ObjectiveTo investigate the present situation of input, output, outcome and impact of all registered community-based rehabilitation stations in Inner Mongolia in China, and analyze how the input predict the output, outcome and impact. MethodsFrom March 1st to April 30th, 2025, a questionnaire survey was conducted on all registered community-based rehabilitation stations in Inner Mongolia, covering four dimensions: input, output, outcome and impact. A total of 1 365 questionnaires were distributed. The input included four items: laws and policies, human resources, equipment and facilities, and rehabilitation information management. The output included two items: technical paths and benefits/effectiveness. The outcome included three items: coverage rates, rehabilitation interventions and functional results. The impact included two items: health and sustainability. Each item contained several questions, all of which were described in a positive way. Each question was scored from one to five. A lower score indicated that the situation of the community-based rehabilitation station was more in line with the content described in the question. Regression analysis was performed using the total score of each item of input dimension as independent variables, and the total scores of the output, outcome and impact dimensions as dependent variables. ResultsA total of 1 262 valid questionnaires were collected. The mean values of input, output, outcome and impact of community-based rehabilitation stations were 1.827 to 1.904, with coefficient of variation of 45.892% to 49.239%. The regression analysis showed that, rehabilitation information management, human resources, and laws and policies significantly predicted the output dimension (R² = 0.910, P < 0.001). Meanwhile, all four items in the input dimension predicted both the outcome (R² = 0.850, P < 0.001) and impact dimensions (R² = 0.833, P < 0.001). ConclusionInput, output, outcome and impact of the community-based rehabilitation stations in Inner Mongolia were generally in line with the content of the questions, although some imbalances were observed. Additionally, the input of community-based rehabilitation stations could significantly predict their output, outcome and impact.

BACKGROUND/OBJECTIVES: Lutein, a dietary carotenoid, plays a crucial role in protecting eye health as an anti-inflammatory agent and antioxidant. Green leafy vegetables constitute a major source of lutein; however, comparative studies on different consumption methods are limited. Therefore, this study aimed to evaluate the bioavailability of lutein from lutein-rich foods, namely, raw vegetables and raw vegetable juice. SUBJECTS/METHODS: In this study, 18 adults were recruited. They were randomly divided into three groups: commercial lutein supplement (LUT, 20 mg), raw vegetable (RV), and raw vegetable juice (RVJ) groups. Blood was collected at 0-, 4-, 6-, 8-, 12-, 24-, and 30-h intervals after the consumption of each test meal. Participants’ serum lutein levels were analyzed using high-performance liquid chromatography (HPLC). Considering lutein’s wellestablished anti-inflammatory properties, changes in inflammatory status were assessed by measuring serum high-sensitivity C-reactive protein (hs-CRP) levels. Furthermore, urinary metabolomic profiling was conducted using 1 H nuclear magnetic resonance spectroscopy to evaluate metabolic alterations. RESULTS: After consuming each lutein-rich food, participants’ blood lutein levels were analyzed, and the serum concentration peaked at 12 h (0.37 ± 0.13 μg/mL), 24 h (0.61 ± 0.18 μg/mL), and 30 h (0.42 ± 0.16 μg/mL) after RV, LUT, and RVJ consumption, respectively.Additionally, hs-CRP levels decreased following lutein-rich food consumption. Twelve hours after consumption, hs-CRP levels decreased to 0.81 and 0.83 mg/L in the RV and RVJ groups, respectively. Twenty-four hours after consumption, they further decreased to 0.68 and 0.74 mg/L in the LUT and RVJ groups, respectively. Thirty hours after consumption, a reduction to 0.61 mg/L was observed in the RVJ group. Furthermore, after consuming each luteinrich food, N-acetyl glycoprotein levels decreased at 24 h, reflecting metabolic alterations potentially associated with lutein metabolism. CONCLUSION These findings suggest that the short-term consumption of lutein-rich foods, regardless of their type or source, potentially yields health benefits.

