Working memory is an executive memory process that includes encoding, maintenance, and retrieval. These processes can be modulated by transcranial alternating current stimulation (tACS) with sinusoidal waves. However, little is known about the impact of the rate of current change on working memory. In this study, we aimed to investigate the effects of two types of tACS with different rates of current change on working memory performance and brain activity. We applied a randomized, single-blind design and divided 81 young participants who received triangular wave tACS, sinusoidal wave tACS, or sham stimulation into three groups. Participants performed n-back tasks, and electroencephalograms were recorded before, during, and after active or sham stimulation. Compared to the baseline, working memory performance (accuracy and response time) improved after stimulation under all stimulation conditions. According to drift-diffusion model analysis, triangular wave tACS significantly increased the efficiency of non-target information processing. In addition, compared with sham conditions, triangular wave tACS reduced alpha power oscillations in the occipital lobe throughout the encoding period, while sinusoidal wave tACS increased theta power in the central frontal region only during the later encoding period. The brain network connectivity results showed that triangular wave tACS improved the clustering coefficient, local efficiency, and node degree intensity in the early encoding stage, and these parameters were positively correlated with the non-target drift rate and decision starting point. Our findings on how tACS modulates working memory indicate that triangular wave tACS significantly enhances brain network connectivity during the early encoding stage, demonstrating an improvement in the efficiency of working memory processing. In contrast, sinusoidal wave tACS increased the theta power during the later encoding stage, suggesting its potential critical role in late-stage information processing. These findings provide valuable insights into the potential mechanisms by which tACS modulates working memory.
Humans ; Memory, Short-Term/physiology* ; Male ; Female ; Young Adult ; Transcranial Direct Current Stimulation/methods* ; Brain/physiology* ; Adult ; Electroencephalography ; Single-Blind Method

Objective To systematically evaluate the published models in prediction of the risk of lung infections in elderly patients with hip fracture so as to provide a guidance for medical workers in selection or development of suitable risk prediction models.Methods Relevant studies were searched from databases including CNKI,Wanfang Data,VIP,SinoMed,PubMed,Web of Science,Cochrane Library,Embase and CINAHL,from the inception to 31st January,2024.Data were extracted from the selected literature and a bias assessment tool of risk predictive model was used to evaluate the risk of bias and applicability of the included literature.Results A total of 1,035 articles were retrieved,of which seven studies involving 13 predictive models were finally included after screening.The sample sizes ranged from 305 to 2,669 cases and lung infection rates ranged from 5.40%to 20.02%.The repeatedly reported predictors included age,gender,chronic obstructive pulmonary disease,hypoproteinaemia,American Society of Anesthesiologists(ASA)Physical Status Classification and white blood cell count.In the 13 models constructed,the reported area under the curve(AUC)of subjects'job characteristics ranged from 0.667 to 0.996.Five out of seven studies had good overall applicability,but all with high risk of bias.Conclusion The predictive models for lung infections in elderly patients with hip fracture are still in the stage of development.Although the predictive models show some predictive performance,however they are still deficient,and all studies have been found with a high risk in bias.

[Objective]To examine the botanical origin of the exotic medicinal materia Alebo firstly contained in Bencao Shiyi.[Methods]Based on the records of Haiyao Bencao,Compendium of Materia Medica,etc.,through ancient and modern literature verification and comparative botanical studies,combined with fieldwork in the field,from the perspectives of plant morphology,habitat distribution,herb name,nature and flavor,efficacy,the Alebo was examined.[Results]Comparative study revealed that the Alebo(Brahman saponaria)of the Bencao Shiyi matches the morphological characteristics of the Leguminosae Tamarindus indica L.(T.indica).T.indica are native to the Indian Peninsula and the Malay Archipelago,matching the habitat and name of the Brahmin saponaria.The two properties of similar nature and flavor,efficacy and mouth taste of T.indica peel and seeds are in line with the Brahmin Saponaria of the"taste".The Compendium of Materia Medica blackmail variant of Abole(Persian saponaria)is morphologically consistent with the Leguminosae Cassia fistula L.(C.fistula),and also bears some of the characteristics of the Kigelia africana(Lam.)Benth.(K.africana).In conjunction with further research,the habitat,name,and nature and flavor,efficacy effects of the C.fistula are consistent with the characteristics of Abole.Compendium of Materia Medica appendix Guihai Zhi tamarind,Sterculiaceae Sterculia nobilis Smith(S.nobilis)in line with the"nine layers of skin fruit"one.S.nobilis and Sterculia lanceolata Cav.(S.lanceolata)are consistent with tamarind in morphology,habitat,and nature and flavor,efficacy.[Conclusion]It is suggested that in the revision of the Dictionary of Chinese Medicine and other books,the origin of"Brahmin saponaria"should be changed to T.indica of the Leguminosae,and that in the revision of the Chinese Materia Medica Uyghur Medicine Volume and other books,the origin of"tamarind"should be changed to S.nobilis and S.lanceolata of the Sterculiaceae.In order to correct the origin,renew the history of medicine,inherit the essence.

