Objective To analyze the research status,hotspots and development trends in the field of central post-stroke pain(CPSP).Methods Relevant literatures up to April 8,2025 were retrieved from the Web of Science Core Collection database.CiteSpace 6.4.R1 advanced version was used for bibliometric and visualization analysis of publication trends,country/institution/author collaboration networks,keywords and burst terms.Results A total of 119 publications were included.Researches on CPSP have shown an overall upward trend since 2002,which could be divided into a slow development period(from 2002 to 2015)and a rapid growth period(from 2016 onwards).The number of published papers reached its peak in 2024.China and the United States led in pub-lication volume.Harvard University was the most productive institution,and Asian institutions contributed a sig-nificant number of publications.The most prolific author was Gao Ju.The top five keywords by co-occurrence frequency were central post-stroke pain,neuropathic pain,pathophysiology,transcranial magnetic stimulation and motor cortex stimulation.Keyword clustering analysis generated ten clusters,which were integrated into four core research areas:pain types,clinical characteristics and diagnostic techniques,pathophysiological mecha-nisms,and treatment strategies.The bursting words included spinal cord and molecular expression in recent years;pathophysiology was the most bursting word.Conclusion In recent years,researches on CPSP are significantly increasing,focusing on pathophysiological mecha-nisms and intervention strategies.Future studies should strengthen the integration of basic and clinical research,promote multidisciplinary collaboration,and enhance research quality.

Objective:To investigate the effects and mechanisms of cyclic adenosine monophosphate (cAMP) on cisplatin-induced acute kidney injury (AKI).Methods:GSE227970 dataset derived from human renal tubular epithelial cells (HK-2 cells) in the GEO database was downloaded, and Kyoto Encyclopedia of Genes and Genomes and Gene Ontology analysis were performed in normal and cisplatin-damaged cells. Eighteen 8-week-old male C57BL/6J mice with body weight of (22±2) g were randomly divided into normal group, cisplatin group and cAMP group according to random number table method, with 6 mice in each group. cAMP group was intraperitoneally injected with 30 mg/kg glumine cyclic adenosine monophosphate, while normal group and cisplatin group were intraperitoneally injected with the same volume of 0.9% sodium chloride solution for 10 consecutive days. The cisplatin and cAMP groups were intraperitoneally injected with 20 mg/kg cisplatin once on the 8th day. The body weight and kidney weight of mice were weighed, and kidney weight to body weight ratio was calculated. The blood urea nitrogen (BUN) and serum creatinine (Scr) in mice were detected. HE staining was used to evaluate the degree of renal injury. Western blotting was used to detect the protein expression of AMP-activated protein kinase (AMPK)/acetyl-CoA carboxylase (ACC) signaling pathway in renal tissues. In vitro experiments, HK-2 cells were set up in normal group, cisplatin group, cAMP group and cAMP+AMPK inhibitor group. Immunofluorescence was used to detect the protein expression of phosphorylated (p)-AMPK in HK-2 cells. Adenosine triphosphate content and ratio of NAD + to NADH in cells were detected. Flow cytometry was used to detect cell apoptosis. Results:Biological signal analysis showed that axon guidance, Ras-related protein 1 signaling pathway and cAMP signaling pathway were significantly changed in cisplatin group. The body weight, kidney weight and kidney weight/body weight ratio in cisplatin group were significantly lower than those in normal group (all P<0.05). However, after cAMP treatment, kidney weight was significantly higher compared with cisplatin group ( P<0.05), and body weight and kidney weight/body weight ratio also increased, but the differences were not statistically significant (both P>0.05). BUN, Scr and renal tubular injury score in cisplatin group were significantly higher than those in normal group (all P<0.05). After cAMP treatment, BUN, Scr and renal tubular injury score were significantly lower than those in cisplatin group (all P<0.05). Western blotting results showed that cAMP treatment could significantly increase the decreased AMPK/ACC signaling pathway protein in the renal tissues of cisplatin-induced mice (all P<0.05). In vitro experiments, immunofluorescence detection showed that the expression of p-AMPK protein in cisplatin-induced HK-2 cells decreased, and the addition of cAMP increased the expression of p-AMPK protein in cisplatin-induced HK-2 cells (all P<0.05). cAMP treatment could alleviate cisplatin-induced injury in HK-2 cells, restore the reduction of adenosine triphosphate content and NAD +/NADH ratio, and reduce the apoptosis induced by cisplatin (all P<0.05), while AMPK inhibitor could eliminate the protective effect of cAMP on cisplatin-induced injury in HK-2 cells. Conclusion:cAMP can play a protective role in renal injury caused by cisplatin, and its mechanism may be related to activation of AMPK/ACC signaling pathway.

