Post-traumatic stress disorder (PTSD) is a psychiatric disorder caused by traumatic past experiences, rooted in the neurocircuits of fear memory formation. Memory processes include encoding, storing, and recalling to forgetting, suggesting the potential to erase fear memories through timely interventions. Conventional strategies such as medications or electroconvulsive therapy often fail to provide permanent relief and come with significant side-effects. This review explores how fear memory may be erased, particularly focusing on the mnemonic phases of reconsolidation and extinction. Reconsolidation strengthens memory, while extinction weakens it. Interfering with memory reconsolidation could diminish the fear response. Alternatively, the extinction of acquired memory could reduce the fear memory response. This review summarizes experimental animal models of PTSD, examines the nature and epidemiology of reconsolidation to extinction, and discusses current behavioral therapy aimed at transforming fear memories to treat PTSD. In sum, understanding how fear memory updates holds significant promise for PTSD treatment.
Fear/psychology* ; Extinction, Psychological/physiology* ; Animals ; Stress Disorders, Post-Traumatic/psychology* ; Humans ; Memory Consolidation/physiology* ; Memory/physiology*

Objective To analyze the relationship between heart rate variability(HRV)parameters and cognitive impairment in elderly patients with ischemic cerebral small vessel disease(CSVD).Methods A total of 120 elderly patients with ischemic CSVD admitted in Affiliated Hospital of Southwest Medical University from December 2020 to December 2022 were recruited,and accord-ing to Montreal cognitive assessment(MoCA)score,they were divided into cognitively impaired group(MoCA score＜26,n=38)and cognitively normal group(MoCA score≥26,n=82).All pa-tients received dynamic electrocardiography to obtain HRV parameters,including standard devia-tion of R-R interval(SDNN),percentage of the number of pairs of adjacent R-R intervals differing by more than 50 ms(PNN50),power in low frequency range(LF)and power in high frequency range(HF).The relationship between HRV parameters and cognitive impairment was analyzed by Spearman correlation analysis,and the value of HRV parameters in evaluating cognitive impair-ment was explored by ROC curve analysis.Results The cognitively impaired group had signifi-cantly lower SDNN,PNN50,LF and HF than the cognitively normal group(P＜0.05,P＜0.01).Spearman correlation analysis indicated that SDNN,PNN50,LF and HF were negatively correla-ted with cognitive impairment in elderly patients with ischemic CSVD(r=-0.185,r=-0.720,r=-0.278,r=-0.387;P＜0.05).ROC curve analysis manifested that the AUC value,sensitivi-ty and specificity of combination of SDNN,PNN50,LF and HF in evaluating cognitive impair-ment in the patients was 0.972(95％CI:0.949-0.996),94.70％and 89.00％,respectively.The efficiency of combined evaluation was better than that of each indicator alone(P＜0.01).Conclusion The HRV parameters are closely associated with cognitive impairment in elderly pa-tients with ischemic CSVD.Early determination of SDNN,PNN50,LF,HF and other HRV pa-rameters can provide reference for the evaluation of cognitive impairment.

Objective To analyze the relationship between heart rate variability(HRV)parameters and cognitive impairment in elderly patients with ischemic cerebral small vessel disease(CSVD).Methods A total of 120 elderly patients with ischemic CSVD admitted in Affiliated Hospital of Southwest Medical University from December 2020 to December 2022 were recruited,and accord-ing to Montreal cognitive assessment(MoCA)score,they were divided into cognitively impaired group(MoCA score＜26,n=38)and cognitively normal group(MoCA score≥26,n=82).All pa-tients received dynamic electrocardiography to obtain HRV parameters,including standard devia-tion of R-R interval(SDNN),percentage of the number of pairs of adjacent R-R intervals differing by more than 50 ms(PNN50),power in low frequency range(LF)and power in high frequency range(HF).The relationship between HRV parameters and cognitive impairment was analyzed by Spearman correlation analysis,and the value of HRV parameters in evaluating cognitive impair-ment was explored by ROC curve analysis.Results The cognitively impaired group had signifi-cantly lower SDNN,PNN50,LF and HF than the cognitively normal group(P＜0.05,P＜0.01).Spearman correlation analysis indicated that SDNN,PNN50,LF and HF were negatively correla-ted with cognitive impairment in elderly patients with ischemic CSVD(r=-0.185,r=-0.720,r=-0.278,r=-0.387;P＜0.05).ROC curve analysis manifested that the AUC value,sensitivi-ty and specificity of combination of SDNN,PNN50,LF and HF in evaluating cognitive impair-ment in the patients was 0.972(95％CI:0.949-0.996),94.70％and 89.00％,respectively.The efficiency of combined evaluation was better than that of each indicator alone(P＜0.01).Conclusion The HRV parameters are closely associated with cognitive impairment in elderly pa-tients with ischemic CSVD.Early determination of SDNN,PNN50,LF,HF and other HRV pa-rameters can provide reference for the evaluation of cognitive impairment.

