ObjectiveCerebrospinal fluid (CSF) plays a crucial role in maintaining the homeostasis of the central nervous system (CNS). CSF rapidly exchanges with interstitial fluid (ISF) via the glymphatic system within the brain parenchyma. CSF-ISF circulation and its associated mechanisms are often referred to as the brain lymphatic system. This system is connected directly to meningeal lymphatic vessels (mLVs), jointly performing the function of clearing metabolic waste from the CNS. Emerging evidence indicates that this system is closely associated with the onset and progression of neurodegenerative diseases (NDs) such as Alzheimer’s disease (AD). Importantly, abnormal CSF circulation is not only a downstream consequence of AD pathology, but also a risk factor. In AD, the dynamics of CSF flow within the CNS are diminished, immune dysregulation occurs, and this may increase the risk of AD by exacerbating the burden of amyloid β-protein (Aβ). In the mouse model of AD, impaired CSF flow compromises this clearance function, leading to cognitive deficits. Clinically, acupuncture at cognition-related acupoints is commonly used for the prevention and treatment of AD. However, whether its therapeutic effects are mediated through the modulation of CSF dynamics remains unclear. This study aimed to evaluate the impact of acupuncture on CSF flow and investigate its acupoint specificity. MethodsMice were randomly assigned to experimental groups for the different electroacupuncture groups with the following acupoints: Baihui point (GV 20), Ear point, Neiguan point (PC 6), and Tianshu point (ST 25). Wild-type mice on a C57BL/6J background were used as controls. Fluorescent tracer was injected into the cisterna magna to label CSF flow. Fluorescence imaging was employed to assess the distribution of CSF within the brain before and after acupuncture stimulation. ResultsFollowing tracer injection into the cisterna magna, fluorescence signals rapidly reached the cerebellum and medulla—the regions closest to the injection site. Fluorescence intensity was higher in ventral brain regions compared to dorsal regions, likely due to greater vascular density in ventral areas facilitating CSF-ISF exchange. Electroacupuncture at the GV 20 produced the most pronounced enhancement of CSF across the whole brain, while stimulation at the ST 25 primarily augmented flow within subcortical regions. In contrast, electroacupuncture at the Ear point or the PC 6 had no observable effect on CSF in mice. ConclusionElectroacupuncture promotes CSF flow into the brain parenchyma in an acupoint-specific manner, with GV 20 exhibiting the most pronounced enhancement of CSF dynamics. These findings suggest that acupuncture-mediated facilitation of CSF flow may represent a potential therapeutic strategy for preventing or delaying age-related cognitive decline.

ObjectiveCerebrospinal fluid (CSF) plays a crucial role in maintaining the homeostasis of the central nervous system (CNS). CSF rapidly exchanges with interstitial fluid (ISF) via the glymphatic system within the brain parenchyma. CSF-ISF circulation and its associated mechanisms are often referred to as the brain lymphatic system. This system is connected directly to meningeal lymphatic vessels (mLVs), jointly performing the function of clearing metabolic waste from the CNS. Emerging evidence indicates that this system is closely associated with the onset and progression of neurodegenerative diseases (NDs) such as Alzheimer’s disease (AD). Importantly, abnormal CSF circulation is not only a downstream consequence of AD pathology, but also a risk factor. In AD, the dynamics of CSF flow within the CNS are diminished, immune dysregulation occurs, and this may increase the risk of AD by exacerbating the burden of amyloid β-protein (Aβ). In the mouse model of AD, impaired CSF flow compromises this clearance function, leading to cognitive deficits. Clinically, acupuncture at cognition-related acupoints is commonly used for the prevention and treatment of AD. However, whether its therapeutic effects are mediated through the modulation of CSF dynamics remains unclear. This study aimed to evaluate the impact of acupuncture on CSF flow and investigate its acupoint specificity. MethodsMice were randomly assigned to experimental groups for the different electroacupuncture groups with the following acupoints: Baihui point (GV 20), Ear point, Neiguan point (PC 6), and Tianshu point (ST 25). Wild-type mice on a C57BL/6J background were used as controls. Fluorescent tracer was injected into the cisterna magna to label CSF flow. Fluorescence imaging was employed to assess the distribution of CSF within the brain before and after acupuncture stimulation. ResultsFollowing tracer injection into the cisterna magna, fluorescence signals rapidly reached the cerebellum and medulla—the regions closest to the injection site. Fluorescence intensity was higher in ventral brain regions compared to dorsal regions, likely due to greater vascular density in ventral areas facilitating CSF-ISF exchange. Electroacupuncture at the GV 20 produced the most pronounced enhancement of CSF across the whole brain, while stimulation at the ST 25 primarily augmented flow within subcortical regions. In contrast, electroacupuncture at the Ear point or the PC 6 had no observable effect on CSF in mice. ConclusionElectroacupuncture promotes CSF flow into the brain parenchyma in an acupoint-specific manner, with GV 20 exhibiting the most pronounced enhancement of CSF dynamics. These findings suggest that acupuncture-mediated facilitation of CSF flow may represent a potential therapeutic strategy for preventing or delaying age-related cognitive decline.

