This study aims to isolate and culture primary rabbit spinal cord microvascular endothelial cells in vitro,providing a practical source of test cells for spinal cord injury research.Spinal cord tissue was aseptically extracted from one-month-old rabbits and processed sequentially through mincing,bovine serum albumin density gradient centrifugation,mesh filtration,and type Ⅱ collagenase digestion to ob-tain purified spinal cord microvascular segments.The microvascular segments were homogeneously mixed with an apprapriate volume of M199 complete culture medium and seeded into a culture dish for primary culture.Throughout the culture period,cell growth performance were continuously observed and recor-ded.Additionally,immunocytochemical staining was performed to evaluate the expression of factor Ⅷ-re-lated antigen.The results showed that after 24 hours of inoculation,a small amount of endothelial-like cells were observed to emerge from the spinal cord microvascular segments.Within 36～60 hours,the cell colonies gradually expanded and fused.After 72 hours,the cells spread across the base of the dish,forming a"cobblestone-like"monolayer.Immunocytochemical staining showed that more than 99％of the cells showed brown-red cytoplasm and were positive for factor Ⅷ-related antigen.It is these results that suggest this study has successfully established a convenient and stable primary rabbit spinal cord micro-vascular endothelial cells culture method.

This study aims to isolate and culture primary rabbit spinal cord microvascular endothelial cells in vitro,providing a practical source of test cells for spinal cord injury research.Spinal cord tissue was aseptically extracted from one-month-old rabbits and processed sequentially through mincing,bovine serum albumin density gradient centrifugation,mesh filtration,and type Ⅱ collagenase digestion to ob-tain purified spinal cord microvascular segments.The microvascular segments were homogeneously mixed with an apprapriate volume of M199 complete culture medium and seeded into a culture dish for primary culture.Throughout the culture period,cell growth performance were continuously observed and recor-ded.Additionally,immunocytochemical staining was performed to evaluate the expression of factor Ⅷ-re-lated antigen.The results showed that after 24 hours of inoculation,a small amount of endothelial-like cells were observed to emerge from the spinal cord microvascular segments.Within 36～60 hours,the cell colonies gradually expanded and fused.After 72 hours,the cells spread across the base of the dish,forming a"cobblestone-like"monolayer.Immunocytochemical staining showed that more than 99％of the cells showed brown-red cytoplasm and were positive for factor Ⅷ-related antigen.It is these results that suggest this study has successfully established a convenient and stable primary rabbit spinal cord micro-vascular endothelial cells culture method.

