Objective:To investigate the effect of iTBS stimulation of left hemisphere Broca region on view naming func-tion in patients with motor aphasia after stroke.Method:A total of 35 patients with aphasia who were treated in the department of rehabilitation medicine,Xuanwu hospital,capital medical university from September 2021 to May 2023 were retrospectively included.The enrolled patients were randomly divided into control group(n=17)and experimental group(n=18).Both groups received speech and language therapy with the same training duration and content,which consisted of pictures of training items.Meanwhile,iTBS was used to stimulate the left hemisphere Broca region in the ex-perimental group.Picture naming(training items and non-training items)was evaluated before treatment and 2 weeks after treatment.Result:There was no statistical difference between the two groups before treatment(P>0.05)in the naming results of training items and non-training items.After 2 weeks of treatment,the results of naming training items in both groups were significantly improved compared with before treatment(P<0.05).The experimental group was significantly higher than the control group(P<0.05),with the naming scores of the two groups af-ter treatment were(16.88±4.211)and(19.28±3.028),respectively.The results of naming non-training items were significantly higher than those before treatment(P<0.05)and significantly higher than those in control group(P<0.05).After treatment,the results of non-training items were(13.18±3.187)and(19.11±3.563)respectively.Conclusion:iTBS combined with speech language therapy has a certain therapeutic effect on the picture nam-ing ability of motor aphasia patients with left frontal lobe injury,and can significantly improve the generaliza-tion effect of speech language therapy.

Objective:To investigate the impact of Wenyang Ligong Decoction on pregnancy outcomes after transcervical resection of adhesions (TCRA) in patients with intrauterine adhesions (IUA).Methods:A retrospective cohort study was conducted to collect clinical data from 151 patients with IUA who underwent TCRA in the Reproductive Medicine Department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 2020 and January 2023. Patients were divided into a Traditional Chinese medicine (TCM) group (79 patients) and a control group (72 patients) based on whether they received Wenyang Ligong Decoction after TCRA. The TCM group received estrogen and progesterone sequential therapy post-surgery, combined with Wenyang Ligong Decoction for 2-3 menstrual cycles. The control only received sequential treatment with estrogen and progesterone.Pregnancy outcomes one year after surgery were compared between the two groups. After adjusting for confounding factors using multivariate Cox regression analysis, the effect of Wenyang Ligong Decoction on pregnancy outcomes after TCRA in patients with IUA was observed.Results:The live birth rate [54.43%　(43/79)], the ongoing pregnancy rate [56.96% (45/79)], and the clinical pregnancy rate [52.03% (49/79)] were higher in the TCM group than in the control [26.39% (19/72), P<0.001; 30.56% (22/72), P=0.001;37.50% (27/72), P=0.003], with statistically significant differences. There were no statistically significant differences in early abortion rate and late abortion rate between the TCM group and the control (all P>0.05). According to the stratified analysis by preparation methods, in the natural conception group, the live birth rate [60.78% (31/51)], the ongoing pregnancy rate [62.75% (32/51)], and the clinical pregnancy rate [68.63% (35/51)] in the TCM group were significantly higher than those in control group [21.43% (12/56), P<0.001; 26.79% (15/56), P<0.001; 33.93% (19/56), P<0.001]; there were no statistically significant differences in early miscarriage rate and late miscarriage rate between the two groups (both P>0.05). In the assisted reproductive technology group, there were no statistically significant differences in live birth rate, ongoing pregnancy rate, clinical pregnancy rate, early miscarriage rate, and late miscarriage rate between the two groups (all P>0.05). According to the stratified analysis by age, in the <35-year-old patients, the live birth rate [66.00% (33/50)], the ongoing pregnancy rate [70.00% (35/50)], and the clinical pregnancy rate [74.00% (37/50)] in the TCM group were significantly higher than those in control group [41.30% (19/46), P=0.015; 47.83% (22/46), P=0.027; 54.35% (25/46), P=0.044]; there were no statistically significant differences in early miscarriage rate and late miscarriage rate between the two groups (both P>0.05). In the ≥35-year-old patients, the live birth rate [34.48% (10/29)], the ongoing pregnancy rate [34.48% (10/29)], and the clinical pregnancy rate [41.38% (12/29)] in the TCM group were significantly higher than those in control group [0%, P=0.001; 0%, P=0.001; 7.69% (2/26), P=0.004]; there were no statistically significant differences in early miscarriage rate and late miscarriage rate between the two groups (both P>0.05).Univariate Cox regression analysis showed that age, number of previous uterine cavity interventions, IUA score, degree of IUA, and endometrial thickness after TCRA were independent risk factors for live births, and age, IUA score, degree of IUA, intima thickness after TCRA, and treatment group were the influencing factors of persistent pregnancy (all P<0.05). After adjusting for confounding factors, multivariate Cox regression analysis showed that Wenyang Ligong Decoction significantly improved the live birth rate ( HR=3.19, 95% CI: 1.77-8.11, P=0.001) and the rate of continuous pregnancy ( HR=3.66, 95% CI: 1.80-7.48, P<0.001) in patients with IUA. Conclusion:Wenyang Ligong Decoction can significantly improve pregnancy outcomes after TCRA in patients with IUA.

