Objective:To compare the effect of transcranial magnetic stimulation (rTMS) of the contralesional hemisphere at different frequencies on the recovery of upper limb motor function after a moderate-to-severe ischemic stroke.Methods:The inter-hemisphere compensation model was applied along with electroencephalogram (EEG) power spectrum density measurements. Thirty stroke survivors were randomly assigned to a sham stimulation group ( n=9), a high-frequency stimulation group ( n=11) or a low-frequency stimulation group ( n=10). In addition to physical and pharmacological therapy, the low-frequency and high-frequency groups received 1Hz or 5Hz rTMS, while the sham group received sham stimulation. The rTMS was delivered over the contralesional (unaffected) hemisphere once daily for 20 minutes over 15 consecutive days. Before, as well as 7 and 15 days after the treatment, all of the subjects′ motor functioning was assessed using the Fugl-Meyer Assessment for the upper extremity (FMA-UE) and their ability in the activities of daily living was assessed using the modified Barthel Index (MBI). Resting-state EEGs with the eyes closed were also recorded, and absolute alpha power across the whole brain was calculated. Changes from baseline FMA-UE and MBI scores and absolute alpha power were analyzed using one-way and repeated-measures analysis of variance. Results:After the treatment, significant within-group improvements from baseline were observed in the FMA-UE scores, MBIs and absolute alpha power, except for absolute alpha power in the low-frequency and sham groups. The repeated-measures analysis of variance revealed significant time × group interactions for FMA-UE ( F=9.926, P≤0.001), MBI ( F=8.789, P≤0.001) and absolute alpha power ( F=4.511, P≤0.05). So the treatment effects varied among the groups. Post hoc Bonferroni-corrected comparisons showed that the high-frequency group exhibited significantly greater improvements from baseline in terms of all three indicators compared with the other two groups. Conclusions:High-frequency (5Hz) rTMS applied to the contralesional hemisphere produced greater improvement than low-frequency (1Hz) stimulation in the upper limb motor function of patients with moderate-to-severe stroke. These findings support the use of the interhemispheric compensation model to guide rTMS therapy, particularly for patients with FMA-UE scores below 43.

Objective:To conduct a Meta-analysis for domestically and internationally relative literature on management for medical consumables during 2014 to 2024 through CiteSpace 6.3.1 R1 scientific knowledge mapping software,so as to provide reference for medical institutions in managing medical consumables.Methods:Keywords included"consumables management"and"medical supplies management"were searched in the China National Knowledge Infrastructure(CNKI)and Web of Science(WOS)databases.CiteSpace software was employed to conduct keyword co-occurrence analysis,time-zone visualization analysis,cluster analysis,and burst detection analysis.Results:In the 684 articles meeting the inclusion criteria,the United States and China were the two countries with the largest number of publications,contributing 68 articles and 376 articles,respectively.In CNKI database,"High-value consumables"had the highest number of publications in cluster literatures(33 articles,silhouette value=0.91),which indicated a strong research focus in the field of management for high-value medical consumables.In the international database,both of the"da Vinci Si"(31 articles,silhouette value=0.982)and"sustainability"(22 articles,silhouette value=0.981)had significant research hotspots,which reflected global attention on technological innovation and sustainability in management for consumables.Conclusion:The main research hotspots and development trends in the field of medical supplies management,both domestically and internationally,concentrate on the informatization and whole-process supervision of high-value medical supplies,technological management innovation for supplies related to robotic surgery,as well as the sustainability and environmentally friendly development of medical supply management systems.Future research should further integrate intelligent technologies,advance the practice of whole-life cycle management,and strengthen its application and validation in clinical effectiveness,so as to enhance the efficiency and quality of healthcare services.

