Objective To explore the optimal warning threshold of motor evoked potentials(MEP)in decompression surgery for ossification of the posterior longitudinal ligament(OPLL)at cervical and thoracic segments,and the predictive role of different MEP parameters on postoperative lower extremity motor function.Methods A retrospective analysis was conducted on the clinical data of 227 patients diagnosed with cervical or thoracic OPLL and underwent decompression surgery from January 2022 to January 2024 in the hospital.There were 131 males and 96 females,with an average age of(60±10)years.All patients underwent continuous neuro-physiological monitoring during the operation,and the minimum ratio of MEP amplitude change to the baseline at the beginning of the operation(Dmax)and the ratio of MEP terminal amplitude change to the baseline at the end of the operation(Dend)were recorded.The correlations between these two ratios and the lower extremity motor func-tion immediately after the operation and at 1 year were compared.According to the Medical Research Council muscle strength score(MRC)standard,a postoperative score increase of≥1 point compared to preoperative was defined as postoperative motor dysfunction.Pearson correlation coefficients were used to evaluate the correlations between Dmax and Dend and the lower extremity motor function immediately after the operation and at 1 year.Receiver operating characteristic(ROC)curves were drawn to predict postoperative lower extremity motor dysfunc-tion using Dmax and Dend.Results Among the 227 patients,186 had cervical OPLL and 41 had thoracic OPLL.The incidence of lower extremity motor dysfunction immediately after the operation and at 1 year was 7 cases(3.76%)and 2 cases(1.08%)in the cervical group,and 9 cases(21.95%)and 3 cases(7.32%)in the thoracic group,respectively.The incidence of lower extremity motor dysfunction in the thoracic group was higher than that in the cervical group(P<0.001).The baseline induction rate of bilateral lower extremity MEPs was 98.92%(368/372)in the cervical group and 96.34%(79/82)in the thoracic group.The Pearson correlation coefficients of Dend with the bilateral lower extremity motor function immediately after the operation in the cervical and thoracic groups were both greater than those of Dmax,and the differences were statistically significant(cervical group:r=0.669,0.517,P=0.001 2;thoracic group:r=0.882,0.727,P=0.003 6),while the differences in the Pearson corre-lation coefficients of Dend and Dmax with the bilateral lower extremity motor function at 1 year were not statistically significant(cervical group:r=0.457,0.352,P=0.088;thoracic group:r=0.760,0.625,P=0.098).The cut-off values of Dend for the cervical group were 0.853 immediately after the operation and at 1 year,and the cut-off values of Dmax were 0.881 and 0.978,respectively.For the thoracic group,the cut-off values of Dend were 0.532 immediately after the operation and 0.639 at 1 year,and the cut-off values of Dmax were 0.532 and 0.640,respec-tively.Conclusions In OPLL surgery,the MEP monitoring strategy should be adjusted according to the surgical segment.For the cervical segment,Dmax should be emphasized to balance high sensitivity and specificity,while for the thoracic segment,Dmax or Dend can be flexibly selected.Higher MEP warning thresholds are required for cervical OPLL surgery(Dmax:0.881 immediately after the operation and 0.978 at 1 year;Dend:0.853),while significantly lower thresholds are needed for thoracic OPLL(Dmax/Dend:0.532 immediately after the operation and 0.640 at 1 year).

