ObjectiveTo develop an assessment tool for apraxia of speech (AOS) of Chinese Putonghua speakers and test its reliability and validity. MethodsThe Chinese Apraxia of Speech Assessment and Diagnostic Tool (CAADT) was developed based on the Apraxia of Speech Rating Scale 3.5, combined with the linguistic characteristics of Chinese and clinical experience. The tool consistsed of eleven items across three sections: articulation, prosody and alternating motion rates. Six experts evaluated the content validity. From November, 2024 to May, 2025, 51 patients with post-stroke AOS (experimental group) and ten patients with post-stroke aphasia without AOS (control group) were recruited from Anhui Wannan Rehabilitation Hospital (the Fifth People's Hospital of Wuhu), and tested with CAADT. Reliability was assessed using Cronbach's α coefficient, Kendall's coefficient of concordance W and Pearson correlation coefficient. Validity was evaluated using the content validity index (CVI) and Spearman correlation coefficient. Discriminative effect was analyzed using the receiver operating characteristic (ROC) curve. ResultsThe Cronbach's α coefficients for the articulation and prosody sections and the total scale were all > 0.9, while it was 0.454 for the alternating motion rates. Inter-rater reliability was good (W ≥ 0.598, P < 0.001). Test-retest reliability showed high positive correlations for the three sections and the total score between the two assessments (r ≥ 0.84, P < 0.001). The scale-level CVI was 0.95, and the item-level CVI ≥ 0.83. The Spearman correlation coefficients among the sections ranged from 0.30 to 0.70. ROC analysis revealed an area under the curve of 0.953, with a cut-off value of 11, yielding a sensitivity of 0.92 and a specificity of 0.90. ConclusionCAADT demonstrates good reliability, validity and discriminative effect, which can be used for clinical assessment and auxiliary diagnosis of Chinese Putonghua speaking patients with post-stroke AOS.

Objective:To analyze the application of Sengstaken-Blakemore tubes combined with endoscopic intervention on the prognosis of patients with acute esophageal and gastric variceal rupture and bleeding due to portal hypertension in liver cirrhosis, and to explore the impact of Sengstaken-Blakemore tubes combined with endoscopic intervention on the prognosis of patients.Methods:A retrospective study included patients with liver cirrhosis who visited the Zhongshan Hospital, Fudan University from January 2023 to July 2024 due to acute upper gastrointestinal bleeding, had no response to drug treatment and unstable hemodynamics, and received the Sengstaken-Blakemore tubes compression hemostasis. According to whether endoscopic intervention was received or not, the patients were divided into the endoscopic intervention group and the non-endoscopic intervention group. The medication and subsequent treatment of the patients were analyzed, and the survival of the patients 28 days after bleeding was followed up. Kaplan-Meier survival analysis and Cox regression analysis were used to evaluate the effect of endoscopic intervention on the 28-day mortality rate of patients.Results:A total of 31 cases successfully had three-lumen two-cystic tubes indwelled. Among them, 8 cases further received endoscopic examination and intervention, and 23 cases did not receive endoscopic examination. During the 28-day follow-up after bleeding, a total of 20 cases died. The Kaplan-Meier survival analysis showed that the 28-day mortality rate in the endoscopic intervention group was significantly lower than that in the non-endoscopic intervention group (25.0% vs 78.3%, P=0.007). Multivariate Cox regression analysis showed that endoscopic intervention was an independent protective factor for 28-day mortality ( HR: 0.14, 95% CI: 0.03-0.63, P=0.01). In addition, the severity of bleeding and prothrombin time were also important factors affecting the prognosis of patients. Conclusions:The Sengstaken-Blakemore tubes, as an important hemostasis method for acute esophageal and gastric variceal rupture and bleeding, can buy time for subsequent endoscopic treatment, but the risk of complications is relatively high. Creating conditions for early endoscopic intervention as early as possible can significantly reduce the mortality rate of patients and improve the prognosis of patients with liver cirrhosis.

