ObjectiveTo analyze the characteristics of 150 patients with spinal cord injury complicated with spasticity. MethodsA cross-sectional survey was conducted on 150 patients with spinal cord injury accompanied by spasticity from September, 2019 to December, 2024. Their age, gender, cause of injury, injury site, severity of injury, spasticity severity and other indicators were recorded. The relationships between different characteristics were analyzed, and a correlation analysis of disease duration, spasticity grade, injury level, injury severity and age were conducted. ResultsThere was no significant difference in age distribution between patients with tetraplegia and paraplegia (Z = 0.806, P = 0.420). The proportions of trauma (χ² = 3.982, P = 0.046) and tetraplegia (χ² = 10.559, P = 0.010) were higher in males than in females. Trauma was the main cause of injury in both tetraplegia and paraplegia patients; the proportion of tetraplegia was higher than paraplegia in trauma patients, while paraplegia was higher than tetraplegia in non-trauma patients (χ² = 11.885, P < 0.001). Patients with tetraplegia was dominated by incomplete injury, whereas patients with paraplegia was dominated by complete injury (χ² = 10.885, P = 0.012). Grade A injury was predominant in trauma patients (P = 0.003). Spasticity grade showed a very weak positive correlation with disease duration (r = 0.175, P = 0.032) and age (r = 0.168, P = 0.040). Injury severity showed a very weak positive correlation with age (r = 0.183, P = 0.025). ConclusionCharacteristics of patients with spinal cord injury complicated with spasticity is different with gender, cause of injury, injury level, injury severity.

ObjectiveTo develop and validate a nomogram for predicting the risk of concurrent cognitive impairment in older adults with heart disease. MethodsSelf-reported data from 2 673 respondents in the 2020 China Health and Retirement Longitudinal Study were analyzed. The participants were randomly divided into a training set (n = 1 871) and a validation set (n = 802). Heart disease status was determined using a self-report questionnaire. Logistic regression analysis was performed to identify predictors, and a nomogram for predicting the risk of concurrent cognitive impairment in older adults with heart disease was developed using R software. Bootstrap resampling was used for internal validation, and model performance was further evaluated in the randomly split validation set. The predictive performance of the model was assessed using the area under the receiver operating characteristic curve (AUC) and calibration curves.. ResultsA total of 2 673 older adults with heart disease were included, out of whom 315 participants in the training set had cognitive impairment. Lasso regression analysis identified age, education level, place of residence, instrumental activities of daily living and depression as predictors of concurrent cognitive impairment. A prediction model incorporating these five variables was constructed. The AUC were 0.827 (95%CI 0.804 to 0.850) in the training set and 0.847 (95%CI 0.812 to 0.882) in the validation set. The Hosmer-Lemeshow test yielded P = 0.154 and P = 0.716 in the training and validation sets, respectively. Calibration curves showed good agreement between predicted and observed probabilities. Decision curve analysis indicated that the model provided favorable net benefit and predictive performance. ConclusionThe nomogram may provide a useful reference for risk screening and early intervention for cognitive impairment in older adults with heart disease.

Objective:Using ecological niche width and situation model,the operation and management of public Traditional Chinese Medicine(TCM)hospitals in 16 cities in Shandong Province were evaluated to put forward countermeasures.Methods:The relevant index data of public TCM hospitals in 16 cities in Shandong Province from 2019 to 2022 were collected to analyze the development status.The ecological niche width model and niche situation model were applied to evaluate the operation and management of public TCM hospitals in 16 cities in Shandong.Results:The top three public TCM hospitals in terms of average ecological niche width were City G,City P and City F.The ecological niche situation value of public TCM hospitals in City K,City A and City J ranked the top three.Conclusion:The dimensions of operation management structure of public TCM hospitals in Shandong need to be enhanced and the development of operation management space needs to be balanced.It is feasible to evaluate operation management by using ecological niche width and situation model.It is suggested to improve the allocation efficiency of health personnel,facilities,funds and other resources;promote the spatial balanced development of operation management;promote the application of ecological niche width and situation model in the field of medicine and health management.

