ObjectiveTo systematically compare the effects of diverse electromagnetic stimulation protocols on hand function and activities of daily living (ADL) in stroke patients using network meta-analysis (NMA), and screen the optimal stimulation strategy for post-stroke hand dysfunction rehabilitation. MethodsNMA was performed in accordance with the PRISMA-NMA statement. Databases of CNKI, Wanfang data, VIP, CBM, PubMed, Web of Science and Embase were searched from database inception to April, 2026 for eligible randomized controlled trials (RCTs) comparing different electromagnetic stimulation protocols for post-stroke hand impairment. The Cochrane Risk of Bias tool and PEDro scale were used to assess methodological quality of included studies, while the GRADE system was adopted to grade evidence quality of primary outcomes of Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI). After literature screening, data extraction and bias evaluation, RevMan 5.4 and Stata 17.0 were used for meta-analysis and NMA. ResultsA total of 22 RCT involving 17 electromagnetic stimulation protocols were finally included. The PEDro scores ranged from six to ten. The top five protocols for improving FMA-UE score were repetitive peripheral magnetic stimulation (rPMS) + repetitive transcranial magnetic stimulation (rTMS), intermittent theta-burst stimulation (iTBS) + rPMS, iTBS + transcranial direct current stimulation (tDCS), transcutaneous electrical acupoint stimulation (TEAS) and contralaterally controlled functional electrical stimulation (CCFES). tDCS was the most effective on MBI, followed by TEAS and iTBS+rPMS. Evidence quality for FMA-UE and MBI was moderate. Funnel plots suggested low risk of publication bias, and consistency tests verified good coherence between direct and indirect comparisons in network models. ConclusionElectromagnetic stimulation significantly facilitates upper limb and hand functional recovery, and improves ADL in stroke patients. The combined central-peripheral magnetic stimulation protocol may be the most effective on motor rehabilitation, whereas tDCS on ADL.

A solid-phase extraction-ultra-performance liquid chromatography-tandem mass spectrometry(SPE-UPLC-MS/MS)method was established for simultaneous determination of 10 kinds of neonicotinoid pesticide residues in aquaculture water.Based on the chemical properties of neonicotinoid pesticides and the matrix characteristics of aquaculture water,suitable temporary storage methods for water samples and appropriate solid-phase extraction columns were selected,and the extraction conditions(including elution solvents and sample loading volumes)were optimized.The method employed acetonitrile and 5 mmol/L ammonium acetate solution(containing 0.1%formic acid)as the mobile phase and an Oasis HLB solid-phase extraction column combined with PSA as a dispersive sorbent for sample purification.The method exhibited good linearity in detection of neonicotinoid in concentration range of 0.2-50 ng/mL(R2>0.99797),with a detection limit of 0.5 ng/L and a quantification limit of 1 ng/L,which were significantly lower than the maximum acceptable method detection limits(9-500 ng/L)for neonicotinoid insecticides in water published by the European Commission.In pond water,rice-fish water,and seawater,the average recoveries of the 10 target analytes were 74.6%-114.1%,with relative standard deviations ranging from 0.3%to 9.6%.Using this method,actual sample tests were conducted on the Pearl River water,Zhaoqing pond water,and Qingyuan rice-fish aquaculture water.The total concentration of five neonicotinoid pesticides in the Pearl River water ranged from 154.8 to 246.6 ng/L,the total concentration of four neonicotinoid pesticides in the Zhaoqing pond water was 95.0-176.1 ng/L,and the total concentration of three neonicotinoid pesticides in the Qingyuan rice-fish aquaculture water was 2.3-11.7 ng/L.This method was simple in operation,highly sensitive,and had strong resistance to interference.It was suitable for detection of trace neonicotinoid pesticides in aquaculture water and could provide technical support for construction of a green aquaculture environment and resolution of international trade disputes.

