Objective:To evaluate the incidence and frequency of inappropriate shocks caused by defibrillation lead failure in patients with implantable cardioverter-defibrillators (ICD), and to explore methods for reducing the incidence and frequency of such inappropriate shocks.Methods:This was a single-center retrospective study involving patients treated for defibrillation lead failures at Peking University People′s Hospital between March 2015 and May 2024. Patients were divided into an alarm function group and a non-alarm function group based on whether their ICDs were equipped with lead alarm functions. Clinical data, lead data, and the incidence and frequency of inappropriate shocks were collected and compared between the two groups. A multivariate logistic regression model was used to analyze factors influencing the incidence and frequency of inappropriate ICD shocks. Kaplan-Meier survival curves were plotted to compare the trends in the incidence and frequency of inappropriate shocks over time since ICD implantation between the two groups.Results:A total of 59 patients were enrolled, with a age of (56.7±15.2) years, including 42 males (71%). The lifespan of the failed leads in the entire cohort was 64.0 (36.0, 96.0) months. There were 26 patients in the alarm function group and 33 in the non-alarm function group. The most common manifestations of lead failure were oversensing (85%, 50/59) and abnormal pacing impedance (42%, 25/59). A total of 33 patients (56%, 33/59) experienced inappropriate shock therapy, with an average of 27.3 shocks per patient. The frequency of inappropriate ICD shocks in the non-alarm function group was higher than that in the alarm function group (25.0 (10.0, 60.0) times/year vs. 5.0 (2.8, 7.8) times/year, P=0.001). Multivariate logistic regression analysis showed that oversensing ( OR=2.057, 95% CI 1.125-6.763, P=0.019) was an influencing factor for incidence of inappropriate shocks, while the lead alert function ( OR=0.062, 95% CI 0.005-0.719, P=0.001) was a factor influencing the frequency of inappropriate shocks. Kaplan-Meier survival analysis revealed that the incidence and frequency of inappropriate shocks increased with the duration of ICD implantation in both groups, but the differences were not statistically significant (incidence: log-rank P=0.908; frequency: log-rank P=0.767). Conclusion:The lead alert function can reduce the frequency of inappropriate shocks caused by lead failure.

This study assessed the role and mechanism of the recombinant Bacillus Calmette-Gue?rin vaccine(rBCG)with c-di-AMP adjuvant in regulating metabolism and immunity in epididymal white adipose(eWAT)in mice.Male C57BL/6 mice were intravenously immunized with BCG and rBCG,and their body weights were monitored.eWAT was isolated from the mice,and the stromal vascular fractions(SVFs)cell number was counted with a hemocytometer.Sections of mouse adipose tissue were prepared,and the size,number,and morphology of eWAT adipocytes and crown-like structure(CLS)formation were compared under a microscope after HE staining.The transcription levels of lipid metabolism-associated factors,cytokines and aging-associated genes in each group were determined with qRT-PCR.The body weights of mice gradually increased after immunization with BCG and rBCG.The proportions of eWAT increased,and the SVFs cell number decreased,in rBCG immunized mice.HE staining indicated that BCG immunization promoted hyperplasia,whereas rBCG immunization promoted hypertrophy of eWAT adipocytes;moreover,both BCG and rBCG immunization induced CLS formation in eWAT.The qRT-PCR results indicated that rBCG immunization inhibited the expression of genes associated with lipolysis and energy expenditure in eWAT.BCG immunization had little effect on cytokine transcription,whereas rBCG significantly induced the transcription of IFN-γ and IL-1Ra,and inhibited that of IL-15 and IL-2,but did not induce the expression of aging-associated genes.Thus,rBCG immunization induced eWAT adipocyte hypertrophy,which was associated with the inhibition of eWAT lipolysis and the regulation of cytokine expression.