Objective:To explore patterns of traditional Chinese medicine (TCM) use among patients with inflammatory bowel disease (IBD) in Jiangsu Province, China from 2019 to 2023.Methods:Using data from the IBD health data platform of the National Healthcare Big Data (Eastern) Center, a retrospective cohort study was conducted. We performed descriptive analyses on hospitalised patients diagnosed with IBD between 2019 and 2023, who received TCM treatment.Results:The study included 11 095 case records from 4 760 patients, with TCM diagnoses primarily indicating diarrhoea and abdominal pain. Ulcerative colitis (UC) accounted for 4 782 hospitalizations (3 103 patients), while Crohn's disease (CD) accounted for 6 313 hospitalizations (1 657 patients). Patient demographics showed a trend towards younger age and a higher proportion of males. Treatment utilisation was highest in southern Jiangsu compared with the central and northern regions. In terms of disease burden, all treatment costs showed a downward trend. In terms of external TCM therapies, UC patients tend to prefer plasters and enemas, while CD patients are more inclined to use acupuncture. Regarding herbal medicine, licorice, white atractylodes, and white peony root are commonly used single herbs for IBD patients.Conclusions:The number of IBD patients treated with TCM in Jiangsu Province has steadily increased from 2019 to 2023. It is important to identify effective TCM treatment methods to reduce the burden of patients.

ObjectiveTo analyze the impact of diabetes-related deaths on the probability of premature mortality and life expectancy in Minhang District of Shanghai from 2004 to 2023, and to provide reference data for the optimization of targeted prevention and control strategies. MethodsAll death cases involving diabetes among the registered residents of Minhang District from 2004 to 2023 were collected. The probability of premature mortality and life expectancy was computed using the abridged life table method. The average annual percent change (AAPC) was calculated with Joinpoint 4.9.0.0. The Arriaga decomposition method was employed for statistical analyses of the influence of cause-specific and age-specific mortality related to diabetes on life expectancy. ResultsThe total number of diabetes-related mortality, crude mortality, and standardized mortality for both males and females in Minhang District from 2004 to 2023 exhibited an increasing trend (P<0.001). The primary causes of death among diabetes-related cases were cardiovascular disease (37.68%), diabetes mellitus (31.95%), and malignant tumor (17.80%). From 2004 to 2023, probability of premature mortality to diabetes-related diseases demonstrated a rising trend (P<0.001), contrasting with the declining trend observed in the overall population (P=0.001). Males showed a significant upward trajectory (P<0.001), while females displayed a stable pattern. Among the diseases exerting considerable influence, cardiovascular disease and malignant tumor revealed a marked increase over time (P<0.001), whereas diabetes mellitus maintained a stable trend; both factors negatively impacted the reduction in probability of premature mortality. From 2004 to 2023, diabetes-related mortality reduced life expectancy among residents by an average of 1.22 years (-49.89%), indicating a negative impact; the reduction was 1.41 years in males and 0.90 years in females. The age groups exhibiting greater negative contributions differed by genders, namely males aged 50‒54 years and females aged 70‒74 years. Cardiovascular disease, diabetes mellitus, and malignant tumor contributed significantly to this decline (-0.46 years, -0.42 years, -0.20 years, respectively), with male experiencing higher negative contributions than females. ConclusionIn Minhang District, the rising mortality associated with diabetes-related diseases negatively impact both the reduction of the probability of premature mortality and the increase in life expectancy. This trend is primarily attributed to the rapid escalation of mortality and younger age demographic of male residents, which warrants significant attention. It is recommended that, based on the enhancement of case management, efforts should be directed towards the targeted prevention and control of risk factors and high-risk populations.

Objective:To explore patterns of traditional Chinese medicine (TCM) use among patients with inflammatory bowel disease (IBD) in Jiangsu Province, China from 2019 to 2023.Methods:Using data from the IBD health data platform of the National Healthcare Big Data (Eastern) Center, a retrospective cohort study was conducted. We performed descriptive analyses on hospitalised patients diagnosed with IBD between 2019 and 2023, who received TCM treatment.Results:The study included 11 095 case records from 4 760 patients, with TCM diagnoses primarily indicating diarrhoea and abdominal pain. Ulcerative colitis (UC) accounted for 4 782 hospitalizations (3 103 patients), while Crohn's disease (CD) accounted for 6 313 hospitalizations (1 657 patients). Patient demographics showed a trend towards younger age and a higher proportion of males. Treatment utilisation was highest in southern Jiangsu compared with the central and northern regions. In terms of disease burden, all treatment costs showed a downward trend. In terms of external TCM therapies, UC patients tend to prefer plasters and enemas, while CD patients are more inclined to use acupuncture. Regarding herbal medicine, licorice, white atractylodes, and white peony root are commonly used single herbs for IBD patients.Conclusions:The number of IBD patients treated with TCM in Jiangsu Province has steadily increased from 2019 to 2023. It is important to identify effective TCM treatment methods to reduce the burden of patients.

