OBJECTIVE To explore the improvement effects of Suting pingchuan decoction （STPC） on bronchial asthma in rats and its potential mechanism. METHODS Male SD rats were randomly divided into blank group， model group， STPC low-， medium- and high-dose groups （4.14， 8.28， and 16.56 g/kg， respectively， based on the crude drug dosage）， and dexamethasone group （positive control， 1 mg/kg）， with 8 rats in each group. Except for the blank group， the other groups were sensitized by intraperitoneal injection of ovalbumin and challenged by nebulized inhalation of ovalbumin to establish a bronchial asthma model. From the day of nebulization challenge， rats of each group were administered the corresponding drug solution or normal saline by gavage 1 hour before aerosolization， once a day， for 7 consecutive days. During the experiment， behavioral changes in rats of each group were observed. After the last administration， the levels of inflammatory factors （interleukin-1β， interleukin-18） in bronchoalveolar lavage fluid （BALF）， and oxidative stress indexes [malondialdehyde （MDA）， superoxide dismutase （SOD）] in lung tissue were determined； pathological changes in lung tissue were observed； cell apoptosis in lung tissue， and the mRNA expression of nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 （NLRP3） and the protein expressions of NLRP3， cleaved caspase-1， caspase-1， gasdermin D （GSDMD） and gasdermin D-N-terminal domain （GSDMD-N） in lung tissue were detected. RESULTS Compared with the blank group， rats in the model group showed symptoms such as scratching their ears and noses and frequent sneezing； the lung tissue structure was severely damaged， and there was obvious inflammatory cell infiltration. The levels of inflammatory factors in BALF， as well as the level of MDA， TUNEL-apoptotic cell rate， the mRNA expression of NLRP3， and the protein expressions of NLRP3， cleaved caspase-1， caspase-1， GSDMD-N and GSDMD in lung tissue were significantly increased or up-regulated， while the level of SOD in lung tissue was significantly decreased （ P ＜0.05 or P ＜0.01）. Compared with the model group， the above symptoms and pathological damages of lung tissue in each drug group were significantly improved， and all quantitative indicators （except for the protein expressions of GSDMD in the STPC groups， as well as the level of SOD， and the protein expressions of cleaved caspase-1， caspase-1 and GSDMD-N in the STPC low-dose group） were significantly reversed （ P ＜0.05 or P ＜0.01）. CONCLUSIONS STPC can improve airway inflammation and lung tissue damage in rats with bronchial asthma， reduce the level of oxidative stress， and decrease the release of inflammatory factors such as IL-1β and IL-18. Its mechanism of action may be related to the inhibition of pyroptosis activation mediated by the NLRP3/caspase-1/GSDMD signaling pathway.

AIM:To assess the efficacy of intravitreal conbercept for treating neovascular age-related macular degeneration(nAMD)under a treat-and-extend(T & E)regimen.METHODS: A retrospective analysis was conducted on nAMD patients followed over a 2-year period(May 2020 to May 2022). All eyes received three monthly loading intravitreal injections of conbercept, followed by a T& E regimen in which the injection interval was extended by 2 or 4 wk according to disease activity, up to a maximum of 16 wk. When disease activity recurred, the interval was shortened. Patients were divided into initial and non-initial treatment groups based on treatment history. Best-corrected visual acuity(BCVA), central macular thickness(CMT), injection frequency, and intervals between injections over the 24-month follow-up were compared.RESULTS:Totally 27 patients(15 males and 12 females, 33 eyes)were enrolled. In the initial treatment group(18 eyes, mean age 65.72±12.32 y), BCVA significantly improved at 1, 3, and 6 mo(P<0.05), and CMT significantly improved at 1 and 3 mo(P<0.05). In the non-initial treatment group(15 eyes, mean age 69.00±9.21 y), BCVA improved significantly at 3 mo(P<0.05), whereas CMT remained stable(P >0.05). Baseline CMT was similar between the groups(P>0.05). However, significant differences were observed at multiple post-injection time points(P<0.05). The total number of injections did not differ between the groups(P>0.05). Intervals between injections varied, with the majority at 4 and 3-4 mo in the initial and non-initial treatment groups, respectively.CONCLUSION:Initiating intravitreal conbercept therapy under a T & E regimen results in superior visual and anatomical outcomes compared with non-initial treatment.

