Parkinson’s disease (PD) is a common neurodegenerative disorder that significantly impacts patients’ independence and quality of life, imposing a substantial burden on both individuals and society. Although dopaminergic replacement therapies provide temporary relief from various symptoms, their long-term use often leads to motor complications, limiting overall effectiveness. In recent years, non-invasive deep brain stimulation (DBS) techniques have emerged as promising therapeutic alternatives for PD, offering a means to modulate deep brain regions with high precision without invasive procedures. These techniques include temporal interference stimulation (TIs), low-intensity transcranial focused ultrasound stimulation (LITFUS), transcranial magneto-acoustic stimulation (TMAS), non-invasive optogenetic modulation, and non-invasive magnetoelectric stimulation. They have demonstrated significant potential in alleviating various PD symptoms by modulating neural activity within specific deep brain structures affected by the disease. Among these approaches, TIs and LITFUS have received considerable attention. TIs generate low-frequency interference by applying two slightly different high-frequency electric fields, targeting specific brain areas to alleviate symptoms such as tremors and bradykinesia. LITFUS, on the other hand, uses low-intensity focused ultrasound to non-invasively stimulate deep brain structures, showing promise in improving both motor function and cognition in PD patients. The other three techniques, while still in early research stages, also hold significant promise for deep brain modulation and broader clinical applications, potentially complementing existing treatment strategies. Despite these promising findings, significant challenges remain in translating these techniques into clinical practice. The heterogeneous nature of PD, characterized by variable disease progression and individualized treatment responses, necessitates flexible protocols tailored to each patient’s unique needs. Additionally, a comprehensive understanding of the mechanisms underlying these treatments is crucial for refining protocols and maximizing their therapeutic potential. Personalized medicine approaches, such as the integration of neuroimaging and biomarkers, will be pivotal in customizing stimulation parameters to optimize efficacy. Furthermore, while early-stage clinical trials have reported improvements in certain symptoms, long-term efficacy and safety data are limited. To validate these techniques, large-scale, multi-center, randomized controlled trials are essential. Parallel advancements in device design, including the development of portable and cost-effective systems, will improve patient access and adherence to treatment protocols. Combining non-invasive DBS with other interventions, such as pharmacological treatments and physical therapy, could also provide a more comprehensive and synergistic approach to managing PD. In conclusion, non-invasive deep brain stimulation techniques represent a promising frontier in the treatment of Parkinson’s disease. While they have demonstrated considerable potential in improving symptoms and restoring neural function, further research is needed to refine protocols, validate long-term outcomes, and optimize clinical applications. With ongoing technological and scientific advancements, these methods could offer PD patients safer, more effective, and personalized treatment options, ultimately improving their quality of life and reducing the societal burden of the disease.

OBJECTIVE: To explore the clinical application value of metagenomic next-generation sequencing (mNGS) in pathogen detection of bloodstream infection secondary to hematologic diseases in children. METHODS: 42 children with bloodstream infections secondary to hematologic diseases admitted to the Children's Hematology and Tumor Center of the Affiliated Hospital of Guangdong Medical University from November 2021 to May 2023 were included in the study, and their clinical data, results of peripheral blood mNGS and traditional blood culture, pathogen distribution characteristics, and diagnostic efficacy of mNGS were retrospectively analyzed. RESULTS: Among the 42 children included, there were 2 cases (4.8%) of aplastic anemia (AA), 27 cases (64.3%) of acute lymphoblastic leukemia (ALL), 7 cases (16.7%) of acute myeloid leukemia (AML), 1 case (2.4%) of chronic myeloid leukemia (CML), 2 cases (4.8%) of hemophagocytic lymphohistiocytosis (HLH), 2 cases (4.8%) of non-Hodgkin lymphoma (NHL), and 1 case (2.4%) of Wiskott-Aldrich syndrome (WAS). In mNGS testing, pathogens were detected in 31 peripheral blood samples, with a positive rate of 73.8% (31/42), significantly higher than the pathogen positive rate of 16.7% (7/42) detected by traditional blood culture, and the difference was statistically significant (P < 0.05). Among the pathogen-positive cases detected by mNGS, 23 cases (74.2%) were positive for bacteria, 12 cases (38.7%) were positive for viruses, and 9 cases (29.0%) were positive for fungi. 32.2% (10/31) of the pathogen-positive samples detected by mNGS were mixed pathogens, which could not be effectively detected by traditional blood culture. CONCLUSION Peripheral blood mNGS has advantages in the detection of pathogens of bloodstream infection secondary to hematologic diseases, with a higher detection rate of pathogen positivity than traditional blood cultures. It can detect viruses, rare pathogens and mixed pathogens, and has good clinical application value.
Child ; Child, Preschool ; Female ; Humans ; Male ; Hematologic Diseases/immunology* ; High-Throughput Nucleotide Sequencing ; Metagenomics ; Retrospective Studies ; Sepsis/microbiology*