Triple-negative breast cancer (TNBC) represents a distinctive subtype, characterized by the absence of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2). Due to its high inter-tumor and intra-tumor heterogeneity, TNBC poses significant chanllenges for personalized diagnosis and treatment. The advant of clustered regular interspaced short palindromic repeats (CRISPR) technology has profoundly enhanced our understanding of the structure and function of the TNBC genome, providing a powerful tool for investigating the occurrence and development of diseases. This review focuses on the application of CRISPR/Cas technology in the personalized diagnosis and treatment of TNBC. We begin by discussing the unique attributes of TNBC and the limitations of current diagnostic and treatment approaches: conventional diagnostic methods provide limited insights into TNBC, while traditional chemotherapy drugs are often associated with low efficacy and severe side effects. The CRISPR/Cas system, which activates Cas enzymes through complementary guide RNAs (gRNAs) to selectively degrade specific nucleic acids, has emerged as a robust tool for TNBC research. This technology enables precise gene editing, allowing for a deeper understanding of TNBC heterogeneity by marking and tracking diverse cell clones. Additionally, CRISPR facilitates high-throughput screening to promptly identify genes involved in TNBC growth, metastasis, and drug resistance, thus revealing new therapeutic targets and strategies. In TNBC diagnostics, CRISPR/Cas was applied to develop molecular diagnostic systems based on Cas9, Cas12, and Cas13, each employing distinct detection principles. These systems can sensitively and specifically detect a variety of TNBC biomarkers, including cell-specific DNA/RNA and circulating tumor DNA (ctDNA). In the realm of precision therapy, CRISPR/Cas has been utilized to identify key genes implicated in TNBC progression and treatment resistance. CRISPR-based screening has uncovered potential therapeutic targets, while its gene-editing capabilities have facilitated the development of combination therapies with traditional chemotherapy drugs, enhancing their efficacy. Despite its promise, the clinical translation of CRISPR/Cas technology remains in its early stages. Several clinical trials are underway to assess its safety and efficacy in the treatment of various genetic diseases and cancers. Challenges such as off-target effects, editing efficiency, and delivery methods remain to be addressed. The integration of CRISPR/Cas with other technologies, such as 3D cell culture systems, human induced pluripotent stem cells (hiPSCs), and artificial intelligence (AI), is expected to further advance precision medicine for TNBC. These technological convergences can offer deeper insights into disease mechanisms and facilitate the development of personalized treatment strategies. In conclusion, the CRISPR/Cas system holds immense potential in the precise diagnosis and treatment of TNBC. As the technology progresses and becomes more costs-effective, its clinical relevance will grow, and the translation of CRISPR/Cas system data into clinical applications will pave the way for optimal diagnosis and treatment strategies for TNBC patients. However, technical hurdles and ethical considerations require ongoing research and regulation to ensure safety and efficacy.

Objective To investigate the electroencephalography(EEG)signal characteristics in patients with neuropathic pain(NP)associated with spinal cord injury(SCI).Methods A total of 90 patients with SCI from January,2018 to November,2023 were selected from the EEG database of the Department of Rehabilitation Medicine,Xijing Hospital,and divided into NP group(n=46)and non-NP group(n=44)according to their symptoms.The resting-state EEG power and reactivity to eye-opening were compared between two groups.Results Compared with non-NP group,EEG power increased in frontal lobe in α and β1 bands,central lobe in δ,θ,α1 and β1 bands,parietal lobe in α and β1 bands,temporal lobe in α and β1 bands,left occipital lobe in α2 band,and occipital lobe in α1 and β1 bands(|Z|>1.998,P<0.05)in NP group during eye-opening;during eye-closing,EEG power increased in prefrontal lobe in α1 and β1 bands,right frontal lobe in θ band,frontal lobe in α and β1 bands,left frontal lobe in β2 band,central lobe in δ,α1 and β1 bands,parietal lobe in α1 and β1 bands,left pari-etal lobe in α2 and β2 bands,right temporal lobe in θ band,temporal lobe in α and β bands,occipital lobe in α1 and β1 bands,and left occipital lobe in β2 band(|Z|>1.970,P<0.05);while the reactivity to eye-opening de-creased in right prefrontal lobe in β1 band,frontal lobe in θ,α and β bands,right central lobe in β1 band,parietal lobe in α1 and β1 bands,right parietal lobe in β2 band,right temporal lobe in δ and θ band,temporal lobe in α1 and β bands,left occipital lobe in α1 band,and occipital lobe in β1(|Z|>1.967,P<0.05).Conclusion Resting-state EEG power characteristically elevates in NP patients after SCI,and the reactivity to eye-open-ing reduces.

