ObjectiveTo evaluate the efficacy and safety of Xihuang Pill/Capsule （西黄丸/胶囊， XP/XC） as an adjuvant to radiotherapy and/or chemotherapy in the treatment of malignant digestive tract tumors. MethodsA systematic search was conducted in the China Biomedical Literature Database， China National Knowledge Infrastructure （CNKI）， Wanfang Data Knowledge Service Platform， VIP Database， PubMed， Web of Science， Embase， and Cochrane Library for randomized controlled trials （RCTs） published before March 6， 2024， regarding the use of XP/XC in clinical adjuvant treatment of malignant digestive tract tumors. The methodological quality of the included studies was assessed using the risk of bias assessment tool. RevMan 5.4 was used to perform a Meta-analysis on 1-year survival rate， 2-year survival rate， clinical efficacy， including objective response rate and disease control rate， Karnofsky Performance Status （KPS） score， immune markers （CD3⁺， CD4⁺， CD8⁺， and CD4⁺/CD8⁺ ratio）， and adverse event rates （incidence of gastrointestinal reactions and bone marrow suppression）. ResultsThirteen RCTs involving 962 patients were included， with 527 patients in the experimental group and 435 patients in the control group. Meta-analysis results showed that the experimental group had better outcomes than the control group in terms of 2-year survival rate ［RR = 0.49， 95% CI （0.31， 0.78）］， objective response rate ［RR = 0.68， 95% CI （0.60， 0.77）］， disease control rate ［RR = 0.85， 95% CI （0.80， 0.91）］， and immune markers CD3⁺ ［MD = -7.99， 95% CI （-9.12， -6.86）］， CD4⁺ ［MD = -5.42， 95% CI （-7.11， -3.74）］， and CD4⁺/CD8⁺ ratio ［MD = -0.26， 95% CI （-0.32， -0.20）］ （P＜0.05）. However， no statistically significant differences were found between the experimental and control groups in terms of 1-year survival rate ［RR = 0.91， 95% CI （0.73， 1.14）］， KPS ［MD = -3.73， 95% CI （-8.67， 1.21）］， CD8⁺ ［MD = -0.53， 95% CI （-1.45， 0.39）］， incidence of gastrointestinal reactions ［RR = 0.82， 95% CI （0.46， 1.46）］， and incidence of bone marrow suppression ［RR = 0.93， 95% CI （0.72， 1.20）］ （P＞0.05）. ConclusionCompared with radiotherapy/chemotherapy alone， the combination of XP/XC with radiotherapy/chemotherapy can effectively improve clinical efficacy and 2-year survival rate， enhance immune function， and achieve similar adverse event rates as radiotherapy/chemotherapy alone in patients with malignant digestive tract tumors.

Non-alcoholic fatty liver disease (NAFLD), as a metabolic disease, has shown a constant upward trend in prevalence among the people in recent years. In addition to changing lifestyles and conventional drug treatment, bariatric surgery, represented by Roux-en-Y gastric bypass surgery and sleeve gastrectomy, has gradually become one of the treatment options for NAFLD. However, the mechanism of bariatric surgery in treating NAFLD remains to be studied. The "multiple-hit theory", which has gradually been recognized in recent years, believes that NAFLD is formed by the combined effect of multiple mechanisms such as insulin resistance, bile acid metabolism pathway, and intestinal flora. Based on relevant literatures and clinical practices, the authors explore the relevant mechanisms of bariatric surgery for direct or indirect treatment of NAFLD.

