ObjectiveTo investigate the characteristics of gray matter structure and clinical symptoms in patients with Alzheimer's disease （AD） comorbid with apathy （AD-A）. MethodsThe study included 30 patients with AD-A， 30 AD disease patients without apathy （AD without apathy， AD-NA）， and 30 healthy controls （HCs） matched in gender， age， and years of education. All participants underwent a comprehensive neuropsychological assessment and magnetic resonance imaging （MRI） scans. Voxel-based morphometry （VBM） was used to analyze changes in gray matter volume among the three groups. Additionally， the correlation between the identified abnormal brain regions and apathy scale scores was analyzed. ResultsThere were no statistically significant differences among the three groups in terms of age， gender， years of education， or total intracranial volume. Compared with the HCs group， both the AD-A and AD-NA groups showed significantly lower scores in cognitive function （P<0.001）. The AD-A group exhibited significantly higher apathy scale scores compared with the AD-NA group （P<0.001）. Compared with the AD-NA group， the AD-A group showed reduced gray matter volume in the bilateral caudate nucleus， left orbitofrontal cortex， lingual gyrus， inferior frontal gyrus， superior frontal gyrus， entorhinal cortex， right middle frontal gyrus and posterior cingulate cortex （FWE-corrected， P<0.05 for all）. Compared with the HCs group， the AD-A group exhibited reduced gray matter volume in the bilateral middle temporal gyrus， left fusiform gyrus， calcarine sulcus， postcentral gyrus， right inferior frontal gyrus and supramarginal gyrus （FWE-corrected， P<0.05 for all）. Compared with the HCs group， the AD-NA group showed reduced gray matter volume in the left precuneus， inferior temporal gyrus， and right inferior temporal gyrus （FWE-corrected， P<0.05 for all）. In the AD-A group， changes in the gray matter volume of the left caudate nucleus （r= -0.557， P=0.002） and right middle frontal gyrus （r=-0.620， P=0.001） were negatively correlated with the apathy evaluation scale （AES） scores. ConclusionPatients in the AD-A group exhibited significant atrophy in the frontal-temporal-basal ganglia circuit， and the degree of gray matter atrophy was correlated with the severity of apathy.

Objective To investigate the efficacy of leaflet augmentation technique to repair the recurrent mitral valve (MV) regurgitation after mitral repair in children. Methods A retrospective analysis was conducted on the clinical data of children who underwent redo MV repair for recurrent regurgitation after initial MV repair, using a leaflet augmentation technique combined with a standardized repair strategy at Fuwai Hospital, Chinese Academy of Medical Sciences, from 2018 to 2022. The pathological features of the MV, key intraoperative procedures, and short- to mid-term follow-up outcomes were analyzed. Results A total of 24 patients (12 male, 12 female) were included, with a median age of 37.6 (range, 16.5–120.0) months. The mean interval from the initial surgery was (24.9±17.0) months. All children had severe mitral regurgitation preoperatively. The cardiopulmonary bypass time was (150.1±49.5) min, and the aortic cross-clamp time was (94.0±24.2) min. There were no early postoperative deaths. During a mean follow-up of (20.3±9.1) months, 3 (12.5%) patients developed moderate or severe mitral regurgitation (2 severe, 1 moderate). One (4.2%) patient died during follow-up, and one (4.2%) patient underwent a second MV reoperation. The left ventricular end-diastolic diameter was significantly reduced postoperatively compared to preoperatively [ (43.5±8.6) mm vs. (35.8±7.8)mm, P<0.001]. Conclusion The leaflet augmentation technique combined with a standardized repair strategy can achieve satisfactory short- to mid-term outcomes for the redo mitral repair after previous MV repair. It can be considered a safe and feasible technical option for cases with complex valvular lesions and severe pathological changes.

