This study aims to explore the protective effect of Chaihu Jia Longgu Muli Decoction on rats with heart failure after myocardial infarction, and to clarify its possible mechanisms, providing a new basis for basic research on the mechanism of classic Chinese medicinal formula-mediated inflammatory response in preventing and treating heart failure induced by apoptosis after myocardial infarction. A heart failure model after myocardial infarction was established in rats by coronary artery ligation. The rats were divided into sham group, model group, and low, medium, and high-dose groups of Chaihu Jia Longgu Muli Decoction, with 10 rats in each group. The low-dose, medium-dose, and high-dose groups of Chaihu Jia Longgu Muli Decoction were given 6.3, 12.6, and 25.2 g·kg~(-1) doses by gavage, respectively. The sham group and model group were given an equal volume of distilled water by gavage once daily for four consecutive weeks. Cardiac function was assessed using color Doppler echocardiography. Myocardial pathology was detected by hematoxylin-eosin(HE) staining, apoptosis was measured by TUNEL assay, and mitophagy was observed by transmission electron microscopy. The levels of tumor necrosis factor-α(TNF-α), interleukin(IL)-1β, and N-terminal pro-B-type natriuretic peptide(NT-proBNP) in serum were detected by enzyme-linked immunosorbent assay(ELISA). The expression of apoptosis-related proteins B-cell lymphoma 2(Bcl-2), Bcl-2-associated X protein(Bax), and cleaved caspase-3 was detected by Western blot. Additionally, the expression of phosphorylated nuclear transcription factor-κB(NF-κB) p65(p-NF-κB p65)(upstream) and nuclear factor kappa B inhibitor alpha(IκBα)(downstream) in the NF-κB signaling pathway was assessed by Western blot. The results showed that compared with the sham group, left ventricular ejection fraction(LVEF) and left ventricular short axis shortening(LVFS) in the model group were significantly reduced, while left ventricular end diastolic diameter(LVEDD) and left ventricular end systolic diameter(LVESD) increased significantly. Myocardial tissue damage was severe, with widened intercellular spaces and disorganized cell arrangement. The apoptosis rate was increased, and mitochondria were enlarged with increased vacuoles. Levels of TNF-α, IL-1β, and NT-proBNP were elevated, indicating an obvious inflammatory response. The expression of pro-apoptotic factors Bax and cleaved caspase-3 increased, while the anti-apoptotic factor Bcl-2 decreased. The expression of p-NF-κB p65 was upregulated, and the expression of IκBα was downregulated. In contrast, the Chaihu Jia Longgu Muli Decoction groups showed significantly improved of LVEF, LVFS and decreased LVEDD, LVESD compared to the model group. Myocardial tissue damage was alleviated, and intercellular spaces were reduced. The apoptosis rate decreased, mitochondrial volume decreased, and the levels of TNF-α, IL-1β, and NT-proBNP were lower. The expression of pro-apoptotic factors Bax and cleaved caspase-3 decreased, while the expression of the anti-apoptotic factor Bcl-2 increased. Additionally, the expression of p-NF-κB p65 decreased, while IκBα expression increased. In summary, this experimental study shows that Chaihu Jia Longgu Muli Decoction can reduce the inflammatory response and apoptosis rate in rats with heart failure after myocardial infarction, which may be related to the regulation of the IκBα/NF-κB signaling pathway.
Animals ; Apoptosis/drug effects* ; Drugs, Chinese Herbal/administration & dosage* ; Rats ; Myocardial Infarction/physiopathology* ; Male ; NF-kappa B/genetics* ; Heart Failure/etiology* ; Rats, Sprague-Dawley ; Signal Transduction/drug effects* ; NF-KappaB Inhibitor alpha/genetics* ; Humans ; Tumor Necrosis Factor-alpha/genetics*

