ObjectiveTo develop an assessment tool for apraxia of speech (AOS) of Chinese Putonghua speakers and test its reliability and validity. MethodsThe Chinese Apraxia of Speech Assessment and Diagnostic Tool (CAADT) was developed based on the Apraxia of Speech Rating Scale 3.5, combined with the linguistic characteristics of Chinese and clinical experience. The tool consistsed of eleven items across three sections: articulation, prosody and alternating motion rates. Six experts evaluated the content validity. From November, 2024 to May, 2025, 51 patients with post-stroke AOS (experimental group) and ten patients with post-stroke aphasia without AOS (control group) were recruited from Anhui Wannan Rehabilitation Hospital (the Fifth People's Hospital of Wuhu), and tested with CAADT. Reliability was assessed using Cronbach's α coefficient, Kendall's coefficient of concordance W and Pearson correlation coefficient. Validity was evaluated using the content validity index (CVI) and Spearman correlation coefficient. Discriminative effect was analyzed using the receiver operating characteristic (ROC) curve. ResultsThe Cronbach's α coefficients for the articulation and prosody sections and the total scale were all > 0.9, while it was 0.454 for the alternating motion rates. Inter-rater reliability was good (W ≥ 0.598, P < 0.001). Test-retest reliability showed high positive correlations for the three sections and the total score between the two assessments (r ≥ 0.84, P < 0.001). The scale-level CVI was 0.95, and the item-level CVI ≥ 0.83. The Spearman correlation coefficients among the sections ranged from 0.30 to 0.70. ROC analysis revealed an area under the curve of 0.953, with a cut-off value of 11, yielding a sensitivity of 0.92 and a specificity of 0.90. ConclusionCAADT demonstrates good reliability, validity and discriminative effect, which can be used for clinical assessment and auxiliary diagnosis of Chinese Putonghua speaking patients with post-stroke AOS.

Objective To investigate the role of the prefrontal cortex in the generation and adaptation of chro-nic subjective tinnitus using resting-state functional magnetic resonance imaging(rs-fMRI).Methods Resting-state functional magnetic resonance imaging scan were acquired from 20 patients with chronic subjective tinnitus and 20 healthy controls.Fractional amplitude of low-frequency fluctuations(fALFF)and seed-based whole-brain functional connectivity(FC)methods were used to detect abnormal prefrontal cortex activity in tinnitus patients and to investi-gate interactions between prefrontal cortex activity and brain regions associated tinnitus perception.The analysis aimed to assess the relationship between prefrontal cortex spontaneous neural activity,atypical functional connectivi-ty across various brain regions,and clinical characteristics of tinnitus.Results Compared with healthy controls,pa-tients with chronic tinnitus showed a significant reduction in fALFF values in some specific brain areas of prefrontal cortex,including the left/right medial superior frontal gyrus and the left/right middle frontal gyrus.Functional con-nectivity values were notably enhanced between the left medial superior frontal gyrus and the left anterior insula,as well as between the right medial superior frontal gyrus and the left superior temporal gyrus.Furthermore,increased functional connectivity was observed between the left middle frontal gyrus and the right middle temporal gyrus,as well as between the right middle frontal gyrus and the left parahippocampal gyrus,left superior parietal lobule,and left supplementary motor area.Importantly,the functional connectivity between the left middle frontal gyrus and the right superior temporal gyrus exhibited a negative correlation with tinnitus handicap inventory scores(r=-0.627,P=0.003)and visual analogue scale scores(r=-0.596,P=0.005).Conclusion There are abnormal brain function changes in medial prefrontal cortex and dorsolateral prefrontal cortex in patients with chronic subjec-tive tinnitus,accompanied by changes in the intensity of functional connections with the salience and auditory net-works.These abnormalities are highly related to the severity of tinnitus.The prefrontal cortex may play an impor-tant role in the sensory prediction and auditory regulation of tinnitus.

