Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A total of 2874 patients from the large prospective, observational perioperative lung symptom study cohort (CN-PRO-Lung 3) in the Department of Thoracic Surgery at Sichuan Cancer Hospital between April 7, 2021, and January 31, 2024, were selected as the survey subjects. A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of (52.4±10.2) years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers for postoperative exercise were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.

In recent years， repetitive transcranial magnetic stimulation （rTMS） has garnered significant attention as a therapeutic approach for sleep disorders in the elderly. However， the prevailing rTMS protocols are predominantly developed based on normative neurophysiological data derived from young adults and fail to incorporate individualized parameters tailored to the brain characteristics of the elderly. To address this gap， the consensus development group synthesized the latest evidence from 2010 to 2025 and established a standardized rTMS protocol specifically for elderly patients with sleep disorders. Adhering to the Appraisal of Guidelines for Research and Evaluation II （AGREE II） framework， systematically screened randomized controlled trials （RCTs） and systematic reviews regarding rTMS in the treatment of sleep disorders across various conditions. Meanwhile， the Grading of Recommendations Assessment， Development and Evaluation （GRADE） system was employed to rigorously grade the quality of evidence and the strength of recommendations. This consensus guideline delineates precise rTMS protocols for the management of sleep disorders in the elderly， highlights the adjustment of stimulation intensity according to scalp-cortex distance recommends either MRI‑guided neuronavigation or the Beam F3/F4 heuristic approach for accurate target localization， thereby providing precise rTMS intervention protocol for sleep disorders in the elderly， aiming to enhance clinical efficacy while ensuring treatment safety. ［Funded by National Key Research and Development Program （number， 2023YFC3603200）； General Program of Shenzhen Science and Technology Innovation Commission （number， JCYJ20240813112859008， JCYJ20240813112900002）； Youth Program of Shenzhen Kangning Hospital （number， KN2023A004）； www.guidelines-registry.cn number， PREPARE-2026CN530］

ObjectiveThe frequency difference limen (FDL) serves as a fundamental metric utilized for effectively quantifying the precise perceptual capabilities of the central auditory system. However, traditional measurement methods rely heavily on the active behavioral responses of subjects and are consequently highly susceptible to the negative influence of confounding subjective factors. Furthermore, existing research paradigms frequently employ uniform stimulus configurations that overlook critical individual perceptual differences. Based on brain-computer interface (BCI) technology, this comprehensive study aims to establish an objective and quantitative evaluation method for auditory frequency discrimination by systematically analyzing and decoding the specific neural responses elicited at the exact threshold state. MethodsWe designed a personalized rapid serial auditory presentation (RSAP) paradigm customized based on each individual’s precise FDL. A cohort of eleven healthy participants was recruited to evaluate the paradigm using pure-tone sequences at a baseline frequency of 4 000 Hz. This experimental paradigm simulates a realistic auditory perception environment through the continuous presentation of acoustic stimuli, thereby allowing for an in-depth investigation into the specific neural representations evoked by weak frequency deviations at the threshold state. Given that auditory stimulus-evoked response features exhibit complex and differentiated spatiotemporal distribution patterns across multiple frequency domains, this study further deeply integrates the cross-scale feature interaction module with the dynamic spatiotemporal attention allocation strategy, innovatively proposing the Multi-Scale Spatial-Temporal Dual Attention Network (MS-STAMNet). Specifically, the network constructs parallel processing branches with multiple receptive fields and introduces a dynamic adaptive weighting strategy to precisely localize core neural activity signals, further deeply integrating multi-scale information through cross-branch feature information interaction to achieve robust single-trial decoding of weak auditory evoked responses. ResultsThe comprehensive electrophysiological data analysis demonstrated that subtle auditory frequency deviation stimuli presented at the threshold level successfully elicited pronounced N2 and P3 event-related potential features, reflecting pre-attentive mismatch detection and subsequent cognitive evaluation, which were prominently distributed over the frontal, central, and temporal regions of the scalp. In the complex time-frequency domain, the extracted neural response characteristics exhibited distinct, statistically significant event-related synchronization within both the low-frequency δ and θ frequency bands, which was simultaneously accompanied by a widespread, prominent event-related desynchronization within the higher α band. A comparative analysis of model performance demonstrated that MS-STAMNet achieved an average unweighted average recall (UAR) of (69.67±6.12)% and area under the curve (AUC) of 0.761 8±0.07, significantly outperforming the established baseline models such as EEGNet and PLNet. Furthermore, a distinct dissociation phenomenon was verified between neural decoding and behavioral performance through regression analysis (R²=0.016, P=0.709), indicating that this model can effectively capture the implicit features of subtle frequency deviations, even when they fail to trigger explicit conscious responses. Additionally, attention weight visualization analysis further reveals the highly accurate focus of the network on key features concentrated over the bilateral temporal and fronto-parietal regions. ConclusionThis study systematically and comprehensively uncovers the multi-dimensional spatiotemporal evolutionary patterns of complex neural responses processing subtle acoustic variations under long-sequence threshold auditory stimulation. Concurrently, it verifies the efficacy and robustness of the proposed MS-STAMNet architecture in accurately deciphering weak, single-trial electroencephalogram signals amidst complex background noise. Ultimately, these neurophysiological and algorithmic findings lay a solid theoretical and methodological foundation for the objective and quantitative evaluation of individual auditory cognitive capabilities in clinical applications, transcending the fundamental limitations of traditional behavioral paradigms and providing robust technical support for future auditory research and related clinical assessments.