Objective:To systematically evaluate studies validating the performance of the Global Leadership Initiative on Malnutrition (GLIM) in diagnosing malnutrition.Methods:Seven Chinese and English databases including Embase, Web of Science (WOS), PubMed, CINAHL, Cochrane Library, SinoMed, CNKI, Wanfang Data, and VIP Database were searched for articles on the validation of GLIM criteria published between September 2018 and September 2024. Two researchers independently performed literature screening and data extraction. The concurrent and predictive validity of the criteria was analyzed.Results:A total of 136 papers were included for analysis. The GLIM criteria for diagnosing malnutrition had a sensitivity of 77%, a specificity of 87%, and an area under the curve (AUC) of 0.90. Malnutrition diagnosed by the GLIM criteria predicted prolonged hospital and intensive care unit (ICU) stays, increased readmission and complication rates (both overall and infectious), reduced survivals (median, overall, and disease-free), and increased in-hospital and follow-up mortalities. Both moderate and severe malnutrition predicted decreased overall survival. However, only three studies analyzed the impact of nutritional therapy on the clinical outcomes of malnourished patients.Conclusions:The GLIM criteria accurately differentiate malnutrition and are a valid predictive tool of clinical outcomes. However, the validity criteria in these validation studies were questionable, along with high methodological heterogeneity. Furthermore, there is a lack of studies validating the role of nutritional therapy in improving the clinical outcomes of malnourished patients.

AIM:To investigate whether direct stimulation of the Du Meridian improves autism-like behaviors in mice by modulating synaptic pruning.METHODS:Pregnant mice received intraperitoneal injections of valproic acid(VPA)or saline on gestational day 12.5.Offspring from saline-treated mice were assigned to the saline group.Offspring from VPA-treated mice were randomly divided into the model(VPA)group and the VPA-model-DuMaiTuiFa(VPA-DMTF)group.Each group included five mice.The VPA-DMTF group received direct stimulation along the Du Mai at 80 times per minute,10 minutes per session,twice daily for 21 days.After treatment,behavioral tests were conducted,in-cluding the three-chamber test for social interaction and the open field test for anxiety-like behavior.Hippocampal tissue was collected for analysis.Golgi staining was used to assess dendritic spine density.Immunofluorescence staining for post-synaptic denisty protein(PSD95)and synapsin 1(SYN1)was performed to evaluate synaptic protein expression.Staining for ionized calcium-binding adapter molecule 1(IBA1)and CD68 was used to assess microglial phagocytosis.Western blot analysis was conducted to evaluate hippocampal expression levels of PSD95,SYN1,IBA1,complement component 1,q subcomponent(C1q),complement component 3(C3),and complement receptor 3(CR3).RESULTS:Compared with the saline group,VPA mice showed reduced social behavior and increased anxiety(P<0.05).The expression levels of IBA1,PSD95,and SYN1 were significantly increased(P<0.05),whereas C1q,C3,and CR3 were significantly de-creased(P<0.05).Microglial phagocytosis declined.Immunofluorescence analysis showed increased levels of synaptic proteins(PSD95 and SYN1)in the VPA group(P<0.05).Golgi staining revealed a higher dendritic spine density and an increased proportion of immature dendritic spines(P<0.05).Compared with the VPA group,VPA-DMTF mice showed improved behavior,reduced IBA1,PSD95,and SYN1 levels(P<0.05),and increased expression of C1q,C3,and CR3(P<0.05).Microglial phagocytosis was enhanced,and dendritic spine number was reduced.CONCLUSION:Direct stimulation of the Du Mai alleviates autism-like behaviors in mice.This effect may be mediated by upregulation of comple-ment proteins C1q and C3,which enhance microglia-mediated synaptic pruning and reduce synaptic overabundance.

