Background In the context of global climate change, investigating the impact of temperature variability (TV) on the circulatory system is of significant importance for public health promotion. Objective To evaluate the effect of TV on the risk of hospital admissions for circulatory system diseases in Tangshan City. Methods Data on hospital admissions for circulatory diseases from four general hospitals in Tangshan between 2021 and 2023 were collected, while concurrent meteorological data were also obtained. A time-stratified case-crossover design was employed to analyze the association between TV and the risk of hospital admissions for circulatory system diseases. Subgroup analyses were further conducted by gender, age, and cold/heat wave days. Results A total of 11974 hospital admissions for circulatory system diseases were recorded from 2021 to 2023, with a median daily temperature of 13.90 ℃. The effects of TV01 through TV07 on hospitalization risks for overall circulatory system diseases and coronary heart disease were all statistically significant (P<0.05). Additionally, the effects of TV01 and TV04 through TV07 on hospitalization risk for stroke were also statistically significant (P<0.05). A 1°C increase in TV07 was associated with odds ratios (ORs) of 1.041 (95%CI: 1.032, 1.050) for overall circulatory system diseases, 1.050 (95%CI: 1.037, 1.064) for coronary heart disease, and 1.029 (95%CI: 1.014, 1.045) for stroke. Furthermore, the effect of TV on the risk of hospital admissions were stronger during cold wave days compared with non-cold/hot wave days. Conclusion TV may contribute to increased risk of hospital admissions for circulatory system diseases in Tangshan, and the impact of TV exhibits a certain lag effect. It is suggested to explore and develop targeted intervention measures.

OBJECTIVE To establish the specific chromatogram of Qianghuo Shengshi Tang(QHSS) reference sample, clarify the key quality attributes of QHSS, providing reference for the quality evaluation of QHSS reference sample. METHODS The SilGreen C18 column(4.6 mm×250 mm, 5 μm) was used. The mobile phase consisted acetonitrile and 0.2% formic acid aqueous solution. The detection wavelength was 328 nm. Established an HPLC characteristic spectrum analysis method for the reference sample of QHSS. A variety of chromatographic columns and different instruments were applied to investigate the adaptability of the system. HPLC-LTQ-Orbitrap MS was used to identify the specific peaks of the QHSS reference samples in positive ion mode. RESULTS There were 14 peaks in the specific chromatogram, which belonged to Notopterygii Rhizoma Et Radix, Angelicae Pubescentis Radix, Ligustici Rhizoma Et Radix, Chuanxiong Rhizome, Viticis Fructus, respectively. Ferulic acid(peak 3) was reference peak. A total of 22 compounds were identified by mass spectrometry, including coumarin and flavonoids. CONCLUSION The established specific chromatogram method of QHSS is simple, stable and reproducible. The material basis of QHSS reference sample is basically determined, providing a reference for the development and quality control of QHSS.

Objective:To analyze the correlation between the skin temperature changes in the radiation area and the occurrence of radiodermatitis during postoperative radiotherapy for female breast cancer and to explore the application value of skin temperature monitoring in the early warning of radiodermatitis risks.Methods:A total of 103 patients who received three-dimensional conformal radiotherapy after radical mastectomy in the Fourth Hospital of Hebei Medical University were continuously enrolled from May to November, 2022 in this study. Their skin temperature in the radiation area and radiodermatitis were recorded weekly. The relationships between relative skin temperature differences and different grades of radiodermatitis were determined. The optimal cut-off values for grade ≥ radiodermatitis were calculated, and the predictive effect was evaluated using the receiver operating characteristic (ROC) curve. Furthermore, the radiodermatitis risks under different skin temperatures were compared using binary logistic regression.Results:There was a positive correlation between the skin temperature in the radiation field and the grade of radiodermatitis. The optimal cut-off values for the average relative skin temperature difference of the chest wall (under 40 Gy/20 fractions), the maximum relative skin temperature difference of the chest wall (under 40 Gy/20 fractions), and the relative skin temperature difference of the supraclavicular block (under 30 Gy/15 fractions) were 0.45℃, 0.55℃, 0.15℃, respectively. The patients were divided into low- and high-risk groups based on the optimal cut-off values (0.45℃, 0.55℃, and 0.15℃). Binary logistic regression result showed that the risks of grade ≥ 2 radiodermatitis in the high-risk group were 5.71, 4.29, and 5.15 times those in the low-risk group, respectively ( OR = 5.71, 95% CI 1.81-17.99, P = 0.003; OR = 4.29, 95% CI 1.65-11.12, P = 0.003; OR = 5.15, 95% CI 2.16-12.31, P < 0.001). Conclusions:Skin temperature monitoring using medical infrared thermometers can be used to effectively predict the occurrence of grade ≥ 2 radiodermatitis. The skin temperature changes in the radiotherapy area should be closely observed. The risk of grade ≥ 2 radiodermatitis will increase when the mean and maximum relative temperature differences of the chest wall increase by 0.45℃ and 0.55℃, respectively under 40 Gy/20 fractions of radiotherapy or when the relative temperature differences of the supraclavicular block increases by 0.15℃ under 30 Gy/15 fractions of radiotherapy.