Objective We aimed to evaluate the efficacy and safety of Shengxuebao Mixture in the treatment of cancer-related anemia(CRA)presenting with syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood.Methods A randomized,double-blind,placebo-controlled,multicenter clinical trial was conducted.Eligible patients with malignant tumors meeting the inclusion and exclusion criteria were enrolled from 26 hospitals,including Dongzhimen Hospital,Beijing University of Chinese Medicine,Xiaogan Central Hospital,and Yangzhou Hospital of Traditional Chinese Medicine,from June 1,2022,to September 30,2024.Patients were allocated 1:1 to either the experimental group receiving Shengxuebao Mixture or the control group receiving its simulator(placebo)using a block randomization method under double-blind conditions.Both groups received 15 mL orally three times daily for 28 consecutive days.The primary efficacy indicators included the hemoglobin(Hb)improvement rate(RHb)and the traditional Chinese medicine(TCM)syndrome improvement rate(RTCM)at week 4 of treatment.The secondary efficacy indicators encompassed Hb and red blood cell(RBC)count,Karnofsky Performance Status(KPS)score,TCM syndrome score,individual TCM symptom scores,and changes in each of these indicators compared to the baseline period at weeks 2,4,and 6 of treatment.Safety evaluations were conducted at week 4 of treatment.Results A total of 239 patients were enrolled,with 225 cases included in the Full Analysis Set(FAS)(109 in the experimental group vs.116 control group),163 in the Per Protocol Set(PPS)(77 vs.86),and 225 in the Safety Set(SS)(109 vs.116).Baseline characteristics between groups showed no significant differences.Significant differences were observed between the experimental and control groups in RHb at week 4(FAS:49.51%vs.35.24%,P<0.05;PPS:53.25%vs.36.05%,P<0.05)and RTCM at week 4(FAS:61.54%vs.39.62%,P<0.01;PPS:64.94%vs.40.70%,P<0.01).At weeks 2,4,and 6,the experimental group showed greater improvements in Hb and RBC counts than the control group.Additionally,the TCM syndrome scores were lower in the experimental group than in the control group at these time points.Except for week 2 in PPS,the KPS improvement was better in the experimental group than in the control group(P<0.05).The experimental group also demonstrated a greater reduction in scores for individual TCM symptoms such as spiritlessness and weakness,poor appetite and reduced food intake at weeks 4 and 6 compared to the control group(P<0.05,P<0.01).Furthermore,the reduction in vertigo score was more pronounced in the experimental group at week 6(P<0.01).For the score of pale and lusterless complexion,only in the PPS was the reduction from baseline more significant in the experimental group than in the control group at weeks 4 and 6(P<0.05).No significant differences were observed between the experimental and control groups in the incidence of all adverse events or drug-related adverse reactions.Conclusion Shengxuebao Mixture demonstrates significant efficacy in patients with CRA presenting syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood,effectively increasing Hb levels,ameliorating TCM syndromes,alleviating clinical symptoms,and enhancing functional status,with no significant difference in adverse drug reactions compared to the placebo.

Objective:The relationship between benign prostatic hyperplasia(BPH)and the oxidative balance score(OBS)will be discussed in this study.Methods:The clinical data on 16 dimensions of diet and 4 dimensions of lifestyle from the National Health and Nutrition Examination Survey(NHANES)from 2001 to 2008 were used to calculate OBS.We considered BPH as the out-come and investigated the linear and nonlinear relationships between the two.Additionally,subgroup analyses and interaction tests were conducted as well.Furthermore,the methods of machine learning including XGBoost,support vector machine(SVM)and naive Bayes(NB)were used to establish a predictive model for BPH.Results:Higher OBS was consistently associated with an increased preva-lence of BPH,with Restricted Cubic Splines highlighting a significant positive nonlinear association(P=0.015).Subgroup analyses revealed differences and interactive relationships based on alcohol consumption.Among the seven machine learning models that we in-cluded the OBS score in,the XGBoost model emerged as the best,with an AUC value of 0.769.Conclusion:There is a significant association between OBS and the prevalence of BPH in the American population,which provides a valuable insight for further diagnosis and research of the disease.

Objective:To explore the intervention effect of virtual reality technology assisted early cardiac rehabilitation on exercise fear and self-efficacy after coronary artery bypass grafting (CABG), and provide theoretical basis for constructing intelligent and personalized cardiac rehabilitation models.Methods:A prospective non-contemporaneous controlled study was conducted. One hundred and two CABG patients admitted to the First Affiliated Hospital of the Chinese People's Liberation Army Naval Medical University were selected as the research subjects. They were divided into a control group (51 cases, from January to June 2024) and an experimental group (51 cases, from August to December 2024) according to their admission time, with July 2024 as the washout period. The control group received routine postoperative early cardiac rehabilitation intervention, while the experimental group received virtual reality technology intervention on the basis of the control group. The Tampa Scale of Kinesiophobia Heart (TSK-SV-Heart) and General Self-Efficacy Scale (GSES) were used to evaluate exercise fear and self-efficacy on the third day after surgery, one day before discharge, and one month after discharge, and the 6-minute walking distance was recorded at one day before discharge, and one month after discharge.Results:The control group consisted of 49 complete participants, aged (58.50 ± 5.88) years, with 26 males and 23 females, while the experimental group consisted of 48 complete participants, aged (60.31±6.58) years, with 30 males and 18 females. There was no statistically significant difference in the scores of exercise fear and self-efficacy between the two groups on the third day after surgery (both P>0.05). The exercise fear scores of the experimental group at one day before discharge and one month after discharge were (34.16 ± 5.76), (26.86 ± 4.52) points, respectively, which were lower than those of the control group (37.95 ± 6.14), (33.71 ± 5.49) points, and the differences were statistically significant ( t=3.13, 6.70, both P<0.05). The self-efficacy scores of the experimental group at one day before discharge and one month after discharge were (30.78 ± 3.49), (32.42 ± 3.37) points, respectively, which were higher than those of the control group (26.65 ± 4.21) , (26.54 ± 3.68) points, and the differences were statistically significant ( t=4.73, 8.25, both P<0.05). The 6-minute walking distance of the experimental group at one day before discharge and one month after discharge were (422.65 ± 74.32), (485.22 ± 76.84) m, respectively, which were longer than those of the control group (385.43 ± 68.17), (423.76 ± 62.75) m, and the differences were statistically significant ( t=2.57, 4.32, both P<0.05). Conclusions:Virtual reality technology can improve the fear of movement in patients after CABG surgery, enhance their self-efficacy, and simultaneously improve the 6-minute walking distance, providing a theoretical reference for the development of intelligent nursing measures after CABG surgery.

