Analysis and comparison of retinal vascular parameters under different glucose metabolic status based on deep learning.

AIM: To develop a deep learning-based model for automatic retinal vascular segmentation, analyzing and comparing parameters under diverse glucose metabolic status (normal, prediabetes, diabetes) and to assess the potential of artificial intelligence (AI) in image segmentation and retinal vascular parameters for predicting prediabetes and diabetes. METHODS: Retinal fundus photos from 200 normal individuals, 200 prediabetic patients, and 200 diabetic patients (600 eyes in total) were used. The U-Net network served as the foundational architecture for retinal artery-vein segmentation. An automatic segmentation and evaluation system for retinal vascular parameters was trained, encompassing 26 parameters. RESULTS: Significant differences were found in retinal vascular parameters across normal, prediabetes, and diabetes groups, including artery diameter (P=0.008), fractal dimension (P=0.000), vein curvature (P=0.003), C-zone artery branching vessel count (P=0.049), C-zone vein branching vessel count (P=0.041), artery branching angle (P=0.005), vein branching angle (P=0.001), artery angle asymmetry degree (P=0.003), vessel length density (P=0.000), and vessel area density (P=0.000), totaling 10 parameters. CONCLUSION: The deep learning-based model facilitates retinal vascular parameter identification and quantification, revealing significant differences. These parameters exhibit potential as biomarkers for prediabetes and diabetes.

Rational selection of 4,4',4″-(1,3,5-triazine-2,4,6-triyl) trianiline-based covalent organic framework as adsorbent for effective co-extraction of aflatoxins, zearalenone and its metabolites from food and biological samples.

Aflatoxins, zearalenone and its metabolites, as representative hazard mycotoxins cause adverse effects on food safety and human health. Developing a sensitive and reliable extraction and detection method is of great importance for monitoring their residue and exposure levels. In contrast to traditional trial-and-error selection steps, 4,4',4″-(1,3,5-triazine-2,4,6-triyl) trianiline covalent-bonding with 2,5-dihydroxyterephthalaldehyde, namely TAPT-OH-COF was screened as a potential adsorbent utilizing density functional theory calculations prior to the synthesis procedure. After experimental verification, magnetic TAPT-OH-COFs were prepared, characterized and applied for the extraction of aflatoxins, zearalenone and its metabolites from food and biological samples, coupled with high-performance liquid chromatography tandem mass spectrophy detection. Under the optimal conditions, the developed method exhibited low limits of quantification (0.05-0.50 µg/kg), satisfactory recoveries (75.8 %-110.9 %) and good precision with intraday and interday relative standard deviations (RSDs) not exceeding 12.2 %. This study may provide great potential for the selection of candidate adsorbents for multi-mycotoxins extraction from complex samples.

Evaluation of Latent Tuberculosis Infection Using the ESAT6-CFP10 Skin Test Among International Freshmen With Diverse Skin Tones at a University - Nanjing City, Jiangsu Province, China, September 2023.

Introduction: Newer skin tests, including the ESAT6-CFP10 (EC) skin test, were recommended for diagnosing Mycobacterium tuberculosis (M. tb) infection. However, no data exist assessing the diagnostic performance of the EC skin test among foreign students with different skin tones. Methods: A cohort study at Nanjing Medical University screened incoming foreign freshmen. The EC skin test was used to assess for M. tb infection, and results were read at 24, 48, 72, and 96-hours post-administration. Results: Among 96 participants, M. tb infection rates at 24, 48, 72, and 96-hours post-injection were 3.13%, 7.29%, 13.54%, and 9.38%, respectively. While infection rates were lower among individuals with darker skin tones, the difference was not statistically significant (P=0.186), and variations were consistent across different measurement times. Trajectory analysis revealed 5.3% in the continuous-increasing group, 86.5% in the low-stable group, and 5.2% in the elevated-decreasing group. Notably, participants in the elevated-decreasing group had lighter skin tones, with trajectory patterns consistent across different skin colors. Discussion: The EC skin test is safe, and redness diameter is a more reliable indicator than induration. Results should be collected within 48 to 72 hours, with verification at 72 hours crucial if initial results are negative. Importantly, skin color does not affect EC skin test outcomes.

Investigating the Association of Chinese EFL Students' Growth Mindset, Grit, and Foreign Language Enjoyment: A Structural Equation Modelling Study.