Objective:To systematically evaluate the global disease burden of neonatal sepsis and other neonatal infections（NSNIs），providing scientific basis for their prevention and control.Methods:Using the Global Burden of Disease（GBD）2021 database，this article calculated the incidence，mortality，and age-standardized rates for NSNIs. Trends were evaluated with Joinpoint regression model，and compared at different socio-demographic index（SDI）levels.Results:From 1990 to 2021，the global age-standardized incidence rate（ASIR）of NSNIs decreased from 78.98 to 62.70 per 100 000 with an with average annual percentage change（AAPC）of -0.73%（ P<0.01）. The age-standardized mortality rate（ASMR）declined from 4.77 to 3.76 per 100 000 with an AAPC of -0.76%（ P<0.01）. In particular，the disease burden was consistently higher among male neonates. Low birth weight was the primary risk factor globally，followed by preterm birth. Regions with lower SDI levels exhibited higher ASIR and ASMR，and household solid fuel air pollution contributed more to NSNIs-related mortality. Conclusion:Although the overall disease burden of NSNIs has declined，male neonates and low-SDI regions still face substantial challenges. Continuous efforts to improve air quality are warranted，and low-SDI regions should further strengthen healthcare infrastructure to enhance diagnostic and treatment quality.

AIM To investigate the clinical effects of Modified Banxia Xiexin Decoction combined with Lizhong Decoction on patients with type 2 diabetes mellitus due to Cold-heat Complex in the Middle Energizer.METHODS One hundred and sixty-eight patients were randomly assigned into control group(84 cases)for 12-week intervention of conventional treatment,and observation group(84 cases)for 12-week intervention of Modified Banxia Xiexin Decoction,Lizhong Decoction and conventional treatment.The changes in clinical effects,compliance rate of blood glucoses,discontinuation and reduction rate of hypoglycemic drugs,continuous glucose parameters(TIR,GVP,FPG-ARV,MAGE),FPG,2 hPG,HbA1c,FINS,HOMA-β,HOMA-IR,lnISI,intestinal flora metabolites(SCFAs,CA,DC A,CDCA,CA/CDCA),score for Cold-heat Complex in the Middle Energizer and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher marked improvement rate,total effective rate,compliance rate of blood glucoses and discontinuation and reduction rate of hypoglycemic drugs,than the control group(P＜0.05).After the treatment,the two groups displayed increased TIR,FINS,HOMA-β,lnISI,SCFAs,CDCA(P＜0.05),and decreased GVP,FPG-ARV,MAGE,FPG,2 hPG,HbA1c,HOMA-IR,CA,DC A,CA/CDCA,score for Cold-heat Complex in the Middle Energizer(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with type 2 diabetes mellitus due to Cold-heat Complex in the Middle Energizer,Modified Banxia Xiexin Decoction combined with Lizhong Decoction can improve islet β cell function and insulin resistance,enhance insulin sensitivity index and compliance rate of blood glucoses,reduce blood glucose fluctuation and dosages of hypoglycemic drugs,regulate intestinal flora metabolites,and affect glucose metabolism.

AIM To investigate the clinical effects of Modified Banxia Xiexin Decoction combined with Lizhong Decoction on patients with type 2 diabetes mellitus due to Cold-heat Complex in the Middle Energizer.METHODS One hundred and sixty-eight patients were randomly assigned into control group(84 cases)for 12-week intervention of conventional treatment,and observation group(84 cases)for 12-week intervention of Modified Banxia Xiexin Decoction,Lizhong Decoction and conventional treatment.The changes in clinical effects,compliance rate of blood glucoses,discontinuation and reduction rate of hypoglycemic drugs,continuous glucose parameters(TIR,GVP,FPG-ARV,MAGE),FPG,2 hPG,HbA1c,FINS,HOMA-β,HOMA-IR,lnISI,intestinal flora metabolites(SCFAs,CA,DC A,CDCA,CA/CDCA),score for Cold-heat Complex in the Middle Energizer and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher marked improvement rate,total effective rate,compliance rate of blood glucoses and discontinuation and reduction rate of hypoglycemic drugs,than the control group(P＜0.05).After the treatment,the two groups displayed increased TIR,FINS,HOMA-β,lnISI,SCFAs,CDCA(P＜0.05),and decreased GVP,FPG-ARV,MAGE,FPG,2 hPG,HbA1c,HOMA-IR,CA,DC A,CA/CDCA,score for Cold-heat Complex in the Middle Energizer(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with type 2 diabetes mellitus due to Cold-heat Complex in the Middle Energizer,Modified Banxia Xiexin Decoction combined with Lizhong Decoction can improve islet β cell function and insulin resistance,enhance insulin sensitivity index and compliance rate of blood glucoses,reduce blood glucose fluctuation and dosages of hypoglycemic drugs,regulate intestinal flora metabolites,and affect glucose metabolism.

