Sleep disorders are a serious global health problem influenced by neuropsychiatric disorders, diseases, environment, diet, and other factors. Recent studies have revealed that gut microbes (GM) are closely associated with sleep. Their metabolites regulate circadian rhythms, neurotransmitter systems, and other physiological processes through the gut-brain axis, influencing brain homeostasis and contributing to the pathogenesis of insomnia. Suanzaoren decoction (SZRD) is a classic and well-known traditional Chinese medicine (TCM) prescription for the treatment of insomnia. Modern pharmacological research indicates that SZRD can maintain intestinal microbial homeostasis, regulate microbial metabolites, and safeguard the intestinal immune barrier. This review elucidates the pathophysiological interplay between sleep disorders and GM and summarizes the progress of research on SZRD in treating insomnia via the “microbes-gut-brain axis” by regulating intestinal microecology. It is expected to broaden the clinical application of TCM in insomnia treatment and provide a theoretical foundation for pharmacological innovation of classic TCM prescriptions.

OBJECTIVE To statistically analyze and detect signals for the adverse drug reactions(ADRs)related to tigecycline based on the ADR spontaneous reporting system,so as to provide reference for the prevention of medi-cation risks of tigecycline.METHODS ADR reports of tigecycline were extracted from the ADR spontaneous repor-ting system of the hospital from Oct.2013 to Mar.2024.Statistical analysis was conducted by Microsoft Excel and Free Statistics 2.1.1.The data mining and analysis were performed using the reporting odds ratio(ROR),the proportional reporting ratio(PRR)and the composite criteria of UK Medicines and Healthcare products Regulato-ry Agency(MHRA).RESULTS Among the 574 ADR reports with tigecycline as the primarily suspected drug,elderly patients accounted for over 50％.The ADRs mainly occurred within one week after medication administra-tion,involving 12 organ systems and 57 adverse reaction signals.Through comprehensive analysis using three methods,20 positive risk signals related to tigecycline were identified,mainly affecting the gastrointestinal system,hepatobiliary system and hematological system.The top 5 frequent ADR signals were nausea,vomiting,diarrhea,thrombocytopenia and hyperbilirubinemia.According to the ROR method,the top five ranked ADR sig-nals were hyperbilirubinemia(ROR=330.55),hepatocellular injury(ROR=110.22),elevated amylase(ROR=78.90),cholestasis(ROR=73.32),and decreased fibrinogen(ROR=43.65).CONCLUSIONS The adverse reac-tions of tigecycline mainly occur during the initial stage of medication,and special caution is required when used in elderly patients.High-intensity risk signals for ADRs are hyperbilirubinemia,liver injury,and others related to hematological system and gastrointestinal system.Close monitoring of these ADRs and timely intervention are necessary during medication.

