Stroke is a leading cause of mortality and disability worldwide, with approximately 70% of all cases being acute ischemic strokes. Reperfusion therapy (such as intravenous thrombolysis and emergency endovascular treatment) is the first-line treatment for acute ischemic stroke, yet the prognosis remains suboptimal for some patients. In recent years, research on neuroprotection based on reperfusion therapy has made significant progress, with some cytoprotective drugs and therapies showing promising clinical potential. This consensus summarizes recent advances in the field of cytoprotection based on reperfusion therapy and, in combination with the specific clinical and healthcare context of clinical and healthcare China, develops a practical and clinically applicable expert consensus. It aims to provide a scientific basis for cytoprotection research and clinical application in acute ischemic stroke, further optimizing treatment strategies and improving patient outcomes.

Under physiological conditions, the blood-brain barrier (BBB) blocks over 95% of various drugs from entering the central nervous system (CNS). How to achieve precise and efficient intracranial drug delivery by overcoming the BBB in a minimally invasive or non-invasive manner has become one of the current challenges in pharmaceutical research and development. This review summaries the feasibility and efficacy of a novel CNS drug delivery pathway that bypasses the BBB through the skull bone marrow-dura-glymphatic system, to provide new perspectives and strategies for drug delivery and treatment in a range of major brain diseases.

Hypertension is one of the most prominent modifiable risk factors for stroke. Accurate blood pressure control can substantially reduce the incidence and mortality of stroke  serves as the cornerstone of primary stroke prevention. This article systematically summarizes the evidence from randomized controlled trials relating to blood pressure interventions in populations with higher risk of stroke, with a focus on two core implementations: intensive blood pressure lowering and remote blood pressure monitoring with wearable devices. By conducting an in-depth analysis of the impacts of different intervention measures on blood pressure control and stroke risk, this article aims to provide evidence-based basis and practical references for primary medical institutions to carry out primary stroke prevention among populations with higher risks.

Objective  To explore the principle of restricted mean survival time (RMST) and its application in cerebrovascular disease research. Methods  RMST is employed as a robust method for survival analysis, providing an alternative to Cox proportional hazards （PH） model when the PH assumption is violated and a complement when it was satisfied. In this study, outcomes were analyzed by Cox PH model or RMST method according to the results of the PH assumption test. The Clopidogrel with Aspirin in High-Risk Patients with Acute Nondisabling Cerebrovascular Events Ⅱ (CHANCE-2) trial was used to assess the difference in 1-year RMST for stroke recurrence between the ticagrelor-aspirin and clopidogrel-aspirin groups. The  China National Stroke Registry-Ⅲ (CNSR-Ⅲ) was used to examine the effect of antihypertensive therapy on 5-year survival among patients with cerebrovascular disease and hypertension. Results  In CHANCE-2, the PH assumption was satisfied. Compared with clopidogrel-aspirin, Cox regression showed that ticagrelor-aspirin reduced the risk of recurrent stroke by 20% (HR=0.805, 95% CI: 0.682－0.949), and RMST analysis further indicated an approximate 6.646－d prolongation in the mean stroke-free survival time over one year (341.316 vs 334.755 d, P < 0.05). In CNSR-Ⅲ, the PH assumption was violated. Multivariable-adjusted RMST analysis demonstrated that antihypertensive treatment extended overall survival by 17.455  d over five years in patients with cerebrovascular disease and hypertension, with similar findings after propensity score matching (ΔRMST=22.883  d, P < 0.05). Conclusion  RMST yield robust estimates and interpretable effect measures beyond the PH assumption, highlighting its significance in cerebrovascular disease research.

