Objectives:To investigate the clinical value of cardiac magnetic resonance imaging(CMR)feature-tracking strain analysis in risk stratification of diabetic heart failure with preserved ejection fraction(HFpEF).Methods:In this retrospective study,a total of 215 patients with diabetic HFpEF who underwent CMR at Chinese Academy of Medical Sciences Fuwai Hospital from January 2012 to December 2018 were included.Myocardial strain parameters were calculated using CMR feature-tracking technology.Patients were followed up by medical records or telephone calls.Composite endpoint event,all-cause death or heart failure hospitalization during follow-up were recorded.Patients were divided into event group and event-free group.Univariable and multivariable Cox proportional hazard regression analyses were performed to determine the risk factors for the outcomes in diabetic HFpEF.The effects of hypertension and obesity on the prognosis of diabetic HFpEF patients and whether they affect the prognostic value of CMR feature-tracking strain analysis were also analyzed.Results:During a follow-up of(7.1±1.8)years,93(43.3%)patients had endpoint events(event group),including 28 all-cause deaths and 65 heart failure hospitalization.Compared with the event-free group(n=122),patients in the event group had significantly lower left ventricular ejection fraction,higher prevalence and extent of late gadolinium enhancement,and significantly reduced global longitudinal strain(GLS),global circumferential strain,global radial strain,and global systolic longitudinal strain rate(all P<0.05).The absolute GLS value was significantly lower in event group than in event-free group,regardless of the presence of hypertension and obesity.Multivariate Cox regression analysis showed that estimated glomerular filtration rate(HR=0.983,95%CI:0.972-0.993,P=0.001),left atrial volume index(HR=1.015,95%CI:1.005-1.026,P=0.004),and GLS(HR=1.142,95%CI:1.060-1.231,P<0.001)were independent risk factors for adverse cardiovascular events in diabetic HFpEF patients.However,adjusted N-terminal pro-brain natriuretic peptide was not an independent prognostic factor.The cut-offvalue of GLS to predict outcome was-14.09%from ROC curve analysis.The Kaplan-Meier curve showed that in patients with and without hypertension and obesity,patients with the GLS>-14.09%had lower event-free survival compared to patients with GLS≤-14.09%(all P<0.05),and the ability of GLS to predict adverse outcomes was not affected by hypertension and obesity.Conclusions:GLS obtained by CMR feature-tracking strain analysis is an independent predictor of adverse outcomes in diabetic HFpEF,and its ability to predict adverse outcomes is independent of hypertension and obesity.

Objective To explore the efficacy of hypofractionated radiotherapy at different time intervals after surgery for keloid,and to analyze the factors affecting the efficacy.Methods A total of 76 patients who underwent 20 Gy/5 postoperative radiotherapy regimen in the Fifth Affiliated Hospital of Zhengzhou University from January 2021 to June 2023 were selected as study subjects,and a total of 100 keloids were divided into effective group(n=79)and recurrence group(n=21).Regular follow-up and record of the patients after radiotherapy treatment effect and adverse effects,and multivariate Logistic was used to analyze factors of recurrence in keloid patients.Results Multivariate Logistic regression analysis found that postoperative radiotherapy time and scar incision length were related to recurrence after treatment,radiotherapy within 7h of surgery was an independent risk factor for recurrence after treatment(OR＞1,P=0.022),and scar incision≤5cm was an independent protective factor for recurrence after treatment(OR＜1,P=0.028).Conclusion Surgical excision combined with hypofractionated radiotherapy is one of the effective measures to prevent and treat keloid recurrence,though keloids on the trunk may need more effective treatment options.The recurrence rate of radiotherapy initiated 7-48h after surgery is relatively the lowest,and it is worthy of clinical promotion and application.

