Objective: Exploring the effect and mechanism of Xinyang Tablet on reduction of ferroptosis in myocardial cells from mice with chronic heart failure. Methods: Sixty C57BL/6J mice were randomly assigned to the sham, model, Xinyang Tablet low-dose (0.34 g/kg), Xinyang Tablet medium-dose (0.68 g/kg), Xinyang Tablet high-dose (1.36 g/kg), and perindopril (0.607 mg/kg) groups using a random number table method (10 mice in each group). Except for the sham group, all other groups underwent aortic arch constriction surgery to construct a chronic heart failure model. On the third day after completion of the modeling, each treatment group was administered the corresponding medication by gavage, while the sham and model groups were administered equal volumes of water by gavage once a day for eight consecutive weeks. After treatment, cardiac ultrasound was used to detect the structure and function of the mouse heart. Hematoxylin and eosin staining was used to detect pathological changes in mouse heart tissue. Masson staining was used to detect the proportion of fibrotic area of mouse heart tissue. Realtime fluorescence PCR was used to detect the mRNA expression of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), collagen 3α (Col3α), and myosin heavy chain 7 (MYH7) in mouse myocardial tissue. Transmission electron microscope was used to detect the ultrastructure of myocardial cell mitochondria. Reactive oxygen species (ROS) staining was used to detect the mean fluorescence intensity of ROS in myocardial tissue. Micro-determination was used to detect superoxide dismutase (SOD) activity in myocardial tissue. An immunofluorescence assay was used to detect the mean fluorescence intensity of phosphorylated histone deacetylase 2 (p-HDAC2) in myocardial cell. Western blotting was used to detect the protein expression of nuclear factor-erythroid 2-related factor 2 (Nrf2), p-HDAC2, nicotinamide adenine dinucleotide phosphate oxidase 1 (NOX1), glutathione peroxidase 4 (GPX4), and cystine glutamate reverse transporter (xCT) in mouse myocardial tissue. Results: Compared to the sham group, the model group showed a decrease in left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), an increase in left ventricular end-systolic diameter(LVESD) and left ventricular end-diastolic diameter (LVEDD), an increase in the proportion of cardiac fibrosis area, an increase in relative expression levels of ANP, BNP, Col3α, and MYH7 mRNA, an increase in ROS mean fluorescence intensity, a decrease in SOD activity, an increase in mean fluorescence intensity of p-HDAC2, an increase in relative expression levels of p-HDAC2 and NOX1 proteins, and a decrease in relative expression levels of Nrf2, GPX4, and xCT proteins (P<0.05). Myocardial fibrosis lesions are obvious, with disordered mitochondrial arrangement, decreased volume and shrinkage, increased membrane density, and reduced mitochondrial cristae. Compared to the model group, the LVEF and LVFS of mice in each dose group of Xinyang Tablet and the perindopril group increased, LVESD and LVEDD decreased, the proportion of fibrotic area of heart tissue decreased, the relative expression levels of ANP, BNP, Col3α, MYH7 mRNA decreased, ROS mean fluorescence intensity decreased, SOD activity increased, mean fluorescence intensity of p-HDAC2 decreased, relative expression levels of p-HDAC2 and NOX1 proteins decreased, and relative expression levels of Nrf2 and xCT proteins increased (P<0.05). Myocardial fibrosis was reduced, the mitochondrial arrangement was more regular, the mitochondria enlarged, the membrane density was reduced, and mitochondrial cristae increased. Compared to the model group, the relative expression level of the GPX4 protein in myocardial tissue increased in the Xinyang Tablet medium-, high-dose, and the perindopril groups (P<0.05). Conclusion Xinyang Tablet can improve ferroptosis and ventricular remodeling in mice with chronic heart failure by regulating the HDAC2-mediated Nrf2 antioxidant pathway.

