ObjectiveBased on functional near-infrared spectroscopy (fNIRS), we investigated the brain activity characteristics of gross motor tasks in children with autism spectrum disorder (ASD) and motor dysfunctions (MDs) to provide a theoretical basis for further understanding the mechanism of MDs in children with ASD and designing targeted intervention programs from a central perspective. MethodsAccording to the inclusion and exclusion criteria, 48 children with ASD accompanied by MDs were recruited into the ASD group and 40 children with typically developing (TD) into the TD group. The fNIRS device was used to collect the information of blood oxygen changes in the cortical motor-related brain regions during single-handed bag throwing and tiptoe walking, and the differences in brain activation and functional connectivity between the two groups of children were analyzed from the perspective of brain activation and functional connectivity. ResultsCompared to the TD group, in the object manipulative motor task (one-handed bag throwing), the ASD group showed significantly reduced activation in both left sensorimotor cortex (SMC) and right secondary visual cortex (V2) (P<0.05), whereas the right pre-motor and supplementary motor cortex (PMC&SMA) had significantly higher activation (P<0.01) and showed bilateral brain region activity; in terms of brain functional integration, there was a significant decrease in the strength of brain functional connectivity (P<0.05) and was mainly associated with dorsolateral prefrontal cortex (DLPFC) and V2. In the body stability motor task (tiptoe walking), the ASD group had significantly higher activation in motor-related brain regions such as the DLPFC, SMC, and PMC&SMA (P<0.05) and showed bilateral brain region activity; in terms of brain functional integration, the ASD group had lower strength of brain functional connectivity (P<0.05) and was mainly associated with PMC&SMA and V2. ConclusionChildren with ASD exhibit abnormal brain functional activity characteristics specific to different gross motor tasks in object manipulative and body stability, reflecting insufficient or excessive compensatory activation of local brain regions and impaired cross-regions integration, which may be a potential reason for the poorer gross motor performance of children with ASD, and meanwhile provides data support for further unraveling the mechanisms underlying the occurrence of MDs in the context of ASD and designing targeted intervention programs from a central perspective.

Aim To clarify the differential proteins of mammary tissues in Xihuang pills(XHP)against hy-perplasia of mammary glands(HMG)based on quanti-tative proteomics technology and validate them,and to explore the mechanism of action.Methods SD rats were randomly divided into blank group,model group and XHP group,with 10 rats in each group.Except for the blank group,estrogen and progesterone were injec-ted intramuscularly to establish a rat model of mamma-ry hyperplasia for 30 d.After XHP was administered for 14 d,the rats in each group were observed to have morphological changes in the apparent morphology of the mammary tissues,and pathological changes in the mammary tissues were stained with hematoxylin-eosin staining(HE),and the differentially expressed pro-teins(DEPs)in the groups were screened by quantita-tive proteomics technology and subjected to bioinforma-tics analysis,and Western blot to verify the key DEPs.Results Compared with the model group,the appar-ent pathological morphology of the XHP group was sig-nificantly improved,the diameter of the nipple height of the rats was significantly reduced(P＜0.01),and the degree of histopathology was significantly allevia-ted.Quantitative proteomics identified 4,299 DEPs in mammary tissue,and bioinformatics analysis of 14 DEPs with consistent changes between the XHP group and the blank group relative to the model group re-vealed that they were related to the regulation of mus-cular systemic processes,regulation of muscle contrac-tion,DNA replication,and pre-initiation of DNA repli-cation.Western blot results showed that,compared with the model group,rat mammary tissue of the XHP group showed significantly lower levels of ACLY and ALDOC protein expression levels were significantly re-duced and BIN1 protein expression levels were signifi-cantly increased(P＜0.01).Conclusions XHP may exert its anti-mammary hyperplasia effect through the regulation of BIN1,ACLY and ALDOC protein lev-els,the regulation of DNA replication,the regulation of pre-initiation of DNA replication and muscular sys-temic processes,and the regulation of muscle contrac-tion.