Objective:To investigate the correlation between carotid-femoral pulse wave velocity(cfPWV)and carotid artery structural,hemodynamic,and cardiac functional parameters.Methods:A total of 420 healthy volunteers who underwent neck ultrasound,cardiac ultrasound,and cfPWV examination at Kailuan General Hospital from June 2022 to February 2023 were selected,and they were divided into two groups based on the atherosclerosis threshold value of cfPWV>10 m/s,which included high cfPWV group(140 cases,cfPWV>10 m/s)and low cfPWV group(280 cases,cfPWV≤10 m/s).The demographic data(age,sex)of 420 persons were collected,and the common carotid artery diameter(CCAD),common carotid artery intima-media thickness(CIMT),plaque status,peak systolic velocity(PSV),end-diastolic velocity(EDV)and mean flow velocity(MFV)were compared between two groups.Then,the differences of interventricular septal thickness(IVST)of heart,left ventricular posterior wall thickness(LVPWT),the ratio of blood flow velocity at early stage to that at advanced stage in mitral valve(E/A)and stroke volume(SV)were analyzed.Multivariate logistic regression was adopted to analyze the independent influence factors of cfPWV enhancement.Results:The average age of high cfPWV group was(61.31±9.66)years old,which was significantly higher than(51.06±10.47)years old of low cfPWV group,and the difference of that was significant(t=-9.56,P<0.01).In the parameters of common carotid artery,63 persons(45.0%)occurred plaque in 140 persons of high cfPWV group,which was significantly lower than 50 persons(17.86%)in 280 persons of low cfPWV group,and the difference of that between two groups was significant(x2=34.97,P<0.05).The differences of CCAD,CIMT,PSV,EDV and MV of common carotid artery at right side of persons between two groups were significant(t=-2.16,-5.40,4.52,5.59,5.04,P<0.05),respectively.The parameters of heart showed that the LVPWT thickness increased(9.35±1.13)mm,and the ratio of E/A<1 increased 77.86%in high cfPWV group,which were significantly related to the increase of cfPWV(r=0.27,0.38,P<0.01).Multivariate logistic regression analysis indicated that age(OR=1.05,95%CI:1.02-1.08),CCAD(OR=1.63,95%CI:1.22-2.16),plaque presence(OR=1.84,95%CI:1.07-3.17),LVPWT(OR=1.35,95%CI:1.05-1.72),and the ratio of E/A<1(OR=2.37,95%CI:1.32-4.26)were independent predictors of cfPWV enhancement.Conclusion:The enhancement of cfPWV is closely related to high age,the reconstruction of common carotid artery(widening of inside diameter,and plaque formation),left ventricular hypertrophy,and diastolic abnormality,which indicates it is possible that atherosclerosis process accompanies by the change of interaction mechanism of blood vessels-heart.

Objective:To explore the clinical characteristics of patients with porto-sinusoidal vascular disease (PSVD) complicated with esophageal and gastric varices, and to evaluate the effect of portal vein pressure (PVP) on esophageal and gastric varices bleeding and rebleeding after endoscopic treatment.Methods:Patients who were hospitalized in the Department of Gastroenterology of the Zhongshan Hospital, Fudan University due to portal hypertension from July 2022 to October 2024, underwent liver biopsy for diagnosis of PSVD, and received direct PVP measurement were included. Their clinical manifestations, liver histopathological characteristics were analyzed, and the prognosis was followed up.Results:A total of 29 patients were included, and 19 patients had experienced rupture and bleeding of esophageal and gastric varices. Compared with the non-bleeding group, the hemoglobin level of patients in the bleeding group was lower and the international normalized ratio was higher (all P<0.05). There was no statistically significant difference between the two groups in other laboratory examination indicators, complications of portal hypertension, combined diseases, etc. (all P>0.05). The pathology of liver biopsy suggests that dilation of the hepatic sinuses and abnormalities of the central vein are common pathological changes. The direct PVP of patients in the bleeding group was significantly higher than that in the non-bleeding group [28.0(24.5-31.0)mmHg vs 18.5(10.5-23.8)mmHg, P=0.011]. However, there was no statistically significant difference in the measured values of liver wedge pressure, free pressure and hepatic venous pressure gradient (HVPG) between the two groups of patients (all P>0.05). Correlation analysis revealed that there was no significant correlation between HVPG and PVP ( R2=0.129 9, P=0.076 7). Grouped according to the median PVP value of 25 mmHg, the risk of esophageal and gastric variceal rupture and bleeding in the high PVP group (≥25 mmHg) was significantly higher than that in the low PVP group (<25 mmHg) (14/16 vs 5/13, P=0.016). The risk of rebleeding after endoscopic treatment in patients with high PVP (4/13) was higher than that in patients with low PVP (0/4). Conclusions:Patients with porto-sinusoidal vascular disease complicated with portal hypertension are often accompanied by rupture and bleeding of esophageal and gastric varices. HVPG cannot accurately reflect the portal vein pressure. The risk of rupture and bleeding of esophageal and gastric varices and rebleeding in patients with elevated portal vein pressure is significantly increased.

