Objective: To explore the correlation of balance ability with short term memory and executive function among college students, so as to provide a theoretical basis for balance training and cognitive enhancement in college students. Methods: In November 2024, 80 college students were recruited from Chongqing Normal University. The dynamic and static balance abilities were measured using the Y-balance test(YBT) and PhysioSensing equipment. Short term memory and executive function were assessed through the digital span test, trail making test(TMT) and Stroop colour-word task. Pearson or Spearman analysis was used to explore the correlation between balance ability and cognitive function among college students. Results: The comprehensive scores of the balance YBT for college students were as follows: left side (95.14±5.93)% and right side (95.17±5.24)%.The average sway velocity of static balance under the conditions of stable surface with eyes open, stable surface with eyes closed, unstable surface with eyes open and unstable surface with eyes closed were 27.58(20.45, 37.64), 23.56(17.57, 34.77), 61.15(40.73, 78.05), 55.88 (40.84, 66.65)mm/s. The comprehensive scores of the YBT for both lower limbs in college students were negatively correlated with the time taken for TMT Part A (TMT-A), TMT Part B (TMT-B), and the difference in time spent between TMT-A and TMT-B (TMT-D) ( r =-0.55 to -0.24，all P <0.05). The average sway velocity under the four conditions was positively correlated with TMT-A, TMT-B, TMT-D, consistent reaction time, conflict reaction time and reaction time difference ( r =0.26-0.69，all P < 0.05). Under conditions of normal vestibular sensation with proprioception interference, the visual contribution in college students was negatively correlated with TMT-A, TMT-B, conflict reaction time and reaction time difference ( r =-0.28 to -0.22,all P < 0.05 ). Under conditions of normal vision and vestibular sensation, the proprioception contribution in college students was positively correlated with TMT-A, TMT-B, consistent reaction time, conflict reaction time and reaction time difference( r =0.26-0.39,all P < 0.05). Under conditions of normal vestibular sensation with visual interference, the proprioception contribution in college students was positively correlated with consistent reaction time and conflict reaction time ( r =0.24, 0.25,both P <0.05). Conclusions There is a correlation between balance ability and executive function in college students. When maintaining static balance, if the visual or proprioceptive system is interfered with, college students with poorer executive function rely more on other systems for compensation.

ObjectiveTo systematically investigate the discrepancies between employment preferences and actual job placements among postgraduate students in rehabilitation medicine, explore the influencing factors, and elucidate the underlying mechanisms of their employment decisions. MethodsA cross-sectional questionnaire survey was conducted among 100 full-time postgraduate students who had graduated from Capital Medical University School of Rehabilitation in the past six years. A self-designed questionnaire was used to collect information on personal background, self-assessed competencies, employment preferences, and actual job placements. Logistic regression models were employed to analyze the factors influencing employment preferences and actual job placements, respectively. ResultsEmployment preferences among rehabilitation medicine postgraduates were highly concentrated on large tertiary hospitals (79.0%), yet the actual placement rate (61.0%) showed a significant gap. Preference for tertiary hospitals showed no significant association with individual factors such as gender, degree type or self-assessed competencies (P > 0.05). Univariate analysis revealed that those who entered tertiary hospitals scored significantly higher in self-assessed clinical skills, research ability, communication and coordination, and resource integration (|t| > 3.661, P < 0.001), and demonstrated clearer career planning (P = 0.012). Multivariate logistic regression analysis did not identify any independent predictors of actual employment within the context of this study sample (P > 0.05). ConclusionEmployment among rehabilitation medicine postgraduates is characterized by highly homogeneous preferences coexisting with complexity of factors influencing actual employment. It is recommended to optimize the training system, deepen personalized career education, and establish diversified employment guidance mechanisms to promote rational talent flow and facilitate the balanced development of the rehabilitation medical service system.

Objective To develop a symptom and function assessment scale for patients after Nuss procedure for pectus excavatum and to test its reliability and validity. Methods Following the principles and procedures of patient-reported outcome (PRO) scale development stipulated by the U.S. Food and Drug Administration, an initial draft was formed through literature analysis, qualitative interviews, and Delphi expert consultation. The preliminary draft was used to conduct a pre-survey on patients who underwent Nuss procedure for pectus excavatum at Guangdong Provincial People's Hospital, and the reliability and validity of the scale were tested. Results A preliminary PRO-based symptom and function scale was constructed, covering two domains: symptoms and impact on daily functions. The symptom dimension included six items: chest tightness, palpitations, pain, shortness of breath, foreign body sensation of the steel plate, and distress; while the impact on daily functions included four items: difficulty in getting out of bed or lying down, raising arms, bending over, and standing or sitting for a long time. A total of 73 patients who underwent Nuss procedure for pectus excavatum were included in the questionnaire survey, with 70 valid questionnaires collected, including 64 males and 6 females, with 56 patients aged 12-17 years and 14 patients ≥18 years. Through exploratory factor analysis, two common factors were extracted, with a cumulative variance contribution rate of 70%. The Cronbach’s α coefficient of the scale was 0.917. Conclusion The scale developed in this study has good reliability and validity, high reliability and stability, and can be used as an evaluation tool for the recovery status of patients after Nuss procedure for pectus excavatum.

