Objective:To investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] and arterial stiffness in the physical examination population.Methods:It was a cross-sectional study, the data were collected from adults who received physical examination in the Health Management Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2016 to April 2022, all the participants completed the tested for brachial and ankle pulse wave conduction velocity (baPWV) and serum 25(OH)D. The general information, anthropometric metrics and relevant laboratory data were recorded. A total of 41 090 participants were included. According to baPWV, the subjects were divided into arterial stiffness group (baPWV≥1 800 cm/s, n=2 440) and normal group (baPWV<1 800 cm/s, n=38 650). The subjects were categorized into three groups based on serum 25(OH)D level: sufficient group [25(OH)D≥30 μg/L, n=2 830], insufficient group [25(OH)D 20-<30 μg/L, n=11 400] and deficiency group [25(OH)D<20 μg/L, n=26 860]. Logistic regression analysis was performed to assess the relationship between 25(OH)D and arterial stiffness. The dose-response relationship between serum 25(OH)D levels and the risk of arterial stiffness was analyzed using restricted cubic spline functions. Results:Of the 41 090 participants included, 25 001 were males and 16 089 were females, 2 440 cases (5.94%) were detected with arterial stiffness. Compared with normal group, the age, body mass index, uric acid, creatinine, 25(OH)D level and proportion of dyslipidemia were all significantly higher in the arterial stiffness group [(60.1±9.8) vs (46.0±10.4) years, (25.3±3.4) vs (24.5±3.4) kg/m 2, (356.2±99.6) vs (345.0±95.8) μmol/L, (77.0±21.5) vs (73.8±15.9) μmol/L, (18.51±7.93) vs (18.11±7.27) μg/L, 48.4% vs 38.5%], while the glomerular filtration rate was significantly lower [(87.2±16.1) vs (99.1±14.0) ml·min -1·1.73 m -2] (all P<0.05). The 25(OH)D deficiency was positively correlated with the risk of arteriosclerosis ( OR=1.26, 95% CI: 1.07-1.51), and the risk of arterial stiffness increased by 16% for every 10 μg/L decrease in serum 25(OH)D levels (all Ptrend<0.001). The mean baPWV level in the 25(OH)D deficiency group was 12.45 cm/s (95% CI: 3.89-21.02) higher than that in 25(OH)D adequacy group; and for every 10 μg/L decrease in 25(OH)D, the baPWV increased by 11.23 cm/s (95% CI: 8.11-14.19) (all Ptrend<0.001). The association between serum 25(OH)D deficiency and the risk of arteriosclerosis was more pronounced in individuals with a body mass index of 24 kg/m2 or above ( Pfor interaction=0.039). Moreover, there was an “L”-shaped dose-response relationship between serum 25(OH)D level and the risk of arteriosclerosis ( Pnon-linear<0.001). Conclusion:The 25(OH)D deficiency is closely correlated with the risk of arteriosclerosis in the physical examination population, and the association is stronger in overweight individuals.

Objective To investigate the risk factors for recurrence of persistent atrial fibrillation(AF)after radiofrequency ablation with circumferential pulmonary vein isolation+top line+back wall line based on the features of cardiac imaging and serum biomarkers,and then to establish a nomogram risk prediction model.Methods A total of 172 patients with persistent AF admitted to our hospital from June 2022 to September 2023 were enrolled and then according to recurrence or not in 6 months after surgery,they were divided into the recurrence group(51 cases)and the non-ecurrence group(121 cases).Before surgery,routine electrocardiography,and transthoracic and esophageal echocardiography were performed,while blood routine indicators and related biochemi-cal indicators were measured.All patients underwent radiofrequency ablation with circumferential pulmonary vein isolation,top line,and back wall line.They were followed up for 6 months after surgery.Binary logistic analysis was used to analyze the independent risk factors for postoperative recurrence,and then a nomogram risk prediction model was constructed and its diagnostic per-formance was evaluated.Results Lager LAD,higher LAVI,neutrophil count and NLR,and ele-vated BNP and CRP levels,while lower LAAFV,LAAEV and LAAEF were observed in the re-current group than those in the non-recurrent group(P＜0.01).Binary logistic regression analysis showed that elevated LAVI(OR=1.160,95％CI:1.006-1.337),decreased LAAEV(OR=0.740,95％CI:0.583-0.940),decreased LAAEF(OR=0.608,95％CI:0.422-0.877),elevated BNP(OR=1.017,95％CI:1.004-1.030),and higher NLR(OR=10.116,95％CI:1.316-77.755)were independent risk factors for recurrence after radiofrequency ablation of pulmonary vein isolation+top line+posterior wall line in persistent AF patients(P＜0.05,P＜0.01).The AUC value of the nomogram model constructed with LAVI,LAAEV,LAAEF,BNP and NLR in predicting postop-erative recurrence was 0.889(95％CI:0.833-0.932).Conclusion The cardiac imaging parame-ters LAVI,LAAEV and LAAEF,and serum biomarkers BNP and NLR are closely associated with postoperative recurrence of persistent AF in patients after radiofrequency ablation with cir-cumferential pulmonary vein isolation+top line+back wall line,and the relevant nomogram mod-el has better diagnostic value for postoperative recurrence.

