The philosophy of “treating disease before its onset” is a fundamental concept of traditional Chinese medicine (TCM), permeating its diagnostic and therapeutic framework, and is central to clinical practice. However, current TCM diagnostic and treatment models for the “pre-disease to disease” window period face several limitations, including the lack of comprehensive clinical parameters, difficulties in characterizing and integrating heterogeneous multimodal data, and insufficient dynamic precision in interventions and efficacy evaluations. To address these issues, guided by Professor Candong Li’s theory of TCM stateology, this study focuses on integrating objective multimodal data. It proposes a new model for personalized TCM diagnosis and treatment targeting the “pre-disease to disease” window period. This approach first proposes the idea of restructuring the conceptual framework of “symptom” and integrating multi-source heterogeneous data at macroscopic, mesoscopic, and microscopic levels to form a three-dimensional assessment indicator system. By integrating graph neural networks, convolutional neural networks, attention mechanisms, and knowledge graph-guided weight allocation, this approach enables collaborative representation, alignment, and fusion of multi-source data. Subsequently, it plans to construct a multimodal fusion model at both feature and decision levels, in order to establish mappings between indicators and TCM state elements, and to screen key indicators characterizing pathological evolution during the window period. Furthermore, it proposes a technical path for enhancing model interpretability using methods such as SHapley Additive exPlanations (SHAP) and Ablation-CAM++. Finally, with state assessment as the core, it proposes the concept of constructing a dynamic evaluation method for individualized diagnosis and treatment based on time-series data analysis using algorithms such as long short-term memory (LSTM) networks and gated recurrent units (GRUs). Moreover, a causal inference framework and semi-supervised learning strategies are introduced to enable quantitative evaluation of individual intervention effects and to provide interpretable therapeutic feedback, forming a complete technical path from data representation and fusion, weight adjustment, and interpretability analysis, to dynamic diagnosis feedback. This study aims to address deficiencies in the current TCM diagnosis and treatment model during the “pre-disease to disease” window period and to provide an operational framework for the clinical practice of TCM’s “treating disease before its onset”.

OBJECTIVE: To review the research progress of pathological changes of glenohumeral capsule in patients with recurrent shoulder anterior dislocation (RSAD). METHODS: The literature on shoulder capsules, both domestic and international, was reviewed. The anatomy, histology, and molecular biology characteristics of the glenohumeral capsule in RSAD patients were summarized. RESULTS: Anatomically, the glenohumeral capsule is composed of four distinct parts: the upper, lower, anterior, and posterior sections. The thickness of these sections is uneven, and the stability of the capsule is further enhanced by the presence of the glenohumeral and coracohumeral ligaments. Histologically, the capsule tissue undergoes adaptive changes following RSAD, which improve its ability to withstand stretching and deformation. In the realm of molecular biology, genes associated with the regulation of structure formation, function, and extracellular matrix homeostasis of the shoulder capsule's collagen fibers exhibit varying degrees of expression changes. Specifically, the up-regulation of transforming growth factor β ₁ (TGF-β ₁), TGF-β receptor 1, lysyl oxidase, and procollagen-lysine, 2-oxoglutarate 5-dioxygenase 1 facilitates the repair of the joint capsule, thereby contributing to the maintenance of shoulder joint stability. Conversely, the up-regulation of collagen type Ⅰ alpha 1 (COL1A1), COL3A1, and COL5A1 is linked to the recurrence of shoulder anterior dislocation, as these changes reflect the joint capsule's response to dislocation. Additionally, the expressions of tenascin C and fibronectin 1 may play a role in the pathological processes occurring during the early stages of RSAD. CONCLUSION Glenohumeral capsular laxity is both a consequence of RSAD and a significant factor contributing to its recurrence. While numerous studies have documented alterations in the shoulder capsule following RSAD, further research is necessary to confirm the specific pathological anatomy, histological, and molecular biological changes involved.
Humans ; Joint Capsule/metabolism* ; Shoulder Dislocation/metabolism* ; Recurrence ; Shoulder Joint/metabolism* ; Tenascin/metabolism* ; Transforming Growth Factor beta1/genetics* ; Collagen Type I/genetics* ; Extracellular Matrix/metabolism*

