ObjectiveBased on functional near-infrared spectroscopy (fNIRS), we investigated the brain activity characteristics of gross motor tasks in children with autism spectrum disorder (ASD) and motor dysfunctions (MDs) to provide a theoretical basis for further understanding the mechanism of MDs in children with ASD and designing targeted intervention programs from a central perspective. MethodsAccording to the inclusion and exclusion criteria, 48 children with ASD accompanied by MDs were recruited into the ASD group and 40 children with typically developing (TD) into the TD group. The fNIRS device was used to collect the information of blood oxygen changes in the cortical motor-related brain regions during single-handed bag throwing and tiptoe walking, and the differences in brain activation and functional connectivity between the two groups of children were analyzed from the perspective of brain activation and functional connectivity. ResultsCompared to the TD group, in the object manipulative motor task (one-handed bag throwing), the ASD group showed significantly reduced activation in both left sensorimotor cortex (SMC) and right secondary visual cortex (V2) (P<0.05), whereas the right pre-motor and supplementary motor cortex (PMC&SMA) had significantly higher activation (P<0.01) and showed bilateral brain region activity; in terms of brain functional integration, there was a significant decrease in the strength of brain functional connectivity (P<0.05) and was mainly associated with dorsolateral prefrontal cortex (DLPFC) and V2. In the body stability motor task (tiptoe walking), the ASD group had significantly higher activation in motor-related brain regions such as the DLPFC, SMC, and PMC&SMA (P<0.05) and showed bilateral brain region activity; in terms of brain functional integration, the ASD group had lower strength of brain functional connectivity (P<0.05) and was mainly associated with PMC&SMA and V2. ConclusionChildren with ASD exhibit abnormal brain functional activity characteristics specific to different gross motor tasks in object manipulative and body stability, reflecting insufficient or excessive compensatory activation of local brain regions and impaired cross-regions integration, which may be a potential reason for the poorer gross motor performance of children with ASD, and meanwhile provides data support for further unraveling the mechanisms underlying the occurrence of MDs in the context of ASD and designing targeted intervention programs from a central perspective.

Objective:To investigate the effects of bunched cognitive behavior intervention on disease fear and psychological security in patients with glioma.Methods:A total of 92 patients with glioma who underwent surgical treatment from January 2022 to June 2023 were selected.According to the order of enrollment, all subjects were divided into research group( n=44)and control group( n=48). The patients in control group received routine medical and nursing intervention, and patients the research group adopted glioma bunched cognitive behavior intervention on the basis of routine medical and nursing intervention, including 4 intervention cycles.At enrollment, 2 weeks after intervention, and 4 weeks after intervention, all subjects were evaluated by the fear of progression questionnaire-short form (FoP-Q-SF), safety questionnaire (SQ), self-rating anxiety scale (SAS) and self-rating depression scale (SDS). All the data in this study were processed by SPSS 26.0 statistical software.The scores of FoP-Q-SF, SQ, SAS and SDS before and after intervention were compared by repeated measures ANOVA between the two groups. Results:(1)The total FoP-Q-SF score, physiological health dimension scores, and social family dimension scores of the two groups showed significant interaction effects before and after intervention ( F=254.839, 52.738, 12.237, all P<0.05). Further simple effect analysis showed that after 2 and 4 weeks of intervention, the FoP-Q-SF scores of the research group (2 weeks after intervention: 33.80±4.94, 36.48±4.04; 4 weeks after intervention: 31.25±4.55, 35.94±4.47) and social family dimensions (2 weeks after intervention: 15.32±2.56 points, 17.06±2.14; 4 weeks after intervention: 14.05±2.59, 16.96±1.99) were lower than those of the control group (all P<0.05). The physiological health dimension score of the research group was lower than that of the control group after 4 weeks of intervention (4 weeks after intervention: 17.30±2.92, 19.06±2.38) ( P<0.05). After 4 weeks of intervention, the FoP-Q-SF score, physiological health dimension score, and social family dimension score of the research group were all lower than those at 2 weeks after intervention and before intervention (all P<0.05). (2)The total SQ score, interpersonal security dimension score and the determined control score of the two groups showed significant interaction effects before and after intervention( F=193.129, 54.706, 44.015, all P<0.05). Further simple effect testing showed that after 2 and 4 weeks of intervention, the total SQ score and interpersonal security score of the research group were higher than those of the control group (all P<0.05). The determined control score of the research group was higher than that of the control group after 4 weeks of intervention ( P<0.05). After 2 and 4 weeks of intervention, the total SQ score, interpersonal security score, and determination control score of the research group were higher than before intervention (all P<0.05), and the total SQ score and interpersonal security score of the research group were higher than 2 weeks after intervention (both P<0.05). (3)The SAS score and SDS score of the two groups showed significant interaction effects before and after intervention( F=237.867, 282.882, both P<0.05). Further simple effect analysis showed that after 2 and 4 weeks intervention, the SAS and SDS scores of the research group were lower than those of the control group (all P<0.05). The SAS and SDS scores of the research group were lower after 2 weeks and 4 weeks intervention than before intervention (all P<0.05). The SAS and SDS scores of the research group at 4 weeks after intervention were lower than those at 2 weeks after intervention (both P<0.05). Conclusion:Bundled cognitive behavioral intervention can improve disease fear and negative emotions in patients with glioma, and enhance psychological security.

