Alzheimer's disease （AD）， a degenerative disease of the central nervous system， is characterized by progressive degradation of learning， memory， and cognitive functions. Currently， few drugs are available for treating AD， and their effects are limited. Berberine （BBR） is a natural isoquinoline （quaternary ammonium-like） with a wide range of pharmacological effects. Studies have proven that BBR has good potential in the treatment of AD. Specifically， BBR can inhibit the generation， aggregation， and neurotoxicity of amyloid-β and the hyperphosphorylation of Tau protein， promote the clearance of phosphorylated Tau protein， reduce the cholinesterase activity， neuroinflammation， and oxidative stress， regulate neuronal apoptosis， improve the mitochondrial function and glucose and lipid metabolism， suppress the monoamine oxidase activity， and modulate gut microbiota. In addition， researchers have ameliorated the low bioavailability of BBR. Probing into the potential targets is hoped to provide a reference for further research on the prevention and treatment of AD by BBR.

[Objective] To investigate the differences in metabolomics between apheresis platelets stored at 4℃ and at 22℃ with agitation, aiming to provide a theoretical basis for the cold storage of apheresis platelets. [Methods] Samples were collected at four time points (d1, d5, d10, d15) for platelets stored at 4℃ (experimental group) and two time points (d1, d5) for platelets stored at 22℃ with agitation (control group). Liquid chromatography-tandem mass spectrometry (LC-MS/MS) technology was used to detect changes in platelet metabolome levels under different storage conditions. Platelet functional activity was assessed by thromboelastography (TEG) for maximum amplitude (MA) values and flow cytometry for CD62P activation rates. [Results] Metabolites in the glycolytic pathway, key metabolites in the tricarboxylic acid cycle (citrate, α-ketoglutarate), metabolites in the purine metabolism pathway (adenine, inosine monophosphate, guanine, etc.) and amino acid metabolites significantly decreased by d5 in the control group, whereas they remained stable in the experimental group. The content of fatty acid metabolites, such as prostaglandin G2, 13(S)-HOTrE, and linoleic acid, significantly increased in the control group. Statistically significant differences in MA values were observed between the two groups at d1 and d5 (P<0.05). However, in the experimental group, as the storage time extended, the MA values at d10 and d15 showed no significant difference compared to the control group at d5 (P>0.05). The CD62P activation rate between the two groups was statistically significant (P<0.05). Additionally, the CD62P activation rate of platelets in the 22℃ group increased rapidly from d1, while it rose gradually in the 4 ℃ group. [Conclusion] Platelets stored at 4 ℃ exhibit more stable metabolic activity and slower functional deterioration, which is beneficial for extending the effective storage period of platelets.

Objective:To analyze and compare differences in cortical functioning between patients with post-stroke dysphagia (PSD) following a left hemisphere stroke and healthy individuals using functional near-infrared spectroscopy (fNIRS).Methods:Twenty-six patients recovering from post-stroke dysphagia following a left hemisphere stroke formed the study′s PSD group, and 26 age-matched healthy subjects serves as the HC group. A 41-channel infrared spectroscope was used to record any changes in oxyhemoglobin (HbO) concentration while swallowing and at rest. The fNIRS data were statistically analyzed using Nirspark software. The β-values, reflecting the level of cortical activation, and the swallowing-related specific functional connectivity (FC) strength values (ΔFCs), representing task-specific FC strength, were extracted. The β-values and ΔFCs of the two groups were compared.Results:Compared with the HC group, the PSD group showed significantly reduced activation in Brodmann area (BA) 3/4/6/43 and BA4/6 of the left hemisphere during swallowing. Those areas correspond to the left primary motor cortex (M1), primary somatosensory cortex (S1), premotor cortex, and supplementary motor area (PM). Significantly reduced activation was observed in the PSD group in the right hemisphere at BA45/46/47, BA45/38/48, and BA10, corresponding to the right prefrontal cortex (PFC). The ΔFC values between the left PM-left M1, left PM-left S1, left M1-right S1, and left S1-right M1 in the PSD group were significantly lower than those in the HC group.Conclusions:Left hemispheric PSD is associated not only with decreased activation in the ipsilesional sensorimotor cortex (M1, S1, PM) but also with functional decline in the contra-lesional PFC. During swallowing, persons with left hemispheric PSD exhibit extensive impairment in inter-cortical network connectivity, with particularly marked reductions in connectivity between their ipsilesional and contra-lesional sensorimotor cortices.