Objective:This study aims to evaluate the clinical efficacy and safety of Dibai Yijing Formula(DYF)in the treat-ment of male infertility with essence deficiency in the kidney and damp-heat in the essence chamber(Abbreviation:kidney deficiency and damp-heat type).Methods:This study employed a randomized,controlled clinical trial design,recruiting 72 male patients with infertility due to kidney deficiency and damp-heat type.Patients were randomly assigned to an treatment group(36 patients)and a control group(36 patients)using a random number table.The control group received oral Clomiphene Citrate Capsules(50 mg,twice daily),while the treatment group received oral DYF(one dose daily,200 ml each time,30 minutes after breakfast and dinner).Both groups underwent a 12-week treatment period.After treatment,sperm concentration(SC),percentage of progressively motile sperms(PR),total sperm motility[PR+percentage of non-progressively motile sperms(NP)],and semen volume(SV)were compared between the two groups before and after treatment.Additionally,the total score of Traditional Chinese Medicine(TCM)syndrome score and sperm DNA fragmentation index(DFI)and pregnancy outcomes of the patients'spouses were compared between the two groups.Results:Three patients dropped out from the treatment group and four from the control group.There were no statistically sig-nificant differences in semen parameters between the two groups(P＞0.05).After treatment,the patients in the treatment group showed significant difference in the percentage of SC([19.42±5.30]x 106/ml vs[10.75±2.41]x 106/ml),PR([27.72±6.62]％vs[20.04±4.10]％),PR+NP([49.86±10.68]％vs(33.74±5.58)％],DFI([12.33±3.43]％vs[15.06±3.98]％)and TCM symtom score([7.45±1.82]vs[13.85±1.91]),and the difference was statistically significant(P＜0.05).The patients in the control group showed significant difference in the percentage of SC([19.56±5.24]× 106/ml vs[11.31±2.08]× 106/ml)and TCM symptom score([12.81±1.86]vs[14.06±1.64]).But no significant changes were observed in the PR([21.75±5.93]％vs[20.05±4.67]％),PR+NP([34.23±7.15]％vs[32.35±4.09]％),SV([3.19±1.08]ml vs[3.12±1.13]ml),and DFI([15.11±4.76]％vs[15.51±4.35]％)were not statistically significant(P＞0.05).Improve-ments in PR,PR+NP,TCM symptom score and DFI in the treatment group were better than those in the control group after treatment(P＜0.05);the differences in SC and SV and spousal pregnancy in the treatment group were not statistically significant compared with those in the control group(P＞0.05).No serious adverse events occurred in both groups during the treatment period.Conclusion:The treatment of male infertility with DYF is effective and safe.

