ObjectiveTo explore the changes in volatile components， total polysaccharides， enzyme activity， and chromaticity value of Myristicae Semen Koji（MSK） during the fermentation process， and conduct correlation analysis. MethodsBased on gas chromatography-mass spectrometry（GC-MS）， the changes of volatile components in MSK at different fermentation times were identified. The phenol sulfuric acid method， dinitrosalicylic acid method（DNS）， and carboxymethyl cellulose sodium salt method（CMC-Na） were used to investigate the total polysaccharide content， amylase activity， and cellulase activity during the fermentation process. Visual analysis technology was used to explore the changes in chromaticity values， revealing the fermentation process of MSK and the dynamic changes of various measurement indicators， partial least squares-discriminant analysis（PLS-DA） was used to explore the differential compounds of MSK at different fermentation degrees， and Pearson correlation analysis was used to explore the correlation between volatile components of MSK and total polysaccharides， enzyme activity， and chromaticity values. ResultsA total of 60 volatile compounds were identified from MSK， the relative contents of components such as （+）-α-pinene， β-phellandrene， β-pinene， （+）-limonene， and p-cymene obviously increased， while the relative contents of components such as safrole， methyl isoeugenol， methyleugenol， myristicin， and elemicin significantly decreased. During the fermentation process， the total polysaccharide content showed an upward trend， while the activities of amylase and cellulase showed an initial increase followed by a decrease， and reached their maximum value at 40 h. the overall brightness（L^*） and total color difference（ΔE^*） gradually increased， while the changes in red-green value（a^*） and yellow-blue value（b^*） were not obvious. PLS-DA results showed that MSK could be clearly distinguished at different fermentation times， and 13 differential biomarkers were screened out. Pearson correlation analysis results showed that the contents of α-terpinene， β-phellandrene， methyleugenol， β-cubebene and myristic acid had an obvious correlation with chromaticity values. ConclusionAfter fermentation， the volatile components， total polysaccharides， amylase activity， and cellulase activity of MSK undergo significant changes， and there is a clear correlation between them and chromaticity values， which reveals the dynamic changes in the fermentation process and related indicators of MSK， laying a foundation for the quality control.

Objective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.

Objective:To compare the changes of maximun flow rate and residual urine volume after tension-free vaginal tape(TVT)and trans-obturator tape(TOT)in the treatment of stress urinary incon-tinence in women.Methods:The clinical data of female patients with stress urinary incontinence who underwent transvaginal midsection tension-free urethral suspension in Peking University People's Hospital from January 2022 to January 2024 were retrospectively analyzed.All the patients were followed up 1 month,6 months and 12 months after surgery.Urodynamics were performed to evaluate urethral sphincter function before surgery.At the same time,B-ultrasonography was improved to determine the residual uri-nary volume of the bladder,and urgent incontinence,detrusor weakness and bladder outlet obstruction were excluded,and the diagnosis was clearly stress incontinence.Maximum flow rate and residual urinary volume were measured during follow-up,and combined with the urinary incontinence questionnaire of the International Urinary Incontinence Advisory Committee,the surgical effect was judged to be cured,im-proved or ineffective according to the degree of improvement of urinary leakage symptoms after surgery.Results:A total of 150 female patients with stress urinary incontinence were included in the study,the average age of the patients was(55.12±10.23)years old,and the follow-up time was 12 months.All patients completed postoperative follow-up,of whom 60 underwent TVT and 90 underwent TOT.The overall effective rates(cure+improvement)1,6,and 12 months after surgery in the TVT group were 93.3％(56/60),91.7％(55/60),and 91.7％(55/60),and those in the TOT group were 92.2％(83/90),90.0％(81/90),90.0％(81/90),respectively,and there was no statistical difference be-tween the two groups.The average maximum urinary flow rates 1,6,and 12 months after surgery in the TVT group were(17.21±4.22)mL/s,(18.05±5.33)mL/s,and(18.37±4.92)mL/s,and those in the TOT group were(18.21±5.32)mL/s,(19.05±4.33)mL/s,and(19.27±4.92)mL/s,re-spectively,and there was no statistical difference between the two groups.The mean residual urine volume 1,6,and 12 months after surgery in the TVT group was(13.21±5.22)mL,(18.25±5.33)mL,and(16.37±7.92)mL,and those in the TOT group was(11.21±6.32)mL,(13.05±5.33)mL,and(11.27±5.92)mL,respectively,and there was no statistical difference between the two groups.Compared with preoperative levels,there were no significant differences in the average maximum flow rate and the residual urine volume in both group at 1,6,and 12 months after surgery.Conclusion:Both TVT and TOT are effective in the treatment of stress incontinence,and have no effect on postopera-tive maximum flow rate and residual urine volume.

