ObjectiveThis paper aims to study the effects of four weeks of aerobic exercise combined with Anmeidan on the synaptic plasticity marker protein and synaptic ultrastructure of the hippocampus in the model rats with sleep deprivation， thereby investigating the possible mechanism of its action to improve the learning memory of rats with sleep deprivation. Methods50 Sprague-Dawley （SD） rats were randomly divided into blank control group （group C）， sleep deprivation group （group M）， aerobic exercise + sleep deprivation group （group MEX）， Anmeidan + sleep deprivation group （group MA， 18.18 g∙kg^-1∙d^-1）， and aerobic exercise + Anmeidan + sleep deprivation group （group MEXA， 18.18 g∙kg^-1∙d^-1）. Anmeidan was administered by gavage in the MA group for four weeks. Aerobic exercise was performed in the MEX group for four weeks. Anmeidan was administered by gavage in the MEXA group in combination with aerobic exercise for four weeks， and sleep deprivation was performed for 72 h by using the multi-platform water environment method. At the end of sleep deprivation， Morris water maze was used to assess the learning and memory ability of rats in each group， and hematoxylin-eosin （HE） staining was used to observe the morphological changes of rats' hippocampal neurons. A transmission electron microscope was used to observe the synaptic ultrastructure of rats' hippocampus. The expression levels of brain-derived neurotrophic factor （BDNF）， tyrosine kinase receptor B （TrkB）， cAMP-response element binding protein （CREB）， postsynaptic density-95 （PSD-95）， and synaptophysin （SYN） were detected by Western blot， and the real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the relative mRNA expression levels of BDNF， TrkB， and CREB in the rats' hippocampus. ResultsCompared with those in group C， rats in group M had significantly longer latency and total swimming distance on the platform （P<0.01） and a significantly reduced number of traversals across the platform as well as the residence time in the target quadrant （P<0.01）. Part of the hippocampal neurons damaged， with a reduced number， disorganized arrangement， fuzzy synaptic gaps， thinning of post-synaptic dense material， and uneven density of synaptic vesicles. The protein expression levels and relative mRNA expression levels of BDNF， TrkB， and CREB were significantly reduced （P<0.01）， and the protein expression levels of PSD-95 and SYN were significantly reduced （P<0.01）. Compared with those in group M， rats in MA， MEX， and MEXA groups showed a decrease in latency to platform and total distance swum， an increase in the number of traversals across the platform and residence time in the target quadrant （P<0.05， P<0.01）， a reduction in hippocampal neuronal damage， a better arrangement， a more intact synaptic structure， a thickening of post-synaptic dense material， a uniform density of synaptic vesicles， and an increase in the protein expression levels and mRNA expression levels of BDNF， TrkB， and CREB （P<0.05， P<0.01）. The protein expressions of PSD-95 and SYN rose （P<0.05， P<0.01）. ConclusionAerobic exercise combined with Anmeidan can improve learning memory in rats with sleep deprivation， and its mechanism of action may be related to the modulation of the BDNF/TrkB/CERB signalling pathway， up-regulation of the expression of PSD-95 and SYN， and improvement of synaptic structural damage. The combination of interventions is superior to single exercise or drugs.

ObjectiveTo construct a large language model （LLM）-based intelligent pre-consultation system for traditional Chinese medicine （TCM） to improve efficacy of clinical practice. MethodsA TCM large language model was fine-tuned using DeepSpeed ZeRO-3 distributed training strategy based on YAYI 2-30B. A weighted undirected graph network was designed and an agent-based syndrome differentiation model was established based on relationship data extracted from TCM literature and clinical records. An agent collaboration framework was developed to integrate the TCM LLM with the syndrome differentiation model. Model performance was comprehensively evaluated by Loss function， BLEU-4， and ROUGE-L metrics， through which training convergence， text generation quality， and language understanding capability were assessed. Professional knowledge test sets were developed to evaluate system proficiency in TCM physician licensure content， TCM pharmacist licensure content， TCM symptom terminology recognition， and meridian identification. Clinical tests were conducted to compare the system with attending physicians in terms of diagnostic accuracy， consultation rounds， and consultation duration. ResultsAfter 100 000 iterations， the training loss value was gradually stabilized at about 0.7±0.08， indicating that the TCM-LLM has been trained and has good generalization ability. The TCM-LLM scored 0.38 in BLEU-4 and 0.62 in ROUGE-L， suggesting that its natural language processing ability meets the standard. We obtained 2715 symptom terms， 505 relationships between diseases and syndromes， 1011 relationships between diseases and main symptoms， and 1 303 600 relationships among different symptoms， and constructed the Agent of syndrome differentiation model. The accuracy rates in the simulated tests for TCM practitioners， licensed pharmacists of Chinese materia medica， recognition of TCM symptom terminology， and meridian recognition were 94.09%， 78.00%， 87.50%， and 68.80%， respectively. In clinical tests， the syndrome differentiation accuracy of the system reached 88.33%， with fewer consultation rounds and shorter consultation time compared to the attending physicians （P＜0.01）， suggesting that the system has a certain pre- consultation ability. ConclusionThe LLM-based intelligent TCM pre-diagnosis system could simulate diagnostic thinking of TCM physicians to a certain extent. After understanding the patients' natural language， it collects all the patient's symptom through guided questioning， thereby enhancing the diagnostic and treatment efficiency of physicians as well as the consultation experience of the patients.