During the period of the Republic of China, acupuncture faced different opportunities and developments in China and the West. The correspondence between Soulié de Morant, the father of European acupuncture, and FANG Shen'an, a famous acupuncture master of the Republic of China, is of great significance to explore the exchange of acupuncture between China and France, the development of acupuncture in France, the Western learning of Chinese medicine, and the dissemination of academic ideas of acupuncture in the Republic of China. The authors studied Soulié de Morant's collection stored in the Museum of Western Studies of Chinese Medicine of Yunnan University of Chinese Medicine, and found Soulié de Morant's annotation of Jinzhen Mizhuan (Secrets of Golden Needle), the 1937 edition, and 3 paper letters with FANG Shen'an (2 letters in French and 1 letter in Chinese). After the language translation and collation, based on the correspondence between two masters, in association with the historical background and the narration of CHEN Yemeng, the inheritor of Fang's acupuncture, this paper reviews the process of academic exchanges between them, so as to display the historical development of acupuncture in China and the West.
China ; History, 20th Century ; Acupuncture/education* ; Humans ; Acupuncture Therapy/history* ; France ; Correspondence as Topic/history*

In 1929, George Soulié de Morant and Paul Ferreyrolles co-authored their first acupuncture-moxibustion paper titled "L' Acuponcture en Chine vingt siècles avant J.-C. et la réflexothérapie moderne", greatly advancing the development of acupuncture-moxibustion in Europe. Their paper systematically explains the holistic view and the concept of yin-yang balance in traditional Chinese medicine, describes the techniques of acupuncture and moxibustion, innovatively classifies acupuncture-moxibustion as "reflexotherapy", organizes the effects of certain acupuncture points illustrated on human acupoint atlas; and for the first time, it summarizes the correspondence between acupuncture points and Weihe trigger points. In the historical background of the neo-Hippocratic movement, they used the existing theories at that time to explain acupuncture, and adopted the analogical medicine to explore the mechanisms of acupuncture-moxibustion, which gradually initiated the modern era of acupuncture-moxibustion in France. Such research method is conducive to reducing the unfamiliarity of acupuncture-moxibustion among westerners, deepening their understanding of its theories and therapeutic effect, and also integrating it with other medical research. It breaks through the limitations of traditional theories and obtains the self-improvement and progress.
Humans ; Moxibustion/history* ; Acupuncture Therapy/history* ; China ; History, Ancient ; History, 20th Century ; Acupuncture/history* ; Reflexotherapy/history* ; Acupuncture Points ; History, 19th Century ; Medicine, Chinese Traditional/history*

During the mid-20th century, Dr. Paul Ferreyrolles played an important role in the dissemination of acupuncture in France. He keenly recognized the unique value of the acupuncture knowledge brought from China by Soulié de Morant, devoted himself to its practice and research, and attempted to interpret its principles through western knowledge. From Ferreyrolles' experiences and contributions, three key factors can be identified for the successful spread of acupuncture in Europe: the availability of comprehensive translated texts, the broad recognition of therapeutic efficacy, and the adaptation and interpretation of acupuncture in western terms.
Acupuncture Therapy/history* ; France ; Humans ; History, 20th Century ; Acupuncture/education*