With the rapid development of artificial intelligence(AI),how to digitize the teaching of Medical Immunology is a new challenge posed by the times and education.This study is based on the advanced teaching model of Medical Immunology,which includes lectures-PAD class-flipped classrooms-expert lecture.By introducing knowledge mapping and AI teaching assistant into the entire learning process,the students not only deepen their understanding of the knowledge system of Medical Immunology,but also ex-ercise their ability to apply immunological knowledge to solve practical clinical problems,enhance their self-learning ability,expres-sion ability,communication ability,on-site performance ability,and cultivate a spirit of unity,cooperation,and exploration.The practice of empowering Medical Immunology teaching with digital intelligence achieves the integration of theory and application,the linkage between in class and out of class teaching,the connection between commonalities and individualities,and the union of abili-ties and qualities in Medical Immunology teaching.It also provides practical basis for exploring the implementation path of digital intel-ligence empowerment in Medical Immunology teaching.

Objective To analyze the bromodomain-containing protein 9(BRD9)and heterogeneous nuclear ribonucleoprotein A2/B1(HNRNPA2B1)in the bromine domain of multiple myeloma(MM)and explore their correlation with the survival prognosis of MM patients.Methods A total of 102 MM patients who received treatment in the First Affiliated Hospital of Xi'an Jiaotong University from May 2017 to May 2020 were selected as the MM group,while 60 patients who were confirmed to have no bone marrow dysfunction through bone marrow puncture were selected as the control group.Real time fluorescence quantitative PCR(qRT-PCR)was applied to detect the expression of BRD9 mRNA and HNRNPA2B1 mRNA in bone marrow tissue.Pearson correlation analysis was applied to analyze the relationship between BRD9 mRNA and HNRNPA2B1 mRNA.Kaplan-Meier curve and COX regression analysis were used to investigate the relationship between BRD9 mRNA and HNRNPA2B1 mRNA expression and the survival prognosis of MM patients.Results The relative expression levels of BRD9 mRNA(3.14±0.66)and HNRNPA2B1 mRNA(2.93±0.57)in the bone marrow tissue of the MM group were higher than those in the control group(0.84±0.22,0.92±0.36),and the differences were statistically significant(t=26.124,24.567,all P<0.001).Pearson correlation analysis showed a positive correlation between BRD9 mRNA and HNRNPA2B1 mRNA expression in the bone marrow tissue of MM group(r=0.761,P<0.001).The relative expression levels of BRD9 mRNA(3.90±0.69)and HNRNPA2B1 mRNA(4.13±0.64)in the bone marrow tissue of the MM group with ISS stage III were higher than those in international staging system(ISS)stages I,II(2.70±0.60,3.15±0.65;2.23±0.51,2.95±0.56),and the differences were statistically significant(t=7.399,4.272;13.255,7.551,all P<0.05).The 3-year overall survival rates of the BRD9 mRNA high expression and low expression groups were 60.00%(30/50)and 82.69%(43/52),respectively,the overall 3-year survival rates of HNRNPA2B1 mRNA high and low expression groups were 57.14%(28/49)and 84.91%(45/53),respectively,with statistically significant differences between the groups(Log Rank χ2=7.572,9.686,P=0.006,0.002).ISS stage III,high expression of BRD9 mRNA,and high expression of HNRNPA2B1 mRNA were risk factors affecting the poor survival prognosis of MM patients(all P<0.001).Conclusion The expression of BRD9 and HNRNPA2B1 are elevated in MM patients,both of them are risk factors for poor prognosis in MM patients.

AIM To investigate the ameliorative effects of Compound Fufangteng Mixture(CFM)on cyclophosphamide(CTX)-induced immunosuppression in mice.METHODS Forty-eight male C57BL/6J mice were randomly divided into the blank control group,the model group,the levamisole hydrochloride group(40 mg/kg)and the low-dose,medium-dose and high-dose CFM groups(3.75,7.5,10 g/kg),with 8 mice in each group,and given respective intervention orally once daily for 14 days.On the 5th to 7th day of administration,with the blank control group given normal saline intraperitoneally,the other groups underwent intraperitoneal CTX injections(80 mg/kg).24 hours after the last administration,organ indices of thymus and spleen were calculated;splenic histopathological alterations were assessed by HE staining;serum levels of IL-2,IL-6 and IgG were quantified using ELISA;splenic CD4+,CD8+T lymphocytes,alongside CD86+and CD206+macrophages populations were analyzed by flow cytometry;and splenic expression of CD4,CD8 and F4/80 was evaluated by immunohistochemical staining.RESULTS In CTX-treated mice,CFM administration mitigated body weight loss;enhanced thymus weight and thymic index;ameliorated splenic immune cell populations,elevated serum levels of cytokines IL-2,IL-6 and IgG in serum;and upregulated splenic levels of CD45+CD3+T lymphocytes and F4/80+CD11b+macrophages,alongside increasing the expression of CD4,CD8 and F4/80 surface markers.CONCLUSION CFM alleviates CTX-induced immunosuppression state in mice by modulating immune cells,restoring immune function and enhancing anti-inflammatory and tissue repair capabilities.

