Objective To establish the functional constipated mouse model by compound diphenoxylate, and explore the anti-constipation effect of black garlic polysaccharide. Methods Mouse small intestine ink propulsion experiment and mouse defecation experiment were carried out respectively. The mice in each experiment were randomly divided into blank group, model group, positive group and black garlic polysaccharide （0.25, 0.5, 1 g/kg） groups. Mice in blank group and model group were given distilled water, and in positive group were given lactulose oral solution. Compound diphenoxylate （5 mg/kg） was intragastric administrated after 1 week of administration, and small intestine propulsion experiment and defecation experiment were conducted respectively. Results Compared with model group, intestinal propulsion rate of black garlic polysaccharide groups was significantly increased and first dejection time was significantly shorten, and the number, weight and fecal water content increased significantly at 6 h in middle and high dose groups. Conclusion Black garlic polysaccharide could promote intestinal propelling, shorten defecation time and increase fecal water content.

OBJECTIVE To evaluate the cost-effectiveness of different sequential treatment regimens for human epidermal growth factor receptor 2 （HER-2）-positive advanced gastric cancer from the perspective of the Chinese health system. METHODS Survival data were obtained from the ToGA， WJOG 4007 and RAINBOW-Asia trials， and adjusted using network meta-analysis. A four-state Markov model was constructed to evaluate the cost-effectiveness of six treatment sequences， with a lifetime simulation horizon and a cycle period of 4 weeks （28 d）， and the main output parameters of the model included total costs， quality-adjusted life year （QALY）， and incremental cost-effectiveness ratio （ICER）. Sensitivity analysis was conducted to test the robustness of the basic analysis results， and a price reduction scenario analysis for trastuzumab was performed. RESULTS Compared with chemotherapy sequentially treated with paclitaxel， the ICER of trastuzumab combined with chemotherapy sequentially treated with paclitaxel， or irinotecan， or ramucirumab plus paclitaxel were 349 845.25， 772 410.64， and 2 510 470.39 yuan/QALY， respectively， all exceeding three times China’s 2023 per capita gross domestic product （GDP） （268 074 yuan/QALY） as the willingness-to-pay （WTP） threshold. This indicated that chemotherapy sequential paclitaxel was the optimal treatment regimen. The sensitivity analysis confirmed the robustness of the basic analysis. The scenario analysis showed that when trastuzumab was reduced by more than 20%， trastuzumab combined with chemotherapy sequentially treated with paclitaxel became cost-effective under this study’s WTP threshold. CONCLUSIONS When using three times China’s 2023 per capita GDP as the WTP threshold， chemotherapy sequentially treated with paclitaxel is the optimal regimen for HER-2 positive advanced gastric cancer， with trastuzumab combined with chemotherapy sequentially treated with paclitaxel as the second best option. With enhanced medical insurance optimization， trastuzumab combined with chemotherapy sequentially treated with paclitaxel is expected to become the most cost-effective treatment regimen.

This study established the HPLC fingerprints and a multi-component content determination method for Bidens pilosa var. radiata and B. pilosa and conducted comprehensive evaluation by integrating fingerprint similarity comparison, cluster analysis(CA), and principal component analysis(PCA), aiming to provide a reference for the establishment of quality standards for Bidentis Herba. HPLC was launched on an Agilent Poroshell 120 EC-C_(18) chromatographic column(4.6 mm×250 mm, 4 μm) by gradient elution with a mobile phase of 0.1% aqueous phosphoric acid-acetonitrile at a flow rate of 0.7 mL·min~(-1), detection wavelength of 270 nm, column temperature of 25 ℃, and an injection volume of 5 μL. The fingerprint similarity of 20 batches of Bidentis Herba ranged from 0.775 to 0.979. A total of 20 common peaks were identified, and seven components were confirmed through comparison with reference substances: neochlorogenic acid, chlorogenic acid, isochlorogenic acid A, isochlorogenic acid B, isochlorogenic acid C, rutin, and hyperoside. These seven components exhibited good linearity within the ranges of 3.4-67.4, 33.0-660.3, 26.6-531.2, 3.5-70.5, 6.2-124.9, 2.4-48.3, and 4.6-91.5 μg·mL~(-1), respectively, with correlation coefficients(r) greater than 0.999. The average recovery rates ranged from 96.47% to 104.6%. CA and PCA classified the 20 batches of Bidentis Herba into two categories. PCA yielded two principal components, with a cumulative variance contribution rate of 80.557%. The established HPLC fingerprints and multi-component content determination method are simple and accurate, providing a scientific basis for the quality control and quality standard formulation of Bidentis Herba.
Chromatography, High Pressure Liquid/methods* ; Drugs, Chinese Herbal/chemistry* ; Quality Control ; Chemometrics/methods* ; Bidens/chemistry* ; Principal Component Analysis

