ObjectiveTo evaluate the efficacy and possible mechanism of Wei's Huoxue Tongluo Formula （韦氏活血通络方，WHTF） in treating atrophic-stage non-arteritic anterior ischemic optic neuropathy （NAION） with qi deficiency and blood stasis. MethodsA total of 82 atrophic-stage NAION patients with qi deficiency and blood stasis were randomly divided into a treatment group and a control group， with 41 cases in each group. The treatment group was given oral administration of WHTF twice a day plus acupoint injection of distilled water 2 ml at Taiyang （EX-HN5） once daily， while the control group received injection of compound anisodine injection 2 ml at Taiyang （EX-HN5） once daily and oral administration of WHTF placebo twice a day. Both groups received treatment for a course of 14 days. The best-corrected visual acuity （BCVA）， optic disc perfusion density （PD）， flux index （FI）， macular superficial PD， vascular density （VD）， and traditional Chinese medicine （TCM） syndrome scores were compared between groups before treatment and on day 7 and day 14 of treatment. Additionally， mean defect （MD） and mean sensitivity （MS） of visual fields were measured before treatment and on day 14， along with safety evaluation. ResultsAfter treatment， both groups showed significant improvement in BCVA， visual field MD and MS， and TCM syndrome scores （P＜0.05 or P＜0.01）. On day 14 of treatment， the TCM syndrome score in the treatment group was significantly lower than that in the control group （P＜0.05）. There was no significant improvement in optic disc PD and FI， and macular superficial PD and VD after treatment in either group （P＞0.05） except that on day 7 the macular superficial foveal PD in the control group was significantly better than that in the treatment group （P＜0.05）. During the treatment period， no serious adverse events occurred in either group. ConclusionWHTF can improve the visual function indicators including visual acuity and visual field， as well as TCM syndrome scores in atrophic-stage NAION patients with qi deficiency and blood stasis. It shows clinical safety， although it does not appear to have a significant effect on optic disc or macular blood flow.

To address the constrains imposed by insufficient hydrogen peroxide (H2O2) and high glutathione (GSH) expression in tumor cells on the efficacy of chemodynamic therapy (CDT), zeolitic imidazolate framework-8 (ZIF-8) loaded with disulfiram (DSF) and 3-amino-1,2,4-triazole (3-AT) was synthesized via a one-pot approach. Subsequently, hyaluronic acid (HA)-modified cupric peroxide (CuO2) was in-situ grown on its surface through biomineralization to construct a multifunctional copper-based nanozyme ADZCH (3-AT/DSF@ZIF-8@CuO2-HA). This nanoplatform disrupts the intratumoral H2O2 homeostasis, depletes GSH, and synchronously delivers DSF and Cu2+ via cascade catalysis, thereby enhancing CDT and sensitizing tumors to DSF-based chemotherapy. The results of physicochemical characterization indicated that ADZCH presented a uniform core-shell structure with favorable dispersibility. Its particle size and Zeta potential were 196.5 nm and −19.5 mV, respectively. It possessed a microporous structure with a specific surface area of 81.8600 m2/g, and demonstrated efficient loading capacity for DSF and 3-AT, achieving drug loading efficiencies of 5.91% and 45.07%, respectively. Moreover, ADZCH can continuously and slowly release drugs in an acidic environment and maintain good stability under diverse physiological conditions. In vitro functional assays verified that ADZCH catalytically generated H2O2 and hydroxyl radicals while concurrently depleting GSH in a concentration- and incubation time-dependent manner. Cellular uptake experiments showed that HA modification significantly improved the uptake of nanoparticles by 4T1 cells. Cytotoxicity tests showed that 80 μg/mL ADZCH had a significant cytotoxic effect on 4T1 cells but no significant toxicity on L929 cells. DCFH-DA probe detection indicated that ADZCH could significantly induce intracellular reactive oxygen species (ROS) generation, thereby enhancing CDT efficacy. Live/dead staining experiments showed that ADZCH efficiently induced apoptosis, with the proportion of dead cells reaching 94.74%, demonstrating its promising potential for anti-tumor applications.This study provides new research ideas and experimental basis for overcoming the tumor microenvironment barrier and enhancing the anti-tumor effect of CDT combined with chemotherapy.

