Objective:To relate the changes in electroencephalography (EEG) signals after a spinal cord injury (SCI) with functional independence.Methods:The EEG data describing ninety SCI patients in both open and closed eye states were compared with those collected from 45 healthy counterparts. The SCI patients′ EEG data were correlated with their spinal cord independence measure (SCIM) scores at corresponding time points. The SCI patients were divided into a cervical SCI group (SCI-C group) and a non-cervical SCI group (SCI-NC group), with 45 cases in each group. The difference in EEG data between them and its correlation with the SCIM scores were also compared and analyzed.Results:In the eyes-open state, the EEG power in the frontal, central, temporal, and right occipital regions of the SCI group was lower than among the control group, on average. There were significant differences in the δ and θ low-frequency bands. The α1 band power in the frontal and right parietal regions was significantly higher in the SCI group, on average. With the eyes closed the δ band power in the right prefrontal, frontal, left central, and temporal regions of the SCI group was lower than among the control group, while the α1 band power in the right prefrontal, frontal, central, and parietal regions was significantly higher. The reactivity to eye opening of the α1 band in the right prefrontal, frontal, central, parietal, and temporal regions was less in the SCI patients compared to healthy subjects. Among the SCI patients, higher EEG power in the β2 band of the right frontal lobe and the α2 and β bands of the right temporal lobe was significantly positively correlated with higher SCIM scores during the eyes-open measurements. And the higher EEG power in the α2 band of the prefrontal and frontal lobes, the β2 band of the frontal lobe, the α2 band of the right central region, the α2 and β bands of the temporal lobe, and the α2 and β2 bands of the occipital lobe was significantly positively correlated with higher SCIM scores during the eyes-closed state. The subgroup analysis showed that the δ band power in the left temporal lobe and the α2 band power in the parietal lobe were lower among the SCI-C compared with the SCI-NC patients in the eyes-open state. With the eyes closed, the δ band power in the left frontal, left parietal, and left temporal lobes and the α2 band power in the frontal, central, parietal, temporal, and right occipital lobes was significantly lower in the SCI-C group compared to the SCI-NC group, on average. The reactivity to eye opening of the δ band in the temporal lobe, the α2 band in the left prefrontal, frontal, central, parietal, temporal, and right occipital lobes, and the β2 band in the right parietal and left occipital lobes was less in the SCI-C group than in the SCI-NC group ( P≤0.05). Among the SCI-C patients, higher EEG power in the β1 and β2 bands of the right temporal lobe with the eyes open was significantly positively correlated with higher SCIM scores. With the eyes closed, higher EEG power in the α2 and β1 bands of the right prefrontal lobe was significantly positively correlated with higher SCIM scores. Among the SCI-NC patients, higher EEG power in the δ band of the prefrontal lobe, the β1 and β2 bands of the left prefrontal lobe, and the δ bands of the frontal, central, right parietal, and right temporal lobes during the eyes open measurements was significantly positively correlated with higher SCIM scores. Conclusions:The EEG power of cervical and non-cervical SCI patients shows characteristic changes which correlate with their functional independence.

Objective:To investigate the application effect of entrustable professional activities (EPAs) in competency evaluation of dermatology residents, to practice the goal of hierarchical progressive training for EPAs competency in dermatology residents, and to improve the competency of physicians.Methods:A questionnaire survey was conducted among 8 clinical instructors and 165 residents who received standardized residency training in Department of Dermatology, The First Affiliated Hospital of Jinzhou Medical University, from September 2019 to September 2022, and self-assessment and trainer-assessment were performed based on EPAs. The Kruskal-Wallis H test and the Mann-Whitney U test were used for comparison of entrustable level between the dermatology residents of different grades. Results:The scores of both trainer-assessment and self-assessment based on EPAs increased with the increase in the grade of the resident physicians, and the resident physicians of the third year (the PGY3 group) had the highest levels of trainer-assessment and self-assessment based on EPAs. The resident physicians of all grades showed relatively low assessment scores of EPA4 (making a medical decision), EPA8 (recognize a patient requiring urgent or emergent care and initiate evaluation and management), EPA14 (clinical teaching), and EPA15 (public health events management). There were significant differences in all EPAs items of trainer-assessment and self-assessment between the residents of different grades (Kruskal-Wallis test, P<0.05). There was a significant difference in trainer-assessment between PGY1 and PGY2 and between PGY1 and PGY3 (Bonferroni P correction, P<0.05), while there was no significant difference between the PGY2 and PGY3 groups ( P>0.05). Conclusions:There are differences in the evaluation of EPAs in dermatology residents of different grades, and hierarchical progressive training of EPAs competency can effectively improve the clinical competency of dermatology residents. Given the inconsistency between the scores of self-assessment and trainer-assessment, it is necessary to improve the feedback plan in the future.