Objective:To explore the effect and safety profile of psycho-cardiology model combined with phased re-habilitation exercise on psychological state,cardiac function,sleep quality,cognitive function and quality of life of patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:This ran-domized controlled study enrolled 150 CHD patients with anxiety and sleep disorder who underwent PCI in the Psy-cho-cardiology Medical Center of Beijing Anzhen Hospital,Capital Medical University between January 2023 and April 2023.Patients were randomly divided into control group(n=75)and intervention group(n=75).Patients in the control group received routine management mode intervention after PCI,comparing to those in the intervention group receiving psycho-cardiology model combined with phased rehabilitation exercise intervention after PCI.Both groups were intervened for 2 months and followed up for 6 months.Mental state,heart function,sleep quality,cog-nitive function,quality of life and incidence of adverse events were compared between two groups.Results:Com-pared to those in control group,patients in intervention group had significant lower scores of generalized anxiety dis-order-7(GAD-7)[(5.16±1.19)points vs.(7.53±1.68)points],patient health questionaire-9(PHQ-9)[(7.63±1.03)points vs.(10.41±1.54)points],Athens insomnia scale(AIS)[(3.69±1.35)points vs.(6.43±2.11)points]and left ventricular end diastolic diameter(LVEDd)[(44.50±2.86)mm vs.(54.11±3.46)mm](P＜0.001 all),and significant higher left ventricular ejection fraction(LVEF)[(60.06±3.05)％vs.(53.90±3.05)％],scores of Seattle angina questionnaire(SAQ)[(83.31±6.59)points vs.(52.75±5.66)points]and mini-mental state examination(MMSE)[(26.44±4.68)points vs.(23.23±4.01)points](P＜0.001 all).We detec-ted significant lower incidence of adverse events in intervention group compared to control group(4.29％vs.16.44％,P=0.018).Conclusion:Psycho-cardiology model combined with phased rehabilitation exercise may im-prove psychological state,heart function,sleep quality,cognitive function and quality of life in CHD patients with anxiety and sleep disorder after PCI with considerable safety.

Objective : To explore the causal relationship between 46 phenotypes ( including 15 seropositive case- control phenotypes and 31 quantitative antibody-measurement phenotypes) and ulcerative colitis( UC) using two- sample bidirectional Mendelian randomization( TSMR) . Methods: Single nucleotide polymorphisms ( SNPs) sig- nificantly associated with the relative abundance of the 46 antibody sera were extracted as instrumental variables ac- cording to preset thresholds . Summary statistics for UC were obtained from the OPEN GWAS database ( n = 47 745) . MR-Egger regression , weighted median method ( WME) , inverse variance weighting ( IVW) , the simple mode method (SM) , and weighted multitude method (WM) were used to estimate the causal relationship between antibody levels and UC , primarily using the IVW method . The results were assessed according to the effect indica- tor dominance ratios (OR) and 95% confidence intervals (CI) . Sensitivity analysis , heterogeneity test , gene plei- otropy test , and outlier test (MR-PRESSO) were combined to verify the stability and reliability of the results , and the causal association study was performed again using reverse Mendelian randomization(MR) . Results : IVW re- sults showed that Epstein-Barr( EB) virus EA-D antibody levels ( OR = 0. 806 , 95% CI = 0. 693 - 0. 939 , P < 0. 01) , Epstein-Barr virus EBNA-1 antibody levels ( OR = 1 . 870% , 95% CI = 1 . 480 - 2. 360 , P < 0. 000 1) , Anti-polyomavirus 2 IgG seropositivity (OR = 0. 570 , 95% CI = 0. 435 - 0. 746 , P < 0. 000 1) were associated with UC . The inverse MR analysis revealed a causal effect on anti-polyomavirus 2 IgG seropositivity , and none of the a- bove revealed genetic pleiotropy or significant heterogeneity of IVs . Conclusion EB virus EBNA-1 antibody levels are positively associated with the risk of UC , while EB virus EA-D antibody levels and anti-polyomavirus 2 IgG se- ropositivity are negatively associated with the risk of UC , indicating that they are protective factors for UC .

