Objective:To observe any effect of combining interactive scalp acupuncture with constraint-induced movement therapy (CIMT) in treating the upper extremity motor function of children with spastic hemiplegic cerebral palsy.Methods:Fifty-seven children with spastic hemiplegic cerebral palsy were randomly divided into a control group of 28 and an observation group of 29. The control group was given conventional rehabilitation and routine CIMT, while the observation group was additionally provided with interactive scalp acupuncture. In the observation group the CIMT lasted for 30 minutes while the needles were retained. Then, after the needles were removed, the family administered simple rehabilitation training for 2.5 hours guided by a rehabilitation therapist. The treatments were administered 5 days per week for 3 weeks as a session, and the whole treatment consisted of 3 sessions. Before, as well as 1 month and 3 months after the treatment, upper extremity motor function in both groups was evaluated using the Melbourne assessment scale 2 (MA2) and the fine motor Peabody developmental motor scales. Muscle tone in the children′s elbow flexors was assessed using the modified Ashworth scale (MAS).Results:After both 1 and 3 months of treatment, the average MA2 scores of both groups were significantly better than those before treatment, with those of the observation group significantly superior to the control group′s averages. After both 1 and 3 months, both groups′ visual-motor integration scores, grasping ability scores and total scores had improved significantly, with those of the observation group significantly better than in the control group, on average. The MAS scores of both groups were also significantly better than before the treatment, but with no significant differences between the two groups at either time point.Conclusions:Interactive scalp acupuncture combined with constraint-induced movement therapy can significantly improve the upper extremity motor functioning and fine motor ability of children with spastic hemiplegic cerebral palsy.

Objective:To investigate the effect of intravitreal injection of 7, 8-dihydroxyflavone (DHF) on N-methyl-D-aspartate (NMDA)-induced apoptosis of retinal ganglion cells (RGCs).Methods:A total of 138 male Sprague-Dawley rats aged 6-8 weeks were randomly divided into normal control group (30 rats), model control group (36 rats), DHF treatment group (36 rats), and brain-derived neurotrophic factor (BDNF) control group (36 rats) using the random number table method, which received intravitreal injections of 5 μl 0.1 mmol/L phosphate buffered saline, 10 mmol/L NMDA, 10 mmol/L NMDA+ 100 mmol/L DHF, and 10 mmol/L NMDA+ 100 mmol/L BDNF, according to the group.The right eye was taken as the experimental eye.At 12 hours, 1 day, 3 days, 7 days, 14 days, and 28 days after modeling, RGCs were observed and counted by immunofluorescence staining.The apoptosis rate of peripapillary cells was assessed by TUNEL staining.At 12 hours, 3 days, 14 days, and 28 days after treatment, the expression of caspase-3, B-cell lymphoma-2 (bcl-2), bcl-2 associated X protein (bax), and tyrosine kinase receptor B (TrkB) were detected by real-time quantitative fluorescence PCR.The use and feeding of experimental animals in this study followed the Regulations on the Management of Laboratory Animals issued by the Ministry of Science and Technology.This research protocol was reviewed and approved by the Medical Ethics Committee of Southwest Jiaotong University (No.SWJTU-2303-NSFC[066]).Results:The RGCs count and the apoptosis rates in the normal control group, DHF treatment group, and BDNF control group were significantly higher than those in the model control group at each time point after treatment (all P<0.05).There was no significant difference in the apoptosis rate of peripapillary cells between the DHF treatment group and the BDNF control group at different time points after treatment (all P>0.05).Compared with the model control group, the TrkB mRNA expressions were significantly increased in the DHF treatment group at 12 hours, 3 days, and 14 days after treatment and in the BDNF control group at 3, 14, and 28 days after treatment (all P<0.05).At 12 hours and 3 days after treatment, the expression of caspase-3 mRNA was significantly decreased in the DHF treatment group and BDNF control group compared with the model control group (all P<0.05).At 12 hours after treatment, the relative expressions of bax and bcl-2 mRNA were significantly higher in the DHF treatment group than in the normal control group (both P<0.05).Compared with normal control group, the relative expression of bax mRNA at 14 days after treatment and the relative expression of bcl-2 mRNA in the BDNF control group were significantly increased at 12 hours and 3 days (all P<0.05). Conclusions:Intravitreal injection of DHF effectively alleviates NMDA-induced RGCs damage in the rat model.Its neuroprotective mechanism may be achieved by promoting TrkB expression and inhibiting related apoptotic factors.

