Objective To propose a lightweight end-to-end neural network model for automated Korotkoff sound phase recognition and subsequent blood pressure (BP) measurement, aiming to improve measurement accuracy and population adaptability. Methods We developed a streamlined architecture integrating depthwise separable convolution (DSConv), multi-head attention (MHA), and bidirectional gated recurrent unit (BiGRU). The model directly processes Korotkoff sound time-series signals to identify auscultatory phases. Systolic BP (SBP) and diastolic BP (DBP) were determined using phase Ⅰ and phaseⅤdetections, respectively. Given the clinical relevance of phase Ⅳ for specific populations (e.g., children and pregnant women, denoted as DBPⅣ), BP values from this phase were also recorded.Results The study enrolled 106 volunteers with 70 males and 36 females at mean age of (40.0±12.0) years. The model achieved 94.25% phase recognition accuracy. Measurement errors were (0.1±2.5) mm Hg (SBP), (0.9±3.4) mm Hg (DBPⅣ), and (0.8±2.6) mm Hg (DBP). Conclusion Our method enables precise phase recognition and BP measurement, demonstrating potential for developing population-adaptive blood pressure monitoring systems.

BACKGROUND:Micro-abrasion,at-home whitening combined with infiltration resin have a good effect on dental fluorosis,but the effect of this method on micro-cracks in dental fluorosis is still unclear. OBJECTIVE:To explore the effect of micro-abrasion,at-home whitening combined with infiltration resin on micro-cracked dental fluorosis. METHODS:(1)Clinical research:A total of 23 patients with micro-cracked dental fluorosis,including 255 micro-cracked dental fluorosis,were selected from July 2020 to March 2021 in the Department of Prosthodontics,Stomatology Hospital,Tianjin Medical University.All of them received combined treatment of tooth micro-abrasion,at-home whitening and infiltration resin.The tooth color,tooth sensitivity,and tooth pain threshold were compared before treatment and 1 week and 1 month after treatment.(2)In vitro experiment:60 teeth with fluorosis with at least one crack on the tooth surface were collected and randomly divided into three groups for treatment.The control group was treated without any treatment.The whitening group was treated with micro-abrasion and at-home whitening,and the combined group was treated with micro-abrasion,at-home whitening,and infiltration resin,with 20 teeth in each group.The microhardness of the three groups of teeth samples after treatment was measured. RESULTS AND CONCLUSION:(1)Clinical study:6 months after treatment,among 255 teeth with micro-cracked dental fluorosis,whitening treatment for 207 teeth was significantly effective and whitening treatment for 48 teeth was effective,and the overall treatment efficiency was 100%.With the extension of treatment time,the proportion of moderate and severe dental sensitivity showed a decreasing trend.At 6 months after treatment,255 teeth with dental fluorosis had no severe sensitivity,15 with moderate sensitivity,125 with mild sensitivity,and 115 with no sensitivity,and the difference was significant compared with the sensitivity before treatment(P<0.05).There was no significant difference in the threshold of tooth pain before treatment and 1 week and 6 months after treatment(P>0.05).(2)In vitro experiment:The tooth microhardness of the whitening group was lower than that of the control group and the combined group(P<0.05),but there was no significant difference between the control group and the combined group(P>0.05).(3)The results show that the methods of micro-abrasion,at-home whitening combined with infiltration resin have good clinical efficacy in the treatment of micro-cracked dental fluorosis.

