"Spirit turns but does not reverse； if it reverses， it ceases to turn" originates from the Plain Questions： Discussion on Essential Jade Plates （《素问·玉版论要篇》）. It profoundly summarizes the objectivity of life as a phenomenon subject to the laws of the universe and nature， while also expressing the subjectivity of individuals possessing systematic， stable， and ordered biological rhythms. In light of relevant ancient philosophical insights， the theory of "spirit turns but does not reverse； if it reverses， it ceases to turn" embodies the principles of constant motion in life， change according to dao （道）， orderly progression， and the rule that reversal disrupts continuity. In clinical diagnosis and treatment， one should adopt the therapeutic principle of regulating spirit to promote "spirit turning". Guiding along the trend and acting in accordance with the natural momentum must be adopted to maintain the operation of spirit turning. Adhering to constancy while recognizing variability， and prioritizing harmony above all， should be employed to ensure the orderly progress of spirit turning. Regulating qi movement serves as the driving force behind facilitating spirit turning. This will provide clinical insights and theoretical foundations for treating diseases through the concept of "regulating spirit".

"Spirit turns but does not reverse； if it reverses， it ceases to turn" originates from the Plain Questions： Discussion on Essential Jade Plates （《素问·玉版论要篇》）. It profoundly summarizes the objectivity of life as a phenomenon subject to the laws of the universe and nature， while also expressing the subjectivity of individuals possessing systematic， stable， and ordered biological rhythms. In light of relevant ancient philosophical insights， the theory of "spirit turns but does not reverse； if it reverses， it ceases to turn" embodies the principles of constant motion in life， change according to dao （道）， orderly progression， and the rule that reversal disrupts continuity. In clinical diagnosis and treatment， one should adopt the therapeutic principle of regulating spirit to promote "spirit turning". Guiding along the trend and acting in accordance with the natural momentum must be adopted to maintain the operation of spirit turning. Adhering to constancy while recognizing variability， and prioritizing harmony above all， should be employed to ensure the orderly progress of spirit turning. Regulating qi movement serves as the driving force behind facilitating spirit turning. This will provide clinical insights and theoretical foundations for treating diseases through the concept of "regulating spirit".

ObjectiveThis study aimed to construct a neural network model integrating readily available clinical data and two-dimensional （2D） conventional ultrasound images to evaluate the severity of steatotic liver disease （SLD）. MethodsClinical data and ultrasound images were retrospectively collected from 649 patients who underwent ultrasound attenuation imaging （ATI）. Using ATI as the reference standard， patients were divided into four groups： normal （S0）， mild （S1）， moderate （S2）， and severe （S3） SLD. Data were randomly divided into training and validation sets at an 8∶2 ratio. A contrastive language-image pre-training （CLIP） model was utilized to extract features from both clinical and imaging data， which were then used to train random forest （RF） and multilayer perceptron （MLP） models. The diagnostic performance of these multimodal models was compared their single-modal counterparts in the validation set. ResultsThe MLP model outperformed the RF model （AUC［95%CI］： S0 = 0.96 ［0.93-0.99］， S1 = 0.99 ［0.96-1.00］， S2 = 0.75 ［0.64-0.82］， S3 = 0.88 ［0.81-0.93］）. Furthermore， the multimodal fusion model demonstrated significantly superior performance compared to single-modal models （clinical data only： AUC［95%CI］ of 0.89 ［0.81-0.95］， 0.69 ［0.52-0.79］， 0.64 ［0.43-0.67］ and 0.80 ［0.73-0.90］ for S0-S3， respectively； image data only： AUC［95%CI］ of 0.91 ［0.86-0.96］， 0.89 ［0.67-0.89］， 0.69 ［0.58-0.78］ and 0.86 ［0.82-0.94］）. Metrics including precision， recall， F1-score， F2-score， confusion matrices， and loss function learning curves further confirmed that multimodal data fusion significantly improved the predictive capability. ConclusionThe proposed CLIP-based MLP multimodal model can effectively and automatically grade SLD severity. This demonstrates the significant advantage of integrating clinical and ultrasound data， providing an accurate and reliable adjunctive tool for the clinical management of chronic SLD.