OBJECTIVE To observe the clinical efficacy of Maitong Jun'an Decoction in treating coronary heart disease(CHD)angina of qi deficiency and blood stasis type,and preliminarily elucidate its possible mechanism of action through transcriptomics meth-ods.METHODS A total of 140 patients with CHD angina of qi deficiency and blood stasis type were included and randomly divided into a treatment group and a control group,with 70 cases in each group.During the treatment period,3 patients in the control group dropped out.The control group received basic Western medicine treatment for secondary prevention of CHD,while the treatment group received Maitong Jun'an Decoction in addition to the treatment in the control group.The treatment period for both groups was 8 weeks.Before and after treatment,the patients in both groups were evaluated for the TCM syndrome score,Canadian Cardiovascular Society(CCS)angina grading,Seattle angina questionnaire(SAQ)score,self-rating anxiety scale(SAS),self-rating depression scale(SDS)score,and adverse reactions.The peripheral blood of 9 patients before and after treatment was selected for transcriptomic sequencing based on the principle of gender,age,and disease duration matching.RESULTS After treatment,the TCM syndrome scores and total scores of the 2 groups were significantly reduced(P<0.01).The treatment group was better than the control group in improving chest pain,chest tightness,shortness of breath,fatigue and total score(P<0.05,P<0.01);the overall improvement rate of CCS angina grading in the treatment group was better than that in the control group(P<0.05);the SAQ,SAS and SDS scores of the 2 groups were significantly reduced before and after treatment(P<0.01),and the SAQ score of the treatment group was improved better than that of the control group(P<0.05,P<0.01).The transcriptomics results showed that there were 862 significantly different mR-NAs before and after treatment,including 509 up-regulated and 353 down-regulated.GO analysis showed that there were 666 biologi-cal processes in the differentially expressed mRNAs,mainly including viral gene expression,translation initiation,RNA catabolism,etc.There were 112 cell components,mainly including focal adhesion,ribosome subunit,nuclear spot,etc.There were 94 molecular functions,mainly including double-stranded RNA binding,cadherin binding,transcription co-regulatory factor activity,etc.KEGG analysis showed that the differentially expressed mRNAs enriched in 20 signaling pathways,mainly including glycerophospholipid me-tabolism pathway,AMPK signaling pathway,ribosome pathway,etc.CONCLUSION Maitong Jun'an Decoction can improve clini-cal symptoms in patients with CHD angina of qi deficiency and blood stasis type.Its mechanism of action is multi-target and multi pathway,mainly related to the regulation of glycerophospholipid metabolism pathway,AMPK signaling pathway,ribosome pathway.

In order to provide basic information for the utilization and development of famous classical formulas containing Bletillae Rhizoma， this article systematically analyzes the historical evolution of the name， origin， harvesting and processing of Bletillae Rhizoma by reviewing the ancient materia medica， prescription books， medical books and modern literature. The research results showed that Baiji（白及） was the main name， some scholars took Baiji（白芨） as its main name， and there were many other names such as Baiji（白给）， Baigen（白根）， Baiji（白苙）. The mainstream source of Bletillae Rhizoma was the tubers of Bletilla striata， and drying， large， white， solid， root-free and skin removed completely were the good quality standards. With the promotion of wild to cultivated medicinal materials， there were certain differences between their traits， and the quality evaluation indexes should be adjusted accordingly. The origin of records in the past dynasties was widely distributed， with Guizhou and Sichuan having high production and good quality in modern times. The harvesting period is mostly in spring and autumn， and harvested in autumn was better. The processing and processing technology is relatively simple， and it was used fresh or powdered in past dynasties， while it is mainly sliced for raw use in modern times. Based on the results， it is suggested that the tubers of Bletilla striata of Orchidaceae should be used in the famous classical formulas， and it should be uniformly written as Baiji（白及）. And if the original formula indicates the requirement of processing， it should be operated according to the requirement， if the requirement of processing is not indicated， it can be used in raw form as medicine.

Pregnancy ; Female ; Humans ; Placenta ; Nuclear Transfer Techniques ; Embryo, Mammalian ; Cell Nucleus

Single-cell genomics provides substantial resources for dissecting cellular heterogeneity and cancer evolution. Unfortunately, classical DNA amplification-based methods have low throughput and introduce coverage bias during sample preamplification. We developed a single-cell DNA library preparation method without preamplification in nanolitre scale (scDPN) to address these issues. The method achieved a throughput of up to 1800 cells per run for copy number variation (CNV) detection. Also, our approach demonstrated a lower level of amplification bias and noise than the multiple displacement amplification (MDA) method and showed high sensitivity and accuracy for cell line and tumor tissue evaluation. We used this approach to profile the tumor clones in paired primary and relapsed tumor samples of hepato-cellular carcinoma (HCC). We identified three clonal subpopulations with a multitude of aneuploid alterations across the genome. Furthermore, we observed that a minor clone of the primary tumor containing additional alterations in chro-mosomes 1q, 10q, and 14q developed into the dominant clone in the recurrent tumor, indicating clonal selection during recurrence in HCC. Overall, this approach provides a comprehensive and scalable solution to understand genome hetero-geneity and evolution.