Objective:To explore the value of serum P-selectin,Interleukin-18(IL-18),and Homocysteine(Hcy)levels in predicting the adverse outcomes of interventional therapy in elderly patients with deep vein thrombosis(DVT)in the lower extremities.Methods:A total of 165 elderly patients with DVT from January 2020 to August 2023 were se-lected.All patients underwent transcatheter intervention thrombolysis therapy.Patients were divided into good outcome group and poor outcome group according to the clinical treatment outcome.Serum P-selectin,IL-18,and Hcy levels were compared between the two groups.The correlation between serum P-selectin,IL-18,and Hcy levels and disease indicators,as well as the outcomes of interventional therapy was analyzed.The predictive value of serum P-selectin,IL-18,and Hcy levels for the outcomes of interventional therapy was evaluated.Results:The total effective rate of catheter-based interventional thrombolysis in 165 patients was 81.82%(135/165).The patients with good outcomes were included in the good outcome group,and the patients with poor outcomes were included in the poor outcome group.The difference in circumference between the affected side and the healthy side of the thigh and the difference in circumference between the affected side and the healthy side of the calf in the poor outcome group were greater than those in the good outcome group(P<0.05).The levels of serum P-selectin,IL-18,and Hcy in the poor outcome group were higher than those in the good outcome group(P<0.05).The levels of serum P-selectin,IL-18,and Hcy were posi-tively correlated with the difference in circumference between the affected and healthy thighs and the difference in cir-cumference between the affected and healthy calves,and negatively correlated with the outcome of interventional therapy(P<0.05).Before and after correcting other factors,serum P-selectin,IL-18,and Hcy were all independent risk factors for the outcome of interventional therapy in elderly patients with DVT(P<0.05).The area under the curve(AUC)of serum P-selectin,IL-18,and Hcy for predicting the outcome of interventional therapy for elderly DVT was 0.789(95%CI:0.718-0.848),0.812(95%CI:0.744-0.868),and 0.792(95%CI:0.722-0.851),respectively.The cutoff values were 44.21 ng/mL,185.73 ng/L,and 23.60 μmol/L,with sensitivities of 70.00%,70.00%,and 80.00%,and specificities of 82.22%,82.96%,and 68.15%,respectively.The AUC of the combined prediction of the outcomes of interventional therapy for elderly DVT was 0.935(95%CI:0.886-0.967),with a cutoff value of 44.08 ng/mL,185.16 ng/L,and 23.37 μmol/L for the three variables,with a sensitivity of 86.67%and a specificity of 88.15%.This was significantly better than the individual prediction values of the three variables(Z=5.817,4.753,5.206,all P<0.001).Conclusion:Serum P-selectin,IL-18,and Hcy are significantly correlated with disease indicators and interventional treatment outcomes in el-derly patients with DVT,and can effectively predict the outcome of interventional treatment,with a high combined pre-dictive value.