Objective:To explore the effect and safety profile of psycho-cardiology model combined with phased re-habilitation exercise on psychological state,cardiac function,sleep quality,cognitive function and quality of life of patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods:This ran-domized controlled study enrolled 150 CHD patients with anxiety and sleep disorder who underwent PCI in the Psy-cho-cardiology Medical Center of Beijing Anzhen Hospital,Capital Medical University between January 2023 and April 2023.Patients were randomly divided into control group(n=75)and intervention group(n=75).Patients in the control group received routine management mode intervention after PCI,comparing to those in the intervention group receiving psycho-cardiology model combined with phased rehabilitation exercise intervention after PCI.Both groups were intervened for 2 months and followed up for 6 months.Mental state,heart function,sleep quality,cog-nitive function,quality of life and incidence of adverse events were compared between two groups.Results:Com-pared to those in control group,patients in intervention group had significant lower scores of generalized anxiety dis-order-7(GAD-7)[(5.16±1.19)points vs.(7.53±1.68)points],patient health questionaire-9(PHQ-9)[(7.63±1.03)points vs.(10.41±1.54)points],Athens insomnia scale(AIS)[(3.69±1.35)points vs.(6.43±2.11)points]and left ventricular end diastolic diameter(LVEDd)[(44.50±2.86)mm vs.(54.11±3.46)mm](P＜0.001 all),and significant higher left ventricular ejection fraction(LVEF)[(60.06±3.05)％vs.(53.90±3.05)％],scores of Seattle angina questionnaire(SAQ)[(83.31±6.59)points vs.(52.75±5.66)points]and mini-mental state examination(MMSE)[(26.44±4.68)points vs.(23.23±4.01)points](P＜0.001 all).We detec-ted significant lower incidence of adverse events in intervention group compared to control group(4.29％vs.16.44％,P=0.018).Conclusion:Psycho-cardiology model combined with phased rehabilitation exercise may im-prove psychological state,heart function,sleep quality,cognitive function and quality of life in CHD patients with anxiety and sleep disorder after PCI with considerable safety.

Objective To observe the value of multiparametric quantitative MRI for diagnosis of thyroid-associated ophthalmopathy(TAO)complicated with dysthyroid optic neuropathy(DON).Methods Fifty-five TAO patients with 109 affected eyes were retrospectively enrolled and divided into DON group(22 cases with 44 affected eyes)and non DON group(33 cases with 65 affected eyes)based on complicated with DON or not.Clinical data and multiparametric quantitative MRI indicators were compared between groups.The influencing factors of TAO complicated with DON were screened with logistic regression to establish a model,and the diagnostic efficacy of the model was observed.Results Significant differences of the course of disease,degree of eyeball protrusion,muscle index,as well as the number,thickness,T1 value,T2 value,fat fraction and orbital fat water fraction of thickened extraocular muscle were found between groups(all P＜0.05).T1 value and orbital fat water fraction of thickened extraocular muscle were both independent influencing factors of TAO complicated with DON,with the area under the curve(AUC)for diagnosing TAO complicated with DON of 0.859 and 0.868,respectively,and AUC of the combined diagnosis of the two was 0.922,significantly higher than orbital fat water fraction alone(P=0.034)but not significantly different with that of T1 value alone(P=0.851).Conclusion T1 value and orbital fat water fraction of thickened extraocular muscle based on multiparametric quantitative MRI were helpful for diagnosing TAO complicated with DON.

Purpose: This study aimed to evaluate the ability of ultrafast power Doppler (PD) to assess disease activity in rheumatoid arthritis (RA) by examining the correlations between variables from ultrafast PD perfusion imaging and clinical measures of disease activity. Methods: Thirty-three RA patients underwent clinical assessments of disease activity and ultrasound scans of bilateral wrists using both ultrafast and conventional PD systems. A spatial singular value decomposition filter was applied to the ultrafast PD imaging. Singular vectors representing perfusion and fast flows were selected to produce perfusion images. All images were quantitatively analyzed with computer assistance and scored semiquantitatively (0-3) by a physician for synovial vascularity. The Pearson correlation coefficients between image variables and clinical indices were calculated. Results: The correlation coefficients ranged from weakly to moderately positive between ultrafast PD variables and clinical indices (r=0.221-0.374, all P<0.05). The strongest correlations were observed for synovial PD brightness with the 28-joint Disease Activity Score based on C-Reactive Protein (DAS28-CRP) and the Simplified Disease Activity Index (SDAI). In patients within the deep clinical remission (dCR) subgroup, synovial PD brightness showed stronger correlations with DAS28-CRP, the Clinical Disease Activity Index, and SDAI (r=0.578-0.641, all P<0.001). The correlation coefficients between conventional PD variables and clinical indices were similar to those observed with ultrafast PD variables. Conclusion Ultrafast PD imaging effectively extracts capillary blood signals and generates perfusion images. In the RA population, ultrafast PD variables exhibit weak-to-moderate correlations with clinical indices, with these correlations being notably stronger in dCR patients.