Objective  To systematically analyze the associations between the cholesterol, high-density lipoprotein, and  fasting blood glucose (CHG) index and stroke recurrence as well as other adverse outcomes in patients with ischemic stroke or transient ischemic attack (TIA).Methods  The data source for this study was the  China National Stroke Registry-Ⅲ (CNSR-Ⅲ）. Patients with ischemic stroke or TIA within 7 d of onset were included. The exposure factor was the baseline CHG index. The study population was grouped according to the quartiles of the CHG index, designated as Q1, Q2, Q3, and Q4. The primary outcome measure was stroke recurrence within 1 year. The Cox proportional hazards model was employed to analyze the relationship between the CHG index and the outcomes, and the hazard ratio (HR) and 95% confidence intervals (CI) were calculated. A total of four models were constructed.Results  A total of 11 946 patients were included in the analysis. The median (interquartile range) age of the patients was 62 (54, 70) years, and 8 126 (68.02%) patients were male. Compared with the Q1 group, the Q2, Q3, and Q4 groups were all associated with a higher risk of stroke recurrence. In Model 4, the HR (95% CI) were 1.38 (1.08-1.77), 1.46 (1.15-1.87), and 1.44 (1.12-1.86), respectively. When the CHG index was treated as a continuous variable, the association remained statistically significant.Conclusion  The CHG index is positively associated with stroke recurrence in patients with ischemic stroke or TIA. In clinical practice, it is advisable to pay more attention to patients with abnormal lipid and blood glucose levels and strengthen the implementation and adherence to secondary prevention measures to reduce stroke recurrence.

Objective  To screen and validate risk factors associated with stroke recurrence in Chinese patients with symptomatic intracranial and extracranial atherosclerotic stenosis and to identity patients at high-risk of stroke recurrence. Methods  This study utilized data from the Third China National Stroke Registry. Patients with stroke and ≥50% intracranial or extracranial arterial stenosis were included. The data collected included demographic characteristics, medical history, prehospital care, physical examination findings on admission, admission scores, imaging information, discharge diagnoses, and laboratory parameters. The primary outcome was ascertained as stroke recurrence within 3 months. Cox proportional hazards regression was used to identify independent risk factors for stroke recurrence in symptomatic intracranial and extracranial atherosclerotic stenosis patients. A prediction model for 3-month stroke recurrence was developed based on the identified factors and its predictive performance was compared with the traditional ESSEN score. Results  Among 3 944 enrolled patients (median age 64 years,  67.8% male), 324 (8.7%) patients experienced stroke recurrence within 3 months. Multivariable Cox regression analysis identified the following independent risk factors for recurrence: age≥75 years (HR=1.36, 95% CI: 1.06-1.76, P=0.016), time from onset to admission <72 h (HR=1.64, 95% CI: 1.14-2.35, P=0.007), admission National Institutes of Health Stroke Scale (NIHSS) >5 (HR=3.38, 95% CI: 1.13-10.14, P=0.029), non-lacunar infarction (HR=1.71, 95% CI: 1.13-2.57, P=0.011), and elevated plasma interleukin-6 level (HR=1.02, 95% CI: 1.00-1.05, P=0.040). The novel prediction model demonstrated superior discriminative ability compared to the ESSEN score, with the C-statistic increasing from 0.557 to 0.616 (P=0.003). Significant improvements were also observed in integrated discrimination improvement (IDI=0.79%, 95% CI： 0.44%-1.14%, P<0.001) and net reclassification index (NRI=21.34%, 95% CI: 10.88%-31.80%, P<0.001).Conclusion  In Chinese patients with symptomatic intracranial and extracranial atherosclerotic stenosis, age≥75 years, onset-to-admission time <72 h, admission NIHSS >5, non-lacunar infarction, and elevated plasma interleukin-6 levels are independent risk factors for 3-month stroke recurrence. The prediction model incorporating these factors outperforms the conventional ESSEN score in identifying patients at high-risk of stroke recurrence.

Objective  To investigate the association between blood-brain barrier (BBB) permeability in the left hippocampal cornu ammonis 4 (CA4) subregion and post-stroke cognitive impairment (PSCI). Methods  This multicenter prospective cohort study consecutively enrolled 97 patients with transient ischemic attack (TIA) or minor ischemic stroke. Within 7 d of admission, all participants underwent dynamic contrast-enhanced magnetic resonance imaging, and BBB permeability parameters volume transfer constant(Ktrans) of hippocampal subregions were calculated using the Patlak model. According to Montreal Cognitive Assessment (MoCA) scores at 6-month follow-up, patients were divided into the PSCI group and the post-stroke non-cognitive impairment (PSNCI) group. Multivariate Logistic regression analysis was performed to examine the independent association between BBB permeability in the left hippocampal CA4 region and cognitive outcomes. Results  A total of 65 patients completed the follow-up, including 13 (20.0%) in the PSCI group. Patients in the PSCI group were older, had fewer years of education, and lower baseline MoCA scores (all P < 0.05). Increased BBB permeability in the left hippocampal CA4 region was associated with lower total MoCA scores, and negatively correlated with executive and naming function scores. Multivariate Logistic regression analysis indicated that elevated BBB permeability in the left hippocampal CA4 region was an independent risk factor for PSCI. Conclusion  Increased BBB permeability in the left hippocampal CA4 subregion is independently associated with lower cognitive scores at 6 months in patients with TIA or minor ischemic stroke. It may serve as a potential imaging biomarker for predicting PSCI.