Objective To analyze the research status,hotspots and development trends in the field of central post-stroke pain(CPSP).Methods Relevant literatures up to April 8,2025 were retrieved from the Web of Science Core Collection database.CiteSpace 6.4.R1 advanced version was used for bibliometric and visualization analysis of publication trends,country/institution/author collaboration networks,keywords and burst terms.Results A total of 119 publications were included.Researches on CPSP have shown an overall upward trend since 2002,which could be divided into a slow development period(from 2002 to 2015)and a rapid growth period(from 2016 onwards).The number of published papers reached its peak in 2024.China and the United States led in pub-lication volume.Harvard University was the most productive institution,and Asian institutions contributed a sig-nificant number of publications.The most prolific author was Gao Ju.The top five keywords by co-occurrence frequency were central post-stroke pain,neuropathic pain,pathophysiology,transcranial magnetic stimulation and motor cortex stimulation.Keyword clustering analysis generated ten clusters,which were integrated into four core research areas:pain types,clinical characteristics and diagnostic techniques,pathophysiological mecha-nisms,and treatment strategies.The bursting words included spinal cord and molecular expression in recent years;pathophysiology was the most bursting word.Conclusion In recent years,researches on CPSP are significantly increasing,focusing on pathophysiological mecha-nisms and intervention strategies.Future studies should strengthen the integration of basic and clinical research,promote multidisciplinary collaboration,and enhance research quality.

Objective:To investigate the effects and mechanisms of cyclic adenosine monophosphate (cAMP) on cisplatin-induced acute kidney injury (AKI).Methods:GSE227970 dataset derived from human renal tubular epithelial cells (HK-2 cells) in the GEO database was downloaded, and Kyoto Encyclopedia of Genes and Genomes and Gene Ontology analysis were performed in normal and cisplatin-damaged cells. Eighteen 8-week-old male C57BL/6J mice with body weight of (22±2) g were randomly divided into normal group, cisplatin group and cAMP group according to random number table method, with 6 mice in each group. cAMP group was intraperitoneally injected with 30 mg/kg glumine cyclic adenosine monophosphate, while normal group and cisplatin group were intraperitoneally injected with the same volume of 0.9% sodium chloride solution for 10 consecutive days. The cisplatin and cAMP groups were intraperitoneally injected with 20 mg/kg cisplatin once on the 8th day. The body weight and kidney weight of mice were weighed, and kidney weight to body weight ratio was calculated. The blood urea nitrogen (BUN) and serum creatinine (Scr) in mice were detected. HE staining was used to evaluate the degree of renal injury. Western blotting was used to detect the protein expression of AMP-activated protein kinase (AMPK)/acetyl-CoA carboxylase (ACC) signaling pathway in renal tissues. In vitro experiments, HK-2 cells were set up in normal group, cisplatin group, cAMP group and cAMP+AMPK inhibitor group. Immunofluorescence was used to detect the protein expression of phosphorylated (p)-AMPK in HK-2 cells. Adenosine triphosphate content and ratio of NAD + to NADH in cells were detected. Flow cytometry was used to detect cell apoptosis. Results:Biological signal analysis showed that axon guidance, Ras-related protein 1 signaling pathway and cAMP signaling pathway were significantly changed in cisplatin group. The body weight, kidney weight and kidney weight/body weight ratio in cisplatin group were significantly lower than those in normal group (all P<0.05). However, after cAMP treatment, kidney weight was significantly higher compared with cisplatin group ( P<0.05), and body weight and kidney weight/body weight ratio also increased, but the differences were not statistically significant (both P>0.05). BUN, Scr and renal tubular injury score in cisplatin group were significantly higher than those in normal group (all P<0.05). After cAMP treatment, BUN, Scr and renal tubular injury score were significantly lower than those in cisplatin group (all P<0.05). Western blotting results showed that cAMP treatment could significantly increase the decreased AMPK/ACC signaling pathway protein in the renal tissues of cisplatin-induced mice (all P<0.05). In vitro experiments, immunofluorescence detection showed that the expression of p-AMPK protein in cisplatin-induced HK-2 cells decreased, and the addition of cAMP increased the expression of p-AMPK protein in cisplatin-induced HK-2 cells (all P<0.05). cAMP treatment could alleviate cisplatin-induced injury in HK-2 cells, restore the reduction of adenosine triphosphate content and NAD +/NADH ratio, and reduce the apoptosis induced by cisplatin (all P<0.05), while AMPK inhibitor could eliminate the protective effect of cAMP on cisplatin-induced injury in HK-2 cells. Conclusion:cAMP can play a protective role in renal injury caused by cisplatin, and its mechanism may be related to activation of AMPK/ACC signaling pathway.