Objective:To compare the effect of transcranial magnetic stimulation (rTMS) of the contralesional hemisphere at different frequencies on the recovery of upper limb motor function after a moderate-to-severe ischemic stroke.Methods:The inter-hemisphere compensation model was applied along with electroencephalogram (EEG) power spectrum density measurements. Thirty stroke survivors were randomly assigned to a sham stimulation group ( n=9), a high-frequency stimulation group ( n=11) or a low-frequency stimulation group ( n=10). In addition to physical and pharmacological therapy, the low-frequency and high-frequency groups received 1Hz or 5Hz rTMS, while the sham group received sham stimulation. The rTMS was delivered over the contralesional (unaffected) hemisphere once daily for 20 minutes over 15 consecutive days. Before, as well as 7 and 15 days after the treatment, all of the subjects′ motor functioning was assessed using the Fugl-Meyer Assessment for the upper extremity (FMA-UE) and their ability in the activities of daily living was assessed using the modified Barthel Index (MBI). Resting-state EEGs with the eyes closed were also recorded, and absolute alpha power across the whole brain was calculated. Changes from baseline FMA-UE and MBI scores and absolute alpha power were analyzed using one-way and repeated-measures analysis of variance. Results:After the treatment, significant within-group improvements from baseline were observed in the FMA-UE scores, MBIs and absolute alpha power, except for absolute alpha power in the low-frequency and sham groups. The repeated-measures analysis of variance revealed significant time × group interactions for FMA-UE ( F=9.926, P≤0.001), MBI ( F=8.789, P≤0.001) and absolute alpha power ( F=4.511, P≤0.05). So the treatment effects varied among the groups. Post hoc Bonferroni-corrected comparisons showed that the high-frequency group exhibited significantly greater improvements from baseline in terms of all three indicators compared with the other two groups. Conclusions:High-frequency (5Hz) rTMS applied to the contralesional hemisphere produced greater improvement than low-frequency (1Hz) stimulation in the upper limb motor function of patients with moderate-to-severe stroke. These findings support the use of the interhemispheric compensation model to guide rTMS therapy, particularly for patients with FMA-UE scores below 43.

Objective:To conduct a Meta-analysis for domestically and internationally relative literature on management for medical consumables during 2014 to 2024 through CiteSpace 6.3.1 R1 scientific knowledge mapping software,so as to provide reference for medical institutions in managing medical consumables.Methods:Keywords included"consumables management"and"medical supplies management"were searched in the China National Knowledge Infrastructure(CNKI)and Web of Science(WOS)databases.CiteSpace software was employed to conduct keyword co-occurrence analysis,time-zone visualization analysis,cluster analysis,and burst detection analysis.Results:In the 684 articles meeting the inclusion criteria,the United States and China were the two countries with the largest number of publications,contributing 68 articles and 376 articles,respectively.In CNKI database,"High-value consumables"had the highest number of publications in cluster literatures(33 articles,silhouette value=0.91),which indicated a strong research focus in the field of management for high-value medical consumables.In the international database,both of the"da Vinci Si"(31 articles,silhouette value=0.982)and"sustainability"(22 articles,silhouette value=0.981)had significant research hotspots,which reflected global attention on technological innovation and sustainability in management for consumables.Conclusion:The main research hotspots and development trends in the field of medical supplies management,both domestically and internationally,concentrate on the informatization and whole-process supervision of high-value medical supplies,technological management innovation for supplies related to robotic surgery,as well as the sustainability and environmentally friendly development of medical supply management systems.Future research should further integrate intelligent technologies,advance the practice of whole-life cycle management,and strengthen its application and validation in clinical effectiveness,so as to enhance the efficiency and quality of healthcare services.