Ulcerative colitis （UC） is a chronic inflammatory bowel disease primarily affecting the colon and rectum. With a rising incidence， UC has aroused an increasingly serious public health concern. The etiology and pathogenesis of UC are complex， involving genetic susceptibility， intestinal barrier dysfunction， immune dysregulation， and environmental factors such as diet， smoking， and infection. Current UC therapies face limitations including persistent drug resistance， multiple side effects， and compromised immune function， necessitating the exploration of novel intervention strategies. In recent years， with the continuous advancement of research into UC mechanisms， the Toll-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB） signaling pathway has been revealved as one of the classical pathways involved in inflammation. Being crucial for maintaining intestinal homeostasis， this pathway regulates inflammatory and immune responses by controlling gene transcription， thereby playing a significant role in the occurrence and progression of UC. However， systematic summarization within this field remains lacking. Traditional Chinese medicine （TCM） possesses unique advantages through its multi-target， multi-pathway， and multi-mechanism approaches， being capable of curbing the pathological progression of UC by targeting key molecules in the TLR4/NF-κB signaling pathway. This paper systematically summarizes the mechanisms by which TLR4/NF-κB-related pathways regulate UC， primarily encompassing inflammatory responses， oxidative stress， immune balance， and gut microbiota. It reviews single herbs （e.g.， Rosa roxburghii root and Saposhnikoviae Radix）， active components （e.g.， resveratrol， Tripterygium glycosides， and gypenosides）， herbal extracts （e.g.， Zingiberis Rhizoma extract and Taraxaci Herba extract）， and compound formulas for clearing heat and removing dampness， invigorating the spleen and warming the kidneys， clearing heat and detoxifying， harmonizing the liver and spleen， and treating cold and heat in complexity （e.g.， Huaihua Powder， Shenling Baizhu Powder， and Jiedu Huayu Formula）. The aim is to fully leverage the advantages of TCM in UC treatment and provide novel insights for clinical and pharmacological research on UC.

