OBJECTIVE To investigate the effects of loganin on inflammatory response and intestinal barrier damage in septic rats by regulating the Ras homolog gene family member A （RhoA）/Rho-associated coiled-coil forming protein kinase 1 （ROCK1） signaling pathway. METHODS A sepsis rat model was established by cecal ligation and puncture， and randomly divided into sepsis group， loganin low-dose group （50 mg/kg loganin， gavage）， loganin high-dose group （200 mg/kg loganin， gavage）， positive control group （0.2 mg/kg atorvastatin， intraperitoneal injection）， and loganin high-dose + lysophosphatidic acid （LPA） group （200 mg/kg loganin gavage and intraperitoneal injection of 10 mg/kg RohA activator LPA）. An additional sham surgery group was established. Each group consisted of 10 rats， and medications were administered once every 6 hours for 4 times. After 24 hours of the last intervention， the levels of serum inflammatory factors interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， and IL-1β were detected. The pathological changes of ileal tissue were observed and Chiu’s intestinal mucosal injury score was also performed. The levels of intestinal function-lactate dehydrogenase （D-lactate）， D-amino acid oxidase （DAO） and endotoxin， the percentages of zonula occludens-1 protein （ZO-1） and Occludin positive staining area， as well as protein expressions of RhoA， and ROCK1 were all detected. com RESULTS Compared with the sepsis group， the percentages of ZO-1 and Occludin positive areas increased significantly in loganin low-dose and high-dose groups； while the levels of IL-6， TNF-α， IL-1β， DAO， D-lactate and endotoxin， Chiu’s intestinal mucosal injury score as well as protein expressions of RhoA and ROCK1 decreased significantly （P＜0.05）； the destruction of rat ileal tissue was alleviated， and tissue edema and inflammatory infiltration were significantly reduced； moreover， the improvement effect in loganin high-dose group was superior to that in loganin low-dose group （P＜0.05）. Compared with loganin high-dose group， RhoA activator LPA reversed the trend of changes in the above indicators （P＜0.05）. CONCLUSIONS Loganin can alleviate inflammatory response and intestinal barrier damage in septic rats， the mechanism of which may be associated with inhibiting RhoA/ROCK1 signaling pathway.

OBJECTIVES: To evaluate the effectiveness of single-balloon and double-balloon enteroscopy in diagnosing pediatric small bowel diseases and assess the diagnostic efficacy of computed tomography enterography (CTE) for small bowel diseases using enteroscopy as the reference standard. METHODS: Clinical data from 576 children who underwent enteroscopy at Hunan Children's Hospital between January 2017 and December 2023 were retrospectively collected. The children were categorized based on enteroscopy type into the single-balloon enteroscopy (SBE) group (n=457) and double-balloon enteroscopy (DBE) group (n=119), and the clinical data were compared between the two groups. The sensitivity and specificity of CTE for diagnosing small bowel diseases were evaluated using enteroscopy results as the standard. RESULTS: Among the 576 children, small bowel lesions were detected by enteroscopy in 274 children (47.6%).There was no significant difference in lesion detection rates or complication rates between the SBE and DBE groups (P>0.05), but the DBE group had deeper insertion, longer procedure time, and higher complete small bowel examination rate (P<0.05). The complication rate during enteroscopy was 4.3% (25/576), with 18 cases (3.1%) of mild complications and 7 cases (1.2%) of severe complications, which improved with symptomatic treatment, surgical, or endoscopic intervention. Among the 412 children who underwent CTE, the sensitivity and specificity for diagnosing small bowel diseases were 44.4% and 71.3%, respectively. CONCLUSIONS SBE and DBE have similar diagnostic efficacy for pediatric small bowel diseases, but DBE is preferred for suspected deep small bowel lesions and comprehensive small bowel examination. Enteroscopy in children demonstrates relatively good overall safety. CTE demonstrates relatively low sensitivity but comparatively high specificity for diagnosing small bowel diseases.
Retrospective Studies ; Treatment Outcome ; Double-Balloon Enteroscopy/statistics & numerical data* ; Single-Balloon Enteroscopy/statistics & numerical data* ; Humans ; Male ; Female ; Child ; Operative Time ; Tomography, X-Ray Computed/statistics & numerical data* ; Sensitivity and Specificity ; Intestine, Small/surgery* ; Intestinal Diseases/surgery*