Objectives:To evaluate the predictive value of Tabular Prior-data Fitted Network(TabPFN) for short-term outcome in patients with spontaneous intracerebral hemorrhage (sICH), and compared with the Extreme Gradient Boosting (XGboost) model and traditional logistic regression (LR) model. Methods:Patients with sICH admitted to the Department of Neurology, Hefei Second People's Hospital from January 2018 to March 2024 were included retrospectively. The demographic and baseline data were collected. At 3 months after onset, the modified Rankin Scale score was used to determine the outcome, 0-2 was defined as good outcome and >2 was defined as poor outcome. All enrolled patients were randomly divided into a training set and a testing set at a ratio of 7:3. Feature selection was performed using recursive feature elimination (RFE) method, and then the selected feature variables were included into TabPFN, XGboost, and LR models for training and testing. The area under the curve (AUC) of receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the models. Shapley additive explanations (SHAP) method was used for model interpretation.Results:A total of 547 patients with sICH were enrolled, including 367 males (67.1%), with a median age of 65 (interquartile range, 54-76) years. Two hundred twenty-six patients (41.3%) had poor outcome. Age, baseline blood pressure (systolic blood pressure, diastolic blood pressure), baseline laboratory tests (white blood cell count, red blood cell count, platelet count, neutrophil count, hemoglobin, fasting blood glucose, creatinine, uric acid, urea nitrogen, alanine aminotransferase, aspartate aminotransferase), hematoma rupture into the ventricle, island sign, baseline hematoma volume, and baseline National Institutes of Health Stroke Scale (NIHSS) score were selected as characteristic variables using RFE method. ROC curve analysis showed that the ROC AUC for TabPFN, Xgboost, and LR models predicting poor short-term outcome in the testing set were 0.918 (95% confidence interval [ CI] 0.870-0.966], 0.883 (95% CI 0.826-0.940), and 0.905 (95% CI 0.854-0.957), respectively. SHAP analysis showed that the top four important variables in the TabPFN model were baseline NIHSS score, baseline hematoma volume, baseline aspartate aminotransferase, and age. Conclusions:The TabPFN model is superior to the LR model and the XGBoost model in predicting poor outcome in patients with sICH. In the TabPFN model, baseline NIHSS score, baseline hematoma volume, aspartate aminotransferase, and age are the most important predictors of poor outcome in patients with sICH.Objectives To evaluate the predictive value of Tabular Prior-data Fitted Network(TabPFN) for short-term outcome in patients with spontaneous intracerebral hemorrhage (sICH), and compared with the Extreme Gradient Boosting (XGboost) model and traditional logistic regression (LR) model. Methods Patients with sICH admitted to the Department of Neurology, Hefei Second People's Hospital from January 2018 to March 2024 were included retrospectively. The demographic and baseline data were collected. At 3 months after onset, the modified Rankin Scale score was used to determine the outcome, 0-2 was defined as good outcome and >2 was defined as poor outcome. All enrolled patients were randomly divided into a training set and a testing set at a ratio of 7:3. Feature selection was performed using recursive feature elimination (RFE) method, and then the selected feature variables were included into TabPFN, XGboost, and LR models for training and testing. The area under the curve (AUC) of receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the models. Shapley additive explanations (SHAP) method was used for model interpretation. Results A total of 547 patients with sICH were enrolled, including 367 males (67.1%), with a median age of 65 (interquartile range, 54-76) years. Two hundred twenty-six patients (41.3%) had poor outcome. Age, baseline blood pressure (systolic blood pressure, diastolic blood pressure), baseline laboratory tests (white blood cell count, red blood cell count, platelet count, neutrophil count, hemoglobin, fasting blood glucose, creatinine, uric acid, urea nitrogen, alanine aminotransferase, aspartate aminotransferase), hematoma rupture into the ventricle, island sign, baseline hematoma volume, and baseline National Institutes of Health Stroke Scale (NIHSS) score were selected as characteristic variables using RFE method. ROC curve analysis showed that the ROC AUC for TabPFN, Xgboost, and LR models predicting poor short-term outcome in the testing set were 0.918 (95% confidence interval [ CI] 0.870-0.966], 0.883 (95% CI 0.826-0.940), and 0.905 (95% CI 0.854-0.957), respectively. SHAP analysis showed that the top four important variables in the TabPFN model were baseline NIHSS score, baseline hematoma volume, baseline aspartate aminotransferase, and age. Conclusions The TabPFN model is superior to the LR model and the XGBoost model in predicting poor outcome in patients with sICH. In the TabPFN model, baseline NIHSS score, baseline hematoma volume, aspartate aminotransferase, and age are the most important predictors of poor outcome in patients with sICH.