Objective:To design and develop a molecular imaging probe of 68Ga-labeled bombesin (BBN) analogue, 68Ga-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid (DOTA)-polyethylene glycol (PEG) 4-BBN, and investigate its potential to target prostate cancer with high expression of gastrin-releasing peptide receptor (GRPR) while minimizing uptake in pancreatic tissue. Methods:Based on the amino acid sequence of BBN peptides, the precursor DOTA-PEG 4-BBN was designed and prepared, followed by labeling with 68Ga and conducting to quality control analysis. The tumor uptake of 68Ga-DOTA-PEG 4-BBN was assessed by microPET/CT imaging on tumor-bearing nude mice models with PC3 of high GRPR expression or HT29 of low GRPR expression (3 mice per group). 68Ga-DOTA-PEG 4-BBN microPET/CT imaging was also performed on 6 tumor-bearing nude mice models with PC3, among which 3 mice were treated with gastrin-releasing peptide antagonist 1 h prior to injection of the tracer (blocked group). After imaging, the ex vivo tissues of 3 PC3 tumor-bearing nude mice of the non-blocked group were examined for radioactivity counting to evaluation the biodistribution of 68Ga-DOTA-PEG 4-BBN, and the percentage injected dose per gram of tissue (%ID/g) was calculated. Independent-sample t test was used for data analysis. Results:The synthesis of 68Ga-DOTA-PEG 4-BBN took 40 min, with the radiochemical yield of 50%-60% (no decay correction) and the radiochemical purity of over 95%. After incubation in the serum at 37 ℃ for 4 h, the radiochemical purity remained more than 95%. The microPET/CT imaging results indicated that the uptake in the PC3 tumor was 3.2 times higher than the uptake in the tumor after GRPR blockade ((1.34±0.24) vs (0.42±0.03) %ID/g; t=5.47, P=0.005). After the injection of 68Ga-DOTA-PEG 4-BBN at 1 h and following imaging for 15 min, the PC3 tumor-bearing nude mice models of the non-blocked group showed that the pancreatic uptake ((0.150±0.058) %ID/g) was significantly lower than that in kidneys, lungs and liver ((9.452±0.234), (0.720±0.041), (1.572±0.213) %ID/g) with a profound statistical distinction ( t values: 11.28-53.02, all P<0.001). The tumor/pancreas uptake ratio could reach 16.92 in the tumor-bearing nude mice models with high GRPR expression. Conclusion:A novel molecular imaging probe 68Ga-DOTA-PEG 4-BBN demonstrates specific recognition of tumors with high GRPR expression while exhibiting low uptake in the pancreas, which shows its potential in prostate cancer molecular imaging.

Aim Investigating the effects of exercise during pregnancy on blood pressure and brain ischemia-reperfusion injury in 1-month-old(1M)and 3-month-old(3M)offspring of spontaneously hypertensive rat(SHR).Methods SHR and Wistar Kyoto rats(WKY)were selected,they were paired in a 1∶1 male-to-female ratio within the same strain,and the first day of pregnancy was confirmed by the presence of copulatory plugs and sperm on a vaginal smear.Pregnant rats were randomly divided into pregnancy sedentary group(p-WKY-SED,p-SHR-SED)and pregnancy exercise group(p-WKY-EX,p-SHR-EX).The rats in the exercise group were performed non-weight-bearing swimming for 60 minutes per day,6 days per week,in water 40 cm deep at a temperature of 34～35 ℃,until the 20th day of preg-nancy.The body weight of the pregnant rats,as well as physiological indicators such as fetal weight,body length,and placental efficiency were monitored to reflect the growth and development of the fetus.1M and 3M offspring were selected as research subjects,non-invasive blood pressure was measured in the tail artery,a rat middle cerebral artery occlusion(MCAO)model was prepared by using the thread embolism method,and the area of cerebral infarction was observed 24 hours after reperfusion.Results(1)Compared with p-WKY-SED group,the body weight of p-SHR-SED pregnant rats was significantly decreased(P＜0.01);there was no significant difference in the litter size among all groups of preg-nant rats(P＞0.05).(2)Compared with p-SHR-SED group,exercise during pregnancy can significantly increase the body weight and placental efficiency of both female and male fetal rats in the p-SHR-EX group(P＜0.05),and decrease the weight of the placenta(P＜0.05).(3)Compared with p-WKY-SED group,the body weight of both female and male offspring rats at 1M and 3M was significantly decreased in the p-SHR-SED group,and their blood pressure was significantly increased(P＜0.01);Compared with p-SHR-SED group,exercise during pregnancy had no significant effect on the body weight and blood pressure of 1M offspring in the p-SHR-EX group(P＞0.05),but it could significantly reduce the blood pressure of 3M male offspring in the p-SHR-EX group(P＜0.01);The body weight and blood pressure of 3M male off-spring were significantly higher in p-WKY-SED group and p-SHR-SED group than those of female in the same group(P＜0.01).(4)Compared with p-WKY-SED group,the infarct area of MCAO injury in both female and male offspring rats at 1M and 3M was significantly increased in the p-SHR-SED group(P＜0.01);Compared with p-SHR-SED group,exercise during pregnancy can significantly reduce the infarct area of MCAO injury in both female and male offspring at 1M and 3M in the p-SHR-EX group(P＜0.05).Conclusion Aerobic exercise during pregnancy can significantly improve blood pressure in the offspring of hypertensive rats,and reduce their susceptibility to ischemic reperfusion injury in the brain as adults.