OBJECTIVE: Evaluate the clinical application effect of low-field infant MRI. METHODS: Using literature review, expert consultation, and two rounds of Delphi to determine the evaluation index system. Then retrospectively analyze and compare the data of low-field infant MRI and high-field MRI from January 2023 to December 2024. RESULTS: There is a certain gap between low-field infant MRI and high-field MRI in terms of signal-to-noise ratio, image uniformity, software system reliability, scanning time, user interface friendliness and image result consistency. However, there was no difference in terms of spatial resolution and image quality. The noise, hardware system reliability, mean time between failure and the rate of examination completed without sedation are better than that of high-field MRI. CONCLUSION Low-field infant MRI meets needs of clinical diagnostic and has stable performance. It can be used as a routine screening tool for brain diseases near the bed.
Magnetic Resonance Imaging/methods* ; Humans ; Infant ; Retrospective Studies ; Signal-To-Noise Ratio ; Reproducibility of Results ; Brain Diseases/diagnostic imaging* ; Brain/diagnostic imaging* ; Software

OBJECTIVE: As an age-related neurodegenerative disease, the prevalence of mild cognitive impairment (MCI) increases with age. Within the framework of traditional Chinese medicine, spleen-kidney deficiency syndrome (SKDS) is recognized as the most frequent MCI subtype. Due to the covert and gradual onset of MCI, in community settings it poses a significant challenge for patients and their families to discern between typical aging and pathological changes. There exists an urgent need to devise a preliminary diagnostic tool designed for community-residing older adults with MCI attributed to SKDS (MCI-SKDS). METHODS: This investigation enrolled 312 elderly individuals diagnosed with MCI, who were randomly distributed into training and test datasets at a 3:1 ratio. Five machine learning methods, including logistic regression (LR), decision tree (DT), naive Bayes (NB), support vector machine (SVM), and gradient boosting (GB), were used to build a diagnostic prediction model for MCI-SKDS. Accuracy, sensitivity, specificity, precision, F1 score, and area under the curve were used to evaluate model performance. Furthermore, the clinical applicability of the model was evaluated through decision curve analysis (DCA). RESULTS: The accuracy, precision, specificity and F1 score of the DT model performed best in the training set (test set), with scores of 0.904 (0.845), 0.875 (0.795), 0.973 (0.875) and 0.973 (0.875). The sensitivity of the training set (test set) of the SVM model performed best among the five models with a score of 0.865 (0.821). The area under the curve of all five models was greater than 0.9 for the training dataset and greater than 0.8 for the test dataset. The DCA of all models showed good clinical application value. The study identified ten indicators that were significant predictors of MCI-SKDS. CONCLUSION The risk prediction index derived from machine learning for the MCI-SKDS prediction model is simple and practical; the model demonstrates good predictive value and clinical applicability, and the DT model had the best performance. Please cite this article as: Ai YT, Zhou S, Wang M, Zheng TY, Hu H, Wang YC, Li YC, Wang XT, Zhou PJ. Development of a machine learning-based risk prediction model for mild cognitive impairment with spleen-kidney deficiency syndrome in the elderly. J Integr Med. 2025; 23(4): 390-397.
Humans ; Cognitive Dysfunction/diagnosis* ; Aged ; Male ; Female ; Machine Learning ; Spleen ; Aged, 80 and over ; Kidney ; Medicine, Chinese Traditional

Objective To explore accuracy and clinical effect of robot-assisted implantation of sacroiliac penetrating screw in orthopedic surgery for posterior pelvic ring fracture.Methods The clinical data of 24 patients with posterior pelvic ring frac-ture treated with robot-assisted sacroiliac penetration screws from August 2022 to August 2023 were retrospectively analyzed,including 10 males and 14 females;aged from 21 to 73 years old with an average of(49.29±14.48)years old;according to Tile pelvic fractures,13 patients were type B and 11 were type C.The effect of screw placement was evaluated according to Gras criteria based on postoperative CT scan results.At the final follow-up,fracture healing was evaluated according to Matta score,and functional recovery was evaluated by Majeed score.Results All patients were followed up for 3 to 13 months with an aver-age of(6.00±3.28)months.Totally 36 sacroiliac penetrating screws,18 S1 penetrating screws,18 S2 penetrating screws were inserted,a total of 29 were excellent and 7 good according to Gras standard.Screw adjustment times was 0.00(0.00,0.75)times.At the final follow-up,Matta score was excellent in 18 patients,5 good and 1 moderate,and the maximum displacement distance was 2.55(0.00,5.65)mm.Majeed score was 84.37±8.38,15 patients were excellent,7 good and 2 moderate.Con-clusion Robot could accurately and safely assist in the placement of sacroiliac joint screws for the treatment of posterior pelvic ring fractures,and promote postoperative functional recovery of patients.