Objective  To explore the impact of insulin resistance on the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in reducing the risk of stroke recurrence in patients with minor stroke or transient ischemic attack (TIA) who carry CYP2C19 loss-of-function alleles. Methods  Based on the Clopidogrel with Aspirin in High-Risk Patients with Acute Nondisabling Cerebrovascular Events Ⅱ （CHANCE-2） trial, patients with complete baseline data on triglycerides, fasting plasma glucose, height, weight, and waist circumference (WC) were included. The triglyceride-glucose-body mass index (TyG-BMI), TyG-WC, and TyG-waist-to-height ratio (TyG-WHtR) were used as surrogate markers of insulin resistance. Patients were divided into high and low insulin resistance subgroups according to the median of each index. The primary efficacy and safety outcome were defined as stroke recurrence and moderate or severe bleeding within 90 d. Results  In the high TyG-WC and high TyG-WHtR subgroups, ticagrelor-aspirin significantly reduced the risk of stroke recurrence compared with clopidogrel-aspirin(P<0.05), the hazard ratios (HR) were 0.70 (95% CI: 0.53 － 0.92) and 0.74 (95% CI: 0.56 － 0.97), respectively; In the high TyG-BMI, low TyG-WC, low TyG-WHtR, or low TyG-BMI subgroups, ticagrelor-aspirin showed a trend toward better efficacy, but this benefit was not statistically significant (P > 0.05). Additionally, there was no significant difference in the risk of severe and moderate bleeding within 90 d between the two treatment groups across all subgroups (all P > 0.05). Conclusion  Patients with high insulin resistance characterized by high TyG-WC or high TyG-WHtR  may represent responsive subgroup for ticagrelor-aspirin treatment as determined by their CYP2C19 genotype.

Objective  To develop and validate a 10-year prediction model for the incidence risk of cardiovascular diseases (CVD) among the aerospace occupational population, providing a quantitative tool for early CVD prevention and control in this occupational group. Methods  We included CVD-free employees from Shanghai Academy of Spaceflight Technology who underwent physical examinations at Aerospace Wuxi Health Management Center in 2014. Annual physical examination was conducted, with follow up through April 5, 2025. The data were randomly divided into a training set and a validation set at a ratio of 7∶3. A total of 236 physical examination indicators were screened using the LASSO-penalized Cox algorithm. The model was constructed using Cox regression, and a nomogram was drawn. The discrimination was evaluated using the Harrell C statistic and the area under the receiver operating characteristic（ROC） curve (AUC), the calibration was evaluated using the calibration curve, and the DeLong's test was used to compare the performance differences with classic domestic and international models. Results  A total of 13 303 participants was included, with a median baseline age of 32 (28,43) years. The model incorporated 8 risk factors: a history of diabetes, a history of hypertension, a family history of hypertension,total cholesterol (TC)/high density lipoprotein -cholesterol(HDL-C), age, systolic blood pressure, waist circumference, and γ-glutamyltransferase. The model demonstrated adequate discrimination ［Harrell C: 0.898 vs 0.874; AUC (95% CI): 0.911 (0.889-0.931) vs 0.890 (0.854-0.923)］ and calibration in both the training set and the validation set, outperforming the classic models (P<0.05). Conclusion  A model constructed using readily accessible physical examination indicators can accurately predict the 10-year CVD incidence risk among the aerospace occupational population. This provides a scientific basis for early identification of high-risk individuals within this population, development of occupation-specific strategies, and implementation of preventive measures, thereby filling the gap in CVD risk assessment tools tailored to aerospace occupations. 