A deep learning-based method for recognizing the minutiae in fingerprint,as well as a Python programming-based evaluation system for quantifying the evidence value of fingerprint was proposed.Firstly,latent fingerprints,which were developed using a series of fluorescent nanomaterials synthesized by chemical methods,were used as unknown fingerprint(UKFP),while ink impressed fingerprints were used as known fingerprint(KFP).Then,the bifurcations and terminations in minutiae were recognized using the improved YOLOv8 deep learning model.After that,the similarity index(Sim.)of UKFP vs KFP were calculated by analyzing the angle similarity factor(α)and the curve similarity factor(β)between UKFP and KFP,meanwhile,the sensitivity index(Sen.)were calculated by analyzing the fineness factor(γ)between UKFP and KFP.The evidence value(EV)of fingerprint was thus obtained by the combination of Sim.and Sen..The calculation formulas for above evaluation factors(i.e.α,β and γ),evaluation indexes(i.e.Sim.and Sen.),and EV were also put forward.Finally,the evaluation system for quantifying the evidence value of fingerprint was established,the feasibility and reliability of this system were verified,and the external factors that impacted on Sim.,Sen.,and EV were investigated in detail.The Python-based evaluation system for quantifying the evidence value of fingerprint could achieve the goals objectively,comprehensively,accurately and efficiently,exhibiting easy operability,high efficiency,responsiveness and reliability.This research was expected to provide beneficial references for quantitatively evaluating and thoroughly developing the evidence value.

The influence of material properties on fingerprint development effects were systematically studied.Firstly,carbon dots/NaYF4 and Cu nanoclusters/starch nanocomposites respectively possessing different fluorescent intensities and dual fluorescent colors,as well as NaYF4 micro-/nano-materials exhibiting different morphologies,sizes,and surface properties were chemically synthesized and further used for latent fingerprint development.Then,the developing effects were comprehensively evaluated by visual analysis combining with spectral characterization and Python-based calculation.Finally,the influences of material properties on latent fingerprint development were quantitatively evaluated from three dimensions including contrast,sensitivity,and selectivity.The fluorescence properties of developing materials and substrates could significantly affect the developing contrast,namely,the stronger the developing signal,the higher the contrast;the weaker the background noise,the higher the contrast.The sizes and morphologies of the developing materials could respectively influence the quantity and quality of developed minutiae,and significantly affect the developing sensitivity,namely,the smaller the particle size of developing materials,the more the quantity of developed minutiae and the higher the sensitivity;the smaller the surface area of developing materials,the higher the quality of developed minutiae and the higher the sensitivity.The surface properties together with the sizes and morphologies of developing materials could influence their adsorption performances,and significantly affect the developing selectivity,namely,the stronger the specific adsorption of developing materials with fingerprint substance,and the weaker the non-specific adsorption of developing materials with substrate,the higher the selectivity.Moreover,the fingerprint development using the materials with suitable surface area and appropriate mass would have a high selectivity.

Objective:To establish 30-day of age transcutaneous bilirubin (TcB) reference curves for healthy neonates, and to investigate regional variations in bilirubin dynamics.Methods:A multicenter retrospective cohort study was conducted. A total of 220 950 healthy neonates born at a gestational age of 35-<42 weeks, with a birth weight ≥2 000 g, who did not receive phototherapy within 60 h after birth were recruited. All of them underwent remote TcB monitoring using the Bilibaby remote jaundice monitoring system between August 1 st, 2020 and December 31 st, 2024 in 426 hospitals. TcB data were collected within the period from birth to 30-day of age. The P40, P75, and P95 of TcB values were calculated, and dynamic TcB curves for 30-day of age were constructed. Patterns of bilirubin change, rates of change, and transition outcomes were described. Regional comparisons between South and North were conducted using linear mixed-effects models for TcB trajectories and Pearson′s chi-square test for outcome differences. Results:A total of 220 950 neonates were included, of whom 101 711 (46.03%) were female. Gestational age at birth was (38.75±1.12) weeks, and birth weight was (3 272±417) g. TcB levels increased rapidly within 3-day of age, peaked at 4-6-day of age, with peak values at P40, P75, and P95 of 200.6, 239.7 and 275.4 μmol/L (11.8, 14.1 and 16.2 mg/dl), respectively. TcB levels gradually declined thereafter and stabilized after 13-day of age, with values at P40, P75, and P95 fluctuating between 147.9-159.8, 190.4-200.6, and 231.2-239.7 μmol/L (8.7-9.4, 11.2-11.8, 13.6-14.1 mg/dl), respectively. Notably, among neonates categorized as low-or low-intermediate-risk within 3-day of age, 6 700 (12.76%) progressed to intermediate-high or high risk between 4 and 30 days of age. Before 13-day of age, TcB levels in the southern regions were consistently higher than those in the northern regions ( P=0.039); from 14 to 30 days of age, the overall TcB levels had no statistically difference, but the temporal changes in TcB still showed regional differences (degrees of freedom=3, all interaction P<0.05). Among neonates classified as low-or low-intermediate risk within 3-day of age, 25 326 were from southern regions, of whom 4 254 (16.80%) progressed to intermediate-high or high risk between 4 and 30 days of age. In northern regions, 27 193 neonates were classified as low-or low-intermediate risk within 3-day of age, among whom 2 446 (8.99%) progressed to intermediate-high or high risk. The risk progression between the 2 regions had statistically difference ( χ2=716.49, P<0.001). Conclusions:A TcB percentile curve for neonates within 30-day of age was established, revealing that both the overall TcB level and its temporal trend were higher in southern than in northern newborns. These findings provide baseline data to support continuous management of neonatal jaundice.

