ObjectiveTo explore the effect of cluster scalp acupuncture combined with Taijiquan training on depressive symptom, motor function, activities of daily living, serum markers, as well as brain functional connectivity (FC) and network topological properties in patients with post-stroke depression (PSD). MethodsA total of 40 PSD patients in the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from September, 2022 to September, 2023 were enrolled and randomly divided into control group (n = 20) and experimental group (n = 20). The control group received cluster scalp acupuncture alone, while the experimental group underwent Taijiquan training in addition, for four weeks. They were assessed with Hamilton Depression Scale-17 (HAMD-17), Fugl-Meyer Assessment (FMA) and Barthel Index (BI) before and after treatment, while the serum levels of dopamine (DA), 5-hydroxytryptamine (5-HT), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected with enzyme-linked immunosorbent assay. Resting-state functional magnetic resonance imaging (rs-fMRI) was applied to assess brain FC, as well as the global efficiency (Eg) and small-world property (σ) of brain networks. ResultsThe scores of HAMD-17, FMA and BI improved in both groups (t > 2.922, P < 0.01) after treatment, and improved more in the experimental group than in the control group (t > 2.517, P < 0.05). The serum levels of DA and 5-HT increased in both groups (t > 2.637, P < 0.05), and increased more in the experimental group (t > 2.192, P < 0.05). The serum levels of IL-6 and TNF-α decreased in the experimental group after treatment (t > 4.059, P < 0.001), and they were less than those in the control group (t > 2.154, P < 0.05). FC between left middle frontal gyrus and right anterior cingulate gyrus, as well as between left hippocampus and right precuneus were higher in the experimental group than in the control group after treatment (t > 3.867, P < 0.001), while Eg and σ increased in both groups (t > 2.828, P < 0.05), and they were higher in the experimental group (t > 2.675, P < 0.05). ConclusionCombination of Taijiquan training is more effective on depressive symptoms, motor function and activities of daily living in PSD patients, which may be related to up-regulation of serum DA and 5-HT, reduction of inflammatory factors, enhancement of prefrontal-limbic system functional connectivity and optimization of brain network topological properties.

Objective To analyze the clinical, imaging, pathological characteristics and prognosis of renal mucinous tubular and spindle cell carcinoma (MTSCC), so as to provide preference for the differential diagnosis and clinical management of this disease.Methods A retrospective analysis was conducted on the clinical and follow-up data of 14 patients diagnosed with renal MTSCC at the Eastern Theater Command General Hospital during June 2021 and Aug.2025.Relevant literature was reviewed.Results Of the 14 patients, 10 were female (71.4%) and 4 were male (28.6%), with a mean age of 56.9 years. Pathological staging included pT1a in 6 cases, pT1b in 7 cases, and pT2b in 1 case.The median tumor diameter was 4.5 (range 2.0-11.0) cm.Twelve cases (85.7%) were asymptomatic and detected incidentally.On ultrasonography, most tumors exhibited well-defined margins and regular morphology (9/10, 90%) and appeared as homogeneous hypoechoic masses (7/10, 70%).All lesions demonstrated hypovascular features on imaging studies.Ten patients (71.4%) underwent laparoscopic radical nephrectomy, and 4(28.6%) received partial nephrectomy.Histologically, a distinctive architecture composed of tubular structures, spindle-shaped cells, and mucinous stroma was exhibited.Immunohistochemically, the positive rates of PAX-8, VIMENTIN and CK7 in tumor cells were 100% (13/13), 91.7% (11/12) and 84.6% (11/13), respectively.The Ki-67 proliferation index ranged from 2.0% to 40.0%.During a median follow-up of 25.0 (range4.9-0.0) months, no local recurrence or distant metastasis was observed.Conclusion Renal MTSCC is a rare subtype of renal cell carcinoma, typically lacking specific clinical symptoms and characterized by hypovascular imaging features.The tumor generally follows an indolent course with a favorable prognosis.For localized tumors, partial nephrectomy should be the primary consideration.For cases with high-risk pathological features such as sarcomatoid changes, due attention should be paid to the potential invasiveness and follow-up should be closely conducted.

