Chronic heart failure （CHF） is a complex clinical syndrome that the cardiac output is not enough to meet the metabolic needs of the body， or depends on the increase of filling pressure to compensate. Its high morbidity and mortality pose a serious threat to human health， necessitating attention and active intervention. At present， western medicine treatment of CHF is mainly based on diuretics， intravenous vasodilators， intravenous positive inotropic drugs， etc.， which， however， have problems such as long medication cycles， serious side effects， and limited applicable population. Recent studies have shown that traditional Chinese medicine can act in a multi-pathway， multi-component， and multi-target manner， showing unique advantages in the prevention and treatment of CHF. Buyang Huanwutang has the effects of tonifying Qi， activating blood， and dredging collaterals. Clinical and mechanism studies have confirmed that this prescription is effective in treating CHF and its syndromes. The clinical studies can be classified into two categories. Studies of the first category use simple modern medical diagnostic criteria as the inclusion criteria for CHF patients， which can improve the scientificity and objectivity. Studies of the second category uses modern medicine combined with traditional Chinese medicine disease diagnostic criteria for the screening of CHF patients， which helps to improve the accuracy of efficacy evaluation. However， there are problems such as the lack of unified research standards and the insufficiency of mechanism research. In addition， the available studies remain to be classified or summarized. This study systematically sorted out the clinical and mechanism studies of Buyang Huanwutang in the treatment of CHF in recent years to review the research status. In clinical treatment， Buyang Huanwutang can be used alone， or modified， or combined with other prescriptions or Western medicine. The mechanism studies predict that Buyang Huanwutang can ameliorate CHF by regulating the calcium balance， protecting the mitochondrial structure and function， and regulating intestinal flora. This review aims to provide a theoretical basis and practical guidance for the clinical application and optimization and subsequent in-depth study of Buyang Huanwutang in the treatment of CHF.

BACKGROUND:Previous brain studies have mostly focused on adults and fetuses,and the developmental characteristics of young children's brainstems have rarely been studied. OBJECTIVE:To observe the brainstem development characteristics of healthy young children and to explore the age-related differences and their correlation with sex. METHODS:From January 2019 to April 2022,a retrospective study of 3.0T MRI images of 174 children aged 2 to 6 years in the Affiliated Hospital of Inner Mongolia Medical University was conducted,and the median sagittal diameter,area and angle of the brainstem(including midbrain,pons and medulla oblongata)were measured. RESULTS AND CONCLUSION:There is an age-related increase in the anterior and posterior diameters of the midbrain,pons and medulla oblongata in the 2-5 years old group as well as in the longitudinal diameter and area of the midbrain,pons and medulla oblongata in the 2-6 years old group.Except for the longitudinal diameter of the medulla oblongata,all others show a positive correlation with age(r>0,P<0.05).In the 2-3 years old group and 4-5 years old group,the children are in the rapid growth and development stage,and these two age groups can be used as the key observation indicators for the development of young children.The anterior-posterior diameter,longitudinal diameter,area of the pons and total brainstem area are strongly correlated with age,which can be used as the key observation indicators for the brainstem development in young children.

Humans ; Gastrointestinal Microbiome ; Constipation/therapy* ; Probiotics/therapeutic use* ; Patients

Objective:To assess the reliability,and validity of the Chinese version of a short-form of Health Literacy Dental scale(HeLD-14)in 3-6 years old preschool children's parents.Methods:The study population consisted of those eligible 3-6 years old preschool children's parents in Yanqing Dis-trict,Beijing,China in 2021.A total of 1 479 preschool children's parents were surveyed by question-naire to understand the general situation of parents and oral health literacy related content.SPSS 21.0 and Mplus 7.4 were used for statistical analysis.Through Cronbach's α coefficient,confirmatory factor a-nalysis,Pearson correlation calculation,Student's t test and other methods,the internal consistency reli-ability,structure validity,calibration validity and discrimination validity of the scale were evaluated.Re-sults:The Cronbach's α coefficient of Chinese version HeLD-14 scale was 0.958,and Cronbach's α co-efficient of different constructs ranged from 0.778 to 0.963.The confirmatory factor analysis showed that the factor loadings of each item of the Chinese version HeLD-14 scale were between 0.719 and 0.977(P＜0.001),root-mean-square error of approximation(RMSEA)=0.04,comparative fix index(CFI)=0.992,Tucker-Lewis index(TLI)=0.988,and the model had good goodness of fit.The total score of the Chinese version HeLD-14 scale and the scores of the dimension of concerning,understanding,sup-porting,financial burden,medical treatment,communication,and application were all positively correla-ted with general self-efficacy,and the correlation coefficients were 0.439,0.406,0.370,0.344,0.346,0.367,0.373,0.390,respectively(P all＜0.05).For parents in the high group with the top 27％HeLD-14 score,the average HeLD-14 score was 69.27±1.06,which was higher than the low group with the bottom 27％HeLD-14 score,41.29±11.09(t=48.13,P＜0.01).Conclusion:The Chinese version HeLD-14 scale has good reliability and validity in the 3-6 years old preschool children's parents,and can be used as a tool to assess the oral health literacy of parents of preschool children.