Objective:To explore the efficacy of the features of ultrasound imaging omics at the area peripheral thyroid nodule in predicting cervical lymph node metastasis(LNM)of papillary thyroid carcinoma(PTC),and construct a prediction model based on the features of imaging omics and to verify its performance.Methods:A total of 237 PTC patients who admitted to Shaanxi Provincial Hospital of Chinese Medicine from March 2021 to June 2024 and were confirmed by pathology were retrospectively collected.They were divided into the training set(166 cases)and the validation set(71 cases)as a ratio of 7 to 3.According to the postoperatively pathological results,237 patients were divided into the metastasis group(108 cases)and the non-metastasis group(129 cases).The clinical data and conventional ultrasound characteristic information of all patients were collected,and a feature model of imaging omics was constructed through quantitative extracting and screening the features of ultrasound imaging omics within nodules and peripheral nodules,and utilizing machine learning classifier.Then,the feature score(Rad-Score)of image omics was obtained.The Rad-Score values within and peripheral nodules,and the Rad-Score values peripheral nodules of metastasis group and non-metastasis group were compared.In training set,the independent risk factors of affecting neck LNM were analyzed,and a clinical-ultrasonic model was constructed,which was combined with Rad-Score to construct a joint model based on the features of imaging omics peripheral nodules.The receiver operating characteristic(ROC)curve was used to analyze and compare its predictive efficacy.The nomogram of the joint model was constructed,and then,the calibration and fitting degrees of the nomogram were assessed by calibration curve and Hosmer-Lemeshow test.Result:In training set,6 features of imaging omics within nodules and 11 features of imaging omics peripheral nodules were respectively extracted and screened out through the least absolute shrinkage and selection operator(LASSO)algorithm.In the training set and validation set,the Rad-Scores peripheral the nodules in the metastasis group were respectively(7.43±0.45)points and(7.19±0.51)points,which were significantly higher than(3.25±0.28)points and(3.51±0.32)points peripheral the nodules in the non-metastasis group,and the differences were statistically significant(t=72.708,61.222,P<0.05).The results of factor analysis showed that age,capsule invasion,microcalcification,ultrasound-indicated lymph node positivity and Rad-Score around nodules were independent risk factors of affecting cervical LNM of PTC patients(OR=0.592,2.983,3.593,4.424,2.575,P<0.05).The ROC curve showed that the area under curve(AUC)values of the ROC curve of joint model in training set and validation set were respectively 0.861 and 0.872 in predicting LNM,respectively,which were superior to 0.759 and 0.783 of the clinical-ultrasound model.Conclusion:In both the training set and the validation set,the nomogram of joint model has favorable calibration and fitting in predicting cervical LNM of PTC patients.The construction of clinical model based on the features of ultrasound imaging omics peripheral nodules has a favorable efficacy in predicting the status of cervical lymph node of PTC patients before surgery,which is expected to be an effective tool of individual prediction for LNM.

Objective To analyze the influencing factors of tumor-specific mortality in patients with advanced endometrial carcinoma and construct a risk prediction model.Methods A total of 150 patients with advanced endometrial carcinoma admitted to the Fourth Clinical College of Zhejiang Chinese Medical University,Hangzhou First People's Hospital from January 2020 to January 2023 were selected as subjects.Cox regression was employed to analyze factors influencing mortality in advanced endometrial carcinoma.A Logistic regression model was constructed,with receiver operating characteristic(ROC)curve used to evaluate model discrimination,calibration curve for precision assessment,and decision curve for net benefit evaluation.Results Overall 2-year survival rate of 150 patients was 58.67％.The univariate analysis demonstrated that histological grade,lymph node metastasis,tumor maximum diameter,and preoperative carcinoembryonic antigen 125(CA125)levels were all significant risk factors for mortality in advanced endometrial carcinoma(P＜0.05).Multivariate analysis confirmed these parameters as independent prognostic indicators(P＜0.05).A Logistic regression model established using multivariate Cox regression yielded a C index of 0.873(95％CI:0.792-0.951).ROC curve analysis revealed the model's area under the curve for predicting mortality risk factors in advanced endometrial carcinoma was 0.916(95％CI:0.872-0.960).Conclusion The linear chart prediction model constructed based on histological grading,lymph node metastasis,maximum tumor diameter and preoperative CA125 level in this study can effectively predict the death of advanced endometrial carcinoma.