Objective  To investigate the relationship between the hemoglobin levels in early pregnancy and risk of gestational diabetes mellitus (GDM). Methods  Clinical data of 1 044 pregnant women without preconception diabetes who gave birth in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 1, 2024 to June 30, 2024 were selected, and their age, preconception body mass index (BMI) and the results of the first hemoglobin laboratory test in early pregnancy(at 6－10 weeks of gestations) were collected. According to the results of oral glucose tolerance test (OGTT) in the second trimester, the patients were divided into GDM group(173 cases) and non-GDM group(871 cases). Logistic regression was used to analyze the relationship between hemoglobin (HGB) and GDM in the first trimester. Results  In this study, the incidence of GDM was 16.57%, The Age, BMI and HGB in the early pregnancy of the GDM group were all higher than those of the non-GDM group, and the differences were statistically significant (P < 0.05). The HGB in the early pregnancy was significantly positively correlated with the blood glucose at 0 h (r= 0.069, P=0.025), 1h (r=0.15, P < 0.001) and 2 h (r=0.124, P<0.001) of OGTT in the mid-pregnancy. HGB concentration in the first trimester was an independent risk factor affecting the occurrence of GDM (OR=1.02,95%CI:1.004－1.046, P=0.021)，and after stratification by age and BMI,HGB levels in the early pregnancy stage remained an independent risk factor for the occurrence of GDM (all P<0.05), and the results were reliable.As the HGB level rises during the early stage of pregnancy, the risk of developing GDM increases. Conclusion  The increase of HGB level in early pregnancy is significantly correlated with the occurrence of GDM, which has predictive value for the occurrence of GDM.

Objective  To analyze the relationship between thyroid peroxidase antibody (TPOAb), free thyroxine (FT4) in the first trimester of pregnancy and the risk of gestational diabetes mellitus (GDM). Methods  A total of 440 pregnant women who received regular prenatal check-ups and had complete data in the Department of Perinatal Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2020 to October 2020 were selected. They were divided into the GDM group (n=335) and the non-GDM group (n=105) according to whether GDM was diagnosed. Univariate and multivariate regression analyses were used to explore the relationship between TPOAb, FT4 in the first trimester and the occurrence of GDM. Results  The age, body mass index (BMI) and TPOAb levels of patients in the GDM group were higher than those in the non-GDM group, while the FT4 level was lower than that in the non-GDM group, with statistically significant differences (P<0.05). There was no statistically significant difference in thyroid-stimulating     hormone (TSH) level between the two groups (P>0.05). Univariate analysis showed that the occurrence of GDM was correlated with age, BMI, TPOAb and FT4 levels. Multivariate Logistic regression analysis showed that the influencing factors for the incidence of GDM were age (OR=1.111, 95%CI: 1.005-1.228), BMI (OR=1.141, 95%CI: 1.028-1.266), TPOAb level (OR=1.046, 95%CI: 1.015-1.078) and FT4 level (OR=0.749, 95%CI: 0.644-0.871). The combined area under the curve (AUC) of TPOAb and FT4 levels for predicting the prevalence of GDM was higher than that of a single indicator. Conclusion  Increased TPOAb and decreased FT4 during pregnancy are independent risk factors for GDM, and the combined detection of these two indicators has higher predictive value for the risk of GDM. It is recommended to conduct thyroid function and antibody screening for women in the first trimester of pregnancy, to provide a reference for early intervention of GDM.

Objective  To evaluate the clinical efficacy of a specialized electro-acupuncture technique in treating postpartum women with non-infectious lower urinary tract symptoms (LUTS). Methods  A total of 120 primiparous women with LUTS, who were treated at the Beijing Daxing District Hospital of Integrated Chinese and Western Medicine, from January 2024 to April 2025,  were randomly assigned to the study group (n=60) and the control group (n=60). The control group received routine lifestyle guidance and pelvic floor functional training, while the study group underwent additional treatment with the specialized electro-acupuncture technique. Needles inserted into the Ciliao  acupoint and  Sanyinjiao acupoints were punctured with filiform needles, followed by electrode attachment. The treatment was administered for 30 min per session, 3 times weekly, for a total of 8 weeks. The ICIQ-FLUTS scores were collected and analyzed before and after treatment in both groups. Results  Comparison of the before and after treatment suggested that the study group showed a reduction in frequent urination (FU), urgency, dysuria, nocturia, urge urinary incontinence (UUI), stress urinary incontinence (SUI), and voiding symptoms (VS) (P<0.05), and the control group showed only a reduction in FU, nocturia, and SUI (P<0.05). Comparison within two groups after treatment suggested that the study group had a greater reduction in FU, urgency, dysuria, UUI, SUI and VS(P<0.05). The study group showed a significant reduction in severity of distress(FU, urgency, dysuria, nocturia, UUI) after the treatment.  Within  two groups after treatment, the study groups was more significant than the control group in reduction of the serious distress (P<0.05). Conclusion  The specialized electro-acupuncture technique is effective in treating postpartum women with non-infectious LUTS 42 d after delivery, which reduced the severe distress caused by FU, urgency, dysuria, nocturia, and UUI. It is worthy of clinical promotion and application.