The importance of individual differences, personality traits, and psycho-affective factors in second language (L2) learning has been increasingly substantiated by recent research. However, the relationship between students' mindsets and positive emotions has received insufficient attention in the English as a foreign language (EFL) context. To fill this research gap, we drew on "broaden-and-build" and "control value" (CVT) theories to examine associations among L2 students' growth mindset, grit, and foreign language enjoyment (FLE). A sample of 750 Chinese students completed three formerly validated scales on each of these constructs. Structural equation modeling (SEM) and correlation analysis illustrated significant, strong, positive correlations among English as a foreign language (EFL) students' growth mindset, L2 grit, and FLE. We found that 56% of changes in Chinese students' FLE could be predicted by changes in their growth mindset and grit. We discuss the obtained results, their implications, and future research directions to highlight the contagious nature of positive emotions in L2 education.

Association of Physical Activity and Dietary Diversity with Cognitive Function in the Elderly with Type 2 Diabetes Mellitus: Findings from a Cross-Sectional Study.

AIMS: Mild cognitive impairment (MCI) is a common complication of type 2 diabetes mellitus (T2DM). Changes in lifestyle and dietary patterns play a crucial role in preventing both diabetes and cognitive impairment. METHODS: A cross-sectional study was conducted on 899 aging participants. The Dietary Diversity Score (DDS) was used to evaluate dietary diversity. The physical activity (PA) levels were divided based on metabolic equivalents and weekly activity time. Individual PA levels were further re-scored and combined with DDS scores to obtain each participant's total score. RESULTS: Regardless of T2DM status, individuals with MCI had lower DDS and plant-derived DDS compared to non-MCI individuals. Non-MCI subjects had higher total PA and DDS scores than MCI subjects. There were differences in the correlation between DDS or PA scores and blood glucose and MoCA scores among different groups. The subjects with high DDS levels showed a significantly decreased risk of MCI and T2DM + MCI. Those with a total PA and DDS score in Q4 showed a significantly decreased risk of MCI and T2DM + MCI compared to Q1. CONCLUSIONS: A diversified diet improved blood glucose levels and cognitive function. Elderly individuals with diverse diets and adequate PA had a reduced risk of developing T2DM and MCI.

Effective extraction and detection of aflatoxins in cereals using nitrogen-rich benzodiimidazole linkage magnetic covalent organic framework based solid phase extraction and HPLC-MS/MS analysis.

Cereals are frequently contaminated by aflatoxins (AFs). The objective of this study was to develop an efficient extraction materials for rapidly extracting and detecting AFs. A novel amino-functionalized benzodiimidazole linkage magnetic covalent organic framework (Fe3O4@BB-COF) was simply fabricated by one-step cyclization and aromatization. The Fe3O4@BB-COF, having multiple N-containing active sites, exhibited excellent extraction capability towards AFs due to synergistic interactions, including the π-π interactions, hydrogen bonding interactions, polar interactions, electrostatic interactions and Lewis acid-base interactions. The Fe3O4@BB-COF based MSPE method for detecting aflatoxins has advantages of simple operation, short extraction time (6 min), and low material consumption (2 mg). This method exhibited satisfactory linearity (0.05-20 µg/kg), and sensitivity (0.01-0.45 µg/L for the detection limits) and accuracy (76.8-97.1 % for recovery) and was successfully applied for extracting and detecting AFs in cereals.

The protective effect of S-adenosylmethionine on chronic adolescent stress-induced depression-like behaviors by regulating gut microbiota.

The efficacy and tolerability of current antidepressants for adolescent depression are inadequate. S-adenosylmethionine (SAMe), known for its effectiveness and minimal side effects in adult depression, remains unstudied in adolescents. This study explored the potential of SAMe to address depression-like behaviors in juvenile rats induced by chronic unpredictable mild stress (CUMS), with a focus on gut microbiome interactions. Adolescent male Wistar rats were subjected to a 4-week CUMS regimen and received daily intraperitoneal injections of 300 mg/kg SAMe. Behavioral assessments included the sucrose preference test, elevated plus maze test, open field test, and Y-maze test. Histopathological changes of the hippocampus and colon were observed by Nissl staining and hematoxylin and eosin staining, respectively. Gut microbiome composition was analyzed using Accurate 16S absolute quantification sequencing. The results showed that SAMe significantly improved behavioral outcomes, reduced histopathological damages in hippocampal neurons and colon tissues, and modulated the gut microbiota of depressed rats. It favorably altered the ratio of Bacteroidetes to Firmicutes, decreased the absolute abundance of Deferribacteres, and adjusted levels of key microbial genera associated with depression-like behaviors. These results suggested that SAMe could effectively counter depression-like behaviors in CUMS-exposed adolescent rats by mitigating hippocampal neuronal and colon damage and modulating the gut microbiota. This supports SAMe as a viable and tolerable treatment option for adolescent depression, highlighting the importance of the gut-brain axis in therapeutic strategies.