Objective:To investigate the application effect of entrustable professional activities (EPAs) in competency evaluation of dermatology residents, to practice the goal of hierarchical progressive training for EPAs competency in dermatology residents, and to improve the competency of physicians.Methods:A questionnaire survey was conducted among 8 clinical instructors and 165 residents who received standardized residency training in Department of Dermatology, The First Affiliated Hospital of Jinzhou Medical University, from September 2019 to September 2022, and self-assessment and trainer-assessment were performed based on EPAs. The Kruskal-Wallis H test and the Mann-Whitney U test were used for comparison of entrustable level between the dermatology residents of different grades. Results:The scores of both trainer-assessment and self-assessment based on EPAs increased with the increase in the grade of the resident physicians, and the resident physicians of the third year (the PGY3 group) had the highest levels of trainer-assessment and self-assessment based on EPAs. The resident physicians of all grades showed relatively low assessment scores of EPA4 (making a medical decision), EPA8 (recognize a patient requiring urgent or emergent care and initiate evaluation and management), EPA14 (clinical teaching), and EPA15 (public health events management). There were significant differences in all EPAs items of trainer-assessment and self-assessment between the residents of different grades (Kruskal-Wallis test, P<0.05). There was a significant difference in trainer-assessment between PGY1 and PGY2 and between PGY1 and PGY3 (Bonferroni P correction, P<0.05), while there was no significant difference between the PGY2 and PGY3 groups ( P>0.05). Conclusions:There are differences in the evaluation of EPAs in dermatology residents of different grades, and hierarchical progressive training of EPAs competency can effectively improve the clinical competency of dermatology residents. Given the inconsistency between the scores of self-assessment and trainer-assessment, it is necessary to improve the feedback plan in the future.

