OBJECTIVE:Based on different algorithms of machine learning,the prediction model of lumbar disc herniation has become a trend and hot spot in the development of precision medicine.However,there is limited evidence on the reporting quality and methodological quality of prediction models of lumbar disc herniation outcomes using machine learning.This article is aimed to explore the performance of machine learning algorithms in predicting the prognosis of lumbar disc herniation by comprehensively analyzing the report quality and risk of bias of previous studies that developed and validated prognosis prediction models based on machine learning through a comprehensive literature search,in order to explore the performance of machine learning algorithms in predicting the prognosis of lumbar disc herniation.METHODS:The databases of CNKI,WanFang,VIP,SinOMED,PubMed,Web of Science,Embase,and The Cochrane Library were searched by computer.Studies on the use of machine learning to develop(and/or validate)prognostic prediction models for lumbar disc herniation were collected from the inception of the database to December 31,2023.Two researchers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.The reporting quality and risk of bias of the included studies were assessed by the Multivariable Transparent Reporting of Predictive Models(TRIPOD)statement and the Predictive Model Risk of Bias Assessment Tool(PROBAST).The results of the evaluation were analyzed using descriptive statistics and visual charts.RESULTS:(1)A total of 23 articles were included,and the TRIPOD compliance of each study ranged from 11％to 87％,with a median compliance of 54％.The quality of reporting of titles,detailed descriptions of treatment measures,blinding of predictors,handling of missing data,details of risk stratification,specific procedures for enrollment,model interpretation,and model performance was mostly poor,with TRIPOD adherence rates ranging from 4％to 35％.(2)Of all included studies,61％had a high risk of bias and 39％had an unclear overall risk of bias.The area under the curve,accuracy,sensitivity and specificity were used to evaluate the performance of the model.The areas under the curve of 20 models were reported,ranging from 0.561 to 0.999.Three models reported the accuracy of the model,ranging from 82.07％to 89.65％.(3)Among all included studies,the statistical analysis domain was most often assessed as having a high risk of bias,mainly due to the small number of valid samples,the selection of predictors based on univariate analysis and the lack of calibration and discrimination assessment of the model in the study.CONCLUSION:These results indicate that machine learning can achieve good predictive ability in the development and validation of prognostic models for lumbar disc herniation.The commonly used algorithms include regression algorithm,support vector machine,decision tree,random forest,artificial neural network,naive Bayes and other algorithms.Reasonable algorithms combined with clinical practice can improve the accuracy of prognosis prediction of lumbar disc herniation.However,the reporting and methodological quality of prognosis prediction models based on machine learning are poor,the prediction performance of different models varies greatly,and the generalization and extrapolation of research models are unclear.There is an urgent need to improve the design,implementation and reporting of such studies.To promote the application of machine learning in the clinical practice of lumbar disc herniation prediction models,it is necessary to comprehensively consider various predictors related to the prognosis of the disease before modeling,and strictly follow the relevant standards of PROBAST tool during modeling.

ObjectiveThis paper aims to clarify the material basis of Gualou Niubangtang and establish a quantitative analysis method for its main constituents， providing a reference for the overall quality control of this preparation. MethodsThe constituents in the formula were systematically characterized based on ultra-performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry （UPLC-Q-TOF-MS/MS）. Identification was performed by matching with the UNIFI 9.6 software and utilizing database platforms such as PubChem， ChemicalBook， and ChemSpider， combined with relevant literature reports. A quantitative analysis method for the seven main constituents in Gualou Niubangtang was established by using high performance liquid chromatography （HPLC）. ResultsUPLC-Q-TOF-MS/MS analysis identified 155 constituents， including 69 flavonoids， 36 terpenoids， 23 phenylpropanoids， 8 phenylethanoid glycosides， and 19 other types of constituents. In the established quantitative analysis method， the seven main constituents showed good linearity within their respective linear ranges. The precision， repeatability， stability， and spike recovery all met the required standards. The results showed that the content ranges of geniposide， liquiritin， hesperidin， arctiin， baicalin， oroxylin A-7-O-β-D-glucuronide， and wogonoside in 15 batches of Gualou Niubangtang were 13.67-21.25， 1.20-7.64， 5.45-7.45， 22.97-33.51， 29.95-39.07， 2.58-4.80， and 6.56-9.31 mg·g^-1， respectively. ConclusionThis study successfully characterizes and attributes multi-category constituents in Gualou Niubangtang， clarifying that its material basis is primarily composed of flavonoids， terpenoids， phenylethanoid glycosides， and phenylpropanoids. Furthermore， it enables the quantification of seven constituents within the formula. This work lays a foundation for research on the quality control， action mechanism， and clinical application of this formula.

To systematically analyzed the reporting status of core elements in publicly available clinical practice guideline(hereafter referred to as "guideline") protocols published domestically and internationally over the past decade, identified existing problems, and provided evidence to inform the standardized writing and publication of future guideline protocols.

