Objective To investigate the regulatory mechanism of transforming growth factor-β1 (TGF-β1) in different types of mitral valvular disease (MVD) with atrial fibrillation (AF). Methods From August 2011 to August 2012, patients with moderate to severe MVD accompanied by AF who required mitral valve replacement at the Department of Cardiovascular Surgery, West China Hospital, Sichuan University, were included. Based on echocardiographic results, patients were divided into two groups: a mitral regurgitation (MR) with AF (MR-AF) group and a mitral stenosis (MS) with AF (MS-AF) group. Left atrial tissue samples were collected during surgery. Techniques such as enzyme-linked immunosorbent assay, real-time fluorescence quantitative polymerase chain reaction, immunohistochemistry, and Western blotting were used to detect key molecules in the TGF-β1/JNK pathway. Results Sixteen patients were enrolled. There were 8 patients in the MR-AF group, including 5 males and 3 females, with an average age of (41.38±11.19) years; and 8 patients in the MS-AF group, including 6 males and 2 females, with an average age of (43.12±5.30) years. The left atrial volume load was higher in MR-AF patients, while the left atrial pressure load was higher in MS-AF patients. In MS-AF patients, the relative expression levels of MAPK9, JUN, CASP3, BAX, and BCL2 mRNA in left atrial tissues were significantly upregulated. The serum TGF-β1 protein level and the relative expression levels of p-JNK, p-c-Jun, and Caspase-3 proteins in the left atrial tissues of the MR-AF group were higher. Myocardial cell damage was more severe in the MS-AF group, and the protein expression level of Bcl-2 was higher. Conclusion Different MVD have distinct hemodynamic characteristics. The myocardium of the left atrium in MR-AF patients is more prone to apoptosis, possibly through the activation of the TGF-β1/JNK signaling pathway.

Objective: To explore the correlation between traditional Chinese medicine (TCM) constitution and depressive symptom among school aged children and adolescents, so as to provide evidences for informing constitution based regulation and prevention of depressive symptom. Methods: From June to December 2024, a total of 4 729 students aged 6-14 were recruited by cluster random sampling from 10 primary schools in Baoding (Hebei Province), Heze and Liaocheng (Shandong Province). General information, TCM constitution and depressive symptom were collected. Restricted cubic spline (RCS) models were used to analyze related factors and threshold effects of depressive symptom. Binary Logistic regression was applied to examine the association between depressive symptom and TCM constitution, with subgroup analyses conducted. Results: The detection rate of depressive symptom among the included children and adolescents was 25.82%. RCS analyses indicated non linear associations between depressive symptom and age (inflection point at 10 years old), bedtime (inflection point at 22:00), and wake up time (inflection point at 6:30 ) (all P non linearity <0.01). Linear associations were observed with body mass index (BMI) and sleep duration (all P non linearity > 0.05 ). After adjusting for covariates such as age, BMI and sleep status, binary Logistic regression analyses showed that Yin deficient constitution ( OR =1.26, 95% CI =1.09-1.45) and Phlegm-dampness constitution ( OR =1.42, 95% CI =1.11-1.82) were significantly associated with depressive symptom among children and adolescents (all P <0.05). Conclusions Depressive symptom among school aged children and adolescents is primarily associated with Yin deficiency and Phlegm dampness constitutions in TCM constitution. Active attention should be paid to susceptible TCM constitution among children and adolescents. Targeted health guidance and interventions should be implemented to improve TCM constitution health status for preventing the occurrence of depressive symptom.