Objective  To investigate the role of N-acetyltransferase 10 (NAT10) in pulmonary fibrosis (PF) and its association with oxidative stress. Methods  Public transcriptome datasets (GEO: GSE110147, GSE282477, GSE128033) were integrated to analyze NAT10 mRNA levels in pulmonary fibrosis (PF). A murine PF model was established by intratracheal Bleomycin (BLM) administration. The expression of NAT10 protein in lung tissue was assessed  by immunofluorescence. Human bronchial epithelial cell line BEAS-2B was  stimulated by BLM to establish an in vitro fibrosis model. The mRNA expression of fibrotic markers and NAT10 were analyzed by using reverse transcription polymerase chain reaction (RT-qPCR), while the protein levels of inflammatory factors were evaluated by enzyme-linked immunosorbent assay (ELISA). To study the function of NAT10, BEAS-2B cells with NAT10 inhibition  were treated with BLM. Intracellular reactive oxygen species (ROS) levels were analyzed by flow cytometry. The concentrations of interleukin 6 (IL-6), transforming growth factor-β1 (TGF-β1), superoxide dismutase (SOD) activity, and the lipid peroxidation product malondialdehyde (MDA) content were measured via ELISA. Results  Based on public transcriptome analysis, NAT10 mRNA expression was elevated to 1.05- and 1.38-fold of controls in lung tissues from idiopathic pulmonary fibrosis (IPF) patients (GSE110147) and BLM-induced fibrotic mice (GSE282477), respectively (both P<0.05). Single-cell RNA sequencing of IPF lungs (GSE128033) indicated that bronchiolar club and other epithelial cells exhibited the most pronounced NAT10 upregulation compared to other pulmonary cell types (all P<0.05). Immunofluorescence quantification confirmed a 1.94-fold increase in NAT10 protein in BLM-induced fibrotic murine lungs versus model controls (P<0.05). In BEAS-2B cells, BLM stimulation for 48 hours induced fibrotic changes and increased NAT10 mRNA to 1.36-fold of baseline (P<0.05). This was accompanied by elevated supernatant levels of ROS, MDA content, TGF-β1 and IL-6 levels, alongside reduced SOD activity (all P<0.05). NAT10 knockdown rescued these alterations, increasing SOD activity and decreasing ROS levels, MDA content, TGF-β1, and IL-6 levels compared to the BLM-stimulated group (all P<0.05). Conclusion  NAT10 is a critical regulator of oxidative stress injury in pulmonary fibrosis. Its expression is significantly elevated in fibrotic tissues and cellular models, suggesting a possible correlation with disease severity. At the cellular level, targeting NAT10 effectively mitigates BLM-induced oxidative stress and fibrotic responses. Further animal studies will help clarify its therapeutic potential.

Objective  To investigate the effect of Yiqi Qingre Xiaozheng Formula on pyroptotic injury in renal tubular epithelial cells induced by high glucose (HG) combined with lipopolysaccharide (LPS), and to elucidate the underlying mechanisms by which the formula ameliorates tubular cell pyroptosis in the context of diabetic kidney disease (DKD). Methods  Human renal proximal tubular epithelial cells (HK-2) were used for in vitro experiments. Pyroptosis was induced by stimulation with high glucose and lipopolysaccharide, and cell viability was assessed by using the CCK-8 assay to determine optimal modeling conditions. HK-2 cells were divided into control, model, and treatment groups (treated with Yiqi Qingre Xiaozheng Formula). Phalloidin staining was used to observe cytoskeletal morphology. Cell apoptosis was evaluated by Annexin V/PI double staining and flow cytometry. Immunofluorescence staining was performed to detect lysosomalc-associated membrane protein-1 (LAMP-1) and cathepsin B (CTSB). Western blotting was performed to assess the protein expression levels of key  NOD-like receptor family, pyrin domain containing 3（NLRP3) and apoptosis-associated speck-like protein containing a CARD（ASC). Lysosomal membrane permeabilizer LLOMe was used as a positive control. Levels of  interleukin-18 (IL-18) and IL-1β in the cell supernatant were quantified by ELISA to assess lysosomal membrane permeability and pyroptosis. Results  Stimulation with 30 mmol/L HG and 10 μg/mL LPS for 24 h significantly reduced HK-2 cell viability, while treatment with Yiqi Qingre Xiaozheng Formula restored cell viability. Compared with the control group, HG+LPS treatment led to disorganized cytoskeletal morphology, increased apoptosis, lysosomal membrane permeabilization, cytoplasmic release of CTSB, and upregulation of pyroptosis-related proteins NLRP3 and ASC, as well as increased pro-inflammatory cytokines of IL-1β and IL-18. In contrast, the formula stabilized cytoskeletal structure, inhibited apoptosis, protected lysosomal membrane integrity, and reduced CTSB release into the cytoplasm. Consequently, the expression of NLRP3 and ASC was downregulated, and the levels of IL-1β and IL-18 in the supernatant were significantly decreased. Conclusion  Yiqi Qingre Xiaozheng Formula mitigates high glucose-induced tubular cell injury in DKD. Its protective mechanism may be associated with inhibition of pyroptosis via modulation of the LAMP-1/CTSB/NLRP3 signaling axis.