Objective To establish and validate a multimodal MRI radiomics model based on intratumoral and peritumoral heterogeneity for prediction of spatial pattern of locally recurrent high-grade gliomas(HGGs).Methods A retrospective analysis was conducted on the clinical and imaging data of all HGGs patients who underwent maximum safe resection followed by postoperative radiotherapy combined with temozolomide treatment and experienced in local recurrence in Army Medical Center of PLA from 2012 to 2021.Two radiologists independently assessed the spatial patterns of locally recurrence HGGs through continuous follow-up MRI data,and primarily categorized the pattern into intra-resection cavity recurrence and extra-resection cavity recurrence.The subjected patients were randomly divided into a training set and a validation set in a 7∶3 ratio.In the training set,Pearson or Spearman correlation analysis and least absolute shrinkage and selection operator(LASSO)analysis were employed to screen radiomic features within the intratumoral and peritumoral regions,as well as to calculate radiomic scores.A radiomics model was established using logistic regression analysis.The performance of the model was assessed using calibration curves,Hosmer-Lemeshow goodness-of-fit test,and the area under the receiver operating characteristic curve(AUC).Validation of the model was performed in the validation set.Results A total of 121 patients with locally recurrent HGGs were enrolled in this study,including 54 in intra-resection cavity recurrence group and 67 in extra-resection cavity recurrence group.Among them,84 were assigned into the training set and 37 into the validation set.In the training set,the radiomics score for the extra-resection cavity recurrence group was 0.424(0.278,0.573),which was higher than that for the intra-resection cavity recurrence group[-0.030(-0.226,0.248),P<0.001].In the validation set,the radiomics score for the extra-resection cavity recurrence group was 0.369(0.258,0.487),which was higher than that for the intra-resection cavity recurrence group[0.277(0.103,0.322),P=0.033].The established radiomics model exhibited good calibration and performed well in predicting spatial recurrence patterns,with an AUC value of 0.844(95%CI:0.749～0.914)in the training set and 0.706(95%CI:0.534～0.844)in the validation set.Conclusion Our multimodal radiomics model combined with intratumoral and peritumoral heterogeneity can predict the spatial pattern of locally recurrent HGGs,providing a basis for individualized treatment of HGGs.

[Objective]To analyze the Yunqi characteristics and periodicity of drought disasters in He'nan Province during 2000 years.[Methods]On the foundation of the drought data of He'nan Province from 221 BC to 1840 AD,a hierarchical classification was conducted,using statistical tools and wavelet analysis to explore the frequency and periodicity of drought in different Yunqi periods.[Results]The most frequent dominant Qi period of drought in He'nan Province was 4th Qi(Taiyin Shitu)(P<0.001),the most of Sitian period was Jueyin Fengmu and Shaoyin Junhuo(P<0.05),the most of Zaiquan period was Shaoyang Xianghuo(P<0.05).At multiple time scales,drought disasters in He'nan Province had 4 quasi-cycles,the 1st to the 4th quasi-cycles were 510,690,300 and 150 years,respectively.[Conclusion]There was a significant difference in the frequency of drought levels in He'nan Province in different periods of dominant Qi,Sitian period and Zaiquan period,which was partly consistent with the Yunqi theory.Besides,the drought disaster in He'nan Province had certain periodic characteristics.

Objective:To compare the changes of maximun flow rate and residual urine volume after tension-free vaginal tape(TVT)and trans-obturator tape(TOT)in the treatment of stress urinary incon-tinence in women.Methods:The clinical data of female patients with stress urinary incontinence who underwent transvaginal midsection tension-free urethral suspension in Peking University People's Hospital from January 2022 to January 2024 were retrospectively analyzed.All the patients were followed up 1 month,6 months and 12 months after surgery.Urodynamics were performed to evaluate urethral sphincter function before surgery.At the same time,B-ultrasonography was improved to determine the residual uri-nary volume of the bladder,and urgent incontinence,detrusor weakness and bladder outlet obstruction were excluded,and the diagnosis was clearly stress incontinence.Maximum flow rate and residual urinary volume were measured during follow-up,and combined with the urinary incontinence questionnaire of the International Urinary Incontinence Advisory Committee,the surgical effect was judged to be cured,im-proved or ineffective according to the degree of improvement of urinary leakage symptoms after surgery.Results:A total of 150 female patients with stress urinary incontinence were included in the study,the average age of the patients was(55.12±10.23)years old,and the follow-up time was 12 months.All patients completed postoperative follow-up,of whom 60 underwent TVT and 90 underwent TOT.The overall effective rates(cure+improvement)1,6,and 12 months after surgery in the TVT group were 93.3％(56/60),91.7％(55/60),and 91.7％(55/60),and those in the TOT group were 92.2％(83/90),90.0％(81/90),90.0％(81/90),respectively,and there was no statistical difference be-tween the two groups.The average maximum urinary flow rates 1,6,and 12 months after surgery in the TVT group were(17.21±4.22)mL/s,(18.05±5.33)mL/s,and(18.37±4.92)mL/s,and those in the TOT group were(18.21±5.32)mL/s,(19.05±4.33)mL/s,and(19.27±4.92)mL/s,re-spectively,and there was no statistical difference between the two groups.The mean residual urine volume 1,6,and 12 months after surgery in the TVT group was(13.21±5.22)mL,(18.25±5.33)mL,and(16.37±7.92)mL,and those in the TOT group was(11.21±6.32)mL,(13.05±5.33)mL,and(11.27±5.92)mL,respectively,and there was no statistical difference between the two groups.Compared with preoperative levels,there were no significant differences in the average maximum flow rate and the residual urine volume in both group at 1,6,and 12 months after surgery.Conclusion:Both TVT and TOT are effective in the treatment of stress incontinence,and have no effect on postopera-tive maximum flow rate and residual urine volume.