Objective To explore TCM syndrome distribution law in patients with overlapping non-erosive reflux disease(NERD)and epigastric pain syndrome(EPS)gastrointestinal symptoms.Methods A multi-center,cross-sectional study was conducted to investigate the general information of 800 patients with overlapping NERD and EPS gastrointestinal symptoms in four hospitals,such as gender,age,body mass index(BMI)and four diagnostic information of TCM.Descriptive frequency analysis,factor analysis and clustering analysis were used to summarize the TCM syndrome types and distribution characteristics.Results The average age of 800 patients with overlapping NERD and EPS gastrointestinal symptoms was(44.50±14.43)years old,the average BMI was(23.17±4.80)kg/m2,and the male to female ratio was 3:5.Frequency of 95 TCM symptoms/signs≥20%.18 common factor variables were obtained based on factor analysis,and the cumulative contribution rate was 67.11%.The first three syndrome elements of disease location were liver,stomach and spleen,and the disease nature syndrome elements were qi stagnation,qi deficiency and yin deficiency.Based on the clustering analysis of 18 common factor variables,combined with expert discussion,four main TCM syndrome types were obtained,which were liver-stomach stagnation heat syndrome(213 cases,26.63%),spleen-stomach damp heat syndrome(209 cases,26.13%),spleen-stomach deficiency and cold qi stagnation syndrome(190 cases,23.75%)and qi-phlegm stagnation syndrome(188 cases,23.50%).There was no significant difference in the distribution of TCM syndrome types among patients with different genders,ages and BMI values(P>0.05).Patients with a course of disease≥2 years and those residing long-term north of the Qinling-Huaihe Line showed a significantly higher prevalence of spleen-stomach dampness-heat syndrome(P<0.05).Conclusion The syndrome elements of disease location of overlapping NERD and EPS gastrointestinal symptoms are mainly liver,stomach and spleen.The TCM syndrome types are liver-stomach stagnation heat syndrome,spleen-stomach damp heat syndrome,spleen-stomach deficiency cold qi stagnation syndrome and qi-phlegm stagnation syndrome.The course of disease and the regional differences between north and south may be the influencing factors of the distribution of syndrome types.

Objective To investigate the potential mechanism of Jianpi Qinghua Granules in treating gastroesophageal reflux disease(GERD)with spleen deficiency and damp heat syndrome.Methods Six of 50 SPF male SD rats were randomly selected as the sham-operation group,the other 44 rats were treated with modified esophagoduodenostomy+abnormal hunger and satiety+internal and external damp heat intervention to establish GERD model of spleen deficiency and damp heat syndrome.The modeled rats were randomly divided into model group,omeprazole group,sodium cromoglicate group and Jianpi Qinghua Granules low-,medium-and high-dosage group,with 6 rats in each group.Each group was intervened with corresponding measures.Pathological changes in esophageal tissue were observed,ELISA was used to detect serum and esophageal mucosal tissue contents of interleukin(IL)-1β,tumor necrosis factor-α(TNF-α),IL-6 and IL-10.Western blot was used to detect protein expressions of nuclear factor-κB(NF-κB)p65,mast cell tryptase(MCT),proteinase-activated receptor 2(PAR2),Toll-like receptor 4(TLR4),TNF receptor-associated factor 6(TRAF6)and transforming growth factor β-activated kinase 1(TAK1)in esophageal mucosal tissue,RT-qPCR was used to detect mRNA expressions of MCT,PAR2,TLR4 and TRAF6 in esophageal mucosal tissue.Results Compared with the sham-operation group,the esophageal mucosal epithelium in the model group was thickened,basal cells proliferated,cell gaps widened,tissue edema and inflammatory cells infiltration were observed;the contents of IL-1β,TNF-α and IL-6 in serum and esophageal mucosa significantly increased,while the content of IL-10 significantly decreased(P<0.01);the expressions of NF-κB p65,MCT,PAR2,TLR4,TRAF6,TAK1 protein and MCT,PAR2,TLR4,TRAF6 mRNA in esophageal mucosa significantly increased(P<0.01).Compared with the model group,the injury of esophageal mucosa in each treatment group was alleviated in varying degrees;the contents of IL-1β,TNF-α and IL-6 in serum and esophageal mucosa increased,while the content of IL-10 decreased,the expressions of NF-κB p65,MCT,PAR2,TLR4,TRAF6 and TAK1 protein in esophageal mucosa decreased,the mRNA expressions of MCT,PAR2,TLR4 and TRAF6 decreased,and the differences were statistically significant in Jianpi Qinghua Granules high-dosage group(P<0.01).Conclusion Jianpi Qinghua Granules can reduce the esophageal mucosal injury and inflammatory reaction in GERD rats with spleen deficiency and damp heat syndrome,and its mechanism may be related to the inhibition of TLR4/NF-κB pathway activation induced by LPS.