ObjectiveTo explore the central neuroregulation mechanism of heat-sensitive moxibustion for knee osteoarthritis on pain relief. MethodsThirty patients who did not have experience of Deqi （得气） during heat-sensitive moxibustion treatment were assigned to the "non-Deqi group"， while another 30 patients who had experience of Deqi were assigned to the "Deqi group". Both groups received moxibustion at the left Heding （EX-LE2） acupoint. In the Deqi group， after the patients experienced sensation of Deqi at the acupoint， moxibustion was applied at approximately 3 cm from the skin for 10 minutes； in the non-Deqi group， moxibustion was also applied at approximately 3 cm from the skin for 10 minutes. Both groups received treatment once daily for 10 consecutive days. Knee joint pain was assessed before and after treatment using the visual analog scale （VAS）. Resting-state functional magnetic resonance imaging （rs-fMRI） scans were performed on all participants before the first treatment session and after the final session on the 10th day. The fractional amplitude of low-frequency fluctuations （fALFF） maps before and after treatment were processed using the SPM12 module by MATLAB. ResultsAfter treatment， VAS scores in both groups were significantly lower than before treatment （P＜0.05 or P＜0.01）， with the Deqi group showing significantly lower VAS scores than the non-Deqi group （P＜0.01）. Compared to before treatment， the Deqi group exhibited significant activation in the prefrontal cortex （t = 6.28）， white matter （t = 6.36）， and left temporal lobe （t = 9.33）， while significant inhibition was observed in the occipital lobe （t = -9.86） and right cerebrum （t = -4.54， P＜0.01）； in the non-Deqi group， significant changes after treatment were observed in the left occipital lobe （t = -6.42）， left medial frontal gyrus （t = -4.35）， left middle frontal gyrus （t = -4.74）， right superior frontal gyrus （t = -4.82）， right superior temporal gyrus （t = -6.61）， and right cerebellar posterior lobe （t = -8.64）， all of which were in inhibited states （P＜0.01）. Compared to the non-Deqi group， the Deqi group exhibited significant activation after treatment in the external nucleus （t = 5.77）， white matter （t = 3.58）， right cerebrum （t = 5.84）， left cerebellum （t = 5.35）， and left cerebrum （t = 4.32）， while significant inhibition was observed in the prefrontal cortex （t = -4.16）， occipital lobe （t = -4.87）， and precentral gyrus （t = -4.46， P＜0.01）. ConclusionsHeat-sensitive moxibustion provides better analgesic effects for knee osteoarthritis under state of Deqi. Its central neuroregulation mechanism may be related to the involvement of the frontal lobe， temporal lobe， occipital lobe， external nucleus， white matter， right cerebrum， left cerebellum， left cerebrum， and precentral gyrus in modulating pain signals.