Objective To investigate the effects of electroacupuncture at Neiguan(PC6)combined with Buyang Huanwu Decoction on myocardial edema-related proteins and its cardioprotective role in mice with acute high-altitude hypoxic myocardial injury,and to explore the potential mechanisms by which this combined therapy ameliorates acute hypoxic myocardial damage.Methods Mice were randomly divided into control,hypoxia model,electroacupuncture at Neiguan,Buyang Huanwu Decoction,and electroacupuncture at Neiguan+Buyang Huanwu Decoction groups.Except for the normal control group,all other groups were subjected to the establishment of an acute high-altitude hypoxia-induced myocardial injury model.Four days before entering the low-pressure hypoxia animal simulation chamber,the electroacupuncture at Neiguan group was treated with bilateral electroacupuncture at Neiguan,the Buyang Huanwu Decoction group was treated with Buyang Huanwu Decoction by gavage,and the electroacupuncture at Neiguan+Buyang Huanwu Decoction group was treated with a combination of electroacupuncture at Neiguan and Buyang Huanwu Decoction.The intervention lasted for 7 days.The normal control group and the hypoxia model group were handled normally without any other treatment.Myocardial pathology and ultrastructure were evaluated using HE staining and transmission electron microscopy.Serum levels of creatine kinase-MB(CK-MB)and cardiac troponin I(cTn-I)were measured by ELISA.Western blot was performed to quantify β1-AR,cAMP,PKA,and AQP1 protein expression.Results Compared with normal control group,the hypoxia model group exhibited significant myocardial damage,elevated cardiac biomarkers,and upregulated β1-AR/cAMP/PKA pathway proteins with increased AQP1 expression(all P<0.01).The electroacupuncture at Neiguan+Buyang Huanwu Decoction group demonstrated attenuated myocardial injury,reduced biomarker levels,and downregulated target proteins(all P<0.01)versus the hypoxia model group.Conclusion Electroacupuncture at Neiguan combined with Buyang Huanwu Decoction alleviates myocardial edema and injury in acute hypobaric hypoxia by reducing vascular permeability,potentially via suppression of the β1-AR/cAMP/PKA pathway and subsequent inhibition of AQP1 expression.

Objective To explore the characteritics of spontaneous brain functional activities for patients with hand dysfunction after ischemic stroke using resting state functional magnetic resonance imaging(rs-fMRI).Methods From August,2024 to June,2025,23 patients with hand dysfunction after ischemic stroke were as patients group,and ten age-matched healthy adults were recruited as healthy control group.The patients group was as-sessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Wolf Motor Function Test(WMFT)and modified Lindmark Scale.All subjects underwent rs-fMRI examinations,and the amplitude of low frequency fluctuations(ALFF),fractional amplitude of low frequency fluctuations(fALFF)and regional homogeneity(Re-Ho)were compared between two groups.The resting state functional network was constructed based on indepen-dent component analysis,and the functional connectivity(FC)were analyzed.The rs-fMRI indicators of the pa-tients and the clinical scale scores were analyzed.Results Compared with the healthy control group,the zALFF value decreased in the precentral gyrus(P<0.05,FWE corrected)in the patient group,as well as the values of zfALFF in Cerebelum-Crus2-R(P<0.05,FWE correct-ed),and ReHo values in the putamen(P<0.05,corrected by Alpha Sim).FC of the inferior frontal gyrus(IF-Goperc.R)in the executive control network enhanced(P<0.05,Alpha Sim corrected),while FC of the middle oc-cipital gyrus(MOG.L)in the dorsal attention network(DAN)weakened(P<0.05,Alpha Sim corrected).There was a positive correlation between FC of MOG.L in the patient's DAN and the scores of FMA-UE(r=0.439,P=0.036),WMFT(r=0.516,P=0.012),and modified Lindmark Scales(r=0.425,P=0.043).Conclusion The resting state spontaneous activity of some brain areas of the cerebrum,cerebellum and basal ganglia is reduced in patients with hand dysfunction after ischemic stroke,and some brain network connections are abnor-mal.FC of MOG.L may serve as an objective imaging marker for evaluating hand dysfunction.

