Objective To find out about perceived stress,self-compassion,cognitive flexibility,and depression among young males at high altitudes,construct a relational model between perceived stress and depression,explore the relationship between perceived stress and depression,and examine the roles of self-compassion and cognitive flexibility.Methods Using the convenient sampling method,733 young males from a high-altitude unit were surveyed via the general information questionnaire,the Chinese Perceived Stress Scale(CPSS),the Cognitive Flexibility Inventory(CFI),Self-Compassion Scale(SCS)and Center for Epidemiologic Studies Depression Scales(CES-D).Results(1)TheCES-D score was 13.92±3.38.(2)Perceived stress was positively correlated with depression(r=0.28,P＜0.01).(3)Self-compassion partially mediated the relationship between perceived stress and depression,accounting for 59.05％of the total effect.(4)Cognitive flexibility moderated the relationship between self-compassion and depression(P＜0.05).Conclusion Young males at high altitudes exhibit notable levels of depressive symptoms.Perceived stress was significantly positively correlated with depression.By enhancing self-compassion and cognitive flexibility,the incidence of depressive symptoms among young males in prolonged high-stress conditions can be reduced.

Objective To establish a cell bank of extrahepatic cholangiocarcinoma (ECC)-derived organoids and investigate the key factors influencing the organoids generation. Methods The tumor samples from patients with portal cholangiocarcinoma (pCCA) and distal cholangiocarcinoma (dCCA) were used to isolate cells, and these cells were cultured using three-dimensional (3D) technique to establish ECC organoids. Histological characteristics of the organoids were evaluated and identified through hematoxylin-eosin (HE) and immunohistochemistry stainings. The success rates of organoids generation from different tumor types were compared. And clinical characteristics of patients between successful and failure culture groups were compared. Results The success rates of organoids establishment from pCCA and dCCA were all low, with 42.4% (14/33), 51.9% (14/27), respectively. The tumor was larger in successful group than that in failure group (P＜0.001); there was no statistical difference in tumor differentiation status, microvascular invasion, and perineural invasion between the two groups. Conclusions The successful rate of ECC-derived organoids establishment is low, and larger tumor has higher successful culture rate.

Objective　To investigate the expression of neutrophil elastase (ELANE) mRNA in peripheral blood mononuclear cells (PBMCs) under different infection states of Mycobacterium tuberculosis (MTB), and analyze the feasibility of ELANE as a diagnostic marker for MTB infection. Methods　PBMCs were isolated from peripheral blood of active tuberculosis patients (ATB), latent infection of Mycobacterium tuberculosis (LTBI) and healthy control (HC) Luanzhou People's Hospital, Hebei Province, February-November 2023 and cell RNA was extracted. After reversing into cDNA, the difference of ELANE mRNA level in PBMCs in each group was detected by fluorescence quantitative PCR. The whole cell lysate of Mycobacterium tuberculosis H37Rv was used to stimulate PBMCs in each group, and total RNA was extracted. Fluorescence quantitative PCR was also used to detect the expression differences of ELANE gene before and after cell stimulation in each group; these expression differences were analyzed for identifying the feasibility of ATB. Results　The expression of ELANE gene in peripheral blood mononuclear cells of ATB patients was significantly higher than that of LTBI and healthy individuals (t=4.550, P<0.001; t=4.540, P<0.001). ROC analysis showed that the area under the curve for ELANE differential diagnosis of ATB and LTBI, ATB and HC were 0.802 and 0.805, respectively. H37Rv whole cell lysate can upregulate the expression of ELANE gene in PBMCs of ATB patients, with a significant difference before and after stimulation (t=4.717, P<0.001). However, there was no significant difference in ELANE gene expression in PBMCs of LTBI and HC populations before and after H37Rv bacterial lysate stimulation. Conclusion 　Compared with LTBI and healthy individuals, the expression level of ELANE mRNA in peripheral blood mononuclear cells of ATB was significantly upregulated; After stimulation with MTB whole cell lysate antigen, the expression level of ELANE in PBMCs of ATB population significantly increased. ELANE can serve as a diagnostic biomarker for active pulmonary tuberculosis to differentiate ATB from LTBI and healthy individuals.

