Objective: To develop a depression recognition model by integrating the spirit-expression diagnostic framework of traditional Chinese medicine (TCM) with machine learning algorithms. The proposed model seeks to establish a TCM-informed tool for early depression screening, thereby bridging traditional diagnostic principles with modern computational approaches. Methods: The study included patients with depression who visited the Shanghai Pudong New Area Mental Health Center from October 1, 2022 to October 1, 2023, as well as students and teachers from Shanghai University of Traditional Chinese Medicine during the same period as the healthy control group. Videos of 3 – 10 s were captured using a Xiaomi Pad 5, and the TCM spirit and expressions were determined by TCM experts (at least 3 out of 5 experts agreed to determine the category of TCM spirit and expressions). Basic information, facial images, and interview information were collected through a portable TCM intelligent analysis and diagnosis device, and facial diagnosis features were extracted using the Open CV computer vision library technology. Statistical analysis methods such as parametric and non-parametric tests were used to analyze the baseline data, TCM spirit and expression features, and facial diagnosis feature parameters of the two groups, to compare the differences in TCM spirit and expression and facial features. Five machine learning algorithms, including extreme gradient boosting (XGBoost), decision tree (DT), Bernoulli naive Bayes (BernoulliNB), support vector machine (SVM), and k-nearest neighbor (KNN) classification, were used to construct a depression recognition model based on the fusion of TCM spirit and expression features. The performance of the model was evaluated using metrics such as accuracy, precision, and the area under the receiver operating characteristic (ROC) curve (AUC). The model results were explained using the Shapley Additive exPlanations (SHAP). Results: A total of 93 depression patients and 87 healthy individuals were ultimately included in this study. There was no statistically significant difference in the baseline characteristics between the two groups (P > 0.05). The differences in the characteristics of the spirit and expressions in TCM and facial features between the two groups were shown as follows. (i) Quantispirit facial analysis revealed that depression patients exhibited significantly reduced facial spirit and luminance compared with healthy controls (P < 0.05), with characteristic features such as sad expressions, facial erythema, and changes in the lip color ranging from erythematous to cyanotic. (ii) Depressed patients exhibited significantly lower values in facial complexion L, lip L, and a values, and gloss index, but higher values in facial complexion a and b, lip b, low gloss index, and matte index (all P < 0.05). (iii) The results of multiple models show that the XGBoost-based depression recognition model, integrating the TCM “spirit-expression” diagnostic framework, achieved an accuracy of 98.61% and significantly outperformed four benchmark algorithms—DT, BernoulliNB, SVM, and KNN (P < 0.01). (iv) The SHAP visualization results show that in the recognition model constructed by the XGBoost algorithm, the complexion b value, categories of facial spirit, high gloss index, low gloss index, categories of facial expression and texture features have significant contribution to the model. Conclusion This study demonstrates that integrating TCM spirit-expression diagnostic features with machine learning enables the construction of a high-precision depression detection model, offering a novel paradigm for objective depression diagnosis.

This review aimed to provide a comprehensive analysis of the etiology, epidemiology, pathology, and conventional treatment of heterotopic ossification (HO), especially emerging potential therapies. HO is the process of ectopic bone formation at non-skeletal sites. HO can be subdivided into two major forms, acquired and hereditary, with acquired HO predominating. Hereditary HO is a rare and life-threatening genetic disorder, but both acquired and hereditary form can cause severe complications, such as peripheral nerve entrapment, pressure ulcers, and disability if joint ankylosis develops, which heavily contributes to a reduced quality of life. Modalities have been proposed to treat HO, but none have emerged as the gold standard. Surgical excision remains the only effective modality; however, the optimal timing is controversial and may cause HO recurrence. Recently, potential therapeutic strategies have emerged that focus on the signaling pathways involved in HO, and small molecule inhibitors have been shown to be promising. Moreover, additional specific targets, such as small interfering RNAs (siRNAs) and non-coding RNAs, could be used to effectively block HO or develop combinatorial therapies for HO.
Humans ; Ossification, Heterotopic/genetics*