Background Obsessive-compulsive personality disorder and obsessive-compulsive disorder(OCD)are common psychological disorders with similar clinical symptoms,but the differences between the two need further clarification.Objective To explore the clinical features of and influencing factors of obsessive-compulsive personality disorder in patients with OCD,so as to provide references for further relevant clinical diagnosis and treatment.Methods A total of 195 patients with OCD were selected as the research subjects,who received treatment at the outpatient and inpatient departments of the Affiliated Brain Hospital of Nanjing Medical University from July 2022 to December 2023 and met the diagnostic criteria for OCD in the International Classification of Diseases,tenth edition(ICD-10).Evaluation was conducted by using the Yale-Brown Obsessive Compulsive Scale(Y-BOCS),Personality Diagnostic Questionnaire-4+(PDQ-4+),Obsessive-Compulsive Inventory-Revised(OCI-R),Beck Depression Inventory(BDI),Beck Anxiety Inventory(BAI)and Sheehan Disability Scale(SDS).In accordance with the score of Obsessive-Compulsive Personality Disorder Scale in PDQ-4+,patients were divided into the OCD group with obsessive-compulsive personality disorder(n=58)and the OCD group without obsessive-compulsive personality disorder(n=137).Pearson correlation analysis and Spearman correlation analysis were adopted to examine the correlation between clinical features and the score of the Obsessive-Compulsive Personality Disorder Scale.Multiple linear regression analysis was used to explore the influencing factors of OCD patients with obsessive-compulsive personality disorder.Results Statistically significant differences were observed between OCD patients with and without obsessive-compulsive personality disorder in the age,family history of mental illness,time without treatment,hoarding and ranking dimension scores in OCI-R,OCI-R total score,score of Obsessive-Compulsive Personality Disorder Scale in PDQ-4,and BDI score(P≤0.05).OCD patients with obsessive-compulsive personality disorder in the time without treatment,OCI-R total score,hoarding and ranking dimension scores in OCI-R and BDI score are all positively correlated with the score of the Obsessive-Compulsive Personality Disorder Scale(r=0.120,0.526,0.364,0.492,0.414,P<0.05).The results of multiple linear regression analysis showed that time without treatment(β=0.132,P<0.05),hoarding dimension score(β=0.283,P<0.05)and ranking dimension score in OCI-R(β=0.418,P<0.05)were the influencing factors of OCD patients with obsessive-compulsive personality disorder.Conclusion OCD patients with obsessive-compulsive personality disorder may have longer untreated periods,more pronounced functional impairments in hoarding and sorting and more severe depressive symptoms.Untreated time,hoarding symptoms and sorting symptoms may be influencing factors for OCD patients with obsessive-compulsive personality disorder.

ObjectiveTo compare the effect of toe-spread-out exercises (TSO) and modified TSO in females with hallux valgus. MethodsFrom September to December, 2023, a total of 45 females with hallux valgus were recruited in Capital University of Physical Education and Sports and randomly divided into blank control group (n = 15), TSO group (n = 15), and modified TSO group (n = 15). The blank control group received no intervention, the TSO group received routine TSO, and the modified TSO group received fibularis longus fascia release followed by TSO, for eight weeks. Changes in the hallux valgus angle (HVA) and the cross-sectional area (CSA) of the abductor hallucis muscle were measured before intervention, and four and eight weeks after intervention, respectively. ResultsOne case dropped out from the blank control group. The changes of HVA in the TSO and modified TSO groups were significantly greater than in the blank control group (F > 15.263, P < 0.05). After four weeks of intervention, the change of left HVA in the modified TSO group was significantly greater than in the TSO group (P < 0.05). The main effect of time was significant on the CSA of the abductor hallucis muscle (F > 13.245, P < 0.05). The main effect of group was significant on the left foot's CSA of the abductor hallucis (F = 3.798, P < 0.05). The interaction effect of time and group was also significant (F > 4.744, P < 0.05). The CSA of the abductor hallucis in both the TSO and modified TSO groups after four weeks and eight weeks of intervention was significantly greater than before intervention (P < 0.05). At eight weeks, the CSA of the right foot in the modified TSO group was significantly greater than in the blank control group (P < 0.05). ConclusionBoth TSO and modified TSO can improve HVA and the CSA of the abductor hallucis muscle in females with hallux valgus, and modified TSO is better.