OBJECTIVE: To investigate the regulatory effect of electroacupuncture (EA) at "Neiguan" (PC6) on mitochondrial autophagy in rats with myocardial ischemia-reperfusion injury (MIRI) at different phases (ischemia and reperfusion phases), and to explore the bidirectional regulatory effects of EA at "Neiguan" (PC6) and its potential mechanism. METHODS: Forty-five male SD rats were randomly divided into 6 groups according to the random number table method, namely, sham-operation group (n=9), model-A group (n=6), model-B group (n=9), EA-A1 group (n=6), EA-B1 group (n=6), and EA-B2 group (n=9). Except the rats in the sham-operation group, the MIRI model was established in the other groups with the physical ligation and tube pushing method. In the model-A group, the samples were collected directly after ligation, and in the model-B group, the samples were collected after ligation and reperfusion. In the EA-A1 group, EA was delivered while the ligation was performed, and afterwards, the samples were collected. In the EA-B1 group, while the ligation was performed, EA was operated at the same time, and after reperfusion, the samples were collected. In the EA-B2 group, during ligation and the opening of the left anterior descending branch of the coronary artery, EA was delivered, and after reperfusion, the samples were collected. EA was performed at bilateral "Neiguan" (PC6), with a disperse-dense wave, a frequency of 2 Hz/100 Hz, a current of 1 mA, and a duration of 30 min. HE staining was employed to observe the morphology of cardiomyocytes, TUNEL was adopted to detect the apoptosis of cardiomyocytes, transcriptome sequencing was to detect the differentially expressed genes in the left ventricle, JC-1 flow cytometry was to detect the mitochondrial membrane potential (MMP) of cardiomyocytes, Western blot was to detect the protein expression of phosphatase and tensin homolog-induced kinase 1 (Pink1), Parkin and p62 in the left ventricle of rats, and ELISA was to detect the levels of serum creatine kinase isoenzyme (CK-MB) and cardiac troponin I (cTn-I) in the rats. RESULTS: Compared with the sham-operation group, the cardiomyocytes of rats in the model-B group were severely damaged, with disordered arrangement, unclear boundaries, broken muscle fibers, edema and loose distribution; and the cardiomyocytes in the EA-B2 group were slightly damaged, the cell structure was partially unclear, the cells were arranged more regularly, and the intact cardiomyocytes were visible. Compared with the sham-operation group, the apoptosis of cardiomyocytes increased in the model-B group (P<0.001); and when compared with the model-B group, the apoptosis alleviated in the EA-B2 group (P<0.001). The differentially expressed genes among the EA-B2 group, the sham-operation group and the model-B group were closely related to cell autophagy and mitochondrial autophagy. Compared with the sham-operation group, MMP of cardiomyocytes was reduced (P<0.001), the protein expression of Pink1, Parkin, and p62 of the left ventricle and the levels of serum CK-MB and cTn-I were elevated in the model B group (P<0.001). In comparison with model-A group, the MMP of cardiomyocytes and the levels of serum CK-MB and cTn-I were reduced (P<0.001, P<0.05), and the protein expression of Pink1 in the left ventricle rose in the EA-A1 group (P<0.01). Compared with the model-B group, MMP of cardiomyocytes increased (P<0.001), the protein expression of Pink1, Parkin, and p62 of the left ventricle, and the levels of serum CK-MB and cTn-I decreased (P<0.001) in the EA-B1 group and the EA-B2 group. When compared with the EA-A1 group, MMP of cardiomyocytes increased (P<0.001), and the protein expression of Pink1, Parkin, and p62 of the left ventricle, and the levels of serum CK-MB and cTn-I decreased in the EA-B1 group (P<0.01). CONCLUSION EA at "Neiguan" (PC6) can ameliorate MIRI in rats, which may be achieved through the Pink1/Parkin-mediated mitochondrial autophagy pathway. EA can alleviate myocardial injury by enhancing mitochondrial autophagy at the ischemia phase, and it can reduce reperfusion injury by weakening mitochondrial autophagy at the reperfusion phase.
Animals ; Electroacupuncture ; Male ; Myocardial Reperfusion Injury/metabolism* ; Rats, Sprague-Dawley ; Rats ; Acupuncture Points ; Autophagy ; Humans ; Mitochondria/genetics*

Objective To investigate the relationship between serum cyclophilin A(CypA),ischemia modi-fied albumin(IMA),galectin-3(Gal-3)levels and oxidative stress and cognitive impairment(CI)in patients with acute cerebral infarction(ACI)complicated with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 168 patients with ACI complicated with OSAHS who were admitted to the hospital from December 2020 to October 2023 were selected,and the levels of serum CypA,IMA,Gal-3 and oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)]in patients with different severity(mild group,moderate group,severe group)were compared.The correlation between serum CypA,IMA,Gal-3 lev-els and oxidative stress indexes were analyzed by Pearson method.The incidence of CI in patients with ACI complicated with OSAHS were statistically analyzed,the levels of serum CypA,IMA and Gal-3 were com-pared between normal cognitive group and CI group,and the risk factors of CI in patients with ACI complicat-ed with OSAHS were analyzed by multivariate Logistic regression model.Results The levels of serum CypA,IMA,Gal-3 and MDA in mild group,moderate group and severe group increased in turn(P<0.05),and ser-um SOD level decreased in turn(P<0.05).Serum CypA,IMA and Gal-3 in ACI patients complicated with OSAHS were negatively correlated with SOD(P<0.05),and positively correlated with MDA(P<0.05).Of 168 ACI patients complicated with OSAHS,79 cases(47.02%)had CI and were included in the CI group.Compared with normal cognitive group,the serum levels of CypA,IMA and Gal-3 in CI group were signifi-cantly increased(P<0.05).Multivariate Logistic regression model analysis showed that apnea hypopnea in-dex(AHI)≥20 times/h,frontal and temporal lobe infarction,elevated CypA level,elevated IMA level,and el-evated Gal-3 level were risk factors for CI in ACI patients complicated with OSAHS(P<0.05).Conclusion The high expression of serum CypA,IMA and Gal-3 in patients with ACI complicated with OS-AHS is significantly correlated with oxidative stress and CI.The increase of serum CypA,IMA and Gal-3 lev-els indicates an increased risk of CI in patients with ACI complicated with OSAHS,and early detection of the three has good clinical value in evaluating the condition of patients with ACI complicated with OSAHS.