Objective To explore the effect of bifidobacterium quadruple viable bacteria on intestinal flora based on the use of cefaclor in the treatment of infantile bacterial enteritis.Methods A total of 96 children with bacterial enteritis admitted in our hospital were selected as the research objects,and the patients were divided into the combined group(n=48)and the single drug group(n=48).The single drug group was treated with cefaclor alone,while the combined group was treated with a combination of live combined bifidobacterium,lactobacillus,enterococcus and bacillus cereus tablets and cefaclor.The clinical effects,numbers of microbiota,levels of inflammatory factors[tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-8(IL-8),interleukin-2(IL-2)],T lymphocyte subsets and adverse reactions were compared between the two groups.Results The total effective rate of the combined group was higher than that of the single drug group,and the improvement time of symptoms and signs was shorter than that of the single drug group(P＜0.05).After treatment,levels of Escherichia coli,TNF-α,CRP and IL-8 decreased in both groups,which were lower in the combined group than those of the single drug group(P＜0.05).Bifidobacterium,Lactobacillus,IL-2,and T lymphocyte subsets(CD3+,CD4+,CD4+/CD8+)were increased in both groups,and those were higher in the combined group than the single drug group(P＜0.05).Adverse reactions occurred in two patients of each groups(P＞0.05).Conclusion On the basis of using cefaclor and adding bifidobacterium quadruple viable bacteria in the treatment of bacterial enteritis in children can improve the treatment efficiency,improve the intestinal flora and inflammatory response,and have good safety.

Objective:To compare the short-term clinical outcomes of robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) in treating gastric cancer, as well as the overall 5-year's survival rate.Methods:In this retrospective cohort study, 874 patients undergoing minimally invasive gastrectomy were recruited from Jan 2016 to Jan 2020 (LG: n=719; RG: n=155). A one-to-one propensity score matching analysis was applied to minimize the selection bias due to confounding factors, yielding 150 patients in each of the RG and LG groups. After matching, the short-term outcomes and 5-year overall survival were compared in the two groups. Results:The propensity score matching cohort analysis showed a similar 5-year overall survival between RG and LG groups ( P=0.235). Concerning the short-term outcomes, the RG compared to LG resulted in lower blood loss ( P=0.011), lower postoperative complications ( P=0.001), less postoperative pain ( P=0.014), earlier initiation of soft diet ( P=0.010), shorter hospital stay ( P=0.011), but higher hospitalization expenses ( P=0.004). Conclusions:RG had a similar overall survival outcome compared to LG while offering better safety and efficacy in terms of less blood loss, lower surgery complications, faster recovery, and less postoperative pain. Higher hospital expenses were the main disadvantage of RG that could limit its application.

