OBJECTIVE To study the pharmacokinetic characteristics of antidepressant active components from Jiaotai pills in healthy subjects. METHODS Eight healthy subjects （3 males and 5 females） were recruited and given a single oral dose of 8.55 g of Jiaotai pills. Venous blood samples were collected before administration （0 h） and at intervals from 0.25 to 36.0 hours post- administration. After treating the plasma samples with protein precipitation， the blood concentrations of the antidepressant active ingredients （coptisine， berberine， magnoflorine， and palmatine） in Jiaotai pills were determined using liquid chromatography- tandem mass spectrometry （LC-MS/MS） method. DAS 2.0 software was employed to calculate the pharmacokinetic parameters of healthy subjects [half-life （t1/2）， peak concentration （cmax）， time to peak concentration （tmax）， area under the concentration-time curve （AUC）， and mean residence time （MRT）] using a non-compartmental model. RESULTS After healthy subjects took Jiaotai pills， the drug-time curve of the four antidepressant active ingredients conforms to a two-compartment model and tmax values were similar， with all reaching peak blood concentrations within 2.00 to 4.00 hours post-administration. However， the t1/2 and MRT of coptisine and berberine were significantly longer than that of magnoflorine and palmatine. There were also significant differences in the AUC and cmax among the four antidepressant active ingredients， with magnoflorine exhibiting markedly higher AUC0-t and cmax compared to the other three components. CONCLUSIONS In this study，LC-MS/MS is used to analyze the pharmacokinetic characteristics of the antidepressant active ingredients from Jiaotai pills in healthy subjects， can provide valuable references for the clinical application of Jiaotai pills.

Objective To investigate the current distribution of radiotherapy resources in Gansu Province, evaluate the equity of resource allocation, and provide a scientific basis for optimizing regional resource allocation. Methods A questionnaire survey was carried out to assess radiotherapy resources in medical institutions across Gansu Province, China. The equity of radiotherapy resource distribution and associated disparities were assessed using the Gini coefficient, Lorenz curve, and Theil index. Results A total of 23 medical institutions in Gansu Province provided radiotherapy services, comprising 39 radiotherapy devices and 438 professionals, of whom medical physicists accounted for 16.9%. The radiotherapy frequency was 0.47 cases per thousand population. The Gini coefficients for radiotherapy resource distribution ranged from 0.38 to 0.56 by population and from 0.52 to 0.70 by geography. The Theil index for radiotherapy resources ranged from 1.36 to 3.67. Conclusion Radiotherapy resources in Gansu Province were insufficient, and the capacity of radiotherapy service was suboptimal. The equity of radiotherapy resource allocation by geography was worse than that by population. Therefore, it is imperative to address the shortage of radiotherapy resources, strengthen the professional workforce, enhance the capacity radiotherapy service and resource utilization, optimize resource allocation, and promote regional equity in radiotherapy provision in Gansu Province.

Objective To assess the quality of gross α and β radioactivity measurements conducted by radiological health service institutions and disease prevention and control centers in Gansu Province, China, and regulate their measurement methods. Methods The samples were distributed by Gansu Provincial Center for Disease Control and Prevention as the organizer of the inter-comparison through mail. The institutions participated in the inter-comparison carried out the measurements in accordance with national standards, and submitted the inter-comparison reports in the form required by the inter-comparison scheme. Results A total of 13 institutions participated in the 2023 inter-comparison of gross α and β radioactivity measurement capabilities, and all measurement results met the required standards. The absolute Z-scores for gross α inter-comparison ranged from 0 to 1.21, and the absolute Z-scores for gross β inter-comparison ranged from 0.08 to 1.85. The comprehensive scores ranged from 74.5 to 93.0. Conclusion The measurement capacities of the institutions participated in the 2023 inter-comparison showed improvement compared with the previous year. However, 12 institutions participated in the inter-comparison showed issues in data processing, report formatting, and laboratory quality control. It is necessary to strengthen technical training, standardize the measurement procedures, and improve the measurement capabilities and skills to ensure the quality of services.