Objective To explore the role of secreted phosphoprotein 1(SPP1)and myeloid differentiation primary response 88(MYD88)in morphine-induced cardiomyocyte apoptosis.Methods A morphine addiction model was established in Sprague-Dawley(SD)rats.Twelve SD rats were randomly assigned to the normal saline(NS)group or the morphine-dependent(DAM)group.Histopathological analysis was employed to observe and compare myocardial tissue morphology between the two groups.Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL)staining was performed to assess the number of apoptotic cells in each group.The expression levels of SPP1 and MYD88 were evaluated using immunohistochemistry.Quantitative real-time poly merase chain reaction(RT-qPCR)and Western blot were used to detect the mRNA and protein expression of SPP1,MYD88,Bax,Bcl2,Caspase-3,and Caspase-9.Simultaneously,Western blot analysis was used to detected the expression of Cleaved Caspase-3 and Cleaved Caspase-9 proteins.In vitro,SPP1 expression was knocked down in primary neonatal rat cardiomyocytes(NRCMs),and cells were divided into three groups:control(CON),morphine treated(DA),and shSPP1#3+DA.Cell viability was assessed using the CCK-8 assay,and apoptosis rates were determined by flow cytometry.Results HE and TUNEL staining of myocardial tissues from morphine-addicted SD rats revealed that,compared with the NS group,myofibrils in the DAM group exhibited partial disruption and a significant increase in apoptotic cells(P<0.05).Western blot and RT-qPCR analyses demonstrated that,relative to the NS group,the mRNA and protein levels of SPP1,MYD88,Bax,Caspase-3,and Caspase-9 were significantly upregulated in the DAM group(P<0.05),whereas Bcl2 expression was significantly downregulated at both mRNA and protein levels(P<0.05),and the protein expression levels of Cleaved Caspase-3 and Cleaved Caspase-9 were also increased.with all differences being statistically significant.In NRCMs following morphine intervention,cell viability in the DA group was markedly reduced compared to the CON group(P<0.05),accompanied by a signifi-cant increase in apoptosis rate(P<0.05).Consistently,Western blot and RT-qPCR results showed elevated mRNA and protein expression of SPP1,MYD88,Bax,Caspase-3,and Caspase-9 in the DA group(P<0.05),along with decreased Bcl2 expression(P<0.05).The protein expression levels of Cleaved Caspase-3 and Cleaved Caspase-9 were elevated simultaneously.In contrast,the shSPP1#3+DA group exhibited opposing trends compared to the DA group,with statistically sig nificant differences(P<0.05).Conclusion SPP1 and MYD88 play critical roles in mediating morphine-induced cardiomyocyte apoptosis,and silencing SPP1 has been shown to significantly reduce the extent of cardiomyocyte apoptosis following morphine exposure.

