Objective To observe the effect of scalp acupuncture points including Shenting(GV24),Benshen(GB13)and Sishen-cong(EX-HN1)combined with computer-assisted training on memory impairment after stroke.Methods From May,2023 to December,2024,62 patients with post-stroke memory dysfunction who received rehabilita-tion treatment in Beijing Bo'ai Hospital were selected and divided into control group(n=31)and observation group(n=31)randomly.Both groups received conventional treatment and computer-assisted training,while the observation group received additional scalp acupuncture treatment,for four weeks.They were evaluated with Montreal Cognitive Assessment(MoCA),auditory memory span,and modified Barthel Index(MBI)before and after treatment.Results No adverse reaction occured during treatment.After treatment,the total score of MoCA and the memory dimen-sion score,and auditory memory span score improved in both groups(|t|>3.838,P<0.001),and the d-value was more in the observation group than in the control group(|t|>2.160,P<0.05);the score of MBI improved in both groups(|t|>7.471,P<0.001),however,there was no significant difference between two groups(P>0.05).Conclusion Computer-assisted training could significantly improve the cognitive function of patients with post-stroke memory dysfunction,especially the memory function,and is more effective while combining with scalp acupunc-ture.

Objective:To conduct a scoping review on the current status, assessment tools and influencing factors of malnutrition in elderly stroke patients, so as to provide new ideas for the development of individualized nutritional intervention programs.Methods:Studies related to malnutrition in elderly stroke patients were searched in China National Knowledge Infrastructure, VIP, WanFang Data, China Biology Medicine disc, PubMed, Web of Science, Embase and Clinical Trial Registration Center. The search period was from the establishment of the database to January 2024. Two researchers independently screened the literature, extracted information based on inclusion and exclusion criteria, and finally categorized and reported the findings.Results:A total of 33 papers were included. In elderly stroke patients, the prevalence of malnutrition varied between studies. There was a wide range of tools to assess the nutritional status of patients, but there was an overall lack of multidimensional and specific tools. Commonly used was the Short-form Mini-nutritional Assessment. Factors influencing malnutrition in patients included general demographic, disease-related and lifestyle factors, physiologic and biochemical indicators, functional correlates, nutrient literacy-related factors, psychological and supportive factors.Conclusions:Malnutrition in elderly stroke patients is influenced by a variety of factors and seriously affects patient prognosis. Standardized assessment tools should be adopted to detect timely and accurately, take targeted measures for each factor, and carry out personalized intervention programs to promote benign changes in the nutritional status of elderly stroke patients.

Objective:To investigate the feasibility of transcatheter edge-to-edge repair (TEER) using a short-clip strategy for patients with moderate-to-severe or greater degenerative mitral regurgitation caused by commissural prolapse.Methods:This retrospective study included patients with severe mitral regurgitation secondary to commissural prolapse who underwent TEER at the Second Affiliated Hospital of Zhejiang University School of Medicine between September 2022 and July 2024. Preoperative clinical and imaging data, intraoperative details, procedural outcomes, and 1-month postoperative follow-up results were collected.Results:A total of 19 patients were enrolled, aged (74.1±6.1) years, including 12 males. Among them, 10 patients had external commissural prolapse, and 9 patients had internal commissural prolapse. Preoperatively, all patients exhibited severe mitral regurgitation (4+), with an effective regurgitant orifice area of (0.55±0.17) cm2, left atrial volume of (104.77±36.57) ml, left ventricular end-diastolic volume of (102.29±32.47) ml, left ventricular end-diastolic dimension of (5.34±0.59) mm, and prolapse width of (1.18±0.34) cm. All procedures utilized short clips (NTR or NTW clips) to target the prolapsed commissural region and were completed successfully without intraoperative complications. At 1-month follow-up, no mortality, stroke, single-leaflet device attachment, myocardial infarction, or unplanned mitral reintervention occurred. Mitral regurgitation severity improved to ≤2+ in all patients, with left atrial volume of (74.49±33.83) ml, left ventricular end-diastolic volume of (85.90±18.05) ml, and left ventricular end-diastolic dimension of (4.93±0.37) mm (all P<0.05). Conclusion:The short-clip strategy, focusing on precise clip placement at the commissural interface, is feasible and effective for TEER in patients with severe mitral regurgitation due to commissural prolapse.