Objective To optimize the process conditions and analyze the components of alkaloids from Zanthoxylum bungeanum Maxim（Z. bungeanum）using macroporous resin. Methods Combining single factor tests and orthogonal tests, the content of hydroxy-α-sanshool（HAS）and hydroxy-β-sanshool（HBS）were considered as indexes to determine the best process parameters. Ultra-performance liquid chromatography-quadrupole tandem time-of-flight mass spectrometry（UPLC-Q-TOF-MS^E）was used to identify the structures of alkaloids. Results The optimal conditions were Mitsubishi HP-20 macroporous resin, the loading solution concentration was 0.2 g crude drug/ml, the ratio of crude drug to resin volume was 1 g∶2.5 ml, the diameter/height ratio of resin column was 1∶7, the dynamic adsorption flow rate was 4 times of bed volume（BV）per hour, and the adsorption time was 1 h. Impurities were removed by using 2 BV of 20% ethanol, 5 BV of 80% ethanol was used to elution, and the content of HAS and HBS was 4.71% and 1.02%, respectively. A total of 20 alkaloids were identified from Z. bungeanum. Conclusion This method was stable and feasible, obtaining high purity and various kinds of alkaloids, which could be used for the enrichment and purification of alkaloids from Z. bungeanum.

Objective:To investigate the application value of 72-hour three-lead electrocardiogram(ECG)monitoring with adhesive patch(AP)in patients with palpitation.Methods:A retrospective analysis was performed for the medical history and ECG data of the patients who underwent 72-hour three-lead ECG monitoring with AP due to palpitation in The First Affiliated Hospital of Chongqing Medical University.The incidence rates of arrhythmia and transient ST-T changes were compared at 24 and 72 hours,as well as the rate difference between the detection rate of arrhythmia and transient ST-T changes at 72 hours and the detection rate at 24 hours in the context of various risk factors such as age,hypertension,hyperlipidemia,and coronary heart disease.Results:Among the 216 pa-tients with palpitation,the detection rates of various types of arrhythmia and transient ST-T changes at 72 hours were significantly higher than those at 24 hours(P<0.05).The rate difference of atrial premature beats in patients aged<60 years was significantly higher than that in patients aged≥60 years(P<0.01).The rate difference of atrial premature beats in hypertensive patients was lower than that in non-hypertensive patients(P<0.05).The rate difference of T-wave changes in patients without hypertension or coronary heart dis-ease was greater than that in patients with hypertension or coronary heart disease(P<0.01).Compared with 24-hour three-lead ECG monitoring,72-hour three-lead ECG monitoring with AP can significantly improve the detection rate of arrhythmia and transient ST-T changes.In patients with palpitation aged<60 years or without hypertension,72-hour three-lead ECG monitoring with AP is more sen-sitive to atrial premature beats which are consistent with self-perceived symptoms,and in patients with palpitation without hyperten-sion or coronary heart disease,72-hour three-lead ECG monitoring with AP is more sensitive to transient T-wave changes associated with symptoms.Conclusion:The technique of 72-hour three-lead ECG monitoring with AP greatly promotes the accuracy and timeli-ness of diagnosis,reduces the economic burden of patients with pal-pitations,and optimizes the allocation of medical resources.

Bone morphogenetic proteins (BMPs) are multifunctional growth factors of the transforming growth factor β (TGF-β) superfamily. They regulate steroid secretion from mammalian granulosa cells, promote granulosa cell survival and proliferation, and inhibit follicular atresia, luteinization, and granulosa cell apoptosis, thereby promoting the development and maturation of mammalian follicles. At the same time, BMPs play an important role in embryonic morphogenesis, induction of uterine receptivity, and blastocyst attachment. This paper describes the effects of BMPs on mammalian follicular and embryonic development and the roles of BMPs in female reproduction, focusing on the process in which BMPs promote follicular maturation by regulating steroid secretion from granulosa cells during mammalian oocyte maturation. This review aims to provide a reference for further research on mammalian oocyte culture and improvement of reproductive efficiency in female animals.
Animals ; Embryonic Development/drug effects* ; Female ; Bone Morphogenetic Proteins/pharmacology* ; Reproduction/physiology* ; Humans ; Granulosa Cells/cytology* ; Oocytes