ObjectiveTo observe the effectivenss and safety of Yiqi Huoxue Formula （益气活血方） combined with surgery and sequential therapy of estrogen and progesterone for the treatment of intrauterine adhesion with syndrome of qi deficiency and blood stasis. MethodsSixty-four patients with intrauterine adhesions were recruited in Guang'anmen Hospital， China Academy of Chinese Medical Sciences during 1st June 2021 to 31st December 2022， and they were randomly divided into two groups， with 32 patients in each group， all receiving transcervical resection of adhesions （TCRA）. The control group was treated with sequential therapy of estrogen and progesterone after surgery， taking 1 tablet orally daily， estradiol tablets for the first 14 days， and estradiol dydrogesterone tablets for the last 14 days. In the treatment group， the postoperative treatment was combined with Yiqi Huoxue Formula on the basis of the treatment in the control group， and 1 dose was taken daily. The treatment course of both groups was 3 months. We observed the clinical effectiveness， syndrome scores of traditional Chinese Medicine （TCM）， endometrial thickness， uterine adhesion score， menstrual flow points， and the re-adhesion rate and pregnancy rate 3 months after the end of treatment of the two groups， and conducted evaluation on safety. ResultsThe total clinical effectiveness rates of the treatment group and the control group were 90.63% and 75.00%， respectively， significantly better in the treatment group （P＜0.05）. The endometrial thickness and menstrual flow of patients in both groups increased after treatment， and the scores of uterine adhesion and TCM syndrome scores decreased significantly （P＜0.05 or P＜0.01）. After treatment， the uterine adhesion score and TCM syndrome scores of the treatment group decreased significantly compared with the control group （P＜0.05）. The 6-month postoperative pregnancy rate in the treatment group was 37.50%， higher than the 12.50% in the control group （P＜0.05）. The re-adhesion rate was 3.13% in the treatment group and 9.38% in the control group， and the difference between the two groups was not statistically significant （P＞0.05）. No adverse events occurred in both groups. ConclusionYiqi Huoxue Formula combined with surgery and sequential therapy of estrogen and progesterone for treating intrauterine adhesion patients with syndrome of qi deficiency and blood stasis can promote endometrial recovery， increase menstrual flow， improve patients' clinical symptoms， and improve pregnancy rate， showing certain clinical effectiveness and safety.