Objective:To explore the effect of inflammatory cell levels on the anticoagulant efficacy in patients with liver cirrhosis complicated with portal vein thrombosis (PVT).Methods:A total of 106 patients with liver cirrhosis complicated with PVT who visited the Zhongshan Hospital, Fudan University from 2017 to 2022 were prospectively included. The PVT grade and recanalization were evaluated by imaging. Cox regression was used to analyze the predictive factors of anticoagulation efficacy. The time-dependent receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value of inflammatory cells for predicting anticoagulation efficacy. The Kaplan-Meier method was used to compare the 1-year PVT recanalization rate of patients with different levels of inflammatory cells.Results:Univariate analysis showed that Child-Pugh score ( HR=1.41), D-dimer ( HR=0.98), platelet ( HR=0.98), C-reactive protein to lymphocyte ratio ( HR=1.01), monocyte ( HR=0.21), lymphocyte ( HR=0.34), and prothrombin time( HR=1.32) was related to the improvement of PVT (all P<0.05). Multivariate analysis confirmed that lymphocytes ( HR: 0.41, 95% CI: 0.20-0.85, P=0.016) and prothrombin time ( HR: 1.23, 95% CI: 1.01-1.50, P=0.036) were independent predictors of anticoagulant efficacy. Grouped according to the ROC cutoff value, the 1-year recanalization rate of PVT in the high-level lymphocyte group (4.55% vs 32.84%, P=0.012) and the high-level monocyte group (5.56% vs 31.4%, P=0.028) was significantly lower than that in the low-level group. After excluding patients undergoing splenectomy, the recurrence rate in the high-level lymphocyte group was still lower than that in the low-level group (6.25% vs 33.77%, P=0.038). Conclusions:Among patients with liver cirrhosis accompanied by PVT, high levels of lymphocytes and monocytes are the key factors for the poor efficacy of anticoagulation therapy. For PVT patients with poor anticoagulation efficacy, the therapeutic strategy of anti-inflammatory combined with anticoagulation can be considered for exploration in the future.