Mycophenolic acid (MPA), the active moiety of both mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), serves as a primary immunosuppressant for maintaining solid organ transplants. Therapeutic drug monitoring (TDM) enhances treatment outcomes through tailored approaches. This study aimed to develop an evidence-based guideline for MPA TDM, facilitating its rational application in clinical settings. The guideline plan was drawn from the Institute of Medicine and World Health Organization (WHO) guidelines. Using the Delphi method, clinical questions and outcome indicators were generated. Systematic reviews, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence quality evaluations, expert opinions, and patient values guided evidence-based suggestions for the guideline. External reviews further refined the recommendations. The guideline for the TDM of MPA (IPGRP-2020CN099) consists of four sections and 16 recommendations encompassing target populations, monitoring strategies, dosage regimens, and influencing factors. High-risk populations, timing of TDM, area under the curve (AUC) versus trough concentration (C₀), target concentration ranges, monitoring frequency, and analytical methods are addressed. Formulation-specific recommendations, initial dosage regimens, populations with unique considerations, pharmacokinetic-informed dosing, body weight factors, pharmacogenetics, and drug‍-‍drug interactions are covered. The evidence-based guideline offers a comprehensive recommendation for solid organ transplant recipients undergoing MPA therapy, promoting standardization of MPA TDM, and enhancing treatment efficacy and safety.
Mycophenolic Acid/administration & dosage* ; Drug Monitoring/methods* ; Humans ; Organ Transplantation ; Immunosuppressive Agents/administration & dosage* ; Delphi Technique

The rapid development of artificial intelligence (AI), especially generative AI (GenAI), has already brought, and will continue to bring, revolutionary changes to our daily production and life, as well as create new opportunities and challenges for diagnostic and therapeutic practices in the medical field. Haihe Hospital of Tianjin University collaborates with the National Supercomputer Center in Tianjin, Tianjin University, and other institutions to carry out research in areas such as smart healthcare, smart services, and smart management. We have conducted research and development of a full-process disease diagnosis and treatment assistance system based on GenAI in the field of smart healthcare. The development of this project is of great significance. The first goal is to upgrade and transform the hospital's information center, organically integrate it with existing information systems, and provide the necessary computing power storage support for intelligent services within the hospital. We have implemented the localized deployment of three models: Tianhe "Tianyuan", WiNGPT, and DeepSeek. The second is to create a digital avatar of the chief physician/chief physician's voice and image by integrating multimodal intelligent interaction technology. With generative intelligence as the core, this solution provides patients with a visual medical interaction solution. The third is to achieve deep adaptation between generative intelligence and the entire process of patient medical treatment. In this project, we have developed assistant tools such as intelligent inquiry, intelligent diagnosis and recognition, intelligent treatment plan generation, and intelligent assisted medical record generation to improve the safety, quality, and efficiency of the diagnosis and treatment process. This study introduces the content of a full-process disease diagnosis and treatment assistance system, aiming to provide references and insights for the digital transformation of the healthcare industry.
Artificial Intelligence ; Humans ; Delivery of Health Care ; Generative Artificial Intelligence