ObjectiveTo explore the effects and mechanism of the modified Danggui Yinzi on "itch-anxiety" model rats of chronic urticaria （CU）. MethodsThe 36 SPF-grade 6-8-week-old female SD rats were randomly divided into a blank control group，a model group，a positive control group，a low-dose modified Danggui Yinzi group，a medium-dose modified Danggui Yinzi group，and a high-dose modified Danggui Yinzi group. A "itch-anxiety" model was established by intraperitoneal injection of a suspension of sodium chloride and aluminum hydroxide and ovalbumin，combined with chronic unpredictable emotional stress stimulation. After successful modeling，rats in each group were administered drugs by gavage. The positive control group was given intragastric administration of the drug solutions of cetirizine and fluoxetine （2.08 mg·kg^-1·d^-1 fluoxetine， 2 mg·kg^-1·d^-1 cetirizine）， the low-，medium-，and high-dose modified Danggui Yinzi groups were administered traditional Chinese medicine at 1.44，2.88， 5.76 g·kg^-1， respectively，while the blank control group and model group were given an equal volume of normal saline. All interventions lasted for 15 days. Behavioral changes were evaluated by the elevated plus-maze test （detecting the percentage of entries into the open arms （OE%），the percentage of time spent in the open arms （OT%），and the total number of entries into the open and closed arms （TNE）），the open-field test （detecting total activity，average movement speed，and latency to enter the central area），and scratching behavior observation. Pathological changes of skin tissues were observed by hematoxylin-eosin （HE） staining and toluidine blue staining，while those of amygdala tissues were observed by HE staining，Nissl staining，and immunofluorescence detection of ionized calcium-binding adapter molecule-1 （Iba-1）. The content of immunoglobulin E （IgE），interleukin-33 （IL-33），histamine in serum and glutamate in the amygdala was detected by enzyme-linked immunosorbent assay （ELISA）. Western blot was used to detect the protein expression of striatal-enriched protein tyrosine phosphatase （STEP），N-methyl-D-aspartate receptor subunit 2B （NR2B）， calmodulin-dependent protein kinase Ⅱ （CaMKⅡ），phosphorylated CaMKⅡ （p-CaMKⅡ），mitogen-activated protein kinase （MAPK），phosphorylated MAPK （p-MAPK），nuclear factor kappa-light-chain-enhancer of activated B cells （NF-κB），phosphorylated NF-κB （p-NF-κB），and postsynaptic density protein-95 （PSD-95） in the amygdala. ResultsCompared with the blank control group，the model group rats showed obvious anxiety-like behaviors （decreased OE%，OT%，and TNE，reduced total activity，slower average movement speed，and prolonged latency to enter the central area），increased scratching times，obvious skin inflammation and mast cell degranulation，severe amygdala tissue damage，increased glutamate content in the amygdala，and elevated levels of IgE and IL-33 in serum. The expression of STEP，NF-κB，p-NF-κB，NR2B，MAPK，p-MAPK，CaMKⅡ，and p-CaMKⅡ proteins in the amygdala increased，while the expression of PSD-95 protein decreased （P<0.05）. Compared with the model group，the modified Danggui Yinzi group of each dose had increased OE%，OT%，TNE，total activity，and average movement speed，shortened latency to enter the central area， reduced scratching times，alleviated skin inflammation and mast cell degranulation，relieved amygdala tissue damage，decreased glutamate content in the amygdala，and reduced levels of IgE and IL-33 in serum. Moreover，compared with the model group，the low -，medium-，and high-dose modified Danggui Yinzi groups showed decreased expression levels of STEP，NF-κB，p-NF-κB，NR2B，MAPK，p-MAPK，CaMKⅡ，and p-CaMKⅡ proteins in the amygdala，and increased expression of PSD-95 protein. There was a significant dose-effect relationship，with the high-dose group showing the most significant regulatory effect （P<0.05）. ConclusionThe modified Danggui Yinzi has a therapeutic effect on "itch-anxiety" model rats of CU. Its mechanism may be related to regulating glutamate metabolism in the amygdala，modulating the STEP/NR2B/CaMKⅡ/MAPK/NF-κB pathway，and regulating the expression of PSD-95.