Purpose To quantitatively compare the diffusion parameters of mono-and biexponential diffusion-weighted imaging models,and to obtain optimal sets of b-values in diffusion-weighted MRI for obtaining monoexponential apparent diffusion coefficient(ADC)close to perfusion-insensitive intravoxel incoherent motion(IVIM)model ADC(ADCIVIM)in identifying of pulmonary solid benign and malignant lesions.Materials and Methods IVIM was performed in 40 patients with solid nodule and masse in Xi'an Gaoxin Hospital from July 2021 to August 2022 using a 3.0T MR imager.Two experienced diagnostic radiologists subjectively evaluated the IVIM images.A single index model was used to calculate ADC values(ADC0-1 000,ADC20-1 000,ADC50-1 000,ADC80-1 000,ADC150-1 000,ADC300-1 000,ADC500-1 000,ADC300,500,1 000,ADC300,800,1 000,ADC300,500,ADC300,800 and ADC300,1 000).The reference standard ADCIVIM value were calculated using a double-exponential model.The physician's measurements between two physicians were measured.The malignant and benign groups were compared and receiver operator characteristic curve for all parameters were analyzed.Results The measurement consistency of ADC values under b value sets and ADCIVIM was very good,and the intraclass correlation coefficient was more significant than 0.75.The differences between ADCIVIM and ADC values in each b group were statistically significant(t=-6.016--2.500,all P<0.05).The area under the curve(AUC)of ADCIVIM was the largest(0.906),with an optimal threshold of 1.271×10-3 mm2/s,a sensitivity of 80.0%and a specificity of 93.0%.The diagnostic efficacy close to ADCIVIM were ADC300,800(AUC=0.891),ADC50-1 000(AUC=0.827)and ADC300,800,1 000(AUC=0.795),respectively.The optimal threshold of ADC300,800 was 1.140×10-3 mm2/s,the sensitivity and specificity were 80.0%and 93.7%,respectively.Conclusion Combining b-values 300 s/mm2 and 800 s/mm2 is recommended as routine scanning parameters for identifying the insensitive monoexponential ADC between benign and malignant solid pulmonary lesions.

Objective:To analyze the evolution and diffusion characteristics of policies related to life expectancy(LE)and healthy life expectancy(HLE)in China from 1982 to 2024 using a biometric approach to policy analysis,revealing the patterns of policy diffusion.Methods:By retrieving databases such as PKULAW.com,We comprehensively collected 701 policy documents closely related to LE and HLE during the period(including 62 central policies and 639 local policies),the policy diffusion process was quantified in four dimensions:diffusion intensity,diffusion breadth,diffusion speed and diffusion direction by using the policy—reference network analysis method.Results:Related policy has gone through the germination period(1982-2001),the development period(2002-2010),the rapid rise period(2011-2015)and the four stages of innovation and pioneering period(2016—present).Policy diffusion is influenced by the hierarchical level of the issuing institution,policy type,and regional economic development level.Policies promulgated by central institutions exhibit stronger and broader diffusion,with guideline—type policies diffusing most widely.The diffusion rate follows a trend of"initial growth,followed by deceleration,and then a slight increase."The primary diffusion directions are vertical diffusion from central to local levels and horizontal diffusion among peers.Conclusion:The diffusion of policies related to LE and HLE is characterized by significant stages,regions and levels.

