OBJECTIVE: To explore the improvement effect of electroacupuncture (EA) based on Xingnao Kaiqiao acupuncture (acupuncture for regaining consciousness and opening orifices) on cognitive impairment in mice with Parkinson's disease (PD), and to explore its regulatory mechanisms on the kinesin family member 5A (KIF5A)/mitochondrial Rho GTPase 1 (Miro1) pathway and mitophagy in prefrontal cortical neurons. METHODS: A total of 70 male C57BL/6J mice of clean grade were randomly divided into a normal group (12 mice), a sham operation group (12 mice), and a model pre-screening group (46 mice). Unilateral stereotaxic injection of 6-hydroxydopamine (6-OHDA) into the medial forebrain bundle was adopted to establish the PD model in the model pre-screening group. Twenty-four mice after successful modeling were randomly selected and divided into a model group and an EA group, 12 mice in each one. In the EA group, acupuncture was applied at "Shuigou" (GV26) and bilateral "Sanyinjiao" (SP6) and "Neiguan" (PC6), ipsilateral "Sanyinjiao" (SP6) and "Neiguan" (PC6) were connected to EA respectively, with disperse-dense wave, 5 Hz/20 Hz in frequency, 0.5 mA in current intensity, 20 min a time, 6 times a week for 30 days. Cognitive function was assessed by Y-maze and Morris water maze tests; morphology of prefrontal cortex was observed by H.E. staining; reactive oxygen species (ROS) level in prefrontal cortex was detected by fluorescence probe method; mitochondrial morphology and autophagosome ultrastructure were observed by transmission electron microscopy; the mRNA expression of tyrosine hydroxylase (TH) was detected by quantitative real-time PCR; the protein expression of TH, KIF5A, Miro1, p62, Parkin and PTEN induced kinase 1 (PINK1) was detected by Western blot. RESULTS: Compared with the sham operation group, both the model group and the EA group exhibited increased rotation number of per minute (P<0.001). Compared with the sham operation group, in the model group, the novel arm exploration time of Y-maze test was shortened (P<0.001), the escape latency of Morris water maze test was prolonged (P<0.05) and the platform crossing number of Morris water maze test was reduced (P<0.01); in the prefrontal cortex, the number of cellular vacuole and neurons with karyopyknosis was increased (P<0.001), and mitochondrial autophagosomes could be observed; in the prefrontal cortex, the relative expression of ROS was increased (P<0.001), the protein and mRNA expression of TH was decreased (P<0.001), the protein expression of Miro1, PINK1, Parkin was increased (P<0.001, P<0.01), the protein expression of KIF5A and p62 was decreased (P<0.001). Compared with the model group, in the EA group, the novel arm exploration time of Y-maze test was prolonged (P<0.01), the escape latency of Morris water maze test was shortened (P<0.05) and the platform crossing number of Morris water maze test was increased (P<0.05); in the prefrontal cortex, the number of cellular vacuole and neurons with karyopyknosis was decreased (P<0.001), and the number of mitochondrial autophagosomes reduced and the mitochondrial morphology was improved; in the prefrontal cortex, the relative expression of ROS was decreased (P<0.01), the protein and mRNA expression of TH was increased (P<0.001, P<0.01), the protein expression of Miro1, PINK1, Parkin was decreased (P<0.001, P<0.01, P<0.05), the protein expression of KIF5A and p62 was increased (P<0.01, P<0.05). CONCLUSION Xingnao Kaiqiao electroacupuncture effectively alleviates cognitive impairment and damage of neuronal function in PD mice, its mechanism may be related to the regulation of KIF5A/Miro1 pathway, hence reducing the mitophagy in prefrontal cortical neurons.
Animals ; Electroacupuncture ; Male ; Mice ; Parkinson Disease/physiopathology* ; Cognitive Dysfunction/psychology* ; Kinesins/genetics* ; Humans ; Mitophagy ; Mice, Inbred C57BL ; rho GTP-Binding Proteins/genetics* ; Mitochondria/genetics* ; Prefrontal Cortex/metabolism*