Objective:To analyze the application of Sengstaken-Blakemore tubes combined with endoscopic intervention on the prognosis of patients with acute esophageal and gastric variceal rupture and bleeding due to portal hypertension in liver cirrhosis, and to explore the impact of Sengstaken-Blakemore tubes combined with endoscopic intervention on the prognosis of patients.Methods:A retrospective study included patients with liver cirrhosis who visited the Zhongshan Hospital, Fudan University from January 2023 to July 2024 due to acute upper gastrointestinal bleeding, had no response to drug treatment and unstable hemodynamics, and received the Sengstaken-Blakemore tubes compression hemostasis. According to whether endoscopic intervention was received or not, the patients were divided into the endoscopic intervention group and the non-endoscopic intervention group. The medication and subsequent treatment of the patients were analyzed, and the survival of the patients 28 days after bleeding was followed up. Kaplan-Meier survival analysis and Cox regression analysis were used to evaluate the effect of endoscopic intervention on the 28-day mortality rate of patients.Results:A total of 31 cases successfully had three-lumen two-cystic tubes indwelled. Among them, 8 cases further received endoscopic examination and intervention, and 23 cases did not receive endoscopic examination. During the 28-day follow-up after bleeding, a total of 20 cases died. The Kaplan-Meier survival analysis showed that the 28-day mortality rate in the endoscopic intervention group was significantly lower than that in the non-endoscopic intervention group (25.0% vs 78.3%, P=0.007). Multivariate Cox regression analysis showed that endoscopic intervention was an independent protective factor for 28-day mortality ( HR: 0.14, 95% CI: 0.03-0.63, P=0.01). In addition, the severity of bleeding and prothrombin time were also important factors affecting the prognosis of patients. Conclusions:The Sengstaken-Blakemore tubes, as an important hemostasis method for acute esophageal and gastric variceal rupture and bleeding, can buy time for subsequent endoscopic treatment, but the risk of complications is relatively high. Creating conditions for early endoscopic intervention as early as possible can significantly reduce the mortality rate of patients and improve the prognosis of patients with liver cirrhosis.

Pasteurella multocida(Pm)type A is an important pathogen responsible for respiratory diseases,such as bovine pneumonia,which seriously restricts the development of cattle industry in China.Currently,the prevention of Pm infection-related diseases primarily relies on vaccination in production.However,the diverse Pm serotypes result in inadequate cross-immunological protection from vaccines.Therefore,it is of great significance to develop vaccines with cross-protection for the prevention and control of Pm infectious diseases.The previous studies conducted by our team have demonstrated that PmCQ2△cra exhibits a strong immune protective effect against Pm type A(PmA),Pm type B(PmB),and Pm type F(PmF).Transcriptomic sequencing results suggest that the cross-immunoprotective effect of PmCQ2△cra may be attributed to high expression levels of bacterial surface protective antigens.Consequently,four putative immune protective antigens,namely PmCQ2-5175,PmCQ2-6290,PmCQ2-0275 and PmCQ2-2640,were screened through bioin-formatics analysis in this study.Subunit vaccines formulated with these potential antigenic proteins exhibited protective efficacy of 62.5％,25％,12.5％and 10％against PmA-infected mice,respectively.Importantly,PmCQ2-5175,one of the most protective single-component antigen vac-cines,demonstrating a 75％cross-protection against PmB infection in mice.Furthermore,the pro-tective efficacy of the PmCQ2-5175 protein screened in this study was superior to that of the previ-ously reported Pm antigen protein plpE.Moreover,the fusion expression protein PmCQ2-5175-PLPE exhibited better protective effects against PmA compared to a single protein.The findings of this study will establish a theoretical foundation for the advancement of Pm subunit vaccines with broad-spectrum immune protection.

Objective Exploring the MAP(meta analytic predictive)methods for historical information borrowing for adaptive trials.Methods Taking the clinical trial of recurrent or metastatic head and neck squamous cell carcinoma as an example,the applicability of the MAP method in the adaptive trial was evaluated with different heterogeneity of historical control data and different degrees of data conflict.Results For the five applicable extreme protocol historical studies with a total of 253 subjects,the MAP prior converted to an effective sample size(ESS)of 19 cases,and the RMAP(robust MAP)prior converted to ESS of 17 cases.The RMAP method balanced the potential conflicts between historical data and current trial data better than the MAP method.With the increase of the heterogeneity among historical controls and the conflict between the prior and the current data,the type-I error of both the MAP method and the RMAP method were slightly inflated.When the current control data corresponded with the historical controls,the power of both the MAP prior and the RMAP prior decreased with the increase of heterogeneity.For the two-stage adaptive trial,borrowing information saved 30%-35% of ESS in control group.Conclusion The MAP method can be a valid and robust methodoiogical tool for the effective application of historical information borrowing for the adaptive design trials,which can help to optimize experimental design,cinserve resources,and assist for trial decision.