Objective To investigate the current nursing practice of nurses specializing in nutritional support in ICUs and analyze their influencing factors in order to improve the training program and promote the development of standardized and precise nursing practice.Methods Convenience sampling method was used to select nutritional support nurses in ICUs in 29 provinces(autonomous regions and municipalities)from October 2023 to March 2025,and the self-developed questionnaire on nursing practice behaviors of nutritional support nurses in ICUs was used to conduct the survey.SPSS 21.0 software was used for descriptive analysis and multiple linear regression analysis.Results A total of 774 questionnaires were distributed,and 766 valid questionnaires were collected,with a recovery rate of 98.97％,and the score of the questionnaire on nursing practice behaviors of nurses specializing in nutritional support in ICU was(90.41±1 1.82).The results of multiple linear regression analysis showed that gender,presence of a nutritional support nursing team in the hospital,a standardized process of nutritional support nursing in the department,clear positional responsibilities of the nutritional support nursing team members,and inclusion of the nutritional support status of the patients in the quality management of the department were the factors influencing the nursing practice behavior scores of the nurses specializing in nutritional support in ICUs(P＜0.05).Conclusion Nurses in the ICUs have a high level of nursing practice behavior,but there is a need for further standardization in parenteral nutrition infusion and monitoring of complications.ICU nursing managers should formulate improvement strategies to address the weaknesses of clinical practice,strengthen nutritional support training,and improve the quality management program,and further improve the practical ability of nurses specializing in nutritional support.

Objective To review the clinical trial registration characteristics of TCM prevention and treatment of stroke;To provide reference for future relevant clinical trials.Methods Clinical trials of TCM prevention and treatment of stroke registered on ChiCTR and NCT from the establishment of the databases to August 31,2023 were retrieved.Excel 2019 was used to remove duplication and extract relevant data.SPSS 27.0 was used to analyze the included data and drown corresponding charts.The characteristics of trails were summarized.Results Totally 540 registered clinical trials were included,among which,449(83.15%)were from ChiCTR and 91(16.85%)were from NCT.The number of registered was is generally increasing year by year.The included research involved 8 countries,of which 29 provinces of China were involved;213 institutions and 391 researchers were involved.The main source of funding was government finance(52.41%);a total of 216 368 participants were included in these trials,with the majority of trials having a sample size of 50-100 cases(32.22%).The main research type was intervention study(88.70%),and the study design was mostly randomized controlled trial(82.59%).Most of the trials(39.63%)did not clearly report the blind method,followed by double blind clinical trail(21.67%)and evaluator blind clinical trial(13.70%).Clinical trials focused on the full cycle of stroke management,including acute,convalescent,sequelae,and stroke prevention.Among them,the study of sequelae stage of stroke accounted for the largest proportion(62.04%),which specifically covered motor dysfunction,cognitive mental dysfunction,swallowing disorders,etc.The main intervention measures were acupuncture(42.41%),followed by Chinese patent medicine(21.12%)and tuina(10.37%).The main outcome evaluation indexes were motor function evaluation(17.10%)and nerve function evaluation(14.56%).Conclusion The clinical research on the TCM prevention and treatment of stroke is in a period of rapid growth with increasing attention and deepening of the research,which is conducive to improving the prognosis of patients.However,there are still some problems,such as studies with weak systematicness,unreasonable proportion structure of intervention measures,and strong subjectivity of outcome evaluation indicators.