Objective To analyze the prevalence of dengue fever in Guangzhou based on circuit-qi theory.Methods Data on dengue fever cases in Guangzhou from January 21,2012,to January 19,2024 were collected.And then the incidence of dengue fever was analyzed under the circuit-qi conditions of dominant qi,guest qi,celestial qi,joining of guest qi with dominant qi,and dissimilation of circuit and qi.Results Higher incidence of dengue fever in Guangzhou was presented under the circuit-qi conditions of the fifth qi of the dominant qi in each year,shaoyang minister fire of the guest qi,shaoyin monarch fire of the celestial qi,guest qi restricting dominant qi in the joining of guest qi with dominant qi,shaoyang minister fire(guest qi)joining with yangming dry-metal(dominant qi)in the pattern of guest qi restricting dominant qi.The outbreak of dengue fever under the circuit-qi conditions of dissimilation of circuit and qi showed no statistically significant difference.Conclusion Over the 12-year period from 2012 to 2024,the prevalence of dengue fever in Guangzhou exhibited a 4-5-year cyclical pattern,often with consecutive outbreaks over two years.The prevalence of dengue fever in Guangzhou is associated with the factors of dampness and heat in the theory of five circuits and six qi,while has less relation with dissimilation of circuit and qi.

Objective To explore the relationship between the coagulation and fibrinolysis function in the early pregnancy and the occurrence of gestational diabetes mellitus(GDM)in women with different pre pregnancy body mass indexes(BMI).Methods 290 pregnant women undergoing the prenatal check ups at the Second Affiliated Hospital of Kunming Medical University from September 2023 to February 2024 were selected.Pre pregnancy BMI,age,family genetic history,parity,parity,and early pregnancy coagulation and fibrinolysis function test results were collected.Based on whether GDM had occurred,they were divided into GDM group(n=72)and non GDM group(n=218),and further divided into low weight GDM group(n=8),low weight non GDM group(n=29),normal weight GDM group(n=39),normal weight non GDM group(n=145),overweight/obesity GDM group(n=25),overweight/obesity non GDM group(n=44)based on pre pregnancy BMI.Basic data comparison was conducted on the total population and BMI groups.Independent sample t-test or Mann Whitney U test was used for quantitative data,and chi square test or Fisher's exact probability method was used for qualitative data.Multivariate logistic regression was used to correct the influencing factors.Results After adjusting the confounding factors such as age,family history,and pre pregnancy BMI,APTT was negatively correlated with the occurrence of GDM in the overall population(P<0.05,OR=0.840),while FIB was positively correlated with GDM(P<0.01,OR=2.598).In low body weight recombination,APTT was negatively correlated with GDM(P<0.05,OR=0.483),FIB was positively correlated with GDM(P<0.05,OR=82.501),while there was no significant correlation between APTT,FIB and GDM after adjusting the age,family history,and pre pregnancy BMI;In the normal weight group,APTT was negatively correlated with GDM(P<0.01,OR=0.786)and FIB was positively correlated with GDM(P<0.05,OR=2.413).However,after adjusting the age,family history,and pre pregnancy BMI,APTT remained negatively correlated with GDM(P<0.05,OR=0.812)and FIB remained positively correlated with GDM(P<0.05,OR=2.391);In the overweight/obese group,TT was negatively correlated with GDM(P<0.05,OR=0.510),while there was no significant correlation between TT and GDM after adjusting the age,family history,and pre pregnancy BMI.Conclusion In the normal weight population,APTT is negatively correlated with the occurrence of GDM,while FIB is positively correlated with the occurrence of GDM;In the low weight and overweight/obese populations,coagulation and fibrinolysis related indicators are greatly influenced by BMI and have no significant correlation with the occurrence of GDM.