Spectacle correction may affect refractive progression in children with unilateral myopic anisometropia: A retrospective study.

OBJECTIVE: To investigate the effect of spectacle correction on refractive progression in children with unilateral myopic anisometropia (UMA). METHODS: In this retrospective study, 153 children with UMA (aged 8-12 years) were recruited and classified into an uncorrected (UC) group (n = 47) and a spectacle (SP) group (n = 106). The spherical equivalent refraction (SER) of the myopic eyes ranged from -0.75 to -4.00 D; the SER of the emmetropic eyes ranged from +1.00 to -0.25 D; anisometropia was ≥1.00 D and the follow-up duration was 1 year. Nineteen subjects from the SP group with follow-up records spanning at least 6 months before and after wearing spectacles were selected as a subgroup. Changes in the SER and axial length (AL), the degree of anisometropia and interocular AL differences of the two groups and the subgroup were analysed. RESULTS: During the 1-year follow-up period, AL and SER changes in myopic eyes were significantly greater than those in emmetropic eyes in the UC group (p < 0.001). For the UC group, the degree of anisometropia and AL change increased (all p < 0.001). For the SP group, there were no significant differences in the degree of anisometropia or AL change (all p > 0.05). When comparing the groups, AL elongation of the myopic eyes in the UC group occurred significantly faster than in the SP group (p = 0.02), and AL elongation for the emmetropic eyes in the UC group occurred significantly slower than in the SP group (p = 0.04). For the subgroup, the AL and SER changes in the myopic eyes 6 months before wearing spectacles occurred significantly faster than those after correction (p < 0.001). CONCLUSIONS: Spectacle correction could prevent increased anisometropia in uncorrected children with UMA by slowing myopia progression in the myopic eyes and accelerating the myopic shift in the contralateral eye.

TCR-like bispecific antibodies toward eliminating infected hepatocytes in HBV mouse models.

Therapeutics for eradicating hepatitis B virus (HBV) infection are still limited and current nucleos(t)ide analogs (NAs) and interferon are effective in controlling viral replication and improving liver health, but they cannot completely eradicate the hepatitis B virus and only a very small number of patients are cured of it. The TCR-like antibodies recognizing viral peptides presented on human leukocyte antigens (HLA) provide possible tools for targeting and eliminating HBV-infected hepatocytes. Here, we generated three TCR-like antibodies targeting three different HLA-A2.1-presented peptides derived from HBV core and surface proteins. Bispecific antibodies (BsAbs) were developed by fuzing variable fragments of these TCR-like mAbs with an anti-CD3ϵ antibody. Our data demonstrate that the BsAbs could act as T cell engagers, effectively redirecting and activating T cells to target HBV-infected hepatocytes in vitro and in vivo. In HBV-persistent mice expressing human HLA-A2.1, two infusions of BsAbs induced marked and sustained suppression in serum HBsAg levels and also reduced the numbers of HBV-positive hepatocytes. These findings highlighted the therapeutic potential of TCR-like BsAbs as a new strategy to cure hepatitis B.

The mediating role of resilience between caregiver burden and hope among patients with inflammatory bowel disease.

AIM: To investigate whether resilience mediates the connection between caregiver burden and hope among caregivers of patients with inflammatory bowel disease (IBD). DESIGN: A cross-sectional study. METHODS: Two hundred patients with IBD were conveniently sampled from two tertiary hospitals in Jiangsu Province, China. The main instruments involved the Zarit Burden Interview, the 10-item Connor-Davidson resilience scale, and the Herth Hope Index. We conducted descriptive analysis and Pearson correlations using SPSS 25.0. The PROCESS v3.3 macro analysed the mediating effect. We report the results in line with the STROBE checklist. RESULTS: Caregiver burden was significantly negatively connected with hope and resilience, whereas resilience positively correlated with hope. The mediation role of resilience was significant in the relationship between caregiver burden and hope, with mediating effects accounting for 47.86% of the overall effect. CONCLUSIONS: Resilience partially mediates the association between caregiver burden and hope among patients with IBD. This finding highlights the protective role of resilience in undermining caregiver burden and strengthening hope. IMPLICATIONS FOR PRACTICE: In clinical practice, healthcare providers should perform routine psychological assessments for caregivers of patients with IBD. Furthermore, resilience training should be incorporated into interventions to alleviate caregiver burden and enhance hope. PATIENT OR PUBLIC CONTRIBUTION: None.