This study established the HPLC fingerprints, characteristic chromatograms, and a multi-component content determination method for Bidens bipinnata and B. biternata. The chemical pattern recognition analysis was then employed to clarify the characteristic indexes of quality differences between the two original plants of Bidentis Herba, providing a reference for establishing the quality standards of Bidentis Herba. HPLC was launched on an Agilent Poroshell 120 EC-C_(18) chromatographic column(4.6 mm×250 mm, 4 μm) by gradient elution with a mobile phase of 0.1% aqueous phosphoric acid-acetonitrile at a flow rate of 0.7 mL·min~(-1), detection wavelength of 270 nm, column temperature of 25 ℃, and an injection volume of 5 μL. The similarity between the fingerprints of 18 batches of Bidentis Herba samples and the common pattern(R) ranged from 0.572 to 0.933. A total of 23 chromatographic peaks were calibrated. Through comparison with the reference substances, six components(neochlorogenic acid, chlorogenic acid, isochlorogenic acid A, isochlorogenic acid B, rutin, and hyperoside) were identified and subjected to quantitative analysis. The characteristic fingerprints of B. bipinnata and B. biternata were calibrated with 20 and 17 characteristic peaks, respectively. Among them, peaks 8, 9, 22, and 23 were the characteristic peaks of B. bipinnata, and peak 7 was the characteristic peak of B. biternata, which can be used to distinguish the two original plants of Bidentis Herba. The relative standard deviation of the content of the above-mentioned six components ranged from 36% to 123%. The cluster analysis, principal component analysis, and orthogonal partial least squares-discriminant analysis(OPLS-DA) classified the 18 batches of Bidentis Herba samples into two categories. Additionally, through the analysis of variable importance in projection(VIP) under OPLS-DA, three characteristic indexes, rutin, isochlorogenic acid A, and isochlorogenic acid B, were identified. The analytical method established in this study can comprehensively evaluate the consistency of Bidentis Herba samples derived from different original plants, specifically identify the differential components between them, and effectively distinguish the two original plants of Bidentis Herba, providing a basis for the differentiation between different original plants and the quality control of Bidentis Herba.
Chromatography, High Pressure Liquid/methods* ; Drugs, Chinese Herbal/chemistry* ; Quality Control ; Bidens/chemistry*

Heart rate is a crucial indicator of human health with significant physiological importance. Traditional contact methods for measuring heart rate, such as electrocardiograph or wristbands, may not always meet the need for convenient health monitoring. Remote photoplethysmography (rPPG) provides a non-contact method for measuring heart rate and other physiological indicators by analyzing blood volume pulse signals. This approach is non-invasive, does not require direct contact, and allows for long-term healthcare monitoring. Deep learning has emerged as a powerful tool for processing complex image and video data, and has been increasingly employed to extract heart rate signals remotely. This article reviewed the latest research advancements in rPPG-based heart rate measurement using deep learning, summarized available public datasets, and explored future research directions and potential advancements in non-contact heart rate measurement.
Humans ; Deep Learning ; Heart Rate/physiology* ; Photoplethysmography/methods* ; Video Recording ; Face ; Monitoring, Physiologic/methods* ; Signal Processing, Computer-Assisted