Schizophrenia (SZ) stands as a severe psychiatric disorder. This study applied diffusion tensor imaging (DTI) data in conjunction with graph neural networks to distinguish SZ patients from normal controls (NCs) and showcases the superior performance of a graph neural network integrating combined fractional anisotropy and fiber number brain network features, achieving an accuracy of 73.79% in distinguishing SZ patients from NCs. Beyond mere discrimination, our study delved deeper into the advantages of utilizing white matter brain network features for identifying SZ patients through interpretable model analysis and gene expression analysis. These analyses uncovered intricate interrelationships between brain imaging markers and genetic biomarkers, providing novel insights into the neuropathological basis of SZ. In summary, our findings underscore the potential of graph neural networks applied to multimodal DTI data for enhancing SZ detection through an integrated analysis of neuroimaging and genetic features.
Humans ; Schizophrenia/pathology* ; Diffusion Tensor Imaging/methods* ; Male ; Female ; Adult ; Brain/metabolism* ; Young Adult ; Middle Aged ; White Matter/pathology* ; Gene Expression ; Nerve Net/diagnostic imaging* ; Graph Neural Networks

In this work, starting from 4-hydroxycoumarin, three series of 22 coumarin derivatives, among which 8 have not been reported in the literature, were synthesized and their in vitro anti-inflammatory activities and mechanisms of action were preliminarily investigated using mouse macrophage model. The results showed that most of the derivatives could significantly inhibit the production of pro-inflammatory factor NO, with compounds 2e, 2f, 2g, 2h, 2i, 2j, 4e, and 4f showing better anti-inflammatory activity than the positive control drug dexamethasone. Further experiments showed that compounds 2h and 4f significantly inhibited the production of pro-inflammatory factors IL-6, TNF-α and IL-1β in RAW264.7 macrophages, and could, therefore, be used as lead compounds for further studies.

The morbidity of gout is increasing year by year,and it has become a common and frequent disease.Once induced,the pain will reach its peak within 24 hours,which leading unsufferable pain to the patients.Buccal needling is a new micro-needling therapy created by Professor WANG Yongzhou's team,which was discovered and summarized in clinical practice of acupuncture after years of research.Buccal needling exerts certain efficacy in the treatment of acute gout.The progress of gout is related to the three levels of"body,qi and spirit".This paper discusses buccal needling in the treatment of acute gouty arthritis from the view of biological holographic theory,generalized triple energizer theory,and the theory of the integration of spirit and body,thus to provide certain reference for the further development of buccal needling in the treatment of pain-related diseases.

Objective To investigate the detection conditions,risk factors and preventive measures of colorectal polyps in health examination population undergoing painless colonoscopy.Methods A total of 2 680 people who underwent painless colonoscopy at the Health Management Center of the First Affiliated Hospital of Naval Medical University from January to December 2023 were enrolled in this retrospective study.They were assigned into polyp group and non-polyp group according the examination results.The general information of the two groups was collected to explore the risk factors of colorectal polyps,so as to provide reference for the prevention strategy of colorectal polyps.Results The colorectal polyps were detected in 1 223 people(45.63%),including 633 cases(51.76%)of adenomatous polyps,587 cases(48.00%)of non-adenomatous polyps,and 3 cases(0.25%)of colorectal cancer.Logistic regression analysis indicated that male,smoking history,alcohol drinking history,age 40-59 years old,hyperlipidemia,and CRP>10 mg/L were risk factors of colorectal polyps(P<0.05).Conclusion There is a high detection rate of colorectal polyps in physical examination population.Men,aged 40-59 years old,hyperlipidemia,smoking history,alcohol drinking history,and CRP>10 mg/L are high risk factors of colorectal polyps,which should be paid more attention for the prevention and monitoring of colorectal polyps.

