Coptis chinensis Franch. and Panax ginseng C. A. Mey. are traditional herbal medicines with millennia of documented use and broad therapeutic applications, including anti-diabetic properties. However, the synergistic effect of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng on type 2 diabetes mellitus (T2DM) and its underlying mechanism remain unclear. The research demonstrated that the optimal ratio of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng was 4∶1, exhibiting maximal efficacy in improving insulin resistance and gluconeogenesis in primary mouse hepatocytes. This combination demonstrated significant synergistic effects in improving glucose tolerance, reducing fasting blood glucose (FBG), the weight ratio of epididymal white adipose tissue (eWAT), and the homeostasis model assessment of insulin resistance (HOMA-IR) in leptin receptor-deficient (db/db) mice. Subsequently, a T2DM liver-specific network was constructed based on RNA sequencing (RNA-seq) experiments and public databases by integrating transcriptional properties of disease-associated proteins and protein-protein interactions (PPIs). The network recovery index (NRI) score of the combined treatment group with a 4∶1 ratio exceeded that of groups treated with individual components. The research identified that activated adenosine 5'-monophosphate-activated protein kinase (AMPK)/acetyl-CoA carboxylase (ACC) signaling in the liver played a crucial role in the synergistic treatment of T2DM, as verified by western blot experiment in db/db mice. These findings demonstrate that the 4∶1 combination of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng significantly improves insulin resistance and glucose and lipid metabolism disorders in db/db mice, surpassing the efficacy of individual treatments. The synergistic mechanism correlates with enhanced AMPK/ACC signaling pathway activity.
Animals ; Panax/chemistry* ; Ginsenosides/administration & dosage* ; Diabetes Mellitus, Type 2/metabolism* ; Mice ; Male ; Alkaloids/pharmacology* ; Coptis/chemistry* ; Drug Synergism ; Insulin Resistance ; Mice, Inbred C57BL ; Humans ; Transcriptome/drug effects* ; Blood Glucose/metabolism* ; Hypoglycemic Agents/administration & dosage* ; Drugs, Chinese Herbal/administration & dosage* ; Hepatocytes/metabolism*

Objective To investigate the association between antenatal white blood cell count(WBC)and the risk of histological chorioamnionitis(HCA)in pregnant women with late pregnancy premature rupture of membranes(PROM).Methods A retrospective analysis was performed on totally 118 pregnant women with PROM in late pregnancy from March 2018 to August 2021 in the hospital.They were divided into HCA group and non-HCA group according to the presence or absence of HCA.The general clinical data,laboratory indica-tors and delivery outcomes of the two groups were compared.Univariate and multivariate Logistic regression were used to analyze the association between prenatal WBC and HCA risk.Generalized additive models were used for curve fitting,and segmented regression models were used to further explain the nonlinear relationship between maternal prenatal WBC and HCA risk.Results The prenatal WBC of the HCA group was signifi-cantly higher than that of the non-HCA group(P＜0.001).After adjusting for covariates,elevated prenatal WBC increased the risk of HCA,with an OR of 1.190(95％CI:1.006-1.406,P=0.042).Curve fitting showed that there was a nonlinear relationship between prenatal WBC and HCA risk,and the log-likelihood ratio test of WBC at the inflection point 13.5×109/L(95％CI:11.75-14.56)was statistically significant(P=0.029).For the three groups of prenatal WBC,the risk of HCA in pregnant women gradually increased with the increase of WBC level,which was 0.314(95％CI:0.200-0.456)in the normal group,0.439(95％CI:0.252-0.645)in the high group,and 0.682(95％CI:0.354-0.893)in the elevated group.Conclusion The higher the prenatal WBC of pregnant women with PROM in late pregnancy,the greater the risk of HCA,but there is no simple linear relationship between the two,and there is a threshold effect.