Objective:To develop a rapid, sensitive, and quantitative method for detecting Klebsiella pneumoniae using digital loop-mediated isothermal amplification(LAMP)-CRISPR/Cas12b. Methods:Five LAMP primers targeting the Kp-1 gene of Klebsiella pneumoniae and guide RNA (gRNA) for Cas12b were designed. The digital LAMP-CRISPR/Cas12b reaction mixture included 1×WarmStart ? LAMP master mix, 1×LAMP primers, 250 nmol/L Cas12b, 250 nmol/L gRNA, 3 μmol/L ssDNA reporter, 1 000 U/ml RNase inhibitor, 4 mmol/L Mg 2+, and DEPC water. After preparing the digital chip, it was incubated at 60℃ for one hour. Fluorescence distribution was then detected using a biochip analyzer to calculate the input DNA concentration. The specificity of the method was tested using genomic DNA from seven pathogenic microorganisms. The quantitative performance was assessed using serial dilutions of Klebsiella pneumoniae DNA ranging from 5-500 000 copies/μl. Clinical sputum samples were collected for comparison of quantitative performance with qPCR and qualitative performance with culture methods. Results:The digital LAMP-CRISPR/Cas12b method showed high specificity, yielding negative results for all six non-target pathogens. Quantitative performance tests indicated a sensitivity as low as 5 copies/μl, with a linear dynamic range of 5-50 000 copies/μl ( R2=0.927 4). Clinical sample quantitative testing showed that the correlation coefficient between digital LAMP-CRISPR/Cas12b and qPCR quantification was 0.917 0. Compared with the culture results of 72 samples, this method had a sensitivity of 100% and detected two additional samples with negative culture result, with a specificity of 91%; Compared with the culture method, qPCR had a sensitivity of 96% and a specificity of 83%. These results indicated that the digital LAMP-CRISPR/Cas12b method had good quantitative and qualitative detection performance for clinical sputum samples. Conclusions:This method offers advantages over qPCR, including rapidity, simplicity, and high precision. The digital LAMP-CRISPR/Cas12b method enables absolute quantification of Klebsiella pneumoniae in sputum samples, enhancing the accuracy of early screening for Klebsiella pneumoniae infections. These advantages make digital LAMP-CRISPR/Cas12b technology highly promising for the precise diagnosis of pathogenic microorganisms in field detection, primary healthcare, and resource-limited environments.

Objective:To analyze the current development status and spatial distribution characteristics of traditional Chinese medicine (TCM) hospitals in China, predict the changing trends of the number of TCM hospitals, the number of beds, and the number of physicians, and provide references for the development of TCM hospitals and the formulation of related policies.Methods:From the official websites of the National Bureau of Statistics and the State Administration of Traditional Chinese Medicine, the total population and number of TCM hospitals of 31 provinces (excluding China′s Hong Kong, Macao, and Taiwan) in China from 2013 to 2022 were included, as well as the number of beds and practicing (assistant) physicians in TCM hospitals from 2013 to 2021. The grey prediction model was applied to predict the changing trends of the number of TCM hospitals, beds and physicians. Using the global Moran′s I index in spatial autocorrelation analysis, the distribution of TCM hospitals per 10 000 people in China was analyzed by spatial correlation analysis, and local G coefficient was analyzed by local hot spots.Results:From 2013 to 2027, the number of TCM hospitals, beds and practicing (assistant) TCM physicians in China all showed an increasing trend year by year. The number of TCM hospitals per 10 000 people in China showed a spatial correlation between 2013 and 2022 ( P<0.05). The hot spots of TCM hospitals were mainly concentrated in North China and Northeast China, while the cold spots were mainly concentrated in southeast coastal areas and Northwest China. Conclusions:The number of TCM hospitals in China is increasing year by year, but it is necessary to control the reasonable increase and avoid blind expansion. It is necessary to formulate regional policies of TCM hospitals according to local conditions and pay attention to the individuation of policies. Focus on hot and cold areas to promote balanced development of TCM hospitals.

