BACKGROUND:Inflammation is one of the important factors that induce cerebral ischemia-reperfusion injury.Studies have shown that electroacupuncture can effectively reduce inflammation after ischemic stroke and improve the symptoms of neurological deficits,but the mechanism is not clear. OBJECTIVE:To observe the effect of electroacupuncture on Toll-like receptor 4/nuclear factor-κB in rats with cerebral ischemia-reperfusion injury. METHODS:Forty-eight male Sprague-Dawley rats were randomly divided into sham operation group,model group and electroacupuncture group,with 16 rats in each group.The rat model of cerebral ischemia-reperfusion injury was prepared by middle cerebral artery occlusion.At 24 hours after modeling,the rats in the electroacupuncture group were treated with electroacupuncture,once a day,20 minutes each time,for a total of 5 days.The sham operation group and the model group did not do any intervention.After 5 days of intervention,Longa method was used to evaluate the degree of neurological injury in rats.Triphenyl tetrazolium chloride staining and hematoxylin-eosin staining were used to measure the volume of cerebral infarction and the pathological changes of brain tissue in rats.Serum interleukin-6,interleukin-18 and tumor necrosis factor-α were detected by ELISA.Expressions of Toll-like receptor 4 and nuclear factor-κB in the cerebral cortex at mRNA and protein levels were detected by fluorescence quantitative PCR and western blot,respectively. RESULTS AND CONCLUSION:Compared with the sham operation group,the neurological function scores,serum interleukin-6,interleukin-18,and tumor necrosis factor-α levels,Toll-like receptor 4 and nuclear factor-κB mRNA and protein expression levels were significantly higher in the model group(P＜0.01).Compared with the model group,electroacupuncture significantly reduced the neurological function scores,serum interleukin-6,interleukin-18,and tumor necrosis factor-α levels,Toll-like receptor 4 and nuclear factor-κB mRNA and protein expression levels(P＜0.05,P＜0.01).Compared with the sham operation group,the volume of cerebral infarction in the model group increased significantly(P＜0.01).Compared with the model group,the volume of cerebral infarction in the electroacupuncture group decreased(P＜0.05).In the model group,the arrangement of neurons was disordered,some nerve cells disappeared,nuclei presented with pyknosis and incomplete structure.After electroacupuncture intervention,the degree of neuronal degeneration and neuronal loss in the cerebral cortex of rats were reduced compared with those in the model group.To conclude,electroacupuncture can significantly improve the neurobehavior of rats with cerebral ischemia-reperfusion injury,reduce brain tissue injury,and effectively reduce the level of serum inflammatory factors.The mechanism may be related to the inhibition of Toll-like receptor 4/nuclear factor-κB signaling pathway.

Background Sleep quality is one of the important factors affecting soldiers’ task performance. Objective To explore the effects of mindful attention awareness, burnout, and occupational stress on sleep quality among soldiers in plateau areas. Methods A total of 1090 soldiers were selected from four units in plateau areas by cluster sampling method and were asked to participate a cross-sectional questionnaire survey using the Pittsburgh Sleep Quality Index (PQSI), Occupational Stress Inventory (OSI), Maslach Burnout Inventory-General Survey (MBI-GS), and Mindful Attention Awareness Scale (MAAS). Correlation analysis, regression analysis, and mediated effect test were conducted for the study. Results Of the 1090 soldiers recruited, 1082 soldiers returned valid questionnaires, and the valid recovery rate was 99.26%. The median (P₂₅, P₇₅) score of PSQI was 4.00 (2.00,7.00), the median score of OSI was 26.00 (17.00, 34.00), the median score of MBI-GS was 3.53 (3.13, 4.00), and the median score of MAAS was 71.00 (59.00, 82.00). The burnout and mindful attention awareness levels varied among military personnel of different age groups (P<0.05), so did the burnout and occupational stress levels among military personnel of different length of service groups (P<0.05), and the occupational stress, PSQI, burnout, and mindful attention awareness levels among military personnel with different educational backgrounds and genders (P<0.05). The results of mediated effect test showed that occupational stress and burnout had both a parallel mediated effect and a sequential mediating effect on the relationship between mindful attention awareness and sleep quality, with effect sizes of 15.3%, 21.5% and 31.8%, respectively. Conclusion There is a mediated effect on the relationship between mindful attention awareness and sleep quality by the occupational stress and burnout of military personnel in plateau areas, and sleep quality is also affected by mindful attention awareness through the chain-mediated effect of occupational stress and burnout.

Metabolic dysfunction-associated steatotic liver disease(MASLD)is the most prevalent chronic liver disease globally,encompassing the entire spectrum of fatty liver pathogenesis.It progresses from simple steatosis to metabolic-associated steatohepatitis(MASH),involving injury and inflammation,with or without fibrosis,ultimately leading to cirrhosis and hepatocellular carcinoma,which affects approximately a quarter of the world's population.Liver biopsy remains the gold standard for differentiating MASH from steatosis and assessing advanced fibrosis.However,its limitations,including costliness,invasiveness,and sampling bias,have spurred the development of noninvasive diagnostic techniques.In addition,there are no FDA-approved drugs for the treatment of MASLD.Enumerating noninvasive diagnostic markers that have the potential to replace liver biopsy were summarized,and the current treatment options for MASLD were discussed,with clinical trials designed to evaluate the efficacy and safety of single agents or combination therapies to halt or reverse disease progression,which could provide new insights for the clinical diagnosis and treatment of MASLD.