Objective:To explore the pattern of pulmonary vascular remodeling in patients with chronic obstructive pulmonary disease (COPD) using artificial intelligence technology based on chest CT images.Methods:This was a cross-sectional study. The clinical and imaging data of 257 patients with stable COPD who underwent chest high resolution CT (HRCT) and pulmonary function tests (PFT) from January 2018 to October 2022 at Shanxi Bethune Hospital were retrospectively analyzed. In addition, 28 healthy individuals with normal HRCT and PFT were collected in the same period as a control group. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading criteria, COPD patients were classified into 31 cases of GOLD 1, 116 cases of GOLD 2, 82 cases of GOLD 3, and 28 cases of GOLD 4. FACT digital lung software was used to automatically segment the pulmonary arteries and pulmonary veins of all the cases, and to calculate the relevant pulmonary vascular parameters, including total lung volume (TLV), vessel volumes at all levels [cross-sectional area less than 5 mm 2 (CSA <5), between 5 and 10 mm 2 (CSA 5-10), and more than 10 mm 2 (CSA >10)], number of vascular branches, and vascular density (pulmonary vascular volume/TLV). Percentage of emphysema (%LAA) and pulmonary artery diameter/aortic diameter (PAD/AD) were calculated for all cases. ANOVA or Kruskal-Wallis H test was used for multiple intergroup comparisons, and LSD test or Bonferroni correction was used for within-group pairwise comparisons. Spearman correlation test was conducted to examine the relationship between CT pulmonary vascular parameters and pulmonary function parameters, as well as %LAA, in both the control group and the COPD group. Results:Differences in age, body mass index, pulmonary function parameters, %LAA and PAD/AD were statistically significant among the 5 groups ( P<0.001). Differences in overall pulmonary vascular density parameters were statistically significant among the 5 groups ( P<0.05). Differences in pulmonary arterial density parameters among the 5 groups with CSA <5, CSA 5-10, and CSA >10 were statistically significant ( P<0.05). The pulmonary arterial density values of GOLD 1 CSA <5, CSA 5-10 and CSA >10 were higher than those of the control group, and then showed a decreasing trend with the increase of COPD severity. The differences in pulmonary venous density parameters among the 5 groups with CSA< 5, CSA 5-10, and CSA >10 were statistically significant ( P<0.001), and the CSA 5-10 pulmonary venous density was higher in GOLD 1 patients than in the control group, and the remaining pulmonary venous densities showed a gradual decreasing trend with the increase in the severity of COPD. The number of arterial and venous vascular branches/TLV tended to decrease in the control group, GOLD 1, GOLD 2, GOLD 3, and GOLD 4 patients ( P<0.001). Pulmonary vascular density parameters were positively correlated with all PFT parameters ( r=0.138-0.510, P<0.05), and negatively correlated with %LAA ( r=-0.340--0.671, P<0.001); PAD/AD was negatively correlated with PFT parameters ( r=-0.208--0.286, P<0.001) and positively correlated with %LAA ( r=0.131, P<0.05). Conclusion:Various pulmonary vascular density parameters can be quantitatively analyzed by artificial intelligence technology based on chest CT images, which can reveal the changing pattern of pulmonary vascular remodeling in COPD patients.

[Objective]To assess the repeatability(intra-operator variability)and reproducibility(inter-operator variability)of a new partial coherence interferometry(PCI)-based ocular biometer,Myopia Master,and its agreement with IOL Master 500 for measuring axial length(AL)and corneal curvature(K)in children aged 8-12 years.[Methods]The same operator measured school children with the Myopia Master and the IOL Master 500 in random order to assess agreement.Additionally,some of these children received measurements from another operator using the Myopia Master to assess repeatability and reproducibility.AL,flat keratometry(Kf),steep keratometry(Ks),mean keratometry(Km),J0 and J45 were analyzed.The repeatability and reproducibility were assessed by the within-subject standard deviation(Sw),test-retest repeatability(TRT),coefficient of variation(CoV)and intra-class correlation coefficient(ICC).The agree-ment between the Myopia Master and the IOL Master 500 was assessed by Bland-Altman plots and 95%limits of agree-ment(LoA).[Results]Both repeatability and reproducibility of the Myopia Master were high for AL measurements(Sw=0.02 mm,ICC=0.999;Sw=0.04 mm,ICC=0.998),but moderate for K measurements(Sw range,0.04 to 0.12 D,ICC range,0.861 to 0.991;Sw range,0.06 to 0.20 D,ICC range,0.835 to 0.992).There were significant mean differences be-tween the Myopia Master and the IOL Master 500 in measurements of AL(-0.01±0.04)mm,Kf(-0.09±0.15)D,Ks(-0.47±0.40)D,and Km(-0.28±0.23)D,J0(0.18±0.20)D and J45(-0.01±0.12)D.[Conclusions]The Myopia Master provided high repeatability and reproducibility for AL measurements in schoolchildren with myopia,but the Myopia Master and the IOL Master 500 cannot be used interchangeably in measuring AL and K.