Objective To evaluate the consistency of multi-slice spiral CT (MSCT), Digital Radiography (DR) and fat-suppression MRI in detecting occult knee joint injury. Method Clinical data from 150 patients with suspected occult knee injuries who presented to the Department of imaging at the General Hospital of Ordnance Industry between August 2022 and August 2023 were retrospectively reviewed. All patients underwent MSCT, DR, and fat-suppression MRI for diagnostic evaluation. Arthroscopic or surgical findings served as the gold standard. We analyzed and compared the detection rates of specific types of occult knee injuries (ligament, meniscus, occult fracture, etc.) across the three modalities, as well as their ability to assess the degree of collapse and horizontal displacement in patients with knee fractures, and their overall diagnostic performance. Result According to the gold standard, among the 150 patients with suspected occult knee injury, 103 tested positive and 47 negative. Statistically significant differences were observed among MSCT, DR, and fat-suppression MRI in detecting occult fractures(P<0.05). The detection rates ranked in descending order asfollows: fat-suppression MRI>MSCT>DR. However, no significant difference were found in the detection rates of joint effusion and patellar cartilage injuries among the three techniques (P>0.05). Statistically differences were also note among the three techniques in detecting the degree of collapse and horizontal displacement in patients with knee fractures (P<0.05). Specifically fat-suppression MRI identified a higher proportion of grade 1 and 2 lesions than both MSCT and DR. Statistically significant differences were observed among the three techniques in diagnostic sensitivity and accuracy for occult knee injuries (P<0.05). Fat-suppression MRI demonstrated superior sensitivity (99.03%) and accuracy (96.67%) compared with MSCT (75.73%, 79.33%) and DR (61.17%, 68.00%). However, no significant difference was found in diagnostic specificity among the three techniques (P>0.05). Conclusion Compared with MSCT and DR, fat-suppression MRI offers higher diagnostic sensitivity and accuracy for occult knee injuries, particularly in identifying ligament injuries, meniscus injuries, and occult fractures.

AIM:To explore the toxicological mechanisms of benzalkonium chloride(BAC)as a preservative in ophthalmic preparations leading to corneal injury in dry eye.METHODS:Network toxicology was employed to obtain the chemical structure of BAC, its toxic targets, and targets associated with dry eye-related corneal injury from databases including PubChem, CTD, ChEMBL, and STITCH. The protein-protein interaction(PPI)networks were constructed using the STRING database to screen key toxicity targets. Gene ontology(GO)functional annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses were performed to elucidate the potential biological processes and signaling pathways affected by BAC. Furthermore, molecular docking techniques were employed to validate the binding affinity of BAC to its key targets(IL-6, IL-1β, TNF, and EGF).RESULTS:BAC had a toxicity grade of 4 and exhibited significant eye irritation. A total of 85 common targets of BAC and dry eye corneal damage were screened out, of which 49 were key toxic targets, including TNF, IL-6, TP53, IL-1β, BCL2, etc. KEGG enrichment analysis showed that BAC mainly acted on 7 corneal injury pathways closely associated with corneal injury, such as IL-17, TNF, NF-κB, JAK-STAT, PI3K-Akt, Rap1, and MAPK. The results of molecular docking showed that BAC had stable binding ability to IL-6, IL-1β, TNF, EGF, and other targets(binding energy <0).CONCLUSION:BAC may induce corneal damage in dry eye through multi-target and multi-pathway mechanisms, involving processes such as inflammatory response, apoptosis, disruption of tear film stability, and delayed corneal repair, which suggests that long-term use of ophthalmic preparations containing BAC may aggravate ocular surface damage.

Objective To evaluate the consistency of multi-slice spiral CT (MSCT), Digital Radiography (DR) and fat-suppression MRI in detecting occult knee joint injury. Method Clinical data from 150 patients with suspected occult knee injuries who presented to the Department of imaging at the General Hospital of Ordnance Industry between August 2022 and August 2023 were retrospectively reviewed. All patients underwent MSCT, DR, and fat-suppression MRI for diagnostic evaluation. Arthroscopic or surgical findings served as the gold standard. We analyzed and compared the detection rates of specific types of occult knee injuries (ligament, meniscus, occult fracture, etc.) across the three modalities, as well as their ability to assess the degree of collapse and horizontal displacement in patients with knee fractures, and their overall diagnostic performance. Result According to the gold standard, among the 150 patients with suspected occult knee injury, 103 tested positive and 47 negative. Statistically significant differences were observed among MSCT, DR, and fat-suppression MRI in detecting occult fractures(P<0.05). The detection rates ranked in descending order asfollows: fat-suppression MRI>MSCT>DR. However, no significant difference were found in the detection rates of joint effusion and patellar cartilage injuries among the three techniques (P>0.05). Statistically differences were also note among the three techniques in detecting the degree of collapse and horizontal displacement in patients with knee fractures (P<0.05). Specifically fat-suppression MRI identified a higher proportion of grade 1 and 2 lesions than both MSCT and DR. Statistically significant differences were observed among the three techniques in diagnostic sensitivity and accuracy for occult knee injuries (P<0.05). Fat-suppression MRI demonstrated superior sensitivity (99.03%) and accuracy (96.67%) compared with MSCT (75.73%, 79.33%) and DR (61.17%, 68.00%). However, no significant difference was found in diagnostic specificity among the three techniques (P>0.05). Conclusion Compared with MSCT and DR, fat-suppression MRI offers higher diagnostic sensitivity and accuracy for occult knee injuries, particularly in identifying ligament injuries, meniscus injuries, and occult fractures.