The combined effect of triglyceride-glucose index and high-sensitivity C-reactive protein on cardiovascular outcomes in patients with chronic coronary syndrome: A multicenter cohort study.

BACKGROUND: The triglyceride-glucose (TyG) index and high-sensitivity C-reactive protein (hsCRP) are the commonly used biomarkers for insulin resistance and systemic inflammation, respectively. We aimed to investigate the combined association of TyG and hsCRP with the major adverse cardiovascular events (MACE) in patients with chronic coronary syndrome (CCS). METHODS: A total of 9421 patients with CCS were included in this study. The primary endpoint was defined as a composite of MACE covering all-cause death, nonfatal myocardial infarction, and revascularization. RESULTS: During the 2-year follow-up period, 660 (7.0%) cases of MACE were recorded. Participants were divided equally into three groups according to TyG levels. Compared with the TyG T1 group, the risk of MACE was significantly higher in the TyG T3 group. It is noteworthy that among patients in the highest tertile of TyG, hsCRP >3 mg/L was significantly associated with an increased risk of MACE, whereas the results were not significant in the medium to low TyG groups. When patients were divided into six groups according to hsCRP and TyG, the Cox regression analysis showed that patients in the TyG T3 and hsCRP >3 mg/L group had a significantly higher risk of MACE than those in the TyG T1 and hsCRP ≤3 mg/L group. However, no significant interaction was found between TyG and hsCRP on the risk of MACE. CONCLUSION: Our study suggests that the concurrent assessment of TyG and hsCRP may be valuable in identifying high-risk populations and guiding management strategies among CCS patients.

ADS-J21 is a novel HIV-1 entry inhibitor targeting gp41.

HIV-1 envelope glycoprotein gp41 mediates fusion between HIV-1 and host cell membranes, making inhibitors of gp41 attractive anti-HIV drugs. We previously reported an efficient HIV-1 fusion inhibitor, ADS-J1, with a Y-shaped structure. Here, we discovered a new compound, ADS-J21, with a Y-shaped structure similar to that of ADS-J1 but with a lower molecular weight. Moreover, ADS-J21 exhibited effective anti-HIV-1 activity against divergent HIV-1 strains in vitro, including several HIV-1 laboratory-adapted strains and primary isolates with different subtypes (clades A to F) and tropisms (X4 or R5). Mechanistic studies have demonstrated that ADS-J21 blocks the formation of the gp41 six-helix bundle (6-HB) by targeting conserved amino acids Lys35 and Trp32. These findings suggest that ADS-J21 can be used as a new lead compound for further optimization in the development of a small-molecule fusion inhibitor.

microRNA-125b-5p alleviated CCI-induced neuropathic pain and modulated neuroinflammation via targeting SOX11.

BACKGROUND: Increasing evidence demonstrated the involvement of microRNAs (miRNAs) in the onset and development of neuropathic pain (NP). Exploring the molecular mechanism underlying NP and identifying key molecules could provide potential targets for the therapy of NP. The function and mechanism of miR-125b-5p in regulating NP have been studied, aiming to find a potential therapeutic target for NP. METHODS: NP rat models were established by the chronic constriction injury (CCI) method. The paw withdrawal threshold and paw withdrawal latency were assessed to evaluate the establishment and recovery of rats. Highly aggressive proliferating immortalized (HAPI) micoglia cell, a rat microglia cell line, was treated with lipopolysaccharide (LPS). The M1/M2 polarization and inflammation were evaluated by enzyme-linked immunosorbent assay and western blotting. RESULTS: Decreasing miR-125b-5p and increasing SOX11 were observed in CCI rats and LPS-induced HAPI cells. Overexpressing miR-125b-5p alleviated mechanical allodynia and thermal hyperalgesia and suppressed inflammation in CCI rats. LPS induced M1 polarization and inflammation of HAPI cells, which was attenuated by miR-125b-5p overexpression. miR-125-5p negatively regulated the expression of SOX11 in CCI rats and LPS-induced HAPI cells. Overexpressing SOX11 reversed the protective effects of miR-125b-5p on mechanical pain in CCI rats and the polarization and inflammation in HAPI cells, which was considered the mechanism underlying miR-125b-5p. CONCLUSION: miR-125b-5p showed a protective effect on NP by regulating inflammation and polarization of microglia via negatively modulating SOX11.