BACKGROUND:Cervical instability is a common orthopedic disease in young and middle-aged people,and is the early manifestation of cervical spondylosis,which has a great impact on the quality of life of patients.Therefore,early diagnosis of cervical instability to implement early intervention has positive clinical and social significance.OBJECTIVE:The clinical prediction model of cervical instability in young and middle-aged people was constructed based on machine learning to realize early screening of cervical instability in young and middle-aged people before X-ray examination.METHODS:From September 2022 to October 2023,155 young and middle-aged adults with cervical instability and 88 with non-cervical instability recruited through recruitment advertisements and spinal department outpatient of Wangjing Hospital,China Academy of Chinese Medical Sciences were selected as research subjects.The research subjects'general information,living and working habits,discomfort symptoms,visual analog scale score,Neck Disability Index,and 36-ltem Short Form Health Survey were collected on site based on questionnaires.The above information was used as predictive factors.After screening,six machine learning algorithms of Support Vector Machine,LightGBM,RandomForest,Logistic,AdaBoost,and XGBClassifier were used to train the model by ten-fold cross-validation method,and the clinical prediction model of cervical instability was constructed.Area under the curve was used as the main evaluation index.Univariate analysis was performed on the predictors,and SHAP method was used to rank the importance of the predictors.Correlation heat maps were used to show the degree of linear correlation between the predictors and the cervical instability.RESULTS AND CONCLUSION:(1)Among the six machine learning models,RandomForest model was chosen as the final prediction model,including nine predictors,such as age,body mass index,neck circumference/neck length,visual analog scale score,Neck Disability Index,bodily pain,general health,vitality,and mental health,area under the curve=0.725 4,and the calibration degree was good.It could be used as a reference tool for early screening of cervical instability in young and middle-aged people.(2)There were significant differences in age,visual analog scale score,Neck Disability Index,bodily pain,general health,and vitality between the two groups(P＜0.05).(3)The order of importance of predictors was age,Neck Disability Index,visual analog scale score,general health,body mass index,vitality,bodily pain,neck circumference/neck length,mental health,among which age,visual analog scale score,Neck Disability Index were positively correlated with cervical instability,while general health,body mass index,vitality,bodily pain,neck circumference/neck length,and mental health were negatively correlated with cervical instability.