Objective To investigate the correlation between WT1,BCR-ABL genes and interleukin-6(IL-6),vascular endothelial growth factor(VEGF),plasma protein C(PC),plasma protein S(PS)in patients with myeloproliferative neoplasms(MPN).Methods A total of 54 MPN patients treated in this hospital from January 2021 to January 2024 were selected as the MPN group,and 54 healthy subjects undergoing physical examination during the same period were selected as the control group.The gene relative expression levels of WT1,BCR-ABL and levels of IL-6,VEGF,PC,and PS were detected and compared between the two groups.The correlations between WT1,BCR-ABL gene relative expression levels and IL-6,VEGF,PC,PS levels were analyzed,and the diagnostic efficacy of WT1 and BCR-ABL genes for MPN was evaluated by receiver operat-ing characteristic(ROC)curve.Results Compared with the control group,the gene relative expression levels of WT1,BCR-ABL and the levels of IL-6 and VEGF in the MPN group were higher,while the levels of PC and PS were lower,with statistically significant differences(P<0.05).Pearson correlation analysis showed that WT1 and BCR-ABL gene relative expression levels were positively correlated with IL-6 and VEGF levels,and negatively correlated with PC and PS levels(P<0.05).The combined use of WT1 and BCR-ABL genes has higher diagnostic efficacy for MPN than single indicators,with an area under the curve(AUC)of 0.833 and a sensitivity of 88.69%.Conclusion The relative expression levels of WT1 and BCR-ABL genes are correlated with IL-6,VEGF,PC,and PS levels in MPN patients.The combination of WT1 and BCR-ABL genes can effec-tively diagnose MPN.

Objective To explore the influence of 3D printed individualized tissue compensators on the dose of the radiotherapy target area and the radiotherapy accuracy in intensity-modulated radiotherapy for vul-var carcinoma.Methods Twenty patients with vulvar cancer who visited this hospital from December 2022 to December 2024 were selected as the research subjects and divided into the control group and 3D group accord-ing to the random number table method,10 cases in each group.The control group used the conventional tis-sue compensators,while the 3D group used the 3D printed individualized tissue compensators.The dosimetric results of the target area and normal tissues were compared between the two groups.Results Compared with the control group,the maximum dose[(5 501.00+22.12)cGy vs.(5 659.60+84.59)cGy],average dose[(5 203.60+52.45)cGy vs.(5 258.70+42.95)cGy]and dose of 2％target volume[(5 360.30+63.70)cGy vs.(5 408.90+91.90)cGy]in the 3D group were lower,and the homogeneity index(0.12+0.01 vs.0.13+0.02)and conformity index(1.16+0.05 vs.1.23+0.04)were better,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in dose of 30％clinical target volume of the bladder and rectum between the two groups(P＞0.05).During and after radiotherapy,among 20 cases,4 cases presented with grade 3 skin reactions,which were wet peeling,with 2 cases in each of the two groups.The remaining 16 cases had the grade 1 to 2 skin reactions.Conclusion In intensity-modulated radiotherapy for vulvar carcinoma,the dose distribution of 3D-printed personalized tissue compensators is superior to that of conventional organizational compensators.