Objective:To investigate the protective function and mechanism of β-hydroxybutyrate (β-HOB) on cisplatin (CP)-induced nephrotoxicity.Methods:C57BL/6 male mice aged 10 weeks were randomly divided into the following three groups: control group (no special treatment), β- HOB+CP group (mice received intraperitoneal injection of 20 mmol/kg β-HOB for 10 days), CP group (received intraperitoneal injection of normal saline for 10 days). CP group and β-HOB+CP group were given once cisplatin (20 mg/kg) intraperitoneal injection on the 8th day in the experiment. On the 10th day, all the mice were sacrificed. Renal pathology was evaluated by HE staining; blood samples were collected for blood urea nitrogen (BUN) and serum creatinine (Scr) measurement; immunohistochemistry staining was performed to detect the protein level of Caspase3, Cleaved-caspase3, mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) in renal tissues; Western blotting was used to detect the relative expression levels of p-MAPK/MAPK and p-NF-κB/NF-κB. In vitro experiment, HK-2 cells were set into three groups: control group, CP group, β-HOB+CP group, and β-HOB+CP+Sappanone A (Sap, MAPK-p38 activator) group. The expression levels of p-MAPK, p-NF-κB, Caspase3 and Cleaved-caspase3 were tested by cell immunofluorescence. The cell apoptosis and mitochondrial membrane potential (MMP) were examined by flow cytometry. DNA damage was detected by TUNEL staining. Results:In vivo experiments, the renal pathological injury score, BUN and Scr in CP group were significantly higher than those in control group (all P<0.05), while renal pathological injury score, BUN and Scr in β-HOB+CP group were lower than those in CP group (all P<0.05). The protein expression levels of p-MAPK, p-NF-κB, Caspase3 and Cleaved-caspase3 in CP group were higher than those in control group, while these indexes in β-HOB+CP group were lower than those in CP group (all P<0.05). In vitro experiments, compared with CP group, the MMP was higher in β-HOB+CP group; the ratio of cell apoptosis, the expression of Caspase3, Cleaved-caspase3, p-MAPK and p-NF-κB, and the number of TUNEL staining positive cells were significantly lower (all P<0.05). Compared with β-HOB+CP group, the MMP in β-HOB+CP+Sap group was lower; the ratio of cell apoptosis, the expression of Caspase3 and Cleaved-caspase3, and the number of TUNEL staining positive cells were significantly higher (all P<0.05). Conclusions:β-HOB can alleviate the acute renal injury induced by cisplatin, which may be related to the reduction of apoptosis and inhibition of MAPK/NF-κB pathway.

Objective:To explore the risk factors for early mortality in heart transplant(HT)recipients and construct a nomogram prediction model.Methods:From 2018 to 2022, preoperative clinical data were retrospectively reviewed for 163 consecutive HT recipients.Risk factor variables were shortlisted by univariate correlation analysis based upon early(90-day)postoperative patient survival.Lasso regression was then employed for screening all variables and common variables were combined.A nomogram was constructed for predicting the probability of early mortality after considering actual circumstance.Receiver operating characteristic(ROC)curve, area under the ROC curve(AUC), Harrell's C-index and calibration curves were employed for evaluating and internally validate the performance of the model.Decision curve analysis was performed for assessing clinical utility of the model.Results:In survival and mortality groups, mechanical ventilation, nervous system lesions, use of extracorporeal membrane oxygenation, red blood cell count ≤3.52×10 12/L, mean pulmonary arterial pressure>27 mmHg, pulmonary vascular resistance>4.01 Wood Unit, albumin≤33 g/L, aspartate aminotransferase >50 U/L, hemoglobin ≤108 g/L, platelet count ≤109×10 9/L and total bilirubin>57 μmol/L demonstrated statistically significant differences( P<0.05). At the same time, according to actual situations and different variables, hemoglobin ≤108 g/L, albumin ≤33 g/L, platelet count ≤109×10 9/L, total bilirubin>57μmol/L, aspartate aminotransferase>50 U/L, nervous system lesions and average pulmonary arterial pressure >27 mmHg were seven variables.And a nomogram with relatively high reliability was constructed for predicting the probability of early mortality post-HT(nomogram model evaluation, AUC 0.917, C index 0.910 and good calibration curve). Decision curve analysis indicated that the nomogram could benefit HT recipients. Conclusions:Risk factors have been identified for early mortality in HT recipients.And the nomogram prediction model offers a simple and reliable tool for predicting early mortality post-HT.It has important implications for individualized treatment of HT candidates.