The Portable Life Support System(PLSS),serving as a core component of the Extravehicular Activity spacesuit,must balance the requirements of life support protection and lightweight design.This study proposes a sandwich structure design based on Carbon Fiber Reinforced Polymer and validates the structural reliability of the composite backpack under launch/return segment overloads and space collision conditions through multi-scenario mechanical simulations.Simulation results demonstrate that the design achieves maximum deformations of 0.372 mm(mounting plate)under 6 g acceleration and 7.4 mm(skeleton)under 0.97 MPa impact loading,satisfying structural integrity requirements under extreme loads.The composite backpack manufactured by the autoclave molding process has passed the impact protection test under load conditions,verifying the manufacturing feasibility of the composite PLSS.This research provides a technically reliable pathway for lightweight design of EVA spacesuit structures by using composite materials,offering practical engineering value.

Objective To construct a nonparametric proportional hazards (PH) model for mixed informative interval-censored failure time data for predicting the risks in heart transplantation surgeries. Methods Based on the complexity of mixed informative interval-censored failure time data, we considered the interdependent relationship between failure time process and observation time process, constructed a nonparametric proportional hazards (PH) model to describe the nonlinear relationship between the risk factors and heart transplant surgery risks and proposed a two-step sieve estimation maximum likelihood algorithm. An estimation equation was established to estimate frailty variables using the observation process model. I-spline and B-spline were used to approximate the unknown baseline hazard function and nonparametric function, respectively, to obtain the working likelihood function in the sieve space. The partial derivative of the model parameters was used to obtain the scoring equation. The maximum likelihood estimation of the parameters was obtained by solving the scoring equation, and a function curve of the impact of risk factors on the risk of heart transplantation surgery was drawn. Results Simulation experiment suggested that the estimated values obtained by the proposed method were consistent and asymptotically effective under various settings with good fitting effects. Analysis of heart transplant surgery data showed that the donor's age had a positive linear relationship with the surgical risk. The impact of the recipient's age at disease onset increased at first and then stabilized, but increased against at an older age. The donor-recipient age difference had a positive linear relationship with the surgical risk of heart transplantation. Conclusion The nonparametric PH model established in this study can be used for predicting the risks in heart transplantation surgery and exploring the functional relationship between the surgery risks and the risk factors.

Objective To observe the changes in functional connectivity(FC)of raphe nucleus in patients with first-episode depression complicated with suicidal ideation(SI).Methods Ninety-eight first-episode depression patients were prospectively enrolled and assigned into SI group(n=56)or non SI group(n=42)based on complicated with SI or not,while 47 healthy volunteers were recruited as control group.Resting-state functional MRI was performed.FC between dorsal raphe nucleus(DRN),median raphe nucleus(MRN)and the whole brain were analyzed and compared among 3 groups and between each 2 groups,and the correlations of FC of different brain regions with clinical data of SI group were explored.Results Compared with control group,FC between DRN and left cerebellum and left putamen in SI group and non SI group decreased(all P＜0.05),between MRN and right inferior temporal gyrus increased but between MRN and left inferior frontal gyrus,right superior occipital gyrus,left inferior parietal lobule,left putamen decreased(all P＜0.05).FC between DRN and left putamen in SI group was higher than that in non SI group(P＜0.05).FC between MRN and right central posterior gyrus of SI group increased compared with that in the rest 2 groups(both P＜0.05).FC between MRN and left putamen in SI group was positively correlated with body mass score of Hamilton depression scale-24(HAMD-24)(rs=0.297,P=0.026).Conclusion Abnormal changes of FC between raphe nucleus and cortex,also between raphe nucleus and subcortical area occurred,and FC between MRN and left putamen positively correlated with body mass score of HAMD-24 in patients with first-episode depression complicated with SI.