Ulcerative colitis （UC） is a chronic inflammatory bowel disease primarily affecting the colon and rectum. With a rising incidence， UC has aroused an increasingly serious public health concern. The etiology and pathogenesis of UC are complex， involving genetic susceptibility， intestinal barrier dysfunction， immune dysregulation， and environmental factors such as diet， smoking， and infection. Current UC therapies face limitations including persistent drug resistance， multiple side effects， and compromised immune function， necessitating the exploration of novel intervention strategies. In recent years， with the continuous advancement of research into UC mechanisms， the Toll-like receptor 4 （TLR4）/nuclear factor-κB （NF-κB） signaling pathway has been revealved as one of the classical pathways involved in inflammation. Being crucial for maintaining intestinal homeostasis， this pathway regulates inflammatory and immune responses by controlling gene transcription， thereby playing a significant role in the occurrence and progression of UC. However， systematic summarization within this field remains lacking. Traditional Chinese medicine （TCM） possesses unique advantages through its multi-target， multi-pathway， and multi-mechanism approaches， being capable of curbing the pathological progression of UC by targeting key molecules in the TLR4/NF-κB signaling pathway. This paper systematically summarizes the mechanisms by which TLR4/NF-κB-related pathways regulate UC， primarily encompassing inflammatory responses， oxidative stress， immune balance， and gut microbiota. It reviews single herbs （e.g.， Rosa roxburghii root and Saposhnikoviae Radix）， active components （e.g.， resveratrol， Tripterygium glycosides， and gypenosides）， herbal extracts （e.g.， Zingiberis Rhizoma extract and Taraxaci Herba extract）， and compound formulas for clearing heat and removing dampness， invigorating the spleen and warming the kidneys， clearing heat and detoxifying， harmonizing the liver and spleen， and treating cold and heat in complexity （e.g.， Huaihua Powder， Shenling Baizhu Powder， and Jiedu Huayu Formula）. The aim is to fully leverage the advantages of TCM in UC treatment and provide novel insights for clinical and pharmacological research on UC.

The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

Objective To evaluate the performance and clinical application value of EasyNAT nucleic acid test kits for influenza A virus(Flu A),influenza B virus(Flu B),and Mycoplasma pneumoniae(MP)based on cross-primed amplification(CPA)technology.Methods In compliance with relevant standards,the detection limits,cross-reactivity,and anti-interference abilities of the EasyNAT Flu and MP nucleic acid test kits were validated using influenza(Flu)and MP reference materials.Additionally,a total of 811 suspected Flu or MP infection patients who visited the hospital from January 1 to July 5,2024 were enrolled in this study.Their oropharyngeal swabs were collected and tested using reverse transcription quantitative polymerase chain reac-tion(RT-qPCR)as the gold standard to evaluate the concordance and compliance of the EasyNAT Flu and MP nucleic acid test kits,thus assessing their clinical application value.Results The EasyNAT Flu and MP nucleic acid test kits yielded positive results in 8 repeated tests at the detection limit concentrations of the ref-erence materials.No pathogen-specific peaks were detected in Flu and MP negative samples that had been spiked with common cross-reacting pathogens.Furthermore,the detection results of Flu or MP positive sam-ples were unaffected by the presence of interfering substances.Among the 811 clinical samples,the sensitivity of the EasyNAT Flu A test was 97.33%,and the sensitivity for Flu B was 98.47%,both with a specificity of 98.04%.The EasyNAT MP nucleic acid test showed a sensitivity of 97.95%and specificity of 99.03%.The results demonstrated a high degree of agreement with RT-qPCR(Kappa values were over 0.900).Further-more,detection rates of the EasyNAT Flu test kits showed no difference in positive samples with different Ct values(Flu A:χ2=4.20,P=0.08;Flu B:χ2=2.22,P=0.31)and MP test kits showed significant differences in positive samples with different cycle threshold values(χ2=11.84,P<0.01).Conclusion The EasyNAT Flu and MP nucleic acid test kits exhibit excellent detection performance with high sensitivity and specificity.Moreover,the products are easy to operate,offer rapid detection,and provide accurate results.These features make them suitable for primary healthcare settings,with significant potential for clinical application.