OBJECTIVE To evaluate the anticoagulant efficacy and safety of nafamostat mesylate （NM） in the treatment of uremic patients at high risk of bleeding undergoing continuous veno-venous hemofiltration （CVVH） with different methods （pre- dilution and post-dilution）. METHODS A total of 130 uremic patients at high risk of bleeding who underwent CVVH treatment in the nephrology department of Chongqing University Three Gorges Hospital from July 2023 to September 2024 were selected. They were divided into pre-dilution group and post-dilution group according to the random number table method， with 65 cases in each group. Both groups of patients received CVVH treatment under NM anticoagulation. The pre-dilution group adopted the pre-dilution replacement method， while the post-dilution group adopted the post-dilution replacement method. The coagulation， pressure， and usage duration of the filter and dialysis circuit venous reservoirs were compared between the two groups. The changes in prothrombin time （PT）， prothrombin time-international normalized ratio （PT-INR）， activated partial thromboplastin time （APTT）， and fibrinogen （FIB） in the peripheral venous blood before the heparin pump and after the filter at 1， 4 and 7 h of CVVH treatment， as well as 20 min after the end of treatment， were compared between the two groups. The single-compartment urea clearance rate （spKt/V）， β2-microglobulin （β2-MG） clearance rate and the incidence of adverse reactions were duni2007@foxmail.com compared between the two groups. RESULTS Both the pre-dilution and post-dilution groups had 60 patients who completed the study. The incidence of grade Ⅱ-Ⅲ coagulation of the filter and venous reservoirs， as well as the number of patients with transmembrane and venous pressure alarm intervention in the post- dilution group were significantly higher or more than those in the pre-dilution group （P＜0.05）， while usage time of the filter and the pipeline in the post-dilution group was significantly shorter than that in the pre-dilution group （P＜0.05）. The APTT values before the heparin pump as well as PT and APTT values after the filter at 1 h， 4 h， and 7 h of CVVH treatment in the post-dilution group were significantly higher than those in the pre-dilution group （P＜0.001）. There were no significant differences in PT， PT- INR， APTT and FIB between the two groups of patients 20 min after the end of treatment （P＞0.05）. The spKt/v and β2-MG clearance rates in the post-dilution group were significantly higher than those in the pre-dilution group （P＜0.001）. There was no significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. CONCLUSIONS When NM is used as an anticoagulant in the CVVH treatment of uremic patients at high risk of bleeding， compared with the pre-dilution treatment method， the post-dilution treatment method has a higher incidence of filter and dialysis tubing venous reservoir， a shorter usage time of the filter and pipeline， and a greater impact on extracorporeal coagulation， but has a higher solute clearance rate. Clinically， different dilution methods can be selected according to the different treatment needs of patients.

The American Heart Association (AHA) and the American College of Cardiology (ACC), in collaboration with multiple professional organizations, jointly released the "Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults" in August 2025. Based on the latest evidence-based medical findings from February 2015 to January 2025, the guideline proposes an individualized treatment strategy grounded in total cardiovascular disease risk stratification, incorporates the novel PREVENT risk assessment model, lowers the medication initiation threshold and control targets for high-risk populations, and provides specific management recommendations for special populations. This article provides an interpretation of these updates and conducts a comparative analysis with the current status of hypertension prevention and treatment in China as well as Chinese guidelines, aiming to offer reference for hypertension control practices in China.

The American Heart Association (AHA) officially released the "2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association" on January 27, 2025. This report systematically compiles the latest statistics on major cardiovascular diseases worldwide, while simultaneously integrating relevant outcome indicators, including quality of care, procedures, and economic costs, and updating the global prevalence patterns and evolving trends of diverse risk factors impacting cardiovascular health, providing essential guidance for the prevention, diagnosis, and treatment of cardiovascular diseases. Synthesizing insights from this pivotal report and other relevant studies, this article highlights key findings concerning the global prevalence and mortality of heart diseases, associated risk factors, and emerging diagnostic and therapeutic technologies.

ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.

ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.

Congenital blood group chimerism refers to the coexistence of two or more distinct blood types within an individual, resulting from the presence of hematopoietic cell populations with different genotypes. Consequently, red blood cells in such individuals may express different blood group antigens. Based on the timing and mechanism of formation, blood group chimerism can be classified as either congenital or acquired. Although congenital blood group chimerism is rare and involves complex mechanisms, it holds significant implications in transfusion medicine, transplantation, and obstetrics. This article reviews the formation mechanisms, detection methods, and clinical significance of congenital blood group chimerism in transfusion medicine. Particular emphasis is placed on the principles, advantages, and limitations of various detection techniques. Furthermore, the potential applications of these technologies in clinical diagnosis are discussed, providing a technical foundation for the development of precise transfusion strategies.

ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.