Objective:To investigate the factors influencing fall risk scores in elderly individuals.Methods:A total of 4 419 individuals were randomly selected using the cluster sampling method from Beijing, Nanning(Guangxi), and Yinchuan(Ningxia).Data on demographic characteristics and fall-related incidents were gathered and analyzed for their correlation with fall risk scores.Results:The fall risk score showed significant associations with various factors, such as the history of falls within one year( β=-3.607, 95% CI: -3.881 to -3.332), care methods( β=2.442, 95% CI: 2.226 to 2.658), exercise( β=0.714, 95% CI: 0.443 to 0.986), retirement( β=-0.585, 95% CI: -0.819 to -0.351), age( β=0.173, 95% CI: 0.159 to 0.187), and use of walking aids( β=-3.737, 95% CI: -4.054 to -3.421). Conclusions:Fall risk scores in older adults are influenced by a variety of factors.Factors such as no history of falls within the past year, living independently, engaging in physical activity, and being employed may contribute to lower fall risk scores in older adults.

Objective This study aimed to explore the effect of surgery combined with bone perforation for treating stage Ⅱ medication-related osteonecrosis of the jaw(MRONJ).Methods A total of 21 patients with stage Ⅱ mandibu-lar MRONJ who underwent surgical treatment from June 2020 to June 2023 were included in this study.Retrospective analysis was conducted on their clinical data,including gender,age,primary disease,drug name and administration meth-od,pre-surgery drug cessation,and prognosis.The cohort comprised 14 males and 7 females,with an average age at on-set of 68.33±10.74 years.According to the guidelines of the American Association of Oral and Maxillofacial Surgeons,the included patients had stage Ⅱ mandibular MRONJ.The treatment approach consisted of partial mandibulectomy combined with bone perforation techniques,ensuring tension-free suturing of soft tissues.Follow-up was performed reg-ularly,and the curative effect was evaluated.The SF-12 health survey was used to assess the quality of life for all pa-tients before and after surgery.Results A total of 21 patients were followed up for 8-38 months after surgery,and the mucosal healing of 17 patients was good(80.95%).The postoperative quality of life score(83.62±5.90)was sig-nificantly higher than that before operation(63.67±4.70,P<0.05).Conclusion Surgery combined with bone per-foration technique is an effective treatment method with high success rate in refractory stage Ⅱ MRONT patients.

Objective:To explore the mediating effect of breastfeeding self-regulation on the relationship between breastfeeding self-efficacy and breastfeeding adaptation in parturient women.Methods:Totally 310 parturient women who visited the postpartum clinic at Wuxi Maternity and Child Health Care Hospital from May to September 2023 were selected by convenience sampling. The participants were surveyed using a General Information Questionnaire, the Breastfeeding Self-Regulation Questionnaire (BSRQ), the Breastfeeding Self-Efficacy Scale Short Form (BSES-SF), and the Breastfeeding Adaptation Scale (BFAS). The mediating effect of breastfeeding self-regulation between breastfeeding self-efficacy and breastfeeding adaptation was tested using the Process macro and Bootstrap method.Results:The scores for the 310 parturient women were 16.83 (13.83, 19.67) for BSRQ, (45.20±12.38) for BSES-SF, and 107.50 (96.00, 118.00) for BFAS. Spearman correlation analysis showed that breastfeeding self-efficacy was positively correlated with breastfeeding self-regulation and breastfeeding adaptation ( rs=0.314, 0.673; P<0.01), and breastfeeding self-regulation was positively correlated with breastfeeding adaptation ( rs=0.618; P<0.01). The mediating effect of breastfeeding self-regulation between breastfeeding self-efficacy and breastfeeding adaptation was 0.149, accounting for 21.88% of the total effect. Conclusions:Breastfeeding self-regulation mediates the relationship between breastfeeding self-efficacy and breastfeeding adaptation in parturient women. In early postpartum breastfeeding management, healthcare professionals should take measures to improve breastfeeding self-efficacy, help parturient women enhance their self-regulation abilities, and thereby improve their breastfeeding adaptation.

We reported a case of a patient dignosed as tuberculosis and severe malnutrition with coronavirus disease 2019 （critical type） treated with a combination of Chinese medicine and Western medicine. Through the retrospective analysis of the diagnosis and treatment process of this patient， on the basis of Chinese medicine's understanding of the etiology and pathogenesis of “old state” and “deficient state”， the critical coronavirus pneumonia combined with pulmonary tuberculosis and severe malnutrition was mostly due to the physical condition and the invasion of epidemic toxin， resulting in dysfunctions of the internal organs such as the lungs， spleens， kidneys and other organs. Based on the understanding of the cause and mechanism of the coronavirus disease， the treatment combined Chinese and Western medical therapies was given. The western medicine was used with the main treatments of oxygen therapy， anti-viral， intestinal nutritional support， and anti-coagulation， while the Chinese medicine was used by tonifying qi， blood， yin， and yang， warming yang and dissipating cold， and clearing heat and dampness， then tonifying qi， nourishing yin and eliminating heat， in which tonifying middle and replenishing qi ran through the whole process. The integrated treatment eventually improved the patient's symptoms and accelerated the negative conversion of nucleic acid of the coronavirus.