Objective To study the influencing factors of postoperative recurrence of vocal cord leukoplakia and establish a clinical prediction model.Methods A total of 386 patients with vocal cord leukoplakia treated in our hospital from February 2016 to February 2020 were selected retrospectively.According to the follow-up results,the patients were divided into two groups:recurrent group(n=89)and non-recurrent group(n=297).The general and clinical data of the two groups were collected.The influencing factors of postoperative recurrence of vocal cord leu-koplakia were screened by univariate analysis and Logistic regression analysis,and the Logistic risk prediction model was established.The model was internally verified by R software and boostrap method.Results Age(OR=0.924),drinking history(OR=1.946),voice abuse(OR=2.436),laryngopharyngeal reflux(OR=0.487),mod-erate dysplasia(OR=0.420)and severe dysplasia(OR=0.303)were the influencing factors of postoperative recur-rence of vocal cord leukoplakia.The internal verification AUC of the model was 0.777,95％the confidence interval was 0.663～0.825,and the model fit well.Conclusion The postoperative recurrence of vocal cord leukoplakia is related to the patient's age,leukoplakia range,pathological morphology and laryngopharyngeal reflux.

Objective:To explore the mediating effect of e-health literacy on disease control and lifestyle of type 2 diabetes patients.Methods:From June 2022 to June 2023, 337 patients with type 2 diabetes who visited Beijing Friendship Hospital, Capital Medical University were selected by convenience sampling. The patients were investigated with General Information Questionnaire, e-Health Literacy Scale (eHEALS), Control Status Scale for Diabetes (CSSD), and Health Promoting Lifestyle ProfileⅡ (HPLP-Ⅱ). Pearson correlation was used to analyze the correlation between e-health literacy, disease control, and lifestyle. AMOS 21.0 software was used to establish a structural equation model and perform mediating effect validation. A total of 337 questionnaires were distributed, and 315 valid questionnaires were collected, with an effective responding rate of 93.47% (315/337) .Results:Among 315 patients with type 2 diabetes, the score of eHEALS was (20.13±5.28), among which the scores of application ability, judgment ability and decision-making ability were (14.33±4.16), (4.06±1.34) and (1.74±0.50) respectively. The CSSD score was (77.38±9.24), and the HPLP-Ⅱ score was (159.37±21.03). The eHEALS score, application ability score, judgment ability score, and decision-making ability score were all positively correlated with CSSD score and HPLP-Ⅱ score ( P<0.05), and the CSSD score was positively correlated with the HPLP-Ⅱ score ( P<0.05). Lifestyle had a direct effect on disease control (β=0.363, P<0.01), e-health literacy had a direct effect on disease control (β=0.440, P<0.01), e-health literacy partially mediated the relationship between lifestyle and disease control (β=0.322, P<0.01), and the mediating effect accounted for 47.01% of the total effect. Conclusions:The e-health literacy of patients with type 2 diabetes is low as a whole, especially the judgment ability and decision-making ability. The e-health literacy plays a partial mediating role between disease control and lifestyle.