This study aims to clarify the incidence and prevention status of dairy cow mastitis in 79 large-scale pastures in China in 2022,reduce the incidence of dairy cow mastitis,and provide scien-tific basis for formulating prevention and control strategies for dairy cow mastitis in large-scale pastures suitable for China's national conditions.The research team relied on the large-scale ranch of the Comprehensive Experimental Station of National Dairy Industry Technology System to car-ry out research.A total of 79 questionnaires were received.The information on the stock of large-scale farms,the proportion of cows in the herd,the level of cow yields,the incidence and cure rate of cow mastitis,the prevention and control of cow mastitis,diagnosis and treatment programs of cow mastitis,the cost of treating cow mastitis,and the culling rate of farms was collected.Chi-square test and correlation analysis were carried out on the incidence of mastitis in dairy cows and the prevention and control plan,treatment plan,yield level and elimination rate of mastitis in dairy cows by descriptive statistical cross table.The incidence of cow mastitis in some pastures was con-trolled between 5％and 10％,and the cure rate was mostly as high as 98％.According to the co-hort analysis,the importance of prevention and control measures for dairy cow mastitis was as fol-lows:DMT＞DHI＞milk yield＞milk traits＞breast apparent change＞electrical conductivity＞CMT.The importance of treatment measures for dairy cow mastitis is as follows:DMT＞DHI＞milk yield＞milk traits＞breast apparent changes＞electrical conductivity＞CMT.The importance of treatment measures for mastitis is as follows:traditional Chinese medicine＞pathogen detection and drug sensitivity test＞non-steroidal anti-inflammatory drugs＞regular maintenance of milking equipment＞normal milking without treatment＞broad-spectrum antibiotics.The incidence of mas-titis in dairy cows is moderately positively correlated with the yield per unit area,that is,the in-crease in the incidence of mastitis in dairy cows has a certain impact on the yield per unit area of dairy cows.Economic analysis shows that the treatment cost of mastitis is closely related to the in-cidence rate,and the treatment cost of pasture with higher incidence rate is higher.Pastures with higher yields usually have more efficient means of disease prevention and control,and the corre-sponding treatment costs are lower.In conclusion,China's large-scale pastures should strengthen the scientific feeding management level,improve the prevention and control methods to reduce the incidence of cow mastitis,improve the cure rate,and reduce the cost of pasture treatment.

Objective To investigate the correlation between serum vascular endothelial growth factor(VEGF)level and the development and severity of diabetes mellitus cystoid macular edema(CME).Methods A total of 57 patients(57 eyes)with diabetic CME(the case group)and diabetes without eye complications(the control group)admitted to the Vitreoretinal Surgery Department of Tangshan Eye Hospital from June 2023 to June 2024 were prospectively selected,and all of them underwent systematic ophthalmic specialty examination and serum VEGF detection.Multivariate Logistic regression analysis was used to identify the risk factors of diabetes mellitus CME.The diagnostic value of VEGF in patients with diabetes CME was analyzed by receiver operating characteristic(ROC)curve.Spearman correlation was used to analyze the relationship between VEGF levels and the severity of CME in patients with diabetes,such as corrected visual,number of cystoid edema and non-round index of macular foveal avascular zone(FAZ).Results Compared with the control group,the course of diabetes in the case group was longer,the incidence of hypertension was higher,levels of glycosylated hemoglobin(HbA1c),serum creatinine and serum VEGF were higher,and the estimated glomerular filtration rate(eGFR)was lower(P＜0.05).Multivariate Logistic regression results showed that long duration of diabetes,increased levels of HbA1c and VEGF were risk factors for CME in diabetes mellitus patients,while elevated eGFR was protective factor(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of VEGF in diagnosing diabetes mellitus CME was 0.758(95%CI:0.669-0.834).The AUC of the combined application of diabetes duration,HbA1c,eGFR and VEGF in the diagnosis of diabetes mellitus CME was 0.916(95%CI:0.877-0.941),which was significantly higher than that of the application of VEGF alone(P＜0.05).The VEGF level was negatively correlated with the corrected visual acuity[0.34(0.24,0.44)]in patients with diabetic CME,and positively correlated with the detection of cystoid macular edema[3(2,5)]and FAZ non-roundness index[1.16(1.08,1.20)](rs were 0.771,0.700,respectively,P＜0.05).Conclusion Serum VEGF levels are closely related to the onset and severity of CME,and which can be used as a reliable reference index for the diagnosis of CME.

Objective To develop a hypoxia endurance testing system for aviation physiological training of pilots.Methods The hypoxia endurance testing system comprised a low-oxygen mixed gas generator,a pressurization system for low-oxygen mixed gas and a personal breathing apparatus.The low-oxygen mixed gas generator consisted of a main unit composed of an air compressor,a filter,a buffer tank,polymer membrane,a control module,sensors and regulators,wire cables,supporting hoses,etc.;the pressurization system for low-oxygen mixed gas was made up of a protective box,a cooling fan,a motor and a driver,a control module,a solenoid valve,a convergence block,a pressure gauge,etc.;the personal breating apparatus was composed of a gas cylinder,a pressure reducer,an oxygen supply regulator,etc.Forty-eight subjects were selected for hypoxia exposure tests to verify the effectiveness of the system.Results The system developed had the functions of low-oxygen gas preparation,pressurized filling and hypoxia experiment,and the experimental results indicated the acute hypoxia exposure by the system significantly caused signs and symptoms of hypoxia and weakened physiological functions.Conclusion The system developed gains advantages in high accuracy of gas volume fraction control,safety and remarkable effect of simulated hypoxia,and can be an effective tool for acute high-altitude hypoxia testing and training of pilots.[Chinese Medical Equipment Journal,2025,46(10):23-28]