Objective To improve the accuracy of intelligent detection and evaluation of traditional Chinese medicine(TCM)pieces and solve the problems of leakage,misdetection,inaccurate localization and low confidence in the study of TCM pieces identification,YOLOv3 algorithm which has good detection effect for high overlap and small targets was improved.Methods An RGB image database containing 148 commonly used TCM pieces was established.Based on the YOLOv3 algorithm model,the anchor box size was improved by K-means clustering algorithm.The CIoU loss function was introduced for bounding box regression to improve the localization accuracy and confidence of bounding boxes.The traditional non-maximum suppression was improved to DIoUNMS to reduce the problems of missed detection and false detection of dense targets with high overlap by YOLOv3 algorithm.Results 148 kinds of TCM pieces were tested with the improved algorithm,and the average detection accuracy of 98.47%was achieved,which is 1.83%better than the original YOLOv3 algorithm.It realizes better detection effect for TCM pieces in complex situations such as dense,high overlapping,etc.Problems such as leakage,misdetection,imprecise positioning and low confidence level have been alleviated to a certain extent.Conclusion The improved algorithm effectively improves the recognition accuracy and generalization ability of TCM pieces,providing a new reference for the realization of automated intelligent detection of TCM pieces.

ObjectiveTo investigate the effects of Chaihu and Longgu Mulitang （CLMT） on hippocampal neural damage in the mouse model of depression via the extracellular signal-regulated protein kinase （ERK）/cAMP-response element-binding protein （CREB） signaling pathway. MethodsSeventy-eight male C57BL/6 mice were randomly allocated into normal control， model， low/medium/high-dose （2.89， 5.78， and 11.56 g·kg^-1， respectively） CLMT， and paroxetine （10 mg·kg^-1） groups. A depression model was established by chronic unpredictable mild stress （CUMS） combined with social isolation. Behavioral tests were carried out to evaluate depressive-like behaviors. Hematoxylin-eosin staining and Nissl staining were performed to assess hippocampal morphology and neuronal damage. Immunofluorescence was employed to detect glial fibrillary acidic protein （GFAP） and ionized calcium-binding adapter molecule 1 （Iba1）. Real-time PCR was employed to measure the mRNA levels of ERK and CREB. Western blot was employed to determine the expression of ERK/CREB pathway proteins and brain-derived neurotrophic factor （BDNF） in the hippocampal tissue. Molecular Operating Environment （MOE） software was used for molecular docking to evaluate the interactions between CLMT components and target proteins. ResultsCompared with the normal control group， the model group showed decreased sucrose preference （P0.01）， increased tail-suspension immobility time （P0.01）， decreased activity in the central region of the open field test （P0.01）， and decreased activity in the middle and open-arm region of the elevated plus maze test （P0.01）. The hippocampal area in the model group showed wrinkled cells and a reduction in the number of cells， neurons with reduced sizes and Nissl bodies， enhanced fluorescence intensity of GFAP and Iba1 （P0.01）， and down-regulated expression of phosphorylated （p）-ERK， p-CREB， and BDNF （P0.05， P0.01） and mRNA levels of ERK and CREB （P0.01）. Compared with the model group， the CLMT group showed increased body weight （P0.05， P0.01）， restored cell morphology， with only a small number of ruptured cells， normal neuronal structure and morphology with obvious nuclei and abundant Nissl bodies， weakened fluorescence intensity of GFAP and Iba1 （P0.05， P0.01）， up-regulated mRNA levels of ERK and CREB （P0.05， P0.01） and protein levels of phosphorylated （p）-ERK， p-CREB， and BDNF in the hippocampal tissue （P0.05， P0.01）. The results of molecular docking indicated that nine active ingredients in CLMT had good binding affinity with ERK and CREB. ConclusionCLMT may ameliorate the hippocampal nerve injury in the mouse model of depression by regulating the ERK/CREB pathway.