ObjectiveTo analyze the research status and development trends of non-pharmacological therapies for post-stroke spasticity (PSS) over the past two decades. MethodsRelevant literatures on non-pharmacological rehabilitation of PSS published from January, 2004 to June, 2024 were retrieved from Web of Science Core Collection. CiteSpace 6.3.R6 and VOSviewer 1.6.18 were used for visualization analysis. ResultsA total of 780 publications were included. The annual number of publications showed an overall upward trend. China, the USA, and Italy contributed the highest number of publications. The Hong Kong Polytechnic University and researcher Noureddin Nakhostin Ansari were identified as the most influential institution and author, respectively. High-frequency keywords and cluster labels included electric stimulation, transcranial magnetic stimulation, robot and acupuncture. ConclusionOver the past 20 years, researches on non-pharmacological therapies for PSS have remained active, with hotspots focusing on diverse interventions such as electrical stimulation, magnetic stimulation and robot-assisted therapy.

The blood-brain barrier （BBB） is a physical and biochemical barrier that precisely regulates brain homeostasis and plays a central role in controlling the transport of endogenous and exogenous drugs and related metabolites across the blood-brain interface. These functions of the BBB are mediated by its major components， including brain microvascular endothelial cells （BMECs）， tight junction protein complexes， and influx and efflux transporter proteins. One of the pathological features of ischemic stroke （IS） is BBB disruption， which plays an important role in the development of post-stroke brain injury and subsequent neurological dysfunction. Therefore， given the increasing incidence of IS， there is an urgent need to develop new therapeutic strategies to prevent BBB dysfunction and thereby protect injured brain tissue after IS. This study describes the pathological mechanisms by which BMEC injury after IS leads to BBB dysfunction and elucidates the association between BMECs and IS， including the regulation of apoptosis， autophagy， inflammatory responses， oxidative stress， neurotoxic effects， and cerebral edema. In addition， this article summarizes Chinese herbal medicines that may prevent and treat IS by targeting BMECs. These include monomeric compounds and single herbs such as flavonoids， glycosides， phenols， phthalides， terpenoids， and Styrax. Traditional Chinese medicine （TCM） compound formulas and preparations include oral formulations such as Buyang Huanwu decoction， Sailuotong， Naoxintong capsules， Dandeng Tongnao capsules， and Shexiang Tongxin dropping pills， as well as injectable preparations such as Tongluo Jiunao injection， Xingnaojing injection， Danshen polyphenolic acid for injection， Yiqi Fumai injection， and Shuxuetong injection. This study aims to explore the protective effects of TCM against IS through targeted regulation of BMEC function， providing new insights into the mechanisms of IS and endovascular therapeutic strategies.

Severe acute pancreatitis （SAP） is closely related to dysfunction of the spleen-stomach ascent and descent. Due to the influence of modern lifestyle and dietary factors， Qi deficiency in the spleen and stomach has become the pathological basis of SAP. Its pathogenesis is characterized by dampness， heat， pathogenic factors， stasis， stagnation， obstruction， Fu-organs Qi obstruction， pathogenic excess， and healthy Qi deficiency. At different stages of the disease course of SAP， there is a focus on both pathogenic excess and healthy Qi deficiency. It is specifically manifested as Fu-organs stagnation and heat accumulation， as well as pathogenic excess and healthy Qi deficiency， during the systemic inflammatory response phase， intermingling of blood stasis and pathogenic factors， as well as Qi deficiency and blood stasis， during the infection period， and weakness of the spleen and stomach， as well as healthy Qi deficiency and lingering pathogenic factors， during the residual infection period. Based on the theory that "the spleen and stomach are the acquired foundation"， a staged treatment method centered on the core principle of "strengthening healthy Qi to eliminate pathogenic factors" was developed. The staged treatment method included "clearing the Fu-organs to expel turbidity， replenishing Qi to harmonize the stomach， activating blood circulation to expel pathogenic factors， replenishing Qi to relieve pain， promoting digestion to stimulate appetite， and replenishing Qi to invigorate the spleen". In clinical practice， Hewei Tongxie mixture， Yikang mixture， and Shiwei Jianpi Xiaoshi powder were selected for staged treatment of SAP. This article systematically summarized the theoretical basis of traditional Chinese medicine， Western medicine foundation， modern pharmacological mechanisms， and clinical application experience of the staged treatment of SAP with "strengthening the healthy Qi to eliminate pathogenic factors"， providing new ideas for the treatment of SAP with traditional Chinese medicine.