Objective To investigate and analyze the current situation of the construction of Smart Hospital in the dis-trict-level hospital of Beijing,and to provide reference for thedistrict-level hospitals to promote the construction of Smart Hospitals.Methods A questionnaire survey was conducted in Beijing district-level hospitals,and the construc-tion of Smart Hospital was analyzed by descriptive statistical analysis.Results The overall construction rate of Beijing district-level hospitals smart service business function was 50.98％,and the overall average construction rate of hos-pital smart management business function was 46.72％.93.75％hospitals thought that the investment in Smart Hos-pital construction was insufficient.The functions of smart service and management in different grades and categories of hospitals were different.Conclusion In order to promote the construction of Smart Hospital in Beijingdistrict-level hospitals,we should improve the top-level system such as strategic planning for the construction of smart hospi-tals,increase the investment in hospital informatization and talent teams,strengthen the standardization of intercon-nection between different hospitals,enhance the sharing and utilization of medical data and information,and strengthen the application of new hospital technologies and hospital information security.

Objective:To investigate the association between metabolic dysfunction-associated steatotic liver disease(MASLD)and the risk of adverse pregnancy outcomes,and to analyze the impact of the type and severity of cardiometabolic risk factor(CMRF)abnormalities on this association.Methods:A retrospective cohort study was conducted among primiparous women with singleton pregnancies who had registered at Beijing Friendship Hospital from March 10,2020,to December 31,2022.A total of 2 623 women were included.Basic characteristics and delivery outcomes were documented,liver ultrasound and relevant prenatal examinations were performed,and adverse pregnancy outcomes were diagnosed.Modi-fied Poisson regression models were used to analyze the association between MASLD and adverse pregnan-cy outcomes.The relationship between the type or severity of CMRF abnormalities in MASLD and the risk of adverse pregnancy outcomes was also explored.Results:After adjusting for confounding factors including age,gestational weight gain,and education level,MASLD was associated with an increased risk of cesarean section(RR=1.531,95％CI:1.304-1.799,P＜0.001),gestational diabetes melli-tus(GDM;RR=2.409,95％CI:1.948-2.979,P＜0.001),pregnancy-associated hypertension(PAH;RR=3.062,95％CI:2.069-4.533,P＜0.001),preterm birth(RR=2.145,95％CI:1.342-3.429,P=0.001),and large for gestational age(LGA;2.224,95％CI:1.599-3.095,P＜0.001).However,no significant associations were found for small for gestational age or postpartum hemorrhage.After adjusting for other CMRF abnormalities,the risk of adverse pregnancy outcomes varied among MASLD pregnant women with different CMRF abnormalities:the body mass index abnormal group had higher risks of cesarean section,GDM,PAH,preterm birth,and LGA;the glucose abnormal group had an increased risk of GDM;the blood pressure abnormal group had a higher risk of PAH;the high density lipoprotein cholesterol abnormal group had higher risks of cesarean section,GDM,and PAH;and the tri-glyceride abnormal group was associated with higher risks of GDM and preterm birth.Additional,as the severity of CMRF abnormalities increased,the risks of cesarean section(RR=1.199,95％CI:1.112-1.292,P＜0.001),GDM(RR=1.478,95％CI:1.345-1.624,P＜0.001),PAH(RR=1.626,95％CI:1.367-1.934,P＜0.001),preterm birth(RR=1.384,95％CI:1.120-1.710,P=0.003),and LGA(RR=1.422,95％CI:1.224-1.650,P＜0.001)continued to rise.Conclusion:MASLD during pregnancy is associated with an increased risk of multiple adverse pregnancy outcomes,and the type and severity of CMRF abnormalities significantly influence this association.These results suggest that attention should be paid to the specific CMRF abnormalities when diagnosed MASLD,as this may help to facilitate targeted interventions and reduce the risk of adverse pregnancy outcomes.