Objective: To investigate the association of the levels of high sensitivity C-reactive protein (hs-CRP) with frailty and its components among the elderly over 65 years old in 9 longevity areas of China. Methods: Cross-sectional data from the Health Ageing and Biomarkers Cohort Study (HABCS, 2017-2018) were used and the elderly over 65 years old were included in this study. Through questionnaire interview and physical examination, the information including demographic characteristics, behavior, diet, daily activity, cognitive function, and health status was collected. The association between hs-CRP and frailty and its components in the participants was analyzed by multivariate logistic regression model and restrictive cubic spline. Results: A total of 2 453 participants were finally included, the age was (84.8±19.8) years old. The median hs-CRP level was 1.13 mg/L and the prevalence of frailty was 24.4%. Compared with the low-level group (hs-CRP<1.0 mg/L), the OR (95%CI) value of the high-level group (hs-CRP>3.0 mg/L) was 1.79 (1.35-2.36) mg/L. As for the components, the hs-CRP level was also positively associated with ADL disability, IADL disability, functional limitation and multimorbidity. After adjusting for confounding factors, compared with the low-level group, the OR (95%CI) values of the high-level group for the four components were 1.68 (1.25-2.27), 1.88 (1.42-2.50), 1.68 (1.31-2.14) and 1.39 (1.12-1.72), respectively. Conclusion: There is a positive association between the levels of hs-CRP and the risk of frailty among the elderly over 65 years old in 9 longevity areas of China. The higher hs-CRP level may increase the risk of frailty by elevating the risk of four physical functional disabilities, namely ADL disability, IADL disability, functional limitation and multimorbidity.
Humans ; Aged ; Aged, 80 and over ; C-Reactive Protein/analysis* ; Frailty/epidemiology* ; Cohort Studies ; Cross-Sectional Studies ; China/epidemiology*

ObjectiveTo investigate the mRNA expression levels of various aquaporins （AQPs） in luteinized granulosa cells from follicles of different diameters. MethodsFrom March 25， 2022 to September 23， 2022 in our reproductive medicine center， 48 women undergoing in-vitro fertilization （IVF） were enrolled and divided into the antagonist group and the agonist group according to the ovarian stimulation protocol. Follicular fluid samples were collected on the day of oocyte pick-up and granulosa cells were extracted from follicles of different diameters： small （<13 mm）， medium （13~18 mm） and large （≥18 mm）. After RNA quantification， 22 cases （66 samples） were included for analysis and mRNA expression levels of AQPs were compared among the three follicle groups. ResultsThe mRNA expression of aquaporin 2 （AQP2） in luteinized granulosa cells increased with the increase of follicle diameter （linear trend P = 0.004） and the difference was statistically significant between two groups of large and small follicles （P = 0.017）. Statistical difference was found in the antagonist group （P = 0.049 6）， but not in the agonist group （P = 0.108）. ConclusionThe mRNA level of AQP2 in luteinized granulosa cells increases with the increase of follicle diameter and its expression is related to the ovarian stimulation protocol， suggesting that AQP2 may play a role in follicle growth and follicular fluid formation， and its mRNA expression level may be regulated by follicle stimulating hormone （FSH） and luteinizing hormone （LH）.

