General anesthesia, pivotal for surgical procedures, requires precise depth monitoring to mitigate risks ranging from intraoperative awareness to postoperative cognitive impairments. Traditional assessment methods, relying on physiological indicators or behavioral responses, fall short of accurately capturing the nuanced states of unconsciousness. This study introduces a machine learning-based approach to decode anesthesia depth, leveraging EEG data across different anesthesia states induced by propofol and esketamine in rats. Our findings demonstrate the model's robust predictive accuracy, underscored by a novel intra-subject dataset partitioning and a 5-fold cross-validation method. The research diverges from conventional monitoring by utilizing anesthetic infusion rates as objective indicators of anesthesia states, highlighting distinct EEG patterns and enhancing prediction accuracy. Moreover, the model's ability to generalize across individuals suggests its potential for broad clinical application, distinguishing between anesthetic agents and their depths. Despite relying on rat EEG data, which poses questions about real-world applicability, our approach marks a significant advance in anesthesia monitoring.
Animals ; Machine Learning ; Electroencephalography/methods* ; Ketamine/administration & dosage* ; Rats ; Male ; Propofol/administration & dosage* ; Rats, Sprague-Dawley ; Anesthesia, General/methods* ; Brain/physiology* ; Intraoperative Neurophysiological Monitoring/methods*

Objective To explore the mediating effect of hope between self-perceived burden and quality of life in patients with recurrent malignant tumors.Methods A cross-sectional survey was conducted using convenience sampling,selecting 204 patients with recurrent malignant tumors from the Oncology Department of Xiangyang Central Hospital in Hubei Province from September to December 2023.A general information questionnaire,Self-Perceived Burden Scale(SPBS),hope level(HHI),and EORTC QLQ-C30 quality of life questionnaire were utilized for the investigation.Results The SPBS score for patients with recurrent malignant tumors was(28.28±8.92),the HHI score was(35.83±4.30)and the quality of life score was(59.68±23.96).Self-perceived burden was negatively correlated with hope and quality of life(P<0.05;P<0.01),while hope was positively correlated with quality of life(P<0.01).The mediating effect of hope between the burden of self-perception and quality of life is reflected,with the indirect effect accounting for 21.18%of the total effect.Conclusion Patients with recurrent malignant tumors generally have a low quality of life and moderate levels of hope,both of which require improvement.The self-perceived burden of patients is at a mild to moderate level.Healthcare professionals should take effective measures to enhance patients'levels of hope and reduce their self-perceived burden,thereby improving the quality of life for patients with recurrent malignant tumors.

ObjectiveTo explore the diagnostic-therapeutic course and epidemiological characteristics of the first imported kala-azar case reported in Changning District of Shanghai, so as to provide references for early detection, timely diagnosis, and effective management of the kala-azar cases in non-epidemic areas. MethodsIn 2025, a comprehensive epidemiological investigation and a complete collection of clinical records of one kala-azar patient imported from other provinces reported by a medical institution in this city were conducted. The source of infection, process of diagnosis and treatment, and clinical outcome of the case were systematically analyzed. ResultsThe case was a male migrant worker from Shanxi Province currently residing in Shanghai. In June 2023, the patient had a history of exposure to mosquito bites during his stay in a kala-azar endemic area. The initial onset occurred in December 2023, with clinical manifestations including unexplained fever accompanied by leukopenia, and subsequently gradually developed night sweats and fatigue during the following months. In June 2024, the patient self-perceived significant weight loss, and physical examination revealed hepatomegaly and splenomegaly, leading to a diagnosis of hemophagocytic syndrome (HPS). Throughout the whole course of the illness, the patient sought treatment at hematology departments of several hospitals multiple times, where he was managed as a case of HPS. In January 2025, a large number of Leishmania donovani were detected in the patient's bone marrow smear, confirming kala-azar. After 2 weeks of standardized treatment with amphotericin B liposomal, there was significant improvement. Combined with the epidemiological investigation, it was speculated that the incubation period of this case was about 6 months, whereas the interval from initial onset to definite diagnosis was approximately 14 months. ConclusionKala-azar has atypical early clinical symptoms, which are prone to confusion with HPS. For patients with recurrent unexplained fever accompanied by peripheral cytopenias, hepatomegaly and splenomegaly, medical institutions should consider the possibility of infectious diseases. Close collaboration between medical institutions and centers for disease control and prevention is essential to conduct a detailed epidemiological investigation and laboratory screening, ensuring confirmed cases receive standardized treatment.

