Objective To analyze the pharmacological mechanism of Shenling Baizhu powder in the treatment of cancer cachexia based on the network pharmacological method and provide a reference for the clinical application of classical traditional Chinese medicine(TCM) prescriptions. Methods Through TCMSP and BATMAN-TCM databases, the main chemical components and their targets of the TCM prescription of Shenling Baizhu powder were obtained, and the active components of the TCM were screened according to ADME. The main targets of cancer cachexia were obtained through OMIM, Genecards, Disgenet and DRUGBANK databases, and protein interaction analysis was conducted using String platform to build a PPI network. The “drug-active ingredient-target” network of Shenling Baizhu powder was constructed by Cytoscape 3.7.2 software, and then the biological processes and pathways involved were analyzed by using Metascape platform. Finally, molecular docking verification was conducted by Discovery Studio. Results The core active ingredients of Shenling Baizhu powder in the treatment of cancer cachexia were quercetin, kaempferol, pyrolignous acid, stigmasterol, luteolin, β-sitosterol, etc. The core targets were AKT1, TP53, TNF, IL-6, MAPK3, CASP3, JUN, CTNNB1, HIF1A, EGFR, etc. The molecular docking test also showed that the top 10 active ingredients, such as pyrolignous acid, stigmasterol and β-sitosterol, had good binding activities with most of the target sites. The biological pathway of Shenling Baizhu powder in treating cancer cachexia wss mainly to regulate tumor related pathway, metabolism related pathway, inflammatory factors and appetite related pathway. Conclusion This study preliminarily revealed the mechanism of action of Shenling Baizhu powder in treating cancer cachexia with multi components, multi targets and multi pathways, which provided a basis for the clinical development and utilization of Shenling Baizhu powder.

OBJECTIVE: To evaluate the efficacy and safety of Shexiang Tongxin Dropping Pill (STDP) in treating stable angina patients with phlegm-heat and blood-stasis syndrome by exercise duration and metabolic equivalents. METHODS: This multicenter, randomized, double-blind, placebo-controlled clinical trial enrolled stable angina patients with phlegm-heat and blood-stasis syndrome from 22 hospitals. They were randomized 1:1 to STDP (35 mg/pill, 6 pills per day) or placebo for 56 days. The primary outcome was the exercise duration and metabolic equivalents (METs) assessed by the standard Bruce exercise treadmill test after 56 days of treatment. The secondary outcomes included the total angina symptom score, Chinese medicine (CM) symptom scores, Seattle Angina Questionnaire (SAQ) scores, changes in ST-T on electrocardiogram and adverse events (AEs). RESULTS: This trial enrolled 309 patients, including 155 and 154 in the STDP and placebo groups, respectively. STDP significantly prolonged exercise duration with an increase of 51.0 s, compared to a decrease of 12.0 s with placebo (change rate: -11.1% vs. 3.2%, P<0.01). The increase in METs was significantly greater in the STDP group than in the placebo group (change: -0.4 vs. 0.0, change rate: -5.0% vs. 0.0%, P<0.01). The improvement of total angina symptom scores (25.0% vs. 0.0%), CM symptom scores (38.7% vs. 11.8%), reduction of nitroglycerin consumption (100.0% vs. 11.3%), and all domains of SAQ, were significantly greater with STDP than placebo (all P<0.01). The changes in Q-T intervals at 28 and 56 days from baseline were similar between the two groups (both P>0.05). Twenty-five participants (16.3%) with STDP and 16 (10.5%) with placebo experienced AEs (P=0.131), with no serious AEs observed. CONCLUSION STDP could improve exercise tolerance in patients with stable angina and phlegm-heat and blood stasis syndrome, with a favorable safety profile. (Registration No. ChiCTR-IPR-15006020).
Humans ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Middle Aged ; Angina, Stable/physiopathology* ; Aged ; Syndrome ; Treatment Outcome ; Placebos ; Tablets

Objective To explore the mediating effect of coping styles on the early postoperative cognitive appraisal of health and stigma in patients with radical prostatectomy,so as to provide a reference for an early intervention in postoperative stigma.Methods Convenience sampling was used to select 223 patients who received radical prostatectomy at 5 Tier-ⅢA hospitals in Guangzhou from November 2022 to December 2023.Data were collected using the demographic data questionnaire,social impact scale,brief health cognition appraisal scale and medical coping style scale.Pearson correlation analysis was performed to examine the correlations between the stigma,health cognition appraisal and coping styles.Structural equation modelling was employed to analyse the mediating effect of coping styles on the health cognition appraisals and stigma.Results A total of 210 patients completed the study.The score of stigma for the patients after the radical prostatectomy was(49.46±13.56).Stigma exhibited positive correlations with negative cognitive appraisals(threat and harm)and negative coping styles(avoidance and submission)(both P<0.01).There were negative correlations between stigma and challenging cognitive appraisal and confrontation coping style(both P<0.01).Submission coping style played a mediating role between the cognitive appraisal of health(harm,threat and challenge)and stigma(β=0.072,0.075,-0.121,all P<0.01),accounting for 14.06％,23.15％and 100.00％,respectively,of the total effect.Conclusion Submission coping style is the mediator between the early postoperative cognitive appraisals and stigma in patients with radical prostatectomy.Negative cognitive appraisal positively predicts stigma through the submission coping style,while challenging cognitive appraisal negatively predicts stigma through the submission coping style.Caregivers should assess the early coping styles of patients after surgery,guide patients to correctly cope with the disease,and help them to avoid submissive responses to the postoperative stress hence to reduce the sense of stigma.