Objective:To explore the effect of staged pressure therapy, in addition to rehabilitation training, on scar hyperplasia and motor function after a deep hand burn.Methods:Sixty patients with deep hand burns were randomly divided into a control group ( n=30) and an observation group ( n=30). In addition to specialized burn treatment and early rehabilitation training, the control group was given routine pressure treatment, while the observation group was provided with staged pressure therapy for 6 months. Before the treatment and after 3 and 6 months of treatment, scar hyperplasia and hand function in both groups was evaluated using the Vancouver scar scale (VSS), grip strength and pinch strength tests, and the Jebsen hand function test (JHFT). Total active motion (TAM) and total passive motion (TPM) of the finger joints was quantified, and any complications during the treatment were recorded. Results:After 3 and 6 months of the treatment, all of the observations in both groups had improved significantly, but the improvements were significantly better among the treatment group, on average.Conclusions:Staged pressure therapy can more effectively inhibit scar hyperplasia after a deep hand burn. In conjunction with rehabilitation training, it better improves the mobility of the finger joints, hand muscle strength and the recovery of hand function. It is worthy of clinical promotion and application.

Objective To compare the cost-effectiveness between sodium valproate and levetiracetam in the treatment of childhood epilepsy and provide an economic basis for clinical medication choices. Methods A cost-effectiveness analysis was conducted using a decision tree model to compare the effectiveness and drug costs of sodium valproate and levetiracetam in treating childhood epilepsy. Single-factor sensitivity analysis and probabilistic sensitivity analysis were used to assess the impact of parameter variations on the study results. Results The treatment cost of levetiracetam was significantly higher than that of sodium valproate. The incremental cost-effectiveness ratio （ICER） of levetiracetam compared to sodium valproate was ¥8 628.43. Sensitivity analysis results were consistent with the base-case analysis. The probabilistic sensitivity analysis showed that, over a 6-month treatment period, levetiracetam became a more cost-effective option when the willingness-to-pay （WTP） threshold was ¥9,000 or higher. One-way sensitivity analysis revealed that the price of levetiracetam was the most influential factor affecting the ICER. Conclusion When the WTP per effective pediatric epilepsy case is ¥9,000 or higher, levetiracetam demonstrates a cost-effectiveness advantage.

ObjectiveTo multidimensionally analyze the clinical effects of Qianyang Yuyin granules on elderly hypertensive patients through an "energy-inflammation-aging" network. MethodsRelevant datasets were retrieved from the GEO database. Gene set enrichment analysis （GSEA） was performed on the gene expression profiles of peripheral blood cells from patients with essential hypertension in dataset GSE24752. The GSEA referenced "GO gene sets" and "KEGG gene sets" to identify significantly enriched gene sets. A clinical trial was conducted using a randomized controlled study design. A total of 40 patients meeting the inclusion criteria were enrolled. The control group received standard antihypertensive treatment with angiotensin receptor blockers （ARBs） or combined calcium channel blockers （CCBs）. In contrast，the treatment group received Qianyang Yuyin Granules in addition to the standard treatment for 12 weeks. Blood pressure levels and clinical efficacy were observed，and changes in energy metabolism indicators，DNA damage markers，and senescence-associated secretory phenotype （SASP） in blood were measured using ELISA before and after treatment. ResultsGSEA results indicated significant energy metabolism dysregulation in hypertensive patients. Clinical findings showed that both groups achieved blood pressure control without significant intergroup differences. In terms of clinical efficacy，the treatment group had a significantly higher effective rate compared to the control group （95% vs 65%，P0.05）. After treatment，the treatment group showed a significant increase in NAD⁺ levels （P0.01），with higher levels compared to the control group （P0.05）. The treatment group also exhibited a greater reduction in DNA damage marker 8-OHdG （P0.01） and cell adhesion factors ICAM-1 and VCAM-1 （P0.01） compared to the control group. Pro-inflammatory cytokines IL-1β and IL-6 were significantly reduced in the treatment group （P0.01），with greater reductions compared to the control group （P0.05，P0.01）. Anti-inflammatory cytokines IFN-α，IL-4，and IL-10 were significantly elevated in the treatment group （P0.01），with higher levels compared to the control group （P0.01）. No significant adverse reactions were reported in either group. ConclusionThe "energy- inflammation- aging" network plays an important role in the pathological mechanism of hypertension patients. Qianyang Yuyin granules may delay the aging process by increasing patients' energy metabolism levels，reducing DNA oxidative damage，and maintaining the balance of inflammatory factors.