Purpose: This study aimed to evaluate the ability of ultrafast power Doppler (PD) to assess disease activity in rheumatoid arthritis (RA) by examining the correlations between variables from ultrafast PD perfusion imaging and clinical measures of disease activity. Methods: Thirty-three RA patients underwent clinical assessments of disease activity and ultrasound scans of bilateral wrists using both ultrafast and conventional PD systems. A spatial singular value decomposition filter was applied to the ultrafast PD imaging. Singular vectors representing perfusion and fast flows were selected to produce perfusion images. All images were quantitatively analyzed with computer assistance and scored semiquantitatively (0-3) by a physician for synovial vascularity. The Pearson correlation coefficients between image variables and clinical indices were calculated. Results: The correlation coefficients ranged from weakly to moderately positive between ultrafast PD variables and clinical indices (r=0.221-0.374, all P<0.05). The strongest correlations were observed for synovial PD brightness with the 28-joint Disease Activity Score based on C-Reactive Protein (DAS28-CRP) and the Simplified Disease Activity Index (SDAI). In patients within the deep clinical remission (dCR) subgroup, synovial PD brightness showed stronger correlations with DAS28-CRP, the Clinical Disease Activity Index, and SDAI (r=0.578-0.641, all P<0.001). The correlation coefficients between conventional PD variables and clinical indices were similar to those observed with ultrafast PD variables. Conclusion Ultrafast PD imaging effectively extracts capillary blood signals and generates perfusion images. In the RA population, ultrafast PD variables exhibit weak-to-moderate correlations with clinical indices, with these correlations being notably stronger in dCR patients.

Purpose: This study aimed to evaluate the ability of ultrafast power Doppler (PD) to assess disease activity in rheumatoid arthritis (RA) by examining the correlations between variables from ultrafast PD perfusion imaging and clinical measures of disease activity. Methods: Thirty-three RA patients underwent clinical assessments of disease activity and ultrasound scans of bilateral wrists using both ultrafast and conventional PD systems. A spatial singular value decomposition filter was applied to the ultrafast PD imaging. Singular vectors representing perfusion and fast flows were selected to produce perfusion images. All images were quantitatively analyzed with computer assistance and scored semiquantitatively (0-3) by a physician for synovial vascularity. The Pearson correlation coefficients between image variables and clinical indices were calculated. Results: The correlation coefficients ranged from weakly to moderately positive between ultrafast PD variables and clinical indices (r=0.221-0.374, all P<0.05). The strongest correlations were observed for synovial PD brightness with the 28-joint Disease Activity Score based on C-Reactive Protein (DAS28-CRP) and the Simplified Disease Activity Index (SDAI). In patients within the deep clinical remission (dCR) subgroup, synovial PD brightness showed stronger correlations with DAS28-CRP, the Clinical Disease Activity Index, and SDAI (r=0.578-0.641, all P<0.001). The correlation coefficients between conventional PD variables and clinical indices were similar to those observed with ultrafast PD variables. Conclusion Ultrafast PD imaging effectively extracts capillary blood signals and generates perfusion images. In the RA population, ultrafast PD variables exhibit weak-to-moderate correlations with clinical indices, with these correlations being notably stronger in dCR patients.

Purpose: This study aimed to evaluate the ability of ultrafast power Doppler (PD) to assess disease activity in rheumatoid arthritis (RA) by examining the correlations between variables from ultrafast PD perfusion imaging and clinical measures of disease activity. Methods: Thirty-three RA patients underwent clinical assessments of disease activity and ultrasound scans of bilateral wrists using both ultrafast and conventional PD systems. A spatial singular value decomposition filter was applied to the ultrafast PD imaging. Singular vectors representing perfusion and fast flows were selected to produce perfusion images. All images were quantitatively analyzed with computer assistance and scored semiquantitatively (0-3) by a physician for synovial vascularity. The Pearson correlation coefficients between image variables and clinical indices were calculated. Results: The correlation coefficients ranged from weakly to moderately positive between ultrafast PD variables and clinical indices (r=0.221-0.374, all P<0.05). The strongest correlations were observed for synovial PD brightness with the 28-joint Disease Activity Score based on C-Reactive Protein (DAS28-CRP) and the Simplified Disease Activity Index (SDAI). In patients within the deep clinical remission (dCR) subgroup, synovial PD brightness showed stronger correlations with DAS28-CRP, the Clinical Disease Activity Index, and SDAI (r=0.578-0.641, all P<0.001). The correlation coefficients between conventional PD variables and clinical indices were similar to those observed with ultrafast PD variables. Conclusion Ultrafast PD imaging effectively extracts capillary blood signals and generates perfusion images. In the RA population, ultrafast PD variables exhibit weak-to-moderate correlations with clinical indices, with these correlations being notably stronger in dCR patients.