Objective To develop a combined model integrating radiomics and 3D deep learning features for improving the predictive efficacy of overall survival in non-small cell lung cancer(NSCLC)patients undergoing radiotherapy,thereby providing a foundation for optimizing individualized radiotherapy strategies.Methods A retrospective analysis was conducted on 522 NSCLC patients from 3 centers.Radiomics features were extracted from the tumor region of interest on radiotherapy planning CT scans,and a 3D-SE-ResNet was constructed to extract deep learning features.Following feature extraction,features were selected via univariate Cox analysis and Lasso-Cox regression,and a combined model was established by fusing the two feature types through principal component analysis.The discriminative ability of the model was evaluated using the concordance index(C-index)and the area under the receiver operating characteristic curve(AUC),while the risk stratification efficacy was verified by Kaplan-Meier survival analysis.Results The predictive performance of deep learning features was significantly superior to that of radiomics features(C-index:0.73 vs 0.65).The combined model achieved the highest predictive performance in the training set,internal test set,and external test set(C-index:0.74,0.69,0.72 respectively),with higher AUC values for predicting 1-year,2-year,and 3-year OS than either single model.Kaplan-Meier analysis showed significant differences in survival between the high-and low-risk groups(Log-rank test,P<0.001),and calibration curves indicated good consistency between predicted and actual survival outcomes.Conclusion The combined model integrating radiomics and 3D deep learning features can accurately predict survival outcomes in NSCLC patients undergoing radiotherapy.The multi-center validation results support its potential application in prognosis stratification for individualized radiotherapy.

Objective To compare the efficacy and safety of bridging therapy and direct thrombectomy in patients with acute ischemic stroke caused by basilar artery occlusion within 4.5 h.Methods Retrospective consecutive patients with acute basilar artery occlusion stroke within 4.5 h of onset admitted to five centers from January 2018 to August 2024 were included and divided into a bridging therapy(intravenous thrombolysis with alteplase given prior to emergency endovascular treatment)group and a direct thrombectomy group according to the treatment modality.Baseline and clinical data were collected from patients,including age,sex,systolic and diastolic blood pressure on admission,past history(including history of hypertension,diabetes mellitus,coronary artery disease,atrial fibrillation,hyperlipidemia,and history of stroke),history of smoking,pre-morbid modified Rankin scale(mRS)scores,National Institutes of Health stroke scale(NIHSS)score on admission,posterior circulation Alberta stroke program early CT score on admission,basilar artery CT angiography score,history of pre-procedural antiplatelet aggregation medications,history of pre-procedural anticoagulant medications,choice of arterial puncture access(via femoral or radial artery),site of vascular occlusion(proximal basilar artery,mid-basilar artery,distal basilar artery),trial of Org 10172 in acute stroke treatment(TOAST)classification,American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology collateral circulation classification,time from onset to admission,time from admission to puncture,time from puncture to revascularization,time from onset to revascularisation,type of embolisation procedure(stenting,aspiration,and combined),immediate post-procedure extended thrombolysis in cerebral infarction(eTICI)classification,and intra-procedural related complications(arterial entrapment,distal occlusion and arterial perforation).The main efficacy indicators(good prognosis[mRS score 0-3 90 d postoperatively],death[mRS score 6 90 d postoperatively],and good recanalisation[eTICI grade ≥2b50]within the immediate postoperative period)and safety indicators(incidence of symptomatic intracranial haemorrhage[sICH]within 7 days post-procedure)were compared between the two groups.The two groups were matched 1∶1 using propensity score matching(PSM)to compare differences in effectiveness and safety indices before and after PSM.Variables with P＜0.05 in the baseline and clinical data comparison between the two groups were included in multifactorial Logistic regression analysis for correction,the differences in safety and efficacy between the two groups were compared before and after correction.Results A total of 206 patients with acute ischemic stroke caused by basilar artery occlusion within 4.5 h of onset were included,comprising 151 males and 55 females.The age ranged from 26 to 93 years old,with an average of(65±13)years old.Among them,101 patients(49.0％)were in the bridging therapy group and 105(51.0％)in the direct thrombectomy group.After 1∶1 PSM,each group consisted of 69 patients.(1)The differences in the proportion of patients with atrial fibrillation between the bridging therapy group and the direct thrombectomy group(16.8％[17/101]vs.28.6％[30/105]),the distribution of pre-morbid mRS scores,and the distribution of TOAST subtypes were statistically significant(all P＜0.05);the differences in the residual baseline and clinical data of the two groups were not statistically significant(all P＞0.05).After 1∶1 PSM,the differences in all baseline and clinical data between the two groups were not statistically significant(all P＞0.05).(2)No statistically significant differences were observed between the bridging therapy group and direct thrombectomy group in the good prognosis rate at 90 d postoperatively,morbidity and mortality rates at 90 d postoperatively,or good revascularization rate in the immediate postoperative period(all P＞0.05).However,the risk of sICH at 7 d postoperatively was higher in the bridging therapy group(9.5％[10/105]vs.19.8％[20/101];OR,2.346,95％CI 1.038-5.299,P=0.037).After correcting for variables with statistically significant differences in baseline and clinical data between the direct thrombectomy group and bridging therapy groups(atrial fibrillation,pre-onset mRS score,and TOAST classification)using a multifactorial Logistic regression model,the results showed no statistically significant differences in the effectiveness and safety metrics between the two groups(all P＞0.05).(3)The results after 1∶1 PSM showed that the bridging therapy group had a higher risk of sICH(11.6％[8/69]vs.26.1％[18/69];OR,2.691,95％CI 1.081-6.700,P=0.033).No statistically significant differences were observed between the two groups in terms of good prognosis rate at 90 d postoperatively,disease-related mortality rate at 90 d postoperatively,or rate of good revascularization in the immediate postoperative period(all P＞0.05).Conclusions In patients with acute basilar artery occlusion stroke within 4.5 h of onset,the effectiveness of bridging therapy and direct thrombectomy was similar,but the incidence of sICH was higher with bridging therapy.The results of this study still need further validation through prospective studies with larger sample sizes.