[Objective]To explore the expression of transcription factor KLF16 in nonalcoholic fatty liver disease(NAFLD)and its effect on lipid metabolism.[Methods]An animal model of NAFLD was constructed in mice induced by a high-fat diet.The mice were divided into normal diet group(ND)and high fat diet group(HFD).NAFLD cell model was constructed by primary mouse liver cells induced by oleic acid.The cells were divided into control group(Control group)and oleic acid induction group(OA group).Real-time fluorescence quantitative PCR(RT-qPCR)and Western blot were used to detect KLF16 expression in NAFLD animal and cell models.In vitro and in vivo models of KLF16 knockdown were constructed by injection of adeno-associated virus(AAV)into mouse tail veins and transient transfection of cell siRNA.Hematoxylin-eosin staining(HE)and other methods were used to detect changes in lipid deposition in NAFLD models be-fore and after KLF16 knockout.RT-qPCR was used to detect the expression of key genes of lipid metabolism in both cellu-lar and animal NAFLD models before and after KLF16 knockdown.Western blot assay was used to detect the expression of endoplasmic reticulum stress protein in NAFLD model before and after KLF16 knockdown.[Results]The expression level of KLF16 was up-regulated in HFD group and OA group,and lipid deposition was increased in OA group after KLF16 was depressed.There was no change in TC level in hepatocytes between groups(P>0.05),and TG level was increased in differ-ent degrees(P<0.05,P<0.001).At the same time,the change of KLF16 expression also caused the change of ER stress protein expression in OA group.[Conclusion]The transcription factor KLF16 may alleviate lipid deposition in nonalcoholic fatty liver disease by endoplasmic reticulum stress.

BACKGROUND: China bears the biggest atrial fibrillation (AF) burden in the world. However, little is known about the incidence and predictors of AF. This study aimed to investigate the current incidence of AF and its electrocardiographic (ECG) predictors in general community individuals aged over 60 years in China. METHODS: This was a prospective cohort study, recruiting subjects who were aged over 60 years and underwent annual health checkups from April to July 2015 in four community health centers in Songjiang District, Shanghai, China. The subjects were then followed up from 2015 to 2019 annually. Data on sociodemographic characteristics, medical history, and the resting 12-lead ECG were collected. Kaplan-Meier curve was used for showing the trends in AF incidence and calculating the predictors of AF. Associations of ECG abnormalities and AF incidence were examined using Cox proportional hazard models. RESULTS: This study recruited 18,738 subjects, and 351 (1.87%) developed AF. The overall incidence rate of AF was 5.2/1000 person-years during an observation period of 67,704 person-years. Multivariable Cox regression analysis indicated age (hazard ratio [HR], 1.07; 95% confidence interval [CI]: 1.06-1.09; P < 0.001), male (HR, 1.30; 95% CI: 1.05-1.62; P = 0.018), a history of hypertension (HR, 1.55; 95% CI: 1.23-1.95; P < 0.001), a history of cardiac diseases (HR, 3.23; 95% CI: 2.34-4.45; P < 0.001), atrial premature complex (APC) (HR, 2.82; 95% CI: 2.17-3.68; P < 0.001), atrial flutter (HR, 18.68; 95% CI: 7.37-47.31; P < 0.001), junctional premature complex (JPC) (HR, 3.57; 95% CI: 1.59-8.02; P = 0.002), junctional rhythm (HR, 18.24; 95% CI: 5.83-57.07; P < 0.001), ventricular premature complex (VPC) (HR, 1.76; 95% CI: 1.13-2.75, P = 0.012), short PR interval (HR, 5.49; 95% CI: 1.36-22.19; P = 0.017), right atrial enlargement (HR, 6.22; 95% CI: 1.54-25.14; P = 0.010), and pacing rhythm (HR, 3.99; 95% CI: 1.57-10.14; P = 0.004) were independently associated with the incidence of AF. CONCLUSIONS The present incidence of AF was 5.2/1000 person-years in the studied population aged over 60 years in China. Among various ECG abnormalities, only APC, atrial flutter, JPC, junctional rhythm, short PR interval, VPC, right atrial enlargement, and pacing rhythm were independently associated with AF incidence.
Humans ; Male ; Middle Aged ; Aged ; Atrial Fibrillation/epidemiology* ; Prospective Studies ; Incidence ; Atrial Flutter/complications* ; Risk Factors ; China/epidemiology* ; Electrocardiography