Questionnaire survey and symposium were carried out on the implementation of GB 8369.1-2019 Transfusion sets for single use—Part 1:Gravity feed,and then analyses were performed on its implementation by relative enterprises,inspection and testing organizations and regulatory authorities,applicability,coordination and implementation constraints accordingly.Some suggestions were put forward,and it was of great significance for comprehensively grasping the overall situation,efficacy and problems of the standard implementation,promoting the updating and upgrading of the standard and facilitating the implementation of compulsory standards.[Chinese Medical Equipment Journal,2025,46(9):70-74]

Objective:To evaluate the clinical efficacy of Tianma Xionglin Zhixuan Tablets in treating hypertension patients with liver yang hyperactivity or comorbid phlegm-stasis syndrome and explore its therapeutic mechanisms through plasma metabolomics.Methods:Thirty-six hypertension patients(4 dropouts)diagnosed with liver yang hyperactivity or phlegm-stasis syndrome were enrolled as the treatment group from June 2022 to September 2023 at the First Affiliated Hospital of Hunan University of Chinese Medicine,while 30 healthy volunteers with balanced constitutions were recruited as the blank group.Plasma samples were collected from patients pre-and post-treatment and from healthy volunteers.Clinical outcomes,including syndrome scores,office blood pressure(BP),and 24-hour ambulatory BP,were recorded.Plasma metabolomic profiling was performed using liquid chromatography-mass spectrometry(LC-MS).Results:Compared with baseline,Tianma Xionglin Zhixuan Tablets significantly reduced traditional Chinese medicine syndrome scores(P＜0.01),office systolic/diastolic BP(P＜0.01),and 24-hour ambulatory BP parameters(24-hour mean BP,daytime/nighttime mean BP;all P＜0.01).Metabolomic analysis identified 45 differential metabolites between the blank group and pretreatment patients,and 64 metabolites altered post-treatment(VIP＞1,P＜0.05).Enrichment analysis of 16 overlapping endogenous metabolites revealed that Tianma Xionglin Zhixuan Tablets primarily modulated arachidonic acid metabolism and sphingolipid metabolism pathways.Conclusion:Tianma Xionglin Zhixuan Tablets demonstrates significant clinical efficacy in hypertension patients with liver yang hyperactivity or phlegm-stasis syndrome,potentially mediated through regulation of arachidonic acid and sphingolipid metabolism.

Aim To explore the in vitro anti-human triple-negative breast cancer(TNBC)effect and mech-anism of Austocystin R.Methods MTT assay was used to evaluate the anti-tumor potential of Austocystin R for various human tumor cells and normal cells.Flow cytometry was employed to evaluate the influence on cell cycle progression.mRFP-GFP-LC3 adenovirus transfection was used to evaluate the autophagic flux process.Western blot assay was used to verify the effect of Austocystin R on the expression of related pro-teins.Results The results showed that Austocystin R significantly inhibited the proliferation of multiple tumor cells in a dose-dependent manner,especially for the MDA-MB-231 cells with an IC50 of 1.45μmol·L-1.In addition,Austocystin R increased the protein expression of PTEN,p53,p-p53,p27,p21,and down-regulated the expression of p-PI3K,p-AKT and p-mTOR.Austocystin R can significantly increase the proportion of S-phase MDA-MB-231 cells,inhibit the expression of Cyclin D1,CDK4,CDK6,Rb,Cyclin B1 and CDK1,and promote the expression of Cyclin E1 and CDK2.Austocystin R can promote the autophagic flux process of MDA-MB-231 cells,promote the expres-sion of LC3 Ⅰ/Ⅱ,p-Beclin-1,p-ULK1,HMGB-1 and Atg 14 proteins,and inhibit the expression of Beclin-1,ULK1,p62,ATG 3,ATG 4B,ATG 5,ATG 7,ATG 12,ATG 13 and ATG 16L1 proteins.Conclusion Austo-cystin R can exhibit its anti-TNBC activity by inhibi-ting the PI3K/AKT/mTOR signaling pathway,blocking the cell cycle at the S phase and inducing autophagic cell death.