BACKGROUND: Over 20 million colonoscopies are performed in China annually. An automatic clinical decision support system (CDSS) with accurate semantic recognition of colonoscopy reports and guideline-based is helpful to relieve the increasing medical burden and standardize the healthcare. In this study, the CDSS was built under a hierarchical-label interpretable classification framework, trained by a state-of-the-art transformer-based model, and validated in a multi-center style. METHODS: We conducted stratified sampling on a previously established dataset containing 302,965 electronic colonoscopy reports with pathology, identified 2041 patients' records representative of overall features, and randomly divided into the training and testing sets (7:3). A total of five main labels and 22 sublabels were applied to annotate each record on a network platform, and the data were trained respectively by three pre-training models on Chinese corpus website, including bidirectional encoder representations from transformers (BERT)-base-Chinese (BC), the BERT-wwm-ext-Chinese (BWEC), and ernie-3.0-base-zh (E3BZ). The performance of trained models was subsequently compared with a randomly initialized model, and the preferred model was selected. Model fine-tuning was applied to further enhance the capacity. The system was validated in five other hospitals with 3177 consecutive colonoscopy cases. RESULTS: The E3BZ pre-trained model exhibited the best performance, with a 90.18% accuracy and a 69.14% Macro-F1 score overall. The model achieved 100% accuracy in identifying cancer cases and 99.16% for normal cases. In external validation, the model exhibited favorable consistency and good performance among five hospitals. CONCLUSIONS The novel CDSS possesses high-level semantic recognition of colonoscopy reports, provides appropriate recommendations, and holds the potential to be a powerful tool for physicians and patients. The hierarchical multi-label strategy and pre-training method should be amendable to manage more medical text in the future.
Humans ; Colonoscopy/methods* ; Deep Learning ; Decision Support Systems, Clinical ; Female ; Male

OBJECTIVE: This study investigates the efficacy and mechanisms of Qingjie Fuzheng Granules (QFG) in inhibiting colitis-associated colorectal cancer (CAC) development via RNA sequencing (RNA-seq) and 16S ribosomal RNA (rRNA) correlation analysis. METHODS: CAC was induced in BALB/c mice using azoxymethane (AOM) and dextran sulfate sodium (DSS), and QFG was administered orally to the treatment group. The effects of QFG on CAC were evaluated using disease index, histology, and serum T-cell ratios. RNA-seq and 16S rRNA analysis assessed the transcriptome and microbiome change. Key pharmacodynamic pathways were identified by integrating these data and confirmed via Western blotting and immunofluorescence. The link between microbiota and CAC-related markers was explored using linear discriminant analysis effect size and Spearman correlation analysis. RESULTS: Long-term treatment with QFG prevented AOM/DSS-induced CAC formation, reduced levels of interleukin (IL)-1β, tumor necrosis factor-alpha (TNF-α), IL-6, and interferon γ (IFN-γ), and increased CD3⁺ and CD4⁺/CD8⁺ T cells ratio, without causing hepatic or renal toxicity. A 16S rRNA analysis revealed that QFG rebalanced the Firmicutes/Bacteroidetes ratio and mitigated AOM/DSS-induced microbiota disturbances. Transcriptomics and Western blotting analysis identified the nucleotide-binding oligomerization domain-containing protein 2 (NOD2)/nuclear factor kappa-B (NF-κB) pathway as key for QFG's treatment against CAC. Furthermore, QFG decreased the abundance of Bacilli, Bacillales, Staphylococcaceae, Staphylococcus, Lactobacillales, Aerococcus, Alloprevotella, and Akkermansia, while increasing Clostridiales, Lachnospiraceae, Lachnospiraceae_NK4A136_group, Ruminococcaceae, and Muribaculaceae, which were highly correlated with CAC-related markers or NOD2/NF-κB pathway. CONCLUSION By mapping the relationships between CAC, immune responses, microbiota, and key pathways, this study clarifies the mechanism of QFG in inhibiting CAC, highlighting its potential for clinical use as preventive therapy.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

Artificial chord is a mature mitral valve repair technique, especially in adult mitral valve repair. It is still challenging to repair mitral valve in children with artificial chords because the quality of mitral valve is soft and immature. There are some differences in the methods of suture, the choice of suture size and the number of artificial chords. Although the artificial chords could not grow naturally, we found through the long-term research that most children did not have mitral valve restriction or even chords rupture due to itself can compensate through the growth of the flap and papillary muscle. This article summarizes the recent research progress on the treatment of mitral valve insufficiency in children with artificial chords, providing reference for clinical treatment.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.

Objective To establish a set of regional evaluation index system for clinical medicine disciplines,and to provide a reference tool for evaluating the effectiveness of its construction.Methods Based on relevant policies and literature research,Delphi expert consultation method and analytic hierarchy process were used to determine the index system and assign corresponding weights.The index system was used to conduct field analysis of 10 clinical disciplines in a district of Shenzhen,and the total score of each discipline was calculated by weighted summing method and spearman correlation analysis was used to verify the validity of the evaluation results.Results A set of evaluation index system including 5 first-level indicators,16 second-level indicators and 54 third-level indicators was formed and the weights of all levels of indicators were quantified,which could truly reflect the level of regional clinical discipline construction.Conclusion The established subject evaluation index system has high initiative,authority and coordination of expert consultation.The results of empirical evaluation have a certain degree of differentiation,and are highly correlated with the ranking results of experts,and have strong feasibility.