Objective:To investigate the efficacy of combined pelvic magnetic therapy and pelvic floor electromyographic (EMG) biofeedback therapy in perimenopausal women with pelvic floor dysfunction (PFD), and its effects on bladder function and urodynamic status.Methods:A total of 137 perimenopausal women with PFD treated at Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine between February 2022 and May 2024 were enrolled. They were randomly divided into a control group ( n=68) and a study group ( n=69) by random number table method. Both groups received Kegel exercises. The control group additionally received pelvic floor EMG biofeedback therapy. The study group received combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy. The outcomes compared between groups were as follows: Bladder Function: First urge voiding volume (FVS), maximum urge voiding volume (MVS), post-void residual urine volume (PVR), prolapse of pelvic floor organs, urodynamics: Pressure of urethral maximum measurement (PUM), maximum urethral closure pressure (PMUC), bladder compliance (BC), pelvic floor muscle function: Pelvic floor muscle strength grade (PFMT), pelvic floor resting pressure (RP), vaginal dynamic pressure (VDPT). Normally distributed continuous data were presented as xˉ± s and compared by independent samples t-test. Categorical data were presented as case (%) and compared by χ2 test. Ranked data were compared by Kruskal-Wallis H test. A P-value<0.05 was considered statistically significant. Results:Baseline characteristics showed no significant differences between groups ( P>0.05). At post-treatment, the study group had a significantly higher clinical effective rate of 97.10% (67/69) compared to the control group, which was 88.24% (60/68) ( χ2=3.98, P=0.046). At post-treatment, the study group had significantly higher FVS [(238.29±10.22) mL vs. (229.37±10.54) mL, t=5.03, P<0.001] and MVS [(436.57±12.48) mL vs. (428.23±12.75) mL, t=3.87, P<0.001], and significantly lower PVR [(5.14±1.28) mL vs. (6.96±1.21) mL, t=8.55, P<0.001] compared to the control group. At post-treatment, urodynamic parameters were significantly higher in the study group: PUM [(10.08±0.97) kPa vs. (8.54±0.73) kPa, t=10.49, P<0.001], PMUC [(8.71±0.75) kPa vs. (7.68±0.64) kPa, t=8.64, P<0.001], and BC [(396.58±30.49) mL/kPa vs. (378.86±32.91) mL/kPa, t=3.27, P<0.001]. For pelvic organ prolapse (POP-Q), the distribution were as follows: Study Group: Grade 0: 16, Grade Ⅰ: 34, Grade Ⅱ: 18, Grade Ⅲ: 1, Grade Ⅳ: 0, control Group: Grade 0: 9, Grade Ⅰ: 31, Grade Ⅱ: 23, Grade Ⅲ:5, Grade Ⅳ: 0. The difference was statistically significant ( Z=2.08, P=0.037). At post-treatment, pelvic floor muscle function was significantly higher in the study group: PFMT [(4.21±0.29) vs. (3.84±0.23), t=8.27, P<0.001], RP [(9.59±1.26) cmH?O vs. (8.34±1.17) cmH?O, t=6.02, P<0.001], and VDPT [(82.74±3.36) cmH?O vs. (77.45±3.52) cmH?O, t=9.00, P<0.001]. Conclusion:Combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy demonstrates significant efficacy in treating PFD in perimenopausal women. It markedly improves bladder function and urodynamic status.

The U.S.Department of Defense(DoD)has made tremendous efforts to build up its biological defense capability in recent years,so that the annual biological defense budget accounts for 14％to 15％of the total of the U.S.government,which is closely related to the rapid development of biotechnology and its strategic significance during the rival between world powers.A second contributor is that the United States has been seeking hegemony in the biological field.In fiscal year 2019-2024,the expenditure/budget of the US DoD's biological defense spikedwith the layout focused on early warning of threats,pathogen detection and response,and capability enhancement.This initiative is characterized by simultaneous implementation of multiple projects in a wide range of fields,strong synergy between different agencies,integration of military and civil resources,systematic planning of support systems for biological defense technologies.

Objective:To observe the effects of transcutaneous electrical point stimulation(TEPS)on awakening,cognition,and immune function in patients undergoing laparoscopic cholecystectomy(LC)under general anesthesia.Methods:Ninety patients undergoing LC under general anesthesia were selected as the study subjects and were divided into a control group and an observation group according to the random number table method,with 45 cases in each group.The control group was operated with conventional general anesthesia.The observation group was treated with the same anesthesia as the control group,and TEPS was performed at Hegu(LI4),Zusanli(ST36),and Neiguan(PC6)before the induction of anesthesia until the completion of the operation.The quality of postoperative awakening,hemodynamic indicators,cognitive function,and immune function of patients in the two groups were compared,and the occurrence of adverse reactions was recorded.Results:The time of recovery of spontaneous breathing and extubation time of the observation group were shorter than those of the control group(P<0.05);there was no statistically significant difference in the heart rate(HR)and mean arterial pressure(MAP)between the two groups at the moment before the induction of anesthesia(T1)(P>0.05);at the moment of extubation(T2)and 5 min after extubation(T3),the HR and MAP of patients in both groups were higher than those at T1(P<0.05),and those of the observation group were lower than those of the control group(P<0.05).Preoperatively,there was no statistically significant difference in the Montreal cognitive assessment scale(MoCA)score between the two groups(P>0.05);3 d postoperatively,the MoCA score of the two groups decreased and was higher in the observation group than in the control group(P<0.05).Preoperatively,there was no statistical difference in the comparison of CD4+,CD8+,and CD4+/CD8+between the two groups(P>0.05);3 d postoperatively,the above indicators decreased in both groups(P<0.05)and were higher in the observation group than in the control group(P<0.05).There was no statistical difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of TEPS at Hegu(LI4),Zusanli(ST36),and Neiguan(PC6)with general anesthesia can improve the quality of postoperative awakening,promote hemodynamic stabilization,and improve cognitive function and immune function in LC patients,with good safety.