Objective:To systematically evaluate studies validating the performance of the Global Leadership Initiative on Malnutrition (GLIM) in diagnosing malnutrition.Methods:Seven Chinese and English databases including Embase, Web of Science (WOS), PubMed, CINAHL, Cochrane Library, SinoMed, CNKI, Wanfang Data, and VIP Database were searched for articles on the validation of GLIM criteria published between September 2018 and September 2024. Two researchers independently performed literature screening and data extraction. The concurrent and predictive validity of the criteria was analyzed.Results:A total of 136 papers were included for analysis. The GLIM criteria for diagnosing malnutrition had a sensitivity of 77%, a specificity of 87%, and an area under the curve (AUC) of 0.90. Malnutrition diagnosed by the GLIM criteria predicted prolonged hospital and intensive care unit (ICU) stays, increased readmission and complication rates (both overall and infectious), reduced survivals (median, overall, and disease-free), and increased in-hospital and follow-up mortalities. Both moderate and severe malnutrition predicted decreased overall survival. However, only three studies analyzed the impact of nutritional therapy on the clinical outcomes of malnourished patients.Conclusions:The GLIM criteria accurately differentiate malnutrition and are a valid predictive tool of clinical outcomes. However, the validity criteria in these validation studies were questionable, along with high methodological heterogeneity. Furthermore, there is a lack of studies validating the role of nutritional therapy in improving the clinical outcomes of malnourished patients.

Objective:To investigate the implementation of boxed warning of drug labels in US Food and Drug Administration (FDA) from 2019 to 2024, and compared it with the relevant situations in China, in order to provide reference for the revision of drug labels and safe drug use.Methods:Data on boxed warning revisions in the US FDA "Drugs Safety Related Labeling Changes" Database from January 1, 2019 to December 31, 2024 were retrieved, and the revised contents were classified. The drug labels for newly marketed drugs in the United States during the same period were collected, the boxed warnings were recorded and summarized, and compared with the warning statements in drug labels of relevant drugs approved in China.Results:From 2019 to 2024, FDA revised boxed warnings in 209 drug labels. Among them, 22 items (10.53%) were newly added, 63 items (30.14%) were major updates, 115 items (55.02%) were minor updates, and 9 items (4.31%) were removed. A total of 293 new drugs were approved in the United States from 2019 to 2024, of which 69 (23.55%) had boxed warnings when they were approved, and 4 (1.37%) were added boxed warnings when they were revised in the labels. Up to December 31, 2024, 92 of the 293 new drugs had been approved in China. Compared with the labeling in the United States, some drugs lacked warning statements section in China, including zolpidem tartrate, dexzopiclone, zaleplon, montelukast sodium, denosumab, terlipressin, etc.Conclusions:The warning statements in some Chinese drug labels are inconsistent with the boxed warnings in the American drug labels. It is suggested that the revision of the boxed warning by US FDA should be regarded as one of the new sources of safety information to assess the risks of related drugs and determine whether it is necessary to revise the relevant drug labels in China.

