This study examines the effects of zearalenone(ZEA)on the survival and function of lu-teinized granulosa cells,and studies the role of activating transcription factor 6(ATF6)in regula-ting apoptosis and functional abnormalities of luteinized granulosa cells induced by ZEA.An in vitro model of luteinized granulosa cells was utilized to examine the effects of ZEA treatment on apoptosis,hormone secretion,and the expression of relevant proteins.Furthermore,the expression of ATF6 was manipulated using siRNA to elucidate its regulatory function in the ZEA-induced damage of luteinized granulosa cells in mice.Our findings revealed that ZEA inhibited the activity of luteinized granulosa cells and reduced the secretion of estradiol(E2)and progesterone(P4)in a dose-dependent manner.The expression levels of p-IRE1,ATF6 and StAR in both low(20 pmol/L)and high(40 μmol/L)ZEA groups were significantly increased after 24 h(P＜0.05).GRP78 had no significant change at low concentration treatment(P＞0.05),but significantly increased at high concentration treatment(P＜0.05).Similarly,ATF4 and p-EIF2α had no significant change at low concentration treatment(P＞0.05),but significantly decreased at high concentration treat-ment(P＜0.05).HSD3B2 and CYP19A1 were significantly decreased in both low and high concentration treatments(P＜0.05).After 48 h of treatment,ATF6 and GRP78 were significantly increased in both low and high concentration treatments(P＜0.05).p-IRE1 was significantly de-creased at low concentration treatment(P＜0.05),but remained unchanged at high concentration treatment(P＞0.05).ATF4,p-EIF2α,HSD3B2 and CYP19A1 were significantly decreased in both low and high concentration treatments(P＜0.05).St AR was significantly increased in both low and high concentration treatments(P＜0.05).Interference with the expression of ATF6 could sig-nificantly reduce the apoptosis induced by low concentration group(P＜0.05),and enhanced the hormone secretion in both high and low concentration groups(P＜0.05).In conclusion,ZEA can cause damage to luteinized granulosa cells and activate ATF6 signaling pathway.Interference with ATF6 can alleviate apoptosis and hormone secretion disturbance induced by low concentration ZEA,but has limited effect on damage caused by high concentration ZEA.

Objective:To verify mechanism of Dunhuang Ruicao ointment in frostbite treatment through network pharmacology and experiment.Methods:Targets of Dunhuang Ruicao ointment in intervention of frostbite was screened through network pharmacology.Dunhuang Ruicao ointment was used to treat rat model of frostbite.Effect of drug was observed and results of network pharmacological enrichment analysis were verified.Results:A total of 239 active drug components,186 disease targets and 36 common targets were screened.KEGG pathway enrichment screened out 96 pathways,mainly enriched in Toll-like receptor signaling pathway,IL-17 signaling pathway,tumor necrosis factor signaling pathway,AGE-RAGE signaling pathway,Th17 cell differentiation pathway,suggesting Toll-like receptor signaling pathway may play an important role in treatment of frostbite by Dunhuang Ruicao ointment.Animal experiments showed that compared with model group,skin frostbite of rats treated with different doses of Dunhuang Ruicao ointment group was significantly improved,wound healing rate was increased,swelling rate was decreased,wound tissue epithelialization was obvious,inflammatory infiltration was reduced,angiogenesis was increased,and collagen fiber content was increased.mRNA and protein expressions of TLR4,MyD88 and NF-κB p65 in local skin lesions were decreased to different degrees,and middle-dose group had the best effect.Conclusion:Dunhuang Ruicao ointment in treatment of frostbite has characteristics of multiple components,multiple targets,multiple pathways synergy,probably playing a role in treatment of frostbite by inhibiting TLR4/MyD88/NF-κB signaling path-way activated to reduce frostbite rats serum proinflammatory media release,reduce inflammation,improve rate of tissue remodeling,promote healing of frostbite,providing a theoretical basis for further study of complex mechanism of Dunhuang Ruicao ointment in treatment of frostbite.