Bariatric surgery is the most effective treatment for patients with severe obesity, which can significantly improve the metabolic disorders, especially type 2 diabetes mellitus. Bariatric and metabolic surgery is the latest and fastest-growing branch of surgery, with the types of procedure and other novel treatment modalities are still evolving and in progress. The authors summarize the recent advancement related to novel bariatric and metabolic surgery in the treat-ment of morbid obesity and type 2 diabetes mellitus in recent years through literature search, which can be divided into the following three parts: (1) novel surgical procedures and new guideline of indication. Sleeve gastrectomy and Roux-en-Y gastric bypass are the most performed bariatric surgery. Duodenal switch or the variant of one anastomosis duodenal ileostomy are also accredited procedures but been less performed. One anastomosis gastric bypass is the most recently accredited bariatric surgical procedures with better safety profile and weight loss efficacy than most of the procedures. For other novel procedures, bipartition procedure may be the next accredited proce-dure. A new worldwide guideline is recently launched and the indication for bariatric surgery is lowered BMI 27.5 kg/m 2 for Asian. (2) The effect and mechanism of bariatric surgery. Bariatric surgery can significantly reduce the incidence of cardiovascular disease and mortality in obese patients. The main beneficiary group is patients with diabetes mellitus. Along with the recent basic research and the success of new gut hormone related drugs, the mechanism of bariatric surgery can be mostly attributed to gut hormonal effect, however, gastric volume still play an important role. (3) Novel obesity treatment modalities. Endoscopic obesity treatment has a major progress in the success of endoscopic gastroplasty by endoscopic suturing designs. More noteworthy is the development of new intestinal hormone drug therapy, which can achieve a weight loss of 14% in one year by injec-ting once a week glucagon-like peptide-1 preparation, and then combining two or three intestinal hormone drugs can achieve a weight loss of 24% in one year, which is close to the effectiveness of bariatric surgery. Pharmacologic treatment of obesity is very promising and expected. With the increasing severity of obesity and diabetes mellitus in the world, in addition to the explosive develo-pment of bariatric and metabolic surgery in recent years, many new surgical methods and new treatments, especially new and effective intestinal hormone related therapeutic drugs, have been developed. The success of bariatric and metabolic surgery depends on a multidisciplinary team with rich clinical experience: precise preoperative planning and comprehensive postoperative manage-ment, as well as patient understanding and cooperation, in order to achieve the best results.

OBJECTIVES: There is less clinical data on multiple myeloma (MM) in China, and the aim of this study was to collect and analyze the clinical data of newly diagnosed multiple myeloma (NDMM) patients in Hunan Province during 1 year, to understand the real clinical features and treatment outcome for Hunan Province patients with MM, and to strengthen the understanding of the standardized diagnosis process and treatment plan of MM. METHODS: The clinical data of 529 patients with NDMM in 12 large-scale general hospitals in Hunan Province from January 1 to December 31, 2019 were collected and analyzed, including baseline data, treatment regimens, duration of treatment, and adverse reactions. The clinical characteristics, treatment, and safety of patients were analyzed by SPSS 21.0. RESULTS: Among the 529 NDMM patients, the age was 33-90 (median 64) years and the male-female ratio was 1.38꞉1. The clinical features ranged from high to low were as follows: Bone pain (77.7%), anemia (66.8%), renal insufficiency (40.6%), hypercalcemia (15.1%). Typing: IgG 46.5%, IgA 24.6%, IgD 2.6%, IgM 0.8%, light chain 15.7%, double clone 3.0%, no secretion 0.6%, absence 6.2%. Staging: Durie-Salmon stage I, II, and III were 4.5%, 10.6%, 77.3%, respectively, and 40 cases (7.6%) missed this data. International Staging System (ISS) stage I, II, and III were 10.4%, 24.4%, and 47.6%, respectively, and 93 cases (17.6%) were missing. Revised International Staging System (R-ISS) stage I, II, and III were 5.5%, 27.0%, 23.1%, respectively, and 235 cases (44.4%) missed this data. Among the 98 NDMM patients in the Third Xiangya Hospital, Central South University, Durie-Salmon (DS) stage missing 2.0%, ISS stage missing 12.3%, and R-ISS stage missing 12.3%.Treatment: Among the 529 patients,475 received treatment, the rate of treatment was 89.8%; 67.4% of the patients were able to complete four courses of chemotherapy at induction phase, 90.3% of the patients