Objective To establish a viable bacteria assay for Helicobacter pylori(H.pylori)by assessing the cgt gene expression,and to develop accordingly a rapid and novel testing method for clinical precision treatment.Methods Viable bacteria count was determined in bacterial cultures.The transcriptional expression level of cgt(hp0421),the conserved gene that encodes cholesterol-α-glucosyltransferase(CGT)in H.pylori,was measured by RT-PCR.The correlation between the number of colonies and cgt gene transcription expression was analyzed and the regression model was constructed.The linear range,sensitivity,and specificity of the new method were examined accordingly.The bactericidal action of clarithromycin was assessed using this method to verify the performance of the method in determining clinical bacterial drug resistance.Results The Ct values of cgt for H.pylori colony counts of 102,104,106,and 108 CFU/mL were 29.67±0.14,23.37±0.36,17.65±0.37,and 11.38±0.39,respectively.In the range of 101-108 CFU/mL,the regression equation for cgt gene expression and viable bacterial counts determined by RT-qPCR was y=-0.350 1x+12.49,with the correlation coefficient being R2=0.9992 and the sensitivity being 101 CFU/mL,showing no cross-reaction with 13 other bacteria.The lg values of live H.pylori bacteria treated with clarithromycin at 0,5,10,20,and 40 μg/mL for 12 h were 2.57±0.02,2.45±0.01,2.19±0.02,1.91±0.07,and 1.33±0.05,respectively.The corresponding cgt gene Ct values were 27.76±0.09,28.37±0.24,29.51±0.14,30.11±0.12,and 31.66±0.11.By applying the cgt gene expression in the equation,the estimated counts of viable bacteria were found to be 2.73±0.03,2.52±0.08,2.11±0.05,1.89±0.02,and 1.33±0.04,showing no significant difference in statistical analysis(P＞0.05).Conclusion The method for assessing viable bacteria account by evaluating cgt gene expression in H.pylori was successfully established,significantly reducing the time required to determine viable bacteria count and providing a new method for clinical viable bacteria testing.

Recent studies have highlighted spatially resolved multi-omics technologies,including spatial genomics,transcriptomics,proteomics,and metabolomics,as powerful tools to decipher the spatial heterogeneity of the brain.Here,we focus on two major approaches in spatial transcriptomics(next-generation sequencing-based technologies and image-based technologies),and mass spectrometry imaging tech-nologies used in spatial proteomics and spatial metabolomics.Furthermore,we discuss their applications in neuroscience,including building the brain atlas,uncovering gene expression patterns of neurons for special behaviors,deciphering the molecular basis of neuronal communication,and providing a more comprehensive explanation of the molecular mechanisms underlying central nervous system disorders.However,further efforts are still needed toward the integrative application of multi-omics technologies,including the real-time spatial multi-omics analysis in living cells,the detailed gene profile in a whole-brain view,and the combination of functional verification.

Model informed precision dosing for warfarin is to provide individualized dosing by integrating information related to patient characteristics, disease status and pharmacokinetics /pharmacodynamics of warfarin, through mathematical modeling and simulation techniques based on the quantitative pharmacology. Compared with empirical dosing, it can improve the safety, effectiveness, economy, and adherence of pharmacotherapy of warfarin. This consensus report describes the commonly used modeling and simulation techniques for warfarin, their application in developing and adjusting dosing regimens, medication adherence and economy. Moreover, this consensus also elaborates the detailed procedures for the implementation in the warfarin pharmacy service pathway to facilitate the development and application of model informed precision dosing for warfarin.

Objective:To explore the effect of insulin pump management led by diabetes specialist nurses in elderly diabetic patients.Methods:From January 2019 to December 2020, convenience sampling was used to select 149 patients with type 2 diabetes mellitus who used insulin pumps during hospitalization in the Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University. Among them, the patients from January to December 2019 were in the control group (71 cases) , and the patients from January to December 2020 were in the observation group (78 cases) . During the use of insulin pump, the two groups were treated with conventional insulin pump management and insulin pump management led by diabetes specialist nurses. The blood glucose fluctuation coefficient, the time to reaching blood glucose target, insulin pump-related negative events, and insulin pump-related knowledge and skills were compared between the two groups.Results:The blood glucose fluctuation coefficient of the observation group was lower than that of the control group, and the time to reaching blood glucose target was shorter than that of the control group, and the differences were statistically significant ( P<0.01) . The incidences of insulin pump-related negative events in the control group and the observation group were 57.75% (41/71) and 20.51% (16/78) , respectively, and the difference was statistically significant (χ 2=21.815, P<0.01) . After intervention, the insulin pump-related knowledge and skills in the observation group were better than those in the control group, and the difference was statistically significant ( P<0.01) . Conclusions:The insulin pump management led by diabetes specialist nurses is beneficial to patients' blood glucose control, can reduce the incidence of insulin pump-related negative events, and improve patients' insulin pump-related knowledge and skills.