Objective We aimed to evaluate the efficacy and safety of Shengxuebao Mixture in the treatment of cancer-related anemia(CRA)presenting with syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood.Methods A randomized,double-blind,placebo-controlled,multicenter clinical trial was conducted.Eligible patients with malignant tumors meeting the inclusion and exclusion criteria were enrolled from 26 hospitals,including Dongzhimen Hospital,Beijing University of Chinese Medicine,Xiaogan Central Hospital,and Yangzhou Hospital of Traditional Chinese Medicine,from June 1,2022,to September 30,2024.Patients were allocated 1:1 to either the experimental group receiving Shengxuebao Mixture or the control group receiving its simulator(placebo)using a block randomization method under double-blind conditions.Both groups received 15 mL orally three times daily for 28 consecutive days.The primary efficacy indicators included the hemoglobin(Hb)improvement rate(RHb)and the traditional Chinese medicine(TCM)syndrome improvement rate(RTCM)at week 4 of treatment.The secondary efficacy indicators encompassed Hb and red blood cell(RBC)count,Karnofsky Performance Status(KPS)score,TCM syndrome score,individual TCM symptom scores,and changes in each of these indicators compared to the baseline period at weeks 2,4,and 6 of treatment.Safety evaluations were conducted at week 4 of treatment.Results A total of 239 patients were enrolled,with 225 cases included in the Full Analysis Set(FAS)(109 in the experimental group vs.116 control group),163 in the Per Protocol Set(PPS)(77 vs.86),and 225 in the Safety Set(SS)(109 vs.116).Baseline characteristics between groups showed no significant differences.Significant differences were observed between the experimental and control groups in RHb at week 4(FAS:49.51%vs.35.24%,P<0.05;PPS:53.25%vs.36.05%,P<0.05)and RTCM at week 4(FAS:61.54%vs.39.62%,P<0.01;PPS:64.94%vs.40.70%,P<0.01).At weeks 2,4,and 6,the experimental group showed greater improvements in Hb and RBC counts than the control group.Additionally,the TCM syndrome scores were lower in the experimental group than in the control group at these time points.Except for week 2 in PPS,the KPS improvement was better in the experimental group than in the control group(P<0.05).The experimental group also demonstrated a greater reduction in scores for individual TCM symptoms such as spiritlessness and weakness,poor appetite and reduced food intake at weeks 4 and 6 compared to the control group(P<0.05,P<0.01).Furthermore,the reduction in vertigo score was more pronounced in the experimental group at week 6(P<0.01).For the score of pale and lusterless complexion,only in the PPS was the reduction from baseline more significant in the experimental group than in the control group at weeks 4 and 6(P<0.05).No significant differences were observed between the experimental and control groups in the incidence of all adverse events or drug-related adverse reactions.Conclusion Shengxuebao Mixture demonstrates significant efficacy in patients with CRA presenting syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood,effectively increasing Hb levels,ameliorating TCM syndromes,alleviating clinical symptoms,and enhancing functional status,with no significant difference in adverse drug reactions compared to the placebo.

Objective To investigate and compare the epidemiological characteristics of common respiratory viruses among influenza-like illness(ILI)and severe acute respiratory infection(SARI)cases in Huzhou,Zhejiang Province before and after the COVID-19 pandemic,so as to provide a basis for formulating and adjusting the prevention and control strategies for viral respiratory infectious diseases.Methods ILI and SARI cases at two influenza surveillance sentinel hospitals in Huzhou and had throat swab samples collected during Nov 2017 to Feb 2020(pre-COVID-19 pandemic period)and Dec 2022 to Apr 2024(post-COVID-19 mitigation phase)were selected as the participants.Seven common viral respiratory pathogens were tested,including influenza A virus(H1N1 and H3N2 subtypes),influenza B virus(Victoria lineage,FluB),respiratory syncytial virus(RSV),rhinovirus(HRV),adenovirus(ADV),and severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).The positive rates of respiratory pathogens before and after the COVID-19 pandemic were compared across different age groups and different time.Results A total of 7 948 ILI samples and 2 294 SARI samples were included.The overall positive rate of ILI samples increased from 33.6%to 47.1%,primarily due to the increase in influenza and COVID-19 infections;the overall positive rate of SARI samples decreased from 31.4%to 24.8%,mainly due to the reduction in HRV and ADV infections.During the post-COVID-19 mitigation phase,SARS-CoV-2(22.1%),H3N2(12.7%),and FluB(6.0%)were the primary pathogens in ILI samples,while RSV(7.1%),H3N2(5.3%),and HRV(4.5%)dominated in SARI samples.During the post-COVID-19 mitigation phase,the influenza virus circulation period was shortened.Before the COVID-19 pandemic,RSV was mainly detected in autumn and winter,while during the post-COVID-19 mitigation phase,out-of-season RSV epidemics were observed in spring and summer.Co-infection rate in ILI cases increased significantly in the post-COVID-19 mitigation phase,predominantly consisting of co-infections of COVID-19 and influenza A virus,while co-infection rate in SARI cases showed a decline.Conclusion We found important epidemiological changes in respiratory viruses in Huzhou during the post-COVID-19 mitigation phase compared to pre-COVID-19 period,including increased positive rates of influenza and COVID-19,and disruptions to the seasonal patterns of influenza and RSV.The prevention and control strategies should be adjusted in a timely manner based on the monitoring data.