To explore an effective health management model for obese students,a comprehensive intervention was carried out for obese students with cardiovascular and metabolic risks,and the effectiveness of this intervention model was evaluated.From Jan to Apr 2024(excluding the winter vacation),300 students were selected from 6 primary schools in Qibao Community,Minhang District,Shanghai,to participate in the study(28 students dropped out during the study period).The study subjects were divided into two intervention groups(pilot intervention group:equipped with a health vice principal;general intervention group:not equipped with a health vice principal)and a control group.The intervention group received comprehensive intervention measures such as science popularization,diet,exercise and psychology,while the control group received daily health management.The post-intervention results showed that the intervention group had significant improvements in healthy diet,scientific exercise and positive psychology,with significant differences compared to the control group(P<0.05).At the same time,the intervention group had a reduced detection rate of obesity(BMI≥P95),and a decreased detection rate of abnormal metabolic indicators such as blood pressure,fasting blood glucose and triglyceride,especially significant differences in fasting blood glucose and triglyceride compared with the control group(P<0.001).In addition,the pilot intervention group under the operation of health vice principal showed better effects in changing healthy behaviors and improving some metabolic indicators compared with the general intervention group.The implementation of this project provided a scientific basis for the promotion of a comprehensive intervention model for student health under the oprtation of health vice principle.

Objective To explore the role of secreted phosphoprotein 1(SPP1)and myeloid differentiation primary response 88(MYD88)in morphine-induced cardiomyocyte apoptosis.Methods A morphine addiction model was established in Sprague-Dawley(SD)rats.Twelve SD rats were randomly assigned to the normal saline(NS)group or the morphine-dependent(DAM)group.Histopathological analysis was employed to observe and compare myocardial tissue morphology between the two groups.Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL)staining was performed to assess the number of apoptotic cells in each group.The expression levels of SPP1 and MYD88 were evaluated using immunohistochemistry.Quantitative real-time poly merase chain reaction(RT-qPCR)and Western blot were used to detect the mRNA and protein expression of SPP1,MYD88,Bax,Bcl2,Caspase-3,and Caspase-9.Simultaneously,Western blot analysis was used to detected the expression of Cleaved Caspase-3 and Cleaved Caspase-9 proteins.In vitro,SPP1 expression was knocked down in primary neonatal rat cardiomyocytes(NRCMs),and cells were divided into three groups:control(CON),morphine treated(DA),and shSPP1#3+DA.Cell viability was assessed using the CCK-8 assay,and apoptosis rates were determined by flow cytometry.Results HE and TUNEL staining of myocardial tissues from morphine-addicted SD rats revealed that,compared with the NS group,myofibrils in the DAM group exhibited partial disruption and a significant increase in apoptotic cells(P<0.05).Western blot and RT-qPCR analyses demonstrated that,relative to the NS group,the mRNA and protein levels of SPP1,MYD88,Bax,Caspase-3,and Caspase-9 were significantly upregulated in the DAM group(P<0.05),whereas Bcl2 expression was significantly downregulated at both mRNA and protein levels(P<0.05),and the protein expression levels of Cleaved Caspase-3 and Cleaved Caspase-9 were also increased.with all differences being statistically significant.In NRCMs following morphine intervention,cell viability in the DA group was markedly reduced compared to the CON group(P<0.05),accompanied by a signifi-cant increase in apoptosis rate(P<0.05).Consistently,Western blot and RT-qPCR results showed elevated mRNA and protein expression of SPP1,MYD88,Bax,Caspase-3,and Caspase-9 in the DA group(P<0.05),along with decreased Bcl2 expression(P<0.05).The protein expression levels of Cleaved Caspase-3 and Cleaved Caspase-9 were elevated simultaneously.In contrast,the shSPP1#3+DA group exhibited opposing trends compared to the DA group,with statistically sig nificant differences(P<0.05).Conclusion SPP1 and MYD88 play critical roles in mediating morphine-induced cardiomyocyte apoptosis,and silencing SPP1 has been shown to significantly reduce the extent of cardiomyocyte apoptosis following morphine exposure.