Objective We aimed to establish the benchmark characteristic map of Fuzi decoction and the determination method of multi-index components,and to clarify the key quality attributes of Fuzi decoction.Methods Fifteen batches of Fuzi decoction substance benchmarks samples were prepared;the high-performance liquid chromatography(HPLC)characteristic spectrum of Fuzi decoction was established;and characteristic peak attribution and similarity analysis were performed.Ginsenosides Rg1,Re,Rf,and Rb1 were used as the index components to establish a method to determine ginseng content in Fuzi decoction.The value range of each quality control index was set at a limit of 70%-130%of the average value,and the quantity transfer analysis was performed on the material basis of 15 Fuzi decoction batches.Results The characteristic spectra of the 15 Fuzi decoction batches had 12 common peaks,and seven characteristic peaks of gallic acid,catechin,paeoniflorin,ginsenosides Rg1,Re,and Rb1,and atractylenolide Ⅲ were identified,with a similarity of more than 0.98.Ginsenosides Rg1,Re,Rf,and Rb1 content ranges were 0.51-0.94,0.34-0.62,0.14-0.27,and 0.41-0.76 mg/g,respectively.The transfer rates of ginsenosides Rg1 and Re,Rf,and Rb1 were 12.05%-26.91%,11.15%-43.71%,and 10.53%-33.23%,respectively.Conclusion The characteristic HPLC of Fuzi decoction and the determination method of Fuzi decoction ginseng content established in this study are accurate,reproducible,and stable,laying the foundation for the quality evaluation of the key chemical properties of Fuzi decoction and its preparation.

Objective To observe the value of ultrasound radiomics for distinguishing early and middle-late stage endometrial cancer(EC).Methods A total of 294 women with EC were retrospectively enrolled,including 196 in early stage and 98 in middle-late stage.The patients were randomly divided into training set(n=206)and validation set(n=88)at the ratio of 7∶3.Clinical data were compared between different stages,and a clinical model was constructed.Radiomics features were extracted and screened based on ultrasound data,and radiomics models were constructed with logistic regression(LR),random forest(RF),support vector machine(SVM),Gaussian naive Bayes(GNB)and extreme gradient boosting(XGBoost),respectively.Finally,a clinical-radiomics model was constructed.The value of each model for distinguishing early and middle-late stages EC was observed.Results Significant differences of age of consultation,menstrual disorders,abdominal pain and proportion of menopause were found between patients with early and middle-late stage EC(all P＜0.05).Among these 5 radiomics models,RF model had the highest area under the curve(AUC)for distinguishing early and middle-late stage EC.Pairwise comparison of clinical model,RF radiomics model and clinical-RF radiomics model showed that significant differences of AUC were found between each 2 models(all P＜0.05),and clinical-RF radiomics model had the highest AUC.Conclusion Ultrasound radiomics based on RF were helpful for distinguishing early and middle-late stage EC,and better diagnostic efficacy could be obtained through combining with clinical data.