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective:To relate the changes in electroencephalography (EEG) signals after a spinal cord injury (SCI) with functional independence.Methods:The EEG data describing ninety SCI patients in both open and closed eye states were compared with those collected from 45 healthy counterparts. The SCI patients′ EEG data were correlated with their spinal cord independence measure (SCIM) scores at corresponding time points. The SCI patients were divided into a cervical SCI group (SCI-C group) and a non-cervical SCI group (SCI-NC group), with 45 cases in each group. The difference in EEG data between them and its correlation with the SCIM scores were also compared and analyzed.Results:In the eyes-open state, the EEG power in the frontal, central, temporal, and right occipital regions of the SCI group was lower than among the control group, on average. There were significant differences in the δ and θ low-frequency bands. The α1 band power in the frontal and right parietal regions was significantly higher in the SCI group, on average. With the eyes closed the δ band power in the right prefrontal, frontal, left central, and temporal regions of the SCI group was lower than among the control group, while the α1 band power in the right prefrontal, frontal, central, and parietal regions was significantly higher. The reactivity to eye opening of the α1 band in the right prefrontal, frontal, central, parietal, and temporal regions was less in the SCI patients compared to healthy subjects. Among the SCI patients, higher EEG power in the β2 band of the right frontal lobe and the α2 and β bands of the right temporal lobe was significantly positively correlated with higher SCIM scores during the eyes-open measurements. And the higher EEG power in the α2 band of the prefrontal and frontal lobes, the β2 band of the frontal lobe, the α2 band of the right central region, the α2 and β bands of the temporal lobe, and the α2 and β2 bands of the occipital lobe was significantly positively correlated with higher SCIM scores during the eyes-closed state. The subgroup analysis showed that the δ band power in the left temporal lobe and the α2 band power in the parietal lobe were lower among the SCI-C compared with the SCI-NC patients in the eyes-open state. With the eyes closed, the δ band power in the left frontal, left parietal, and left temporal lobes and the α2 band power in the frontal, central, parietal, temporal, and right occipital lobes was significantly lower in the SCI-C group compared to the SCI-NC group, on average. The reactivity to eye opening of the δ band in the temporal lobe, the α2 band in the left prefrontal, frontal, central, parietal, temporal, and right occipital lobes, and the β2 band in the right parietal and left occipital lobes was less in the SCI-C group than in the SCI-NC group ( P≤0.05). Among the SCI-C patients, higher EEG power in the β1 and β2 bands of the right temporal lobe with the eyes open was significantly positively correlated with higher SCIM scores. With the eyes closed, higher EEG power in the α2 and β1 bands of the right prefrontal lobe was significantly positively correlated with higher SCIM scores. Among the SCI-NC patients, higher EEG power in the δ band of the prefrontal lobe, the β1 and β2 bands of the left prefrontal lobe, and the δ bands of the frontal, central, right parietal, and right temporal lobes during the eyes open measurements was significantly positively correlated with higher SCIM scores. Conclusions:The EEG power of cervical and non-cervical SCI patients shows characteristic changes which correlate with their functional independence.

Objective:To understand the prevalence of frailty and the importance of its influencing factors in adult population in Shaanxi Province.Methods:The data were from Shaanxi baseline survey of natural population cohort study in northwest China during 2018-2019. The frailty index (FI) was constructed to evaluate the frailty status of the population, and XGboost model combined with Shapley method was used to analyze the importance of the sociodemographic and life behavior factors affecting the prevalence of frailty by gender and age.Results:A total of 25 079 subjects were included, in whom 964 (3.8%) had frailty, and there was no significant difference in the overall prevalence of frailty between women (3.9%) and men (3.8%) ( P=0.629), but there was a gender specific difference in the distribution of FI ( P<0.001), and the proportion of the pre-frailty in men was higher than that in women. The prevalence of frailty increased with age ( P<0.001), the prevalence of frailty were 1.3%, 2.5% and 7.8% in young, middle-aged and elderly women, respectively, and 1.9%, 2.7% and 5.5% in young, middle-aged and elderly men, respectively. Sociodemographic characteristics and lifestyle patterns were both influencing factors for the prevalence of frailty, but their importance varied with gender and age. The top five contributing factors were education level, staying up late, annual family income level, sedentary time and marital status in young women, and staying up late, smoking, annual family income level, sedentary time and drinking in young men. The top five contributing factors were education level, annual family income level, passive exposure to smoking, staying up late, and sedentary time in middle-aged women, and annual family income level, education level, sedentary time, staying up late and drinking in middle-aged men. The top five contributing factors were annual family income level, passive exposure to smoking, sedentary time, marital status, and smartphone use in elderly women, and education level, annual family income level, smoking, smartphone use and sedentary time in elderly men. Conclusions:There are gender specific differences in the distribution of FI in Shaanxi. The prevalence of frailty increased with age, but young and middle-aged people also have frailty risk. The prevalence of frailty in young men was mainly related to unhealthy life behaviors, such as staying up late, smoking, sedentary behavior and drinking, while the prevalence of frailty in middle-aged and elderly men and women were more affected by sociodemographic factors, such as education level, economic status and marital status.