Objective  To investigate the effects of air-abrasion parameters, including pressure, distance, and angle on the abrasive efficacy and extrinsic stain removal effect of chloride-containing bioactive glass abrasives (Cl-BG). Methods  With commonly used abrasive sodium bicarbonate (NaHCO3) as the control, the particle size and morphology of Cl-BG were characterized using a laser particle size analyzer and scanning electron microscope (SEM), and their cytotoxicity was evaluated with a CCK-8 assay. The enamel removal volume on bovine enamel by Cl-BG under different air-abrasion parameters (pressure: 20, 40, 60 psi; distance: 2, 5 mm; angle: 45°, 90°) was quantitatively analyzed using a white light interferometry. An extrinsic stain model on extracted human teeth was established, and the stain removal effects of the two abrasives under set parameters were visually observed using stereomicroscopy and SEM. Results  Cl-BG and NaHCO3 had similar particle sizes and both showed no cytotoxicity. The enamel removal volume by Cl-BG increased with increasing air-abrasion pressure, while the influences of the angle and distance were less significant. Under identical parameters, the stain removal effect of Cl-BG was superior to that of the NaHCO3. Within the Cl-BG group, the removal efficiency at a 90° angle was  found to be superior to than at 45°. SEM observations revealed the presence of residual glass particles on the enamel surface after treatment, providing a potential remineralization ability. Conclusion  Air-abrasion efficacy is primarily regulated by pressure. It demonstrated that Cl-BG was an effective agent for the removal of  dental extrinsic stains. The good biocompatibility and the potential to promote remineralization made it a highly promising novel abrasive for minimally invasive dentistry.

Objective  Previous studies have shown a protective effect of bardoxolone methyl (BM) in an abdominal aortic aneurysm (AAA) model, and this study aims to further explore its therapeutic effect in aortic dissection (AD) model.Methods  A 3-week-old male C57BL/6J mouse was fed a β-aminopropionitrile (BAPN) diet containing 0.4% mass fraction to construct an AD model. The mice were randomly divided into control group, BAPN control group and BAPN+BM group. The BAPN+BM group was given a dose of 1.25 mg/kg per day intraperitoneal injection for 4 weeks, and the control group was injected with the same amount of solvent. During the experiment, the survival of mice was recorded and ultrasound detection was conducted, and aortic anatomy and pathological staining were performed to evaluate the aortic lesion after the experiment.Results  During the 28-day experimental period, both the BAPN control group and the BAPN+BM group had a higher mortality rate (72.7% vs 63.6%, P>0.05). Although BM interventions can delay the time to death, they do not significantly improve survival. Ultrasound results showed that the thoracic aorta of the mice in both groups had different degrees of dilation, and the difference was not significant. Anatomical and pathological analysis showed that BM failed to significantly reduce the incidence of aortic dissection, nor did it improve pathological injuries such as media structure damage, collagen deposition, and elastic fiber rupture.Conclusion  BM at 1.25 mg/kg  per day did not show significant protective effect in BAPN-induced mouse AD models, indicating the differences between AAA and AD animal models in the same dose of BM drug response, which provided a reference for personalized intervention strategies for different types of aortic diseases.