Objective To explore the predictive value of cardiopulmonary exercise test (CPET) combined with clinical indexes in the postoperative complications. Methods The clinical data and CPET data (including lung function) of patients undergoing radical esophagectomy in Xuzhou Central Hospital from January 2018 to March 2022 were collected. Univariate analysis and multivariate logistic regression analysis were used to analyze the meaningful evaluation index for the occurrence of postoperative complications. Results A total of 77 patients with esophageal cancer were included, including 59 (76.6%) males and 18 (23.4%) females aged 47-80 years. There were 42 (54.5%) patients in the non-complication group and 35 (45.5%) patients in the complication group. Univariate analysis results showed that the occurrence of postoperative complications was significantly correlated with age, body mass index (BMI), smoking index, tumor stage, the length of postoperative hospital stay, peak work rate (WRpeak), peak kilogram oxygen uptake (VO2peak/kg), the ventilatory equivalent for carbon dioxide slope (VE/VCO2 slope), forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) and maximum expiratory flow rate (MMEF) (P<0.05). The results of multivariate logistic regression analysis showed that BMI [OR=1.35, 95%CI (1.03, 1.77), P=0.031], peakVO2/kg [OR=0.64, 95%CI (0.45, 0.93), P=0.018], oxygen uptake-anaerobic threshold (ATVO2) [OR=0.66, 95%CI (0.44, 0.98), P=0.044] and VE/VCO2 slope [OR=1.49, 95%CI (1.10, 2.02), P=0.011] were the related indexes of complications after radical resection of esophageal cancer. The sensitivity of BMI, VO2peak/kg, ATVO2/kg and VE/VCO2 slope in predicting postoperative complications was 82.10%, and the specificity was 87.44%, 95%CI (0.744, 0.955). Conclusion BMI, VO2peak/kg, ATVO2/kg and VE/VCO2 slope can be used as predictors for postoperative complications of esophageal cancer.

Although blood banks based on human blood can provide blood transfusions for the wounded timely and effec-tively,scientific research has never given up on finding new blood sources due to the restrictions of human blood sources.With the application of transgenic technology and the successful breeding of gene-edited pigs,gene-edited pig blood as a po-tential source of clinical transfusion has attracted wide attention.Now there are preclinical studies showing the feasibility of transfusing gene-edited pig red blood cells into primates.This paper discusses the related research and future development of xenogeneic transfusion of porcine red blood cells by gene editing.

Objective To establish a rapid detection and identification method for the chemical components of Longshengzhi capsules based on UPLC-Q-TOF/MS.Method UPLC-Q/TOF-MS technology was used to analyze and identify the chemical components of Longshengzhi capsules.The chromatographic column was a Waters Acquity UPLC BEH C18 column(100mm×2.1mm,1.7 μm),and the mobile phase A was 0.1%formic acid water.The mobile phase B was a methanol acetonitrile(1∶1)solution containing 0.1%formic acid(B).The flow rate is 0.3mL/min,the column temperature is 40℃,and the injection volume is 2 μL.The ion source adopts the electric spray ion source.The data is collected in the positive and negative ion modes,and the collection range is m/z 50～1200.The identification and matching are carried out through UNIFI software combined with manual verification of chemical components.Result 87 chemical components were preliminarily and rapidly identified.Conclusion The established method can systematically and rapidly analyze the chemical components in Longsheng leeches,providing a basis for the study of medicinal substances and having important significance for the quality control of Longsheng leeches.