Objective:To explore the application value of multi-slice spiral CT (MSCT) perfusion imaging and magnetic resonance high-resolution vessel wall imaging (HR-VWI) in the evaluation of atherosclerotic ischemic stroke (IS).Methods:A total of 131 patients with atherosclerotic IS (study group) and 62 patients with non-atherosclerotic IS (control group) diagnosed and treated in Handan Central Hospital from May 2022 to May 2024 were retrospectively selected as the study objects. MSCT perfusion imaging and HR-VWI were completed before treatment. MSCT perfusion imaging indexes and HR-VWI indexes were compared between the two groups, and HR-VWI indexes and MSCT perfusion imaging indexes were compared among the study groups with different disease degrees. Receiver operating characteristics (ROC) curve was used to analyze the diagnostic value of HR-VWI indexes and MSCT perfusion imaging indexes in atherosclerotic IS.Results:The stenosis degree, out wall area at maximal lumen narrowing (OWA MLN), plaque loading rate and remodeling index in the study group were higher than those in the control group: (69.22 ± 12.57)% vs. (60.81 ± 10.38)%, (7.62 ± 1.03) mm 2 vs. (6.53 ± 1.18) mm 2, (42.51 ± 8.22)% vs. (36.53 ± 7.29)%, 1.32 ± 0.41 vs. 1.01 ± 0.29; while the lumen area at maximal lumen narrowing (LA MLN) in the study group was lower than that in the control group: (0.84 ± 0.28) mm 2 vs.(1.17 ± 0.41) mm 2, there were statistical differences ( P<0.05). The cerebral blood flow (CBF) and cerebral blood volume (CBV) in the study group were lower than those in the control group: 20.25 ± 2.83) ml/100 min vs. (23.66 ± 2.52) ml/100 min, (1.82 ± 0.53) ml/100g vs. (2.31 ± 0.63) ml/100 g; and the peak time (TTP) and mean transit time (MTT) in the study group were higher than those in the control group: (23.55 ± 4.86) s vs.(19.73 ± 3.73) s, (7.13 ± 1.22) s vs. (6.17 ± 1.06) s, there were statistical differences ( P<0.05). In the study group, with the aggravation of disease severity, the stenosis degree, OWA MLN, plaque load rate and remodeling index were gradually increased, while LA MLN was gradually decreased, there were statistical differences ( P<0.05). ROC curve analysis results showed that the area under the curve value of HR-VWI index combined evaluation and MSCT perfusion imaging index combined evaluation in the diagnosis of atherosclerotic IS was 0.921 and 0.828, respectively. Conclusions:HR-VWI and MSCT perfusion imaging can be used in the assessment of patient's condition of atherosclerotic IS. HR-VWI may be better in evaluating the condition of atherosclerotic IS.

Objective:To investigate the drug resistance of newly diagnosed HIV-1 infected patients in Shanghai and to provide reference value for clinical antiretroviral therapy (ART).Methods:The peripheral venous blood plasma of 196 newly diagnosed HIV-1 infected patients screened according to the inclusion and exclusion criteria at the Shanghai Public Health Clinical Center from April to June 2023 was collected, HIV-1 RNA was extracted, the pol region was amplified by reverse transcription-polymerase chain reaction (RT-PCR) for sequencing, the mutation sites and ART drug resistance were analyzed.Results:The plasma of 196 newly diagnosed HIV-1 infected patients was amplified successfully in 162 cases (amplification success rate was 82.65%). The subtypes consisted of CRF07_BC(51.23%), CRF01_AE (27.78%), and others (6.79%), CRF55_01B (5.56%), B (3.70%), CRF01_AE/B (3.70%) and CRF08_BC (1.23%). The overall transmitted drug resistance rate was 7.41%, the protease inhibitors (PIs), non-nucleoside/nucleotide reverse transcriptase inhibitors (NNRTIs), nucleoside/nucleotide reverse transcriptase inhibitors (NRTIs), integrase inhibitors (INSTIs) resistance rates were 3.09%, 3.70%, 0.00% and 0.62%, respectively. The proportion of NNRTIs-related mutation sites in B (66.67%) and CRF55_01B (88.89%) was higher than that in CRF07_BC (13.25%); the proportion of NNRTIs-related mutation sites in CRF55_01B (88.89%) was higher than that in CRF01_AE (22.22%) and other subtypes (18.18%), the difference was statistically significant (all P<0.05). Multivariate logistic regression analysis showed that the probability of PIs-related mutation sites in CRF01_AE/B was 21.71 times that of CRF07_BC[odds ratio ( OR)=21.71, 95% confidence interval ( CI): 3.36-140.27, P=0.001]. Conclusions:The transmitted drug resistance among newly diagnosed HIV-1 infected patients in Shanghai is at the moderate epidemic level, mainly NNRTIs and PIs-related drug resistance, and the INSTIs resistance rate is low, the use of INSTIs in ART regimens should be considered.

Osteoporosis is a common bone disease， whose incidence is still on the rise， posing great challenges to patients and society. This review mainly studies the pathogenesis of osteoporosis from the aspects of oxidative stress， inflammatory response， and glucolipotoxicity-induced injury and clarifies the efficacy and mechanism of some active ingredients of traditional Chinese medicine against osteoporosis through the integration of in vitro and in vivo experiments. The experimental results suggest that some active ingredients can improve bone resorption markers and maintain bone homeostasis by modulating inflammation， oxidative stress， etc. These active ingredients regulate osteoporosis through the receptor activator of nuclear transcription factor-κB （NF-κB） ligand （RANKL） pathway， osteoprotegerin （OPG） pathway， Wnt/β-catenin pathway， NF-κB pathway， mitogen-activated protein kinase （MAPK） pathway， adenosine monophosphate （AMP）-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） pathway， and oxidative stress pathway. This review provides ideas for the progress of the prevention and treatment of osteoporosis with the active ingredients of traditional Chinese medicine， aiming to provide new potential lead compounds and reference for the development of innovative drugs and clinical therapy for the treatment of osteoporosis.