Objective To investigate the relationship between ST-segment elevation myocardial infarction(STEMI)treatment time nodes and coronary microcirculation dysfunction(CMD)after primary percutaneous coronary intervention(PCI)and its prognosis,providing evidence for early identification of high-risk patients,further optimization of treatment system,shortening treatment time and improving prognosis.Methods This study selected 150 STEMI patients who received primary PCI at the 920th Hospital of the Joint Logistic Support Force of the People's Liberation Army of China from March 2023 to September 2023 as the CMD group after PCI(89 cases),with a microcirculation resistance index(caIMR)of≥40 U based on coronary angiography.caIMR＜40 U was classified as the non-CMD group(61 cases).The clinical data,various examination indicators and imaging data of the two groups of patients were collected,and the occurrence of major adverse cardiovascular events(MACE)within half a year after direct PCI of the patients was followed up.The correlation between the two variables was analyzed using Spearman.Multivariate Logistic regression was used to analyze the relationship between each treatment time point and the occurrence of CMD after direct PCI.Using receiver operating characteristic(ROC)curve analysis to predict the occurrence of CMD after direct PCI.The survival curves between the two groups were plotted using the Kaplan-Meier method.Results The levels of symptom onset-to-balloon(S-to-B),symptom onset-to-first medical contact(S-to-FMC),first medical contact-to-balloon(FMC-to-B),symptom onset-to-door(S-to-D)and first medical contact-to-door(FMC-to-D)in the CMD group were significantly higher than those in the non-CMD group(all P＜0.05).Correlation analysis showed that S-to-D,S-to-FMC,the time from FMC-to-B,and the time from FMC-to-D were all positively correlated with the time from S-to-B(r=0.996,P＜0.001;r=0.937,P＜0.001;r=0.431,P＜0.001;r=0.441,P＜0.001).Multivariate Logistic regression analysis indicated that the duration of S-to-D(OR 2.165,95％CI 1.655-2.830,P＜0.001)was a significant influencing factor for CMD.Moreover,S-to-D has a relatively high predictive value for the occurrence of CMD after direct PCI.The area under the ROC curve is 0.898(95％CI 0.850-0.946,P＜0.001),the optimal cut-off value is 231 min,the sensitivity is 82.0％,and the specificity is 88.5％.Kaplan-Meier curve analysis showed that the cumulative survival rate of MACE outcomes in the CMD group was significantly lower than that in the non-CMD group(Log-rank P=0.009).Conclusions Shortening the S-to-D time can reduce the occurrence of CMD after PCI,thereby reducing the incidence of MACE and improving prognosis.

Diabetic kidney disease(DKD)is one of the common microvascular complications of diabetes mellitus,and it has become the main cause of chronic kidney disease and end stage renal disease.Traditional Chinese medicine can delay the progress of DKD by inhibiting oxidative stress,improving renal tissue damage,restoring renal function.This paper will summarize the relationship between oxidative stress and DKD and the prevention and treatment of DKD by traditional Chinese medicine,so as to provide reference for clinical drug application,basic research and new drug research and development of DKD.

To compare and analyze the clinical manifestations,laboratory characteristics,imaging findings,and treatment outcomes of patients with acute and chronic brucellosis,a retrospective analysis was conducted on 258 patients with brucellosis(202 in the acute group and 56 in the chronic group)hospitalized in Xinkang Hospital in Dalad Banner,Ordos City,Inner Mongolia Autonomous Region,from November 2023 to November 2024.General data,epidemiological characteristics,clinical presentations,laboratory test results,imaging findings,treatment outcomes,and prognosis were collected.The incidences of fever(51.5%vs 7.1%),fatigue(30.2%vs 12.5%),joint pain(42.9%vs 16.1%),and muscle pain(9.9%vs.1.8%)were significantly higher in the acute phase group(all P<0.05).The incidence of osteoarthritis complications was higher in the chronic brucellosis group(51.8%vs 8.9%,χ2=75.697,P<0.01).Univariate ANOVA analysisshowed that the Serum Agglutination Tests(SAT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),creatinine(CRE),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and bone destructionexhibited statistically significant differences between the acute and chronic phases of brucellosis(all P<0.05).Multivariate logistic regression analysis indicated that abnormal ALT(OR=14.18,95%CI:1.11-181.72;P=0.041)and bone destruction(OR=0.16,95%CI:0.04-0.63;P=0.009)were associated with chronic brucellosis.After treatment,all patients experienced have symptom relief in varying degrees,with 157 patients(60.9%)cured and 101 patients(39.1%)symptomatic improved(P<0.01).In conclusion,the incidences of fever,fatigue,and joint pain in patients during the acute phase is significantly higher than that those in patients during the chronic phase,while the incidence of osteoarthritis complications is higher in chronic phase patients.The incidences of abnormal SAT,ALT,AST,TBIL,CRE,CRP,and ESR,and bone destruction varies at different stages of brucellosis.Of those,abnormal ALT and bone destruction show a stronger association with,which can assist the clinical staging of brucellosis.