BACKGROUND: Neoadjuvant chemoradiotherapy followed by radical surgery has been a common practice for patients with locally advanced rectal cancer, but the response rate varies among patients. This study aimed to develop a ResNet-Vision Transformer based magnetic resonance imaging (MRI)-endoscopy fusion model to precisely predict treatment response and provide personalized treatment. METHODS: In this multicenter study, 366 eligible patients who had undergone neoadjuvant chemoradiotherapy followed by radical surgery at eight Chinese tertiary hospitals between January 2017 and June 2024 were recruited, with 2928 pretreatment colonic endoscopic images and 366 pelvic MRI images. An MRI-endoscopy fusion model was constructed based on the ResNet backbone and Transformer network using pretreatment MRI and endoscopic images. Treatment response was defined as good response or non-good response based on the tumor regression grade. The Delong test and the Hanley-McNeil test were utilized to compare prediction performance among different models and different subgroups, respectively. The predictive performance of the MRI-endoscopy fusion model was comprehensively validated in the test sets and was further compared to that of the single-modal MRI model and single-modal endoscopy model. RESULTS: The MRI-endoscopy fusion model demonstrated favorable prediction performance. In the internal validation set, the area under the curve (AUC) and accuracy were 0.852 (95% confidence interval [CI]: 0.744-0.940) and 0.737 (95% CI: 0.712-0.844), respectively. Moreover, the AUC and accuracy reached 0.769 (95% CI: 0.678-0.861) and 0.729 (95% CI: 0.628-0.821), respectively, in the external test set. In addition, the MRI-endoscopy fusion model outperformed the single-modal MRI model (AUC: 0.692 [95% CI: 0.609-0.783], accuracy: 0.659 [95% CI: 0.565-0.775]) and the single-modal endoscopy model (AUC: 0.720 [95% CI: 0.617-0.823], accuracy: 0.713 [95% CI: 0.612-0.809]) in the external test set. CONCLUSION The MRI-endoscopy fusion model based on ResNet-Vision Transformer achieved favorable performance in predicting treatment response to neoadjuvant chemoradiotherapy and holds tremendous potential for enabling personalized treatment regimens for locally advanced rectal cancer patients.
Humans ; Rectal Neoplasms/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Male ; Female ; Middle Aged ; Neoadjuvant Therapy/methods* ; Aged ; Adult ; Chemoradiotherapy/methods* ; Endoscopy/methods* ; Treatment Outcome

Stem cell treatment may enhance erectile dysfunction (ED) in individuals with cavernous nerve injury (CNI). Nevertheless, no investigations have directly ascertained the implications of varying amounts of human umbilical cord-derived mesenchymal stem cells (HUC-MSCs) on ED. We compare the efficacy of three various doses of HUC-MSCs as a therapeutic strategy for ED. Sprague-Dawley rats (total = 175) were randomly allocated into five groups. A total of 35 rats underwent sham surgery and 140 rats endured bilateral CNI and were treated with vehicles or doses of HUC-MSCs (1 × 10 6 cells, 5 × 10 6 cells, and 1 × 10 7 cells in 0.1 ml, respectively). Penile tissues were harvested for histological analysis on 1 day, 3 days, 7 days, 14 days, 28 days, 60 days, and 90 days postsurgery. It was found that varying dosages of HUC-MSCs enhanced the erectile function of rats with bilateral CNI and ED. Moreover, there was no significant disparity in the effectiveness of various dosages of HUC-MSCs. However, the expression of endothelial markers (rat endothelial cell antigen-1 [RECA-1] and endothelial nitric oxide synthase [eNOS]), smooth muscle markers (alpha smooth muscle actin [α-SMA] and desmin), and neural markers (neurofilament [RECA-1] and neurogenic nitric oxide synthase [nNOS]) increased significantly with prolonged treatment time. Masson's staining demonstrated an increased in the smooth muscle cell (SMC)/collagen ratio. Significant changes were detected in the microstructures of various types of cells. In vivo imaging system (IVIS) analysis showed that at the 1 st day, the HUC-MSCs implanted moved to the site of damage. Additionally, the oxidative stress levels were dramatically reduced in the penises of rats administered with HUC-MSCs.
Male ; Animals ; Erectile Dysfunction/metabolism* ; Rats, Sprague-Dawley ; Mesenchymal Stem Cell Transplantation/methods* ; Rats ; Penis/pathology* ; Humans ; Disease Models, Animal ; Umbilical Cord/cytology* ; Peripheral Nerve Injuries/complications* ; Mesenchymal Stem Cells ; Nitric Oxide Synthase Type III/metabolism* ; Actins/metabolism* ; Nitric Oxide Synthase Type I/metabolism*