Objective This study aimed to investigate the expression and prognostic significance of Tubulin Beta 2A Class IIa(TUBB2A)in hepatocellular carcinoma(HCC)and to explore its roles in modulating malignant behavior of HCC cells under hypoxia.Methods The expression of TUBB2A in HCC tissues and its correlation with patient prognosis were analyzed using data from The Cancer Genome Atlas Program(TCGA)and validated by Real-time quantitative PCR(qPCR).HepG2 and Hep3B cells were cultured under both normoxia and hypoxia,and followed by assessment of mRNA and protein levels of TUBB2A by qPCR and Western blot.Stable TUBB2A overexpressing and knockout cell models(HepG2 and Hep3B)were established using lentiviral infection technology.The biological function of TUBB2A in HCC cell proliferation,mobility,and invasion of HCC cells under hypoxia were assessed by CCK-8 assay,colony formation assay,and Transwell migration and invasion assays.Western blot was performed to examine the impact of TUBB2A on the expression of key glycolytic proteins,including glucose transporter 1(GLUT1),pyruvate kinase M2(PKM2),and lactate dehydrogenase A(LDHA)in HCC cells under hypoxia.Results TCGA analysis revealed that TUBB2A expression is highly upregulated in HCC tissues compared to that in adjacent tissues and TUBB2A expression is associated with poorer overall survival(P<0.01).The mRNA expression of TUBB2A in HCC tissues from 30 HCC patients was higher than that in corresponding adjacent tissues,and TUBB2A expression is positively associated with the Ⅰ and Ⅳ clinic stage and AFP level of HCC patients(P<0.05).Hypoxia significantly increased TUBB2A mRNA and protein expression in HepG2 and Hep3B cells.Functional studies demonstrated that TUBB2A overexpression under hypoxia enhanced HCC cells proliferation,mobility and invasion,as well as increased the expression of GLUT1、PKM2 and LDHA(P<0.05 or P<0.01).On the contrary,TUBB2A knockout under hypoxia showed opposite effects,suppressed these malignant phenotypes and downregulated glycolytic markers(P<0.05 or P<0.01).Conclusions TUBB2A is significantly overexpressed in HCC and it is closely associated with poor prognosis.Our findings demonstrated that TUBB2A promotes proliferation,migration,invasion and glycolysis in HCC cells under hypoxia,suggesting its potential as a prognostic biomarker and therapeutic target of HCC.

This study investigated the incidence,prevention and control measures,diagnostic and treatment methods,and treatment costs of hoof diseases in dairy cows across 87 large-scale farms,aiming to provide a scientific basis and new insights for the treatment and prevention of hoof disea-ses in dairy herds.The results showed that the incidence rate of lameness in most farms was con-trolled between 3％and 7％,with a cure rate above 85％.The importance ranking of prevention and control measures was as follows:hoof trimming＞leveling the ground＞disinfection＞regular foot baths＞manure removal＞locomotion(lameness)scoring.The importance ranking of treat-ment measures was:hoof trimming＞disinfection and astringents＞anti-inflammatory treatment＞antibiotics＞block application＞traditional Chinese medicine(fire therapy).Economic analysis showed that the treatment cost of lameness was closely related to the incidence rate,with higher treatment expenses observed in farms with higher incidence rates.Farms with higher individual milk yields typically had more efficient disease management strategies,leading to lower treatment costs.Large-scale farms should continuously optimize management practices to reduce the occur-rence of lameness and improve overall farm efficiency by using effective treatment strategies.