Aim Investigating the effects of exercise during pregnancy on blood pressure and brain ischemia-reperfusion injury in 1-month-old(1M)and 3-month-old(3M)offspring of spontaneously hypertensive rat(SHR).Methods SHR and Wistar Kyoto rats(WKY)were selected,they were paired in a 1∶1 male-to-female ratio within the same strain,and the first day of pregnancy was confirmed by the presence of copulatory plugs and sperm on a vaginal smear.Pregnant rats were randomly divided into pregnancy sedentary group(p-WKY-SED,p-SHR-SED)and pregnancy exercise group(p-WKY-EX,p-SHR-EX).The rats in the exercise group were performed non-weight-bearing swimming for 60 minutes per day,6 days per week,in water 40 cm deep at a temperature of 34～35 ℃,until the 20th day of preg-nancy.The body weight of the pregnant rats,as well as physiological indicators such as fetal weight,body length,and placental efficiency were monitored to reflect the growth and development of the fetus.1M and 3M offspring were selected as research subjects,non-invasive blood pressure was measured in the tail artery,a rat middle cerebral artery occlusion(MCAO)model was prepared by using the thread embolism method,and the area of cerebral infarction was observed 24 hours after reperfusion.Results(1)Compared with p-WKY-SED group,the body weight of p-SHR-SED pregnant rats was significantly decreased(P＜0.01);there was no significant difference in the litter size among all groups of preg-nant rats(P＞0.05).(2)Compared with p-SHR-SED group,exercise during pregnancy can significantly increase the body weight and placental efficiency of both female and male fetal rats in the p-SHR-EX group(P＜0.05),and decrease the weight of the placenta(P＜0.05).(3)Compared with p-WKY-SED group,the body weight of both female and male offspring rats at 1M and 3M was significantly decreased in the p-SHR-SED group,and their blood pressure was significantly increased(P＜0.01);Compared with p-SHR-SED group,exercise during pregnancy had no significant effect on the body weight and blood pressure of 1M offspring in the p-SHR-EX group(P＞0.05),but it could significantly reduce the blood pressure of 3M male offspring in the p-SHR-EX group(P＜0.01);The body weight and blood pressure of 3M male off-spring were significantly higher in p-WKY-SED group and p-SHR-SED group than those of female in the same group(P＜0.01).(4)Compared with p-WKY-SED group,the infarct area of MCAO injury in both female and male offspring rats at 1M and 3M was significantly increased in the p-SHR-SED group(P＜0.01);Compared with p-SHR-SED group,exercise during pregnancy can significantly reduce the infarct area of MCAO injury in both female and male offspring at 1M and 3M in the p-SHR-EX group(P＜0.05).Conclusion Aerobic exercise during pregnancy can significantly improve blood pressure in the offspring of hypertensive rats,and reduce their susceptibility to ischemic reperfusion injury in the brain as adults.