Objective:To relate the changes in electroencephalography (EEG) signals after a spinal cord injury (SCI) with functional independence.Methods:The EEG data describing ninety SCI patients in both open and closed eye states were compared with those collected from 45 healthy counterparts. The SCI patients′ EEG data were correlated with their spinal cord independence measure (SCIM) scores at corresponding time points. The SCI patients were divided into a cervical SCI group (SCI-C group) and a non-cervical SCI group (SCI-NC group), with 45 cases in each group. The difference in EEG data between them and its correlation with the SCIM scores were also compared and analyzed.Results:In the eyes-open state, the EEG power in the frontal, central, temporal, and right occipital regions of the SCI group was lower than among the control group, on average. There were significant differences in the δ and θ low-frequency bands. The α1 band power in the frontal and right parietal regions was significantly higher in the SCI group, on average. With the eyes closed the δ band power in the right prefrontal, frontal, left central, and temporal regions of the SCI group was lower than among the control group, while the α1 band power in the right prefrontal, frontal, central, and parietal regions was significantly higher. The reactivity to eye opening of the α1 band in the right prefrontal, frontal, central, parietal, and temporal regions was less in the SCI patients compared to healthy subjects. Among the SCI patients, higher EEG power in the β2 band of the right frontal lobe and the α2 and β bands of the right temporal lobe was significantly positively correlated with higher SCIM scores during the eyes-open measurements. And the higher EEG power in the α2 band of the prefrontal and frontal lobes, the β2 band of the frontal lobe, the α2 band of the right central region, the α2 and β bands of the temporal lobe, and the α2 and β2 bands of the occipital lobe was significantly positively correlated with higher SCIM scores during the eyes-closed state. The subgroup analysis showed that the δ band power in the left temporal lobe and the α2 band power in the parietal lobe were lower among the SCI-C compared with the SCI-NC patients in the eyes-open state. With the eyes closed, the δ band power in the left frontal, left parietal, and left temporal lobes and the α2 band power in the frontal, central, parietal, temporal, and right occipital lobes was significantly lower in the SCI-C group compared to the SCI-NC group, on average. The reactivity to eye opening of the δ band in the temporal lobe, the α2 band in the left prefrontal, frontal, central, parietal, temporal, and right occipital lobes, and the β2 band in the right parietal and left occipital lobes was less in the SCI-C group than in the SCI-NC group ( P≤0.05). Among the SCI-C patients, higher EEG power in the β1 and β2 bands of the right temporal lobe with the eyes open was significantly positively correlated with higher SCIM scores. With the eyes closed, higher EEG power in the α2 and β1 bands of the right prefrontal lobe was significantly positively correlated with higher SCIM scores. Among the SCI-NC patients, higher EEG power in the δ band of the prefrontal lobe, the β1 and β2 bands of the left prefrontal lobe, and the δ bands of the frontal, central, right parietal, and right temporal lobes during the eyes open measurements was significantly positively correlated with higher SCIM scores. Conclusions:The EEG power of cervical and non-cervical SCI patients shows characteristic changes which correlate with their functional independence.

Liver cancer stands as one of the most lethal malignant tumors globally,and liver transplantation presents a potent and effective therapeutic approach for affected individuals.However,the post-transplantation immune regulation is critical for the survival of the graft and the long-term prognosis of the patient.Energy metabolism plays a pivotal role in both the tumor microenvironment and immunomodulation following liver transplantation.This review explores the metabolic mechanisms within the tumor microenvironment,energy metabolism characteristics in liver transplantation,and the impact of post-transplantation energy metabolism on reducing liver cancer recurrence and mitigating transplant rejection.By gaining an in-depth comprehension of the intricate interplay between metabolic pathways and immune regulation,it is envisioned that innovative therapeutic strategies can be formulated.These strategies aim to enhance the outcomes for liver transplant recipients and offer more efficacious treatment options for those afflicted with liver cancer.

Objective To investigate the electroencephalography(EEG)signal characteristics in patients with neuropathic pain(NP)associated with spinal cord injury(SCI).Methods A total of 90 patients with SCI from January,2018 to November,2023 were selected from the EEG database of the Department of Rehabilitation Medicine,Xijing Hospital,and divided into NP group(n=46)and non-NP group(n=44)according to their symptoms.The resting-state EEG power and reactivity to eye-opening were compared between two groups.Results Compared with non-NP group,EEG power increased in frontal lobe in α and β1 bands,central lobe in δ,θ,α1 and β1 bands,parietal lobe in α and β1 bands,temporal lobe in α and β1 bands,left occipital lobe in α2 band,and occipital lobe in α1 and β1 bands(|Z|>1.998,P<0.05)in NP group during eye-opening;during eye-closing,EEG power increased in prefrontal lobe in α1 and β1 bands,right frontal lobe in θ band,frontal lobe in α and β1 bands,left frontal lobe in β2 band,central lobe in δ,α1 and β1 bands,parietal lobe in α1 and β1 bands,left pari-etal lobe in α2 and β2 bands,right temporal lobe in θ band,temporal lobe in α and β bands,occipital lobe in α1 and β1 bands,and left occipital lobe in β2 band(|Z|>1.970,P<0.05);while the reactivity to eye-opening de-creased in right prefrontal lobe in β1 band,frontal lobe in θ,α and β bands,right central lobe in β1 band,parietal lobe in α1 and β1 bands,right parietal lobe in β2 band,right temporal lobe in δ and θ band,temporal lobe in α1 and β bands,left occipital lobe in α1 band,and occipital lobe in β1(|Z|>1.967,P<0.05).Conclusion Resting-state EEG power characteristically elevates in NP patients after SCI,and the reactivity to eye-open-ing reduces.