Objective To construct a nonparametric proportional hazards (PH) model for mixed informative interval-censored failure time data for predicting the risks in heart transplantation surgeries. Methods Based on the complexity of mixed informative interval-censored failure time data, we considered the interdependent relationship between failure time process and observation time process, constructed a nonparametric proportional hazards (PH) model to describe the nonlinear relationship between the risk factors and heart transplant surgery risks and proposed a two-step sieve estimation maximum likelihood algorithm. An estimation equation was established to estimate frailty variables using the observation process model. I-spline and B-spline were used to approximate the unknown baseline hazard function and nonparametric function, respectively, to obtain the working likelihood function in the sieve space. The partial derivative of the model parameters was used to obtain the scoring equation. The maximum likelihood estimation of the parameters was obtained by solving the scoring equation, and a function curve of the impact of risk factors on the risk of heart transplantation surgery was drawn. Results Simulation experiment suggested that the estimated values obtained by the proposed method were consistent and asymptotically effective under various settings with good fitting effects. Analysis of heart transplant surgery data showed that the donor's age had a positive linear relationship with the surgical risk. The impact of the recipient's age at disease onset increased at first and then stabilized, but increased against at an older age. The donor-recipient age difference had a positive linear relationship with the surgical risk of heart transplantation. Conclusion The nonparametric PH model established in this study can be used for predicting the risks in heart transplantation surgery and exploring the functional relationship between the surgery risks and the risk factors.

Objective:To explore the current situation of maternal childbirth readiness and analyze its influencing factors, providing a basis for improving maternal childbirth readiness.Methods:From March to July 2023, convenience sampling was used to select 355 pregnant women who visited Obstetrics Clinic in three Class Ⅲ Grade A hospitals in Chengde City, Hebei Province as participants. Participants were surveyed using the self-designed General Information Questionnaire, Childbirth Readiness Scale, Perceived Social Support Scale, Family APGAR Index, and Childbirth Self-efficacy Inventory 32. LASSO regression and random forest importance ranking were used to select characteristic variables, and multiple linear regression was combined to enhance interpretability, so as to explore the important factors affecting maternal childbirth readiness.Results:The total score of the Childbirth Readiness Scale for 355 pregnant women was (74.41±7.09), and the mean score of each item was (4.13±0.39). The random forest algorithm showed that when the lambda (λ) value was 0.167 7, the error was minimized, and the corresponding number of influencing factors was six. The top six independent variables in importance ranking were perceived social support, childbirth self-efficacy, gestational week, primiparous status, participation in maternity school, and place of residence. Multiple linear regression analysis showed that perceived social support, childbirth self-efficacy, whether primigravida, gestational week, and participation in maternity school were important influencing factors of maternal childbirth readiness ( P<0.05) . Conclusions:The childbirth readiness of pregnant women is above the middle level. Medical and nursing staff can start with factors that affect the childbirth readiness of pregnant women, adopt personalized nursing measures for pregnant women with different characteristics, and encourage family members to provide sufficient family support to improve the readiness of pregnant women for childbirth.

Objective:To explore the current situation of maternal childbirth readiness and analyze its influencing factors, providing a basis for improving maternal childbirth readiness.Methods:From March to July 2023, convenience sampling was used to select 355 pregnant women who visited Obstetrics Clinic in three Class Ⅲ Grade A hospitals in Chengde City, Hebei Province as participants. Participants were surveyed using the self-designed General Information Questionnaire, Childbirth Readiness Scale, Perceived Social Support Scale, Family APGAR Index, and Childbirth Self-efficacy Inventory 32. LASSO regression and random forest importance ranking were used to select characteristic variables, and multiple linear regression was combined to enhance interpretability, so as to explore the important factors affecting maternal childbirth readiness.Results:The total score of the Childbirth Readiness Scale for 355 pregnant women was (74.41±7.09), and the mean score of each item was (4.13±0.39). The random forest algorithm showed that when the lambda (λ) value was 0.167 7, the error was minimized, and the corresponding number of influencing factors was six. The top six independent variables in importance ranking were perceived social support, childbirth self-efficacy, gestational week, primiparous status, participation in maternity school, and place of residence. Multiple linear regression analysis showed that perceived social support, childbirth self-efficacy, whether primigravida, gestational week, and participation in maternity school were important influencing factors of maternal childbirth readiness ( P<0.05) . Conclusions:The childbirth readiness of pregnant women is above the middle level. Medical and nursing staff can start with factors that affect the childbirth readiness of pregnant women, adopt personalized nursing measures for pregnant women with different characteristics, and encourage family members to provide sufficient family support to improve the readiness of pregnant women for childbirth.