ObjectiveTo explore the efficacy-driving mechanism of Danhong injection （DHI） in the treatment of stable angina pectoris （SAP） based on the composition-activity relationship of target modules and clarify the pharmacological effects of DHI. MethodAccording to the angina frequency （AF） in the Seattle Angina Questionnaire （SAQ） that was obtained in the previous clinical trial， the patients before and after DHI treatment were grouped based on efficacy. The transcriptomic data of the patients before treatment and in the best efficacy group 30 days post-treatment were selected as the data source， and then weighted gene co-expression network analysis （WGCNA） was employed to construct the co-expression network. Relevant modules in the network were identified and associated with clinical features. In addition， the On-modules （Z value below 0） were identified by Zsummary. The topological indicators such as density， centrality， and clustering coefficient were adopted to explore the dynamics of DHI efficacy at the network level and module level， respectively. In addition， the driver genes were screened by the personalized network control （PNC） algorithm. Finally， rat H9C2 cells were used to establish the model of hypoxia/reoxygenation （H/R）， which was used to confirm the potential therapeutic target of DHI for SAP and provide a scientific basis for revealing the therapeutic mechanism of DHI. ResultWe identified 19 modules in the best efficacy group of DHI for SAP， and the comparison between day 0 and day 30 revealed 12 On-modules. The changes of network topological indicators at the network and module levels confirmed the correlation between the best efficacy of DHI treatment and topological dynamics. Finally， the driver genes， Klotho and fibroblast growth factor 22 （FGF22）， in DHI treatment of SAP were verified by the H9C2 cell model of H/R. ConclusionBased on clinical transcriptome data， this study determined the composition-activity relationship of target modules of DHI for SAP， which provided a scientific basis for deciphering the efficacy-driven mechanism of DHI for SAP.

Objective To establish the structural confirmation methods of three suspected new psychoac-tive substances(NPSs),and explore a more general qualitative testing method.Methods Infrared ab-sorption spectroscopy(IR),gas chromatography-mass spectrometry(GC-MS),1H-nuclear magnetic reso-nance spectroscopy(1H-NMR),13C-nuclear magnetic resonance spectroscopy(13C-NMR),19F-nuclear magnetic resonance spectroscopy(19F-NMR)and other techniques were used to identify the composi-tion and structure of 5 samples containing suspected NPS submitted by public security bureaus.Results NPSs were found in the above 5 samples,and 3 were confirmed as NPS included in the newly listed controlled substances on July 1,2024,namely 2-(methylamino)-2-(2-methylphenyl)cyclohexan-1-one(2-MDCK),2-(ethylamino)-2-(2-fluorophenyl)cyclohexan-l-one(2-FXE),1-(3,4-methylenedioxy-phenyl)-2-(dimethylamino)pentan-1-one(dipentylone),respectively.The first two substances were phen-cyclidine NPS,and the third substance was synthetic cathinone NPS.Conclusion This study systemati-cally summarizes the distinguishing features of the infrared absorption spectrometry,nuclear magnetic resonance spectroscopy and mass spectrometry of three NPSs,which can provide a reference for the qualitative identification of unknown substances.