Objective  To establish prediction models by using different algorithms for extrapyramidal adverse reactions to antipsychotic drugs in adult hospitalized patients with schizophrenia,and compare them. Methods  Data from the electronic health record system of Beijing Anding Hospital Capital Medical University from 2010 to 2018 was retrospectively collected, and regularization methods to conduct text mining were used to obtain structured clinical data. By using an elastic network model to screen variables that enter the models, 11 algorithms were used to construct prediction models. The sensitivity, specificity, positive predictive value, negative predictive value, area under the curve and decision curve analysis were compared comprehensively. The best performing model was visualized by using Shapley additive explanations to determine the contribution of the prediction factors. Results  The incidence of extrapyramidal adverse reactions to antipsychotic drugs was 41.09%. In the constructed prediction models, CatBoost performed the best (AUC=0.89), and the SHAP summary graph visualized the contributions of predictors. Conclusion  The best model for predicting adverse reactions is CatBoost, which is superior to the latest algorithm TabPFN. The most important risk factors are haloperidol and length of hospital stay.

Objective  To explore the correlation between serum potassium variability and long-term prognosis in maintenance hemodialysis patients (MHD). Methods  Baseline data were recruited from MHD patients treated at Beijing Luhe Hospital, Capital Medical University hemodialysis center in January 2018,with follow-up through April 2024.Variability of serum potassium was defined as the coefficient of variation of serum potassium from January 2017 to December 2017，and the statistical analysis was performed after log transformation. According to serum potassium variability, MHD patients were divided into the high potassium variability group（0.080 2-0.215 9）and the low potassium variability group（0.026 5-0.080 1）. Kaplan-Meier survival analysis was used to obtain patient survival probabilities, multivariate Cox hazard regression model was used to explore the association between serum potassium variability and all-cause mortality. Results  A total of 213 patients were included in this study, 58.2% were males, with a mean age of (59.1±13.4) years, a median dialysis vintage of 4.4（2.7, 6.9） years,and the median observation period was 6.0 (2.5, 6.25) years. 104 patients（48.8%） died during the observation period, including 52 cardiovascular deaths (50.0%)， 18 infectious deaths（17.3%），15 cerebrovascular deaths（14.4%）. Kaplan-Meier curves showed that a higher potassium variability coefficient was associated with higher all-cause mortality (Log-rank,χ²=9.119，P=0.025).  After adjusting for potential confounding factors such as age, albumin, serum creatinine, and Kt/V（urea clearance index value）, multivariate Cox regression analysis revealed that the high potassium variability group had a higher risk of all-cause mortality than the low potassium variability group (HR=1.537, 95% CI: 1.026-2.302, P=0.037). Conclusion  Higher serum potassium variability was associated with higher all-cause mortality in MHD patients. More attention should be paid to managing serum potassium levels and their fluctuations in MHD patients.

Objective  To establish an evaluation method for the image quality of periapical radiographs based on target teeth and assess its clinical application effect. Methods  A total of 1 000 periapical radiographs were collected from Beijing Stomatological Hospital, Capital Medical University in 2023. Two oral radiologists independently evaluated and graded from six dimensions: target tooth location, image clarity, horizontal projection angle, vertical projection angle, artifacts, and cut-off. The simple agreement and Gwet's test were used to assess the inter-observer consistency between the two radiologists. Meanwhile, McNemar's test and Wilcoxon signed-rank test were applied to compare the evaluation differences of the same radiologist with and without reference to the target tooth. Results  Across all six dimensions, regardless of whether the target tooth was marked or not, both the simple agreement between the two evaluators and the AC1（agreement coefficient 1）values from Gwet's test were greater than 0.9, indicating extremely high consistency. For the grading results, the simple agreement was all above 0.8, and the AC2 values from Gwet's test exceeded 0.65, showing good overall consistency. When comparing the evaluations of each radiologist with and without target tooth reference, significant differences were observed in the two dimensions of target tooth location and artifacts, as well as in the grading evaluation (P<0.05). When evaluating with reference to the target tooth, more periapical radiographs met the evaluation criteria, and the image quality grading was better. Conclusion  This standard demonstrates good consistency. Compared with the overall evaluation, the target tooth-based specific evaluation of periapical radiographs can further improve the image grading of periapical radiographs.