The purpose of this study was to clarify the incidence of ketosis in dairy cows in large-scale dairy farms and the effect of ketosis on the subsequent lactation performance of dairy cows.In this experiment,79 perinatal cows in 8 stages of prenatal 21,14,7 days,delivery day,postpartum 3,7,14,21 days were selected to determine the blood biochemical indexes such as BHB,GLU,NE-FA and ALT in their blood.According to the concentration of BHB in the blood,they were divided into healthy group(CON),subclinical ketosis group(SCK)and clinical ketosis group(CK).There was a disorder of mineral elements in dairy cows in the experimental ranch,and the liver function of dairy cows was abnormal,and there was a disorder of energy metabolism.The incidence of keto-sis in dairy cows in the survey pasture was 26.14％,of which the incidence of SCK was 19.32％,and the incidence of CK was 6.82％,which was comparable to the global average incidence and lower than the average incidence in China.Compared with CON cows,SCK and CK cows had energy metabolism disorders and abnormal liver function,and CK cows were more serious.The milk yield of dairy cows with ketosis decreased significantly.The milk fat rate of dairy cows in SCK group was higher than that in CON group,while the milk fat rate of dairy cows in CK group was significantly lower than that in CON group.The fat-to-egg ratio of dairy cows in CK group was sig-nificantly lower than that in SCK group and CON group.The changes of lactation performance in different types of ketosis at 6 months after ketosis were different,and the lactation performance of dairy cows in CON group was the most stable.In the production of pastures,timely and effective treatment and management are essential for restoring the health and milk production performance of dairy cows.Ketosis can lead to disorder of energy metabolism and abnormal liver function in dairy cows,reduce milk yield,and have a continuous effect on lactation performance of dairy cows.Maintaining the health of dairy cows is the key to improving milk production and maintaining sta-ble lactation performance.For different types of ketosis cows,corresponding management and treatment measures should be taken to reduce economic losses.

Pulmonary arterial hypertension(PAH)is a serious and fatal cardiovascular disease that significantly affects patients'quality of life and survival.Current treatments offer some relief but have limited effectiveness and notable side effects.Sotatercept,as a novel drug,modulates the transforming growth factor-β(TGF-β)signaling pathway and shows promising therapeutic effects in PAH.By summarizing the pharmacological mechanisms and clinical research progress of sotatercept in PAH,assessing its application prospects,and analyzing future research directions in the light of current clinical research results,we provide an important perspective for understanding the clinical application of this drug in China,with a view to promoting its promotion and application in China.

Objective To analyze the CT manifestations of high altitude pulmonary edema(HAPE)to provide radiological evidence for its early and accurate diagnosis.Methods Totally 200 HAPE patients clinically confirmed at some hospital from April 2021 to April 2024 were enrolled into a study group,and 56 individuals undergoing health examinations at the hospital's physical examination center between January and June 2023 were included into a control group.Examinations were carried out with a United Imaging uCT528 40-slice spiral CT scanner.The patients in the study group were observed in terms of HAPE staging,the extent of pulmonary involvement,CT manifestations of different stages including location,distribution,density and morphology of pulmonary lesion.The diameters of the main pulmonary arteries and ascending aortas of the subjects in the two groups were measured,and the ratios of the two diameters were calculated.SPSS 25.0 software was used for statistical analysis.Results In the study group,there were 26 cases(13.0%)at early stage,105 ones at progression stage(52.5%),32 ones at critical outbreak stage(16.0%)and 37 ones at resolution and absorption stage(18.5%),and there were 35.5%with unilateral lung involvement and 64.5%with bilateral involvement.At early stage,HAPE chest CT manifestations included increased and thickened bilateral bronchovascular bundles,widened main pulmonary artery lumen and faint ground-glass opacity in lungs;at progression stage,HAPE chest CT manifestations revealed multiple cloud-like or patchy areas of increased density within lungs;at critical outbreak stage,CT scanning indicated diffuse patchy opacities and consolidation in lungs,white lung-like changes could be found in some severe cases,and bronchial air signs were shown within affected segments in some ones with severer signs in the right lung than in the left lung;at resolution and absorption stage the CT manifestations were similar to those at early stage,with lesions completely resolving after treatment.The study group had the diameters of the main pulmonary arteries greater while the diameters of the ascending aortas less than those of the control group,and the ratios of the diameters of the two diameters in the study group were higher than those in the control group,with the differences being statistically significant(all P<0.05).Conclusion Chest CT is an important examination method for the early diagnosis of HAPE and clarification of its clinical staging,which directly reflects the pulmonary pathological changes in HAPE patients and helps doctors fully understand the disease progression.