Qingfeitang， specialized in resolving phlegm to stop cough and producing fluid to moisten dryness， is a classic prescription inherited and developed by physicians of successive generations and has been included in the Catalogue of Ancient Classic Prescriptions （First Batch） published by the National Administration of Traditional Chinese Medicine （TCM） in 2018. Relevant ancient books data and modern literature were collected by bibliometrics to analyze the historic origin， formula composition， herb origin， preparation methods， processing methods， clinical effect， and indications of Qingfeitang. The key information of Qingfeitang was summarized to provide reference for the clinical application of the decoction. In this study， a total of 43 pieces of effective data on relevant ancient literature， including 35 ancient TCM books， were collected based on a systematic collation of relevant historic and modern literature. Results showed that "Qingfeitang" was originated from the "Renshen Qingfeitang" recorded in the Taiping Holy Prescriptions for Universal Relief from the Qing dynasty. The name of "Qinfeitang" was first recorded in the Yeshi Luyanfang written by YE Dalian in the Song dynasty. We suggested the modern dosage and usage of Qingfeitang as follows： "Scutellariae Radix of 5.60 g， Platycodon grandiflora， Poria， Tangerine， Fritillaria， and Cortex Mori of 3.73 g respectively， Angelicae Sinensis Radix， Asparagi Radix， Gardeniae Fructus， Armeniacae Semen Amarum， and Ophiopogonis Radix of 2.61 g respectively， Schisandra of 1 g， and Glycyrrhizae Radix et Rhizoma of 1.12 g， and they were taken 3 times daily. The above formula is recommended to be decocted with 400 mL of water， with 3.37 g ginger and 6 g jujubae fructus， to 320 mL， and taken after a meal， three times per day". Qingfeitang has the effect of resolving phlegm to stop cough and producing fluid to moisten dryness， specialized in treating cough， asthma， rash， and other symptoms in ancient times. Modern applications are mainly focused on the respiratory system， used for treating diseases such as bronchopneumonia and cough. The above research results provide a reference basis for the later development and research of Qingfeitang.

Objective To report cases of checkpoint inhibitor pneumonitis （CIP） in patients with advanced biliary tract cancer, aiming to provide additional approaches for the assessment, treatment, and monitoring of this condition. Methods Three patients developed oxygen desaturation and interstitial lung lesions during chemotherapy combined with immunotherapy, and were diagnosed with CIP in collaboration with the respiratory department. Antitumor therapy was discontinued in the acute phase, and glucocorticoids were administered, with regular monitoring of disease progression. During follow-up, case 1 developed lung metastasis; case 2 showed improvement; case 3 had concurrent infection and tumor progression. Results Glucocorticoids improved lung lesions and hypoxic symptoms in patients with CIP, but attention should be paid to the potential for concurrent infections and tumor progression. Conclusions Comprehensive assessment and early identification of CIP are crucial for patients with advanced biliary tract cancer. For those with recurrent symptoms after glucocorticoid therapy, timely and accurate adjustment of the treatment regimen is essential.

Objective:To explore the clinical characteristics, treatment, and prognosis of patients with spondyloarthritis (SpA) and clinically insignificant monoclonal garmmopathy of undetermined significance (MGUS).Methods:A retrospective study was performed to analyze the clinical characteristics of patients simultaneously diagnosed with both SpA and MGUS at the First Affiliated Hospital to Zhengzhou University between January 2020 and December 2024, supplemented by a literature review.Results:Among the 5 patients (2 males, 3 females; age range 33~65 years), 4 presented with peripheral arthritis and 2 with extra-articular manifestations. All patients demonstrated elevated globulin and IgG levels, with 4 being HLA-B27 positive. M-protein typing revealed IgG/κ in 3 cases and IgA/λ in 2. All five patients underwent both X-ray and MRI examinations, with sacroiliitis being detected in 4 cases. Three patients with long disease duration showed poor response to conventional therapy (NSAIDs/DMARDs). Targeted therapies yielded variable outcomes: one patient achieved normalized globulin/IgG levels with etanercept (3-year follow-up without MGUS progression); another showed marked clinical improvement and significant globulin/IgG reduction with JAK inhibitor (tofacitinib, treated for 7 years); while a third demonstrated no symptom relief then switching from TNF-α inhibitor to IL-17 inhibitor.Conclusion:Persistent hyperglobulinemia in SpA patients warrants MGUS screening. Those with SpA-MGUS may require targeted therapies, where JAK inhibitors and monoclonal TNF-α inhibitors appear to be the preferred options, though long-term monitoring for MGUS progression remains essential.