Objective At the level of human induced pluripotent stem cell-derived cardiomyocytes(hiPSC-CMs)and neonatal rat cardiomyocytes(NRVMs),investigate the role of serum glucocorticoid regulated kinase 1(SGK1)in the myocardial injury caused by sunitinib and the potential protective effect of berberine.Methods Enzyme-linked immunosorbent assay was used to detect the effect of sunitinib and incubation with berberine on the level of NT-proBNP and cTn-I in hiPSC-CMs.The effect of sunitinib and incubation with berberine on the activity of SGK1 in hiPSC-CMs was quantitatively tested using kinase activity photometry.Western blot was used to detect the expression of SGK1 in NRVMs.And the above indicators were detected again after SGK1 blockade using SGK1 blocker.Results Sunitinib and SGK1 inhibitor significantly increased the NT-proBNP and cTn-I level of hiPSC-CMs(P<0.01),and incubation with berberine activated SGK1 could significantly protect hiPSC-CMs from the increase in NT-proBNP level caused by sunitinib(P<0.01),while the SGK1 inhibitor resisted the protective effect of berberine(P<0.01).Sunitinib and SGK1 inhibitor significantly decreased the activity of SGK1 in hiPSC-CMs(P<0.01),and incubation with berberine activated SGK1,which significantly protected hiPSC-CMs from the inhibition of SGK1 activity caused by sunitinib(P<0.01).Sunitinib and SGK1 inhibitors significantly reduced SGK1 protein expression in NRVMs(P<0.01),and incubating berberine to activate SGK1 significantly protected SGK1 protein expression decrease induced by sunitinib(P<0.01).Conclusions Sunitinib inhibits the activity of SGK1,leading to myocardial injury,while berberine activates SGK1 and has protective effects.

Objective To discusse the application effects of the informatization of the review center and the homogeneity of pharmacists on the rationality of emergency department prescriptions.Methods Based on the system rules of the rational drug use management system and manually set custom rules,the changes in pharmacist's review quality,efficiency homogeneity,and prescription rationality were compared before(February 2023 to July 2023)and after(August 2023 to January 2024)the construction of the review center,according to the informatization and process standardization management.Results After the establishment of the review center,analysis of variance showed that the approval rate of pharmacist's review significantly increased compared to before the establishment of the review center(P＜0.05),while the average time consumption increased significantly(P＜0.01).The average review time,average approval time,and average review return time have been extended from(4.50±0.58),(4.50±0.58),and(4.75±0.96)s to(11.67±1.03),(8.50±0.55)and(13.17±0.98)s,respectively.The trend chi-square test showed that the irrationality rate of emergency department prescriptions decreased monthly from 6.27％in August 2023 to 0.93％in January 2024(P＜0.01).Correlation analysis between the number of intervention system rules since the establishment of the review center and the irrationality rate of emergency department prescriptions revealed a significant correlation(P=0.004 4).Conclusions By utilizing the platform of the review center,establishing dedicated review pharmacists and an information pharmacist team,and implementing informatization and standardized management processes,it can contribute to improving the quality and efficiency of prescription review,increasing the qualification rate of prescriptions,ensuring rational drug use,and enhancing the management level and medical quality of hospitals.

Objective:To systematically and comprehensively retrieve studies on urethra care for patients with urinary catheter at home and abroad, so as to provide a reference for removing low-value care measures in the future.Methods:Arksey and O'?Malley scoping review method was used to systematically search the China National Knowledge Infrastructure, China Biology Medicine disc, WanFang Data, VIP, PubMed, Cochrane Library, CINAHL, Embase, and Web of Science. The search period was from database establishment to January 1, 2024. Literature was screened based on inclusion and exclusion criteria, and catheter care site, disinfection/cleaner type, frequency, institutional norms, and determinants were independently extracted by two researchers, where determinants were framed based on the theoretical domains framework.Results:A total of 21 papers were included. Urethra low-value care measures were reflected in the selection of nursing solutions that differed significantly from guideline recommendations and were inconsistently standardized across hospitals. Thirteen strategies were proposed to remove urethra low-value care measures. Factors that influenced the removal of low-value care behaviors included knowledge, reinforcement, environment and resources, social influences, personal roles and identities, outcome beliefs and memories, and attention and decision-making processes.Conclusions:Future researchers should further refine the evidence on urethra care and develop contextualized care for complex, multilevel healthcare settings to achieve continuous improvement and high quality care at low cost.