Heart rate variability time and frequency indices are widely used in functional assessment for autonomic nervous system (ANS). However, this method merely analyzes the effect of cardiac dynamics, overlooking the effect of cardio-pulmonary interplays. Given this, the present study proposes a novel cardiopulmonary coupling (CPC) algorithm based on cross-wavelet transform to quantify cardio-pulmonary interactions, and establish an assessment system for ANS aging effects using wearable electrocardiogram (ECG) and respiratory monitoring devices. To validate the superiority of the proposed method under nonstationary and low signal-to-noise ratio conditions, simulations were first conducted to demonstrate the performance strength of the proposed method to the traditional one. Next, the proposed CPC algorithm was applied to analyze cardiac and respiratory data from both elderly and young populations, revealing that young populations exhibited significantly stronger couplings in the high-frequency band compared with their elderly counterparts. Finally, a CPC assessment system was constructed by integrating wearable devices, and additional recordings from both elderly and young populations were collected by using the system, completing the validation and application of the aging effect assessment algorithm and the wearable system. In conclusion, this study may offers methodological and system support for assessing the aging effects on the ANS.
Humans ; Autonomic Nervous System/physiology* ; Algorithms ; Aging/physiology* ; Electrocardiography/methods* ; Heart Rate/physiology* ; Wavelet Analysis ; Aged ; Signal Processing, Computer-Assisted ; Wearable Electronic Devices

Hepatic fibrosis is a key intermediate stage in the progression of various chronic liver diseases to liver cirrhosis and liver cancer. Traditional Chinese medicine （TCM） has a good effect in the treatment of hepatic fibrosis， but its mechanism of action remains unclear. This article introduces the pathological mechanisms of hepatic fibrosis， including etiology and pathogenesis based on TCM theory and related mechanisms in Western medicine （such as hepatic stellate cell ［HSC］ activation， hepatic fibrosis driven by metabolic reprogramming， and key signaling pathways in hepatic fibrosis）. On this basis， this article analyzes the core mechanisms of TCM in the treatment of hepatic fibrosis， including inhibiting HSC activation and proliferation， suppressing liver inflammation and modulating immunity， counteracting lipid peroxidation damage， regulating the synthesis and secretion of pro-fibrotic factors， maintaining the metabolic balance of extracellular matrix， regulating key signaling pathways， modulating gut microbiota， and inhibiting sinusoidal capillarization， in order to summarize the mechanism of action of TCM in the treatment of hepatic fibrosis and lay a foundation for better developing TCM-based therapeutics for hepatic fibrosis.

Objective:To establish a framework of entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology, standardize the training process, and provide an effective evaluation method.Methods:Based on literature review and discussions, a preliminary expert consultation questionnaire was developed. From July to November 2024, a modified Delphi method was adopted and relevant experts were invited to assess the importance, validity, and feasibility of each indicator using a 5-point Likert scale. The results were used to screen and refine the entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology.Results:In the two rounds of expert consultation, the valid questionnaire return rate reached 100.00%, with an expert judgment basis coefficient of 0.73 and a familiarity coefficient of 0.90. Based on expert feedback, the final framework retained 3 first-level indicators and 12 second-level indicators. Modifications included renaming "Anesthesia Management" to "Anesthetic Drug Management", swapping the order of "Intraoperative Emergency Management" and "Airway Management", and removing the indicator "Resuscitation Assessment".Conclusions:This study preliminarily developed a framework of entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology. The framework provides a simple and practical competency evaluation method for standardized training, which can enhance training quality and effectiveness.

Objective:To establish a framework of entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology, standardize the training process, and provide an effective evaluation method.Methods:Based on literature review and discussions, a preliminary expert consultation questionnaire was developed. From July to November 2024, a modified Delphi method was adopted and relevant experts were invited to assess the importance, validity, and feasibility of each indicator using a 5-point Likert scale. The results were used to screen and refine the entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology.Results:In the two rounds of expert consultation, the valid questionnaire return rate reached 100.00%, with an expert judgment basis coefficient of 0.73 and a familiarity coefficient of 0.90. Based on expert feedback, the final framework retained 3 first-level indicators and 12 second-level indicators. Modifications included renaming "Anesthesia Management" to "Anesthetic Drug Management", swapping the order of "Intraoperative Emergency Management" and "Airway Management", and removing the indicator "Resuscitation Assessment".Conclusions:This study preliminarily developed a framework of entrustable professional activity indicators for non-anesthesiology residents during rotation in the Department of Anesthesiology. The framework provides a simple and practical competency evaluation method for standardized training, which can enhance training quality and effectiveness.