Medical equipment, as an important indicator of smart hospital evaluation, plays a vital role in hospital operations. To ensure the safe and efficient operation of medical equipment, a reasonable performance evaluation system is indispensable. This study introduces a platform based on Internet of Things (IoT) technology that connects medical devices and collects data, achieving standardized and structured data processing, and supporting online operational supervision. Through the Delphi method, a performance evaluation system for large medical equipment is constructed, including 4 primary indicators and 22 secondary indicators. DICOM data acquisition devices are used to achieve functions such as efficiency analysis, benefit analysis, usage evaluation, and decision-making support for medical equipment. The study is still in its early stages, and in the future, it is expected to integrate more types of equipment, achieve rational resource allocation, and significantly impact decision-making for the development of public hospitals.
Internet of Things ; Delphi Technique

Triple-negative breast cancer is therapeutically challenging due to the low expression of tumor markers and 'cold' tumor immunosuppressive microenvironment. Here, we present a dual-targeting peptide-drug conjugate (PDC) for tumor inhibition. Our PDC efficiently and selectively delivers cytotoxic Monomethyl Auristatin E (MMAE) into tumor cells via C-X-C chemokine receptor type 4 (CXCR4) and folate receptor 1 (FOLR1) for synergistic inhibition of growth and metastasis. Our results show that the dual-targeting PDC has potent antitumor activity in cultured human cells and several murine transplanted tumor models without apparent toxicity. The combination of dual-targeting PDC and radiotherapy modulates the tumor immunosuppressive microenvironment by increasing CD8⁺ T cell infiltration and attenuating the proportion of myeloid-derived suppressor and regulatory T cells. Therefore, our dual-targeting PDC represents a promising new strategy for cancer therapy that rebalances the immune system and promotes tumor regression.

Parkinson's disease is a neurodegenerative disease that mainly affects dopamine neurons in the substantia nigra region of the brain,and its clinical manifestations include shaking and slowness of movement.The means of clinical medicine treatment are limited,but traditional Chinese medicine,with its advantages of low cost and high safety,shows great potential in the prevention and treatment of Parkinson's disease.Our team proposed that the core pathogenesis of Parkinson's disease was"earth deficiency and wood multiplication",that is,spleen(soil)deficiency and liver(wood)dysfunction.Among them,"earth deficiency"was the basis of the disease,and"wood multiplication"was the core of the disease.The treatment advocated"strengthening spleen and soothing liver",the specific methods included strengthening spleen and resolving phlegm,Tonify qi and cultivate the middle and soothing liver and relieve depression,and subdue wind and unblock the meridians,etc.Representative recipes were Lianmei Siwu decoction,Zhengan Xifeng decoction,Huangya decoction and Shenzhu decoction.In the treatment,we should pay attention to the whole concept and syndrome differentiation and treatment,and combine the three factors to improve the clinical effect.At the same time,the advantages and mechanisms of TCM in the prevention and treatment of Parkinson's disease deserve further research and verification.

This study was aimed at comparing the effects of storage conditions on the Brucella survival number in brain heart infu-sion medium,to provide experimental data support for the selection of storage conditions for Brucella strains.We created bacterial sus-pensions of seven strains of Brucella melitensis,Brucella abortus,and Brucella suis(denoted A,B,C,D,E,F,G)by using 30%glycerol brain heart infusion medium,then conducted stability testing.For accelerated stability tests,the bacterial solution was placed in a 37℃chamber for 1,2,3,or 4 weeks continuously,and the Brucella survival number at each time point was measured.For freeze-thaw stability testing,the bacterial solutions were frozen at-80℃,transferred to room temperature for 4 hours,and melted in one freeze-thaw cycle,and the Brucella survival number was measured for 2,4,6,and 8 freeze-thaw times.For long-term stability testing,the bacterial solutions were stored at-80℃,and the Brucella survival number was measured at various time points during the first,third,sixth,and twelfth months of storage.A line graph was plotted to demonstrate the changes in Brucella survival number at each time point in the three stability tests.IBM SPSS Statistics 22 software was used to assess statistically significant differences in Brucella survival number at each time point and the initial Brucella survival number.Accelerated stability tests showed that the Bru-cella survival number of the seven strains significantly decreased,and a statistically significant difference in Brucella survival number was observed after 1 week.In freeze-thaw stability tests,with increasing freeze-thaw times,the Brucella survival number of the seven strains showed a decreasing trend.Strains C and F showed statistically significant differences with respect to the initial Brucella sur-vival number after two times of freeze-thaw;strains A and D showed statistically significant differences with respect to the initial Bru-cella survival number after four times of freeze-thaw;strain G showed statistically significant differences with respect to the initial Bru-cella survival number after six times of freeze-thaw;and strain E showed statistically significant differences with respect to the initial Brucella survival number after eight times of freeze-thaw.The data for strain B showed abnormalities.In long-term stability testing,the Brucella survival number for strains C and F after storage for 1 month showed a statistically significant difference with respect to the initial bacterial solution.No statistically significant difference in Brucella survival number was observed for strains B and E after stor-age for 1,3,6,or 12 months.The data for strains A,D,and G showed abnormalities.The sterile 30%glycerol brain heart infusion medium maintained the Brucella survival number in an-80℃environment,and freezing and thawing multiple times should be avoided.Compared with the traditional freeze-drying method,this method is not only easy to perform but also avoids potential bio-safety hazards,and provides a reliable Brucella culture preservation scheme for researchers in related fields.