Objective:To analyze the clinical characteristics of immune checkpoint inhibitor (ICI)-induced type 1 diabetes (T1D).Methods:This was a retrospective case series study of clinical data from 24 patients with ICI-T1D admitted to People′s Hospital of Henan Provincial between January 2018 and December 2024. The data collected included demographic characteristics, ICI usage, clinical manifestations, laboratory test results, and clinical outcome. Patients were categorized into mild and severe groups based on disease severity. Clinical characteristics between the two groups were compared using the Mann-Whitney U test. Results:Of the 24 patients, 21 (87.5%) were male and 3 (12.5%) were female, with an average age of (62.0±10.6) years. Patients in the severe disease group were significantly older than those in the mild disease group [(68.0±9.5) years vs. (58.4±9.8) years, P<0.05]. Compared to patients with mild disease, those with severe disease had significantly higher rates of impaired consciousness (9/9 vs.2/15), shorter ICI treatment cycles [3 (2, 6) vs. 6 (5, 8)], shorter time from ICI initiation to diabetes diagnosis [68 (31, 168) d vs. 162 (135, 235) d], and shorter time from the onset of diabetes symptoms to medical consultation [4 (2, 5) d vs. 8 (4, 26) d] (all P<0.05). The severe disease group also showed significantly higher blood glucose levels [43.0 (39.1, 57.3) mmol/L vs. 24.6 (19.6, 29.6) mmol/L] and a lower glycated hemoglobin level [6.8% (6.3%, 7.6%) vs. 7.9% (7.6%, 8.6%)], along with a higher incidence of fulminant T1D (8/9 vs. 2/15, all P<0.05). All patients received insulin injection therapy. After discharge, fasting C-peptide levels in 3 patients with mild disease showed a transient increase to 0.26, 0.43, 0.49 nmol/L but declined again after six months. Conclusions:ICI-T1D is characterized by acute onset and rapid progression. Older patients are more likely to develop severe disease. All patients require insulin therapy.

Objective:To observe the effects of transcutaneous electrical point stimulation(TEPS)on awakening,cognition,and immune function in patients undergoing laparoscopic cholecystectomy(LC)under general anesthesia.Methods:Ninety patients undergoing LC under general anesthesia were selected as the study subjects and were divided into a control group and an observation group according to the random number table method,with 45 cases in each group.The control group was operated with conventional general anesthesia.The observation group was treated with the same anesthesia as the control group,and TEPS was performed at Hegu(LI4),Zusanli(ST36),and Neiguan(PC6)before the induction of anesthesia until the completion of the operation.The quality of postoperative awakening,hemodynamic indicators,cognitive function,and immune function of patients in the two groups were compared,and the occurrence of adverse reactions was recorded.Results:The time of recovery of spontaneous breathing and extubation time of the observation group were shorter than those of the control group(P<0.05);there was no statistically significant difference in the heart rate(HR)and mean arterial pressure(MAP)between the two groups at the moment before the induction of anesthesia(T1)(P>0.05);at the moment of extubation(T2)and 5 min after extubation(T3),the HR and MAP of patients in both groups were higher than those at T1(P<0.05),and those of the observation group were lower than those of the control group(P<0.05).Preoperatively,there was no statistically significant difference in the Montreal cognitive assessment scale(MoCA)score between the two groups(P>0.05);3 d postoperatively,the MoCA score of the two groups decreased and was higher in the observation group than in the control group(P<0.05).Preoperatively,there was no statistical difference in the comparison of CD4+,CD8+,and CD4+/CD8+between the two groups(P>0.05);3 d postoperatively,the above indicators decreased in both groups(P<0.05)and were higher in the observation group than in the control group(P<0.05).There was no statistical difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of TEPS at Hegu(LI4),Zusanli(ST36),and Neiguan(PC6)with general anesthesia can improve the quality of postoperative awakening,promote hemodynamic stabilization,and improve cognitive function and immune function in LC patients,with good safety.