Objective To investigate the effect of vascular endothelial function on restenosis after carotid artery stenting(CAS).Methods A total of 236 patients with carotid artery stenosis who received CAS in Jinhua People's Hospital from January 2019 to December 2022 were selected as study objects.According to whether in-stent restenosis(ISR)occurred during follow-up,they were divided into ISR group(n=41)and non-ISR group(n=195).Blood lipid indexes[low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)],vascular endothelial indexes[endothelin-1(ET-1),von Willebrand factor(vWF),vascular endothelial growth factor(VEGF),vascular cell adhesion molecule 1(VCAM-1),thromboxane B2(TXB2),endothelial nitric oxide synthase(eNOS),nitric oxide(NO)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)]and oxidative stress indexes[malondialdehyde(MDA),glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)]were collected and compared between two groups.Transcriptome sequencing was performed on peripheral blood of ISR group and non-ISR group.Multivariate Logistic regression was used to analyze the independent influencing factors of ISR after CAS.Results The levels of TC,TNF-α,CRP,IL-6,MDA,ET-1,vWF,TXB2 and VCAM-1 in ISR group were significantly higher than those in non-ISR group(P＜0.01),and the levels of HDL-C,SOD,GSH-Px,NO,eNOS and VEGF in ISR group were significantly lower than those in non-ISR group(P＜0.01).Transcriptome differential gene enrichment analysis showed that the signaling pathways such as inflammatory response activation,oxidative stress response,and endothelial cell dysfunction were significantly enhanced in ISR group.Multivariate Logistic regression analysis showed that TNF-α,IL-6,ET-1,vWF,VEGF,SOD,and GSH-Px were independent influencing factors for ISR after CAS(P＜0.05).Conclusion Inflammatory factors,oxidative stress indexes and vascular endothelial function jointly promoted the occurrence and development of ISR after CAS in patients with carotid artery stenosis.TNF-α,IL-6,ET-1,vWF,VEGF,SOD,GSH-Px were independent risk factors for ISR after CAS.

Depressive disorder ranks as a major bur-den of disease worldwide,yet the current antidepressant medications are limited by frequent non-responsiveness and significant side effects.The lateral septum(LS)is thought to control of depression,however,the cellular and circuit substrates are largely unknown.Here,we identified a subpopulation of LS GABAergic adenosine A2A receptors(A2AR)-positive neurons mediating depres-sive symptoms via direct projects to the lateral habenula(LHb)and the dorsomedial hypothalamus(DMH).Activa-tion of A2AR in the LS augmented the spiking frequency of A2AR-positive neurons leading to a decreased activation of surrounding neurons and the bi-directional manipula-tion of LS-A2AR activity demonstrated that LS-A2ARs are necessary and sufficient to trigger depressive pheno-types.Thus,the optogenetic modulation(stimulation or inhibition)of LS-A2AR-positive neuronal activity or LS-A2AR-positive neurons projection terminals to the LHb or DMH,phenocopied depressive behaviors.Moreover,A2AR are upregulated in the LS in two male mouse mod-els of repeated stress-induced depression.This identifica-tion that aberrantly increased A2AR signaling in the LS is a critical upstream regulator of repeated stress-induced depressive-like behaviors provides a neurophysiological and circuit-based justification of the antidepressant poten-tial of A2AR antagonists,prompting their clinical transla-tion.