Purpose: Lung cancer is frequently observed as a second primary malignancy following gastric cancer, yet the genetic causality between them remains uncertain. This study aims to evaluate the causal relationship between gastric and lung cancers using Mendelian randomization (MR) analysis. Materials and Methods: Single nucleotide polymorphisms associated with gastric and lung cancers were selected from genome-wide association study in East Asian and European populations as instrumental variables. The causal effects between gastric and lung cancers were evaluated using univariable and multivariable MR analysis, with the inverse variance weighted (IVW) method serving as the primary criterion. Heterogeneity and sensitivity analyses were performed to ensure the robustness of the findings. Results: Univariable MR analysis demonstrated that genetic susceptibility to gastric cancer in the European population was significantly associated with an increased risk of lung cancer (IVW: odds ratio [OR], 1.285; 95% confidence interval [CI], 1.072 to 1.541; p=6.83E-03), which was consistently validated in the East Asian population (IVW: OR, 1.356; 95% CI, 1.114 to 1.651; p=2.40E-03). Multivariable MR analysis further indicated that the significant positive causal relationship between gastric cancer and lung cancer persisted in both populations after adjusting for confounding factors (all p < 0.05). Conversely, no significant causal relationship was observed for the risk of developing gastric cancer following the diagnosis of lung cancer in either population (p > 0.05). Conclusion This study confirms that genetic susceptibility to gastric cancer increases the risk of lung cancer. This finding provides a theoretical basis for exploring the underlying biological mechanisms and suggests that enhancing lung cancer screening in patients with gastric cancer may be necessary to improve patient prognosis.

Background: and Purpose In patients with large vessel occlusion (LVO), intravenous thrombolysis (IVT) frequently alters thrombus location; however, the clinical impact of this phenomenon remains unclear. We aimed to compare post-IVT thrombus dynamics between tenecteplase and alteplase and to evaluate the association between thrombus dynamics and 3-month outcomes. Methods: This retrospective study analyzed prospectively collected, multicenter data from consecutive patients with LVO who underwent bridging therapy between January 2022 and December 2024. Thrombus dynamics were classified as resolution, migration, or stability. Analyses incorporated propensity score matching with weighting to balance baseline characteristics. Results: Of the 806 initially included patients, 746 were included after matching (373 treated with tenecteplase and 373 treated with alteplase). The incidence of thrombus migration was significantly higher in the tenecteplase group than in the alteplase group (19.3% vs. 11.3%; odds ratio [OR]: 1.92; 95% confidence interval [CI] 1.27–2.91). The advantage of tenecteplase over alteplase was restricted to patients with an IVT-to-puncture time of <60 minutes (18.6% vs. 6.2%; p=0.001) and was no longer significant when the interval ≥60 minutes (19.7% vs. 15.0%; p=0.204; pinteraction=0.043). Additionally, thrombus migration was associated with a better functional outcome (OR: 1.62; 95% CI 1.04–2.53). Finally, tenecteplase was associated with improved functional independence compared with alteplase (OR: 1.43; 95% CI 1.04–1.95). Conclusions Tenecteplase demonstrated superior efficacy in inducing thrombus migration compared with alteplase, particularly within 60 minutes of IVT administration. Thrombus migration independently predicted improved functional independence. These findings support the preferential use of tenecteplase for bridging therapy in patients with LVO.