OBJECTIVE: To investigate the efficacy of 3D-printed navigation guided pudendal lead implantation on nervous regulation of lower urinary tract symptoms（LUTS） in male patients. METHODS: Twenty-eight male patients who underwent perineal nervous regulation treatment for LUTS in Gongli Hospital of Pudong New Area from October 2021 to October 2023 were randomly divided into observation group and control group. The technology assisted with 3D-printed navigation to regulate the genital nerves was used in observation group. And the patients in control group were treated with regulation of the genital nerves by routine puncture. Operation time of puncture, number of surgical punctures, and stimulator debugging time compared between the two groups. The improvement of postoperative symptoms and surgical complications of patients in the observation group were recorded as well. RESULT: A total of 12 male LUTS patients were included in the observation group, with an average age of 36.5±6.5 years, including 7 cases of frequent micturition, 3 cases of perineal pain, and 2 cases of dysuria. Four patients showed no significant improvement in symptoms, including two patients with pain and two cases of frequent micturition who did not undergo secondary surgery. While the other eight patients showed significant improvement in symptoms. The average time for successful puncture in control group was (21.13 ± 4.53) minutes, which was longer than that of the 3D-printed navigation group (［10.32 ± 3.42］ min) significantly (P<0.05). The average number of punctures in the ordinary puncture group was 5.62 ± 1.43, which was significantly higher than that in the 3D-printed navigation group (1.5 ± 0.56). There was no statistically significant difference in the average time for stimulator debugging between the two groups of patients. The conversion rate of the 3D-printed navigation group in the second phase was 66.7%, which was higher than that (37.5%) significantly (P<0.05). CONCLUSION 3D printing navigation of pudendal nerve electrode wire implantation can improve the accuracy of electrode implantation and the conversion rate to a certain extent, which has the advantages of reducing the difficulty of surgery.
Humans ; Male ; Printing, Three-Dimensional ; Lower Urinary Tract Symptoms/surgery* ; Adult ; Pudendal Nerve ; Middle Aged ; Electrodes, Implanted

Objective To construct the competency and professional activities of pediatric rehabilitation therapists in China based on World Health Organization rehabilitation competency framework(RCF). Methods Competencies,activities,and tasks in the field of pediatric rehabilitation were collected through literature,offi-cial websites and interviews with key informants using RCF.Competency requirements suitable for pediatric re-habilitation therapists were selected,competency dimensions and activities were adjusted based on the context of pediatric rehabilitation therapy.Similar content was integrated through thematic framework analysis and content analysis.Competencies were matched with typical professional activities.A competency framework and profes-sional activities for Chinese pediatric rehabilitation therapists were developed,and the Delphi method was used to survey 22 experts,ultimately confirming competency dimensions and activity content. Results The enthusiasm coefficient of experts was 88.00%,the authority coefficient was 0.84,and the expert opinions were more focused on importance.The CV values of all competency dimensions and activities were≤0.25,and the W test was statistically significant(P<0.05),indicating a high degree of coordination among experts.A com-petency framework for pediatric rehabilitation therapists in China,included 17 competency dimensions and 17 professional activities. Conclusion To explore the competency of typical professions through RCF may enhance the application of research re-sults in the field of rehabilitation,which provides a reference for clarifying the job content and cultivating the competency of Chinese pediatric rehabilitation therapists.

Objective To investigate the current situation of competency and professional activities of pediatric rehabilitation thera-pists in Jiangsu,Shanghai and Zhejiang. Methods A questionnaire survey was conducted on 168 pediatric rehabilitation therapists in Jiangsu,Shanghai and Zheji-ang,from December,2022 to February,2023,and the general information and the competency were obtained.A total of 35 pediatric rehabilitation therapists were interviewed one-on-one,from October,2022 to January,2023,using thematic framework. Results A total of 162 effective questionnaires were collected.The level of competency of pediatric rehabilitation thera-pists was(3.44±0.87);and it was higher in professional literacy(3.90±0.77)and practice(3.83±0.77),and lower in management and leadership(2.92±1.44),and research(2.14±1.64).Latent class analysis showed that the thera-pists could be divided into four categories,of which the"medium competency"accounted for the most proportion(34.57%),and"low learning and research"was the least(8.64%).The interviews identified problems of compe-tency such as maintaining communication with children's families and managing self-professional development. Conclusion Self-reported rehabilitation competency levels of pediatric rehabilitation therapists in three provinces and cit-ies are above three points in all four dimensions,except for the management and leadership dimension,where the score is below three points.