Objective To explore the effects of different modes of cerebellar transcranial magnetic stimulation(TMS)on response inhibition function in healthy adults and the underlying mechanisms.Methods Eighty-one healthy adult volunteers were randomly divided into 5 Hz repetitive TMS(rTMS)group(n=28),intermittent theta burst stimulation(iTBS)group(n=26)and sham stimulation group(n=27).The TMS stimulation target was the cerebellar Crus Ⅱ region,and the stimulation site was accurately located by the neuronavigation system.The stimulation intensity was 80％of the individual resting motor threshold(RMT).The Go/No-Go task response time(RT)and response inhibition ability and synchronous EEG were measured before and after intervention in each group.The changes of N2 wave and time-frequency in the time window related to response inhibition function in the event-related potential(ERP)were analyzed.Results Compared with that pre-stimulation,RT after stimulation in rTMS group and iTBS group was significantly shortened(all P＜0.05).There was a significant difference in the difference of RT before and after stimulation among the three groups(P＜0.001).Compared with that in the sham stimulation group,the RT after stimulation in the rTMS group and the iTBS group was significantly shortened(P＜0.05-0.01).There was no significant difference in RT changes before and after stimulation between rTMS group and iTBS group(P＞0.05).There was no significant difference in the correct rate of Go task and No-Go task before and after stimulation in the rTMS group,iTBS group and sham stimulation group(all P＞0.05).There was no significant difference in the changes of correct rate in Go task and No-Go task among the three groups(P＞0.05).In the No-Go condition,compared with pre-TMS intervention,the N2 amplitude at Fz and FCz electrodes in rTMS group and iTBS group significantly decreased after intervention(all P＜0.05).Compared with that in the sham stimulation group,the changes of N2 amplitude in the frontal electrodes of the rTMS group and the iTBS group were statistically significant(all P＜0.01),but there was no significant difference in the N2 amplitude changes before and after intervention between the rTMS and iTBS groups(all P＞0.05).In the Go condition,there was no significant difference in N2 amplitude before and after intervention in each group(all P＞0.05).There was no significant difference in the latency changes of Go/No-Go task before and after intervention in each group(all P＞0.05).In the No-Go task,the theta frequency power was increased significantly after rTMS intervention(P＜0.01),and the alpha,beta and gamma frequency powers were decreased significantly(all P＜0.05).Theta frequency power at the Fz channel in the iTBS group was significantly increased after intervention(P＜0.05).No significant time-frequency changes were observed in the sham group before and after the intervention.There were no significant differences in the frequency changes(alpha,theta,beta,gamma)between the rTMS and iTBS groups after intervention(all P＞0.05).In the Go task,there was no significant change in each frequency before and after intervention in each group.Correlation analysis showed that there was no significant correlation between RT and N2 amplitude and theta oscillation activity in each group(all P＞0.05).Conclusions Both 5 Hz rTMS and iTBS interventions significantly improve response inhibition ability in healthy adults.The two types of stimulation may modulate cerebellar executive control functions through similar neuroregulatory mechanisms,providing new evidence for the clinical application of cerebellar TMS in cognitive control-related disorders.

Objective:To analyze the registration status of clinical trials related to contraceptives based on the data of World Health Organization International Clinical Trials Registry Platform (ICTRP), so as to understand the situation of contraceptives development, and provide reference for improving the quality of clinical trials.Methods:All records in the database of ICTRP before January 1, 2025 was researched to screen out contraceptives clinical trials, and the registration time, registration platform, regional distribution, trial design and research content were analyzed.Results:A total of 206 clinical trials related to contraceptives were included. The projects were mainly carried out in the United States, Germany, and India. About 95.63% (197/206) of the study subjects were women of reproductive age. The　main　type　of　study　was　intervention [89.32% (184/206)], among which random trials accounted for 53.26% (98/184), and parallel group trials were the most common [82.65% (81/98)]. Over 64.56% (133/206) of the trials were indicated with open-label. Most of the clinical trials were in phase Ⅲ [47.57% (98/206)] and phase Ⅳ [16.50% (34/206)]. The interventions in female studies were mainly in three aspects: oral contraceptive [42.64% (84/197)], intrauterine delivery [15.23% (30/197)], and vaginal delivery [15.23% (30/197)], and the primary outcome included pregnancy rate [54.82% (108/197)], adverse drug reactions [13.20% (26/197)], ovulation inhibition [8.63% (17/197)], and vaginal infection [4.06% (8/197)].Conclusion:The　clinical　trials　of contraceptives were unevenly distributed, the research types were mainly randomized interventional trials, the included participants were mainly women of reproductive age, the intervention measures were mostly oral contraceptive, intrauterine delivery and vaginal delivery.

In recent years, non-invasive brain stimulation has been widely used in clinical rehabilitation due to its safe and non-invasive features.Particularly for stroke patients, this technique has become a new type of rehabilitation by virtue of its role in improving gait disorders, aphasia, dysphagia, and other complications. Previous research on stroke rehabilitation mainly focused on the cerebral cortex, while the recent evidences suggest that the cerebellum, with its rich synaptic plasticity and extensive structural and functional connectivity with the brain, has emerged as a promising target for non-invasive intervention in stroke rehabilitation. Non-invasive stimulation of the cerebellum is expected to improve patients' impaired function and quality of life. This review discusses the possible mechanisms and clinical applications of non-invasive cerebellar stimulation technology in regulating stroke rehabilitation, aiming to provide new treatment directions and application value for individualized stroke rehabilitation.