With the rapid development of computer vision technology, deep learning models have demonstrated new research area and potential value in intelligent microbiological detection. By utilizing multilayer neural networks and large amounts of training data, these models are capable of automated extraction and analysis for complex features, thereby improving the efficiency and accuracy of detection. This paper introduces the research background of deep learning in microbiological image detection, and elaborates on the methods for constructing microbiological image datasets, including data collection, preprocessing, annotation, and partitioning, and introduces typical deep learning models as well as their application examples in various microbiological detection. Deep learning in microbiological image analysis faces numerous challenges which needs further development.

OBJECTIVE: To evaluate the clinical effect and safety of acupuncture manipulation on treatment of intractable facial paralysis (IFP), and verify the practicality and precision of the Anzhong Facial Paralysis Precision Scale (Eyelid Closure Grading Scale, AFPPS-ECGS). METHODS: A multicentre, single-blind, randomized controlled trial was conducted from October 2022 to June 2024. Eighty-nine IFP participants were randomly assigned to an ordinary acupuncture group (OAG, 45 cases) and a characteristic acupuncture group (CAG, 44 cases) using a random number table method. The main acupoints selected included Yangbai (GB 14), Quanliao (SI 18), Yingxiang (LI 20), Shuigou (GV 26), Dicang (ST 4), Chengjiang (CV 24), Taiyang (EX-HN 5), Jiache (ST 6), Fengchi (GB 20), and Hegu (LI 4). The OAG patients received ordinary acupuncture manipulation, while the CAG received characteristic acupuncture manipulation. Both groups received acupuncture treatment 3 times a week, with 10 times per course, lasting for 10 weeks. Facial recovery was assessed at baseline and after the 1st, 2nd and 3rd treatment course by AFPPS-ECGS and the House-Brackmann (H-B) Grading Scale. Infrared thermography technology was used to observe the temperature difference between healthy and affected sides in various facial regions. Adverse events and laboratory test abnormalities were recorded. The correlation between the scores of the two scales was analyzed using Pearson correlation coefficient. RESULTS: After the 2nd treatment course, the two groups showed statistically significant differences in AFPPS-ECGS scores (P<0.05), with even greater significance after the 3rd course (P<0.01). Similarly, H-B Grading Scale scores demonstrated significant differences between groups following the 3rd treatment course (P<0.05). Regarding temperature measurements, significant differences in temperatures of frontal and ocular areas were observed after the 2nd course (P<0.05), becoming more pronounced after the 3rd course (P<0.01). Additionally, mouth corner temperature differences reached statistical significance by the 3rd course (P<0.05). No safety-related incidents were observed during the study. Correlation analysis revealed that the AFPPS-ECGS and the H-B Grading Scale were strongly correlated (r=0.86, 0.91, 0.93, and 0.91 at baseline, and after 1st, 2nd, and 3rd treatment course, respectively, all P<0.01). CONCLUSIONS Acupuncture is an effective treatment for IFP, and the characteristic acupuncture manipulation enhances the therapeutic effect. The use of the AFPPS-ECGS can more accurately reflect the recovery status of patients with IFP. (Trial registration No. ChiCTR2200065442).
Humans ; Acupuncture Therapy/methods* ; Facial Paralysis/therapy* ; Female ; Male ; Middle Aged ; Adult ; Treatment Outcome ; Acupuncture Points ; Aged