BACKGROUND: The placebo response of sham acupuncture in patients with primary dysmenorrhea is a substantial factor associated with analgesia. However, the magnitude of the placebo response is unclear. OBJECTIVE: This meta-analysis assessed the effects of sham acupuncture in patients with primary dysmenorrhea and the factors contributing to these effects. SEARCH STRATEGY: PubMed, Embase, Web of Science, and Cochrane CENTRAL databases were searched from inception up to August 20, 2022. INCLUSION CRITERIA: Randomized controlled trials (RCTs) using sham acupuncture as a control for female patients of reproductive age with primary dysmenorrhea were included. DATA EXTRACTION AND ANALYSIS: Pain intensity, retrospective symptom scale, and health-related quality of life were outcome measures used in these trials. Placebo response was defined as the change in the outcome of interest from baseline to endpoint. We used standardized mean difference (SMD) to estimate the effect size of the placebo response. RESULTS: Thirteen RCTs were included. The pooled placebo response size for pain intensity was the largest (SMD = -0.99; 95% confidence interval [CI], -1.31 to -0.68), followed by the retrospective symptom scale (Total frequency rating score: SMD = -0.20; 95% CI, -0.80 to -0.39. Average severity score: SMD = -0.35; 95% CI, -0.90 to -0.20) and physical component of SF-36 (SMD = 0.27; 95% CI, -0.17 to 0.72). Studies using blunt-tip needles, single-center trials, studies with a low risk of bias, studies in which patients had a longer disease course, studies in which clinicians had < 5 years of experience, and trials conducted outside Asia were more likely to have a lower placebo response. CONCLUSION Strong placebo response and some relative factors were found in patients with primary dysmenorrhea. PROSPERO registration number: CRD42022304215. Please cite this article as: Sun CY, Xiong ZY, Sun CY, Ma PH, Liu XY, Sun CY, Xin ZY, Liu BY, Liu CZ, Yan SY. Placebo response of sham acupuncture in patients with primary dysmenorrhea: A meta-analysis. J Integr Med. 2023; 21(5): 455-463.
Female ; Humans ; Dysmenorrhea/therapy* ; Acupuncture Therapy ; Pain Management ; Needles ; Placebo Effect

Objective:To develop a short-term prognostic model of spontaneous cerebral hemorrhage based on eXtreme Gradient Boosting (XGBoost) machine learning, and to compare its predictive performance with a Logistic regression model.Methods:Patients with sICH admitted to Department of Neurology, Second People's Hospital of Hefei from January 2018 to March 2022 were chosen; their general demographic characteristics, medical history, laboratory indices and cranial imaging data were retrospectively collected. The prognoses of patients 90 d after discharge were evaluated according to modified Rankin Scale (mRS) scores (good prognosis: mRS scores<3; poor prognosis: mRS scores≥3). XGboost and multiple Logistic regression models were used to screen out the factors for prognoses of patients 90 d after discharge, and area under receiver operating characteristic (ROC) curves, sensitivity, specificity and prediction accuracy of the 2 models were analyzed and compared.Results:A total of 413 patients with sICH were included; 180 patients(43.6 %) had poor prognosis and 233 (56.4%) had good prognosis 90 d after discharge. Multivariate Logistic regression results showed that age≥65 years, hemorrhage into the ventricle, hematoma volume of 20-40 mL, hematoma volume>40 mL and National Institutes of Health Stroke Scale (NIHSS) scores were independent influencing factors for short-term prognoses of sICH ( P<0.05). The variables in the XGBoost model were ranked in order of importance: NIHSS scores, systolic blood pressure at admission, Glasgow coma scale (GCS) scores, age≥65 years, hemorrhage into the ventricle, hematoma volume of 20-40 mL, and hematoma volume>40 mL. AUC of XGBoost model in predicting the prognosis was 0.895 (95% CI: 0.820-0.947), enjoying sensitivity of 68.89%, specificity of 94.83%, and prediction accuracy of 83.5%. AUC of Logistic regression model in predicting the prognosis was 0.894 (95% CI: 0.818-0.946), enjoying sensitivity of 93.33%, specificity of 70.69%, and prediction accuracy of 80.58%. Conclusion:The short-term prognostic model based on XGboost for sICH patients has high predictive efficacy, whose predictive accuracy is better than traditional Logistic regression.