Panax notoginseng is the dried root and rhizome of Panax notoginseng(Burk.)F.H.Chen,a perennial erect herb of the genus Ginseng of the family Wujiaceae.As a traditional Chinese medicine in our country,Panax notoginseng has a good tonic effect,and the Dictionary of Traditional Chinese Medicines has the words that Panax notoginseng is used to tonify the blood,remove the blood stasis and damage,and stop epistaxis.It can also be used to pass the blood and tonify the blood with the best efficacy,and it is the most precious one of the prescription med-icines.Eaten raw,it removes blood stasis and generates new blood,subdues swelling and stabilizes pain,stops bleeding with-out leaving stasis,and promotes blood circulation without hurting the new blood;taken cooked,it can be used to replenish and strengthen the body.Notoginsenoside R1 is a characteristic com-pound in the total saponin of Panax ginseng.In recent years,China's aging has been increasing,and the incidence of neuro-logical disorders has been increasing year by year.Meanwhile,reports on notoginsenoside R1 in the treatment of neurological disorders are increasing,and its neuroprotective effects have been exerted with precise efficacy.The purpose of this paper is to review the treatment of neurological diseases and the mecha-nism of action of notoginsenoside R1,so as to provide a certain theoretical basis for clinical use and new drug development.

Objective:To evaluate the difference in efficacy between liposuction combined with single-port endoscopic subcutaneous adenomectomy and traditional open surgery in treating adolescent male breast development disorder,and to compare their effects on patients'anxiety levels and quality of life.Methods:A total of sixty-four patients with adolescent male mammary gland dysplasia who underwent surgery at our hospital between March 2022 and June 2023 were included in this retrospective analysis,with 28 cases in the open surgery group and 36 cases in the single-hole endoscopic group.The study compared various parameters including surgery duration,intraoperative bleeding,incision length,hospitalization duration,treatment cost,and postoperative complications,alongside collecting GAD-7,SF-36,and SCAR questionnaire scores from the pa-tients.Results:The single-port endoscopy group,in comparison to the open surgery group,showed a slightly longer operation time and higher treatment cost but had a shorter hospitalization duration and smaller incision.There was no significant difference observed between the two groups concerning intraoperative bleeding.Notably,the single-port endoscopy group exhibited more significant improvements in SCAR,SF-36,and GAD-7 scores(P＜0.05).Conclusion:Com-pared with traditional open surgery,liposuction combined with single-port endoscopic subcutane-ous adenomectomy is more effective in treating adolescent gynecomastia.This approach not only offers better aesthetic outcomes but also proves effective in reducing patient anxiety and signifi-cantly enhancing their quality of life.

Objectives:To evaluate the diagnostic value of echocardiography in unroofed coronary sinus syndrome(UCSS)with endocardial cushion defect(ECD). Methods:The echocardiographic data of 43 patients of UCSS with ECD who underwent surgical treatment in our hospital from July 2017 to May 2022 were retrospectively analyzed.The diagnostic accuracy was evaluated by comparing the echocardiographic findings with the intraoperative exploration results. Results:According to Kirklin and Barratt-Boyes classification,there were 26 cases of type Ⅰ(60.5%),9 cases of type Ⅱ(20.9%),2 cases of type Ⅲ(4.7%),4 cases of type Ⅳ(9.3%),and 2 cases of type Ⅲ combined with type Ⅳ(4.7%).There were 26 cases(60.5%)of partial ECD,7 cases(16.3%)of intermediate ECD,10 cases(23.3%)of total ECD.Twenty two cases(51.2%)were associated with single atrium.Twenty seven cases(62.8%)were associated with persistent left superior vena cava(PLSVC).Other coexisting complicated malformations were as follows:2 cases of double outlet of right ventricle,1 case of pulmonary atresia,1 case of total anomalous pulmonary venous connection,and 1 case of aplenia syndrome.The coexisting simple malformations included 4 cases of ostium secundum atrial septal defect,2 cases of ventricular septal defect,3 cases of patent ductus arterial,and 6 cases of patent foramen ovale.Other abnormalities included 5 cases of absence of hepatic segment of inferior vena cava,1 case of hypoplasia of right superior vena cava,1 case of absence of right superior vena cava,3 cases of cor triatriatum,1 case of isolated levocardia,1 case of mirror image dextrocardia,4 cases of right aortic arch.Of the 43 patients,30(69.8%)were correctly diagnosed by preoperative echocardiography and 13(30.2%)by intraoperative exploration.UCSS was misdiagnosed as inferior vena cava type sinus septal defect and PLSVC was missed in 1 case.UCSS was missed in 12 cases,and PLSVC was missed in 3 cases of them. Conclusions:Diagnosis UCSS with ECD by echocardiography is valuable and challenging.It is necessary to strengthen the understanding of the embryonic development and pathological anatomy characteristics of these malformations to improve the diagnostic accuracy.