Objective : To investigate the therapeutic effects of a small interfering RNA(siRNA) vector targeting peptidyl arginine deaminase 4(PAD4) and splenocytes infected with a PAD4-siRNA virus, on collagen-induced arthritis(CIA) mice, and to elucidate the underlying mechanisms. Methods : The experiment mice were divided into four groups: control group, model group, therapy group 1 and therapy group 2, with 7 mice in each group. Control group mice were not treated. Initially, collagen-induced arthritis(CIA) mice model were established using bovine type II collagen. Model group mice were injected by PBS buffer Therapy group 1 mice were injected of PAD4-siRNA virus solution into the tail vein of the CIA mice, while therapy group 2 mice were injected of splenocytes infected with PAD4-siRNA virus via the same route. These injections were carried out once a week for a total of eight weeks. Subsequently, the alterations in T follicular helper(Tfh), T follicular regulatory(Tfr), T helper 1(Th1), and CD4+IL-10+T cells in the splenocytes of the mice were analyzed. Additionally, the pathological changes in the articular cartilage of the mice joints were detected. Results : Comparison with control group, mice of model group exhibited a significant increase in the proportions of Tfh and Th1 cells in the spleen(P<0.05), while the proportions of Tfr and CD4+IL-10+T cells remained unchanged. Comparison with model group, therapy group 1 and therapy group 2 demonstrated a significant decrease in the proportions of Tfh and Th1 cells(P<0.05), with no changes were observed in the proportions of Tfr and CD4+IL-10+T cells. Additionally, the articular surface in the mice of control group was smooth, whereas model group showed signs of inflammatory cell infiltration, rough articular surface, and cartilage destruction. Following treatment with PAD4-siRNA, the infiltration of inflammatory cells and cartilage destruction in the hind paws of CIA mice in therapy group 1 were reduced. However, no reduction was observed in the infiltration of inflammatory cells and cartilage destruction in the front paws of CIA mice. In contrast, therapy group 2 exhibited a reduction in the infiltration of inflammatory cells and cartilage destruction in both the front and hind paws of CIA mice. Conclusion Gene silencing of PAD4 expression can decrease the proportion of Tfh and Th1 cells, leading to an amelioration of pathological changes in joints and cartilage of hind paws. Furthermore, the therapeutic efficacy is observed in the front paws of CIA mice, and PAD4-siRNA plays a role on CIA mice by regulating T cells subpopulation of splenocytes.

Alzheimer′s disease is a serious neurodegenerative disorder. Approximately 80% to 90% of patients are accompanied by behavioral and psychological symptoms of dementia (BPSD), which manifest as a series of behavioral, psychological and mental abnormalities. These abnormalities can accelerate the cognitive deterioration and premature death of patients, and thus are regarded as important clinical symptoms. However, the pathogenesis of BPSD is still unknown, and treatment methods are limited. The pathogenesis of BPSD from the perspective of neuroimaging and pathophysiology, and possible treatment measures were analyzed in this article, in order to provide references for the early diagnosis and treatment of BPSD.

This study retrospectively analyzed the clinical data of 43 patients with large-volume renal calculi treated with flexible ureteroscopic lithotripsy (FURL)at our hospital from August 2020 to August 2023. Among the patients, 26 were male and 17 were female; 22 had left-sided stones and 21 had right-sided stones. Thirty-three patients had preoperative placement of a double-J (D-J)stent, while 10 did not. The mean age was (42.7±11.1)years, the mean stone volume was (10.3±3.5)cm 3, and the mean operative time was (97.9±10.4)minutes. All procedures were completed using reusable flexible ureteroscopic lithotripsy. Twenty-two patients received traditional methods of stone expulsion after FURL (control group), while 21 patients received a combination of traditional methods and extracorporeal physical vibration lithotripsy (EPVL) after FURL (experimental group). The experimental group showed a significantly higher stone-free rate at one month (85.7% vs. 54.5%)and a lower reoperation rate (4.8% vs. 31.8%)compared to the control group. The difference in reoperation rates between the experimental and control groups was statistically significant ( P< 0.05). These results suggest that the combination of reusable ureteroscopic lithotripsy and EPVL is a feasible treatment option for large-volume renal calculi.