Objective:To explore the correlation among SMAD4 gene polymorphisms, early life traumatic experience and their interactions with clinical feature of obsessive-compulsive disorder (OCD). Methods:Totally 484 OCD patients who met the DSM-Ⅳ diagnostic criteria and 368 health controls who met the enrollment criteria were recruited from September 2013 to September 2018. The Yale-Brown obsessive-compulsive scale (Y-BOCS) was used to assess the severity of obsessive-compulsive symptoms, the Beck depression inventory Ⅱ (BDI-Ⅱ) was used to assess the severity of depressive symptoms, the Beck anxiety inventory (BAI) was used to assess the severity of anxiety symptoms, and early trauma inventory-short form (ETI-SF) was used to assess early traumatic experience. SMAD4: rs12452684, rs2276163, rs17663887 and rs3819122 were genotyped using the Taqman genotyping technique. Data were analyzed using SPSS 20.0 software, and comparisons among groups were performed using chi-square test, t-test, Mann-Whitney U non-parametric test and analysis of covariance. Correlation was analyzed using Spearman correlation analysis, and interactions were analyzed using general linear model. Results:All sites except rs17663887 met the Hardy-Weinberg equilibrium (rs12452684: χ2=0.29, P=0.59; rs2276163: χ2=2.58, P=0.11; rs3819122: χ2=0.22, P=0.64).Allele, genotype frequencies of SMAD4: rs12452684, rs2276163 and rs3819122 were not statistically significant between the OCD and the health control groups ( χ2=0.02, 1.20, 0.04, all P>0.05; χ2=1.85, 3.98, 1.45, all P>0.05). The results of covariance analysis (corrected for age and gender) showed that there were significantly differences in compulsion (CC: 12.47±4.23, CT: 12.53±4.15, TT: 13.97±3.11; AA: 12.63±4.08, AC: 12.49±4.19, CC: 13.87±2.93) and total Y-BOCS scores(CC: 25.31±6.42, CT: 25.68±5.90, TT: 27.75±6.01; AA: 25.54±6.52, AC: 25.56±5.98, CC: 27.63±5.75) among the three genotypes of the SMAD4: rs2276163 and rs3819122 between the two groups ( F=3.58, 3.87, 3.48, 3.73, all P<0.05). Emotional abuse in the ETI-SF was positively correlated with obsession and total Y-BOCS scores( r=0.14, 0.14, both P<0.05). The interactions of rs2276163, rs3819122 and emotional abuse were associated with obsession scores ( F=4.65, 3.63, 2.93, all P<0.01). Conclusions:The more emotional abuse experienced in early life, the more severe obsessive-compulsive symptoms, and the interaction between the SMAD4 gene and early traumatic experience is involved in the development of OCD.