The liver performs multiple life-sustaining functions. Hepatic diseases, including hepatitis, cirrhosis, and hepatoma, pose significant health and economic burdens globally. Along with the advances in nanotechnology, mesoporous silica nanoparticles (MSNs) exhibiting diversiform size and shape, distinct morphological properties, and favorable physico-chemical features have become an ideal choice for drug delivery systems and inspire alternative thinking for the management of hepatic diseases. Initially, we introduce the physiological structure of the liver and highlight its intrinsic cell types and correlative functions. Next, we detail the synthesis methods and physicochemical properties of MSNs and their capacity for controlled drug loading and release. Particularly, we discuss the interactions between liver and MSNs with respect to the passive targeting mechanisms of MSNs within the liver by adjusting their particle size, pore diameter, surface charge, hydrophobicity/hydrophilicity, and surface functionalization. Subsequently, we emphasize the role of MSNs in regulating liver pathophysiology, exploring their value in addressing liver pathological states, such as tumors and inflammation, combined with multi-functional designs and intelligent modes to enhance drug targeting and minimize side effects. Lastly, we put forward the problems, challenges, opportunities, as well as clinical translational issues faced by MSNs in the management of liver diseases.

This study investigates the reproductive protective effect and potential mechanism of Cistanches Herba extract(CHE) on a rat model of kidney-Yang deficiency induced by adenine. Rats were randomly divided into five groups: normal, model, low-dose CHE(0.6 g·kg~(-1)·d~(-1)), high-dose CHE(1.2 g·kg~(-1)·d~(-1)), and L-carnitine(100 mg·kg~(-1)·d~(-1)). The rats were administered adenine(200 mg·kg~(-1)·d~(-1)) by gavage for the first 14 days to induce kidney-Yang deficiency, while simultaneously receiving drug treatment. After 14 days, the modeling was discontinued, but drug treatment continued to 49 days. The content of components in CHE was analyzed by high-performance liquid chromatography. The adenine-induced kidney-Yang deficiency model was assessed through symptom characterization and measurement of testosterone(T) levels using an enzyme-linked immunosorbent assay kit. Pathological damage to the testis and epididymis was evaluated based on the wet weight and performing hematoxylin-eosin staining. Sperm density and motility were measured using computer-aided sperm analysis, and sperm viability was assessed using live/dead sperm staining kits, and sperm morphology was evaluated using eosin staining, thereby determining rat sperm quality. Metabolomics was used to analyze changes in serum metabolites, enrich related metabolic pathways, and explore the mechanism of CHE in improving reproductive function damage in rats with kidney-Yang deficiency syndrome. Compared to the normal group, the model group exhibited significant kidney-Yang deficiency symptoms, reduced T levels, decreased testicular and epididymal wet weights, and significant pathological damage to the testis and epididymis. The sperm density, motility, and viability decreased, with an increased rate of sperm abnormalities. In contrast, rats treated with CHE showed marked improvements in kidney-Yang deficiency symptoms, restored T levels, alleviated pathological damage to the testis and epididymis, and improved various sperm parameters. Metabolomics results revealed 286 differential metabolites between the normal and model groups(191 upregulated and 95 downregulated). Seventy-five differential metabolites were identified between the model and low-dose CHE groups(21 upregulated and 54 downregulated). A total of 24 common differential metabolites were identified across the three groups, with 22 of these metabolites exhibiting opposite regulation trends between the two comparison groups. These metabolites were primarily involved in linoleic acid metabolism, ether lipid metabolism, and pantothenic acid and coenzyme A biosynthesis, as well as metabolites including 13-hydroperoxylinoleic acid, lysophosphatidylcholine, and pantethine. CHE can improve kidney-Yang deficiency symptoms in rats, alleviate reproductive organ damage, and enhance sperm quality. The regulation of lipid metabolism may be a potential mechanism through which CHE improves reproductive function in rats with kidney-Yang deficiency. The potential bioactive compounds of CHE include echinacoside, verbascoside, salidroside, betaine, and cistanoside A.
Animals ; Male ; Rats ; Yang Deficiency/physiopathology* ; Metabolomics ; Kidney/physiopathology* ; Rats, Sprague-Dawley ; Drugs, Chinese Herbal/administration & dosage* ; Cistanche/chemistry* ; Kidney Diseases/metabolism* ; Testis/metabolism* ; Humans ; Reproduction/drug effects* ; Testosterone/blood*