Objective To investigate the image quality,radiation dose and contrast medium(CM)intake in coronary computed tomography angiography(CCTA)of overweight patients based on wide-detector using different tube voltages and CM of different concentrations.Methods A total of 150 overweight patients[body mass index(BMI)≥ 25 kg/m2]who underwent CCTA were divided into three groups according to scan protocols:group A(120 kVp,370 mg I/mL CM),group B(100 kVp,350 mg I/mL CM),and group C(80 kVp,320 mg I/mL CM),with each group had 50 patients.The mean CT value,mean signal-to-noise ratio(SNR),mean contrast-to-noise ratio(CNR),figure of merit(FOM)of all images were measured and calculated.Images were assessed using a 5-point scale by two radiologists.The volume CT dose index(CTDIvol)and dose length product(DLP)of each patient were recorded and the effective dose(ED)was calculated.The total iodine intake values of patients in three groups were calculated.The above data were statistically analyzed by one-way ANOVA.Results The mean CT value,mean SNR,mean CNR,and mean subjective score of groups B and C were significantly higher than those of group A(P＜0.001),but there was no significant difference between groups B and C(P＞0.05).The FOM value of groups B and C was significantly higher than that of group A(P＜0.001),and the FOM value of group B was significantly lower than that of group C(P＜0.001).The total iodine intake values of groups B and C was significantly lower than that of group A(P＜0.001).The ED and total iodine intake values in groups B and C were 30.34％,68.53％and 10.22％,16.85％lower than those in group A,respectively(P＜0.001).Conclusion Under the premise of ensuring image quality,the lower tube voltage and lower concentration of CM based on wide-detector allows for significant reduction in radiation dose and total iodine intake in CCTA for overweight patients compared to routine scan protocols.

Objective This work aimed to evaluate the effect of speed sintering and low-temperature degradation on the translucency of high-translucent zirconia.Methods The ST and TT specimens were randomly divided into two groups depending on the sintering process:conventional sintering and speed sintering.The sintered specimens were divided into three subgroups according to the aging time:aged for 0,5,and 20 h.Chromatic parameters(L*,a*,and b*values)were measured by Shade Eye NCC computer colorimeter in a dark environment under black and white back-ground,and the translucency parameter(TP)was used to evaluate the translucency of zirconia.Results Speed sintering may decrease the TP of ST and increase the TP of TT.As for the effect of low-temperature degradation on the translucen-cy of zirconia,the TP of ST decreased with the extension of aging time,and no significant difference was found in rapid sintering ST.Although the TP of TT decreased,no statistical difference was observed.Conclusion Speed sintering may decrease the translucency of high-strength zirconia and increase the translucency of high-translucent zirconia.Low-tem-perature degradation had no effect on the translucency of high-translucent zirconia.Speed sintering can be recommended for high-translucent zirconia in terms of translucency.

BACKGROUND: Evidence on the relations of the American Heart Association's ideal cardiovascular health (ICH) with mortality in Asians is sparse, and the interaction between behavioral and medical metrics remained unclear. We aimed to fill the gaps. METHODS: A total of 198,164 participants without cancer and cardiovascular disease (CVD) were included from the China Kadoorie Biobank study (2004-2018), Dongfeng-Tongji cohort (2008-2018), and Kailuan study (2006-2019). Four behaviors (i.e., smoking, physical activity, diet, body mass index) and three medical factors (i.e., blood pressure, blood glucose, and blood lipid) were classified into poor, intermediate, and ideal levels (0, 1, and 2 points), which constituted 8-point behavioral, 6-point medical, and 14-point ICH scores. Results of Cox regression from three cohorts were pooled using random-effects models of meta-analysis. RESULTS: During about 2 million person-years, 20,176 deaths were recorded. After controlling for demographic characteristics and alcohol drinking, hazard ratios (95% confidence intervals) comparing ICH scores of 10-14 vs. 0-6 were 0.52 (0.41-0.67), 0.44 (0.37-0.53), 0.54 (0.45-0.66), and 0.86 (0.64-1.14) for all-cause, CVD, respiratory, and cancer mortality. A higher behavioral or medical score was independently associated with lower all-cause and CVD mortality among the total population and populations with different levels of behavioral or medical health equally, and no interaction was observed. CONCLUSIONS ICH was associated with lower all-cause, CVD, and respiratory mortality among Chinese adults. Both behavioral and medical health should be improved to prevent premature deaths.
Adult ; Humans ; Cardiovascular Diseases/prevention & control* ; East Asian People ; Prospective Studies ; Risk Factors ; Smoking