Objective: To determine the clinical efficacy and mechanism of Piwei Peiyuan Pill (PPP) combined with moxibustion for treating patients with chronic atrophic gastritis (CAG) with spleen and stomach weakness syndrome. Methods: Ninety-six CAG patients with spleen and stomach weakness syndrome who met the inclusion and exclusion criteria were enrolled at the Department of Spleen and Stomach Diseases of the Second Affiliated Hospital of Anhui University of Chinese Medicine from June 2022 to December 2023. The patients were randomly divided into a control, a Chinese medicine, and a combined group using a random number table method, with 32 cases in each group (two cases per group were excluded). The control group was treated with rabeprazole combined with folic acid tablets (both thrice daily), the Chinese medicine group was treated with PPP (8 g, thrice daily), and the combined group was treated with moxa stick moxibustion (once daily) on the basis of the Chinese medicine group for 12 consecutive weeks. Gastric mucosa atrophy in the three groups was observed before and after treatment. The gastric mucosal pathological score was evaluated. The Patient Reported Outcome (PRO) scale was used to evaluate the patients′ physical and mental health status and quality of life.An enzyme-linked immunosorbent assay was used to detect serum tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-4, IL-10, IL-37, and transforming growth factor (TGF)-β levels in each group. Real-time fluorescence PCR was used to detect the relative expression levels of signal transducer and activator of transcription 3 (STAT3) and mammalian target of rapamycin (mTOR) mRNA in each group. Western blotting was used to detect the relative expression levels of proteins related to the STAT3/mTOR signaling pathway, and the adverse drug reactions and events were recorded and compared. Results: There was no statistical difference in age, gender, disease duration, family history of gastrointestinal tumors, alcohol consumption history, and body mass index among the three groups of patients.The total therapeutic efficacy rates of the control, Chinese medicine, and combined groups in treating gastric mucosal atrophy were 66.67% (20/30), 86.67% (26/30), and 90.00% (27/30), respectively (P<0.05). Compared to before treatment, the pathological and PRO scale scores of gastric mucosa in each group decreased after treatment, and TNF-α, IL-1β, IL-37, and TGF-β levels decreased. The relative STAT3 and mTOR mRNA expression levels, as well as the relative STAT3, p-STAT3, mTOR, and p-mTOR protein expression levels decreased (P<0.05), whereas the IL-4 and IL-10 levels increased (P<0.05). After treatment, compared to the control group, the pathological score of gastric mucosa, PRO scale score, TNF-α, IL-1β, IL-37, TGF-β content, relative STAT3 and mTOR mRNA expression levels, and relative STAT3, p-STAT3, mTOR, and p-mTOR protein expression levels in the Chinese medicine and combined groups after treatment were reduced (P<0.05), whereas the IL-4 and IL-10 levels increased (P<0.05). After treatment, compared to the Chinese medicine group, the combined group showed a decrease in relative STAT3, mTOR mRNA expression levels, and STAT3, p-STAT3, mTOR, and p-mTOR protein expression levels (P<0.05). Conclusion The combination of PPP and moxibustion may regulate the inflammatory mechanism of the body by inhibiting the abnormal activation of the STAT3/mTOR signaling pathway, upregulating related anti-inflammatory factor levels, downregulating pro-inflammatory factor expression, and increasing related repair factor expression, thereby promoting the recovery of atrophic gastric mucosa, reducing discomfort symptoms, and improving the physical and mental state of CAG patients with spleen and stomach weakness syndrome.

Objective:To explore the correlation among SMAD4 gene polymorphisms, early life traumatic experience and their interactions with clinical feature of obsessive-compulsive disorder (OCD). Methods:Totally 484 OCD patients who met the DSM-Ⅳ diagnostic criteria and 368 health controls who met the enrollment criteria were recruited from September 2013 to September 2018. The Yale-Brown obsessive-compulsive scale (Y-BOCS) was used to assess the severity of obsessive-compulsive symptoms, the Beck depression inventory Ⅱ (BDI-Ⅱ) was used to assess the severity of depressive symptoms, the Beck anxiety inventory (BAI) was used to assess the severity of anxiety symptoms, and early trauma inventory-short form (ETI-SF) was used to assess early traumatic experience. SMAD4: rs12452684, rs2276163, rs17663887 and rs3819122 were genotyped using the Taqman genotyping technique. Data were analyzed using SPSS 20.0 software, and comparisons among groups were performed using chi-square test, t-test, Mann-Whitney U non-parametric test and analysis of covariance. Correlation was analyzed using Spearman correlation analysis, and interactions were analyzed using general linear model. Results:All sites except rs17663887 met the Hardy-Weinberg equilibrium (rs12452684: χ2=0.29, P=0.59; rs2276163: χ2=2.58, P=0.11; rs3819122: χ2=0.22, P=0.64).Allele, genotype frequencies of SMAD4: rs12452684, rs2276163 and rs3819122 were not statistically significant between the OCD and the health control groups ( χ2=0.02, 1.20, 0.04, all P>0.05; χ2=1.85, 3.98, 1.45, all P>0.05). The results of covariance analysis (corrected for age and gender) showed that there were significantly differences in compulsion (CC: 12.47±4.23, CT: 12.53±4.15, TT: 13.97±3.11; AA: 12.63±4.08, AC: 12.49±4.19, CC: 13.87±2.93) and total Y-BOCS scores(CC: 25.31±6.42, CT: 25.68±5.90, TT: 27.75±6.01; AA: 25.54±6.52, AC: 25.56±5.98, CC: 27.63±5.75) among the three genotypes of the SMAD4: rs2276163 and rs3819122 between the two groups ( F=3.58, 3.87, 3.48, 3.73, all P<0.05). Emotional abuse in the ETI-SF was positively correlated with obsession and total Y-BOCS scores( r=0.14, 0.14, both P<0.05). The interactions of rs2276163, rs3819122 and emotional abuse were associated with obsession scores ( F=4.65, 3.63, 2.93, all P<0.01). Conclusions:The more emotional abuse experienced in early life, the more severe obsessive-compulsive symptoms, and the interaction between the SMAD4 gene and early traumatic experience is involved in the development of OCD.