Initiation of rest-grazing during soil thawing improves interspecific relationships and stability of plant communities on alpine grassland.

Introduction: Grazing management is essential to maintain the stability of grassland ecosystems. Methods: To determine the optimal rest-grazing period of alpine meadow, five rest-grazing periods were set based on soil thawing and plant re-greening in this study. The niche, interspecific relationships, and stability of plant communities at different rest-grazing periods were investigated. Results: Rest-grazing during soil thawing resulted in a small niche width and niche overlap of plants, overall positive interspecific associations, and a high stability of plant communities. Delayed rest-grazing time to plant re-greening resulted in a large niche width and niche overlap of plants, overall negative interspecific associations, and a low stability of plant communities. Discussion: Rest-grazing in alpine meadows should begin as soon as possible to promote healthy and sustainable utilization of grasslands.

Pathological Changes and Pregnancy Outcomes in Cervical Intraepithelial Neoplasia Patients After Cold Knife Conization.

Objective: Analyze women treated with underwent cold knife conization (CKC) to remove advanced squamous intraepithelial lesions (CIN) of the cervix. The histopathological upgrading of the lesions previously detected on vaginal biopsy and postoperative pregnancy outcomes of were investigated, to identify high-risk subgroups in women. Methods: A retrospective study was conducted at the First Central Hospital of Baoding City from June 2019 to December 2022 to analyze confirmed cases of Cervical Intraepithelial Neoplasia CIN-II and CIN-III. Investigation of pathological changes in postoperative pathological tissues, and to perform binary logistic analysis to identify risk factors for histopathological escalation in postoperative lesions. We analyze the effects of CKC surgery on pregnancy outcomes in patients by comparing against a control group of healthy pregnant women. Results: Out of the 176 patients diagnosed with CIN-II who underwent cervical biopsy, 39 (22.16%) were found to have a final specimen diagnosis of CIN-III, while 7 (3.98%) were downgraded to CIN-I. Among the 108 patients diagnosed with CIN-III who underwent cervical biopsy, 7 cases (6.48%) were ultimately confirmed to have CIN-III. Ki67-positive, p16-positive (OR = 1.13, 95% CI 1.01-1.15), and colposcopy biopsy for CIN-II (OR = 1.59, 95% CI 1.33-3.6) were independent risk factors for pathological upgrade after CKC. Compared with healthy pregnant women, CIN patients had higher rates of premature birth (14.4%), premature rupture of the fetal membrane (13.6%), and cesarean section (37.5%) (P < 0.05). The mode of conception, abortion rate, ectopic pregnancy rate, and postpartum hemorrhage were not different between healthy pregnant women and CIN patients (P > 0.05). Conclusion: Following cervical multi-point biopsy or CKC, along with pathological examination, the accurate diagnosis of cervical lesions is crucial as it allows for more precise identification of such lesions. Additionally, CKC increases the risk of premature birth, premature rupture of membranes, and the need for cesarean section.

Association between frozen embryo transfer and childhood allergy: a retrospective cohort study.

RESEARCH QUESTION: Does frozen embryo transfer (FET) increase the risk of allergic diseases in offspring? DESIGN: This study followed up 653 singleton children: 166 born through FET and 487 born through natural conception. Demographic characteristics, perinatal information and allergic diseases of children and their parents were collected through clinical medical systems and questionnaires. Among these 653 children, allergen-specific immunoglobulin E (IgE) testing was performed using peripheral blood samples collected from 207 children: 145 in the FET group and 62 in the natural conception group. The prevalence of allergic diseases and positive rates of allergen-specific IgE testing were compared between the two groups with adjustments for confounding factors. RESULTS: The prevalence of food allergy was significantly higher in children born through FET compared with children born through natural conception (adjusted OR = 3.154, 95% CI 1.895-5.250; P < 0.001). In addition, positive rates of food allergen sensitization were higher in children in the FET group compared with children in the natural conception group (adjusted OR = 5.769, 95% CI 2.859-11.751, P < 0.001). Children in the FET group had a higher positive sensitization rate to at least one allergen compared with children in the natural conception group (adjusted OR = 3.127, 95% CI 1.640-5.961, P < 0.001). No association was observed between FET and other allergic diseases, including asthma (P = 0.136), atopic dermatitis (P = 0.130) and allergic rhinitis (P = 0.922). Allergen sensitization IgE testing indicated no differences between the two groups in terms of positive sensitization rates of other common allergens, including animal and insect allergens (P = 0.627), inhaled outdoor allergens (P = 0.915) and inhaled outdoor allergens (P = 0.544). CONCLUSION: This study suggests that children born through FET have increased risk of developing food allergy in early childhood.