Objective To investigate the electroencephalography(EEG)signal characteristics in patients with neuropathic pain(NP)associated with spinal cord injury(SCI).Methods A total of 90 patients with SCI from January,2018 to November,2023 were selected from the EEG database of the Department of Rehabilitation Medicine,Xijing Hospital,and divided into NP group(n=46)and non-NP group(n=44)according to their symptoms.The resting-state EEG power and reactivity to eye-opening were compared between two groups.Results Compared with non-NP group,EEG power increased in frontal lobe in α and β1 bands,central lobe in δ,θ,α1 and β1 bands,parietal lobe in α and β1 bands,temporal lobe in α and β1 bands,left occipital lobe in α2 band,and occipital lobe in α1 and β1 bands(|Z|>1.998,P<0.05)in NP group during eye-opening;during eye-closing,EEG power increased in prefrontal lobe in α1 and β1 bands,right frontal lobe in θ band,frontal lobe in α and β1 bands,left frontal lobe in β2 band,central lobe in δ,α1 and β1 bands,parietal lobe in α1 and β1 bands,left pari-etal lobe in α2 and β2 bands,right temporal lobe in θ band,temporal lobe in α and β bands,occipital lobe in α1 and β1 bands,and left occipital lobe in β2 band(|Z|>1.970,P<0.05);while the reactivity to eye-opening de-creased in right prefrontal lobe in β1 band,frontal lobe in θ,α and β bands,right central lobe in β1 band,parietal lobe in α1 and β1 bands,right parietal lobe in β2 band,right temporal lobe in δ and θ band,temporal lobe in α1 and β bands,left occipital lobe in α1 band,and occipital lobe in β1(|Z|>1.967,P<0.05).Conclusion Resting-state EEG power characteristically elevates in NP patients after SCI,and the reactivity to eye-open-ing reduces.

Liver cancer stands as one of the most lethal malignant tumors globally,and liver transplantation presents a potent and effective therapeutic approach for affected individuals.However,the post-transplantation immune regulation is critical for the survival of the graft and the long-term prognosis of the patient.Energy metabolism plays a pivotal role in both the tumor microenvironment and immunomodulation following liver transplantation.This review explores the metabolic mechanisms within the tumor microenvironment,energy metabolism characteristics in liver transplantation,and the impact of post-transplantation energy metabolism on reducing liver cancer recurrence and mitigating transplant rejection.By gaining an in-depth comprehension of the intricate interplay between metabolic pathways and immune regulation,it is envisioned that innovative therapeutic strategies can be formulated.These strategies aim to enhance the outcomes for liver transplant recipients and offer more efficacious treatment options for those afflicted with liver cancer.