Objective:To investigate the relationship between the level of angiotensin Ⅱ type 1 receptor autoantibody (AT1-AA) in the uterine fluid and the thickness of endometrium in infertile women with chronic endometritis.Methods:A case-control study was conducted to select 122 patients who underwent hysteroscopy and endometrial tissue biopsy at Assisted Reproduction Center, Taiyuan Central Hospital due to infertility from March 2023 to January 2024 as the study subjects. According to the results of hysteroscopy and endometrial tissue biopsy, the patients were divided into 52 cases in the infertility group with normal endometrium (NE infertility group) and the chronic endometritis combined with infertility group (CE infertility group) with 70 cases. Enzyme-linked immunosorbent assay was used to detect the level of AT1-AA in uterine fluid of the two groups. General clinical data, AT1-AA absorbance value of uterine fluid and uterine related indexes of the two groups were analyzed, and the correlations between AT1-AA level and the variation of indexes were analyzed.Results:Gravidity (median: 1 vs 1; Z=7.029, P=0.030) and parity (median: 0 vs 0; Z=12.258, P=0.002) in CE infertility group were higher than those in NE infertility group. There was AT1-AA in the uterine fluid, and the level of AT1-AA in CE infertility group was significantly higher than that in NE infertility group (median: 2.07 vs 1.44; Z=3.099, P=0.029). The endometrial thickness of CE infertility group was lower than that of NE infertility group (median: 6.0 vs 7.0 mm; Z=-2.179, P=0.029), and there were no statistical differences in other indexes between the two groups (all P>0.05). Further correlation analysis showed that there were no correlation between the level of AT1-AA in uterine fluid and parity, endometrial thickness, gravidity in NE infertility group (all P>0.05). However, the level of AT1-AA in uterine fluid of CE infertility group was positively correlated with parity (Spearman′s r=0.339, P=0.004), and negatively correlated with endometrial thickness (Spearman′s r=-0.499, P<0.001), but not correlated with gravidity ( P>0.05). Conclusions:AT1-AA is present in the uterine fluid of infertile women. The elevated level of AT1-AA in uterine fluid of infertile women with CE is related to the thinning of the endometrium.

AIM:To investigate whether direct stimulation of the Du Meridian improves autism-like behaviors in mice by modulating synaptic pruning.METHODS:Pregnant mice received intraperitoneal injections of valproic acid(VPA)or saline on gestational day 12.5.Offspring from saline-treated mice were assigned to the saline group.Offspring from VPA-treated mice were randomly divided into the model(VPA)group and the VPA-model-DuMaiTuiFa(VPA-DMTF)group.Each group included five mice.The VPA-DMTF group received direct stimulation along the Du Mai at 80 times per minute,10 minutes per session,twice daily for 21 days.After treatment,behavioral tests were conducted,in-cluding the three-chamber test for social interaction and the open field test for anxiety-like behavior.Hippocampal tissue was collected for analysis.Golgi staining was used to assess dendritic spine density.Immunofluorescence staining for post-synaptic denisty protein(PSD95)and synapsin 1(SYN1)was performed to evaluate synaptic protein expression.Staining for ionized calcium-binding adapter molecule 1(IBA1)and CD68 was used to assess microglial phagocytosis.Western blot analysis was conducted to evaluate hippocampal expression levels of PSD95,SYN1,IBA1,complement component 1,q subcomponent(C1q),complement component 3(C3),and complement receptor 3(CR3).RESULTS:Compared with the saline group,VPA mice showed reduced social behavior and increased anxiety(P<0.05).The expression levels of IBA1,PSD95,and SYN1 were significantly increased(P<0.05),whereas C1q,C3,and CR3 were significantly de-creased(P<0.05).Microglial phagocytosis declined.Immunofluorescence analysis showed increased levels of synaptic proteins(PSD95 and SYN1)in the VPA group(P<0.05).Golgi staining revealed a higher dendritic spine density and an increased proportion of immature dendritic spines(P<0.05).Compared with the VPA group,VPA-DMTF mice showed improved behavior,reduced IBA1,PSD95,and SYN1 levels(P<0.05),and increased expression of C1q,C3,and CR3(P<0.05).Microglial phagocytosis was enhanced,and dendritic spine number was reduced.CONCLUSION:Direct stimulation of the Du Mai alleviates autism-like behaviors in mice.This effect may be mediated by upregulation of comple-ment proteins C1q and C3,which enhance microglia-mediated synaptic pruning and reduce synaptic overabundance.