ObjectiveTo clarify the relationship between intestinal flora and intestinal motility in rats with slow transit constipation （STC） and qi stagnation syndrome by conducting a pseudo-sterile experiment and fecal microbiota transplantation （FMT） technology. MethodsTwenty-four Wistar rats were randomly divided into normal group （n=6）， STC with qi stagnation pattern group （n=6） and pseudo-sterile group （n=12）. In the STC group with qi stagnation pattern， 3 mg/kg of loperamide suspension by intragastric administration combined with tail clamping stimulation were performed to establish the rat model of STC with qi stagnation pattern. After successful modeling， fresh feces from the rats in the STC with qi stagnation pattern group and the normal group were collected to prepare 100 mg/ml of fecal bacterial suspension. In the pseudo-sterile group， the antibiotic cocktail method was used （a mixed antibiotic suspension containing bacitracin， streptomycin sulfate， and neomycin sulfate at 20 mg/ml each was administered intragastrically） to establish pseudo-sterile rats model. After successful modeling， the rats were randomly divided into normal fecal bacterial liquid group and STC with qi stagnation pattern fecal bacterial liquid group， with six rats in each group， and then were given 10 ml/kg of the prepared corresponding rat fecal bacterial suspension by gavage. Rats in STC with qi stagnation pattern group were given an equal volume of sterile water by gavage. All groups were administered once a day for 7 consecutive days. The small intestinal propulsion rate of the STC with qi stagnation pattern group， the normal fecal bacterial liquid group， and STC with qi stagnation pattern fecal bacterial liquid group were compared. ELISA method was used to detect serum 5-hydroxytryptamine （5-HT） levels. Immunohistochemistry was used to detect the positive expression levels of 5-hydroxytryptamine 3 receptor （5-HT3R） and 5-hydroxytryptamine 4 receptor （5-HT4R） in colon tissue. Western blot method was used to detect the protein expression levels of tryptophan hydroxylase 1 （TPH1）， tryptophan hydroxylase 2 （TPH2）， serotonin transporter （SERT）， and monoamine oxidase A （MAO-A） in colon tissue. ResultsCompared to those in the normal fecal bacterial liquid group， the small intestinal propulsion rate， serum 5-HT level， positive expression of 5-HT3R and 5-HT4R in colon tissue， and protein expression of TPH1， TPH2， SERT and MAO-A significantly decreased in the STC with qi stagnation pattern group and STC with qi stagnation pattern fecal bacterial liquid group （P＜0.05）. There was no statistically significant difference in the indicators between the STC with qi stagnation pattern group and STC with qi stagnation pattern fecal bacterial liquid group （P＞0.05）. ConclusionThe intestinal flora in STC rats with qi stagnation pattern can lead to a slowdown in intestinal transmission function， whose mechanism may be related to intestinal motility disorders affected by the synthesis， transport， metabolism and other pathways of 5-HT.

Objective To explore the feasibility and short-term clinical efficacy of single segment thora-columbar tuberculosis treated with one-stage posterior approach lamina-sparing decompression.Methods A total of 11 patients with single segment thoracolumbar tuberculosis who underwent one-stage posterior ap-proach preservation of vertebral plate lesion removal,bone graft fusion,and internal fixation treatment in this hospital from September 2021 to June 2022 were selected.C-reactive protein(CRP)and erythrocyte sedimen-tation rate(ESR)were monitored to evaluate tuberculosis bacteremia and activity control,visual analogue scale(VAS)score and Oswestry disability index(ODI)were followed up to evaluate the improvement of clin-ical function,and the American Spinal Injury Association(ASIA)injury scale was used to evaluate neurologi-cal function,and the correction of kyphosis was followed up.Results All 11 patients were fully followed up.The average surgical duration is(270.91±45.98)minutes,and the average surgical bleeding is(522.72± 194.11)mL.During the follow-up period,none of the 11 patients experienced tuberculosis recurrence,and all 11 patients achieved bone graft fusion.The fusion time was 6-9 months after surgery with an average of(7.36±1.12)months.Two patients with preoperative nerve damage recovered after surgery.During the fol-low-up period,11 patients did not experience any complications related to surgery.The average CRP,ESR,ODI score,and VAS score of postoperative patients decreased compared to preoperative levels,and further de-creased at 12 months after surgery;The patient's kyphosis caused by thoracolumbar tuberculosis was correc-ted,and no obvious angle loss was found at the last follow-up(P＞0.05).Conclusion One-stage posterior ap-proach lamina-sparing decompression is a safe and effective method for treating single segment thoracolumbar tuberculosis.