Objective:To determine the application effect of the "full chain" information-based health management model in the home care of children with bronchial asthma.Methods:Sixty children with bronchial asthma who were hospitalized in the Respiratory Department of Xuzhou Children's Hospital from January to June 2020 were selected and divided into a control group and an observation group according to a random number table with 30 cases in each group. The control group received routine nursing care, and the observation group implemented a "full-chain" informatized health management on the basis of the control group.The intervention time was 6 months. The condition control, medication compliance, self-management and airway function were observed and compared between the two groups.Results:After 6 months of intervention, the frequency of attacks, emergency cases, the medication compliance, the maximum expiratory flow rate, symptom days and peak expiratory flow days were 6.67%(2/30), 3.33%(1/30), 93.33%(28/30), (1.83±0.23) L, (163.00±6.74) d, (168.00±3.78) d in the observation group, and 26.67%(8/30), 20.00%(6/30), 66.67%(20/30), (1.67±0.24) L, (144.00±5.88) d, (157.00±4.08) d in the control group. The differences were statistically significant (χ 2 values were 4.320, 4.043, 6.667, t values were 2.636, 11.635, 10.833, P<0.05). There was no significant difference in the ratio of forced expiratory volume and forced expiratory volume in forced vital capacity in the first second after 6 months of intervention between the two groups ( P>0.05). Conclusions:"Full chain" information health management can reduce the number of attacks and emergency visits of children with asthma, effectively improve medication compliance, thus improving airway function and improving the quality of life of children.

Objective:To analyze the effects of β-receptor blockers on all-cause mortality in elderly patients with mild-moderate chronic heart failure(CHF)and chronic obstructive pulmonary disease(COPD), and to analyze risk factors relevant to death.Methods:This was a multicenter retrospective cohort study from January 2013 to December 2017.The 400 elderly patients with CHF and COPD treated in Rizhao People's Hospital(187 cases), Shandong Provincial Hospital(122 cases)and Beijing Anzhen Hospital(91 cases)were enrolled.The patients receiving β-receptor blockers were included as β-receptor blockers group(n=200), and the patients matching for similar age and cardio-pulmonary function, not receiving β-receptor blockers were selected as the control group(n=200). All patients were followed up until December 31, 2019.The primary endpoints were all-cause mortality.The risk factors for all-cause death were compared and analyzed.Results:Among 400 patients, the average age was(72.2±11.7)years with 226 males(56.5%). There was no significant difference in baseline data such as age, gender ratio, body mass index, heart function, lung function, and treatment regimen after matching between the two groups(all P>0.05). At end of 3-years follow-up, risks of all-cause mortality( χ2=7.284, P<0.01), and re-hospitalization risk due to worsening heart failure( χ2=6.782, P<0.01), acute exacerbation of COPD( χ2=6.921, P<0.01)were significantly reduced in β-receptor blockers group versus control group.Multivariate Cox regression analysis showed that age ≥75 years( HR=2.142), diabetes( HR=1.929), ratio of baseline forced expiratory volume in the first second / forced vital capacity <66.8%( HR=1.114), baseline glomerular filtration rate <72.0 ml/min( HR=3.572)and left ventricular ejection fraction <46.4%( HR=2.294)at end of 3-year follow-up were risk factors for mortality, whileβ-receptor blockers( HR=0.745)was a protective factor(all P<0.05). Conclusions:β-receptor blockers can significantly reduce the mortality and re-hospitalization rate in elderly patients with CHF and COPD.

Objective To provide a scientific basis for the formulation of effective incentive measures for rural health workers,by analyzing the factors influencing their work enthusiasm and constructing an incentive mechanism framework.Methods A field questionnaire survey and personal in-depth interview were conducted on 803 health technicians from 45 township health centers in Shandong,Anhui and Shanxi provinces.The study covered economic,management,education and career supports aspects,and the data were analyzed in descriptive,multi-level model and correlation analyses.Results The work enthusiasm scoring of rural health workers was 89.83 + 9.54.Workload,doctor-patient relationship,work competence and income index were the four influencing factors,with the differences showing statistical significance(P ＜0.05).The income index (income expectancy/real income affects work) influences the enthusiasm negatively,while the rest of the factors were positive.Work enthusiasm was positively correlated with three dimensions of job performance.The satisfaction of interpersonal relationship,workload and competence were positively correlated with work enthusiasm.The correlation indexes are respectively 0.35,0.33 and 0.21 (P ＜ 0.01).Conclusions To motivate primary health institutions and their health workers,the authorities should focus on the economic factors,and take into account non-economic ones,while improving the performance-based wage system and creating a fair workplace culture.