Objective:To investigate the efficacy of combined pelvic magnetic therapy and pelvic floor electromyographic (EMG) biofeedback therapy in perimenopausal women with pelvic floor dysfunction (PFD), and its effects on bladder function and urodynamic status.Methods:A total of 137 perimenopausal women with PFD treated at Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine between February 2022 and May 2024 were enrolled. They were randomly divided into a control group ( n=68) and a study group ( n=69) by random number table method. Both groups received Kegel exercises. The control group additionally received pelvic floor EMG biofeedback therapy. The study group received combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy. The outcomes compared between groups were as follows: Bladder Function: First urge voiding volume (FVS), maximum urge voiding volume (MVS), post-void residual urine volume (PVR), prolapse of pelvic floor organs, urodynamics: Pressure of urethral maximum measurement (PUM), maximum urethral closure pressure (PMUC), bladder compliance (BC), pelvic floor muscle function: Pelvic floor muscle strength grade (PFMT), pelvic floor resting pressure (RP), vaginal dynamic pressure (VDPT). Normally distributed continuous data were presented as xˉ± s and compared by independent samples t-test. Categorical data were presented as case (%) and compared by χ2 test. Ranked data were compared by Kruskal-Wallis H test. A P-value<0.05 was considered statistically significant. Results:Baseline characteristics showed no significant differences between groups ( P>0.05). At post-treatment, the study group had a significantly higher clinical effective rate of 97.10% (67/69) compared to the control group, which was 88.24% (60/68) ( χ2=3.98, P=0.046). At post-treatment, the study group had significantly higher FVS [(238.29±10.22) mL vs. (229.37±10.54) mL, t=5.03, P<0.001] and MVS [(436.57±12.48) mL vs. (428.23±12.75) mL, t=3.87, P<0.001], and significantly lower PVR [(5.14±1.28) mL vs. (6.96±1.21) mL, t=8.55, P<0.001] compared to the control group. At post-treatment, urodynamic parameters were significantly higher in the study group: PUM [(10.08±0.97) kPa vs. (8.54±0.73) kPa, t=10.49, P<0.001], PMUC [(8.71±0.75) kPa vs. (7.68±0.64) kPa, t=8.64, P<0.001], and BC [(396.58±30.49) mL/kPa vs. (378.86±32.91) mL/kPa, t=3.27, P<0.001]. For pelvic organ prolapse (POP-Q), the distribution were as follows: Study Group: Grade 0: 16, Grade Ⅰ: 34, Grade Ⅱ: 18, Grade Ⅲ: 1, Grade Ⅳ: 0, control Group: Grade 0: 9, Grade Ⅰ: 31, Grade Ⅱ: 23, Grade Ⅲ:5, Grade Ⅳ: 0. The difference was statistically significant ( Z=2.08, P=0.037). At post-treatment, pelvic floor muscle function was significantly higher in the study group: PFMT [(4.21±0.29) vs. (3.84±0.23), t=8.27, P<0.001], RP [(9.59±1.26) cmH?O vs. (8.34±1.17) cmH?O, t=6.02, P<0.001], and VDPT [(82.74±3.36) cmH?O vs. (77.45±3.52) cmH?O, t=9.00, P<0.001]. Conclusion:Combined pelvic magnetic therapy and pelvic floor EMG biofeedback therapy demonstrates significant efficacy in treating PFD in perimenopausal women. It markedly improves bladder function and urodynamic status.