received proteasome inhibitor based combination chemotherapy regimen more than once, 67.2% received immunomodulator based regimen more than once, and 59.8% of the patients received proteasome inhibitor and immunomodulator based combination chemotherapy regimen more than once. Curative: Overall response rate (ORR) and high quality response rate (HQR) of the 4-course group were better than those of the 2-course group (ORR: 85% vs 65%, P=0.006; HQR: 68.3% vs 24.0%, P<0.001). The HQR of the standard chemotherapy group was better than that of the non-standard chemotherapy group (65.1% vs 48.2%, P=0.035). Adverse reactions during treatment included hematologic toxicity (17.5%), peripheral neuropathy (24.8%), gastrointestinal adverse events (23.8%), pulmonary infection (25.9%), herpes zoster (4.6%), and venous thrombotic events (1.7%). CONCLUSIONS In 2019, the missed diagnosis rate of MM patients was high, the medium age of diagnosis was older, and the accuracy of patient diagnosis was not high. There is a great difference among medical centers, especially in the stage and risk stratified, nearly half of NDMM patients are not diagnosed with R-ISS stage; the lack of cytogenetic data needs to be supplemented by follow-up studies. A high proportion of patients with NDMM present with bone pain and anemia.Patients received treatment have higher use of chemotherapy regimens containing proteasome inhibitors and/or immunomodulators, but there is a significant gap among different medical centers, and standardized treatment needs to be strengthened. The safety during chemotherapy is controllable.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Female ; Humans ; Immunologic Factors/therapeutic use* ; Male ; Middle Aged ; Multiple Myeloma/therapy* ; Neoplasm Staging ; Pain ; Prognosis ; Proteasome Inhibitors/therapeutic use*

Bariatric surgery is effective on obesity, which can significantly improve the metabolic diseases of obesity patients, especially the type 2 diabetes. However, the surgical proce-dures of bariatric and metabolic surgery are still evolving and in progress. One anastomosis gastric bypass (OAGB) is the latest bariatric surgery recognized by the international bariatric and metabolic surgery community. The authors review the relevant literatures at home and abroad, and introduce the development history, surgical skills, clinical efficacy, status quo and adaptability of OAGB.

Objective:To analyze the risk factors of acute renal injury (AKI) after coronary artery bypass grafting (CABG) in the elderly patients.Methods:A total of 423 patients aged over 60 years who underwent CABG in Linyi People′s Hospital from May 2014 to May 2010 were retrospectively analyzed. Patients were divided into AKI group and control group according to whether AKI occurred. The risk factors of AKI were analyzed by multivariate logistic regression.Results:Among the 423 patients, 62 cases(14.7%)developed postoperative acute kidney injury. Compared with the patients without AKI ( n=361), the proportions of patients with hypertension, heart function (NYHA) ≥ Ⅲ, atrial fibrillation and cardiopulmonary bypass were higher in AKI group, the proportion of patients using statins before operation was lower [71.0%(44/62) vs. 50.7%(183/361),χ 2 =8.75, P<0.01;38.77%(24/62) vs. 7.5%(27/361),χ 2 =48.67, P<0.01;16.1%(10/62) vs. 4.4%(16/361),χ 2 =12.55, P<0.01;51.6%(32/62) vs. 21.3%(77/361),χ 2 =25.37, P<0.01;59.7%(37/62) vs. 85.6%(309/361),χ 2=23.87, P<0.01]. Patients in AKI group had higher level of blood uric acid, urea nitrogen and creatinine [353.8(275.5, 462.5)μmol/L vs. 314.5(262.9, 383.6)μmol/L, Z=2.75, P=0.01;5.5(4.3, 8.2)mmol/L vs. 5.1(4.3, 6.4)mmol/L, Z=2.44, P＝0.02; 74.9(58.5, 92.7)μmol/L vs. 67.0(57.1, 76.3)μmol/L, Z=2.90, P=0.01];and longer operation time, more blood loss and blood vessel bridge than those in control group [(403.2±124.1) vs. (350.6±110.2), t =3.41, P<0.01;(4.0±0.9) vs. (3.7±0.8), t=2.83, P=0.01;(3.8±0.7) vs. (3.5±0.8), t=3.58, P<0.01]. The multivariate logistic regression analysis showed that preoperative cardiac function (NYHA)≥Ⅲ( OR=8.528,95% CI:3.734-19.477, P<0.01),hypertension( OR=6.455,95% CI:2.605-15.997, P<0.01),extracorporeal circulation( OR＝3.046,95% CI:1.190-7.795, P=0.02),diabetes mellitus( OR=2.294,95% CI:1.047-5.026, P=0.04),elevated serum uric acid level( OR=1.004,95% CI:1.000-1.008, P=0.03)were the independent risk factors for AKI. Statins is a protective factor for postoperative AKI( OR=0.366,95% CI:0.154-0.873, P=0.02). Conclusions:AKI is a common complication after CABG in elderly patients. Cardiac function(NYHA) ≥ Ⅲ,hypertension,extracorporeal circulation,diabetes mellitus,elevated serum uric acid level are risk factors and administration of stating is protective factor for the incidence of acute kidney injury in elderly patients after coronary artery bypass grafting.