Objective Changes in relevant indexes in the mouse model of early-onset ovarian insufficiency caused by Tripterygium wilfordii polyglycoside were analyzed,and the optimal time point for intervention was determined.Methods Forty female ICR mice were randomly divided into control and A,B,C,and D model groups with eight mice in each group.The control group was gavaged with purified water for 14 days(0.01 mL/10 g),and the remaining groups were administered a Tripterygium wilfordii polyglycoside suspension(80 mg/kg,0.01 mL/10 g)for 1 day(A model group),3 days(B model group),7 days(C model group),or 14 days(D model group),and samples were collected.Body weight and wet weights of the uterus and bilateral ovaries of mice were determined in each group.Serum FSH,LH,E2,P,AMH,INH-B,and T contents were measured using enzyme-linked immunoassays.HE staining was used to observe the number and developmental status of follicles and corpus luteum at all levels in mice of each group.TUNEL staining was used to detect the apoptosis in the ovaries of mice in each group.IHC detected expression of VEGFA,CD34,and EPO proteins in the ovaries of mice in each group.mRNA expression of HIF-1α,SDF-1,and CXCR4 in each group of mice was detected by PCR.Results Compared with the control group,changes in indicators in model A mice did not meet the POI modeling standard.The ovarian index,uterine index,and body weight of mice in the B model group were decreased significantly(P＜0.01),the weight of the C model group was decreased significantly(P＜0.01),and the ovarian index of the D model group was decreased significantly(P＜0.05).Serum contents of FSH and LH in B,C,and D model groups were increased(P＜0.05,P＜0.01),the E2,PROG,AMH,INH-B,and T contents were decreased(P＜0.01).The numbers of basal follicles,pre-sinus follicles,sinusoidal follicles,antral follicles,preovulatory follicles,and corpus luteum were decreased significantly(P＜0.05,P＜0.01)and the number of atresia follicles was increased significantly(P＜0.01)in B,C,and D model groups.The apoptotic area of TUNEL staining in A,B,C,and D model groups was increased significantly(P＜0.05,P＜0.01).Expression of CD34,VEGFA,and EPO in B,C,and D model groups was decreased significantly(P＜0.05,P＜0.01).mRNA expression of HIF-1α,SDF-1,and CXCR4 in A and B model groups was significantly increased(P＜0.05,P＜0.01).Compared with the B model group,the relevant indexes of C and D model groups were changed significantly,indicating that C and D models were more serious and tended to develop POF.Conclusions The B model group is the turning point of ovarian function from impaired POI to irreversible POF,suggesting that 3 days of administrating Tripterygium wilfordii polyglycoside is optimal to induce a POI disease model for effective drug intervention.

Objectives:This study aimed to assess the efficacy and safety of bendamustine in combination with rituximab (BR regimen) for the treatment of newly diagnosed indolent B-cell non-Hodgkin's lymphoma (B-iNHL) and elderly mantle cell lymphoma (eMCL) .Methods:From December 1, 2020 to September 10, 2022, a multi-center prospective study was conducted across ten Grade A tertiary hospitals in Shandong Province, China. The BR regimen was administered to evaluate its efficacy and safety in newly diagnosed B-iNHL and eMCL patients, and all completed at least four cycles of induction therapy.Results:The 72 enrolled patients with B-iNHL or MCL were aged 24-74 years, with a median age of 55 years. Eastern Cooperative Oncology Group (ECOG) performance status scores of 0-1 were observed in 76.4% of patients, while 23.6% had scores of 2. Disease distribution included follicular lymphoma (FL) (51.4% ), marginal zone lymphoma (MZL) (33.3% ), eMCL (11.1% ), and the unknown subtype (4.2% ). According to the Ann Arbor staging system, 16.7% and 65.3% of patients were diagnosed with stage Ⅲ and stage Ⅳ lymphomas, respectively. Following four cycles of BR induction therapy, the overall response rate was 98.6%, with a complete response (CR) rate of 83.3% and a partial response (PR) rate of 15.3%. Only one eMCL patient experienced disease progression during treatment, and only one FL patient experienced a relapse. Even when evaluated using CT alone, the CR rate was 63.9%, considering the differences between PET/CT and CT assessments. The median follow-up duration was 11 months (range: 4-22), with a PFS rate of 96.8% and an OS rate of 100.0%. The main hematologic adverse reactions included grade 3-4 leukopenia (27.8%, with febrile neutropenia observed in 8.3% of patients), grade 3-4 lymphopenia (23.6% ), grade 3-4 anemia (5.6% ), and grade 3-4 thrombocytopenia (4.2% ). The main non-hematologic adverse reactions such as fatigue, nausea/vomiting, rash, and infections occurred in less than 20.0% of patients.Conclusion:Within the scope of this clinical trial conducted in China, the BR regimen demonstrated efficacy and safety in treating newly diagnosed B-iNHL and eMCL patients.