Objective To evaluate the consistency of multi-slice spiral CT (MSCT), Digital Radiography (DR) and fat-suppression MRI in detecting occult knee joint injury. Method Clinical data from 150 patients with suspected occult knee injuries who presented to the Department of imaging at the General Hospital of Ordnance Industry between August 2022 and August 2023 were retrospectively reviewed. All patients underwent MSCT, DR, and fat-suppression MRI for diagnostic evaluation. Arthroscopic or surgical findings served as the gold standard. We analyzed and compared the detection rates of specific types of occult knee injuries (ligament, meniscus, occult fracture, etc.) across the three modalities, as well as their ability to assess the degree of collapse and horizontal displacement in patients with knee fractures, and their overall diagnostic performance. Result According to the gold standard, among the 150 patients with suspected occult knee injury, 103 tested positive and 47 negative. Statistically significant differences were observed among MSCT, DR, and fat-suppression MRI in detecting occult fractures(P<0.05). The detection rates ranked in descending order asfollows: fat-suppression MRI>MSCT>DR. However, no significant difference were found in the detection rates of joint effusion and patellar cartilage injuries among the three techniques (P>0.05). Statistically differences were also note among the three techniques in detecting the degree of collapse and horizontal displacement in patients with knee fractures (P<0.05). Specifically fat-suppression MRI identified a higher proportion of grade 1 and 2 lesions than both MSCT and DR. Statistically significant differences were observed among the three techniques in diagnostic sensitivity and accuracy for occult knee injuries (P<0.05). Fat-suppression MRI demonstrated superior sensitivity (99.03%) and accuracy (96.67%) compared with MSCT (75.73%, 79.33%) and DR (61.17%, 68.00%). However, no significant difference was found in diagnostic specificity among the three techniques (P>0.05). Conclusion Compared with MSCT and DR, fat-suppression MRI offers higher diagnostic sensitivity and accuracy for occult knee injuries, particularly in identifying ligament injuries, meniscus injuries, and occult fractures.

Objective To study the compliance and influencing factors of inhalation therapy in patients with stable chronic obstructive pulmonary disease (COPD),and carry out patient education and management accordingly. Methods COPD patients were selected from respiratory clinic of Luodian Hospital of Baoshan District of Shanghai from June to December in 2021. Compliance and inhalation techniques were assessed with the Morisky Medication Adherence Scale and the ten-step inhalation technique, and the factors influencing compliance were analyzed. Results A total of 58 outpatients with COPD were included, in which 25 cases (43.1%) with moderate or above compliance. Univariate analysis showed that the patients with course of disease ≥5 years, COPD assessment test(CAT)≥10 points, used 2 inhalation devices and inhalation technique score ≥8 points had better compliance when compared with other patients (P<0.05). Conclusion Patient education and management should be carried out actively. The patients with course of disease<5 years, CAT<10 points should be highly concerned. The inhalation devices should be chosen according to the patients' condition. Training on the use of devices should be strengthened and regularly follow-up evaluation should be carried out.

Objective Genetic testing and prenatal diagnosis were conducted in 18 congenital insensitivity to pain with anhidrosis(CIPA)families,laying the foundation for reducing the incidence of CIPA.Methods Genetic testing was performed using whole-genome sequencing and/or PCR-Sanger sequencing to identify candidate patho-genic vari-ants in the probands.For deep intronic variants,the pathogenicity was validated through minigene assays,RT-PCR,Sanger sequencing,and co-segregation analysis.DNA extracted from chorionic villus or amniotic fluid cells was analyzed by PCR and Sanger sequencing to determine the genotype of the fetuses.Maternal DNA contamination was excluded by microsatellite allele genotyping.Additionally,multiplex ligation-dependent probe amplification(MLPA)was employed to detect common chromosomal aneuploidies.Results A total of 21 NTRK1 variants were identified across 18 CIPA pedigrees,including 9 missense variants,2 nonsense variants,5 frameshift variants,and 5 deep intronic variants.Among them,3 were novel pathogenic variants.Prenatal genetic diagnosis was performed in 20 high-risk fetuses,revealing 2 normal fetuses,12 carriers,and 6 affected with CIPA.Microsatellite genotyping confirmed the absence of maternal DNA contamination in fetal samples.Moreover,MLPA analysis excluded common chromosomal aneuploidies associated with syndromic conditions in all tested fetuses.Conclusions This study achieved a 100%molecular diagnosis rate in CIPA families,identified three novel pathogenic variants,and enabled the simultaneous prevention of CIPA and common chromosomal syndromes through integrated prenatal ge-netic testing,thereby providing critical insights for genetic counseling.