Objective To investigate the inhibitory effect of quercetin on Gastro entero pancreatic NEN(GEP-NEN).Methods Human pancreatic neuroendocrine tumor BON-1 cells were randomly divided into control group,quercetin group(80 μmol·L-1 quercetin),quercetin+si-NC group(transfected with si-NC+80 μmol·L-1 quercetin),quercetin+si-growth arrest-specific+ranscript 5(GAS5)group(transfected with si-GAS5+80 μmol·L-1 quercetin).Dual luciferase reporter gene assay was used to verify the targeted binding of GASS5 to miR-18b-5p;real-time quantitative fluorescent PCR(qRT-PCR)was used to detect the mRNA expression levels of B-cell lymphoma-2(Bcl-2)and Bel-2 associated X protein(Bax);positive expression of GAS5 and miR-18b-5p in cells was detected by fluorescence in situ hybridization(FISH)assay.Results Dual luciferase reporter gene results showed that GAS5 was targeted to miR-18b-5p.The GAS5 expression levels of control group,quercetin group,quercetin+si-NC group and quercetin+si-GAS5 group were 1.00±0.13,1.72±0.19,1.78±0.14 and 1.16±0.11,respectively;the expression levels of miR-18b-5p were 1.00±0.15,0.67±0.08,0.72±0.06 and 0.95±0.11 respectively;Bax mRNA expression levels were 1.00±0.12,2.17±0.25,2.32±0.28 and 1.37±0.15,respectively;Bcl-2 mRNA expression levels were 1.00±0.15,0.41±0.05,0.37±0.06 and 1.21±0.13,respectively.The above indexes were significantly different between quercetin group and control group(all P＜0.05);the above indexes were significantly different between quercetin+si-NC group and quercetin+si-GAS5 group(all P＜0.05).Conclusion Quercetin may slow down the development of GEP-NEN by targeting GAS5/miR-18b-5p molecular axis to inhibit cell growth.

Objective:To investigate the clinical effect of extraperitoneal robot-assisted laparoscopic modified Y-V plasty(LMYVP)in the treatment of refractory bladder neck contracture(BNC).Methods:We retrospectively analyzed the clinical data on 10 cases of refractory BNC after transurethral resection of the prostate between September 2020 and January 2023,all with a history of recurrent urethral dilatation and at least two failures in transurethral surgical treatment of scarring.After definite diagnosis and re-moval of some of the scar tissues to flatten the elevated bladder neck under the cystoscope,we performed robot-assisted LMYVP using the da Vinci Si robotic system and a four-port extraperitoneal approach.The surgical procedure involved an inverted T-shaped incision in the bladder neck and urethral stricture ring,an inverted V-shaped excision of the scar area at the 3-9 o'clock position on the ventral side of the prostatic urethra,continuous full-layer suturing of the bladder neck and inverted V-shaped urethra with 3-0 barbed thread,and indwelling of an F20 silicone catheter for 2 weeks.At 3 months after surgery,we performed cystoscopic examination,measured the maximum urinary flow rate(Qmax),and obtained the IPSS and quality of life(QOL)scores of the patients.Results:Operations were successfully completed in all the cases.At 3 months after surgery,the patients showed significantly increased Qmax([3.65±1.27]vs[20.3±1.77]ml/s,P＜0.05),IPSS(5.9±2.02 vs 30±1.15,P＜0.05)and QOL score(1.3±0.95 vs 5.2±0.79,P＜0.05)compared with the baseline.Cystoscopy revealed a wide and flat bladder neck with good survival and hemody-namics of the bladder flap.All the patients met the criteria for clinical cure at a median follow-up of 13.2 months.Conclusion:Extraper-itoneal robot-assisted LMYVP provides a new strategy for urinary tract reconstruction in the management of refractory BNC,with the ad-vantages of minimal invasiveness,high efficiency and high success rate.