This study examines the effects of zearalenone(ZEA)on the survival and function of lu-teinized granulosa cells,and studies the role of activating transcription factor 6(ATF6)in regula-ting apoptosis and functional abnormalities of luteinized granulosa cells induced by ZEA.An in vitro model of luteinized granulosa cells was utilized to examine the effects of ZEA treatment on apoptosis,hormone secretion,and the expression of relevant proteins.Furthermore,the expression of ATF6 was manipulated using siRNA to elucidate its regulatory function in the ZEA-induced damage of luteinized granulosa cells in mice.Our findings revealed that ZEA inhibited the activity of luteinized granulosa cells and reduced the secretion of estradiol(E2)and progesterone(P4)in a dose-dependent manner.The expression levels of p-IRE1,ATF6 and StAR in both low(20 pmol/L)and high(40 μmol/L)ZEA groups were significantly increased after 24 h(P＜0.05).GRP78 had no significant change at low concentration treatment(P＞0.05),but significantly increased at high concentration treatment(P＜0.05).Similarly,ATF4 and p-EIF2α had no significant change at low concentration treatment(P＞0.05),but significantly decreased at high concentration treat-ment(P＜0.05).HSD3B2 and CYP19A1 were significantly decreased in both low and high concentration treatments(P＜0.05).After 48 h of treatment,ATF6 and GRP78 were significantly increased in both low and high concentration treatments(P＜0.05).p-IRE1 was significantly de-creased at low concentration treatment(P＜0.05),but remained unchanged at high concentration treatment(P＞0.05).ATF4,p-EIF2α,HSD3B2 and CYP19A1 were significantly decreased in both low and high concentration treatments(P＜0.05).St AR was significantly increased in both low and high concentration treatments(P＜0.05).Interference with the expression of ATF6 could sig-nificantly reduce the apoptosis induced by low concentration group(P＜0.05),and enhanced the hormone secretion in both high and low concentration groups(P＜0.05).In conclusion,ZEA can cause damage to luteinized granulosa cells and activate ATF6 signaling pathway.Interference with ATF6 can alleviate apoptosis and hormone secretion disturbance induced by low concentration ZEA,but has limited effect on damage caused by high concentration ZEA.

Objective:To verify mechanism of Dunhuang Ruicao ointment in frostbite treatment through network pharmacology and experiment.Methods:Targets of Dunhuang Ruicao ointment in intervention of frostbite was screened through network pharmacology.Dunhuang Ruicao ointment was used to treat rat model of frostbite.Effect of drug was observed and results of network pharmacological enrichment analysis were verified.Results:A total of 239 active drug components,186 disease targets and 36 common targets were screened.KEGG pathway enrichment screened out 96 pathways,mainly enriched in Toll-like receptor signaling pathway,IL-17 signaling pathway,tumor necrosis factor signaling pathway,AGE-RAGE signaling pathway,Th17 cell differentiation pathway,suggesting Toll-like receptor signaling pathway may play an important role in treatment of frostbite by Dunhuang Ruicao ointment.Animal experiments showed that compared with model group,skin frostbite of rats treated with different doses of Dunhuang Ruicao ointment group was significantly improved,wound healing rate was increased,swelling rate was decreased,wound tissue epithelialization was obvious,inflammatory infiltration was reduced,angiogenesis was increased,and collagen fiber content was increased.mRNA and protein expressions of TLR4,MyD88 and NF-κB p65 in local skin lesions were decreased to different degrees,and middle-dose group had the best effect.Conclusion:Dunhuang Ruicao ointment in treatment of frostbite has characteristics of multiple components,multiple targets,multiple pathways synergy,probably playing a role in treatment of frostbite by inhibiting TLR4/MyD88/NF-κB signaling path-way activated to reduce frostbite rats serum proinflammatory media release,reduce inflammation,improve rate of tissue remodeling,promote healing of frostbite,providing a theoretical basis for further study of complex mechanism of Dunhuang Ruicao ointment in treatment of frostbite.