Objective:To investigate the effect of donor blood lipid levels and the degree of fat deposition on the pancreatic surface on the outcome of islet isolation.Method:A retrospective analysis was conducted on 171 cases of islet isolation data from organ donors between May 2015 and December 2024. According to the percentage of fat deposition area on the surface of the pancreatic capsule after trimming, the samples were divided into three groups: mild surface fat group (<30%, 60 cases) , moderate surface fat group (30%–70%, 55 cases) , and severe surface fat group (>70%, 56 cases). The modified Ricordi method was used to digest pancreatic tissue, and islets were purified by continuous density gradient centrifugation. The digestion efficiency, digestion time, islet yield (islet equivalent/quantity) , purity, score, and size were analyzed and compared among groups. One-way ANOVA was used for inter-group comparisons, and Pearson correlation analysis and multiple linear regression analysis were used to explore the relationship between blood lipid levels and islet isolation parameters.Result:The severe surface fat group had significantly higher pre-purification and post-purification islet equivalents, islet number, amount of digested pancreatic tissue, donor triglyceride levels, and low density lipoprotein (LDL) levels than the other groups (all P<0. 05) . Correlation analysis showed that LDL level was positively correlated with pre-purification islet equivalents (62 cases, r=0. 298, P=0. 019) and islet number (58 cases, r=0. 285, P=0. 030) . Donor high density lipoprotein (HDL) level was negatively correlated with post-purification islet equivalents (54 cases, r= – 0. 282, P=0. 039) ; donor triglyceride level was positively correlated with the amount of digested tissue (56 cases, r=0. 268, P=0. 046) and negatively correlated with purity (51 cases, r= - 0. 297, P=0. 035) ; donor very low density lipoprotein (VLDL) level was positively correlated with the amount of digested tissue (67 cases, r=0. 337, P=0. 005) and negatively correlated with purity (61 cases, r=- 0. 348 , P=0. 006) ; donor total cholesterol level was negatively correlated with pancreatic digestion efficiency (34 cases, r= - 0. 370, P=0. 032) , and the above differences were all statistically significant. Conclusion:Pancreata with heavier surface fat deposition can yield a higher number of islets. Meanwhile, donor blood lipid levels are correlated with islet isolation outcomes and can serve as important indicators for donor pancreas selection.

Objective:To explore the correlation between intestinal flora disturbance and the diagnosis,treatment of rheumatoid arthritis(RA),and to provide bioinformatics basis for further research on precise targeted intervention of RA.Methods:Genes related to intestinal flora disorders and RA genes were downloaded from disease database.Correlation between the two diseases was analyzed via bioinformatics approach.PPI network was conducted by STRING,Cytoscape and their plug-ins,and key genes were screened.Key genes were mapped into Coremine Medicinal to identify medicinal chemicals and medicinal herbs.Results:A total of 525 genes shared by intestinal flora disorders and RA were obtained through integrated screening of the disease database,and key genes with the highest degree of protein interaction were finally selected,namely IL-6,IL-1β,TNF-α,IL-10,STAT3,STAT1 and RELA.These related tar-geted genes were mainly involved in biological processes such as negative feedback regulation and antigen stimulation,and mediate molecular functions such as lipopolysaccharide receptor binding and NF-κB receptor binding,which are mainly concentrated in the plasma membrane region.KEGG analysis showed that these related genes were mainly involved in classical signaling pathways such as IL-17 pathway and Toll-like receptor pathway.Through drug prediction,it was found that Astragalus,Scutellaria,Schisandra and Cop-tis in traditional Chinese medicine might be potential drug sources for RA treatment.Conclusion:Bioinformatics method can predict key genes and signaling pathways of intestinal flora intervention in pathogenesis and progression of RA,and predict the Chinese herbs that may target the regulation of flora for treatment of risk factors,which providing a theoretical basis for further exploration of targeted treatment of RA.