Objective:To investigate the clinical characteristics of vasa previa (VP) with low-lying placenta (LP).Methods:A retrospective case-control study was conducted on pregnant women with VP who delivered at Guangzhou Women and Children's Medical Center from January 2015 to August 2021. According to the status of LP, these cases were classified into VP with LP (VP+LP) and VP without LP (VP-LP) group. The cases diagnosed with placenta previa (PP, n=128) during the same period were collected as control. Maternal-fetal clinical characteristics and outcomes were compared among the three groups using t-test, Mann-Whitney U test, and Chi-square test (or Fisher's exact test). Results:During the study period, 116 VP cases were diagnosed, accounting for 0.085% (116/136 450) of all deliveries. Apart from one case of intrauterine death caused by non-VP reasons in the third trimester, there were 64 in the VP+LP group and 51 in the VP-LP group. VP+LP cases accounted for about 2.9% (64/2 219) of all the cases with PP or LP. The proportions of multiparae and women with a history of cesarean section were significantly higher in the VP+LP group than in the VP-LP group [62.5% (40/64) vs 39.2% (20/51), χ 2= 6.17, P=0.013; 31.3% (20/64) vs 13.7% (7/51), χ 2= 4.85, P=0.028]. Besides, a rare type of VP (type Ⅲ) was only found in the VP+LP group (9.4%, 6/64). The median gestational age at first diagnosis by prenatal ultrasound was significantly larger in the VP+LP group than in the VP-LP group [28.3 (23.6-31.7) vs 23.9 (23.3-25.9) weeks, Z=2.61, P=0.007]. There was no significant difference in the incidence of antepartum hemorrhage between the two groups. In contrast, the amount of postpartum hemorrhage was significantly increased in the VP+LP group [550 (436-732) vs 420 (300-540) ml, Z=3.37, P=0.001]. Compared with the VP-LP group, the VP+LP group showed a lower incidence of lower neonatal Apgar score (<7 at 5 min) and hypoxic-ischemic encephalopathy [0.0%(0/64) vs 6.9%(4/58), 0.0%(0/64) vs 8.6% (5/58), Fisher's exact test, both P<0.05]. No neonatal death was reported in the VP+LP and VP-LP groups. No significant difference in the incidence of antepartum hemorrhage was found between the VP+LP group and the PP group. Still, the median time at delivery was earlier [36.0 (34.3-36.9) vs 37.0 (35.7-37.3) weeks, Z=3.79, P<0.001], and the incidence of abnormal fetal heart rate was higher [10.9% (7/64) vs 3.1% (4/128), Fisher's exact test , P=0.044] in the VP+LP group. Furthermore, the neonatal NICU admission rate and the incidence of respiratory distress syndrome were significantly higher in the VP+LP group than in the PP group [36.4% (24/66) vs 12.1% (16/132), χ 2= 16.04, P<0.001; 25.8% (17/66) vs 12.1% (16/132), χ 2= 5.89, P=0.015]. Conclusions:For VP+LP cases, there might be an additional type (type Ⅲ VP). Patients with VP+LP would have more blood loss within 24 h after delivery and a higher risk of adverse neonatal outcomes. Intensive attention should be paid to those diagnosed with LP during the third trimester to identify any VP.

An innovative sandwich-structural Fe-based metal-organic framework magnetic material(Fe3O4@SW-MIL-101-NH2)was fabricated using a facile solvothermal method.The characteristic properties of the material were investigated by field emission scanning electron microscopy,transmission electron mi-croscopy(TEM),energy-dispersive X-ray spectroscopy,Fourier transform infrared spectroscopy,X-ray powder diffraction,vibrating sample magnetometry,and Brunauer-Emmett-Teller measurements.Fe3O4@SW-MIL-101-NH2 is associated with advantages,such as robust magnetic properties,high specific surface area,and satisfactory storage stability,as well as good selective recognition ability for chlorogenic acid(CA)and its metabolites via chelation,hydrogen bonding,and π-interaction.The results of the static adsorption experiment indicated that Fe3O4@SW-MIL-101-NH2 possessed a high adsorption capacity toward CA and its isomers,cryptochlorogenic acid(CCA)and neochlorogenic acid(NCA),and the adsorption behaviors were fitted using the Langmuir adsorption isotherm model.Then,a strategy using magnetic solid-phase extraction(MSPE)and ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF MS/MS)was developed and suc-cessfully employed for the selective pre-concentration and rapid identification of CA metabolites in rat plasma,urine,and feces samples.This work presents a prospective strategy for the synthesis of magnetic adsorbents and the high-efficiency pretreatment of CA metabolites.

Arrhythmia is the abnormal heart-beat frequency and/or rhythm caused by the origin of cardiac activity and/or conduction disorder. Arrhythmia disease has various manifestations and complex etiology, which can occur alone or complicated with other cardiovascular diseases. A sudden arrhythmic onset may lead to sudden death, whereas a sustained onset may lead to heart failure. In cardiomyocytes, calcium overload induces apoptosis and leads to arrhythmia. Calcium channel blockers have been widely used in clinic as a routine cardiovascular drug to regulate calcium signal, but their efficacy on different arrhythmia complications vary, and they also have potential therapeutic risks. Therefore, it is of great significance to seek calcium signal modulators targeting new mechanisms from plants and other natural product resources and develop them into anti-arrhythmia drugs with higher safety and better curative effect. This review focuses on the calcium signal regulatory effects of plant-derived natural calcium channel antagonists in arrhythmia models, highlights the research progress in recent years, and summarizes the effects and mechanisms of various natural drugs such as alkaloids, saponins, quinones and flavonoids, which regulate Ca²⁺ homeostasis, to provide a theoretical basis for the drug development of natural calcium channel antagonists to prevent and treat arrhythmia in the future.