Objective:To observe any effect of combining interactive scalp acupuncture with constraint-induced movement therapy (CIMT) in treating the upper extremity motor function of children with spastic hemiplegic cerebral palsy.Methods:Fifty-seven children with spastic hemiplegic cerebral palsy were randomly divided into a control group of 28 and an observation group of 29. The control group was given conventional rehabilitation and routine CIMT, while the observation group was additionally provided with interactive scalp acupuncture. In the observation group the CIMT lasted for 30 minutes while the needles were retained. Then, after the needles were removed, the family administered simple rehabilitation training for 2.5 hours guided by a rehabilitation therapist. The treatments were administered 5 days per week for 3 weeks as a session, and the whole treatment consisted of 3 sessions. Before, as well as 1 month and 3 months after the treatment, upper extremity motor function in both groups was evaluated using the Melbourne assessment scale 2 (MA2) and the fine motor Peabody developmental motor scales. Muscle tone in the children′s elbow flexors was assessed using the modified Ashworth scale (MAS).Results:After both 1 and 3 months of treatment, the average MA2 scores of both groups were significantly better than those before treatment, with those of the observation group significantly superior to the control group′s averages. After both 1 and 3 months, both groups′ visual-motor integration scores, grasping ability scores and total scores had improved significantly, with those of the observation group significantly better than in the control group, on average. The MAS scores of both groups were also significantly better than before the treatment, but with no significant differences between the two groups at either time point.Conclusions:Interactive scalp acupuncture combined with constraint-induced movement therapy can significantly improve the upper extremity motor functioning and fine motor ability of children with spastic hemiplegic cerebral palsy.

Objective:To investigate the effect of intravitreal injection of 7, 8-dihydroxyflavone (DHF) on N-methyl-D-aspartate (NMDA)-induced apoptosis of retinal ganglion cells (RGCs).Methods:A total of 138 male Sprague-Dawley rats aged 6-8 weeks were randomly divided into normal control group (30 rats), model control group (36 rats), DHF treatment group (36 rats), and brain-derived neurotrophic factor (BDNF) control group (36 rats) using the random number table method, which received intravitreal injections of 5 μl 0.1 mmol/L phosphate buffered saline, 10 mmol/L NMDA, 10 mmol/L NMDA+ 100 mmol/L DHF, and 10 mmol/L NMDA+ 100 mmol/L BDNF, according to the group.The right eye was taken as the experimental eye.At 12 hours, 1 day, 3 days, 7 days, 14 days, and 28 days after modeling, RGCs were observed and counted by immunofluorescence staining.The apoptosis rate of peripapillary cells was assessed by TUNEL staining.At 12 hours, 3 days, 14 days, and 28 days after treatment, the expression of caspase-3, B-cell lymphoma-2 (bcl-2), bcl-2 associated X protein (bax), and tyrosine kinase receptor B (TrkB) were detected by real-time quantitative fluorescence PCR.The use and feeding of experimental animals in this study followed the Regulations on the Management of Laboratory Animals issued by the Ministry of Science and Technology.This research protocol was reviewed and approved by the Medical Ethics Committee of Southwest Jiaotong University (No.SWJTU-2303-NSFC[066]).Results:The RGCs count and the apoptosis rates in the normal control group, DHF treatment group, and BDNF control group were significantly higher than those in the model control group at each time point after treatment (all P<0.05).There was no significant difference in the apoptosis rate of peripapillary cells between the DHF treatment group and the BDNF control group at different time points after treatment (all P>0.05).Compared with the model control group, the TrkB mRNA expressions were significantly increased in the DHF treatment group at 12 hours, 3 days, and 14 days after treatment and in the BDNF control group at 3, 14, and 28 days after treatment (all P<0.05).At 12 hours and 3 days after treatment, the expression of caspase-3 mRNA was significantly decreased in the DHF treatment group and BDNF control group compared with the model control group (all P<0.05).At 12 hours after treatment, the relative expressions of bax and bcl-2 mRNA were significantly higher in the DHF treatment group than in the normal control group (both P<0.05).Compared with normal control group, the relative expression of bax mRNA at 14 days after treatment and the relative expression of bcl-2 mRNA in the BDNF control group were significantly increased at 12 hours and 3 days (all P<0.05). Conclusions:Intravitreal injection of DHF effectively alleviates NMDA-induced RGCs damage in the rat model.Its neuroprotective mechanism may be achieved by promoting TrkB expression and inhibiting related apoptotic factors.

Objective To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the diagnosis of axillary lymph node metastasis(ALNM)in breast cancer patients with low HER-2 expression.Methods A total of 297 breast cancer patients with low HER-2 expression treated at the Affiliated Hospital of Xuzhou Medical University were enrolled and divided into ALNM group(n=71)and non-ALNM group(n=226)according to whether there was ALNM.All patients underwent DCE-MRI,and DCE-MRI derived parameters were collected and analyzed.Logistic regression analysis was used to identify the risk factors for ALNM,and the efficacy of DCE-MRI in diagnosing ALNM was assessed using receiver operating characteristic curve.Results Significant differences were observed between two groups in lesion distribution,TNM staging,vascular invasion,and most DCE-MRI derived parameters including short-to-long axis ratio,Ve,Ktrans,Kep,ADC and SER(all P<0.05).Multivariate regression analysis revealed that the short-to-long axis ratio,Ve,Ktrans,Kep,ADC and SER were significant risk factors for ALNM in breast cancer patients.Comparative analysis demonstrated that the combination of DCE-MRI derived parameters yielded a maximum area under the curve of 0.976,with a sensitivity of 91.5%and a specificity of 92.9%.Conclusion DCE-MRI is an effective tool for determining the presence of ALNM in breast cancer patients with low HER-2 expression,providing significant diagnostic evidence for clinical practice.