AIM To study the chemical constituents from seeds of Canavalia gladiata(Jacq.)DC.,and their estrogen-like activities.METHODS The 75% ethanol extract from the seeds of C.gladiata was isolated and purified by various chromatography,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The estrogen-like activities were evaluated by human breast cancer cells(MCF-7)stably transfected with estrogen receptor reporter gene(ER-Luc).RESULTS Twelve compounds were isolated and identified as biorobin(1),kaempferol 3-O-[O-β-D-apio-D-furanosyl(1→2)-O-[α-L-rhamno-pyranosyl(1 → 6)]-β-D-galactopyranoside(2),kaempferol 3-O-{β-D-glucopyranosyl(1 → 2)-[α-L-rhamonopyranosyl(1→6)]-β-D-galactopyranoside}(3),iso-quercitrin(4),quercetin 3-O-(6″-O-galloyl)-β-D-glucoside(5),isomyricitrin(6),myricetin-3-O-rutinoside(7)(3-ethenylphenyl)-1,2-ethanediol(8),1,3,6-tri-O-galloyl-β-D-glucopyranose(9),breynioside A(10),4-hydroxy-3-methoxyphenol-1-O-β-D-(6′-O-galloyl)glucoside(11),maesopsin-6-O-β-D-glucopyranoside(12).Compounds 1,3-5,8-9 in the concentration of 50 μmol/L,and compounds 2,12 in 100 μmol/L showed estrogen-like activities.CONCLUSION All compounds are isolated from the gene Canavalia for the first time.Compounds 1,3-5,8-9 showed stronger estrogen-like activities than compounds 2 and 12.

This study constructed a LHCGR-CRE-luc-HEK293 transgenic cell line according to the activation of the cAMP signaling pathway after recombinant human chorionic gonadotropin binding to the receptor. The biological activity of recombinant human chorionic gonadotropin was assayed using a luciferase assay system. The relative potency of the samples was calculated using four-parameter model. And the method conditions were optimized to validate the specificity, relative accuracy, precision and linearity of the method. The results showed that there was a quantitative potency relationship of human chorinonic gonadotropin (hCG) in the method and it was in accordance with the four-parameter curve. After optimization, the conditions were determined as hCG dilution concentration of 2.5 μg·mL^-1, dilution ratio of 1∶4, cell number of 10 000-15 000 cells/well, and induction time of 6 h. The method had good specificity, relative accuracy with relative bias ranging from -8.9% to 3.4%, linear regression equation correlation coefficient of 0.996, intermediate precision geometric coefficient of variation ranging from 3.3% to 15.0%, and linearity range of 50% to 200%. This study successfully established and validated a reporter gene method to detect hCG biological activity, which can be used for hCG biological activity assay and quality control.

Objective To develop and validate a deep learning model for automatic identification of liver CT contrast-enhanced phases.Methods A total of 766 patients with liver CT contrast-enhanced images were retrospectively collected.A three-phase classification model and an arterial phase(AP)classification model were developed,so as to automatically identify liver CT contrast-enhanced phases as early arterial phase(EAP)or late arterial phase(LAP),portal venous phase(PVP),and equilibrium phase(EP).In addition,221 patients with liver CT contrast-enhanced images in 5 different hospitals were used for external validation.The annotation results of radiologists were used as a reference standard to evaluate the model performances.Results In the external validation datasets,the accuracy in identifying each enhanced phase reached to 90.50%-99.70%.Conclusion The automatic identification model of liver CT contrast-enhanced phases based on residual network may provide an efficient,objective,and unified image quality control tool.

AIM To optimize the processing technology of red Notoginseng Radix et Rhizoma and evaluate its blood tonifying activity.METHODS On the basis of a single factor experiment,with steaming temperature,steaming time,drying temperature,and drying time as influencing factors,the total contents of notoginsenoside R1,ginsenoside Rg1,Rb1,Rk3,Rh4,and 20(R)-ginsenoside Rg3 as evaluation indicators,Box-Behnken response surface method ology was used to optimize the processing technology.Upon the anemic mouse models jointly induced by 1-acetyl-2-phenylhydrazine(APH)and cyclophosphamide(CTX),the investigation of the blood tonifying activity of red Notoginseng Radix et Rhizoma was carried out in contrast to that of the steamed Notoginseng Radix et Rhizoma.RESULTS The optimal conditions,contributing saponin content of 8.326%and RSD of 0.087%,were determined as follows:steaming temperature of 130℃,steaming time of 4 hours,drying temperature of 60℃,and drying time of 48 h.The pharmacological activity revealed that the different processing techniques were responsible for the different blood enriching activity of notoginseng,with red Notoginseng Radix et Rhizoma displaying a better efficacy than that of steamed Notoginseng Radix et Rhizoma.CONCLUSION This stable and feasible method can be used to control the production of red Notoginseng Radix et Rhizoma.