Renal carcinoma，a common malignant tumor of the urinary system，poses a significant disease burden . With innovations in artificial intelligence（AI）deep learning algorithms and the expanded clinical use of domestically developed surgical robots，renal carcinoma diagnosis and treatment have seen multi-dimensional breakthroughs. In molecular imaging and pathology diagnosis，AI drives multi-omics fusion diagnosis，while molecular imaging guides precise treatment. In surgical technology，5G-enabled telesurgery transcends geographical limits，and immersive virtual reality technology boosts surgical accuracy. Targeted therapy and immunotherapy revolutionizes advanced renal carcinoma treatment and opens up new therapeutic frontiers. Radiotherapy and energy therapy have become more precise. Despite these advances，bottlenecks persist in diagnosis and treatment. Future progress requires focusing on technological integration，clinical translation，and exploration of energy-based therapies to transition from "precise" to "intelligence" in renal carcinoma diagnosis and treatment.

Objective:To study the effects of hypoxia on the autophagy level in the spleen of mice with OSAHS.Methods:Mouse OSAHS hypoxia model was established in 24 C57BL/6 mice and the mice were divided into 3 groups:normoxic group,hypoxic group and resveratrol group(n=8).Real time PCR,Western blot and immunohistochemical staining(IHC)were used to detect the mRNA and protein expression of autophagy related proteins microtube associated protein 1 light chain 3 B(LC3B),myosin-like BCL2 inteacting protein(Beclin1)and autophagy related gene 5(ATG5)in mouse spleen respectively.Results:The mRNA expres-sion of LC3B,Beclin1,and ATG5 in the hypoxic group was lower than that in the normoxic group(P＜0.01,P＜0.01,P＜0.001),resveratrol upregulated the expression levels of LC3B and ATG5 mRNA in the hypoxic group(P＜0.05,P＜0.001),but did not up-regulate the expression of Beclin1(P＞0.05).The protein expression levels of LC3B,Beclin1 and ATG5 in the hypoxic group were lower than that in the normoxic group(P＜0.05,P＜0.05,P＜0.01).Resveratrol upregulated the expression levels of LC3B and ATG5 in the hypoxic group(P＜0.05,P＜0.01),but did not upregulated the expression of Beclin1(P＞0.05).IHC test showed that the expression level of LC3B,Beclin1 and ATG5 in the hypoxic group was lower than that in the normoxic group(P＜0.01,P＜0.01,P＜0.001).Resveratrol increased the expression level of LC3B and ATG5 in the hypoxic group(P＜0.05,P＜0.01),but did not upregulate the expression of Beclin1(P＞0.05).Conclusion:Hypoxia may inhibite the autophagy level of spleen in mice.Resvera-trol derivatives increases the autophagy level of mice under hypoxia condition,but has no significant effect on Beclin1 expression.

Empty follicle syndrome (EFS), defined by the failure to retrieve oocytes despite normal follicle development following controlled ovarian stimulation, is a multifactorial condition in assisted reproductive treatment and categorized into genuine EFS (GEFS) and false EFS (FEFS). The etiology of GEFS is complex, involving genetic factors and ovarian dysfunction, with mutations in LHCGR and ZP genes being the major causes. However, the underlying cause remains unknown in most patients. Targeted therapies based on specific etiologies are crucial in GEFS management. Oocyte donation is considered as a final viable option when other precision treatments prove ineffective. The etiology of FEFS is relatively clear, primarily associated with inappropriate administration of ovulation-triggering drugs, which can be rescued by a second injection of human chorionic gonadotropin or change the medication regimen. This review summaries current advances in the diagnosis and treatment of EFS, aiming to provide guidance for clinical management and further etiology research.

Trichinella spiralis zinc metalloproteinase NAS-36 gene(TsNas36)is a member of the zinc metalloproteinase family found in excretory secretory products(ESP)of T.spiralis.In this study,TsNas36 gene was cloned and expressed,and its biological characteristics and temporal and spatial characteristics were identified.These results provide a theoretical and material basis for ex-ploring the biological function of TsNas36 gene.Bioinformatics analysis showed that TsNas36 was 470 amino acids(AA)in length with a molecular weight of about 54.69 kDa,no transmembrane region,and contained a signal peptide(1-20 AA),an Astacins domain(116-320 AA)and a CUB domain(355-470 AA).There were five active site residues located at amino acids 216(His),217(Glu),220(His),226(His)and 275(Tyr).The expression plasmid pET-28a(+)/TsNas36 was constructed and induced to express in E.coli BL21(DE3)to obtain the recombinant protein rTs-Nas36.The recombinant protein was used to immunize rabbits to obtain anti-rTsNas36 polyclonal antibody serum.Indirect ELISA results showed that the antibody titer reached 1∶105.qRT-PCR and Western blot results showed that the transcription levels of TsNas36 were significantly higher in newborn larvae(NBL)than in adult worm(AW)and muscle larva(ML)stages.Immunofluo-rescence results showed that TsNas36 was only localized in the epidermis of NBL.In summary,this study characterized the biological characteristics of the TsNas36 gene and found that this gene is highly period-specific and may be involved in the unique developmental process of NBL.