A new iridoid glycoside, cornushmf A(1) and nine known iridoids(2-10) were isolated from the water extract of the wine-processed Corni Fructus by various column chromatographies. Their chemical structures were identified by comprehensive spectroscopic methods as 7β-O-(2″-formylfuran-5″-methylene)-morroniside(1), 7-dehydrologanin(2), sweroside(3), 7β-O-methylmorroniside(4), 7α-O-methylmorroniside(5), 7β-O-ethylmorroniside(6), 7α-O-ethylmorroniside(7), cornuside(8), sarracenin(9), and loganin(10).
Cornus/chemistry* ; Drugs, Chinese Herbal/chemistry* ; Iridoids ; Wine

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome

Objective: To investigate the application effect of augmented reality and mixed reality navigation technology in three-dimensional(3D) laparoscopic narrow right hepatectomy(LRH). Methods: A retrospective analysis was performed on the clinical data of 5 patients with hepatic malignancy admitted to the First Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University from September 2020 to June 2021,all of whom were males,aged from 42 to 74 years.Preoperative evaluation was performed using the self-developed 3D abdominal medical image visualization system; if all the 5 patients were to receive right hemihepatectomy,the remnant liver volume would be insufficient,so LRH were planned.During the operation,the independently developed 3D laparoscopic augmented reality and mixed reality surgical navigation system was used to perform real-time multi-modal image fusion and interaction between the preoperative 3D model and 3D laparoscopic scene.Meanwhile,intraoperative ultrasound assisted indocyanine green fluorescence was used to determine the surgical path.In this way,the LRH under the guidance of augmented reality and mixed reality navigation was completed.The predicted liver resection volume was evaluated before surgery,actual resected liver volume,surgical indicators and postoperative complications were analyzed. Results: All the 5 patients completed LRH under the guidance of augmented reality and mixed reality navigation technology,with no conversion to laparotomy.The median operative time was 300 minutes(range:270 to 360 minutes),no intraoperative blood transfusion was performed,and the median postoperative hospital stay was 8 days(range:7 to 9 days).There were no perioperative deaths,or postoperative complications such as liver failure,bleeding,or biliary fistula. Conclusion: For patients who need to undergo LRH,the use of augmented and mixed reality navigation technology can safely and effectively guide the implementation of surgery,retain more functional liver volume,improve surgical safety,and reduce postoperative complications.
Adult ; Aged ; Augmented Reality ; Hepatectomy/methods* ; Humans ; Imaging, Three-Dimensional ; Laparoscopy/methods* ; Liver Neoplasms/surgery* ; Male ; Middle Aged ; Retrospective Studies ; Technology

Autoimmune hepatitis (AIH) is an inflammatory disease of the liver mediated by autoimmune response, and in the diagnosis and treatment of AIH, it is of great importance to accurately assess the progression of liver inflammation, screen out the patients requiring corticosteroid therapy, and evaluate the therapeutic outcome. This article introduces a variety of new noninvasive techniques which have been discovered by clinical and experimental studies in recent years and have the potential to evaluate the progression of AIH, as well as the advantages and disadvantages of each technique. It is concluded that the new noninvasive techniques have more advantages in guiding the corticosteroid therapy for AIH, but further clinical studies are still needed for verification.

By referring to the relevant ancient herbal literature， medical records and prescription books， the textual research of Violae Herba has been conducted to verify the name， origin， producing area， quality evaluation and processing method changes. The results showed that the name of Zihua Diding originated from its flower color and plant morphological characteristics. The primitive plant of Violae Herba is Viola genus of Violaceae， V. yedoensis， as stipulated in the 2020 edition of Chinese Pharmacopoeia， has been the mainstream in past dynasties of China. Violae Herba is mainly wild， and it is widely distributed throughout the country. Since modern times， the quality of Violae Herba is better with integrity， green color and yellow root. There are few records on the harvesting and processing methods of Violae Herba in ancient times， most of which are directly used after drying. It is suggested that the collection and processing methods of Violae Herba in the famous classical formulas can be implemented in accordance with the provisions of the 2020 edition of Chinese Pharmacopoeia.