Objective:This study aims to evaluate the clinical efficacy and safety of Dibai Yijing Formula(DYF)in the treat-ment of male infertility with essence deficiency in the kidney and damp-heat in the essence chamber(Abbreviation:kidney deficiency and damp-heat type).Methods:This study employed a randomized,controlled clinical trial design,recruiting 72 male patients with infertility due to kidney deficiency and damp-heat type.Patients were randomly assigned to an treatment group(36 patients)and a control group(36 patients)using a random number table.The control group received oral Clomiphene Citrate Capsules(50 mg,twice daily),while the treatment group received oral DYF(one dose daily,200 ml each time,30 minutes after breakfast and dinner).Both groups underwent a 12-week treatment period.After treatment,sperm concentration(SC),percentage of progressively motile sperms(PR),total sperm motility[PR+percentage of non-progressively motile sperms(NP)],and semen volume(SV)were compared between the two groups before and after treatment.Additionally,the total score of Traditional Chinese Medicine(TCM)syndrome score and sperm DNA fragmentation index(DFI)and pregnancy outcomes of the patients'spouses were compared between the two groups.Results:Three patients dropped out from the treatment group and four from the control group.There were no statistically sig-nificant differences in semen parameters between the two groups(P＞0.05).After treatment,the patients in the treatment group showed significant difference in the percentage of SC([19.42±5.30]x 106/ml vs[10.75±2.41]x 106/ml),PR([27.72±6.62]％vs[20.04±4.10]％),PR+NP([49.86±10.68]％vs(33.74±5.58)％],DFI([12.33±3.43]％vs[15.06±3.98]％)and TCM symtom score([7.45±1.82]vs[13.85±1.91]),and the difference was statistically significant(P＜0.05).The patients in the control group showed significant difference in the percentage of SC([19.56±5.24]× 106/ml vs[11.31±2.08]× 106/ml)and TCM symptom score([12.81±1.86]vs[14.06±1.64]).But no significant changes were observed in the PR([21.75±5.93]％vs[20.05±4.67]％),PR+NP([34.23±7.15]％vs[32.35±4.09]％),SV([3.19±1.08]ml vs[3.12±1.13]ml),and DFI([15.11±4.76]％vs[15.51±4.35]％)were not statistically significant(P＞0.05).Improve-ments in PR,PR+NP,TCM symptom score and DFI in the treatment group were better than those in the control group after treatment(P＜0.05);the differences in SC and SV and spousal pregnancy in the treatment group were not statistically significant compared with those in the control group(P＞0.05).No serious adverse events occurred in both groups during the treatment period.Conclusion:The treatment of male infertility with DYF is effective and safe.

Objective To investigate the impact of Sca-1 bone marrow derived stem cells on apoptosis in murine cardiac fibroblasts and the molecular mechanisms of young(Y)Sca-1 bone marrow stem cell(BMSC)on old(O)cardiac fibroblast cell(CFC)apoptosis.Methods The apoptosis and survival of Y and O CFC were assessed under hypoxic conditions.Co-cultures of Y and O Sca-1 bone marrow-derived mesenchymal stem cells(BMSC)with O CFC were established to investigate the impact of Sca-1 BMSC on the apoptotic response and viability of O CFC,employing TUNEL staining,qRT-PCR,Western Blot,and CCK8 assays.Furthermore,differential secretion profiles of growth factors by Y and O Sca-1 BMSC were compared using qRT-PCR and ELISA analysis.Results Compared to Y CFC,O CFC exhibited an increased rate of apoptosis and a decreased rate of cell survival.However,when compared to O cells,Y Sca-1 BMC significantly reduced apoptosis in O CFC and enhanced cell survival.Moreover,Y Sca-1 BMSC demonstrated a higher secretion of GDF5(Growth Differentiation Factor 5)than O cells(P<0.05).Importantly,the protective effects of Y Sca-1 BMSC on apoptosis and survival in O CFC were abolished upon neutral-ization of GDF5 expression.Conclusion Y Sca-1 BMSC decreases O CFC apoptosis through GDF5.

ObjectiveTo understand the influencing factors of work-related injury medical expenses in Kunshan City. Methods The work-related injury data of Kunshan City from 2016 to 2021 were collected from the “Jiangsu Human Resources and Social Security Integration Handling Platform” of Kunshan Municipal Human Resources and Social Security Bureau, and the influencing factors of work-related injury medical expenses were analyzed using quantile regression. Results The median (interquartile range) of per capita work-related injury medical expenses in Kunshan City from 2016 to 2021 was 1 025.6(7 199.1) yuan. The result of 0.50 quantile regression analysis showed that the work-related injury medical expenses of male workers were higher than that of female workers (P<0.01), the work-related injury medical expenses of workers aged 46 and above were higher than those aged 16-<26 (P<0.01), the work-related injury medical expenses of veteran workers were lower than those of new workers (P<0.01), the work-related injury medical expenses of workers in the third, fourth, fifth, and sixth major risk industries were higher than that in the first major risk industry (all P<0.05), the work-related injury medical expenses on lower limb, head and neck, trunk, and multiple injured areas were lower than upper limb injuries (all P<0.01), the work-related injury medical expenses of workers with death, grades 5 to 6, grades 7 to 10, failure to reach grade, and ungraded injuries were lower than those of workers with grades 1 to 4 injuries (all P<0.01), the medical expenses for work-related injuries such as scalds, burns, and scorch were higher than cuts, abrasions, and stabs injuries (P<0.01). Conclusion The influencing factors of the workers' medical expenses for work-related injuries are age, gender, and injured body part. It is necessary to further strengthen the prevention of work-related injuries for males, new workers, workers in the third to sixth major risk industries, and those aged 46 and above. Meanwhile, it is needed to prevent workers from suffering scalds, burns, scorch injuries, upper limb injuries, and high disability grades injuries, to reduce the economic burden on workers and the society.