Neuropathic pain(NP) has similar phenotypes but different sequential neuroinflammatory mechanisms in the pathological process. It is of great significance to inhibit the initiation of neuroinflammation, which has become a new direction of NP treatment and drug development in recent years. Mongolian drug Naru-3 is clinically effective in the treatment of trigeminal neuralgia, sciatica, and other NPs in a short time, but its pharmacodynamic characteristics and mechanism of analgesia are still unclear. In this study, a spinal nerve ligation(SNL) model simulating clinical peripheral nerve injury was established and the efficacy and mechanism of Naru-3 in the treatment of NPs was discussed by means of behavioral detection, side effect evaluation, network analysis, and experimental verification. Pharmacodynamic results showed that Naru-3 increased the basic pain sensitivity threshold(mechanical hyperalgesia and thermal radiation hyperalgesia) in the initiation of SNL in animals and relieved spontaneous pain, however, there was no significant effect on the basic pain sensitivity threshold and motor coordination function of normal animals under physiological and pathological conditions. Meanwhile, the results of primary screening of target tissues showed that Naru-3 inhibited the second phase of injury-induced nociceptive response of formalin test in mice and reduced the expression of inflammatory factors in the spinal cord. Network analysis discovered that Naru-3 had synergy in the treatment of NP, and its mechanism was associated with core targets such as matrix metalloproteinase-9(MMP9) and interleukin-1β(IL-1β). The experiment further took the dorsal root ganglion(DRG) and the stage of patho-logical spinal cord as the research objects, focusing on the core targets of inducing microglial neuroinflammation. By means of Western blot, immunofluorescence, agonists, antagonists, behavior, etc., the mechanism of Naru-3 in exerting NP analgesia may be related to the negative regulation of the MMP9/IL-1β signaling pathway-mediated microglia p38/IL-1β inflammatory loop in the activation phase. The relevant research enriches the biological connotation of Naru-3 in the treatment of NP and provides references for clinical rational drug use.
Rats ; Mice ; Animals ; Matrix Metalloproteinase 9/metabolism* ; Rats, Sprague-Dawley ; Neuroinflammatory Diseases ; Interleukin-1beta/metabolism* ; Spinal Cord/metabolism* ; Signal Transduction ; Hyperalgesia/metabolism* ; Neuralgia/metabolism*

The Baimai Ointment with the effect of relaxing sinew and activating collaterals demonstrates a definite effect on Baimai disease with pain, spasm, stiffness and other symptoms, while the pharmacodynamic characteristics and mechanism of this agent remain unclear. In this study, a rat model of chronic compression of L4 dorsal root ganglion(CCD) was established by lumbar disc herniation, and the efficacy and mechanism of Baimai Ointment in the treatment of CCD were preliminarily explored by behavioral tests, side effect evaluation, network analysis, antagonist and molecular biology verification. The pharmacodynamic experiment indicated that Baimai Ointment significantly improved the pain thresholds(mechanical pain, thermal pain, and cold pain) and gait behavior of CCD model rats without causing tolerance or obvious toxic and side effects. Baimai Ointment inhibited the second-phase nociceptive response of mice in the formalin test, increased the hot plate threshold of normal mice, and down-regulated the expression of inflammatory cytokines in the spinal cord. Network analysis showed that Baimai Ointment had synergistic effect in the treatment of CCD and was related to descending inhibition/facilitation system and neuroinflammation. Furthermore, behavioral tests, Western blot, and immunofluorescence assay revealed that the pain-relieving effect of Baimai Ointment on CCD may be related to the regulation of the interaction between neuroactive ligand and receptors(neuroligands) such as CHRNA7, ADRA2A, and ADRB2, and the down-regulation of the expression of NOS2/pERK/PI3K, the core regulatory element of HIF-1 signaling pathway in spinal microglia. The findings preliminarily reveal the mechanism of relaxing sinew and activating collaterals of Baimai Ointment in the treatment of Baimai disease, providing a reference for the rational drug use and further research of this agent.
Rats ; Mice ; Animals ; Chronic Pain/metabolism* ; Rats, Sprague-Dawley ; Ganglia, Spinal/metabolism* ; Ligands ; Signal Transduction ; Hyperalgesia/metabolism* ; Drugs, Chinese Herbal

BACKGROUND: It is not clear whether sacubitril/valsartan is beneficial for patients with heart failure (HF) with reduced ejection fraction (HFrEF) and low systolic blood pressure (SBP). This study aimed to investigate the efficacy and tolerability of sacubitril/valsartan in HFrEF patients with SBP < 100 mmHg. METHODS & RESULTS: An observational study was conducted on 117 patients, 40.2% of whom had SBP < 100 mmHg without symptomatic hypotension, and 59.8% of whom had SBP ≥ 100 mmHg in an optimized HF follow-up management system. At the 6-month follow-up, 52.4% of patients with SBP < 100 mmHg and 70.0% of those with SBP ≥ 100 mmHg successfully reached the target dosages of sacubitril/valsartan. A reduction in the concentration of N-terminal pro-B-type natriuretic peptide was similar between patients with SBP < 100 mmHg and SBP ≥ 100 mmHg (1627.5 pg/mL and 1340.1 pg/mL, respectively; P = 0.75). The effect of sacubitril/valsartan on left ventricular ejection fraction was observed in both SBP categories, with a 10.8% increase in patients with SBP < 100 mmHg (P < 0.001) and a 14.0% increase in patients with SBP ≥ 100 mmHg (P < 0.001). The effects of sacubitril/valsartan on SBP were statistically significant and inverse across both SBP categories (P = 0.001), with an increase of 7.5 mmHg in patients with SBP < 100 mmHg and a decrease of 11.5 mmHg in patients with SBP ≥ 100 mmHg. No statistically significant differences were observed between the two groups in terms of the occurrence of symptomatic hypotension, deteriorating renal function, hyperkalemia, angioedema, or stroke. CONCLUSIONS Within an optimized HF follow-up management system, sacubitril/valsartan exhibited excellent tolerability and prompted left ventricular reverse remodeling in patients with HFrEF who presented asymptomatic hypotension.