Objective To analyze the correlation between sleep disorder and bone mineral density(BMD)and fracture risk in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods 150 T2DM patients over 50 years old who were hospitalized in the Endocrine Metabolism Department of Changsha First Hospital from September 2022 to April 2023 were selected.According to the Pittsburgh Sleep Quality Index(PSQI),they were divided into a non-sleep disorder group(66 cases)and a sleep disorder group(84 cases).The general data and biochemical indicators of the two groups were compared.The relationship between sleep disorder and BMD,fracture risk was analyzed.Results Compared with the non-sleep disorder group,HbA1c,FPG,female proportion,the proportion of hypnotics and risk scores of vertebral fracture in the sleep disorder group were higher,and BMI,BMD of femoral neck and hip were lower(P<0.05).Pearson correlation analysis showed a negative correlation between PSQI score and BMD of femoral neck and hip(P<0.05).Pearson or Spearman correlation analysis showed that the risk scores of vertebral fracture was positively correlated with age,duration of DM,use of hypnotics and sleep disorder(P<0.05 or P<0.01),and negatively correlated with BMD of femoral neck and hip(P<0.01).Binary logistic regression analysis showed that FPG,use of hypnotics and hip BMD were influencing factors of sleep disorders,while sleep disorders and PSQI scores were influencing factors of osteoporosis.Conclusions For middle-aged and elderly T2DM patients,improving sleep may help reduce the occurrence of osteoporosis and reduce the risk of fractures.

Electrocardiogram (ECG) monitoring owns important clinical value in diagnosis, prevention and rehabilitation of cardiovascular disease (CVD). With the rapid development of Internet of Things (IoT), big data, cloud computing, artificial intelligence (AI) and other advanced technologies, wearable ECG is playing an increasingly important role. With the aging process of the population, it is more and more urgent to upgrade the diagnostic mode of CVD. Using AI technology to assist the clinical analysis of long-term ECGs, and thus to improve the ability of early detection and prediction of CVD has become an important direction. Intelligent wearable ECG monitoring needs the collaboration between edge and cloud computing. Meanwhile, the clarity of medical scene is conducive for the precise implementation of wearable ECG monitoring. This paper first summarized the progress of AI-related ECG studies and the current technical orientation. Then three cases were depicted to illustrate how the AI in wearable ECG cooperate with the clinic. Finally, we demonstrated the two core issues-the reliability and worth of AI-related ECG technology and prospected the future opportunities and challenges.
Humans ; Artificial Intelligence ; Reproducibility of Results ; Electrocardiography ; Cardiovascular Diseases ; Wearable Electronic Devices

Intestinal injury is a common adverse reaction of clinical chemotherapy drugs, which limits the further application of chemotherapy drugs and causes serious physical and mental burden to patients. At present, the mechanism of chemotherapy-induced intestinal injury is complex, and traditional Chinese medicine has an excellent preventive effect. This article reviews the related mechanisms of intestinal flora imbalance, oxidative stress, inflammatory response, cell apoptosis, and immune damage caused by chemotherapy, and summarizes the role of traditional Chinese medicine in prevention and treatment of oxidative stress, inflammatory response, cell apoptosis, and immune damage.

Frostbite is a tissue injury that occurs when the body is exposed to extreme cold. Its pathological mechanism is complex and has not been fully elucidated. In high cold and high altitude areas, outdoor sports people have a high risk of injury, and severe frostbite has high disability and mortality. Exploring the pathological mechanism of frostbite is helpful to determine the treatment methods and timing. At present, the clinical treatment of frostbite is mainly symptomatic treatment, such as drug treatment and surgical treatment, but the curative effect can not meet the clinical needs. Therefore, it is of great significance to seek more efficient drugs or treatment methods. This article reviews the relevant research progress in pathophysiological mechanism, clinical treatment, cellular and molecular pathways of frostbite in recent years, in order to provide new ideas for future research and clinical treatment.