Objective:To analyze the iodine nutrition status of pregnant women in Weihai City before and after (2022, 2023) the iodine deficiency disorders (IDD) intervention, evaluate the effectiveness of intervention measures, and provide a scientific basis for adjusting IDD prevention strategies in the city.Methods:In May 2023, the intervention action of IDD was carried out for pregnent women in Weihai City. In April 2022 and December 2023, respectively, a cross-sectional survey method was conducted in four districts (cities) of Weihai City. Each district (city) was divided into five areas (east, west, south, north, and central) each year, and one township (street) was selected from each areas. At least 20 pregnant women were selected from each township (street) as survey subjects, and their household salt samples and random urine samples were collected to measure salt iodine and urinary iodine concentrations, and to compare the test results.Results:A total of 922 household salt samples were tested, including 530 iodized salt samples and 469 qualified iodized salt samples. The median salt iodine was 24.00 mg/kg. The coverage rate of iodized salt, the qualified rate of iodized salt, and the consumption rate of qualified iodized salt were 57.48%, 88.49%, and 50.87%, respectively. No significant difference was observed in medians salt iodine between 2022 (24.26 mg/kg) and 2023 (24.00 mg/kg, Z = - 1.58, P = 0.113). However, the coverage rate of iodized salt and the consumption rate of qualified iodized salt in 2023 werehigher than those in 2022 [73.72% (373/506) vs 37.74% (157/416), 65.22% (330/506) vs 33.41% (139/416), χ 2 = 120.90, 92.40, P < 0.001]. A total of 922 urine samples were collected from pregnant women, with a median urinary iodine of 135.90 μg/L. The median urinary iodine of pregnant women in 2022 was 113.55 μg/L. There was a statistically significant difference in medians urinary iodine among different regions ( H = 27.91, P < 0.001). The median urinary iodine of pregnant women in 2023 was 153.00 μg/L. There was no statistically significant difference in medians urinary iodine among different regions ( H = 3.33, P = 0.343). The medians urinary iodine of pregnant women in Huancui District, Wendeng District, and Rushan City in 2023 (156.60, 155.00, 140.85 μg/L) were higher than those in 2022 (93.60, 110.00, 110.70 μg/L), and the differences were statistically significant ( Z = - 5.44, - 4.92, - 5.99, P < 0.001). The median urinary iodine of pregnant women in Weihai City in 2023 showed a statistically significant difference compared to 2022 ( Z = - 7.62, P < 0.001). Conclusions:The IDD intervention measures in Weihai City have achieved good results, and the coverage of iodized salt, the consumption rate of qualified iodized salt, and the iodine nutrition level of pregnant women have improved. We should continue to implement intervention measures, improve the iodine nutrition level of key populations, and maintain a sustained elimination of IDD.

Objective:To explore the mediating effect of attitudes to aging between intergenerational support and health behavior in elderly stroke patients.Methods:From March 2023 to February 2024, elderly stroke patients hospitalized in the Department of Neurology at Beijing Tongren Hospital, Capital Medical University, were selected as study subjects using convenience sampling. The survey was conducted using the General Information Questionnaire, Attitudes to Ageing Questionnaire (AAQ), Intergenerational Support Scale (ISS), and Stroke Health Behavior Questionnaire (SHBQ). Pearson correlation was employed to analyze the relationships among attitudes to aging, intergenerational support, and health behavior. AMOS 21.0 software was used to construct the structural equation model and verify the mediating effect.Results:A total of 250 questionnaires were distributed, and 243 valid questionnaires were collected, with a valid response rate of 97.20%. The AAQ, ISS, and SHBQ scores of 243 elderly stroke patients were (70.57±9.03), (19.74±3.65), and (71.67±5.50), respectively. Attitudes to aging were positively correlated with both intergenerational support and health behavior ( P<0.05), and intergenerational support was positively correlated with health behavior ( P<0.05). Intergenerational support had a direct positive effect on health behavior (β=0.552), and attitudes to aging had a direct positive effect on health behavior (β=0.632). Attitudes to aging partially mediated the relationship between intergenerational support and health behavior, accounting for 38.12% (0.340/0.892) of the total effect. Conclusions:Attitudes to aging partially mediates the relationship between intergenerational support and health behavior. Improving intergenerational support may foster positive attitudes to aging, thereby promoting the development of healthy behavior among elderly stroke patients.