Objective:To explore the effect of progressive focusing-based interview combined with standardized stoma nursing in patients with enterostomy.Methods:From June 2019 to June 2021, 150 patients with enterostomy admitted to Lishui Central Hospital were selected by convenience sampling method as the research objects. According to the random number table method, the patients were divided into the control group and the observation group, 75 cases in each group. The control group was given routine psychological nursing combined with standardized stoma nursing, and the observation group was implemented with progressive focusing-based interview combined with standardized stoma nursing, and the intervention period was two months. The stigma, disease coping style and quality of life of the two groups of patients before and after nursing were compared.Results:After two months of nursing, the scores of each dimension of the Social Impact Scale in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The confrontation dimension score of the Medical Coping Modes Questionnaire (MCMQ) in the observation group were higher than those in the control group, and the avoidance and resignation dimension scores were lower than those in the control group, with statistical differences ( P<0.05) . The scores of each dimension of the Stoma Quality of Life in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Progressive focusing-based interview combined with standardized stoma nursing can reduce disease stigma in patients with enterostomy, improve their coping styles and quality of life.

Objective:To analyze the application effect of "Internet+" early grading follow-up management mode after enterostomy for colorectal neoplasms.Methods:The 186 patients who underwent enterostomy for colorectal neoplasms in Lishui Central Hospital were selected as the research objects. The patients enrolled from January 2019 to February 2020 served as the control group, and the patients enrolled from March 2020 to April 2021 served as the observation group, with 93 patients in each group. Routine follow-up measures were taken in the control group, while "Internet+" was used in the observation group for early grading follow-up management of patients with enterostomy for colorectal neoplasms. The timely follow-up feedback, score of skin condition around stoma, incidence of stoma complications and nursing satisfaction during follow-up were compared between the two groups.Results:The two-day non feedback rate in the control group was 20.43% (19/93) and that in the observation group was 7.53% (7/93), the difference was statistically significant ( χ2 = 6.44, P<0.05) .The score of skin condition around stoma in the observation group was (2.53 ± 0.78) points 3 months after discharge, which was significantly better than that in the control group 4.02 ± 1.13, the difference was statistically significant ( t = 10.47, P<0.05). The incidence of stoma complications in the observation group was 9.68% (9/93) , which was lower than that in the control group 21.51% (20/93) , the difference was statistically significant ( χ2 = 4.94, P<0.05). The nursing satisfaction in the observation group was 98.92% (92/93) , which was significantly higher than that in the control group 91.40% (85/93) , the difference was statistically significant ( χ2 = 4.20, P<0.05). Conclusions:"Internet+" early grading follow-up management model can significantly improve the follow-up effect after enterostomy for colorectal neoplasms, improve the skin condition around stoma, reduce stoma complications and improve nursing satisfaction.

Clostridioides difficile is a key pathogen of antibiotic related diarrhea and hospital associated infection, causing several outbreaks in Europe and North Americans and resulting in severe disease burden. However, the standardized diagnostic principle and detection specifications in C. difficile infection (CDI) survey are limited in China, and the infection rate and disease burden of CDI in China are unclear. Therefore, National Institute for Communicable Disease Control and Prevention,National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, together with another 11 institutions, draft the group standard entitled "Diagnosis of Clostridium difficile infection (T/CPMA 008-2020)" of Chinese Preventive Medicine Association. Based on the principle of "legality, scientificity, advancement, and feasibility", this standard clarifies risk factors, diagnosis principles, diagnoses and differential diagnoses in order to improve the accuracy of CDI diagnosis in clinical practice, guide the surveillance for CDI, and understand the infection rate and disease burden of CDI in China .

cFos is one of the most widely-studied genes in the field of neuroscience. Currently, there is no systematic database focusing on cFos in neuroscience. We developed a curated database-cFos-ANAB-a cFos-based web tool for exploring activated neurons and associated behaviors in rats and mice, comprising 398 brain nuclei and sub-nuclei, and five associated behaviors: pain, fear, feeding, aggression, and sexual behavior. Direct relationships among behaviors and nuclei (even cell types) under specific stimulating conditions were constructed based on cFos expression profiles extracted from original publications. Moreover, overlapping nuclei and sub-nuclei with potentially complex functions among different associated behaviors were emphasized, leading to results serving as important clues to the development of valid hypotheses for exploring as yet unknown circuits. Using the analysis function of cFos-ANAB, multi-layered pictures of networks and their relationships can quickly be explored depending on users' purposes. These features provide a useful tool and good reference for early exploration in neuroscience. The cFos-ANAB database is available at www.cfos-db.net .
Animals ; Fear ; Mice ; Neurons ; Proto-Oncogene Proteins c-fos ; Rats