Objective:To analyze the registration status of clinical trials related to contraceptives based on the data of World Health Organization International Clinical Trials Registry Platform (ICTRP), so as to understand the situation of contraceptives development, and provide reference for improving the quality of clinical trials.Methods:All records in the database of ICTRP before January 1, 2025 was researched to screen out contraceptives clinical trials, and the registration time, registration platform, regional distribution, trial design and research content were analyzed.Results:A total of 206 clinical trials related to contraceptives were included. The projects were mainly carried out in the United States, Germany, and India. About 95.63% (197/206) of the study subjects were women of reproductive age. The　main　type　of　study　was　intervention [89.32% (184/206)], among which random trials accounted for 53.26% (98/184), and parallel group trials were the most common [82.65% (81/98)]. Over 64.56% (133/206) of the trials were indicated with open-label. Most of the clinical trials were in phase Ⅲ [47.57% (98/206)] and phase Ⅳ [16.50% (34/206)]. The interventions in female studies were mainly in three aspects: oral contraceptive [42.64% (84/197)], intrauterine delivery [15.23% (30/197)], and vaginal delivery [15.23% (30/197)], and the primary outcome included pregnancy rate [54.82% (108/197)], adverse drug reactions [13.20% (26/197)], ovulation inhibition [8.63% (17/197)], and vaginal infection [4.06% (8/197)].Conclusion:The　clinical　trials　of contraceptives were unevenly distributed, the research types were mainly randomized interventional trials, the included participants were mainly women of reproductive age, the intervention measures were mostly oral contraceptive, intrauterine delivery and vaginal delivery.

In recent years, non-invasive brain stimulation has been widely used in clinical rehabilitation due to its safe and non-invasive features.Particularly for stroke patients, this technique has become a new type of rehabilitation by virtue of its role in improving gait disorders, aphasia, dysphagia, and other complications. Previous research on stroke rehabilitation mainly focused on the cerebral cortex, while the recent evidences suggest that the cerebellum, with its rich synaptic plasticity and extensive structural and functional connectivity with the brain, has emerged as a promising target for non-invasive intervention in stroke rehabilitation. Non-invasive stimulation of the cerebellum is expected to improve patients' impaired function and quality of life. This review discusses the possible mechanisms and clinical applications of non-invasive cerebellar stimulation technology in regulating stroke rehabilitation, aiming to provide new treatment directions and application value for individualized stroke rehabilitation.

Objectives:To investigate the clinical value of cardiac magnetic resonance imaging(CMR)feature-tracking strain analysis in risk stratification of diabetic heart failure with preserved ejection fraction(HFpEF).Methods:In this retrospective study,a total of 215 patients with diabetic HFpEF who underwent CMR at Chinese Academy of Medical Sciences Fuwai Hospital from January 2012 to December 2018 were included.Myocardial strain parameters were calculated using CMR feature-tracking technology.Patients were followed up by medical records or telephone calls.Composite endpoint event,all-cause death or heart failure hospitalization during follow-up were recorded.Patients were divided into event group and event-free group.Univariable and multivariable Cox proportional hazard regression analyses were performed to determine the risk factors for the outcomes in diabetic HFpEF.The effects of hypertension and obesity on the prognosis of diabetic HFpEF patients and whether they affect the prognostic value of CMR feature-tracking strain analysis were also analyzed.Results:During a follow-up of(7.1±1.8)years,93(43.3%)patients had endpoint events(event group),including 28 all-cause deaths and 65 heart failure hospitalization.Compared with the event-free group(n=122),patients in the event group had significantly lower left ventricular ejection fraction,higher prevalence and extent of late gadolinium enhancement,and significantly reduced global longitudinal strain(GLS),global circumferential strain,global radial strain,and global systolic longitudinal strain rate(all P<0.05).The absolute GLS value was significantly lower in event group than in event-free group,regardless of the presence of hypertension and obesity.Multivariate Cox regression analysis showed that estimated glomerular filtration rate(HR=0.983,95%CI:0.972-0.993,P=0.001),left atrial volume index(HR=1.015,95%CI:1.005-1.026,P=0.004),and GLS(HR=1.142,95%CI:1.060-1.231,P<0.001)were independent risk factors for adverse cardiovascular events in diabetic HFpEF patients.However,adjusted N-terminal pro-brain natriuretic peptide was not an independent prognostic factor.The cut-offvalue of GLS to predict outcome was-14.09%from ROC curve analysis.The Kaplan-Meier curve showed that in patients with and without hypertension and obesity,patients with the GLS>-14.09%had lower event-free survival compared to patients with GLS≤-14.09%(all P<0.05),and the ability of GLS to predict adverse outcomes was not affected by hypertension and obesity.Conclusions:GLS obtained by CMR feature-tracking strain analysis is an independent predictor of adverse outcomes in diabetic HFpEF,and its ability to predict adverse outcomes is independent of hypertension and obesity.