ObjectiveTo investigate the incidence and severity of COVID-19 reinfection. MethodsWe searched relevant studies on COVID-19 reinfection， including cohort study， case report， and cross-sectional study in PubMed， Embase， CNKI and Wanfang databases. Revman5.3.0 was used for statistical analysis. ResultsA total of 52 studies in 19 countries were included. These literatures showed moderate and high quality. Furthermore， the pooled incidence of COVID-19 reinfection was estimated to be 1.9%（95%CI： 0.9%‒4.7%， P<0.01）， pooled incidence of reinfection among medical workers in hospitals and staff in nursing home was 13.8%（95%CI： 4.8%‒34.2%， P<0.01）， and pooled incidence of critical reinfection was 17.3%（95%CI： 11.5%‒25.9%， P<0.01）.Sensitivity and publication bias analysis showed that the pooled incidence was stable and no publication bias was identified. ConclusionIncidence and severity of COVID-19 reinfection are both high. Although the prevention and control policy against COVID-19 has been adjusted in China， the public should pay attention to taking protective measures to avoid the reinfection.

Objective:To observe any effects of contralateral repeated transcranial magnetic stimulation (rTMS) of the swallowing motor cortex on the swallowing and brainstem auditory evoked potentials (BAEPs) of stroke survivors with dysphagia.Methods:A total of 83 stroke survivors with dysphagia were randomly divided into an ipsilesional stimulation group ( n=22), a contralesional stimulation group ( n=21), a bilateral stimulation group ( n=20), and a control group ( n=20). In addition to their conventional dysphagia training, those in the three stimulation groups received 3Hz rTMS while the control group was given fake stimulation. The treatment was administered daily for 20 minutes, 6 days a week, for 5 consecutive weeks. Before and after the treatment, swallowing function was assessed videofluoroscopically and using the Dysphagia Outcome and Severity Scale (DOSS). The oral and pharyngeal stages of swallowing were evaluated using the videofluoroscopic dysphagia scale (VDS). Brain stem conduction was assessed using BAEPs. Results:After treatment the average DOSS scores of all 4 groups were significantly better than before the treatment. The average DOSS scores of the contralesional and bilateral sti-mulation groups were then significantly better than those of the other two groups. The sub-item and total VDS scores of all 4 groups had decreased significantly, but the average score of the bilateral stimulation group was significantly lower than the control group′s average. Ipsilesional stimulation significantly improved the VDS sub-item scores for the triggering of pharyngeal swallowing, laryngeal elevation, and pharyngeal transit time compared with the control group. In the contralesional stimulation group the average total score and the VDS sub-item scores for apraxia, premature bolus loss, oral transit times, the triggering of pharyngeal swallowing, vallecular residue, laryngeal elevation, coating on the pharyngeal wall, and pharyngeal transit time were significantly lower than those of the control group, on average. After the treatment the latencies of BAEP waves I, III and V and the I-III, III-V and I-V interpeak intervals had decreased significantly in all four groups, but the average latencies and intervals of the bilateral and contralesional groups were significantly shorter than those of the control group. The latencies and intervals of the bilateral stimulation group were then significantly shorter than those in the ipsilesional stimulation group on average. The average latency of wave V in the bilateral stimulation group (6.53±0.73ms) was significantly shorter than that in the contralesional stimulation group after the treatment.Conclusion:Bilateral rTMS over the swallowing motor cortex combined with conventional dysphagia training can significantly improve the swallowing of dysphagic stroke survivors.

Hypertensive disorder of pregnancy (HDP) involves two major public health issues: mother-infant safety and prevention and controlling major chronic disease. HDP poses a serious threat to maternal and neonatal safety, and it is one of the leading causes of maternal and perinatal morbidity and mortality worldwide, as well as an important risk factor for long-term cardiovascular disease (CVD). In order to explore effective strategies to prevent and control the source of CVD and reduce its risk, we have established a cohort of HDPs in Shenzhen for the primordial prevention of CVD. The construction of the HDP cohort has already achieved preliminary progress till now. A total of 2 239 HDP women have been recruited in the HDP cohort. We have established a cohort data management platform and Biobank. The follow-up and assessment of postpartum cardiovascular metabolic risk in this cohort has also been launched. Our efforts will help explore the pathophysiological mechanism of HDP, especially the pathogenesis and precision phenotyping, prediction, and prevention of pre-eclampsia, which, therefore, may reduce the risk of adverse pregnancy outcomes, and provide a bridge to linking HDP and maternal-neonatal cardiovascular, metabolic risk to promote the cardiovascular health of mothers and their infants.