Objective To observe the effect of neuregulin-1(NRG-1)on retinal ganglion cells(RGCs)in Zucker Di-abetic Fatty(ZDF)rats and explore the mechanism of NRG-1 in exerting neuroprotective effects on the retina.Methods Twenty-four 8-week-old male ZDF rats(24 eyes)were selected.Diabetic obese rat models were established by feeding a high-fat and high-sugar diet(Purina 5008).After 16 weeks,they were randomly divided into the ZDF group and the NRG-1 group(12 rats in each group).Rats in the NRG-1 group received intravitreal injection of human recombinant NRG-1(once a week for a total of two times),rats in the ZDF group were used as negative controls,and Zucker lean control(ZLC)rats were selected as blank controls(ZCL group).The changes in the number of RGCs in rats of each group were observed by immunofluorescence staining.The protein expressions of NOD-like receptor family pyrin domain containing protein 3(NLRP3),Caspase-1,and Gasdermin D(GSDMD)in the retina of rats in each group were observed by immuno-histochemistry and Western blot.Results After 16 weeks of eating a high-fat diet,compared with the ZLC group,the fasting blood glucose of rats in the ZDF group significantly increased(P＜0.001).The results of immunofluorescence stai-ning showed that the RGCs of rats in the ZLC group were continuously and neatly arranged;compared with the ZLC group,the number of RGCs of rats in the ZDF group significantly decreased(P＜0.001);compared with the ZDF group,the num-ber of RGCs of rats in the NRG-1 group significantly increased(P＜0.01).The immunohistochemical results showed that there were statistically significant differences in the average optical density values of NLRP3,Caspase-1 and GSDMD in the retina of rats in each group(all P＜0.01);compared with the ZLC group,the average optical density values of NLRP3,Caspase-1 and GSDMD in the retina of rats in the ZDF group were higher(all P＜0.01);compared with the ZDF group,the average optical density values of NLRP3,Caspase-1 and GSDMD in the retina of rats in the NRG-1 group significantly de-creased(all P＜0.05).Western blot results showed that there were statistically significant differences in the protein ex-pression levels of Brn3a,NLRP3,Caspase-1 and GSDMD in the retina of rats among all groups(all P＜0.01);compared with the ZLC group,the protein expression of Brn3a significantly decreased,while the protein expressions of NLRP3,Caspase-1 and GSDMD significantly increased in the ZDF group(all P＜0.01);compared with the ZDF group,the protein expression of Brn3a significantly increased,while the protein expressions of NLRP3,Caspase-1 and GSDMD significantly decreased in the NRG-1 group(all P＜0.01).Conclusion After retinal lesions occur in diabetic rats,NLRP3,Caspase-1 and GSDMD are all significantly activated.NRG-1 can reduce the expressions of NLRP3,Caspase-1 and GSDMD,reducing damage to RGCs.

OBJECTIVE: We aimed to analyze the current indoor radon level and estimate the population risk of radon-induced lung cancer in urban areas of China. METHODS: Using the passive monitoring method, a new survey on indoor radon concentrations was conducted in 2,875 dwellings across 31 provincial capital cities in Chinese mainland from 2018 to 2023. The attributable risk of lung cancer induced by indoor radon exposure was estimated based on the risk assessment model. RESULTS: The arithmetic mean (AM) and geometric mean (GM) of indoor radon concentrations were 65 Bq/m³ and 55 Bq/m³, respectively, with 13.6% of measured dwellings exceeding 100 Bq/m³ and 0.6% exceeding 300 Bq/m³. The estimated number of lung cancer deaths induced by indoor radon exposure was 150,795, accounting for 20.30% (95% CI: 20.21%-20.49%) of the lung cancer death toll. CONCLUSION This study provided the most recent data on national indoor radon levels in urban areas and the attributable risk of lung cancer. These results served as an important foundation for further research on the disease burden of indoor radon exposure and radon mitigation efforts.
Radon/analysis* ; China/epidemiology* ; Air Pollution, Indoor/analysis* ; Lung Neoplasms/etiology* ; Humans ; Cities/epidemiology* ; Air Pollutants, Radioactive/adverse effects* ; Neoplasms, Radiation-Induced/etiology* ; Risk Assessment ; Radiation Monitoring