Objective To investigate the coagulation effect of a cold atmospheric plasma(CAP)jet device with helium as the working gas and to study its coagulation mechanism preliminarily.Methods A CAP jet device treatment group,a helium airflow treatment group,a hot air treatment group(60℃)and a natural coagulation group were formed according to the treatment modes of the blood samples,with 10 μL of blood samples involved in each group,in order to validate the coagulation effect of the CAP jet device in vitro;the coagulation mechanism of the CAP jet device was explored by its application to the treatment of anticoagulated whole blood,platelet-rich plasma and platelet-depleted plasma;the coagulation effect of the CAP jet device in vivo was verified with a mouse liver punctate hemorrhage model and a rabbit mesenteric hemorrhage model.Results The CAP jet device can significantly accelerate the coagulation of anticoagulated blood droplets,and the coagulation time of anticoagulated blood droplets in the CAP jet device-treated group was shortened from 28 min in the natural coagulation group to(23±1.56)s,with the difference statistically significant(P<0.05),and the CAP jet device treatment group gained advantages significantly over the helium airflow treatment group(P<0.05)and the hot air(60℃)treatment group(P<0.05)in coagulation-promoting effect;the procoagulant effect of the CAP jet device rose with the increase of platelet content in blood droplets,and the coagulation effect of platelet-rich blood droplets was significantly better than that of whole blood(P<0.05),while no coagulation was observed in platelet-poor droplets.The CAP jet device could rapidly stop hemostasis of punctate hemorrhage in mouse liver and mesenteric hemorrhage in rabbits without delayed hemorrhage occurring within 10 min,and no obvious structural abnormality of the liver and thermal damage of the tissue were found microscopically.Conclusion The CAP jet device plays procoagulant and hemostatic effects in vivo and in vitro,and its effect is not dependent on temperature and airflow evaporation effects and is considered to be related to platelet activation,with low thermal damage to living tissue.[Chinese Medical Equipment Journal,2025,46(6):20-27]

Objective To investigate the effect of remimazolam on core body temperature(CBT)and thermoregulatory vasoconstriction in patients undergoing gynecological laparoscopic surgery.Methods 90 gynaecology patients with ovarian or cervical cancer from Jan 2024 to Jun 2024 were randomly divided into experimental group(group R)and control group(group C).45 patients in each group were induced and maintained with remimazolam or propofol.After induction of anesthesia,the CBT and mean skin temperature(MST)were continuously monitored using a nasopharyngeal temperature probe and a skin temperature probe respectively.Record CBT and MST of two groups of patients before surgery(T0),30 min(T1),60 min(T2),90 min(T3),120 min(T4),150 min(T5),180 min(T6)after induction of anesthesia and at extubation(T7),as well as forearm-fingertip temperature gradient(TFOR-FIN).Record vasoconstriction threshold and time to onset of vasoconstriction by TFOR-TIN.Record the changes in mean arterial pressure(MAP),heart rate(HR),and cardiac index(CI)at each time point(T0,T1,T2,T3,T4,T5,T6 and T7 time point);Record the incidence of hypothermia,hypotension and bradycardia and the use of vasoactive drugs.Results Compared with T0 time point,the CBT and TFOR-TIN at T1 to T7 time point decreased significantly,but the MST increased(P<0.05);In group C,the CBT at T1 to T5 decreased significantly than in group R(P<0.05);Compared with group C,MST in group R increased significantly at time T1 to T7(P<0.05).The vasoconstriction threshold in group R was significantly higher than that in group C,and the time to reach the vasoconstriction threshold was significantly less than that in group C(P<0.05).Compared with T0 time point,MAP and CI at T1,T2,T3 time point decreased significantly in two groups,MAP and CI at T1,T2,T3 time point in group R were higher than those in group C(P<0.05);Compared with group R,the incidence of perioperative hypothermia(PH)and hypotension and the utilization rate of ephedirine in group C were increased(P<0.05).Conclusion Remimazolam and propofol for gynecological laparoscopic general anesthesia can cause intraoperative temperature drop in patients,compared with propofol,remimazolam general anesthesia has less influence on CBT,more stable hemodynamics,less influence on thermoregulatory vasoconstriction,less degree of diastolic blood vessels,has better body temperature protection.