To explore an effective health management model for obese students,a comprehensive intervention was carried out for obese students with cardiovascular and metabolic risks,and the effectiveness of this intervention model was evaluated.From Jan to Apr 2024(excluding the winter vacation),300 students were selected from 6 primary schools in Qibao Community,Minhang District,Shanghai,to participate in the study(28 students dropped out during the study period).The study subjects were divided into two intervention groups(pilot intervention group:equipped with a health vice principal;general intervention group:not equipped with a health vice principal)and a control group.The intervention group received comprehensive intervention measures such as science popularization,diet,exercise and psychology,while the control group received daily health management.The post-intervention results showed that the intervention group had significant improvements in healthy diet,scientific exercise and positive psychology,with significant differences compared to the control group(P<0.05).At the same time,the intervention group had a reduced detection rate of obesity(BMI≥P95),and a decreased detection rate of abnormal metabolic indicators such as blood pressure,fasting blood glucose and triglyceride,especially significant differences in fasting blood glucose and triglyceride compared with the control group(P<0.001).In addition,the pilot intervention group under the operation of health vice principal showed better effects in changing healthy behaviors and improving some metabolic indicators compared with the general intervention group.The implementation of this project provided a scientific basis for the promotion of a comprehensive intervention model for student health under the oprtation of health vice principle.

Objective:To observe and evaluate the clinical efficacy and safety of albumin-bound paclitaxel as first-line treatment for patients with advanced pancreatic cancer in China, and to explore the prognosis-related molecules in pancreatic cancer based on next-generation sequencing (NGS) of tumor tissues.Methods:From December 2018 to December 2020, patients with locally advanced or metastatic pancreatic cancer were recruited to accept albumin-bound paclitaxel as first-line treatment in the oncology departments of 24 hospitals in East China. The primary endpoints were overall survival (OS) and treatment related adverse events, and the secondary endpoint was progression-free survival (PFS). Adverse effects were graded using Common Terminology Criteria for Adverse Events 5.0 (CTCAE 5.0). NGS sequencing on the primary or metastatic tissue samples of pancreatic cancer obtained through surgical resection or biopsy was performed.Results:This study recruited 229 patients, including 70 patients with locally advanced pancreatic cancer (LAPC) and 159 patients with metastatic pancreatic cancer (mPC). The disease control rate was 79.9% and the objective response rate is 36.3%.The common adverse effects during treatment were anaemia (159 cases), leucopenia (170 cases), neutropenia (169 cases), increased aminotransferases (110 cases), and thrombocytopenia (95 cases), and the incidence of grade 3-4 neutropenia is 12.2% (28/229). The median follow-up time was 21.2 months (95% CI: 18.5-23.1 months). The median PFS (mPFS) was 5.3 months (95% CI: 4.37-4.07 months) and the median OS (mOS) was 11.2 months (95% CI: 9.5-12.9 months). The mPFS of patients with LAPC was 7.4 months (95% CI: 6.6-11.2 months), and their mOS was 15.5 months (95% CI: 12.6-NA months). The mPFS of patients with mPC was 3.9 months (95% CI: 3.4-5.1 months), and their mOS was 9.3 months (95% CI: 8.0-10.8 months). Multivariate Cox regression analysis showed that clinical stage ( HR=1.47, 95% CI: 1.06-2.04), primary tumor site ( HR=0.64, 95% CI: 0.48-0.86), Eastern Cooperative Oncology Group Performance Status (ECOG PS) score ( HR=2.66, 95% CI: 1.53-4.65), and whether to combine radiotherapy ( HR=0.65, 95% CI: 0.42-1.00) were independent influencing factors for the PFS of these patients. The primary tumor site ( HR=0.68, 95% CI: 0.48-0.95), ECOG score ( HR=5.82, 95% CI: 3.14-10.82), and whether to combine radiotherapy ( HR=0.58, 95% CI: 0.35-0.96) were independent influencing factors of the OS of these patients. The most frequent gene mutations in these advanced stage pancreatic patients were KRAS (89.66%), TP53 (77.01%), CDKN2A (32.18%), and SMAD4 (21.84%) by NGS of tumor tissues from 87 pancreatic cancer patients with sufficient specimens. Further analysis revealed that mutations in CDKN2B, PTEN, FGF6, and RBBP8 genes were significantly associated with an increased risk of death ( P＜0.05). Conclusion:Albumin-bound paclitaxel as first-line treatment demonstrated feasible anti-tumor efficacy and manageable safety for patients with advanced pancreatic cancer in China.