OBJECTIVE To evaluate the cost-effectiveness of brivaracetam （BRV） versus perampanel （PER） as add-on therapy for drug-resistant focal epilepsy in adults from the perspective of the Chinese healthcare system.METHODS A Markov model was established to simulate the progression of drug-resistant focal epilepsy in adults， with a simulation cycle of 5 months， a time horizon of 44 years， and a discount rate of 4.5%. Clinical data required for the model were derived from the phase Ⅲ clinical trial of BRV and a post hoc analysis of PER； cost data and utility data were obtained from Yaozh and related literature. The willingness-to-pay （WTP） threshold was set at twice China’s 2025 per capita gross domestic product （GDP） [199 330 yuan per quality-adjusted life year （QALY）]， and a cost-effectiveness analysis was adopted to compare the cost-effectiveness of the regimens. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to confirm the stability of the base-case analysis conclusions.RESULTS The incremental cost-effectiveness ratio （ICER） of BRV 50 mg/d as an add-on therapy versus PER 8 mg/d was 44 823.08 yuan/QALY， which was below the WTP threshold； the ICER of BRV 200 mg/d versus PER 12 mg/d was 238 783.00 yuan/QALY， which was above the WTP threshold. In the one-way sensitivity analysis， the direct medical cost of seizures ≥53 times/year and the health utility value of a seizure-free state per year had a relatively large impact on the two ICER results mentioned above， respectively. Probabilistic sensitivity analysis indicated that the above results were robust.CONCLUSIONS For the selection of add-on therapy for drug-resistant focal epilepsy in adults in China， when twice China’s per capita GDP is used as the WTP threshold， BRV 50 mg/d has a cost-effectiveness advantage over PER 8 mg/d， whereas BRV 200 mg/d not have a cost-effectiveness advantage over PER 12 mg/d.

Objective To propose a framework for risk assessment and stepwise management of pulmonary nodules based on existing guidelines and key studies, and to clarify the boundaries for triage, workup escalation, and referral in different detection scenarios. Methods A problem-oriented evidence synthesis approach was used, prioritizing Chinese expert consensus, Fleischner Society Guidelines, British Thoracic Society (BTS) Guidelines, and Lung-RADS. This was supplemented by studies on risk models, imaging measurements, liquid biopsy, tissue sampling, and surgical treatments. This paper is not presented as a formal consensus or a validated clinical pathway. Results A three-tiered framework consisting of basic non-invasive assessment, advanced assessment, and invasive diagnosis was established. It specified the applicable populations, boundaries for the use of risk models, imaging review, management of conflicting results, evaluation of histopathological consistency, and post-intervention follow-up. Liquid biopsy, genetic testing, and artificial intelligence were defined as investigational or adjunctive tools. Conclusion This framework can serve as a preliminary reference for multidisciplinary teams in developing local protocols. It cannot replace applicable guidelines, pathological diagnosis, shared decision-making with patients, or real-world validation.

Objective To explore the necessity of routine chest X-ray (CXR) examination after lung surgery based on patient symptom burden. Methods A retrospective study was conducted on the patients who underwent thoracoscopic lung resection at the Department of Thoracic Surgery of Guangdong Provincial People's Hospital from March 2020 to April 2023. Routine CXR findings obtained within 24 h post-operation, after chest tube removal, and at 1-month post-discharge, as well as subsequent clinical interventions triggered by these examinations, were collected and analyzed. The Perioperative Symptom Assessment Lung (PSA-Lung) inventory was used to quantify symptom burden including pain, dyspnea, and sleep disturbance. Results A total of 2 101 patients were collected, including 986 males and 1 115 females, with a median age of 56 years. The rate of clinical interventions triggered by routine CXR examinations was very low, being 1.0%, 0.5%, and 1.3% within 24 h post-operation, within 12 h after extubation, and at 1-month post-discharge, respectively. One month after discharge, patients in the intervention group exhibited significantly higher scores for dyspnea (3 points vs. 2 points, P=0.015), pain (2 points vs. 1 point, P=0.039), and sleep disturbance (3 points vs. 2 points, P=0.036) compared with the non-intervention group. Conclusion Very few routine postoperative CXR examinations change patients’ management, and patients who need extra-intervention tended to have more severe symptom burden after surgery.