Objective:To investigate the functional characteristics of the prefrontal cortex in patients with schizophrenia (SCZ) during resting state and analyze its association with clinical symptoms.Methods:Twenty-eight hospitalized patients with SCZ (SCZ group) were selected from November 2023 to May 2024, and 28 healthy controls (HC group) were recruited concurrently. By using functional near-infrared spectroscopy (fNIRS) technology, data on the concentration changes of oxygenated hemoglobin (HbO) and deoxygenated hemoglobin (HbR) in the prefrontal cortex during resting state were collected from all subjects to measure cortical hemodynamic activity. Regional activation values and functional connectivity (FC) values among brain areas were analyzed. Clinical symptoms in patients were assessed using the positive and negative syndrome scale (PANSS).SPSS 25.0 software was employed for statistical analysis. Between-group comparisons were performed using independent samples t-tests or Mann-Whitney U tests. Spearman correlation analysis and general linear regression models were applied to examine relationships between prefrontal cortical functional characteristics and clinical symptoms. Results:The levels of HbO in the right inferior frontal gyrus and left frontal pole area were significantly higher in the SCZ group (1.5 (1.0, 3.0)μmol/L, 1.0 (1.0, 2.8)μmol/L) than those in the HC group (-0.01 (-0.05, 0.02)μmol/L, -0.02 (-0.07, 0.03)μmol/L) ( Z=-6.46, -6.50, both P<0.01). The levels of HbR in the bilateral dorsolateral prefrontal cortex were significantly higher in the SCZ group (0.02 (-0.01, 0.07)μmol/L, 0.01 (-0.01, 0.03)μmol/L) than those in the HC group (-0.01 (-0.03, 0.01)μmol/L, -0.01 (-0.02, 0.01)μmol/L) ( Z=-2.46, -1.98, both P<0.05).The SCZ group showed significantly higher HbO-based FC values in the frontal pole-temporal pole (0.49±0.21) and temporal pole-dorsolateral prefrontal cortex (0.36±0.25) compared to the HC group (0.33±0.18, 0.15±0.19) ( t=3.02, 3.44, both P<0.01). Conversely, the SCZ group exhibited significantly lower HbR-based FC in the frontal pole-inferior frontal gyrus (0.15±0.13) and inferior frontal gyrus-temporal pole (0.27±0.37) compared to the HC group (0.33±0.26, 0.77±0.48) ( t=-3.17, -4.23, both P<0.01). Correlation analysis revealed that in the SCZ group, the level of HbO in the right inferior frontal gyrus was positively correlated with negative symptoms, positive symptoms, excitement/hostility, and PANSS total score ( r=0.45-0.64, all P<0.05), and the level of HbO in the left frontal pole area was positively correlated with excitement/hostility and PANSS total score ( r=0.57, 0.50, both P<0.01), while the FC value between the frontal pole and temporal pole areas showed a negative correlation with excitement/hostility ( r=-0.39, P<0.05). Regression analysis demonstrated that, the HbO concentration in the right inferior frontal gyrus significantly positively predicted PANSS total score, positive symptoms, and negative symptoms ( β=0.70, 0.64, 0.55, all P<0.01).The HbO concentration in the left frontal pole area significantly positively predicted excitement/hostility ( β=0.77, P<0.01).The frontal pole-temporal pole HbO-based FC significantly negatively predicted excitement/hostility scores ( β=-0.42, P<0.01). Conclusion:Patients with SCZ exhibit hyperactivation of localized prefrontal cortex brain regions and dysfunction of functional connectivity during resting state, which are significantly associated with core clinical symptoms including positive, negative, and excitement/hostility symptoms.

Congenital heart disease (CHD) may result from various risk factors including genetic, epigenetic, and environmental elements. The parallel and synchronous development of the placenta and fetal heart establishes a regulatory relationship known as the placenta-heart axis. Placental insufficiency may impact fetal cardiac development, while abnormal cardiac development can conversely disrupt placental structure and function. This review examines the association between placental abnormalities and CHD, providing insights into the etiology and underlying mechanisms of CHD.

OBJECTIVE To statistically analyze and detect signals for the adverse drug reactions(ADRs)related to tigecycline based on the ADR spontaneous reporting system,so as to provide reference for the prevention of medi-cation risks of tigecycline.METHODS ADR reports of tigecycline were extracted from the ADR spontaneous repor-ting system of the hospital from Oct.2013 to Mar.2024.Statistical analysis was conducted by Microsoft Excel and Free Statistics 2.1.1.The data mining and analysis were performed using the reporting odds ratio(ROR),the proportional reporting ratio(PRR)and the composite criteria of UK Medicines and Healthcare products Regulato-ry Agency(MHRA).RESULTS Among the 574 ADR reports with tigecycline as the primarily suspected drug,elderly patients accounted for over 50％.The ADRs mainly occurred within one week after medication administra-tion,involving 12 organ systems and 57 adverse reaction signals.Through comprehensive analysis using three methods,20 positive risk signals related to tigecycline were identified,mainly affecting the gastrointestinal system,hepatobiliary system and hematological system.The top 5 frequent ADR signals were nausea,vomiting,diarrhea,thrombocytopenia and hyperbilirubinemia.According to the ROR method,the top five ranked ADR sig-nals were hyperbilirubinemia(ROR=330.55),hepatocellular injury(ROR=110.22),elevated amylase(ROR=78.90),cholestasis(ROR=73.32),and decreased fibrinogen(ROR=43.65).CONCLUSIONS The adverse reac-tions of tigecycline mainly occur during the initial stage of medication,and special caution is required when used in elderly patients.High-intensity risk signals for ADRs are hyperbilirubinemia,liver injury,and others related to hematological system and gastrointestinal system.Close monitoring of these ADRs and timely intervention are necessary during medication.