Objective To explore the effect of hypoxic exercise on Irisin secretion of obese rats with a palmitic acid-induced lipid accumulation in L6 myotubes and a high-fat diet-induced model.Methods L6 myotubes were treated with 750 μmol/L palmitic acid to induce lipid accumulation and subsequently divided into four groups of normoxia(N),exercise(E),hypoxia(H),and hypoxic exer-cise(HE).Hypoxic conditions(1%O2)were used to simulate a low-oxygen environment,while AICAR stimulation was applied to the E and HE groups to mimic exercise.Eighty 3-week-old Sprague-Dawley rats were fed a high-fat diet for 16 weeks to establish an obesity model.Fifty obese rats that met the criteria were then selected and randomly assigned according to their body weight into five groups of normoxia-sedentary(NC),normoxia-exercise(NE),hypoxia-sedentary(HC),high-liv-ing high-training(HH),and low-living high-training(LH),each of 10.The hypoxic environment was set at 13.6%O2(simulating 3,500 m altitude).Then the NE,HH and LH groups performed daily one-hour treadmill training(NE:20 m/min;HH and LH:16 m/min),5 days/week for 4 weeks.After the intervention,the body composition was measured using dual-energy X-ray absorptiometry(DEXA),while Irisin concentrations in cell culture media and rat serum were determined by using the enzyme-linked immunosorbent assay.Moreover,fibronectin type Ⅲ domain-containing 5(FNDC5)mRNA expression in L6 cells and rat skeletal muscle was measured by quantitative polymerase chain reaction(qPCR),while FNDC5 and silent information regulator 1-peroxisome proliferators-activated re-ceptor γ coactivator lalpha(SIRT1-PGC-1α)pathway proteins were analyzed using Western blotting.Results(1)Cell experiments:①Compared with the N group,there were significantly higher Irisin lev-els in the culture medium of the E,H,and HE groups(P<0.01,P<0.05),as well as elevated FNDC5 mRNA and protein expression in the E and HE groups(P<0.05,P<0.01).Moreover,the Iri-sin concentration and FNDC5 protein levels of group HE were significantly higher than group E(P<0.05).②Compared with group N,significantly increased SIRT1 and PGC-1α protein expression was observed in groups E and HE(P<0.05,P<0.01).(2)Animal experiments:①Compared with the NC group,body weight and fat mass were significantly lower in the NE,LH,and HH groups(P<0.01),with further reductions observed in the HH group compared with the NE group(P<0.05).② Com-pared with group NC,groups NE,LH,and HH exhibited higher serum Irisin levels and increased FNDC5 mRNA and protein expression in skeletal muscle(P<0.05,P<0.01).Furthermore,FNDC5 pro-tein expression of the HH group was significantly higher than the NE group(P<0.05).③ Compared with the NC group,SIRT1 and PGC-1α protein levels were significantly upregulated in the NE,LH,and HH groups(P<0.05,P<0.01).Conclusion Hypoxic exercise effectively alleviates obesity,reduces body weight and fat accumulation in high-fat diet-induced obese rats,and enhances FNDC5 expres-sion and Irisin secretion,which may be mediated through activation of the SIRT1-PGC-1α signaling pathway.Moreover,among the different hypoxic exercise modalities,the"high-living high-training"protocol appears to have greater benefits in promoting FNDC5/Irisin expression and facilitating weight and fat reduction in obese rats.