Objective:To analyze the situation of rodents carrying Hantavirus and the genetic and evolutionary characteristics of the virus in Zibo city, Shandong province in 2022, and provide reference for the scientific prevention and control of hemorrhagic fever with renal syndrome (HFRS).Methods:Real-time quantitative PCR (RT-qPCR) was used to detect hantavirus (HV) nucleic acids in rodent lung tissues and identify HV genotypes. Each nucleic acid fragment was designed to amplify various gene fragments by segment, and the whole genome of Hantavirus was sequenced by second generation sequencing. Sequence assembly was performed using SeqMan 7.1.0.44, a subprogram of DNAStar. Sequence alignment and evolutionary analysis were conducted using MEGA 7.0 and BioEdit software.Results:A total of 270 host animals were captured in this survey. Among them, 13 rodent lung samples tested positive for Hantavirus, resulting in a virus-positive rate of 4.8%. The full-genome sequences of four hantavirus strains were successfully obtained, all identified as Seoul virus (SEOV) genotype. Four Hantavirus-positive samples showed high nucleotide sequence homology in the M gene and belonged to the SEOV S3 subtype. These strains exhibited high similarity with those from Hebei, Liaoning, and Beijing. The amino acid sequences of the nucleoprotein and glycoprotein immunogenic epitopes were identical to those of the vaccine strain Z37.Conclusions:This study successfully determined the full genome sequences of four hantavirus strains from Zibo city, Shandong province. The genotypes are primarily SEOV, with the subtype being S3. The homology of genes within the same subtype is high, with no significant variations observed. The alignment of immune epitopes in key proteins suggests that the current vaccine may provide protection against locally circulating strains, but further in-depth research is still required.

Objective To compare the distribution characteristics of retinal capillary non-perfusion areas(NPAs)across different layers and regions in patients with neovascular glaucoma(NVG)secondary to proliferative diabetic retinop-athy(PDR)versus those with PDR alone through wide-field swept-source optical coherence tomography angiography(SS-OCTA)and to analyze the impacts of NPAs on the development of NVG.Methods This prospective cross-sectional study enrolled 33 patients with PDR(33 eyes,the PDR group)and 30 patients with NVG(30 eyes,the PDR+NVG group)diag-nosed at Affiliated Hospital of Shandong Second Medical University(formerly Weifang Medical University)from January 2022 to June 2023.The fundus examination was performed using SS-OCTA,and the NPA boundaries of the superficial capil-lary plexus(SCP)and deep capillary plexus(DCP)of the retina were manually delimited with the aid of ImageJ.The reti-na was divided based on two methods.Specifically,according to different concentric circles,the retina could be divided in-to the foveal area,parafoveal area,perifoveal area,annulus6-9,annulus9-12,annulus12-retinal boundary;besides,the ret-ina could also be divided into four quadrants(supratemporal,infratemporal,supranasal,and infranasal quadrants)based on the horizontal and vertical lines centered on the macular fovea.Based on that,the NPA area and ischemia index(ISI)in each layer and subdivision of the two groups of patients were counted.Additionally,the NPA and ISI in different concentric circles and different quadrants of the SCP and DCP were compared between the two groups.Moreover,the distribution characteristics of NPAs as well as the effect of NPAs on NVG were analyzed.Results(1)The NPA area and ISI in the DCP were larger than those in the SCP in both groups(all P＜0.001);the NPA area and ISI in the SCP and DCP of patients in the PDR+NVG group were larger than those in the PDR group(all P＜0.001).(2)In the supratemporal,infratemporal,supranasal,and infranasal quadrants,the NPA area and ISI in the SCP and DCP of patients in the PDR+NVG group were larger than those in the PDR group(all P＜0.01).The NPA area in the inferotemporal quadrant was the largest in the SCP and DCP,respectively,within each group(all P＜0.01).(3)The differences in the NPA area and ISI between the two groups were statistically significant in the annulus6-9,annulus9-12,and annulus12-retinal boundary in the SCP and DCP(all P＜0.01).The differences in the NPA area and ISI were statistically significant between different annular subdivisions in the SCP and DCP within each group(all P＜0.001).The multiple comparison results showed that the NPA area and ISI of the annulus12-retinal boundary in the SCP and DCP were larger than those in other annuli in both groups(all P＜0.05).The NPA area and ISI of the annulus9-12 were larger than those of the parafoveal and perifoveal areas;the NPA area and ISI of the annulus6-9 were larger than those of the parafoveal area(all P＜0.05).There was no statistically significant differ-ence in the NPA area and ISI in the remaining annuli(all P＞0.05).(4)The multivariate logistic regression analysis showed that the NPA area and ISI in the subnasal quadrant of the SCP were negatively correlated with the risk of NVG sec-ondary to PDR(P=0.036 and 0.038).The increased NPA area and ISI in the subnasal quadrant of the DCP were risk fac-tors for NVG secondary to PDR,and they may increase the risk of NVG(P=0.029 and 0.028).Conclusion The in-creased NPA area and ISI in the subnasal quadrant of the DCP were risk factors for secondary NVG in patients in the PDR group.