AIM:To compare the differences of ocular biometric parameters of age-related cataract between Tibetan and Han ethnic groups, and to analyze the distribution characteristics of ocular biometric parameters in Tibetan cataract patients.METHODS:Retrospective cohort study. A total of 661 patients(1 030 eyes)with age-related cataract confirmed in the hospital between January 2019 and December 2020 were enrolled. The parameters of axial length, anterior chamber depth, keratometry, corneal astigmatism and astigmatic axis were measured by IOL Master 500 in 483 cases(739 eyes)of Tibetan age-related cataract patients and 178 cases(291 eyes)of Han patients.RESULTS:The axial length, anterior chamber depth and corneal astigmatism of the Tibetan patients with age-related cataract were 23.33(22.81, 23.86)mm, 3.04(2.79, 3.30)mm and 0.73(0.47, 1.07)D. The mean keratometry was 43.89±1.35 D. The results indicated that Tibetan cataract patients had shorter axial lengths and smaller keratometry compared to Han patients(all P<0.05). Age in Tibetan patients was negatively correlated with axial length and anterior chamber depth, and positively correlated with keratometry(all P<0.05). Tibetan male patients had longer axial lengths, deeper anterior chambers, and flatter corneas compared to female patients(all P<0.05).CONCLUSION:There were differences in ocular biometric parameters between age-related cataract patients of Tibetan and Han ethnicities. The distribution of ocular biometric parameters in Tibetan cataract patients varied across different age groups and gender groups.