Objective:To identify and characterize one Yokenella regensburgei strain(designated as CXLZQ123) isolated from a case of perionychial abscess. Methods:Strain CXLZQ123 was isolated from a patient with periungual abscess at the Dermatology Department of San County Central Hospital in June 2, 2023. The strain was initially identified through morphological and biochemical tests, followed by mass spectrometry identification, 16S rRNA sequencing and whole-genome sequencing. MEGA 11.0 was used to compare and analyze the strain′s genetic relationship with relevant species in GenBank, and a phylogenetic tree was constructed based on genetic distance to analyze its genetic evolution. Meanwhile, the average nucleotide identity between its genome and similar strains were compared.Results:The strain was identified as a Gram-negative rod. MicroScan WalkAway biochemical tests indicated that the strain was either Yokenella regensburgei (91.47%) or Hafnia alvei (8.53%). MALDI-TOF mass spectrometry confirmed it as Yokenella regensburgei. Based on 16S rRNA gene sequence analysis, the strain showed the highest similarity(99.37%) to CIP 105435 (sequence number NR_104934.1). The 16S rRNA gene sequence of the isolated strain Yokenella regensburgei was submitted to the National Center for Biotechnology Information (NCBI) with the GenBank sequence number of OR230248.1. The whole-genome of CXLZQ123 were sequenced and uploaded (NCBI, SRA sequence number: SRR26510420). The average nucleotide identity between CXLZQ123 and Yokenella regensburgei strains W13 and UU2206353 were 98.82% and 99.04%, respectively. Conclusions:Through morphological observation, biochemical identification, mass spectrometry identification, 16S rRNA and whole-genome sequencing, this pathogenic strain is identified as Yokenella regensburgei. This rare bacterium is sensitive to most detected antibiotics. This study provides diagnostic and treatment experience for Yokenella regensburgei-related infections.

Objective To compare the correlation and consistency of liquid chromatography-tandem mass spectrometry(LC-MS/MS)and electrochemiluminescence immunoassay(ECLIA)in the determination of se-rum 25-hydroxyvitamin D[25(OH)D],in order to guide the clinical selection of appropriate detection meth-ods.Methods A total of clinical serum samples were collected from the laboratory,and 25(OH)D levels were detected by LC-MS/MS and ECLIA,respectively.Passing-Boblok regression was used to analyze the correla-tion between the two methods,and Bland-Altman and Mountain plot were used to evaluate the agreement be-tween the two methods.Serum 25(OH)D<20.0 ng/mL was defined as vitamin D deficiency,and serum 25(OH)D as 20.0-<30.0 ng/mL was defined as vitamin D insufficiency.Kappa analysis was used to determine the coincidence rate of the two methods in the diagnosis of vitamin D nutritional status.Results The 25(OH)D levels detected by LC-MS/MS and ECLIA were(26.67±4.79)ng/mL and(39.33±4.09)ng/mL,respec-tively.The regression equation of the two methods was YECLIA=-4.558 1+1.719 8XLC-MS/MS,the slope was 1.719 8(95%CI 1.586 3-1.828 4),excluded 1,and the intercept was 4.558 1(95%CI-7.692 2--2.122 1),excluded 0,prompt system difference or ratio differences of the two methods.There were system-atic or proportional differences between the two methods.The Bland-Altman figure showed two methods aver-ages was 12.7,and the difference of out points(ratio)was 3.19%.The peak value of the mountain plot was-9.17 ng/mL,with more deviations from 0,indicating poor agreement between the results measured by the two methods.The Kappa coefficient of the two methods for judging vitamin D deficiency was 0.875,and the diagnostic coincidence rate was 94.68%.The Kappa coefficient of the two methods for judging vitamin D in-sufficiency was 0.538,and the diagnostic coincidence rate was 75.53%.Conclusion The agreement between ECLIA and LC-MS/MS is poor,but the agreement between ECLIA and LC-MS/MS in the diagnosis of vita-min D deficiency and insufficiency based on nutritional status is high.