The liver performs multiple life-sustaining functions. Hepatic diseases, including hepatitis, cirrhosis, and hepatoma, pose significant health and economic burdens globally. Along with the advances in nanotechnology, mesoporous silica nanoparticles (MSNs) exhibiting diversiform size and shape, distinct morphological properties, and favorable physico-chemical features have become an ideal choice for drug delivery systems and inspire alternative thinking for the management of hepatic diseases. Initially, we introduce the physiological structure of the liver and highlight its intrinsic cell types and correlative functions. Next, we detail the synthesis methods and physicochemical properties of MSNs and their capacity for controlled drug loading and release. Particularly, we discuss the interactions between liver and MSNs with respect to the passive targeting mechanisms of MSNs within the liver by adjusting their particle size, pore diameter, surface charge, hydrophobicity/hydrophilicity, and surface functionalization. Subsequently, we emphasize the role of MSNs in regulating liver pathophysiology, exploring their value in addressing liver pathological states, such as tumors and inflammation, combined with multi-functional designs and intelligent modes to enhance drug targeting and minimize side effects. Lastly, we put forward the problems, challenges, opportunities, as well as clinical translational issues faced by MSNs in the management of liver diseases.

Objective To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the diagnosis of axillary lymph node metastasis(ALNM)in breast cancer patients with low HER-2 expression.Methods A total of 297 breast cancer patients with low HER-2 expression treated at the Affiliated Hospital of Xuzhou Medical University were enrolled and divided into ALNM group(n=71)and non-ALNM group(n=226)according to whether there was ALNM.All patients underwent DCE-MRI,and DCE-MRI derived parameters were collected and analyzed.Logistic regression analysis was used to identify the risk factors for ALNM,and the efficacy of DCE-MRI in diagnosing ALNM was assessed using receiver operating characteristic curve.Results Significant differences were observed between two groups in lesion distribution,TNM staging,vascular invasion,and most DCE-MRI derived parameters including short-to-long axis ratio,Ve,Ktrans,Kep,ADC and SER(all P<0.05).Multivariate regression analysis revealed that the short-to-long axis ratio,Ve,Ktrans,Kep,ADC and SER were significant risk factors for ALNM in breast cancer patients.Comparative analysis demonstrated that the combination of DCE-MRI derived parameters yielded a maximum area under the curve of 0.976,with a sensitivity of 91.5%and a specificity of 92.9%.Conclusion DCE-MRI is an effective tool for determining the presence of ALNM in breast cancer patients with low HER-2 expression,providing significant diagnostic evidence for clinical practice.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective:To investigate the perioperative bleeding of patients undergoing transurethral plasma kinetic prostatectomy (TUPKP) and analyze the related influencing factors.Methods:Retrospectively analyzed the clinical data of 206 patients with TUPKP admitted to Xi′an Lintong District People′s Hospital from March 2021 to March 2024, all patients were aged from 51 to 83 years old, with an average of (64.33±9.74) years; patients′ course of disease was 1 to 7 years, averaged (4.57±1.59) years. and the perioperative bleeding of patients was observed and divided into bleeding group ( n=108) and non-bleeding group( n=98). By comparing the general data and laboratory data between groups, the influencing factors of perioperative bleeding in TUPKP patients were analyzed by multivariate Logistic regression. Results The proportion of diabetes and postoperative constipation in bleeding group was higher than that in non-bleeding group, and the prostate volume and operation time were higher than that in non-bleeding group ( P<0.05). Serum calcium, platelet count (PLT) and activated partial thromboplastin time (APTT) in bleeding group were lower than those in non-bleeding group ( P<0.05). Multivariate Logistic regression analysis showed that diabetes ( OR=4.283), prostate volume ( OR=1.111), operation time ( OR=1.091) and postoperative constipation ( OR=4.144) were the risk factors for perioperative bleeding in TUPKP patients ( P<0.05). Serum calcium ( OR=0.001) and PLT ( OR=0.980) are the protective factors for perioperative bleeding in TUPKP patients ( P<0.05). Conclusion:The rate of perioperative bleeding in TUPKP patients is of great risk. Diabetes, prostate volume, operation time and postoperative constipation are its risk factors, and serum calcium and PLT are its protective factors.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.