Objective:To investigate the abnormalities of gray matter volume (GMV) and the synergistic changes in different cerebral regions in the first-episode and early-onset depression (EOD) patients.Methods:A total of 60 patients with untreated EOD (EOD group) and 64 healthy controls (control group) matched for age, gender, and education underwent high-resolution T 1WI MR scans. Voxel-based morphometry was used to calculate the cerebral GMV. The difference in GMV between the two groups was compared with the t-test. Different brain regions were selected as seeds for structural covariation network (SCN) analysis. Spearman correlation model was used to analyze the correlation between the GMV in different cerebral regions and illness duration as well as the scores of Hamilton rating scale for depression (HAMD) 17 items in EOD group. Results:Compared to control group, the EOD group had significantly increased GMV in the right orbitofrontal cortex, right dorsolateral prefrontal cortex, right inferior parietal lobule, right superior parietal lobule and bilateral precuneus ( P<0.05, corrected by FDR). Based on the right orbitofrontal cortex and dorsolateral prefrontal cortex as seed regions, structural covariance analysis revealed that abnormal cooperative brain regions in EOD group, mainly distributed in the bilateral frontal lobe, parietal lobe, occipital lobe, temporal lobe, paralimbic system and cerebellum ( P<0.05, corrected by FDR). In EOD group, significant negative correlations were observed between the GMV in the right orbitofrontal cortex ( r=-0.314, P=0.015), the left precuneus ( r=-0.283, P=0.029), and illness duration. Significant positive correlations were observed between the GMV in the right dorsolateral prefrontal cortex and the scores of anxiety/somatization factor of HAMD17 ( r=0.331, P=0.010), the left precuneus and weight factor of HAMD17 ( r=0.255, P=0.049), respectively. Conclusions:Abnormal GMV changes are observed in some regions of the prefrontal and parietal lobule in patients with untreated EOD, accompanied by extensive covariant brain regions and additional structural connectivity. In addition, the abnormal GMV changes in some regions are associated with clinical features. Part of the prefrontal and parietal lobule may be the biomarkers to objectively evaluate abnormal brain structure in depression patients in the early stage.

Objective:To study the predictive value of superb microvascular imaging(SMI) in evaluating therapeutic efficacy of hepatic cancer treated by percutaneous radiofrequency ablation(PRFA).Methods:From Feb 2017 to Feb 2018, 55 patients (male: 31, female: 24, age range: 37-68 years, mean age: 56years) with 72 hepatic carcinoma lesions (length: 21.3-45.6 mm, average: 31.2 mm) were detected by SMI and contrast-enhanced CT(CECT)before PRFA. One month after treatment, more than two imaging examinations (CECT, CEMR, ultrasonic imaging) were used as the "gold standard" to evaluate the complete ablation rates. Consistency between the SMI grading and the arterial phase enhancement of CECT was analyzed by the Kappa-test.Results:Before PRFA, SMI showed 12 lesions (16.7%) to be in grade Ⅰ, 28 lesions (38.9%) in grade Ⅱ and 32 lesions (44.4%) in grade Ⅲ. The arterial phase of CECT showed 37 lesions (51.4%) to have no obvious enhancement and 35 lesions (48.6%) to have obvious enhancement. Consistency analysis showed that there was a high consistency between SMI and CECT(Kappa=0.861, P<0.001). The higher the SMI grading, the more obvious the enhancement on CECT. The complete ablation rates of the grade Ⅰ, grade Ⅱ and grade Ⅲ lesions were 100%(12/12), 92.9%(26/28) and 71.9%(23/32), respectively. The complete ablation rate of the lesions in grade Ⅲ was significantly lower than that in grade Ⅰ and grade Ⅱ (both P<0.05). Conclusion:SMI showed a good consistency with CECT in evaluating the blood flow signals of hepatic cancer, SMI grading could be used in predicting the therapeutic efficacy of hepatic cancer treated by PRFA.