OBJECTIVES: To study the risk factors for hypoxemia in children with severe Mycoplasma pneumoniae pneumonia (SMPP). METHODS: A retrospective collection of clinical data from children diagnosed with SMPP at the Third Affiliated Hospital of Zhengzhou University from June to December 2023 was conducted. The patients were categorized into hypoxemia and non-hypoxemia groups. Logistic regression analysis was used to assess the risk factors for hypoxemia, and receiver operating characteristic (ROC) curve analysis was employed to analyze the diagnostic performance of various indicators. RESULTS: A total of 113 children with SMPP were included. Univariate logistic regression analysis showed that ferritin, aspartate aminotransferase, creatinine, creatine kinase isoenzyme, lactate dehydrogenase, alpha-hydroxybutyrate dehydrogenase, immunoglobulin G, complement C3, complement C4, age, extrapulmonary complications, and a chest computed tomography (CT) scan showing a bronchiolitis pattern were significant factors for hypoxemia in children with SMPP (P<0.05). Multivariate logistic regression analysis revealed that elevated ferritin levels, presence of extrapulmonary complications, and a bronchiolitis pattern on lung CT were independent risk factors for hypoxemia in these patients (P<0.05). The ROC curve analysis indicated that the combination of these three indicators for predicting hypoxemia had a sensitivity of 71.9%, a specificity of 95.1%, and an area under the curve of 0.888 (95%CI: 0.809-0.968). CONCLUSIONS In children with SMPP, when there are elevated ferritin levels, a bronchiolitis pattern on chest CT, and the presence of extrapulmonary complications, there should be a high level of vigilance for the potential development of hypoxemia.
Humans ; Pneumonia, Mycoplasma/complications* ; Male ; Female ; Risk Factors ; Child, Preschool ; Hypoxia/etiology* ; Retrospective Studies ; Child ; Logistic Models ; Infant ; ROC Curve ; Adolescent

OBJECTIVE: To investigate the clinical features, treatment and prognosis of extranodal NK/T-cell lymphoma, nasal type (ENKTL) with skin lesions as initial symptom. METHODS: The clinical data of 11 ENKTL patients with skin lesions as initial symptom were retrospectively analyzed from August 2016 to January 2023 in Wuhan First Hospital and Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. RESULTS: Among the 11 patients, there were 6 males and 5 females, with a median age of 50(32-80) years. All patients had different forms of skin lesions as initial clinical symptom, including rash, ulcerative mass, painful skin nodules, infiltrating macula, etc. Most of the skin lesions were involved in the limbs and trunk but also appeared in the lower limbs alone. Five patients had hemophagocytic lymphohistiocytosis (HLH) at initial diagnosis, and 8 patients had B symptoms. All patients were diagnosed with advanced clinical staging (Lugano staging IV), and classified as high risk (PINK-E score ≥3). Immunohistochemical examination revealed that the positive rates of CD56 and EBER were both 100%, and the median Ki-67 index was 75%(50%-80%). Plasma EBV-DNA tests were all positive (≥5×10² copies/ml). Most of the induction chemotherapy regimens were combination chemotherapy (MESA, p-Gemox, SMILE) containing pegaspargase or L-asparaginase, or combined with PD-1 monoclonal immunotherapy, or HLH regimens (HLH-04 regimen, L-DEP). The median follow-up time and overall survival (OS) time were both 4.5(0.5-27) months. During the follow-up period, all 8 patients who did not receive autologous hematopoietic stem cell transplantation (ASCT) died, most of whom died of rapid disease progression. Three patients received ASCT, one died of central nervous system recurrence after transplantation, and two survived. The OS of three patients who underwent ASCT was 21, 27, and 19 months, and PFS was 11, 20, and 13 months, respectively. The plasma EBV-DNA copy number was monitored irregularly after transplantation, and the load of EBV was consistent with the changes of the disease. CONCLUSIONS Early clinical symptoms of ENKTL patients with skin lesions as initial symptom are more atypical, and early diagnosis is particularly difficult. The disease progresses rapidly and the prognosis is poor. There is still no uniform standard for the best treatment strategy. The survival of patients can be significantly prolonged by applying ASCT as soon as possible after complete remission obtained by high-dose induction chemotherapy.
Humans ; Male ; Female ; Lymphoma, Extranodal NK-T-Cell/diagnosis* ; Middle Aged ; Adult ; Retrospective Studies ; Aged ; Prognosis ; Aged, 80 and over