OBJECTIVE:Prolonged sedentary behavior can acutely reduce peripheral and central vascular function,thereby increasing the risk of cardiovascular disease.Interrupting sedentary behavior may be a potential practical strategy to prevent vascular dysfunction caused by prolonged sitting.However,current research findings on its acute effects are inconsistent,and specific application recommendations have not yet been established.This study aims to perform a Meta-analysis on the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults and to explore its regulatory factors.METHODS:Following PRISMA reporting guidelines,literature search was conducted in March 2024 using the keywords of"interrupting,""sedentary,"and"vascular function"in the Web of Science Core Collection,PubMed,and China National Knowledge Infrastructure(CNKI)databases.Acute randomized crossover trials addressing the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults were included.Risk of Bias 2 developed by Cochrane was used to assess bias risk,and the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system was used to evaluate the evidence level.The"meta"and"metaphor"packages in R(version 4.2.0)were used for main effect aggregation(Hedge's g acted as the effect size indicator),publication bias testing,subgroup analysis,and regression analysis.RESULTS:Twenty-two randomized crossover trials involving 364 subjects(aged 21 to 70 years)were included.Meta-analysis results showed that compared with prolonged sitting,interrupting sedentary behavior acutely improved peripheral vascular blood flow volume(Hedge's g=0.48,95%confidence interval:0.14-0.82,P<0.01,I2=63%,low evidence level),shear stress(Hedge's g=0.65,95%confidence interval:0.37-0.93],P<0.01,I2=54%,moderate evidence level),and flow-mediated dilation(Hedge's g=0.43,95%confidence interval:0.15-0.72,P<0.01,I2=61%,moderate evidence level).Disease had a significant moderating effect on the main effect aggregation for blood flow volume(P=0.01 between subgroups),while the mode(P=0.01 between subgroups)and frequency(P=0.02 between subgroups)of interruptions had significant moderating effects on shear stress.Improvements in peripheral vascular shear stress from interrupting sedentary behavior were affected by age(β=-0.02,95%confidence interval:-0.03-0.01,P=0.09)and body mass index(β=-0.10,95%confidence interval:-0.18 to-0.02,P<0.01).Improvements in flow-mediated dilation were influenced by the total number of interruptions(β=-0.09,95%confidence interval:-0.17 to-0.01,P=0.03)and the duration of sitting during the control period(β=-0.21,95%confidence interval:-0.34 to-0.09,P<0.01).Each additional hour of sitting was associated with a 0.67%reduction in the acute improvement effect of flow-mediated dilation from interrupting sedentary behavior(P<0.01),and acute benefits disappeared when sitting control time exceeded 6 hours.A qualitative systematic review found that interrupting sedentary behavior did not significantly affect pulse wave velocity in various populations but could effectively prevent central vascular function decline in older adults due to prolonged sitting.CONCLUSION:Interrupting sedentary behavior acutely improves peripheral vascular blood flow volume(low evidence level),shear stress(moderate evidence level),and flow-mediated dilation(moderate evidence level)in adults and may prevent or protect against central vascular function decline in older adults due to prolonged sitting(very low evidence level).Characteristics of subjects(disease factors,sex,age,and body mass index),interruption intervention schemes(mode,frequency,total number of interruptions),and duration of sitting control all influence the acute improvement effects of interrupting sedentary behavior on vascular function.It is recommended that adults interrupt sedentary behavior with exercises involving large muscle groups,such as stair climbing,at high frequencies(e.g.,once every 40 minutes)with at least 5 minutes of moderate-to low-intensity activity each time,and limit the cumulative duration of prolonged sitting to no more than 6 hours per day.

Objective To compare the effects of stereotactic endoscopic hematoma evacuation on elderly patients with hypertensive intracerebral hemorrhage.Methods A total of 220 patients with hypertensive intracerebral hemorrhage in the basal ganglion admitted to our hospital from January 2020 to December 2023 were retrospectively recruited.According to their surgical treat-ment,they were divided into an observation group(stereotactic endoscopic hematoma evacuation,n=100)and a control group(craniotomy hematoma removal surgery,n=120).Postoperative recovery was observed and compared between the two groups.Results There was no significant difference in operation time between the observation group and the control group(94.56±14.75 min vs 94.03±14.50 min,t=0.268,P=0.789).No statistical differences were observed in the NIHSS score before operation between the two groups(P=0.058),but the observation group obtained significantly lower NIHSS scores in 3 and 6 months after surgery(5.90±4.02 vs 9.23±3.47,P=0.000;4.54±2.56 vs 6.50±3.07,P=0.000).There were no significant differences in GOS score and incidence of postoperative complications between the two groups(P＞0.05).Conclusion Stereotactic endoscopic hematoma evacuation can improve postoperative neurological function in patients with hypertensive intracerebral hemorrhage in the basal ganglia region.