Objective:To investigate the functional characteristics of the prefrontal cortex in patients with schizophrenia (SCZ) during resting state and analyze its association with clinical symptoms.Methods:Twenty-eight hospitalized patients with SCZ (SCZ group) were selected from November 2023 to May 2024, and 28 healthy controls (HC group) were recruited concurrently. By using functional near-infrared spectroscopy (fNIRS) technology, data on the concentration changes of oxygenated hemoglobin (HbO) and deoxygenated hemoglobin (HbR) in the prefrontal cortex during resting state were collected from all subjects to measure cortical hemodynamic activity. Regional activation values and functional connectivity (FC) values among brain areas were analyzed. Clinical symptoms in patients were assessed using the positive and negative syndrome scale (PANSS).SPSS 25.0 software was employed for statistical analysis. Between-group comparisons were performed using independent samples t-tests or Mann-Whitney U tests. Spearman correlation analysis and general linear regression models were applied to examine relationships between prefrontal cortical functional characteristics and clinical symptoms. Results:The levels of HbO in the right inferior frontal gyrus and left frontal pole area were significantly higher in the SCZ group (1.5 (1.0, 3.0)μmol/L, 1.0 (1.0, 2.8)μmol/L) than those in the HC group (-0.01 (-0.05, 0.02)μmol/L, -0.02 (-0.07, 0.03)μmol/L) ( Z=-6.46, -6.50, both P<0.01). The levels of HbR in the bilateral dorsolateral prefrontal cortex were significantly higher in the SCZ group (0.02 (-0.01, 0.07)μmol/L, 0.01 (-0.01, 0.03)μmol/L) than those in the HC group (-0.01 (-0.03, 0.01)μmol/L, -0.01 (-0.02, 0.01)μmol/L) ( Z=-2.46, -1.98, both P<0.05).The SCZ group showed significantly higher HbO-based FC values in the frontal pole-temporal pole (0.49±0.21) and temporal pole-dorsolateral prefrontal cortex (0.36±0.25) compared to the HC group (0.33±0.18, 0.15±0.19) ( t=3.02, 3.44, both P<0.01). Conversely, the SCZ group exhibited significantly lower HbR-based FC in the frontal pole-inferior frontal gyrus (0.15±0.13) and inferior frontal gyrus-temporal pole (0.27±0.37) compared to the HC group (0.33±0.26, 0.77±0.48) ( t=-3.17, -4.23, both P<0.01). Correlation analysis revealed that in the SCZ group, the level of HbO in the right inferior frontal gyrus was positively correlated with negative symptoms, positive symptoms, excitement/hostility, and PANSS total score ( r=0.45-0.64, all P<0.05), and the level of HbO in the left frontal pole area was positively correlated with excitement/hostility and PANSS total score ( r=0.57, 0.50, both P<0.01), while the FC value between the frontal pole and temporal pole areas showed a negative correlation with excitement/hostility ( r=-0.39, P<0.05). Regression analysis demonstrated that, the HbO concentration in the right inferior frontal gyrus significantly positively predicted PANSS total score, positive symptoms, and negative symptoms ( β=0.70, 0.64, 0.55, all P<0.01).The HbO concentration in the left frontal pole area significantly positively predicted excitement/hostility ( β=0.77, P<0.01).The frontal pole-temporal pole HbO-based FC significantly negatively predicted excitement/hostility scores ( β=-0.42, P<0.01). Conclusion:Patients with SCZ exhibit hyperactivation of localized prefrontal cortex brain regions and dysfunction of functional connectivity during resting state, which are significantly associated with core clinical symptoms including positive, negative, and excitement/hostility symptoms.

Congenital heart disease (CHD) may result from various risk factors including genetic, epigenetic, and environmental elements. The parallel and synchronous development of the placenta and fetal heart establishes a regulatory relationship known as the placenta-heart axis. Placental insufficiency may impact fetal cardiac development, while abnormal cardiac development can conversely disrupt placental structure and function. This review examines the association between placental abnormalities and CHD, providing insights into the etiology and underlying mechanisms of CHD.