Objective:To analyze the screening status of high-risk population of chronic obstructive pulmonary disease (COPD) in areas where “Happy Breathing” project was carried out.Method:There were 1 008 518 COPD screening questionnaires (COPD-SQ) filled out in 18 pilot areas of “Happy Breathing” program from November 2017 to October 2019. Within subjects who scored 16 points or more with COPD-SQ, 63 523 of them underwent pulmonary function tests before bronchodilator inhalation. Stratified analysis, chi-square test and other statistical methods were performed to analyze the distribution of COPD high-risk groups, the prevalence of COPD among high-risk groups and risk factors of COPD.Results:Results in this study suggested that the high-risk population of COPD accounted for 18.99% (191 498/1 008 518) of the population who received the questionnaire screening. Among the high-risk population who received lung function test, 31.59% (20 070/63 523) were screened and diagnosed as COPD patients. As for risk factors of COPD, the proportion of high-risk population was higher in people with a smoking index ≥600 compared with never-smokers (54.20% vs 12.60%), and the prevalence of COPD was also higher in people with a smoking index ≥600 (35.62% vs 25.22%); people who were exposed to second-hand smoke almost every day also showed an increased proportion of high-risk groups (27.39% vs 10.97%) and a high prevalence of COPD (31.36% vs 27.93%) than those without second-hand smoke exposure; the presence or absence of biofuel exposure also caused the difference in the proportion of high-risk groups (33.92% vs 13.11%); compared with people without a family history of respiratory diseases, the proportion of high-risk groups (56.38% vs 16.42%) and the prevalence of COPD in high-risk groups (32.40% vs 29.19%) were both higher in those with family history of respiratory diseases.Conclusion:The high-risk group of COPD accounts for a high proportion of the screened population, suggesting that the “Happy Breathing” project is feasible and necessary in COPD screening, which is helpful for the development of COPD diagnosis and treatment.

Objective:To understand the current management status of chronic obstructive pulmonary disease (COPD) in county-level hospitals in China from 2020 to 2021.Methods:This survey was led by the China Association of County Hospital President. In 2021, a questionnaire survey was conducted on 633 secondary and tertiary hospitals from 24 provinces, and the questionnaire was filled out according to the actual situation of the hospital in 2020, including diagnosis, treatment, rehabilitation and comprehensive management of COPD. The nature of the hospital was divided into public or private. The type of hospital was divided into general or specialist. The economic zones was divided into eastern, central or western. Through the content of the questionnaire, the influencing factors of the diagnosis, treatment and management capabilities of COPD in county-level hospitals were explored.Results:A total of 633 questionnaires were collected in this survey, and 26 were removed due to the incorrect information or information loss. Thus, a total of 607 questionnaires were finally included in this survey, including 425 secondary hospitals and 182 tertiary hospitals; 591 public hospitals and 16 private hospitals. For the capabilities of diagnosis and treatment, the tertiary hospital was significantly better than the secondary hospital on the availability of respiratory outpatient clinics, COPD outpatient clinics, outpatient comprehensive clinics, respiratory ward and intensive care unit (ICU) (94.5% and 78.4%, 51.1% and 32.7%, 79.7% and 67.3 %, 84.6% and 59.8%, 78.6% and 61.9%, respectively) (all P<0.01). In terms of lung function test and bronchodilation test, tertiary hospitals performed significantly better than secondary hospitals ( P<0.05). There was no difference in availability of inhaled bronchodilators and expectorant drugs among different hospital levels, nature, type, and economic zones ( P>0.05). However, the proportion of hospitals with available triple inhalation drugs was lower in secondary hospitals than tertiary hospitals. For the non-drug treatment, the proportion of general hospitals carrying out vaccination was significantly higher than that of specialized hospitals (52.7% and 28.1%, P=0.010). The tertiary hospitals performed significantly better than secondary hospitals in smoking cessation guidance (98.4% and 94.4%, P=0.031). In terms of rehabilitation, tertiary hospitals also performed significantly better than secondary hospitals (79.7% and 61.9%, P<0.001). The proportion of hospitals carrying out long-term management of COPD in tertiary hospitals was significantly higher than secondary hospitals, and the proportion in public hospitals was significantly higher than private hospitals (80.2% and 61.2%, 68.2% and 18.8%, both P<0.001). Conclusions:County hospitals in China have a good overall performance in the diagnosis and drug treatment of COPD, but need to be further improved in non-drug treatment, rehabilitation, and comprehensive management. The hospital level is the main factor affecting the management ability of COPD. The nature and type of hospital mainly affect the construction of departments and comprehensive management of COPD.