Objective To observe the clinical efficacy of levofloxacin combined with levofloxacin scheme in the treatment of pulmonary tuberculosis patients with positive hepatitis B surface antigen(HBsAg)and its impact on drug-induced liver injury.Methods Pulmonary tuberculosis patients with positive HBsAg were divided into treatment group and control group according to the anti-tuberculosis treatment plan.The treatment group received 2HLZE/4HLE anti-tuberculosis regimen(levofloxacin 0.6 g,twice a week+isoniazid 0.3 g,qd+ethambutol hydrochloride 0.75 g,qd+pyrazinamide 0.5 g,tid)for 6 months,and the control group received 2HRZE/4HRE anti-tuberculosis regimen(levofloxacin 0.6 g,qd+isoniazid 0.3 g,qd+ethambutol hydrochloride 0.75 g,qd+pyrazinamide 0.5 g,tid)for 6 months.The sputum smear conversion rate,liver function indicators[glutamate pyruvate transaminase(GPT),glutamate oxaloacetate transaminase(GOT),serum total bilirubin(TBIL)],clinical efficacy,drug-induced liver injury,as well as the incidence of adverse drug reactions were compared between the two groups.Results A total of 41 patients were enrolled in the treatment group and 39 patients in the control group.After treatment,the clinical total effective rates in the treatment and control groups were 97.56％and 79.49％,which showed statistically significant difference(P＜0.05).After 4 months of treatment,the sputum smear conversion rates in the treatment group and the control group were 90.24％and 71.79％,respectively;after 6 months of treatment,the sputum smear conversion rates in the treatment group and the control group were 95.12％and 79.49％,respectively,both showing statistically significant differences(all P＜0.05).After 6 months of treatment,the GPT levels in the treatment group and the control group were(87.39±17.26)and(101.49±23.48)U·L-1,the GOT levels were(97.54±19.25)and(119.63±21.57)U·L-1,and the TBIL levels were(31.53±9.35)and(38.27±9.64)μmol·L-1,respectively,all showing statistically significant differences(all P＜0.05).The incidence of drug-induced liver injury in the treatment group and the control group was 19.51％and 41.03％respectively,and the time of liver injury occurrence was(12.98±2.26)and(10.23±1.95)days,both showing statistically significant differences(all P＜0.05).The total incidences of adverse reactions in the treatment group and the control group was 29.27％and 64.10％respectively,with statistically significant differences(P＜0.05).Conclusion Compared with the levofloxacin scheme,the levofloxacin combined with levofloxacin scheme can reduce the incidence and severity of drug-induced liver injury and improve the clinical treatment efficacy in pulmonary tuberculosis patients with positive HBsAg.

OBJECTIVES: To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China. METHODS: A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined. RESULTS: The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05). CONCLUSIONS It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
Female ; Fetal Growth Retardation ; Gestational Age ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Prospective Studies ; Risk Factors

Standardized surgical management of postoperative specimens of gastric cancer is an important part of the standardized diagnosis and treatment of gastric cancer. It can reflect the accurate number and detailed distribution of lymph nodes in the specimen and lay the foundation for accurate and standardized pathological reports after surgery. Meanwhile, it can evaluate the scope of intraoperative lymph node dissection, the safety of cutting edge, and the standardization of surgery (principle of en-bloc dissection), which is an important means of surgical quality control. It also provides accurate research samples for further research and is an important way for young surgeons to train their clinical skills. The surgical management of postoperative specimens for gastric cancer needs to be standardized, including specimen processing personnel, processing flow, resection margin examination, lymph node sorting, measurement after specimen dissection, storage of biological specimens, documentation of recorded data, etc. The promotion of standardized surgical management of specimens after radical gastrectomy can promote the homogenization of gastric cancer surgical diagnosis and treatment in medical institutions and further promote the high-quality development of gastric cancer surgery in China.
Gastrectomy ; Humans ; Laparoscopy ; Lymph Node Excision ; Lymph Nodes/surgery* ; Stomach Neoplasms/surgery*