ObjectiveTo study on the different therapeutic effects and potential mechanisms of Rhei Radix et Rhizoma（RH） before and after steaming with wine on constipation model mice. MethodsFifty-four male ICR mice were randomly divided into control group， model group， lactulose group（1.5 mg·kg^-1）， high， medium and low dose groups of RH and RH steaming with wine（PRH）（8， 4， 1 g·kg^-1）. Except for the control group， the constipation model was replicated by gavage of loperamide hydrochloride（6 mg·kg^-1） in the other groups. After 2 weeks of modeling， each administration group was gavaged with the corresponding dose of drug solution， and the control and model groups were given an equal volume of normal saline， 1 time/d for 2 consecutive weeks. After administration， the feces were collected for 16S rRNA sequencing， the levels of gastrin（GAS）， motilin（MTL）， interleukin-6（IL-6）， γ-interferon（IFN-γ） in the colonic tissue were detected by enzyme-linked immunosorbent assay（ELISA）， the histopathological changes of colon were observed by hematoxylin-eosin（HE） staining， flow cytometry was used to detect the proportion changes of CD4⁺， CD8⁺ and regulatory T cell（Treg） in peripheral blood. ResultsCompared with the control group， the model group showed significantly decrease in fecal number in 24 h， fecal quality and fecal water rate（P<0.01）， the colon was seen to have necrotic shedding of mucosal epithelium， localized intestinal glands in the lamina propria were degenerated， necrotic and atrophied， a few lymphocytes were seen to infiltrate in the necrotic area in a scattered manner， the contents of GAS and MTL， the proportions of CD4⁺， CD8⁺ and Treg were significantly reduced（P<0.01）， the contents of IL-6 and IFN-γ were significantly elevated（P<0.05， P<0.01）. Compared with the model group， the fecal number in 24 h， fecal quality and fecal water rate of high-dose groups of RH and PRH were significantly increased（P<0.05， P<0.01）， the pathological damage of the colon was alleviated to varying degrees， the contents of GAS， MTL， IL-6 and IFN-γ were significantly regressed（P<0.05， P<0.01）， and the proportions of CD4⁺ and CD8⁺ were significantly increased（P<0.01）， although the proportion of Treg showed an upward trend， there was no significant difference. In addition， the results of intestinal flora showed that the number of amplicon sequence variant（ASV） and Alpha diversity were decreased in the model group compared with the control group， and there was a significant difference in Beta diversity， with a decrease in the relative abundance of Lactobacillus and an increase in the relative abundances of Bacillus and Helicobacter. Compared with the model group， the ASV number and Alpha diversity were increased in the high-dose groups of RH and PRH， and there was a trend of regression of Beta diversity to the control group， the relative abundance of Lactobacillus increased， and the relative abundances of Bacillus and Helicobacter decreased. ConclusionRH and PRH can improve dysbacteriosis， promote immune system activation， inhibit the release of inflammatory factors for enhancing the gastrointestinal function， which may be one of the potential mechanisms of their therapeutic effect on constipation.

The neonatal mammalian heart has a remarkable regenerative capacity, while the adult heart has difficulty to regenerate. A metabolic reprogramming from glycolysis to fatty acid oxidation occurs along with the loss of cardiomyocyte proliferative capacity shortly after birth. In this study, we sought to determine if and how metabolic reprogramming regulates cardiomyocyte proliferation. Reversing metabolic reprogramming by carnitine palmitoyltransferase 1 (CPT1) inhibition, using cardiac-specific Cpt1a and Cpt1b knockout mice promoted cardiomyocyte proliferation and improved cardiac function post-myocardial infarction. The inhibition of CPT1 is of pharmacological significance because those protective effects were replicated by etomoxir, a CPT1 inhibitor. CPT1 inhibition, by decreasing poly(ADP-ribose) polymerase 1 expression, reduced ADP-ribosylation of dual-specificity phosphatase 1 in cardiomyocytes, leading to decreased p38 MAPK phosphorylation, and stimulation of cardiomyocyte proliferation. Our present study indicates that reversing metabolic reprogramming is an effective strategy to stimulate adult cardiomyocyte proliferation. CPT1 is a potential therapeutic target for promoting heart regeneration and myocardial infarction treatment.