ObjectiveTo investigate the possible mechanism of Bushen Huoxue Granule （补肾活血颗粒， BHG） in treating Parkinson's disease （PD） from the perspecitve of dopamine （DA） homeostasis. MethodsSeventy-two mice were randomly divided into blank group， model group， madopar group and BHG low-， medium- and high-dose groups， with 12 mice in each group. Except for the blank group， all mice were administered intraperitoneal injections of 1-methyl-4-phenyl-1，2，3，6-tetrahydropyridine （MPTP） for 7 consecutive days to induce a PD model. On the day following the injection， BHG low-， medium- and high-dose groups were administered BHG at doses of 1.25， 2.5， and 5.0 mg/（g·d） by oral gavage， respectively， while the madopar group received madopar tablets at dose of 0.093 8 mg/（g·d） by oral gavage. The blank group and the model group were given 0.2 ml/10 g of distilled water by gavage. All treatments were given once daily for 14 days. Open field test， pole climbing test and grip test were used to evaluate the behavior of mice in each group. Immunohistochemistry was used to detect the expression of tyrosine hydroxylase （TH） in striatum. Nissl staining was used to detect the activity of striatal neurons. The contents of DA and 3,4-dihydroxyphenylacetic acid （DOPAC） in striatum were detected by ultra performance liquid chromatography tandem mass spectrometry. The number and volume of synaptic vesicles were observed by transmission electron microscope. The expression of vesicular monoamine transporter 2 （VMAT2） in striatum was detected by immunofluorescence. Western Blot was used to detect the expression of extracellular signal-regulated kinase （ERK）， phosphorylated ERK （p-ERK）， cAMP response element-binding protein （CREB）， phosphorylated CREB （p-CREB） and VMAT2 in striatum. ResultsCompared to the blank group， mice in the model group showed a significant decline in total distance and average speed in the open field test， along with an increase in total resting time； in the pole test， both the time required for the mice to turn completely downward （T-turn） and the total time taken to reach the bottom of the pole （T-total） were prolonged； forelimb grip strength was reduced； in the striatum， the mean optical density of TH， the average fluorescence intensity of VMAT2 protein， and DA content all decreased， while the number of striatal neurons was reduced， and the DOPAC/DA ratio was elevated； the levels of p-ERK/ERK， p-CREB/CREB， and VMAT2 in the striatum significantly decreased （P＜0.01）； transmission electron microscopy revealed that both the number and volume of synaptic vesicles in striatal neurons were markedly reduced. Compared to the model group， mice in the madopar group and BHG low-， medium- and high-dose groups showed significant improvements in all the above indicators （P＜0.05 or P＜0.01）. Compared to madopar group， the BHG high-dose group exhibited increased DA content and elevated p-CREB/CREB ratio in the striatum （P＜0.05）. Compared to the BHG low-dose group， the BHG high-dose group showed increased total distance and mean velocity， decreased total resting time， T-turn， and T-total， as well as enhanced forelimb grip strength； moreover， the average fluorescence intensity of VMAT2 protein， DA content， p-ERK/ERK， p-CREB/CREB， and VMAT2 levels in the striatum were all significantly elevated （P＜0.05 or P＜0.01）. ConclusionBHG may restore DA homeostasis and alleviate the damage of dopaminergic neurons by regulating ERK/CREB/VMAT2 signaling pathway.

Female reproductive system diseases,such as premature ovarian insufficiency(POI),premature ovarian failure(POF),polycystic ovary syndrome(PCOS),intrauterine adhesions(IUA),ulterus scar diverticulum,salpingitis,and tubal obstruction,may induce infertility,severely impacting patients'physical and mental health and quality of life.Currently,the umbilical cord mesenchymal stem cells(UCMSCs)have emerged as a research focus in gynecological and obstetric fields,demonstrating significant therapeutic potential for female reproductive system disorders.UCMSCs secrete various cytokines,activate relevant signaling pathways and key molecules,reduce inflammation mediators and oxidative stress,and prevent excessive cellular damage and apoptosis,thereby achieving therapeutic effects.In recent years,extensive studies have explored the therapeutic effects of UCMSCs on female reproductive system diseases.This article review the current in vitro and in vivo research progress in UCMSCs for treating female reproductive system diseases,aiming to provide the novel strategies and directions for future research and clinical applications.

Objective To investigate the efficacy and safety of self-help inflatable balloon in the treatment of refractory benign upper digestive tract stricture.Methods From November 2022 to February 2024,10 patients with refractory benign upper digestive tract stricture underwent self-help inflatable balloon were retrospectively analyzed.Preoperative treatment,intraoperative and postoperative complications,dysphagia score before and after surgery,wearing time of external self-help inflatable balloon,and the clinical efficacy were evaluated.Results All the 10 patients received self-help inflatable balloon treatment.No complications such as bleeding and perforation occurred in all patients during the wearing of the balloon.The placement time of the balloon was 60～180 d,and the average wearing time was 104.9 d.Before surgery,nine cases had a stricture segment length less than 2 cm,and one case had a stricture segment length of 6 cm.The dysphagia score before surgery was(3.60±0.52),and the dysphagia score after removal of the self-help inflatable balloon was(0.60±0.52),and there was statistical significance in preoperative and postoperative comparison(P＜0.05).The dysphagia score 3 months after removal of the external self-help inflatable balloon was(0.70±0.48),there was no significant difference in dysphagia score between the day after surgery and 3 months after surgery(P＞0.05).The diameter of the stricture before and after operation was(5.09±2.02)mm and(10.35±0.73)mm respectively,and the difference was statistically significant(P＜0.05).Sore throat,wing of nose pain and balloon displacement were the most common adverse events,with 30.0％(3/10),50.0％(5/10)and 70.0％(7/10),respectively.Conclusion It is safe,effective and feasible to treat refractory benign upper digestive tract stricture with self-help inflatable balloon in vitro.It is worthy for clinical application.