Objective To achieve a preliminary understanding of the current situation of clinical laboratories in Guangdong Province,and discuss how to establish a sound investigation system,and utilize quality indicators to improve laboratory quality through the inves-tigation and analysis of data from 16 clinical laboratory quality indicators issued by the National Center for Clinical Laboratories.Meth-ods The questionnaire was issued by Clinet-EQA system and the basic information and quality indicator information during 2023 were collected.SPSS 20.0 software was used for statistical analysis according to different specialty categories and hospital grades.The 13 quality indicators measured in rate-based units were evaluated by sigma measurement.The P75,P50 and P25 percentiles of the overall distribution of each quality index were used to explore the optimal,appropriate and minimum quality specifications.Results A total of 577 laboratories participated in this survey.In addition to the implementation rate of internal quality assessment and the inter-laboratory comparison rate,the median sigma(σ)value of 11/13 quality indicators was greater than 3σ,and some of them even reach the level of 6σ,and there were disparities between hospital laboratories at different grades.The turnaround time(TAT)of the whole process of emergency examination was significantly less than those of inpatient and outpatient,TAT before emergency examination was controlled within 20 min,TAT before outpatient examination was within 30 min,and TAT before inpatient examination was within 42 min.The optimal quality specifications of 8 out of 13 indicators reached 6σ level,while the minimum quality specifications of 2 out of 13 indica-tors were lower than 3σ level.Conclusion In Guangdong Province,the overall level of quality indicators in the post-analytical of clin-ical laboratories was superior to that in the pre-analytical and analytical process.It should be essential to continuously monitor quality indicators and actively adopt improvement measures for those laboratories with unsatisfactory results,so as to enhance the examination quality of laboratories.

BACKGROUND:The imbalance between proliferation and apoptosis of chondrocytes plays an important role in the occurrence and development of osteoarthritis. Previous studies have found that hsa-miR-3202 is involved in regulating the proliferation and apoptosis of various cells. However,no studies have explored the correlation between hsa-miR-3202 and osteoarthritis.OBJECTIVE:To investigate the expression of hsa-miR-3202 in osteoarthritic chondrocytes and its effect on the proliferation and apoptosis of chondrocytes. METHODS:(1) MicroRNAs differentially expressed in osteoarthritic chondrocytes were screened by biogenic analysis. Based on the current research situation at home and abroad,hsa-miR-3202 was selected for follow-up studies,and its target genes were predicted by gene ontology (GO) functional enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. (2) Human normal chondrocyte cell lines C28/I2 in logarithmic growth phase were selected and randomly divided into four groups for culture:in normal group,cells were cultured in normal medium for 24 hours,the medium was then changed to normal medium for another 6 hours of culture,and changed to normal medium for subsequent culture;in lipopolysaccharide group,cells were cultured in lipopolysaccharide-containing medium for 24 hours,the medium was then changed to normal medium for another 6 hours,and changed to normal medium for subsequent culture;in lipopolysaccharide+NC group,cells were cultured in lipopolysaccharide-containing medium for 24 hours,and then transfected with has-miR-3202 mimics control for 6 hours,and the medium was change to normal medium for subsequent culture;in lipopolysaccharide+hsa-miR-3202 mimics group,cells were cultured in lipopolysaccharide-containing medium for 24 hours and then transfected with has-miR-3202 mimics for 6 hours,and the medium was changed to normal medium for subsequent culture. After further 48 hours of culture,the expression level of hsa-miR-3202 was detected by fluorescence quantitative PCR and cell apoptosis was detected by flow cytometry. After further culture of 0-72 hours,cell proliferation activity was detected by cell counting kit-8. RESULTS AND CONCLUSION:Bioinformatics analysis results indicated that hsa-miR-3202 was significantly down-regulated in osteoarthritic chondrocytes. GO functional enrichment and KEGG pathway enrichment showed that the function of hsa-miR-3202 target gene was closely related to cell growth and apoptosis. The results of in vitro cell experiments showed that compared with the normal group,the expression level of hsa-miR-3202 and proliferation ability of chondrocytes were significantly decreased in the lipopolysaccharide group (P<0.05),while the apoptotic rate was significantly increased (P<0.05). Compared with the lipopolysaccharide group,the expression level of hsa-miR-3202 and proliferation ability of chondrocytes were significantly increased in the lipopolysaccharide+hsa-miR-3202 mimics group (P<0.05),while the apoptotic rate was significantly decreased (P<0.05). To conclude,the expression of hsa-miR-3202 is down-regulated in osteoarthritic chondrocytes to inhibit cell proliferation and promote cell apoptosis,thus affecting the occurrence and development of osteoarthritis.