Objective: To analyze the compliance status of physical fitness indicator and lifestyle characteristics among secondary vocational school students, as well as their associations, so as to provide a reference for physical fitness promotion among secondary vocational school students. Methods: Using a convenience sampling method, a questionnaire survey and physical fitness tests were conducted from September to December 2024 among 5 141 secondary vocational school students recruited from 16 secondary vocational schools across 8 provinces/municipalities in China, including Fujian, Chongqing, Guangdong, Guangxi, Hubei, Jiangxi, Shanghai and Zhejiang. Data on lifestyle factors were collected using a self designed questionnaire combined with standardized scales, including dietary habits, unhealthy behaviors, and 24 hour behaviors (physical activity, screen time, and sleep behavior). Multivariable Logistic regression model was used to analyze the associations of individual lifestyle behaviors and clustering of unhealthy lifestyle behaviors with non-compliance in physical fitness indicators among secondary vocational school students. Results: The compliance rates for waist circumference, vital capacity, grip strength, standing long jump, 30 second sit ups, 20 meter shuttle run, 50 meter dash, sit and reach, 20 second side steps among secondary vocational school students were 55.9%, 89.6%, 81.8%, 79.4%, 77.8%, 61.4%, 87.0%, 12.6%, and 63.5%, respectively, with a non-overweight/obesity rate of 78.9%. The reporting rates of daily breakfast consumption, milk consumption, and vegetable consumption were 58.9%, 18.3%, and 37.5%, respectively. The reporting rates of frequent takeout consumption, frequent sugar sweetened beverage consumption, smoking, alcohol drinking, insufficient moderate to vigorous physical activity (MVPA), excessive screen time, and insufficient sleep were 30.0%, 43.8%, 8.4%, 15.8%, 42.9%, 90.8%, and 42.6%, respectively. Multivariable Logistic regression analysis showed that secondary vocational school students with insufficient MVPA had higher risks of non-compliance in vital capacity, grip strength, standing long jump, 30 second sit ups, 20 meter shuttle run, 50 meter dash, and 20 second side steps ( OR =1.22- 1.60 ); secondary vocational school students who consumed breakfast daily had lower risks of non-compliance in vital capacity and overweight/obesity ( OR =0.81, 0.85); daily vegetable consumption was associated with a lower risk of vital capacity non-compliance ( OR =0.72); frequent takeout consumption was associated with an increased risk of non-compliance in the sit and reach test ( OR =1.28); smoking was associated with increased risks of non-compliance in the 20 meter shuttle run and 20 second side steps ( OR =1.38, 1.58) (all P <0.05). Regarding the clustering of unhealthy behaviors, secondary vocational school students with 4- 5 clustered unhealthy behaviors had higher risks of non-compliance in waist circumference and standing long jump; those with≥6 clustered behaviors had higher risks of non-compliance in standing long jump, 20 meter shuttle run, and 20 second side step ( OR = 1.17-1.36, all P <0.05). Conclusions The clustering of unhealthy behaviors is negatively associated with physical fitness status among secondary vocational school students. Secondary vocational schools should prioritize the promotion of comprehensive lifestyle management to improve the physical fitness levels of secondary vocational school students.

Objective: To analyze the epidemiological characteristics of mumps in Shanxi Province from 2014 to 2023, so as to provide scientific evidence for targeted prevention strategies. Methods: Mumps case data in Shanxi Province were obtained from the China Information System for Disease Prevention and Control. Descriptive epidemiological analysis and age-period-cohort (APC) analysis were carried out on the reported incidence of mumps from 2014 to 2023. Results: A total of 44 360 mumps cases were reported in Shanxi Province from 2014 to 2023, with an average annual incidence rate of 11.78/100 000. The incidence rates were high during 2017-2019, which were 21.00/100 000, 16.76/100 000, and 19.51/100 000, respectively. Males had a higher incidence rate (13.50/100 000) than females (9.98/100 000). Children aged 5-9 years were the most affected group, accounting for 47.29% of total cases. In 2017 and 2019, incidence rates among the 5-15-year-old group were particularly high, reaching 155.08/100 000 and 131.78/100 000, respectively. The APC model age effect, period effect and cohort effect of the reported incidence rate in the high-incidence population aged 0-20 years all had statistical significance ( P <0.05). The age-relative risk ( RR ) decreased from 1.75 in the 0-year-old group to 0.33 in the 20-year-old group, and the birth cohort RR decreased from 2.58 in 1994 to 0.26 in 2023. The morbidity risk of the population aged 0-20 years showed a trend of first increasing and then decreasing over time, among which it was the highest in 2017 ( RR =1.23) and the lowest in 2023 ( RR =0.29). Conclusions Shanxi exhibits cyclical mumps epidemics, with school-aged children as the high-risk population. School health management work should be carried out, and the surveillance of mumps in high-risk areas and the routine vaccination of two doses of mumps-containing vaccines for eligible children should be strengthened.