Objective:To evaluate the diagnostic value of hematological parameters for PCa with prostate-specific antigen(PSA)of 4-10 μg/L and construct a risk-stratification model with these parameters.Methods:We retrospectively analyzed the da-ta on the males undergoing the initial prostatic biopsy in the Affiliated Hospital of Xuzhou Medical University with PSA of 4-10 μg/L from March 2010 to April 2021.According to the results of biopsy,we classified the patients into a PCa and a non-PCa group,and compared the hematological parameters between the two groups.We performed univariate and multivariate logistic regression analyses,identified the independent risk factors for PCa,constructed a risk-stratification model for the prediction of PCa and evaluated its effi-ciency.Results:A total of 415 cases were included in this study,107(25.8％)in the PCa and 308(74.2％)in the non-PCa group.Compared with the non-PCa males,the PCa patients showed a significantly older age,higher ratios of neutrophil to lymphocyte and platelet to lymphocyte,systemic immune-inflammation index(SII),red blood cell distribution width and cystatin C(CysC)level(all P＜0.05),but lower red blood cell count and hemoglobin and free/total PSA(f/tPSA)levels(all P＜0.05).Multivariate logis-tic regression analysis indicated that age,f/tPSA,SII and CysC were independent risk factors for the prediction of PCa(all P＜0.05).Five prediction models were constructed based on the above risk factors,and the area under the ROC curve(AUC)of the four-parameter(age+f/tPSA+SII+CysC)model was 0.745(95％CI:0.694-0.796),significantly higher than those of the other mod-els(P＜0.05).A risk-stratification model(low-,intermediate-,and high-risk)was also constructed based on the total nomogram scores,which showed a comparable performance to that of the Prostate Imaging Reporting and Data System(PI-RADS)for the predic-tion of PCa(AUC:0.727[95％CI:0.650-0.804]vs 0.734[95％CI:0.658-0.811]).However,the prediction rate by the risk-stratification model was evidently higher in the low-risk males than in those with low PI-RADS scores(1-2)(39.4％vs 22.2％).Conclusion:SII and CysC are independent risk factors for the prediction of PCa in patients with gray-zone PSA levels.The risk-stratification model based on age,SII,CysC and f/tPSA is comparable to PI-RADS in the diagnostic efficiency of PCa,with an even higher prediction rate in low-risk patients than in those with low PI-RADS scores,and contributive to precision screening and reduction of excessive biopsies in the diagnosis of PCa with gray-zone PSA.