Objective To observe the effect of scalp acupuncture points including Shenting(GV24),Benshen(GB13)and Sishen-cong(EX-HN1)combined with computer-assisted training on memory impairment after stroke.Methods From May,2023 to December,2024,62 patients with post-stroke memory dysfunction who received rehabilita-tion treatment in Beijing Bo'ai Hospital were selected and divided into control group(n=31)and observation group(n=31)randomly.Both groups received conventional treatment and computer-assisted training,while the observation group received additional scalp acupuncture treatment,for four weeks.They were evaluated with Montreal Cognitive Assessment(MoCA),auditory memory span,and modified Barthel Index(MBI)before and after treatment.Results No adverse reaction occured during treatment.After treatment,the total score of MoCA and the memory dimen-sion score,and auditory memory span score improved in both groups(|t|>3.838,P<0.001),and the d-value was more in the observation group than in the control group(|t|>2.160,P<0.05);the score of MBI improved in both groups(|t|>7.471,P<0.001),however,there was no significant difference between two groups(P>0.05).Conclusion Computer-assisted training could significantly improve the cognitive function of patients with post-stroke memory dysfunction,especially the memory function,and is more effective while combining with scalp acupunc-ture.

Objective:To explore the clinical application value of magnetic resonance imaging (MRI)-guided wire localization to the non-palpable breast lesions (NPBL) identified on MRI only.Methods:A retrospective case series study was conducted. A total of 171 patients with NPBL identified on MRI only who underwent MRI-guided wire localization from April 2017 to May 2024 in Shaanxi Provincial Cancer Hospital were collected. All patients had breast MRI Breast Imaging Report and Data System (BI-RADS) 4a and above lesions, and underwent MRI-guided wire localization within the same menstrual cycle within 2 days to 2 months after diagnostic MRI examination. Based on postoperative pathological results, the MRI characteristics of benign and malignant lesions were compared, and the clinical application value of MRI-guided wire localization was evaluated.Results:There were 179 lesions in 171 patients, including 54 malignant lesions (30.17%) and 125 benign lesions (69.83%). There was no statistically significant difference in the enhancement morphology between pathological benign and malignant NPBL lesions ( χ2 = 0.04, P = 0.982), while there were statistically significant differences in breast background parenchymal enhancement, lesion time-signal intensity curve and BI-RADS classification ( χ2 values were 32.03, 20.72 and 37.60, respectively, all P < 0.05). Conclusions:For NPBL that is identified on MRI only and evaluated as BI-RDADS 4a or above, MRI-guided wire localization can improve the accuracy of diagnosis and treatment of intraductal carcinoma, early invasive cancer and high-risk lesions.

BACKGROUND:Related studies have shown that bone density,postoperative infection,adjacent vertebral fracture,and lumbar fascial edema may be risk factors for lingering pain after vertebroplasty.OBJECTIVE:To scrutinize the risk factors for lumbar fascia edema in osteoporotic vertebral compression fractures patients and investigate its influence on lingering pain after vertebroplasty.METHODS:A retrospective analysis was conducted on 204 osteoporotic vertebral compression fractures patients who underwent percutaneous vertebroplasty at the Clinical Medical College of Yangzhou University from February to October 2022.Patients were categorized based on MRI findings into two groups:without lumbar fascia edema(84 cases)and with lumbar fascia edema(120 cases).Preoperative data,encompassing age,gender,height,weight,body mass index,bone density,serum total protein,serum albumin,inflammatory markers(C-reactive protein and erythrocyte sedimentation rate),degree of fracture compression,presence of prior compression fractures,fracture count,lumbar instability,and Japanese senile independence score were gathered.Postoperative follow-up recorded data such as the number of new vertebral fractures and visual analog scale scores were recorded.Logistic regression method was used to analyze the risk factors of lumbar fascial edema,and the receiver operating characteristic curve was used to determine whether the risk factors had relevant diagnostic significance.RESULTS AND CONCLUSION:(1)Age,prior vertebral compression fractures,Japanese senile independence score score,and lumbar instability presence emerged as autonomous risk factors for lumbar fascia edema in osteoporotic vertebral compression fractures patients,with corresponding odds ratios of 2.76,1.70,2.56,and 4.74,respectively.(2)Employing a visual analog scale score of 4 at 1 month postoperatively to distinguish residual pain revealed 31 cases with residual pain in the lumbar fascia edema group,in contrast to only 8 cases in the non-fascia edema group(P＜0.01).(3)The fascia edema group exhibited a significantly higher visual analog scale score at 1 month postoperatively(2.12±1.35)compared to the group without fascia edema(1.67±1.08)(P＜0.01).(4)It is indicated that age,Japanese senile independence score,prior compression fractures,and lumbar instability presence independently contribute to lumbar fascia edema in osteoporotic vertebral compression fractures patients.Lumbar fascia edema emerges as a determinant of persistent pain in the lumbar region following percutaneous vertebroplasty in these patients.