Objective To explore the quantitative electroencephalography(qEEG)characteristics of the prefrontal cortex in patients with mild cognitive impairment(MCI)during digital screening tasks for MCI screening.Methods A total of 592 MCI patients(MCI group)and 317 normal cognitively elderly individuals(control group)were recruited from 40 communities in Nanjing,Jiangsu Province,from July to August,2024.All participants were as-sessed using Montreal Cognitive Assessment-Beijing Version(MoCA-BJ).Prefrontal EEG data were collected using a portable EEG device,and power spectral analysis was performed via Fast Fourier Transform.An XG-Boost algorithm was employed to construct an MCI identification model based on qEEG power features,and the model's performance was evaluated using receiver operating characteristic(ROC)curve.Results Compared with the control group,prefrontal δ,α,and β band power increased during screening tasks in MCI group(P<0.05);δ power was negatively correlated with MoCA-BJ total scores,and visuospatial/executive func-tion,attention and delayed recall scores(r=-0.269,-0.169,-0.133,-0.171,P<0.001);α power was negative-ly correlated with MoCA-BJ total scores,attention and delayed recall scores(r=-0.113,-0.075,-0.091,P<0.05).The XGBoost model based on δ and α power was excellent in MCI identification,with an area under the curve of 0.91,accuracy of 0.81,precision of 0.89,F1 score of 0.84,recall of 0.80,and specificity of 0.81.Conclusion MCI patients exhibit increased power in the prefrontal δ and α frequency bands during digital screening tasks,which is associated with cognitive decline.An XGBoost model based on qEEG power features can enable early prediction of MCI.

Objective To investigate the efficacy and safety of self-help inflatable balloon in the treatment of refractory benign upper digestive tract stricture.Methods From November 2022 to February 2024,10 patients with refractory benign upper digestive tract stricture underwent self-help inflatable balloon were retrospectively analyzed.Preoperative treatment,intraoperative and postoperative complications,dysphagia score before and after surgery,wearing time of external self-help inflatable balloon,and the clinical efficacy were evaluated.Results All the 10 patients received self-help inflatable balloon treatment.No complications such as bleeding and perforation occurred in all patients during the wearing of the balloon.The placement time of the balloon was 60～180 d,and the average wearing time was 104.9 d.Before surgery,nine cases had a stricture segment length less than 2 cm,and one case had a stricture segment length of 6 cm.The dysphagia score before surgery was(3.60±0.52),and the dysphagia score after removal of the self-help inflatable balloon was(0.60±0.52),and there was statistical significance in preoperative and postoperative comparison(P＜0.05).The dysphagia score 3 months after removal of the external self-help inflatable balloon was(0.70±0.48),there was no significant difference in dysphagia score between the day after surgery and 3 months after surgery(P＞0.05).The diameter of the stricture before and after operation was(5.09±2.02)mm and(10.35±0.73)mm respectively,and the difference was statistically significant(P＜0.05).Sore throat,wing of nose pain and balloon displacement were the most common adverse events,with 30.0％(3/10),50.0％(5/10)and 70.0％(7/10),respectively.Conclusion It is safe,effective and feasible to treat refractory benign upper digestive tract stricture with self-help inflatable balloon in vitro.It is worthy for clinical application.