Humans ; Kidney/pathology* ; Kidney Neoplasms/surgery* ; Soft Tissue Neoplasms

This study aimed to investigate the effect and the possible mechanism of Shenlian( SL) extract on tumor necrosis factor-α( TNF-α)-induced ECV304 injury. After the establishment of TNF-α-induced ECV304 cells injure model,MTT assay was used to detect cell viability and the level of reactive oxygen species( ROS) was measured by flow cytometry. The contents of superoxide dismutase( SOD),malondialdehyde( MDA),nitric oxide( NO),endothelin-1( ET-1) and interleukin-1β( IL-1β) in the supernatant were detected by biochemical method and enzyme linked immunosorbent assay( ELISA). The expression levels of apoptosis-related proteins B-lymphoma-2 gene( Bcl-2),Bcl-2 associated X protein( Bax),caspase-3,caspase-9 and nuclear factor E2 associated factor2( Nrf2)/Kelch like epichlorohydrin associated protein-1( Keap1) signaling pathway related proteins Nrf2,Keap1,quinone oxidoreductase( NQO1) and heme oxygenase 1( HO-1) were detected by Western blot. The results showed that 50 μg·L-1 TNF-α significantly damaged ECV304 cells,induced the impairment of cell viability( P<0. 01),the increase of ROS production,the decrease of SOD activity,and the increase of MDA,NO,ET-1 and IL-1β( P<0. 01),meanwhile,it caused the up-regulation of Keap1,caspase-9 and Bax protein expression,and down-regulation of NQO1 and Bcl-2 protein expression( P<0. 05) compared with the control group.Compared with the model group,SL extract reduced the damage of ECV304 cells induced by TNF-α,improved cell viability,reduced ROS production,increased SOD activity and decreased MDA,NO,ET-1,IL-1β content( P<0. 01 or P<0. 05). In addition,SL extract also down-regulated the protein expression levels of Keap1,caspase-3,caspase-9 and Bax,and increased the protein expressions of Nrf2,NQO1,HO-1 and Bcl-2( P<0. 01 or P<0. 05). The above results indicate that SL extract can provide protective effect on ECV304 cells injury induced by TNF-α,alleviate oxidative stress injury,inflammation and apoptosis,and its mechanism may be related to regulating Nrf2/Keap1 signaling pathway.
Apoptosis ; Kelch-Like ECH-Associated Protein 1/metabolism* ; NF-E2-Related Factor 2/metabolism* ; Oxidative Stress ; Plant Extracts ; Signal Transduction ; Tumor Necrosis Factor-alpha/genetics*

Objective:To investigate the current situation of suicidal self-injurious behavior in teenagers and analyze its influencing factors. Methods:From January to November 2020， a stratified sampling method was used to investigate 707 teenagers in Guangdong. The “questionnaire of health-related behaviors of Chinese teenagers” compiled by the Chinese Center for Disease Control and Prevention was used anonymously to investigate the current situation of suicidal self-injurious behavior of the teenagers. The chi-square test was used for univariate analysis， and logistic regression was used for multivariate analysis. Results:The incidence rate of suicidal self-injurious behavior was 14.57% （103/707）. It was 13.31% （45/338） in males， 15.72% （58/369） in females， 13.83% （48/347） in junior high school students and 15.28% （55/360） in senior high school students. There was no statistical significance in the incidence of suicidal self-injurious behavior of teenagers between different genders， different learning stages， smoking or not， asexual behavior or not， gambling or not， and fighting or not （all P>0.05）. The incidence of suicidal self-injurious behaviors in teenagers from single parent family， drunkenness， runaway， loneliness， under great study pressure， lovelorn， and mobile phone addiction was significantly higher （χ²=13.809， 10.852， 14.279， 11.451， 12.893， 22.905， 19.473， respectively. All P<0.001）. Logistic regression analysis showed that the following were main risk factors affecting the incidence of suicidal self-injurious behavior in teenagers： single parent family （OR=3.826， 95%CI： 1.402-7.501）， drunkenness （OR=3.903， 95%CI： 1.512-7.368）， runaway （OR=3.447， 95%CI： 1.669-7.715）， loneliness （OR=3.613， 95%CI： 1.504-7.697）， great study pressure （OR=3.712， 95%CI： 1.387-7.604）， lovelorn（OR=4.125， 95%CI： 1.516-8.117） and mobile phone addiction（OR=4.027， 95%CI： 1.499-7.984 （all P<0.001）. Conclusion:The incidence of suicidal self-injurious behavior in teenagers is not low in Guangdong， and targeted measures should be developed to screen and intervene based on the influencing factors.