BACKGROUND:In recent years,brain-computer interface technology has emerged as a transformative approach in human-computer interaction by recognizing movement intentions to control external devices.This technology has been utilized in the treatment of lower limb functions after stroke,offering new hope for the rehabilitation of stroke patients.OBJECTIVE:To analyze and summarize the application of brain-computer interface technology in the rehabilitation of lower limb motor functions in stroke patients in recent years,and to explore the clinical application value of brain-computer interface technology in the functional rehabilitation of the lower limbs in stroke patients.METHODS:A literature search in CNKI and PubMed was conducted using"stroke,brain-computer interfaces,lower extremity"as search terms in Chinese and English,respectively,with the search time range set from January 2014 to June 2024.RESULTS AND CONCLUSION:Brain-computer interfaces hold promising prospects for the recovery of lower limb motor function in stroke patients,and their application in the field of rehabilitation medicine is continuously expanding.However,the underlying mechanisms have not yet been fully elucidated.Moreover,there are certain limitations in the acquisition of electroencephalogram signals from patients,resulting in reduced precision for brain-computer interface systems in recognizing limb movements.Current decoding methods also exhibit constraints in identifying the gait cycle and fail to accurately locate voluntary movements of the various joints and muscles of the lower limbs,impeding the application of brain-computer interface technology.Subsequent research should focus on elucidating the neural mechanisms by which brain-computer interface technology facilitates the recovery of lower limb motor functions in stroke patients,refining the technologies and devices for extracting brain motor signals,and formulating multimodal feedback for individual patients to realize more effective motor rehabilitation.These advances could propel the development of brain-computer interface technology in the field of lower limb motor function recovery,ameliorate patient rehabilitation outcomes,and elevate the quality of life.

Based on the target recognition ability of split aptamer and intelligent analytical capability of molecular logic gate,in this work,two split aptamers were integrated into"AND"logic gate to construct a novel ortho-nucleic acid fluorescence sensor for simultaneous detection of thrombin and myoglobin.When there was one target,the response of the signal was only a single fluorescence output signal,which was used as an evaluation standard for early low-risk judgment.When two targets coexisted,the split aptamer bound to the target to form a ternary complex and led to the head and tail ortho-nucleic acid effect respectively,and triggered the G4 chain to enhance the fluorescence signal of thioflavin T and the fluorescence signal quenching of Cyanine 3,which could be used as an evaluation criterion for early high-risk judgement.Under the optimal conditions,the linear range for detection of thrombin was 3-200 nmol/L,with a correlation coefficient of 0.9931 and a detection limit of 0.97 nmol/L,and the linear range for detection of myoglobin was 6-400 nmol/L,with a correlation coefficient of 0.9933,and a detection limit of 2.14 nmol/L.The method was applied to simultaneous determination of thrombin and myoglobin in clinical serum samples,and the recoveries were 85.4%-118.3%and 85.8%-119.9%,respectively,with relative standard deviations of less than 6.5%.Compared with the standard method,the relative error range was from-8.8%to 5.6%.In addition,the logical diagnosis results of 4 serum samples were high-risk of acute myocardial infarction in 2 cases and low-risk in 2 cases.The ″AND″ logic gate ortho-nucleic acid fluorescence sensing method showed many advantages such as high selectivity,rapidity,accuracy and simultaneous detection,which offered important reference for early diagnosis of acute myocardial infarction,and also provided a general detection design strategy and platform for simultaneous detection of biomarkers.

A method that integrates the features of image patches from corneal lesions and conjunctival congestion-like complications is proposed to address the limitations of manual keratitis diagnosis(i.e.,time-consuming,laborious,high subjectivity)and the generally low accuracy of automatic keratitis diagnosis based on original slit-lamp images.Specifically,samples are acquired from the corneal and conjunctival regions.A cost-sensitive convolutional neural network is then used to extract and concatenate the high-level features of these image patches.After dimensionality reduction through principal component analysis,the processed features are input into the fully connected layer for classification.Trained and evaluated on 6414 slit-lamp images collected from Ningbo Eye Hospital,the proposed method achieves accuracies of 97.8%,98.6%,and 97.0%for keratitis,normal cornea,and other abnormal corneas,respectively.This method effectively integrates relevant features and provides a feasible solution for high-accuracy keratitis diagnosis.

Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.

Objective To observe the clinical efficacy of multi-target repetitive transcranial magnetic stimulation on freezing of gait in Parkinson's disease. Methods A total of 45 Parkinson's disease patients with freezing of gait in our hospital from January 2023 to January 2024 were selected and randomly divided into primary motor cortex(M1) treatment group (M1 group),dorsolateral prefrontal cortex (DLPFC) group (D group),and M1+DLPFC group (MD group),with 15 cases in each group. The stimulation site of patients in M1 group was bilateral M1 region lower limb innervation region,the stimulation site of patients in D group was bilateral DLPFC,and the left M1 region and DLPFC region of patients in MD group were stimulated on alternate days. The efficacy of Parkinson's disease patients with freezing of gait and the changes of mood scores were compared among the groups. Results One patient in D group and one in MD group were lost to follow-up,and 43 patients were eventually included. The freezing of gait questionnaire (FOGQ) scores,timed up and go test (TUGT) total time,modified standing-start 180° turn test (SS-180) time,unified Parkinson's disease rating scale part Ⅲ(UPDRS Ⅲ) scores,Hamilton depression scale (HAMD) scores and Hamilton anxiety scale (HAMA) scores of patients after treatment were improved compared with those before treatment in all three groups (P<0.05),and the improvement effect of MD group was significantly better than those of M1 group and D group (P<0.05). Conclusion High-frequency repetitive transcranial magnetic stimulation targeting bilateral M1 region and DLPFC region can improve freezing of gait,walking ability,and motor function,and alleviate symptoms of depression and anxiety of Parkinson's disease patients.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.