Objective This study aimed to investigate the relationship between multiple inflammatory markers and poor outcome in patients with intracerebral hemorrhage,and to compare their predictive abilities.Methods We retrospectively analyzed the patients with intracerebral hemorrhage admitted to the Department of Neurology of the First Affiliated Hospital of Nanchang University from January 1,2015 to March 31,2023.According to the Modified Rankin Scale at 90 days after onset,the patients were divided into good outcome(mRS≤2 points)and poor outcome(mRS score≥3 points).Clinical information,laboratory examinations and follow-up data were compared between the two groups.Inflammatory markers include neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),monocyte to high-density lipoprotein ratio(MHR),systemic inflammatory response index(SIRI),systemic immune-inflammation index(SII),white blood cell count to mean platelet volume ratio(WMR),lymphocyte to monocyte ratio(LMR),and systemic coagulation-inflammation index(SCI).Univariate and multivariate logistic regression analysis were used to analyze the predictors of poor prognosis after intracerebral hemorrhage,and receiver operating characteristic curve(ROC)was constructed to compare their predictive ability.Results A total of 510 patients with intracerebral hemorrhage were included.Of those,297(58.2%)had good outcome,and 213(41.8%)had poor outcome.Comparison of baseline characteristics demonstrated that patients with poor prognosis had higher levels of white blood cells,neutrophils,high-density lipoprotein,fibrinogen,NLR,PLR,SIRI,SII,WMR at admission,larger baseline hematoma volume and baseline perihematomal edema volume,a higher proportion of lobar hemorrhage,older age,and lower levels of platelets,lymphocytes,LMR,and SCI(P<0.05).Multivariate regression analysis showed that NLR(OR:1.081,95%CI:1.032～1.1131,P=0.001),SIRI(OR:1.089,95%CI:1.014～1.169,P=0.019),SII(OR:1.000,95%CI:1.000～1.001,P=0.011),WMR(OR:2.627,95%CI:1.267～5.445,P=0.009)were independently associated with poor prognosis in patients with ICH.In ROC analysis,the area under the curve of NLR(0.729,95%CI:0.685～0.774)was higher than SIRI(0.692,95%CI:0.645～0.738),SII(0.688,95%CI:0.641～0.735)and WMR(0.65,95%CI:0.602～0.698)for predicting poor outcomes.Conclusion NLR,SIRI,SII and WMR at admission are independently associated with poor outcomes in patients with intracerebral hemorrhage,and NLR has the strongest predictive ability.

Objective This study aimed to investigate the relationship between multiple inflammatory markers and poor outcome in patients with intracerebral hemorrhage,and to compare their predictive abilities.Methods We retrospectively analyzed the patients with intracerebral hemorrhage admitted to the Department of Neurology of the First Affiliated Hospital of Nanchang University from January 1,2015 to March 31,2023.According to the Modified Rankin Scale at 90 days after onset,the patients were divided into good outcome(mRS≤2 points)and poor outcome(mRS score≥3 points).Clinical information,laboratory examinations and follow-up data were compared between the two groups.Inflammatory markers include neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),monocyte to high-density lipoprotein ratio(MHR),systemic inflammatory response index(SIRI),systemic immune-inflammation index(SII),white blood cell count to mean platelet volume ratio(WMR),lymphocyte to monocyte ratio(LMR),and systemic coagulation-inflammation index(SCI).Univariate and multivariate logistic regression analysis were used to analyze the predictors of poor prognosis after intracerebral hemorrhage,and receiver operating characteristic curve(ROC)was constructed to compare their predictive ability.Results A total of 510 patients with intracerebral hemorrhage were included.Of those,297(58.2%)had good outcome,and 213(41.8%)had poor outcome.Comparison of baseline characteristics demonstrated that patients with poor prognosis had higher levels of white blood cells,neutrophils,high-density lipoprotein,fibrinogen,NLR,PLR,SIRI,SII,WMR at admission,larger baseline hematoma volume and baseline perihematomal edema volume,a higher proportion of lobar hemorrhage,older age,and lower levels of platelets,lymphocytes,LMR,and SCI(P<0.05).Multivariate regression analysis showed that NLR(OR:1.081,95%CI:1.032～1.1131,P=0.001),SIRI(OR:1.089,95%CI:1.014～1.169,P=0.019),SII(OR:1.000,95%CI:1.000～1.001,P=0.011),WMR(OR:2.627,95%CI:1.267～5.445,P=0.009)were independently associated with poor prognosis in patients with ICH.In ROC analysis,the area under the curve of NLR(0.729,95%CI:0.685～0.774)was higher than SIRI(0.692,95%CI:0.645～0.738),SII(0.688,95%CI:0.641～0.735)and WMR(0.65,95%CI:0.602～0.698)for predicting poor outcomes.Conclusion NLR,SIRI,SII and WMR at admission are independently associated with poor outcomes in patients with intracerebral hemorrhage,and NLR has the strongest predictive ability.