Objective To investigate the coagulation effect of a cold atmospheric plasma(CAP)jet device with helium as the working gas and to study its coagulation mechanism preliminarily.Methods A CAP jet device treatment group,a helium airflow treatment group,a hot air treatment group(60℃)and a natural coagulation group were formed according to the treatment modes of the blood samples,with 10 μL of blood samples involved in each group,in order to validate the coagulation effect of the CAP jet device in vitro;the coagulation mechanism of the CAP jet device was explored by its application to the treatment of anticoagulated whole blood,platelet-rich plasma and platelet-depleted plasma;the coagulation effect of the CAP jet device in vivo was verified with a mouse liver punctate hemorrhage model and a rabbit mesenteric hemorrhage model.Results The CAP jet device can significantly accelerate the coagulation of anticoagulated blood droplets,and the coagulation time of anticoagulated blood droplets in the CAP jet device-treated group was shortened from 28 min in the natural coagulation group to(23±1.56)s,with the difference statistically significant(P<0.05),and the CAP jet device treatment group gained advantages significantly over the helium airflow treatment group(P<0.05)and the hot air(60℃)treatment group(P<0.05)in coagulation-promoting effect;the procoagulant effect of the CAP jet device rose with the increase of platelet content in blood droplets,and the coagulation effect of platelet-rich blood droplets was significantly better than that of whole blood(P<0.05),while no coagulation was observed in platelet-poor droplets.The CAP jet device could rapidly stop hemostasis of punctate hemorrhage in mouse liver and mesenteric hemorrhage in rabbits without delayed hemorrhage occurring within 10 min,and no obvious structural abnormality of the liver and thermal damage of the tissue were found microscopically.Conclusion The CAP jet device plays procoagulant and hemostatic effects in vivo and in vitro,and its effect is not dependent on temperature and airflow evaporation effects and is considered to be related to platelet activation,with low thermal damage to living tissue.[Chinese Medical Equipment Journal,2025,46(6):20-27]

Objective To investigate the effect of remimazolam on core body temperature(CBT)and thermoregulatory vasoconstriction in patients undergoing gynecological laparoscopic surgery.Methods 90 gynaecology patients with ovarian or cervical cancer from Jan 2024 to Jun 2024 were randomly divided into experimental group(group R)and control group(group C).45 patients in each group were induced and maintained with remimazolam or propofol.After induction of anesthesia,the CBT and mean skin temperature(MST)were continuously monitored using a nasopharyngeal temperature probe and a skin temperature probe respectively.Record CBT and MST of two groups of patients before surgery(T0),30 min(T1),60 min(T2),90 min(T3),120 min(T4),150 min(T5),180 min(T6)after induction of anesthesia and at extubation(T7),as well as forearm-fingertip temperature gradient(TFOR-FIN).Record vasoconstriction threshold and time to onset of vasoconstriction by TFOR-TIN.Record the changes in mean arterial pressure(MAP),heart rate(HR),and cardiac index(CI)at each time point(T0,T1,T2,T3,T4,T5,T6 and T7 time point);Record the incidence of hypothermia,hypotension and bradycardia and the use of vasoactive drugs.Results Compared with T0 time point,the CBT and TFOR-TIN at T1 to T7 time point decreased significantly,but the MST increased(P<0.05);In group C,the CBT at T1 to T5 decreased significantly than in group R(P<0.05);Compared with group C,MST in group R increased significantly at time T1 to T7(P<0.05).The vasoconstriction threshold in group R was significantly higher than that in group C,and the time to reach the vasoconstriction threshold was significantly less than that in group C(P<0.05).Compared with T0 time point,MAP and CI at T1,T2,T3 time point decreased significantly in two groups,MAP and CI at T1,T2,T3 time point in group R were higher than those in group C(P<0.05);Compared with group R,the incidence of perioperative hypothermia(PH)and hypotension and the utilization rate of ephedirine in group C were increased(P<0.05).Conclusion Remimazolam and propofol for gynecological laparoscopic general anesthesia can cause intraoperative temperature drop in patients,compared with propofol,remimazolam general anesthesia has less influence on CBT,more stable hemodynamics,less influence on thermoregulatory vasoconstriction,less degree of diastolic blood vessels,has better body temperature protection.

