and 39 (66.10%) cured in needle-knife group (P<0.001). The indexes of trig-ger indications,pain and ROM were significantly relieved in 2 groups,and improved more significantly o-ver time. The comparisons at the time points of the 1st,3rd,6th,12thand 27thweeks showed that,the re-liefs of trigger indications, pain and ROM were superior in push-cut knife group than those in needle-knife group (P<0.05). There were no adverse events or complications occurred in 2 groups. Conclu-sion The push-cut knife has higher one-off cure rate in treatment of stenosal tendosynovitis. The signs of pain,ROM and trigger indications are relieved immediately after treatment,and continuously relieved af-ter half year. There are no adverse events occurred.

Objective To explore the application effects of perioperative personalized nursing in pediatric tonsil adenoidectomy surgery, so as to find the optimum clinical nursing method.Methods A total of 180 cases of pediatric patients who underwent tonsil adenoidectomy surgery in Peking University Third Hospital from September 2015 to September 2016 were selected as the research objects, and divided into control group and observation group by random number table method, with 90 cases in each group. The control group was given routine perioperative nursing care, while the observation group was given perioperative personalized nursing care. Operation time, intraoperative blood loss, postoperative hospitalization time, postoperative visual analogue scale (VAS) score, the incidence of postoperative complications and major postoperative clinical symptoms disappearing time were compared between the two groups.Results In the observation group, the hospitalization time was (3.52±1.24) days, and VAS score was (2.89±1.07), which were both significantly lower than those of the control group (5.63±1.05) days and (4.25±1.13) respectively. The differences were statistically significant (t=5.69, 6.25;P<0.05). There were 2 cases of bleeding in the control group, and no fever, wound infection, pulmonary infection and laryngospasm in both groups. There was no statistical difference in the incidence of complications (χ2=0.89,P>0.05). The disappearing time of nasal congestion, runny nose, nasal voice and sleep breathing symptoms of the observation group was shorter than those of the control group, and the difference was statistically significant (P<0.05).Conclusions The application of perioperative personalized nursing in pediatric tonsil adenoidectomy surgery can shorten the time of postoperative hospitalization and relieve the pain.