Objective:To compare the effects of rosuvastatin and atorvastatin on coronary artery bypass grafting (CABG) on the incidence of acute kidney injury (AKI), and assess the independent risk factors of AKI.Methods:We retrospectively collected 550 patients aged 18 years or older who underwent CABG from May 2014 to May 2020. They were divided into the rosuvastatin group ( n=322), atorvastatin group ( n=125) and non statins group ( n=103) according to whether rosuvastatin or atorvastatin was routinely used before operation. Demographic data, clinical data before and after CABG and laboratory results were collected. Blood urea nitrogen (BUN), serum creatinine (Scr), creatinine clearance rate (Ccr) and incidence of postoperative AKI were compared among the three groups. Univariate analysis and binary logistic regression analysis were used to investigate the effect of statins on AKI in patients undergoing CABG. Results:Compared with preoperation, BUN showed no significant change ( P>0.05), while Scr was increased and Ccr was decreased significantly (both P<0.01); BUN in the rosuvastatin group was decreased significantly ( P<0.01), whereas Scr and Ccr had no significant change ( P>0.05); Scr in the atorvastatin group was increased significantly ( P<0.01), but there was no significant difference in BUN and Ccr ( P>0.05). BUN and Scr in the non statins group were increased significantly (both P<0.01), while Ccr was decreased significantly ( P<0.01). After operation, BUN and Scr in the rosuvastatin group and atorvastatin group were significantly lower than those in the non statins group (all P<0.01); Ccr was significantly higher than that in the non statins group ( P<0.01). BUN and Scr were not significantly different between the rosuvastatin and atorvastatin groups ( P>0.05), but Ccr was significantly higher than that in the atorvastatin group ( P< 0.05). There were significant differences in BUN, Scr and Ccr among the three groups ( χ2=48.925, 22.677 and 34.426, all P<0.01). The incidence of AKI among 550 patients was 15.1% (83/550), of which 9.6% (31/322) in the rosuvastatin group, 16.0% (20/125) in the atorvastatin group and 31.1% (32/103) in the non statins group. The incidence of AKI in the rosuvastatin and atorvastatin groups was significantly lower than that in the non statins group ( χ2=28.412, 7.282, P<0.01). Multivariate regression analysis showed that hypertension ( OR=3.555, 95% CI: 1.959-6.451, P<0.01), NHYAⅢ/Ⅳ ( OR=2.438, 95% CI: 1.187-5.008, P=0.015), and increased serum creatinine level ( OR=1.018, 95% CI: 1.003-1.032, P=0.016), and intraoperative cardiopulmonary bypass ( OR=2.936, 95% CI: 1.454-5.927, P=0.003) were independent risk factors for AKI after CABG, while preoperative conventional statin therapy ( OR=0.490, 95% CI: 0.247-0.974, P=0.042) and increased serum albumin level ( OR=0.920, 95% CI: 0.856-0.990, P=0.026) were protective factors for AKI after CABG. Conclusions:The incidence of AKI after CABG is common. Rosuvastatin or atorvastatin and increased preoperative serum albumin level can protect renal function and reduce the incidence of AKI, which are the protective factors of AKI after CABG. The hypertension, NHYAⅢ/Ⅳ, increased preoperative serum creatinine level and cardiopulmonary bypass are the independent risk factors of AKI after CABG.