Objective To evaluate the efficacy and safety of Qixian Tongluo Formula in the treatment of post-cerebral infarction paralysis with kidney deficiency and blood stasis syndrome,and to preliminarily explore the molecular mechanism of Qixian Tongluo Formula in improving impaired motor function from the perspective of cross-kingdom regulation of Chinese medicine microRNA(miRNA).Methods A pragmatic randomized controlled trial was conducted with 102 patients in the recovery period of post-cerebral infarction paralysis with kidney deficiency and blood stasis syndrome in our hospital.Patients were randomly divided into trial group and control group,with 51 cases in each group.The control group received standard Western medicine standard treatment,while the trial group received Qixian Tongluo Formula in addition to the standard treatment,with one dose per day,boiled in water,and taken warm after breakfast and dinner for a course of 2 months.The disability rate was used as the main efficacy indicator,and the incidence of adverse reactions was used as a safety indicator.miRNA from patient serum and Qixian Tongluo decoction were extracted respectively,and high-throughput sequencing was performed.The two sequences were compared to screen out the cross-kingdom gene transfer of Chinese medicine miRNA.Finally,its target genes of miRNA were predicted,and GO function and KEGG pathway enrichment analysis were carried out.Results A total of 67 patients completed the clinical trial,including 36 cases in the trial group and 31 cases in the control group;The disability rate in the trial group(13.9%)was lower than that in the control group(35.5%)(P<0.05);The incidence of adverse reactions was similar between the trial group(7.69%)and the control group(6.06%)(P>0.05);A total of 9530 Qixian Tongluo decoction miRNA sequences were screened,with 150 potentially involved in cross-kingdom gene transfer,including families such as miR-15 and miR-17;According to the target gene prediction of the top 10 miRNAs in cross-kingdom gene transfer of Chinese medicine,345 overlapping target genes were obtained;GO functional enrichment analysis revealed 16 biological processes,7 cellular components,and 2 molecular functions among the top 25 enriched functions,while KEGG pathway analysis mainly focused on the transforming growth factor-βsignaling pathway,neurotrophin signaling pathway,which are closely related to neural repair and functional recovery processes such as glial scar formation and synaptic plasticity after cerebral ischemia.Conclusion Qixian Tongluo Formula can significantly improve the functional independence level of patients with kidney deficiency and blood stasis syndrome in the recovery period of paralysis after cerebral infarction,offering a safe and effective treatment option for these patients;There were a large number of miRNAs in Qixian Tongluo decoction,some of which could cross-kingdom transferred into the human blood circulation,and promote the recovery of motor function in patients with cerebral infarction through multi-target,multi link and multi pathway gene network regulation.This study provides a new idea for subsequent clinical and basic research.

Objective To investigate the diagnostic efficacy of fat fraction(FF)and T2* values of infrapatellar fat pad(IPFP)based on MR mDixon-Quant technique for knee osteoarthritis(KOA),and to analyze their related influencing factors.Methods A total of 178 knee joints from 114 volunteers were included and underwent knee joints X-ray examination and MR mDixon-Quant sequence scanning.The correlation between FF and T2* values of IPFP with gender,age,body mass index(BMI),and K-L grade was analyzed by Spearman's test and multiple linear regression.Receiver operating characteristic(ROC)curves were plotted to assess the diag-nostic efficacy of FF and T2* values for KOA.Results FF value of IPFP was negatively correlated with age,BMI,and K-L grade(r=-0.470,-0.276,-0.679,P＜0.001),and T2* value was also negatively correlated with age,BMI,and K-L grade(r=-0.291,-0.173,-0.505,P＜0.001).Multiple linear regression analysis results showed that only K-L grade had a statistically significant correlation with FF and T2* values(P＜0.001).ROC curve analysis indicated that the area under the curve(AUC)for diagnosing KOA using the FF and T2* values of IPFP were 0.859 and 0.767,respectively,with sensitivity of 0.878 and 0.841,and specificity of 0.719 and 0.573,respectively.The combined diagnosis had an AUC of 0.855,a sensitivity of 0.625,and a specificity of 0.963,improving the diagnostic specificity for KOA.Conclusion FF and T2* values of IPFP can serve as objective imaging indicators for KOA assessment,and their reduction is correlated with the progress of age,BMI,and K-L grade,of which the K-L grade is an independent influencing factor.The combination of FF and T2 can improve the diagnostic specificity of KOA,and provide a quantitative basis for early KOA detection and severity stratification.