Esophageal squamous-cell carcinoma (ESCC) is one of the most lethal malignancies in the world and occurs at particularly higher frequency in China. While several genome-wide association studies (GWAS) of germline variants and whole-genome or whole-exome sequencing studies of somatic mutations in ESCC have been published, there is no comprehensive database publically available for this cancer. Here, we developed the Chinese Cancer Genomic Database-Esophageal Squamous Cell Carcinoma (CCGD-ESCC) database, which contains the associations of 69,593 single nucleotide polymorphisms (SNPs) with ESCC risk in 2022 cases and 2039 controls, survival time of 1006 ESCC patients (survival GWAS) and gene expression (expression quantitative trait loci, eQTL) in 94 ESCC patients. Moreover, this database also provides the associations between 8833 somatic mutations and survival time in 675 ESCC patients. Our user-friendly database is a resource useful for biologists and oncologists not only in identifying the associations of genetic variants or somatic mutations with the development and progression of ESCC but also in studying the underlying mechanisms for tumorigenesis of the cancer. CCGD-ESCC is freely accessible at http://db.cbi.pku.edu.cn/ccgd/ESCCdb.
Aged ; Asian Continental Ancestry Group ; genetics ; China ; epidemiology ; Databases, Genetic ; Esophageal Squamous Cell Carcinoma ; genetics ; Female ; Genetic Predisposition to Disease ; Genetic Variation ; Genome-Wide Association Study ; Humans ; Internet ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; genetics ; User-Computer Interface

Objective To observe the anesthesia related effect of dexmedetomidine conscious sedation on Laryngeal mask airway general anesthesia in Parkinson patients with deep brain electric stimulus implantation.Methods Forty patients (72 males, 8 females, aged 18-75 years, ASA physical status Ⅰ or Ⅱ) of Parkinson disease with selective operated bilateral subthalamic nucleus deep brain electric stimulus implantation were selected and randomly divided into dexmedetomidine group (group D) and contrast group (group C), 20 cases in each group.The operation divided into two stages: in the first stage, the electrode was put under the local anesthesia, CT examination proof of electrode placement satisfaction was the end of the first stage.The second stage needed to bury the pulse generator under of the chest skin under general anesthesia.For group D, dexmedetomidine 0.5 μg/kg was pumped venously within 15 min after entering the operating room, the speed of 0.1-0.3 μg·kg-1·h-1 was kept subsequently until the end of the first period.For group C, the same dosage of normal saline was pumped.The times of micro-electrode interference, tremor relief were recorded.Ramsay scores of two groups of patients were recorded at the entry of operating room (T0), partial infiltration anesthesia (T1), unilateral electrode implantation (T2), contralateral electrode implantation (T3), the end of the first period (T4);the time needed to vanish consciousness, implant laryngeal mask airway, recover the spontaneous breathing and extubation were recorded;the propofol, remifentanil dosage from the beginning of general anesthesia induction to the end of the surgery were recorded.Results The micro-electrode was intervened and tremble was relieved in both two groups.Compared with group C, the ramsay scores of T1-T4 were obviously increased in group D (P<0.05), the time needed to vanish consciousness, implant laryngeal mask airway, recover the autonomous respiration, extubation were significantly shortened in group D (P<0.05), the dosage of propofol, remifentanil from the beginning of the general anesthesia starts to the end of the surgery were significantly reduced in group D (P<0.05).Conclusion Dexmedetomidine provided the excellent sedation to the first period of Parkinson patients with deep brain electric stimulus implantation;it can shorten the time of the anesthesia induction and awakening time, as well as decreases propofol and remifentanil dosage.