Background Comorbid attention-deficit/hyperactivity disorder(ADHD)and emotional dysregulation may represent a distinct subtype of ADHD,which is characterized by an increased risk of anxiety or depressive disorder and a poor clinical prognosis,so research is urgently required to explore its unique executive functioning profile and clinical characteristics.However,there is limited research comparing the clinical symptoms and executive function in children with ADHD in terms of the presence or absence of emotional dysregulation.Objective To explore the executive function and clinical characteristics of ADHD children with emotional dysregulation.Methods From June 2020 to December 2023,118 children aged 7 to 12 with ADHD attending the Mental Health Center of West China Hospital,Sichuan University and fulfilling the Diagnostic and Statistical Manual of Mental Disorders,fifth edition(DSM-5)diagnostic criteria were enrolled.Children were classified into emotional dysregulation group(n=68)and non-emotional dysregulation group(n=50)based on the standard T-scores of Achenbach's Child Behavior Checklist(CBCL)-anxious/depressed,aggressive behavior and attention problems subscales.All children were then subjected to complete the Chinese version of Swanson Nolan and Pelham,Version IV Scale-parent form(SNAP-IV),Chinese Wechsler Intelligence Scale for Children(C-WISC),Weiss Functional Impairment Scale-Parent form(WFIRS-P)and 4 tests of the Cambridge Neuropsychological Test Automated Battery(CANTAB):①Stockings of Cambridge(SOC)testing spatial planning.②Intradimensional-extradimensional Set Shifting(IED)testing cognitive/attentional flexibility,adjusting the total errors across the task.③Spatial Working Memory(SWM)testing spatial working memory.④Rapid Visual Information Processing(RVP)testing sustained attention.Results The SNAP-IV Inattention,Hyperactivity/Impulsivity and Oppositional Defiant Disorder domain scores and total score were all higher in emotional dysregulation group compared with non-emotional dysregulation group(t=3.206,5.088,6.316,6.553,P<0.01).The WFIRS-P family,school learning,life skills,self-concept,social activities and risky activities domain scores and total score were all higher in emotional dysregulation group compared with non-emotional dysregulation group(t=6.074,4.406,4.143,3.984,6.575,6.662,8.254,P<0.01).In CANTAB,emotional dysregulation group made more total adjusted errors across the IED task compared with non-emotional dysregulation group(t=2.168,P<0.05).Conclusion Children with ADHD who exhibit emotional dysregulation have been observed to experience more severe core symptoms,impaired social functioning and poorer performance on tests assessing executive function,particularly in the area of cognitive flexibility.

Objective To analyse the hot topics(CKD)frontiers,and of blood pressure monitoring in research of chronic kidney disease(CKD)at home and abroad,and provide references for future research in this field.Methods Articles on blood pressure monitoring in published in Web of Science,China Knowledge Network Infrastructure(CNKI),Wanfang(Wanfang Data)and China Science and Technology Journal Database(VIP)from 2011 to 2022 were searched,and CiteSpace 5.8.R3 visual analysis software was employed to analyse the number of articles involved,country,institution,keyword co-occurrence.The analysis was performed on the number of published papers,countries,institutions,keyword co-occurrence atlas,high frequency subject terms,keyword emergence and emergence of literatures.Results ① A total of 504 articles in English and 72 articles in Chinese were extracted from the literature search.Annual distribution of the number of articles generally showed a continuous upward trend,in which 2 peaks of articles were formed in 2016 and 2018;the main country of issuance was the United States,and the main institution of issuance was the Aristotle University of Thessaloniki,Greece;② In the analysis of keyword co-occurrence,8 high-frequency keywords with a word frequency greater than or equal to 30 were identified.It indicated that the research hotspots mainly focused on the classification of hypertension,the characteristics of blood pressure circadian rhythm,the management of cardiovascular disease and the prediction of death and prognosis in the blood pressure monitoring of CKD;③ Further testing of the emergent terms and emergent literatures yielded 23 strongest emergent terms and 11 emergent literatures,which went through three stages of development,namely,early,intermediate and latest.It was found that the research gradually shifted from the application of blood pressure monitoring in the assessment and diagnosis of kidney disease to the treatment,management and prognostic assessment of hypertension in CKD Conclusion The importance of blood pressure monitoring in the management of hypertension in CKD has received increasing attention from researchers,and future researches should focus on using different blood pressure monitoring schemes to enhance the assessment of cardiovascular risks and the individualised management of hypertension.

Deep brain stimulation(DBS)has become an established technique for the treatment of neurodegenerative diseases such as Parkinson disease(PD).This technique significantly improves the clinical symptoms of PD patients by directly stimulating specific basal ganglia nuclei with implanted electrodes,but its physiological mechanism of action remains unclear.The control mechanisms of eye movement involve the cerebral cortex and basal ganglia,which are extensively overlapped with the targeted network of DBS,but there are relatively few studies on the combined analysis of DBS and eye movement.This article explores the interaction mechanism between DBS and eye movement control to deeply understand the influence of DBS on eye movement function,which is of great significance for optimizing stimulation parameters and improving therapeutic effect.In addition,these studies provide new perspectives for revealing the mechanism of action of DBS and the pathophysiology of PD.