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

Objective To investigate the alterations of cerebral blood flow(CBF)in type 2 diabetic mellitus(T2DM) patients without cognitive impairment by using arterial spin labeling(ASL)technique.Methods A total of 23 T2DM patients without cognitive impairment and 23 healthy controls(HC)matched by age,sex,and education attainment were recruited.Their clinical data were collected,and neuropsychological tests and cerebral magnetic resonance imaging were performed.Then,the outcomes of clinical features,neuropsychological tests,and global and regional CBF were compared between the two groups.The significant regional zCBF(z-transformed relative CBF)values were extracted and correlated with clinical data and neuropsychological scores in T2DM patients,controlling age,sex,and education.Results No significant difference was found in whole brain CBF between the two groups(P=0.155),while significantly higher CBF was identified in the left superior temporal gyrus and left insula in the T2DM group(Gaussian random field correction,initial threshold P < 0.001,cluster level P < 0.05).No correlation was observed between the significant regional zCBF values and the clinical data or the neuropsychological scores in T2DM patients(all P>0.05).Conclusion Alterations in cerebral hemodynamics may precede cognitive function changes in T2DM,suggesting that the ASL technique is promising for early monitoring of cerebral hemodynamic changes associated with cognitive impairment in patients with T2DM.
Humans ; Diabetes Mellitus, Type 2/physiopathology* ; Cerebrovascular Circulation ; Middle Aged ; Male ; Female ; Magnetic Resonance Imaging ; Case-Control Studies ; Cognitive Dysfunction ; Neuropsychological Tests ; Aged

Objective:To dynamically monitor the changes of fibrinogen-like protein 2 (FGL2), Vaspin and transport protein (TSPO) in the perioperative period of craniocerebral trauma, and analyze their correlation with disease progression and significance.Methods:One hundred and eight patients with craniocerebral trauma admitted to Hubei Jianghan Oilfield General Hospital Guanghuayuan District from June 2019 to June 2022 were selected and according the scores of Glasgow outcome scale (GOS) at 3 months postoperatively they were divided into good group (GOS 4 - 5 scores, 68 cases) and poor group (GOS 1 - 3 scores, 40 cases). The changes of FGL2, Vaspin and TSPO were monitored and compared between the two groups at preoperatively, 1 d postoperatively and 3 d postoperatively. Pearson analysis was applied to analyze the relationship between FGL2, Vaspin and TSPO at 1, 3 d postoperatively. The value of FGL2, Vaspin, TSPO and combined prediction of disease regression at 3 d postoperatively was analyzed by receiver operating characteristic (ROC) curve.Results:The rate of multiple injuries and brain herniation formation in the poor group were higher than those in the good group: 30.00% (12/40) vs. 7.35% (5/68), 20.00% (8/40) vs. 2.94% (2/68), and the scores of Glasgow coma scale (GCS) was lower than that in the good group: (8.04 ± 1.25) scores vs. (9.18 ± 1.33) scores, there were statistical differences ( P<0.05). The levels of FGL2, Vaspin and TSPO were all higher at 1 d postoperatively than before surgery in patients with different disease regressions, with each index decreasing at 3 d postoperatively compared with 1 d postoperatively in the good group, but continuing to increase at 3 d postoperatively in the bad group ( P<0.05). The levels of FGL2, Vaspin and TSPO in the poor group were higher than those in the good group at 1 d and 3 d postoperatively: at 1 d postoperatively: (314.01 ± 88.67) μg/L vs. (275.33 ± 79.24) μg/L, (0.27 ± 0.08) μg/L vs. (0.22 ± 0.07) μg/L, (3.28 ± 1.03) μg/L vs. (2.01 ± 0.64) μg/L; at 3 d postoperatively: (374.85 ± 92.33) μg/L vs. (259.94 ± 81.78) μg/L, (0.30 ± 0.09) μg/L vs. (0.20 ± 0.06) μg/L, (3.77 ± 1.15) μg/L vs. (1.68 ± 0.52) μg/L, there were statistical differences ( P<0.05). The results of Pearson analysis showed that FGL2, Vaspin and TSPO were negatively correlated with GOS scores at 1 d and 3 d postoperatively (at 1 d postoperatively: r = - 0.729, - 0.796, - 0.814, P<0.05; at 3 d postoperatively: r = - 0.862, - 0.855, - 0.905, P<0.05), FGL2, Vaspin and TSPO were more strongly correlated with GOS scores at 3 d postoperatively (larger r values). The results of ROC curve analysis showed that FGL2, Vaspin and TSPO all had a predictive value for disease regression, and the area under the curve of FGL2 combined with Vaspin and TSPO was the largest (0.923 , 95% CI 0.855 to 0.965). Conclusions:There are many influencing factors in the prognosis of craniocerebral trauma. The changes of FGL2, Vaspin and TSPO during the perioperative period can predict the progress and regression of patients, and the combined dynamic monitoring is more conductive to evaluate the prognosis.