Nuanjian Jian(Decoction for Warming Liver Meridian),originating from Jing Yue Quan Shu(Jingyue's Complete Works)written by Zhang Jingyue,is composed of Angelicae Sinensis Radix(Danggui),Lycii Fructus(Gouqizi),Poria(Fuling),Fructus Foeniculi(Xiaohuixiang),Cinnamomi Cortex(Rougui),Linderae Radix(Wuyao),and Aquilariae Lignum Resinatumd(Chenxiang)or Aucklandiae Radix(Muxiang).Nuanjian Jian is a widely-used classical formula for warming the liver and kidneys,promoting qi circulation and alleviating pain.It was included in the Ancient Classical Formulas Catalog(First Batch)published by the National Administration of Traditional Chinese Medicine in 2018,and was primarily used to treat lower abdominal pain,hernia,and other disorders differentiated as the syndrome of cold stagnation in the liver and kidneys.Based on the principles of key information verification for classical formulas,this article systematically reviewed the ancient and modern literature on Nuangan Jian,and conducted a comprehensive textual research and analysis of its origin,composition,dosage,method of making a decoction and taking medicines,processing,modifications,historical and modern applications,and experimental studies.The study concluded that the composition and dosage of this formula are relatively clear.The contemporary single-dose equivalents are calculated as Danggui 9.33 g,Gouqizi 11.19 g,Fuling 7.46 g,Xiaohuixiang 7.46 g,Rougui 5.60 g,Wuyao 7.46 g,and Chenxiang 3.73 g.The decoction is prepared by adding 300 mL of water and 4 g of ginger,boiling until reduced to 140 mL,and taken 2-3 times daily,2 hours after meals.Modern practitioners have expanded the indications of this formula,extending its use from hernia and lower abdominal pain to various disorders in andrology,gynecology,and gastroenterology.The indications have the core pathogenesis of cold stagnation in the liver meridian,and usually affect the liver while also involve the spleen,kidneys,and lower energizer.Diseases of the lower abdomen,genitals,and breasts belonging to the region of the liver-meridian route,are also commonly treated with Nuangan Jian.The findings of this study provide a reference for the further development of this classical formula.

Objective To study the relationship between irisin and the risk of sarcopenia in elderly patients with hyperhomocysteine-mia of different genders.Methods A retrospective study was conducted on 180 elderly patients with hyperhomocysteinemia who were ad-mitted to the Geriatrics Department of the First Hospital of Lanzhou University between January 2021 and January 2023.The study partici-pants were categorized into the male sarcopenia group(n=43)and the male non-sarcopenia group(n=57),the female sarcopenia group(n=44),and the female non-sarcopenia group(n=36)according to the《2019 Consensus Update on the Diagnosis and Treat-ment of Sarcopenia》.Serum irisin levels were measured by enzyme-linked immunosorbent assay,and the clinical data of patients in sar-copenia and non-sarcopenia groups were compared under different genders.Serum irisin concentrations were grouped into quartiles,and the differences in the indicators related to sarcopenia[appendicular skeletal muscle mass index(ASMI),grip strength,and step speed]were statistically assessed among the four groups using analysis of ANOVA or the Kruskal-Wallis test.Multifactorial Logistic regression a-nalysis was used to evaluate the influencing factors of sarcopenia in elderly patients with hyperhomocysteinemia of different genders.Results Among elderly male patients,there were statistically significant differences in age,irisin,hemoglobin,total protein,albumin,triglycerides,High-density lipoprotein cholesterol,ASMI and percent body fat between the sarcopenia group and the non-sarcopenia group(P＜0.05).Among elderly female patients,there were statistically significant differences in irisin,C-reactive protein,platelets count,uric acid,ASMI and percent body fat between the sarcopenia group and the non-sarcopenia group(P＜0.05).After statistical a-nalysis,it was found that the ASMI was significantly different between the irisin quartile groups of elderly male patients with hyperhomo-cysteinemia(P＜0.001);grip strength and step speed were significantly different between the irisin quartile groups of elderly female pa-tients with hyperhomocysteinemia(P=0.016,0.020).Multiple Logistic regression analysis showed that serum irisin(OR=0.951,95％CI:0.905-0.999)and percent body fat(OR=0.741,95％CI:0.641-0.857)were independent influences on the development of sarcopenia in elderly male patients with hyperhomocysteinemia(P＜0.05).Serum irisin(OR=0.942,95％CI:0.892-0.994),per-cent body fat(OR=0.698,95％CI:0.576-0.846),and platelet count(OR=1.013,95％CI:1.002-1.024)were independent influencing factors for sarcopenia in the elderly female patients with hyperhomocysteinemia(P＜0.05).Conclusion Elevated serum iri-sin and body fat percentage are independent protective factors against sarcopenia in elderly male and female patients with hyperhomocys-teinemia;elevated platelet count is an independent risk factor for sarcopenia in elderly female patients with hyperhomocysteinemia.