Objective:To analyze the clinical characteristics of immune checkpoint inhibitor (ICI)-induced type 1 diabetes (T1D).Methods:This was a retrospective case series study of clinical data from 24 patients with ICI-T1D admitted to People′s Hospital of Henan Provincial between January 2018 and December 2024. The data collected included demographic characteristics, ICI usage, clinical manifestations, laboratory test results, and clinical outcome. Patients were categorized into mild and severe groups based on disease severity. Clinical characteristics between the two groups were compared using the Mann-Whitney U test. Results:Of the 24 patients, 21 (87.5%) were male and 3 (12.5%) were female, with an average age of (62.0±10.6) years. Patients in the severe disease group were significantly older than those in the mild disease group [(68.0±9.5) years vs. (58.4±9.8) years, P<0.05]. Compared to patients with mild disease, those with severe disease had significantly higher rates of impaired consciousness (9/9 vs.2/15), shorter ICI treatment cycles [3 (2, 6) vs. 6 (5, 8)], shorter time from ICI initiation to diabetes diagnosis [68 (31, 168) d vs. 162 (135, 235) d], and shorter time from the onset of diabetes symptoms to medical consultation [4 (2, 5) d vs. 8 (4, 26) d] (all P<0.05). The severe disease group also showed significantly higher blood glucose levels [43.0 (39.1, 57.3) mmol/L vs. 24.6 (19.6, 29.6) mmol/L] and a lower glycated hemoglobin level [6.8% (6.3%, 7.6%) vs. 7.9% (7.6%, 8.6%)], along with a higher incidence of fulminant T1D (8/9 vs. 2/15, all P<0.05). All patients received insulin injection therapy. After discharge, fasting C-peptide levels in 3 patients with mild disease showed a transient increase to 0.26, 0.43, 0.49 nmol/L but declined again after six months. Conclusions:ICI-T1D is characterized by acute onset and rapid progression. Older patients are more likely to develop severe disease. All patients require insulin therapy.

OBJECTIVE To evaluate the consistency between the quetiapine LC-MS/MS kit and the laboratory-built method(reference method) in the detection results of quetiapine therapeutic drug monitoring. METHODS A total of 120 remaining plasma samples were collected from patients receiving quetiapine therapeutic drug monitoring from March to October in 2021. The plasma concentration of quetiapine was detected by kit and reference method respectively. The analysis of correlations and consistency was performed by outlier analysis, linear regression and Bland-Altman method. RESULTS No outliers were detected. The linear regression equation was Y=1.018X+4.400(r=0.998), indicating a good correlation. The Bland-Altman plot analysis showed good agreement between the two measurements. CONCLUSION The detection results of quetiapine LC-MS/MS kit and reference method are in good agreement. The kit can be used for clinical quetiapine treatment drug monitoring.

OBJECTIVE To investigate the effect of eukaryotic translation elongation factor 1A1(eEF1A1)on the replication of vesicular stomatitis virus(VSV)and Herpes simplex virus 1(HSV-1)to identify a potential target for broad-spectrum regulation of viruses.METHODS Small interfering RNA(si-eEF1A)was transfected into human skin fibroblasts(BJ-5ta)to inhibit the expression of eEF1A1,and the negative control group was set up.The transfection efficiency was detected by real-time fluo-rescence quantitative PCR(RT-qPCR)and Western blotting,the cell model of eEF1A1 gene silencing was constructed.The cell model was infected with VSV,the gene copy number and protein expression of VSV in the cells were detected.The cell model was infected with HSV-1,the mRNA and protein expres-sion of HSV-1 in the cells were detected.The cell models were transfected with polyinosinic acid[Poly(I:C)]or sodium deoxyribonucleic acid(HT-DNA),respectively.The mRNA expression of interferon-β(IFN-β),C-X-C Motif Chemokine 10(CXCL10)and interferon-stimulated gene 56(ISG56)were detected by RT-qPCR.The phosphorylation expression of interferon regulatory factor 3(IRF3)and TANK binding kinase 1(TBK1)were detected by Western blotting.RESULT Compared with the negative control group,the mRNA and protein expression of eEF1A1 in the eEF1A1 gene silencing group were signifi-cantly decreased(P<0.01),the cell model of eEF1A1 gene silencing was successfully constructed.Compared with the negative control group,the VSV gene copy number of the eEF1A1 gene silencing group decreased by 70%-80%.The VSV protein expression decreased significantly(P<0.01).The mRNA expression of HSV-1 was decreased by 50%-60%,and the protein expression of HSV-1 was significantly decreased(P<0.01).After stimulation with Poly(I:C)or HT-DNA,compared with the negative control group.there was no significant difference in the mRNA expressions of IFN-β,ISG56 and CXCL10 and the protein phosphorylation expression of IRF3 and TBK1 in the eEF1A1 gene silencing group.CONCLUSION eEF1A1 silencing can inhibit VSV and HSV-1 virus replication,suggesting that eEF1A1 has a potential broad-spectrum regulatory effect on RNA viruses and DNA viruses,and may not recog-nize activated immune pathways through intracellular nucleic acid recognition.