Objective To explore the potential mechanism of action of paeoniflorin in diabetes mellitus,the related targets and pathways were preliminarily discussed,based on the network pharmacology and molecular docking technology.Methods Analyze the potential targets of paeoniflorin using the Swiss Target Prediction database.Genecards and OMIM databases yielded the genes of diabetes-related illnesses.After taking the intersection of the two,protein-protein interaction network(PPI)was established using STRING and Cytoscape programs to search for key genes with strong correlation and complete gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis.Use AutoDockTools and Pymol programs to complete protein molecule docking validation.Results The pharmacologically-related study revealed 63 targets associated with paeoniflorin,4 758 genes related to diabetes,and 50 intersection targets.15 key genes including vascular endothelial growth factor A(VEGFA),epidermal growth factor receptor(EGFR),V-Ha-ras harvey(HRAS),V-src sarcoma(SRC)and heat shock protein hs 90-alpha(HSP90AA1)were screened.RAs-associated protein 1,Ras,calcium and other signaling pathways were obtained by KEGG pathway analysis.Molecular docking results showed that paeoniflorin had good binding ability with key genes.Conclusion Paeoniflorin can treat diabetes through multiple targets and pathways,and this mechanism can provide a basis for the application of paeoniflorin in anti diabetes and drug research and development.

Objective To observe clinical efficacy and safety of adalimumab(ADA)injection combined with methotrexate(MTX)tablets in the treatment of patients rheumatoid arthritis(RA)and its influences on bone metabolism.Methods According to cohort method,the RA patients were divided into treatment group and control group.The control group was treated with oral MTX tablets(10 mg/once,once/week),while treatment group was given subcutaneous injection of ADA ejection(40 mg/once,once/2 weeks)on basis of control group.Both groups were treated for 24 weeks.The clinical curative effect,symptoms improvement,joint function and serum bone metabolism indexes[bone alkaline phosphatase(B-ALP),bone glaprotein(BGP),carboxyterminal propeptide of type Ⅰ procollagen(PICP)]in the two groups were compared,and safety was evaluated.Results There were 37 cases in control group and 43 cases in treatment group.After treatment,total response rates of treatment group and control group were 93.02％(40 cases/43 cases)and 75.68％(28 cases/37 cases),the difference was statistically significant(P＜0.05).After treatment,morning stiffness time in treatment group and control group were(29.27±7.05)and(48.63±12.25)min,the number of joint swelling were 2.64±0.66 and 4.04±1.09,number of joint tenderness were 4.51±1.12 and 6.23±2.07,levels of serum B-ALP were(20.76±2.82)and(26.41±3.05)U·L-1;levels of serum BGP were(27.45±3.41)and(23.86±3.17)ng·mL-1;levels of serum PICP were(47.39±5.63)and(41.68±5.24)ng·mL-1,the differences were statistically significant(P＜0.05).The adverse drug reactions in treatment group were mainly on headache,pruritus at the injection site,diarrhea and nausea,while which in control group were mainly on diarrhea,anorexia and nausea.The difference in incidence of adverse reactions between treatment group and control group was not statistically significant(11.63％vs 8.11％,P＞0.05).Conclusion Clinical curative effect of ADA injection combined with MTX tablets is significant in RA patients,which can significantly relieve clinical symptoms,promote recovery of joint function,reduce levels of serum rheumatoid factor,relieve inflammatory response and improve bone metabolism.

Establishing a new paradigm for high-quality development in public hospitals,embracing a comprehensive,systematic,and innovative strategic management philosophy,and instituting a modern hospital management system hold significant practical importance.It investigates the pathways through which the Guangzhou Women and Children's Medical Center has fulfilled its strategic commitments over its 17-year history.It delves into the meaning and value of constructing hospital strategic commitments,explores pathways for realization,analyzes effects.It aims to understand the normative role of strategic commitments in shaping the development paths of specialized women's and children's hospitals and to provide a reference for the high-quality development of similar hospitals across China.