Objective  To examine the association between serum bilirubin levels and bone mineral density (BMD), as well as osteoporosis (OP) in patients with type 2 diabetes mellitus(T2DM). Methods  A retrospective analysis was conducted in 1 514 T2DM patients  of Beijing Tongren Hospital, Capital Medical University. The age of the patients ranged from 50 to 94 years, with a mean age of (63.49±8.11) years. Serum total bilirubin (TBIL) and direct bilirubin (DBIL) levels were measured, and then was classified as Q1-Q4 groups based on quartiles. BMD was assessed by using dual-energy X-ray absorptiometry. OP was defined according to the diagnostic criteria of the World Health Organization, which indicated a T-score ≤ -2.5 for lumbar spine, total hip or femoral neck. Multivariable Logistic regression and linear regression models were used to analyze the relationship between serum bilirubin (TBIL and DBIL) levels and BMD, OP in T2DM patients. Results  There were significant differences in serum TBIL and DBIL levels between the OP and non-OP groups. After multivariable adjustment, the TBIL-Q4 group had a significantly higher prevalence of OP (OR=1.952, 95% CI: 1.041-3.659,P=0.037) and a significant decrease in lumbar spine BMD (β =-0.038, 95% CI :-0.072--0.004, P=0.027) compared to the TBIL-Q1 group. Compared to the DBIL-Q1 group, the DBIL-Q2 and DBIL-Q3 groups showed significant decreases in BMD at the femoral neck and total hip (P<0.05). Subgroup analysis showed that the impact of TBIL and DBIL on OP was more significant in the age ≤ 65 years and glycosylated hemoglobin (HbA1c) ≤ 7.0% groups. In female patients, TBIL levels were negatively correlated with lumbar spine BMD (β= -0.019, 95% CI:-0.034--0.005, P=0.009). Conclusion  Elevated bilirubin levels are associated with an increased prevalence of OP and decreased BMD, especially in subgroups of age ≤ 65 years and HbA1c ≤ 7.0%.

Artificial intelligence (AI) has demonstrated significant potential in the diagnosis and treatment of cholangiocarcinoma. Deep learning-based imaging analysis techniques enable automated lesion segmentation, accurate differential diagnosis, and prediction of pathological behaviors such as lymph node metastasis, substantially improving diagnostic efficacy. Endoscopic assistance systems, utilizing convolutional neural networks, facilitate real-time identification of biliary structures and malignant strictures, optimizing procedural workflows. In pathological diagnosis, AI models leverage hyperspectral or conventional white-light pathological scanned images to achieve tumor classification and molecular subtyping, providing critical support for prognostic assessment and targeted therapy. Current challenges primarily include insufficient data standardization and limited model generalizability. Future advancements will require multicenter collaboration and algorithmic optimization to promote clinical translation. 

The biobank is the most important source of samples and data for clinical diagnosis, treatment, and scientific research, which is of great significance for improving the level of disease diagnosis and treatment, promoting medical technology innovation, and enhancing people's health and well-being. Informed consent is a key link in the standardization, normalization, and systematic construction of biobanks. According to internationally recognized ethical standards and relevant regulations and policy documents on ethical review in China, combined with the actual construction of biobanks in Beijing, ethical guidelines for informed consent of biobanks in health facilities in Beijing have been developed for reference. It elaborates on the basic principles, key points of informed consent form, implementation process of informed consent, informed consent of vulnerable groups, sharing of biological samples and data, supervision and management, and other aspects.

Objective  To systematically analyze the characteristics of articles retracted due to “paper mills” and explore effective governance strategies to uphold academic integrity. Methods  Based on data from the Retraction Watch Database (2010-2024), a total of 7 513 articles retracted due to “paper mills” were included. Descriptive statistics and categorical analysis were employed to examine disciplinary distribution, national characteristics, article types, retraction timelines, publisher sources, and retraction reasons. Results  Retracted articles were primarily concentrated in Business & Technology (48.3%) and Basic Life Sciences (38.1%). China (including Taiwan Province) contributed to 88.5% of global retractions. Research articles constituted the majority of retracted types (88.3%). The average retraction period was 761.5 d. Publishers such as Hindawi and IOP Publishing were major sources of retractions. Key contributing factors included third-party investigations, data irregularities, and peer review fraud. Conclusion  Retractions linked to “paper mills” exhibit features such as disciplinary concentration, geographical imbalance, publisher accountability deficits, and retraction delays. Multifaceted governance strategies—including reforming academic evaluation systems, strengthening journal review mechanisms, promoting international cooperation, and enhancing research ethics education—are essential to combat paper mill activities and safeguard the integrity of scientific research.