[Causal association between depression and stress urinary incontinence: A two-sample bidirectional Mendelian randomization study].

OBJECTIVE: To investigate the causal correlation between depression and stress urinary incontinence (SUI) using Mendelian randomization (MR) analysis. METHODS: We searched the FinnGen Consortium database for genome-wide association studies (GWAS) on depression and obtained 23 424 case samples and 192 220 control samples, with the GWAS data on SUI provided by the UK Biobank, including 4 340 case samples and 458 670 control samples. We investigated the correlation between depression and SUI based on the depression data collected from the Psychiatric Genomics Consortium (PGC). We employed inverse-variance weighting as the main method for the MR study, and performed sensitivity analysis to verify the accuracy and stability of the findings. RESULTS: Analysis of the data from the UK Biobank and FinnGen Consortium showed that depression was significantly correlated with an increased risk of SUI (P=0.005), but not SUI with the risk of depression (P=0.927). And analysis of the PGC data verified the correlation of depression with the increased risk of SUI (P=0.043). CONCLUSION: Depression is associated with an increased risk of SUI, while SUI does not increase the risk of depression.

Cellular and molecular mechanisms of gastrointestinal cancer liver metastases and drug resistance.

Distant metastases and drug resistance account for poor survival of patients with gastrointestinal (GI) malignancies such as gastric cancer, pancreatic cancer, and colorectal cancer. GI cancers most commonly metastasize to the liver, which provides a unique immunosuppressive tumour microenvironment to support the development of a premetastatic niche for tumor cell colonization and metastatic outgrowth. Metastatic tumors often exhibit greater resistance to drugs than primary tumors, posing extra challenges in treatment. The liver metastases and drug resistance of GI cancers are regulated by complex, intertwined, and tumor-dependent cellular and molecular mechanisms that influence tumor cell behavior (e.g. epithelial-to-mesenchymal transition, or EMT), tumor microenvironment (TME) (e.g. the extracellular matrix, cancer-associated fibroblasts, and tumor-infiltrating immune cells), tumor cell-TME interactions (e.g. through cytokines and exosomes), liver microenvironment (e.g. hepatic stellate cells and macrophages), and the route and mechanism of tumor cell dissemination (e.g. circulating tumor cells). This review provides an overview of recent advances in the research on cellular and molecular mechanisms that regulate liver metastases and drug resistance of GI cancers. We also discuss recent advances in the development of mechanism-based therapy for these GI cancers. Targeting these cellular and molecular mechanisms, either alone or in combination, may potentially provide novel approaches to treat metastatic GI malignancies.

Dual stimulation with iTBS-cTBS treatment in postpartum obsessive-compulsive disorder: a case report.

AIM OF THE STUDY: This study aimed to present a case of intermittent theta-burst stimulation (iTBS) and continuous theta-burst stimulation (cTBS) dual stimulation for the treatment of postpartum obsessive-compulsive disorder (OCD). The objective was to provide a referenceable therapy in cases where medication and psychotherapy treatment are not preferred or contraindicated. This case further emphasized the importance of non-invasive neuromodulation techniques in improving the condition of postpartum OCD patients. MATERIALS AND METHODS: A 32-year-old female was diagnosed with OCD 2 months after delivery. The patient refused to take medication and psychotherapy due to concerns that it would interfere with the infant's breastfeeding. Subsequently, a 2-week combined iTBS and cTBS treatment was carried out. The patient's obsessive-compulsive symptoms, anxiety, and depression improved. There were no significant adverse effects during the treatment, and the treatment effect remained 2 weeks after the end of the treatment. CONCLUSION: This clinical case provides evidence that the combined iTBS and cTBS treatment can potentially effectively alleviate obsessive-compulsive symptoms in the short term. Notably, this therapeutic approach may offer a promising solution for postpartum OCD patients, as it addresses practical concerns such as medication safety for breastfeeding mothers and the specific needs of this population. To further establish the efficacy of this combined therapy, future randomized controlled trials with large samples and long-term follow-up are warranted to validate its therapeutic potential.