Objective: To explore the potential category patterns of risk prevention and control behaviors of HIV infection among young students who have sex with men (MSM) and their impact on HIV infection and late detection, aiming to optimize intervention strategies. Methods: From September 2017 to December 2024, a total of 1 637 MSM young students in Tianjin were recruited through both online and offline channels. Latent class analysis was applied to classify 11 HIV risk prevention and control behaviors [condom use during the most recent anal sex in the past 6 months, consistent condom use, use of water based lubricants, abstinence from recreational drugs, regular on site professional testing, fixed sexual partners, partner testing, awareness of partner s HIV testing results, testing before sexual activity, nucleic acid testing, and use of pre exposure prophylaxis (PrEP) or post exposure prophylaxis (PEP)]. Multivariate Logistic regression analyzed associations between demographic characteristics/intervention services factors and latent classes. Differences in HIV infection and late detection across behavior patterns were compared. Results: HIV risk prevention and control behaviors among MSM students were classified into three latent classes:condom dependent group (38.42%), low prevention group (27.73%), and comprehensive prevention group (33.85%). Students who received condom promotion/testing services were more likely to belong to the comprehensive prevention group ( OR =5.58), while those who received peer education were less likely to the comprehensive prevention group ( OR =0.43) (both P <0.01). Among the MSM student population, the HIV infection rate was 4.83%, with 2.26% of cases detected late. The HIV infection rate (1.45%) and late detection proportion (0.82%) in the comprehensive prevention group were lower than those in the low prevention group (7.89% and 3.83%, respectively) ( χ 2=16.20, 7.31, both P <0.01). Conclusions HIV risk prevention and control behaviors among MSM young students exhibit significant heterogeneity. Comprehensive prevention strategies can effectively reduce HIV infection and late detection risks. It is necessary to optimize peer education content and improve the accessibility of diversified prevention measures such as PrEP/PEP to enhance HIV prevention and control.

[Objective] To determine the correlation between traditional Chinese medicine (TCM) inspection of spirit classification and the severity grade of depression based on facial features, offering insights for intelligent intergrated TCM and western medicine diagnosis of depression. [Methods] Using the Audio-Visual Emotion Challenge and Workshop (AVEC 2014) public dataset on depression, which conclude 150 interview videos, the samples were classified according to the TCM inspection of spirit classification: Deshen (得神, presence of spirit), Shaoshen (少神, insufficiency of spirit), and Shenluan (神乱, confusion of spirit). Meanwhile, based on Beck Depression Inventory-II (BDI-II) score for the severity grade of depression, the samples were divided into minimal (0 – 13, Q1), mild (14 – 19, Q2), moderate (20 – 28, Q3), and severe (29 – 63, Q4). Sixty-eight landmarks were extracted with a ResNet-50 network, and the feature extracion mode was stadardized. Random forest and support vectior machine (SVM) classifiers were used to predict TCM inspection of spirit classification and the severity grade of depression, respectively. A Chi-square test and Apriori association rule mining were then applied to quantify and explore the relationships. [Results] The analysis revealed a statistically significant and moderately strong association between TCM spirit classification and the severity grade of depression, as confirmed by a Chi-square test (χ2 = 14.04, P = 0.029) with a Cramer’s V effect size of 0.243. Further exploration using association rule mining identified the most compelling rule: “moderate depression (Q3) → Shenluan”. This rule demonstrated a support level of 5%, indicating this specific co-occurrence was present in 5% of the cohort. Crucially, it achieved a high Confidence of 86%, meaning that among patients diagnosed with Q3, 86% exhibited the Shenluan pattern according to TCM assessment. The substantial Lift of 2.37 signifies that the observed likelihood of Shenluan manifesting in Q3 patients is 2.37 times higher than would be expected by chance if these states were independent—compelling evidence of a highly non-random association. Consequently, Shenluan emerges as a distinct and core TCM diagnostic manifestation strongly linked to Q3, forming a clinically significant phenotype within this patient subgroup. [Conclusion] Automated facial analysis can serve as a common lens for TCM and western psychological assessments align in the diagnosis of depression. The inspection of spirit decline trajectory parallels worsening depression, supporting early screening and stratified intervention, and providing a reference for the intelligent assistance of integrated TCM and western medicine in the diagnosis of depression.