Objective To explore the effects of different modes of cerebellar transcranial magnetic stimulation(TMS)on response inhibition function in healthy adults and the underlying mechanisms.Methods Eighty-one healthy adult volunteers were randomly divided into 5 Hz repetitive TMS(rTMS)group(n=28),intermittent theta burst stimulation(iTBS)group(n=26)and sham stimulation group(n=27).The TMS stimulation target was the cerebellar Crus Ⅱ region,and the stimulation site was accurately located by the neuronavigation system.The stimulation intensity was 80％of the individual resting motor threshold(RMT).The Go/No-Go task response time(RT)and response inhibition ability and synchronous EEG were measured before and after intervention in each group.The changes of N2 wave and time-frequency in the time window related to response inhibition function in the event-related potential(ERP)were analyzed.Results Compared with that pre-stimulation,RT after stimulation in rTMS group and iTBS group was significantly shortened(all P＜0.05).There was a significant difference in the difference of RT before and after stimulation among the three groups(P＜0.001).Compared with that in the sham stimulation group,the RT after stimulation in the rTMS group and the iTBS group was significantly shortened(P＜0.05-0.01).There was no significant difference in RT changes before and after stimulation between rTMS group and iTBS group(P＞0.05).There was no significant difference in the correct rate of Go task and No-Go task before and after stimulation in the rTMS group,iTBS group and sham stimulation group(all P＞0.05).There was no significant difference in the changes of correct rate in Go task and No-Go task among the three groups(P＞0.05).In the No-Go condition,compared with pre-TMS intervention,the N2 amplitude at Fz and FCz electrodes in rTMS group and iTBS group significantly decreased after intervention(all P＜0.05).Compared with that in the sham stimulation group,the changes of N2 amplitude in the frontal electrodes of the rTMS group and the iTBS group were statistically significant(all P＜0.01),but there was no significant difference in the N2 amplitude changes before and after intervention between the rTMS and iTBS groups(all P＞0.05).In the Go condition,there was no significant difference in N2 amplitude before and after intervention in each group(all P＞0.05).There was no significant difference in the latency changes of Go/No-Go task before and after intervention in each group(all P＞0.05).In the No-Go task,the theta frequency power was increased significantly after rTMS intervention(P＜0.01),and the alpha,beta and gamma frequency powers were decreased significantly(all P＜0.05).Theta frequency power at the Fz channel in the iTBS group was significantly increased after intervention(P＜0.05).No significant time-frequency changes were observed in the sham group before and after the intervention.There were no significant differences in the frequency changes(alpha,theta,beta,gamma)between the rTMS and iTBS groups after intervention(all P＞0.05).In the Go task,there was no significant change in each frequency before and after intervention in each group.Correlation analysis showed that there was no significant correlation between RT and N2 amplitude and theta oscillation activity in each group(all P＞0.05).Conclusions Both 5 Hz rTMS and iTBS interventions significantly improve response inhibition ability in healthy adults.The two types of stimulation may modulate cerebellar executive control functions through similar neuroregulatory mechanisms,providing new evidence for the clinical application of cerebellar TMS in cognitive control-related disorders.

Objective To explore the efficacy of hypofractionated radiotherapy at different time intervals after surgery for keloid,and to analyze the factors affecting the efficacy.Methods A total of 76 patients who underwent 20 Gy/5 postoperative radiotherapy regimen in the Fifth Affiliated Hospital of Zhengzhou University from January 2021 to June 2023 were selected as study subjects,and a total of 100 keloids were divided into effective group(n=79)and recurrence group(n=21).Regular follow-up and record of the patients after radiotherapy treatment effect and adverse effects,and multivariate Logistic was used to analyze factors of recurrence in keloid patients.Results Multivariate Logistic regression analysis found that postoperative radiotherapy time and scar incision length were related to recurrence after treatment,radiotherapy within 7h of surgery was an independent risk factor for recurrence after treatment(OR＞1,P=0.022),and scar incision≤5cm was an independent protective factor for recurrence after treatment(OR＜1,P=0.028).Conclusion Surgical excision combined with hypofractionated radiotherapy is one of the effective measures to prevent and treat keloid recurrence,though keloids on the trunk may need more effective treatment options.The recurrence rate of radiotherapy initiated 7-48h after surgery is relatively the lowest,and it is worthy of clinical promotion and application.