Objective:To develop an artificial intelligence (AI)-based automatic scoring model for magnetic resonance imaging-detected extramural vascular invasion (AI-mrEMVI) and evaluate its performance and prognostic value in patients with rectal cancer.Methods:In this multicenter retrospective cohort study, a total of 2 501 rectal cancer patients from seven centers between November 2012 and December 2020 were included and divided into completely independent training ( n=1 830) and validation ( n=671) cohorts. A nnUNet-based AI-mrEMVI scoring model was constructed. Manual mrEMVI scores assigned by two radiologists served as the reference standard for accessing the accuracy of the AI-mrEMVI scoring. Kaplan-Meier survival analysis and Cox regression were used to evaluate the prognostic stratification ability of the AI-mrEMVI scores. The concordance index (C-index) was calculated to evaluate prognostic performance. Results:In the validation cohort, the manual mrEMVI scores were 0-2 in 425 patients (63.3%), 3 in 89 (13.4%), and 4 in 157 (23.4%). The AI-mrEMVI model identified 0-2 in 375 patients (55.9%), 3 in 95 (14.2%), and 4 in 201 (30.0%), with an overall accuracy of 81.1% (544/671, 95% CI 77.9%-84.0%). The 3-year disease-free survival (DFS) rates for patients with AI-mrEMVI scores of 0-2, 3, and 4 were 85.2%, 70.0%, and 58.2%, respectively, and the 5-year overall survival (OS) rates were 87.2%, 81.6%, and 62.6%, respectively (DFS: χ2=48.74, P<0.001; OS: χ2=30.04, P<0.001). Multivariable Cox regression showed that for DFS, AI-mrEMVI scores of 3 and 4 were associated with hazard ratios ( HR) of 1.75 (95% CI 1.11-2.77, P=0.016) and 2.65 (95% CI 1.86-3.78, P<0.001), respectively. For OS, an AI-mrEMVI score of 4 was associated with an HR of 2.56 (95% CI 1.62-4.03, P<0.001). The C-index values of the AI-mrEMVI scoring model for predicting DFS and OS were 0.647 (95% CI 0.608-0.686) and 0.650 (95% CI 0.598-0.702), respectively. Conclusion:The proposed AI-mrEMVI automatic scoring model demonstrated high diagnostic accuracy and performed favorably in predicting DFS and OS prognostic risk in patients with rectal cancer.

Objective To analyze the acupoint selection law of acupuncture and moxibustion for postherpetic neuralgia(PHN)with R language data mining technology.Methods The clinical research literature on acupuncture and moxibustion treatment of PHN included in CNKI,Wanfang Data,VIP and CBM from January 1,2010 to July 1,2023 was retrieved,and the database was established by Excel 2016.R language was used to statistically analyze the frequency of acupoint usage,meridians,locations,specific acupoints,etc.Through association rule analysis and clustering analysis,the characteristics and law of acupoint selection for acupuncture and moxibustion treatment of PHN were obtained.Results A total of 198 articles were included,including 83 acupoints,with a total frequency of 714 times.The high-frequency acupoints include Ashi acupoint,Jiaji acupoint and Yanglingquan.The commonly used meridians were gallbladder meridian,spleen meridian and large intestine meridiam.The acupoints were mostly in the upper and lower limbs,with the Wushu acupoints,Yuan acupoints and Xiahe acupoints being the most common.The core acupoint was Ashi acupoint,Jiaji acupoint,Hegu,Quchi,and 9 sets of association rules and 5 effective clusters were obtained.Conclusion The most commonly used acupoints for acupuncture and moxibustion treatment of PHN are Ashi acupoint,Jiaji acupoint,Hegu and Quchi,which mainly follow the principle of combining local acupoint selection with distal acupoint selection.