Objective:To analyze the medication law of Professor Liu Guangzhen in the treatment of diabetic nephropathy (DN) with qi-yin deficiency and blood stasis syndrome using data mining methods.Methods:From March 2023 to April 2024, the TCM outpatient prescriptions used by Professor Liu to treat DN with qi-yin deficiency and blood stasis syndrome were collected. The database was established by Excel 2019, and the property, taste, meridian, and use frequency of drugs were analyzed through the TCM inheritance assistance system V2.5. The Apriori algorithm in IBM SPSS Modeler 18.0 was used to analyze the association rules and draw the network diagram of high-frequency drugs, and the two-step hidden tree analysis algorithm (LTM-EAST) in the Lantern 5.0 was used to establish the hidden structure model of high-frequency Chinese materia medica. The obtained hidden variables were clustered and interpreted comprehensively, and scored by Bayesian information measure (BIC).Results:A total of 314 prescriptions were included, involving 182 kinds of Chinese materia medica, with a total frequency of 9 242 times. High frequency Chinese materia medica included Astragali Radix, Saposheikovize Radix, Atractylodis Macrocephalae Rhizoma fried with wheat bran, Litchi Semen, Hedyotis diffusa willd, Benincasae Exocarpium, Mori Folium, etc. The medicinal property was mainly warm, the tastes were mainly sweet, bitter and pungent, and the meridian tropism was mainly spleen, stomach, liver and kidney meridians. The efficacy classification was mainly tonic drugs, heat-clearing drugs, water-clearing and dampness-percolating drugs, and blood circulation-activating drugs. There were 150 association rules of high-frequency Chinese materia medica, including Astragali Radix-Saposheikovize Radix, Atractylodis Macrocephalae Rhizoma fried with wheat bran-Hedyotis diffusa willd, Saposheikovize Radix-Benincasae Exocarpium, etc. A total of 15 hidden variables, 30 hidden classes and 5 comprehensive clustering models were obtained by hidden structure model analysis.Conclusions:Professor Liu's treatment of DN withqi-yin deficiency and blood stasis syndrome is mainly based on tonifying qi and yin, tonifying spleen and kidney, removing dampness and turbidity and removing blood stasis. According to different conditions, the focus of medication has changed.

Objective To investigate the comparative neuroprotective effects of human umbilical cord mesenchymal stem cells(hUC-MSCs-Exos)administered via different routes on hypoxic ischemic brain damage(HIBD)in neonatal mice.Methods Healthy one-week-old SPF-grade BALB/c mice were randomly divided into 4 groups:sham operation group(n=6),model group(n=6),exosome group 1(n=8),exosome group 2(n=8).HIBD was induced using the Rice-Vannucci method.Exosome group 1 and Exosome group 2 were intraperitoneal injection/intranasal drip of phosphate buffer(PBS)100 μl containing 10 μl exosomes within 24 h after successful modeling,respectively.Sham operation and model groups were intraperitoneal injection of PBS 100 μl.On the 7th day after the intervention,neuromotor function was assessed using the horizontal grid test and pole climbing test.On the 2nd day after the evaluation,all mice were killed and their brains were removed by decapitation.HE staining was used to observe the pathological injury of brain tissue,toluidine blue staining was used to observe the survival of neurons in cerebral cortex,and TUNEL staining was used to observe the apoptosis of cerebral cortex cells.Results Compared with sham operation group,model group,exosome group 1 and exosome group 2 exhibited increased hind limb drops in horizontal grid test and climbing scores(P<0.05).No significant difference was found in model group,exosome group 1 and exosome group 2 in these measures(P<0.05).Significant pathology was observed in model group,exosome group 1 and exosome group 2 compared to sham operation group(P<0.05),with significantly reduced damage in exosome group 1 and exosome group 2 compared to model group(P<0.05).Compared with sham operation group,Nissl body count was lower in model group and exosome group 1 and exosome group 2,with a higher count in exosome group 2 compared to exosome group 1(P<0.05).Compared with sham operation group,apoptotic cells were higher in model group and exosome group 1 and exosome group 2,with a significant reduction in exosome group 1 and exosome group 2 compared to model group,and the lowest in exosome group 2(P<0.05).Conclusions hUC-MSCs-Exos can improve the neuronal motor function,promote neuron repair and inhibit apoptosis in HIBD mice.Intranasal administration of hUC-MSCs-Exos is more effective than intraperitoneal administration for reducing neuronal apoptosis in HIBP neonatal mice,offering a convenient and rapid method suitable for clinical application.

Objective To investigate the population composition,seasonal dynamics,and infestation levels of cockroaches in Lanzhou,China,and to provide information for the scientific development of cockroach control strategies.Methods Monitoring was conducted at three locations using the sticky trap method.Habitats included farm product markets,catering establishments,hotels,hospitals,and residential areas.Results From 2016 to 2023,the average cockroach density was 0.77 insects per board,with an average infestation rate of 10.84%.Blattella germanica was the dominant species.Seasonal density of cockroaches showed an approximately unimodal distribution,peaking in September.The highest average density and infestation rates were observed in farm product markets.Conclusions Cockroach density and infestation levels in Lanzhou remained relatively low.A comprehensive prevention and control strategy focusing on environmental management in key areas should be implemented according to the seasonal fluctuations.