Objective To investigate the effect and mechanism of miR-195-5p on myocardial fibro-sis in rats with atrial fibrillation(AF).Methods A total of 72 male SD rats were randomly divid-ed into control group,AF group,negative control group,miR-195-5p inhibitor group,recombinant adeno-associated virus serotype 9(rAAV9)group(miR-195-5p inhibitor+rAAV9-negative con-trol),and combination group[miR-195-5p inhibitor+rAAV9-siRNA-SMAD homolog 7(Smad)],with 12 rats in each group.Except for the control group,the rats in the other groups were inflicted to construct AF model.After receiving corresponding intervention measures,elec-trocardiography was conducted to record the incidence and the duration of AF.HE staining and Masson staining were used to observe the pathological changes and fibrosis in the myocardial tis-sues,respectively.qRT-PCR was applied to detect the mRNA levels of miR-195-5p and Smad7,and Western blotting was performed to detect the expression of TGF-β1,Smad2,p-Smad2,Smad3,p-Smad3,Smad7,Collagen-Ⅰ and Collagen-Ⅲ in the myocardial tissues.Dual luciferase assay was used to verify the regulatory effect of miR-195-5p on Smad7.Results Compared with the control group,the AF group had significantly higher AF incidence(75.0％vs 0)and longer duration(27.02±2.65 s vs 0 s),larger collagen volume fraction(CVF)[(14.47±0.89)％vs(2.12±0.35)％],and increased expression levels of miR-195-5p(3.27±0.21 vs 1.00±0.10),TGF-β1(0.76±0.08 vs 0.23±0.04),Collagen-Ⅰ(0.58±0.07 vs 0.20±0.04),Collagen-Ⅲ(0.46±0.05 vs 0.11±0.02),p-Smad2/Smad2(0.92±0.10 vs 0.37±0.05),and p-Smad3/Smad3(0.65±0.06 vs 0.14±0.03),but notably decreased expression of Smad7 at mRNA(0.32±0.06 vs 1.02±0.09)and protein(0.19±0.03 vs 0.58±0.07)levels in the myocardial tissues(P＜0.05).The AF incidence and duration,CVF,miR-195-5p level,and protein levels of TGF-β1,Collagen-Ⅰ,Colla-gen-Ⅲ,p-Smad2/Smad2,and p-Smad3/Smad3 were significantly decreased,and the mRNA and protein levels of Smad7 were significantly increased in the miR-195-5p inhibitor group than the AF group and the negative control group(P＜0.05).The combined treatment increased the inci-dence and duration of AF,CVF,myocardial TGF-β1,Collagen-Ⅰ,Collagen-Ⅲ,p-Smad2/Smad2 and p-Smad3/Smad3 expression levels,and decreased the mRNA and protein expressions of Smad7 when compared with the miR-195-5p inhibitor group and the rAAV9 group(P＜0.05).Conclusion Down-regulation of miR-195-5p alleviates myocardial fibrosis in AF rats probably by targeting Smad7 to inhibit TGF-β1 signaling.

Objective To investigate and analyze the current situation of the construction of Smart Hospital in the dis-trict-level hospital of Beijing,and to provide reference for thedistrict-level hospitals to promote the construction of Smart Hospitals.Methods A questionnaire survey was conducted in Beijing district-level hospitals,and the construc-tion of Smart Hospital was analyzed by descriptive statistical analysis.Results The overall construction rate of Beijing district-level hospitals smart service business function was 50.98％,and the overall average construction rate of hos-pital smart management business function was 46.72％.93.75％hospitals thought that the investment in Smart Hos-pital construction was insufficient.The functions of smart service and management in different grades and categories of hospitals were different.Conclusion In order to promote the construction of Smart Hospital in Beijingdistrict-level hospitals,we should improve the top-level system such as strategic planning for the construction of smart hospi-tals,increase the investment in hospital informatization and talent teams,strengthen the standardization of intercon-nection between different hospitals,enhance the sharing and utilization of medical data and information,and strengthen the application of new hospital technologies and hospital information security.