Objective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.

[Objective]To analyze the Yunqi characteristics and periodicity of drought disasters in He'nan Province during 2000 years.[Methods]On the foundation of the drought data of He'nan Province from 221 BC to 1840 AD,a hierarchical classification was conducted,using statistical tools and wavelet analysis to explore the frequency and periodicity of drought in different Yunqi periods.[Results]The most frequent dominant Qi period of drought in He'nan Province was 4th Qi(Taiyin Shitu)(P<0.001),the most of Sitian period was Jueyin Fengmu and Shaoyin Junhuo(P<0.05),the most of Zaiquan period was Shaoyang Xianghuo(P<0.05).At multiple time scales,drought disasters in He'nan Province had 4 quasi-cycles,the 1st to the 4th quasi-cycles were 510,690,300 and 150 years,respectively.[Conclusion]There was a significant difference in the frequency of drought levels in He'nan Province in different periods of dominant Qi,Sitian period and Zaiquan period,which was partly consistent with the Yunqi theory.Besides,the drought disaster in He'nan Province had certain periodic characteristics.

Objective To investigate the value of tranexamic acid combined with aspirin,low molecular weight heparin calcium in regulating inflammatory mediators and TEG in blood management of Total knee arthroplast(TKA).Methods 120 elderly patients with TKA in our hospital from January 2020 to October 2022 were randomly divided into group A(n=60)and group B(n=60).They were given tranexamic acid+aspirin and tranexamic acid+low molecular weight heparin calcium,respectively,for 2 weeks.Perioperative indexes,complications[lower limb deep vein thrombosis(DVT),intermuscular vein thrombosis(MCVT),incision infection],blood transfusion rate,adverse reactions(gastrointestinal discomfort,subcutaneous ecchymosis),TEG parameters[coagulation reaction time(R),blood coagulation time(K),maximum amplitude(MA),coagulation angle(α)],inflammatory mediators[soluble CD40 ligand(sCD40L),Toll-like receptor 4(TLR4),tumor necrosis factor(TNF-α)],vascular endothelial injury factors[soluble thromboregulatory protein(sTM),vascular endothelial cell growth factor(VEGF),E-selectin]were compared between the two groups.Results There was no significant difference in the 24 h postoperative drainage volume,latent blood loss,total blood loss,intraoperative blood loss,Hb and HCT levels 72 h after surgery between the two groups(P＞0.05).There was no statistically significant difference in TEG parameters between the two groups,at different time points,and between groups at different time points(P＞0.05);The serum levels of TLR4,sCD40L and TNF-α in group A were lower than those in group B 2 weeks after surgery(P＜0.05).The levels of plasma sTM and serum VEGF and E-selectin in group A were lower than those in group B 2 weeks after surgery(P＜0.05).There was no significant difference in the incidence of deep vein thrombosis(DVT),intermuscular vein thrombosis(MCVT),incision infection and blood transfusion rate between group A and group B(P＞0.05).There was no significant difference in the total incidence of adverse reactions between group A and group B(P＞0.05).Conclusion Compared with the combination of low molecular weight heparin calcium,the combination of tranexamic acid and aspirin can protect vascular endothelium and inhibit inflammatory response.However,both can maintain the patient's coagulation function and avoid massive blood loss or thrombosis.There is no significant difference in safety and effectiveness.

Objective To evaluate the effectiveness and safety of moxibustion for knee osteoarthritis and the methodological quality of systematic reviews(SRs).Methods SRs of moxibustion for knee osteoarthritis were retrieved from CNKI,VIP,Wanfang Data,SinoMed,PubMed,Cochrane Library,Embase and Web of Science was conducted from the establishment of the databases to February 10,2022.AMSTAR 2 was used to assess the methodological quality of SRs.The randomized controlled trials(RCTs)included in these SRs were screened and summarized according to inclusion standard.RevMan 5.4 software was used for Meta-analysis,and GRADE approach was used to assess the certainty of evidence.Results A total of 15 SRs were included.The evaluation results of the AMSTAR 2 showed that the methodological quality was very low for 14 SRs,and low for other 1 SR.A total of 36 RCTs were included.Meta-analysis results showed that compared with the non-steroidal anti-inflammatory drugs(NSAIDs),the moxibustion group had better effects on improvement of WOMAC scores[mean difference(MD)=-5.95;95%confidence interval(CI):-9.25 to-2.65;low quality],relieving pain[MD=-1.26;95%CI:-2.19 to-0.32;very low quality],and improving effective rate[risk ratio(RR)=1.16;95%CI:1.11 to 1.22;low quality].In the moxibustion group,some patients experienced blisters,and most healed in 3 days.Conclusion Moxibustion has advantages in pain reduction and improving effective rate compared with routine Western therapy for knee osteoarthritis.However,well-designed high-quality RCTs are needed for further verification.