Purpose To quantitatively compare the diffusion parameters of mono-and biexponential diffusion-weighted imaging models,and to obtain optimal sets of b-values in diffusion-weighted MRI for obtaining monoexponential apparent diffusion coefficient(ADC)close to perfusion-insensitive intravoxel incoherent motion(IVIM)model ADC(ADCIVIM)in identifying of pulmonary solid benign and malignant lesions.Materials and Methods IVIM was performed in 40 patients with solid nodule and masse in Xi'an Gaoxin Hospital from July 2021 to August 2022 using a 3.0T MR imager.Two experienced diagnostic radiologists subjectively evaluated the IVIM images.A single index model was used to calculate ADC values(ADC0-1 000,ADC20-1 000,ADC50-1 000,ADC80-1 000,ADC150-1 000,ADC300-1 000,ADC500-1 000,ADC300,500,1 000,ADC300,800,1 000,ADC300,500,ADC300,800 and ADC300,1 000).The reference standard ADCIVIM value were calculated using a double-exponential model.The physician's measurements between two physicians were measured.The malignant and benign groups were compared and receiver operator characteristic curve for all parameters were analyzed.Results The measurement consistency of ADC values under b value sets and ADCIVIM was very good,and the intraclass correlation coefficient was more significant than 0.75.The differences between ADCIVIM and ADC values in each b group were statistically significant(t=-6.016--2.500,all P<0.05).The area under the curve(AUC)of ADCIVIM was the largest(0.906),with an optimal threshold of 1.271×10-3 mm2/s,a sensitivity of 80.0%and a specificity of 93.0%.The diagnostic efficacy close to ADCIVIM were ADC300,800(AUC=0.891),ADC50-1 000(AUC=0.827)and ADC300,800,1 000(AUC=0.795),respectively.The optimal threshold of ADC300,800 was 1.140×10-3 mm2/s,the sensitivity and specificity were 80.0%and 93.7%,respectively.Conclusion Combining b-values 300 s/mm2 and 800 s/mm2 is recommended as routine scanning parameters for identifying the insensitive monoexponential ADC between benign and malignant solid pulmonary lesions.

Objective:To analyze the evolution and diffusion characteristics of policies related to life expectancy(LE)and healthy life expectancy(HLE)in China from 1982 to 2024 using a biometric approach to policy analysis,revealing the patterns of policy diffusion.Methods:By retrieving databases such as PKULAW.com,We comprehensively collected 701 policy documents closely related to LE and HLE during the period(including 62 central policies and 639 local policies),the policy diffusion process was quantified in four dimensions:diffusion intensity,diffusion breadth,diffusion speed and diffusion direction by using the policy—reference network analysis method.Results:Related policy has gone through the germination period(1982-2001),the development period(2002-2010),the rapid rise period(2011-2015)and the four stages of innovation and pioneering period(2016—present).Policy diffusion is influenced by the hierarchical level of the issuing institution,policy type,and regional economic development level.Policies promulgated by central institutions exhibit stronger and broader diffusion,with guideline—type policies diffusing most widely.The diffusion rate follows a trend of"initial growth,followed by deceleration,and then a slight increase."The primary diffusion directions are vertical diffusion from central to local levels and horizontal diffusion among peers.Conclusion:The diffusion of policies related to LE and HLE is characterized by significant stages,regions and levels.