Objective:To investigate the diagnosis and treatment of emergency inguinal hernia.Methods:The retrospective cross-sectional study was conducted. The clinical data of 236 patients with emergency inguinal hernia who were admitted to the First Affiliated Hospital of Soochow University from January 2015 to May 2020 were collected. There were 194 males and 42 females, aged (69±30)years. Hospitalized patients received routine blood biochemistry test and imaging examinations for evaluation of characteristics of hernia contents and intestinal obstruction. Manual reduction and surgical treatment were selected according to the conditions of patients. Observation indicators: (1) treatment; (2) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect hernia recurrence and late-onset mesh infection up to August 2020. Measurement data were described as M (range) or M ( P25, P75), and comparison between groups was analyzed using the Wilcoxon rank sum test. Count data were represented as absolute numbers, and comparison between groups was done using the chi-square test. Results:(1) Treatment: of the 236 patients, 106 cases had successful manual reduction, 124 cases underwent emergency operation, 6 cases refused surgery. ① For 106 cases with successful manual reduction (including 4 cases guided by B-ultrasonography), the manual reduction time was 5 minutes (2 minutes,7 minutes). Ninety-three of 106 patients underwent selective operation after manual reduction, including 89 cases with indirect hernia, 2 cases with direct hernia and 2 cases with compound hernia. The time to selective operation was 3 days(2 days,5 days) after manual reduction. Patients underwent mesh repair, of which the operation time, volume of intraoperative blood loss, time to postoperative first flatus, duration of postoperative hospital stay were 44 minutes (29 minutes, 66 minutes),10 mL(5 mL,20 mL), 1 day(1 day,2 days), 1 day(1 day,2 days), respectively. Eleven patients didn't undergo selective operation. Two patients with abdominal pain and fever after manual reduction were diagnosed with perforation of intestine by emergency surgical exploration, and then underwent partial intestinal resection combined with high ligation of hernial sac. ② There were 93 of 124 patients undergoing emergency operation with indirect hernia, 18 cases with femoral hernia, 6 cases with obturator hernia, 6 cases with compound hernia and 1 case with direct hernia. There were 54 of 124 patients undergoing open operation, including 21 cases with Bassini surgery, 18 cases with Lichtenstein surgery, 9 cases with Mc Vay surgery, 6 cases with high ligation of hernia sac. There were 70 patients undergoing laparoscopic operation, including 57 cases with laparoscopic transperitoneal preperitoneal hernia repair (TAPP), 10 cases with laparoscopic explora-tion + tissue repair and 3 cases with laparoscopic exploration + closure of inner inguinal ring. The operation time, volume of intraoperative blood loss, time to postoperative first flatus, cases with short-term postoperative complications were 60 minutes (50 minutes,76 minutes), 20 mL(14 mL,30 mL), 2 days(1 day,2 days), 15 cases for patients undergoing open surgery, respectively. The above indicators were 56 minutes (47 minutes,77 minutes), 20 mL(10 mL,25 mL), 2 days(1 day,2 days), 21 cases for patients under-going laparoscopic surgery. There was no significant difference in the above indicators between the two groups ( Z=?0.88, ?1.37, ?1.56, χ2=0.07, P>0.05). Cases with intraoperative placement of mesh and duration of hospital stay were 18 cases and 5 days(3 days,8 days) for patients undergoing open surgery, versus 57 cases and 3 days(2 days,5 days) for patients undergoing laparoscopic surgery, showing significant differences between the two groups ( χ2=29.50, Z=?4.32, P<0.05). (2) Follow-up: of 236 patients, 192 were followed up for 2?60 months, with a median follow-up time of 19 months. Seven patients had recurrence of hernia after emergency operation, including 3 with high ligation of the hernia sac, 2 with Bassini surgery, 1 with Lichtenstein surgery, and 1 with laparoscopic exploration + closure of inner inguinal ring. One patient with late-onset mesh infection after Lichtenstein surgery was improved after mesh removal. No long-term complications such as hernia recurrence or late-onset mesh infection occurred to the 184 patients. Conclusions:Emergency inguinal hernia had different state of illness, manual reduction is suitable for partial patients with incarceration. Surgery is the first choice, and the surgical procedure needs to be individually selected.

The directed functional connectivity in cerebral cortical is the key to understanding the pattern of the behavioral tissue. This process was studied to explore the directed functional network of rifle shooters at cerebral cortical rhythms from electroencephalogram (EEG) data, aiming to provide neurosciences basis for the future development of accelerating rifle skill learning method. The generalized orthogonalized partial directed coherence (gOPDC) algorithm was used to calculate the effective directed functional connectivity of the experts and novices in the pre-shot period. The results showed that the frontal, frontal-central, central, parietal and occipital regions were activated. Moreover, the more directed functional connections numbers in right hemispheres were observed compared to the left hemispheres. Furthermore, as compared to experts, novices had more activated regions, the stronger strength of connections and the lower value of the global efficiency during the pre-shot period. Those indirectly supported the conclusion that the novices needed to recruit more brain resources to accomplish tasks, which was consistent with "neural efficiency" hypothesis of the functional cerebral cortical in experts.