Objective:To evaluate the efficacy and safety of endoscopic variceal ligation (EVL) of esophageal varices combined with endoscopic variceal intensive ligation (EVIL) of gastric varices for gastroesophageal variceal bleeding with liver cirrhosis under non-emergency settings.Methods:Data of 643 consecutive patients with gastroesophageal variceal bleeding due to liver cirrhosis admitted to the Department of Gastroenterology, Henan Provincial People's Hospital from January 2017 to March 2023 were included in the retrospective study. A total of 192 patients were included after excluding 451 patients. One hundred and forty-nine patients who underwent EVL of esophageal varices combined with EVIL of gastric varices were enrolled into the EVIL group, while 43 patients who underwent EVL of esophageal varices combined with endoscopic tissue adhesive injection (ETAI) of gastric varices were enrolled into the ETAI group. The endoscopic treatment success rate, esophageal variceal ligations number, operation time of endoscopic treatment, hospitalization time, rebleeding rate, mortality and the incidence of adverse events were compared between the two groups.Results:Compared with the ETAI group, the EVIL group exhibited significantly higher endoscopic treatment success rate [100.0% (149/149) VS 95.3% (41/43), P=0.049], slightly greater esophageal variceal ligations number [8 (6, 11) rings VS 7 (6, 9) rings, Z=-1.29, P=0.196], shorter operation time of endoscopic treatment [27.0 (20.5, 34.0) min VS 36.0 (21.0, 51.0) min, Z=-2.30, P=0.021], and significantly shorter hospitalization time [10 (7, 13) d VS 13 (9, 15) d, Z=-3.02, P=0.003]. The rebleeding rate within 24, 72, 120 hours after the operation, early, delayed and total rebleeding in the EVIL group were 0.0% (0/149), 0.0% (0/149), 0.7% (1/149), 2.0% (3/149), 12.8% (19/149) and 14.8% (22/149) respectively, and 4.7% (2/43) ( P=0.049), 9.3% (4/43) ( P=0.002), 9.3% (4/43) ( χ2=6.69, P=0.010), 4.7% (2/43) ( χ2=0.17, P=0.679), 30.2% (13/43) ( χ2=7.34, P=0.007) and 44.2% (19/43) ( χ2=17.20, P<0.001) in the ETAI group, respectively. No death related to rebleeding occurred within 6 weeks after the operation in 2 groups. The mortality related to rebleeding within 1 year after the operation and during the follow-up period in the EVIL group were 1.3% (2/149) and 3.4% (5/149) respectively, and 0.0% (0/43) ( P=1.000) and 2.3% (1/43) ( χ2=0.02, P=0.876) in the ETAI group, respectively. The incidences of fever, chest pain, nausea or vomiting in the EVIL group were 12.1% (18/149), 14.1% (21/149) and 13.4% (20/149) respectively, and 11.6% (5/43) ( χ2=0.01, P=0.936), 16.3% (7/43) ( χ2=0.13, P=0.721) and 18.6% (8/43) ( χ2=0.72, P=0.396) in the ETAI group, respectively. Two patients (1.3%) in the EVIL group had gastric variceal ring loss. Ectopic embolism occurred in 1 patient (2.3%) in the ETAI group. Conclusion:For patients with gastroesophageal variceal bleeding due to liver cirrhosis who are suitable for non-emergency endoscopic treatment, EVL of esophageal varices combined with EVIL of gastric varices is also safe, and more effective than EVL of esophageal varices combined with ETAI of gastric varices. This approach offers improved treatment success rate, reduced operation and hospitalization time, lower rebleeding rates, and decreased rebleeding-related mortality.