Objective:To explore the value of aspartate aminotransferase(AST)and platelet (PLT)ratio index(APRI)in the prognosis of liver transplantation(LT)for hepatocellular carcinoma and establish a nomogram model for evaluating its clinical application potential.Methods:From January 2015 to December 2019, retrospective review was conducted for clinical data of LT for hepatocellular carcinoma(HCC)at First Affiliated Hospital of Zhejiang University School of Medicine and Shulan(Hangzhou)Hospital(601 cases). They were randomized into two groups of modeling (399 cases)and validation(202 cases)and then divided into low and high APRI groups according to the APRI value at Month 1 post-transplantation. The independent risk factors of recurrence and prognosis post-LT were screened in modeling group using univariate and multivariate Cox regression analyses and were further used for constructing a nomogram prediction model. The receiver operating characteristic curve(ROC)and survival curve were utilized for verifying the accuracy of nomogram prediction model.Results:Univariate and multivariate Cox regression analyses revealed that independent risk factors for the prognosis of HCC-LT included cold ischemic time(CIT) >8 h, beyond Hangzhou criteria, surgical bleeding volume >1 000 ml and APRI >1.5. The AUC of HCC-LT recurrence prediction model was 0.734(95%CI: 0.681~0.787)and 0.749(95%CI: 0.671~0.817)in modeling and validation groups; the AUC of HCC-LT mortality prediction model was 0.735(95%CI: 0.679~0.790)and 0.758(95%CI: 0.682~0.834)in modeling and validation groups.Conclusions:APRI>1.5 is an independent risk factor for postoperative recurrence and mortality after HCC-LT. The nomogram prediction model based upon CIT, Hangzhou criteria, intraoperative bleeding volume and APRI can effectively predict the recurrence and overall survival of LT for HCC.

Objective:To customize the individualized 3D printed head film for patients with head tumors undergoing radiotherapy, and to evaluate the physical properties of the material and the precision of this technology compared with the thermoplastic head film.Methods:The 3D printed head film and thermoplastic head film were placed on the solid water surface, and the depth and surface dose were measured at 5 cm by ionization chamber and film, respectively. Thirty patients with head tumors receiving radiotherapy were randomly divided into the control and experimental groups. The patients were fixed with thermoplastic head film and 3D printed head film. The translational and rotational errors in the x, y and z direction were obtained by CBCT.Results:The radiation attenuation rate of two materials at the depth of 5 cm was less than 1%. The dose of thermoplastic head film in the surface position was increased by 27%, and increased by 18% in the 3D printed head film. In two groups, 116 sets of setup errors were collected. The average translational setup errors in the control and experimental groups were 1.29 mm and 1.16 mm, 1.42 mm and 1.24 mm, 1.38 mm and 1.16 mm, respectively, and the average rotational setup errors were 1.29°and 1.08°, 1.02°and 0.96°, 1.01°and 1.00°, respectively. The translational setup errors in the y and z direction and rotational setup errors in the x direction significantly differed between the control and experimental groups (all P<0.05), but no statistical significance was found in the other direction (all P>0.05). Conclusion:The 3D printed head film fixation meets the precise setup requirements of modern radiotherapy, which deserves further application in clinical trials.

Objective To compare the difference of dose distribution between inverse planning simulated annealing (IPSA) and hybrid inverse treatment planning and optimization (HIPO) in 3D brachytherapy plan of cervical cancer,and to provide evidence for selection of reverse planning optimization method for cervical cancer brachytherapy.Methods From Dec 2016 to May 2017,totally 43 cases of patients with cervical cancer radical surgery were selected.Original IPSA brachytherapy treatment plan optimization was applied to all cases.Based on the information of original image,IPSA and HIPO plans were established according to the same initial conditions.Parameters of Dg0,D100,V100％,Homogeneity Index (HI),and conformal index (CI) of the bladder,rectum and sigmoid D2 cm3 data for High-Risk Clinical Target Volume (HR-CTV) were assessed.Results There was no statistically significant difference in D90,D100 and CI for HR-CTV between the two groups.But the V100％ of HR-CTV in HIPO group was significantly higher than that in IPSA group [(87.72 ±0.49)％ vs.(85.01 ± 0.55)％,t =2.54,P ＜0.05].Furthermore,HI in HIPO group was (0.51 ±0.08),which was higher than that in IPSA group (0.42 ± 0.06),and the difference was statistically significant (t =3.02,P ＜ 0.05).Compared with IPSA,bladder D2 cm3 and rectum D2 cm3 [(3.04 ± 0.37) Gy] for HIPO plan were lower [(3.42 ± 0.17) Gy vs.(3.57 ± 0.28) Gy,(3.04 ± 0.37) Gy vs.(3.57 ± 0.28) Gy],which had reached statistical significance (t =0.27,0.19,P ＜ 0.05).There was no statistical significance in the D2 cm3 dose of sigmoid.Conclusions In the treatment of cervical cancer,better target area HI and less irradiated dose of bladder and rectum can be obtained by HIPO optimization than IPSA optimization.