Objective:To investigate the application of multiscale low-rank plus sparsity (MLRS) modeling in fast ultra-high-field intracranial 4D Flow imaging.Methods:Ten healthy volunteers, 5 males and 5 females, aged 23-35 (29±4) years old, recruited from October 2022 to January 2023 at Huashan Hospital of Fudan University, were prospectively collected. A MLRS model acceleration algorithm was proposed according to the characteristics of 4D Flow data based on the multiscale low-rank (MLR) model. Firstly, full sampling brain 4D Flow scans were performed on healthy volunteers using 7.0 T MR, and the acquired data were under-sampled with Gaussian distributions at different acceleration rates (R of 4, 8, 12, and 16, respectively). The root mean square error (RMSE) and peak signal-to-noise ratio (PSNR) of the compressed sensing algorithm (CS), low-rank plus sparse algorithm (L+S), MLR, and MLRS model were calculated at different acceleration rates, with fully sampled data as reference. And the comparison of models was performed using the paired-samples t-test or Wilcoxon signed rank test. Pearson′s test was used to assess the correlation between hemodynamic parameters of the 4 algorithms and the fully sampled reference values at different acceleration rates, and the correlation coefficients were compared using Wilcoxon signed rank test. Results:The RMSE under the same acceleration rates was MLRS, MLR, L+S, and CS models in ascending order, and the RMSE of the MLRS model was significantly lower than that of the MLR, L+S, and CS models ( P<0.05); the PSNR was MLRS, MLR, L+S, and CS models in descending order, and the PSNR of the MLRS model was significantly higher than that of the MLR, L+S, and CS model ( P<0.05). The correlation coefficients between the blood flow velocity measured by the MLRS model and the reference value were significantly higher than those of the MLR, L+S, and CS models for different acceleration rates ( P<0.05). Conclusion:The proposed MLRS algorithm is capable of accelerating ultra-high-field 4D Flow MR imaging of the brain while guaranteeing the image quality, and the MLRS model has higher reconstruction accuracy compared with conventional acceleration models at the same acceleration rate.

Objective:To explore the efficacy of balloon dilation percutaneous kyphoplasty (PKP) combined with prying reduction bone grafting in the treatment of thoracolumbar fractures, and its impact on patients′neurological function.Methods:The clinical data of 184 patients with thoracolumbar fractures from March 2017 to May 2020 in Cangzhou Integrated Traditional Chinese and Western Medicine Hospital of Hebei Province were retrospectively analyzed. Among them, 86 patients were treated with balloon dilation PKP combined with prying reduction and bone grafting (combined group), and 98 patients were treated with open reduction decompression and internal fixation (internal fixation group). The intraoperative bleeding volume, surgical time, intraoperative fluoroscopy frequency, efficacy and complications were recorded. One year after surgery, X-ray films were taken to measure the height of the anterior border and posterior border of vertebral body and the Cobb angle, and the pain visual analogue score (VAS), Barthel index and neurological Frankel grade were evaluated.Results:The intraoperative bleeding volume and surgical time in combined group were significantly higher than those in internal fixation group: (205.64 ± 45.63) ml vs. (180.37 ± 30.08) ml and (110.22 ± 28.91) min vs. (81.66 ± 20.77) min, and there were statistical differences ( P<0.01); there was no statistical difference in intraoperative fluoroscopy frequency between the two groups ( P>0.05). The total effective rate in combined group was significantly higher than that in internal fixation group: 91.86% (79/86) vs. 79.59% (78/98), the total incidence of complications was significantly lower than that in internal fixation group: 13.95% (12/86) vs. 38.78% (38/98), and there were statistical differences ( P<0.05 or <0.01). The height of the anterior border and posterior border of vertebral body 1 year after surgery in combined group were significantly higher than those in internal fixation group: (95.78 ± 1.59) mm vs. (62.74 ± 1.80) mm and (98.53 ± 3.80) mm vs. (95.06 ± 3.28) mm, the Cobb angle was significantly smaller than that in internal fixation group: (6.53 ± 2.80)° vs. (18.06 ± 2.68)°, and there were statistical differences ( P<0.01). The VAS and Barthel index 1 year after surgery in both groups improved significantly, and there were statistical differences ( P<0.01), but there were no statistical differences between the two groups ( P>0.05). The rate of neurological Frankel grade E 1 year after surgery in combined group was significantly higher than that in internal fixation group: 56.98% (49/86) vs. 23.47% (23/98), and there was statistical difference ( P<0.01). Conclusions:Compared with open reduction decompression and internal fixation, the balloon dilation PKP combined with prying reduction and bone grafting patients with thoracolumbar fractures is better for vertebral reduction and deformity repair, with higher safety, more significant pain relief, and better recovery of daily life and neurological function.