Objective:To analyze clinical indicators and imaging data of hospitalized pneumonia patients and develop prediction models for length of hospital stay based on CT radiomics features and clinical indicators.Methods:Patients admitted to the First Clinical School of Hainan Medical University for pneumonia treatment between November 2020 and May 2024 were enrolled. Clinical data and CT imaging were collected, and radiomics features were extracted. Patients were divided into three groups based on the length of stay (<8 d, 8-28 d,>28 d, and poor prognosis). Three prediction models were constructed using logistic regression (LR): clinical features model, imaging features model and a combined clinical and imaging features model. The predictive performance of three models was evaluated using the area under the receiver operating characteristic (ROC) curve and DeLong test, followed by feature analysis. The Kappa test was used to compare the consistency of the overall classification.Results:A total of 343 subjects were included, with an average age of 61.46±20.98 years. The area under the curve (AUC) values of the combined model in different hospitalization duration classifications (<8 d, 8-28 d,>28 d, and poor prognosis) were 0.73, 0.65 and 0.78 in the training set, and 0.71, 0.65 and 0.76 in the validation set, respectively. The AUC values of the clinical feature model in different hospitalization duration classifications were 0.63, 0.64 and 0.73 in the training set, and 0.60, 0.52 and 0.63 in the validation set, respectively. The AUC values of the imaging feature model in different hospitalization duration classifications (<8 d, 8-28 d,>28 d, and poor prognosis) were 0.67, 0.66 and 0.73 in the training set, and 0.68, 0.54 and 0.66 in the validation set, respectively. The DeLong test results showed that the combined model outperformed other models in hospitalization duration classification (validation set AUC, all P<0.05, Bonferroni correction). Kappa test results showed that the combined model achieved the highest consistency between predicted classifications and actual hospitalization classifications ( K=0.615). Shape features, texture features and clinical features all contributed proportionally to the combined model. Conclusion:The combined model integrating radiomics features with clinical indicators can significantly enhance the predictive efficacy for the length of hospitalization in pneumonia patients.

In this paper， the name， origin， producing area， harvesting， processing and functional indications of Arcae Concha were systematically combed and verified by consulting the ancient and modern literature， in order to provide a basis for the development of famous classical formulas containing Arcae Concha. Arcae Concha was first recorded in the name of Han in Bencao Shiyi， but later， due to the influence of LI Shizhen's error of combining Han item with Kuiha in the Ming dynasty， there were aliases such as Kuilu and Fulao， and Yizong Bidu began to include Walengzi as its correct name and has been used ever since. The textual descriptions and illustrations of the medicinal materials of Arcae Concha contained in the materia medica of the past generations were consistent with the modern Arca inflata， A. subcrenata and A. granosa. In ancient times， there were medicinal records of two parts of shell and meat， but now the shell is used as medicine， and the meat is mostly edible. In ancient times， Zhejiang， Shandong， Guangdong and Guangxi were the main producing areas， and Zhejiang was the best. It is now believed that A. inflata is mostly distributed in the northern part of the Huanghai Sea， A. granosa is mostly distributed in the coastal areas south of Shandong Peninsula in China， and A. subcrenata is widely distributed in the coastal areas of China. Its quality is better in a complete， white， no residual meat and sand. In ancient times， there was no clear harvesting period， and the processing was mainly based on vinegar quenching after calcination or powdering of calcined shell， but now the harvesting period is autumn and winter. After harvesting， it is directly washed and crushed for raw use or processed by calcined method. The records of the medicinal materials in the past dynasties on the properties of Arcae Concha were mainly warm， sweet， salty and mild， and it is now believed that Arcae Concha is salty in taste and mild in nature. In ancient times， it was believed that Arcae Concha were mainly used for coldness in the heart and abdomen， coldness in the waist and spine， benefiting the five internal organs， strengthening the stomach. Nowadays， it is believed that Arcae Concha can eliminate phlegm and remove blood stasis， soften the hardness and dissipate the lumps， produce acid and relieve pain. It can be used in the treatment of stubborn phlegm， gall tumor， scrofula and other symptoms. In conclusion， it is suggested that for the famous classical formulas containing Arcae Concha， the corresponding methods should be selected according to the processing requirements of the drug in the formulas， while those without processing requirements can be determined according to the functional position of the products.