Objective To carry out rigid-body inverse dynamics modelling and analysis of a self-designed 6RSS parallel bio-inspired masticatory robot.Methods Firstly,the functions of kinematic variables including translational/rotational velocities and accelerations were derived for rigid-body inverse dynamics modelling.Secondly,the rigid-body inverse dynamics model was established with the Newton-Euler's law.Finally,the chewing motion trajectories of the oral health volunteers were tracked and numerical calculations were carried out in the case where the robot was subjected to a chewing reaction force.Results Numerical calculations showed that the driving torque and the constraint force of the robot peaked when the chewing reaction force was at its maximum.Conclusion The external force has a large impact on the inverse dynamics of the robot,and theoretical references are provided for the motion control and optimal design of the robot.[Chinese Medical Equipment Journal,2024,45(3):16-22]

Objective To track and evaluate the improvement efficacy of a 3-year continuous implementation of special action of"Improving the pathogen detection rate before antimicrobial therapy",and provide evidence-based basis for future work.Methods Clinical data of inpatients in a tertiary comprehensive hospital from 2020 to 2023 were collected.The baseline survey result in 2020 was taken as the pre-improvement group,and the continuous im-plementation of special action improvement goal from 2021 to 2023 was as the post-improvement group.Measures were taken,including improving the information system,establishing a multi-department collaboration mechanism,providing multi-level training and education for all staff,standardizing medical behavior and pathogen detection processes,and strengthening supervision efficiency.Indicators were dynamically tracked and strategies were fo-llowed up promptly.Monitoring and data acquisition were carried out through the hospital infection information sys-tem.R 4.1.3 statistical software was adopted to compare the differences between two sets of indicators and the changing trends of data in different years,and the improvement efficacy was evaluated.Results After promoting the improvement goal of 3-year special action,the therapeutic antimicrobials usage rate decreased,presenting a downward trend with years(P＜0.001).Pathogen detection rate before antimicrobial therapy increased from 39.38％to 85.40％;blood culture detection rate increased from 14.11％to 49.28％;pathogen detection rates before restricted and special antimicrobial therapy increased from 31.76％and 55.97％to 92.11％and 99.10％,respectively;patho-gen detection rate before combined use of key antimicrobial agents increased from 83.09％to 97.74％,all presen-ting increasing trends year by year(all P＜0.001).The detection rate of multidrug-resistant organisms decreased.Detection rates of carbapenem-resistant Enterobacterales(CRE)and methicillin-resistant Staphylococcus aureus(MRSA)presented downward trends(P＜0.001).Healthcare-associated infection(HAI)diagnosis-related patho-gen detection rate remained above 90％.Consistency rate between specimen collection and infection sites increased from 73.26％to 91.67％,with an increasing trend year by year(P＜0.05).The internal medicine department had the lowest consistency rate,while the critical care medicine department had the highest consistency rate.Conclusion Three-year continuous promotion of the special action improvement goal and dynamic evaluation have greatly im-proved the clinical medical personnel's capability in judging the indicators and detection timing of pathogen speci-mens accurately,standardized diagnosis and treatment behavior,and guided the correct and rational use of antimi-crobial agents in clinical practice,thus reduced the occurrence of bacterial resistance in hospital.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Due to the high similarity with the lipid layer between human skin keratinocytes, functional cosmetics with layered liquid crystal structure prepared by liquid crystal emulsification technology encapsulating natural active substances have become a hot research topic in recent years. This type of functional cosmetic often has a fresh and natural skin feel, excellent skin barrier repair function and efficient moisturizing effect, etc., showing great potential in cosmetic application. However, the present research on the application of liquid crystal emulsification technology to functional cosmetics is still in the initial stage, and there are fewer relevant reports with reference values. Based on the mentioned above, this review provides a comprehensive summary of functional cosmetics with layered liquid crystal structures prepared by liquid crystal emulsification technology from the following aspects: the structure of human skin, the composition of lamellar liquid crystal, the advantages of liquid crystal emulsification technology containing natural active substances used in the field of functional cosmetics, the preparation process, main components, influencing factors during the preparation and the market functional cosmetics with lamellar liquid crystal structure. Finally, the prospect of the application of liquid crystal emulsification technology in functional cosmetics is presented, to provide useful references for those engaged in the research of liquid crystal emulsification technology-related functional cosmetics.