Objective:To investigate the computed tomography (CT)-based integrated deep learning model for qualitative and quantitative classification of hepatic portal vein.Methods:The retrospective study was conducted. The CT imaging data of 291 patients undergoing upper-abdomen enhanced CT examination in the Beijing Tsinghua Changgung Hospital of Tsinghua University from October 2017 to January 2019 were collected. There were 195 males and 96 females, aged (51±12)years. The hepatic portal vein was reconstructed using the three-dimensional reconstruction system. Three-dimensional point cloud was input to the encoder model to obtain the three-dimen-sional reconstructed vectorized representation, which was used for qualitative classification and quantitative representation classification. Measurement data with normal distribution were repre-sented as Mean± SD, and comparison between groups was conducted using the paired t test. Count data were repre-sented as percentages or absolute numbers, and comparison between groups was analyzed using the paired chi-square test. Results:(1) Three-dimensional reconstruction of portal vein and anatomical classification. Three-dimensional structure was reconstructed in the 291 patients. Classification of main hepatic portal vein showed 211 cases of Akgul type A, 29 cases of Akgul type B, 16 cases of Akgul type C, 10 cases of Akgul type D, and 25 cases of unclassifiable. (2) Prediction of qualitative classification of main hepatic portal vein. Of the 291 patient samples, 25 unclassifiable or poor quality samples were excluded, 266 samples were used for automated qualitative classification of the main portal vein by machine model. There were 211 cases of Akgul type A, 29 cases of Akgul type B, 26 cases of Akgul type C&D. The Macro-F1 of 266 patients was 61.93%±40.50% and the accuracy was 84.99%, versus 32.38%±19.81% and 61.65% of Random classifier, showing significant differ-ences between them ( t=7.85, χ2=62.89, P<0.05). (3) Quantitative representation of portal vein classification. The probabilities of quantitative classification for Akgul qualitative classification of similar samples included P@1 as 73%±45%, P@3 as 70%±37%, P@5 as 69%±35%, P@10 as 67%± 32%, mean reciprocal rank(MRR) as 80%±34%, versus 57%±50%, 58%±35%, 58%±32%, 58%± 30%, 70%±37% of the baseline model, showing significant differences between the two analytical methods ( t=5.22, 5.11, 5.00, 4.99, 3.47, P<0.05). Conclusion:The automated classification model for the hepatic portal vein structure was constructed using CT-based three-dimensional reconstruc-tion and deep learning technology, which can achieve automatic qualitative classification and quanti-tatively describe the hepatic portal vein structure.

Objective:To understand the true experience and feelings of thestoma therapists on sense of career success, so as to provide a basis for enhancing their sense of career success.Methods:Using the qualitative research method, a semi-structured in-depth interview with 18 stoma therapists from different levels of medical institutions in Henan Province who have been certified for more than one year from August 2 to October 30, 2020. Nvivo12.0 software was used for data analysis, and the Colaizzi 7-step analysis method was used to refine the theme.Results:After repeated reading and analysis of the data, two themes of positive experience and negative experience of stoma therapists' true experience of career success were extracted.Conclusions:The specific policies for the professional development of specialist nurses should be further improved to reduce the negative experience in the career success of stoma therapists and avoid the loss of specialist nursing talents.

Objective:To explore the mechanism of follicular helper T (Tfh) cells, i.e. CD4 +CXCR5 +T cells, and the secreted cytokine programmed death factor 1 (PD-1) in the pathogenesis of tuberculosis, and to explore the significance of Tfh cells and PD-1 in the treatment of tuberculosis. Methods:Flow cytometry was used to detect the changes of Tfh cells and PD-1 in mononuclear cells during the treatment cycle of tuberculosis.Results:Before treatments, the ratio of Tfh cells/CD4 +T cells in peripheral blood mononuclear cells in the pulmonary tuberculosis group was 3.37%±0.45%, which was significantly higher than 2.21%±0.47% of the healthy control group ( P<0.01), and significantly higher than 2.39%±0.38% after treatments ( P<0.01). Before treatments, the ratio of CD4 +CXCR5 +PD-1 +T cells/Tfh cells in the peripheral blood of the tuberculosis group was 25.33%±10.08%, which was significantly higher than 8.42%±2.31% of the healthy control group ( P<0.01), and significantly higher than 11.35%±2.65% after treatments ( P<0.01). After treatments, the levels of Tfh cells and PD-1 in the sputum smear-negative group and the sputum smear-negative group were lower than that before treatments, and the difference between the groups was statistically significant (all P<0.05). Conclusions:The levels of Tfh cells and PD-1 in patients with tuberculosis are significantly higher than those in healthy people, and after drug treatment, the levels of both can be reduced. With the prolongation of the treatment cycle, the sputum smear-transforming group and the non-negative group began to show significant differences. In the course of pulmonary tuberculosis, monitoring changes in Tfh cells and PD-1 levels is helpful for the diagnosis of tuberculosis, and has certain guiding significance for its treatment and outcome.