Objective To explore the effect of Yinchenhao Decoction plus Zexie Decoction on ferroptosis mediated by IRE1 signaling pathway of endoplasmic reticulum stress in NASH mice.Methods Fifty C57BL/6J mice were randomly divided into blank control group,model group,Yinchenhao decoction group,Zexia decoction group and Hefang group,with 10 mice in each group.Except the blank control group,the other groups were fed with high-fat diet.After 20 weeks,Yinchenhao Tang group,Zexia Tang group and Hefang group were respectively given the corresponding drug by intragastric administration,once a day for 8 weeks.HE staining,oil red O staining and Masson staining were used to observe the pathological changes of liver tissue,automatic biochemical analyzer was used to detect blood lipid and liver function indexes,and RT-qPCR was used to detect the mRNA levels of TFR1,FPN,XBP1,Xbp1s and XBP1-dependent UPR target genes.The expressions of GRP78,P-IRE1α,GPX4,TFR1 and FPN proteins in liver were detected by Western Blot,the contents of Fe2+and MDA were detected by colorimetry,SOD activity was detected by WST-8,ROS content was detected by ELISA,and TG content in mouse liver tissue was detected by GPO-PAP.Results Compared with the model group,the NAS scores of Yinchenhao Tang group,Zexia Tang group and Hefang group were significantly reduced,and the effect of Hefang group was more significant.Compared with the blank control group,the liver lipid deposition of model mice was obvious,and the liver lipid deposition of Yinchenhao Tang group,Zexia group and Hefang group were improved to varying degrees,and the effect of Hefang group was more significant.Masson staining results showed that compared with blank control group,liver fibrosis was obvious in model group,Yinchenhao Decoction group,Zexia group and Hefang group,the degree of liver fibrosis was improved,and the effect of Hefang group was more significant.Compared with the blank control group,the levels of serum TC,HDL-C,LDL-C,AST and ALT in the model group were significantly increased,the contents of TG,Fe2+,MDA and ROS in the liver were significantly increased,and the activity of SOD was significantly decreased.The mRNA expression levels of Xbp1,Xbp1s,Dnajb9,Edem1,Sec61a1,Bip,Chop and TFR1were significantly up-regulated,the mrna expression levels of FPN were significantly down-regulated,and the protein expression levels of GRP78,P-IREα,GPX4 and TFR1 in liver were significantly increased.The expression level of FPN protein decreased significantly.Compared with model group,the serum levels of TG,TC,LDL-C,AST and ALT in the combined formula group were significantly decreased,the contents of TG,Fe2+,MDA and ROS in the liver of the combined formula group were significantly decreased,and the activity of SOD was significantly increased.The mRNA expression levels of Xbp1,Xbp1s,Dnajb9,Edem1,Sec61a1,Bip,Cho and TFR1 in liver were significantly decreased,the mrna expression level of FPN was significantly increased,and the protein expression levels of GRP78,P-IRE1α,GPX4 and TFR1 in liver were significantly down-regulated.The expression level of FPN protein was significantly up-regulated.Conclusion Yinchenhao Decoction plus Zexie Decoction may ameliorate NASH by inhibiting ferroptosis of hepatocytes through IRE1α pathway of endoplasmic reticulum stress.

Objective:To analyze the effect of dapagliflozin tablet combined with creatine phosphate sodium on blood glucose and cardiac function in patients with type 2 diabetes mellitus (T2DM) complicated with heart failure.Methods:A total of 80 patients with T2DM complicated with heart failure who received treatment in the Rehabilitation University Qingdao Hospital (Qingdao Municipal Hospital) from October 2021 to October 2022 were selected prospectively as the subjects, and they were randomly divided into two groups with 40 cases in each group by envelope method. The control group was treated with conventional methods, and the observation group was treated with dapagliflozin tablet combined with sodium creatine phosphate on the basis of conventional methods. Both groups completed the treatment for 3 months. The clinical efficacy, blood glucose control effect, cardiac function and serum indexes of the two groups were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group: 95.00%(38/40) vs. 75.00%(30/40), there was statistical difference ( χ2 = 6.28, P<0.05). After treatment, the levels of fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin in the observation group were lower than those in the control group: (6.98 ± 0.67) mmol/L vs. (7.81 ± 0.78) mmol/L, (7.87 ± 1.58) mmol/L vs. (9.58 ± 1.49) mmol/L, (6.95 ± 0.57)% vs. (7.41 ± 0.60)%, there were statistical differences ( P<0.05). After treatment, the levels of left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), serum interleukin6 (IL-6), C-reactive protein (CRP) and brain natriuretic peptide (BNP) in the observation group were lower than those in the control group: (61.76 ± 3.55) mm vs. (64.01 ± 3.87) mm, (45.45 ± 3.58) mm vs. (47.71 ± 3.62) mm, (8.99 ± 0.95) ng/L vs.(10.28 ± 1.16) ng/L, (4.28 ± 1.17) mg/L vs. (5.57 ± 1.31) mg/L, (199.90 ± 34.12) ng/L vs. (250.73 ± 35.11) ng/L; the cardiac output (CO) and left ventricular ejection fraction (LVEF) in the observation group were higher than those in the control group: (4.95 ± 1.06) L/min vs. (4.13 ± 0.92) L/min, (44.51 ± 3.68)% vs. (42.15 ± 3.73)%, there were statistical differences ( P<0.05). Conclusions:Dapagliflozin tablets combined with creatine phosphate sodium can improve the effective rate of patients with T2DM complicated with heart failure, reduce the level of blood sugar, help to improve the heart function, and reduce the levels of serum inflammatory factors.

This paper reviews the current situation of massive open online course (MOOC) construction both domestically and internationally, highlighting the similarities, differences, and limitations of MOOC construction across nations. Based on the full-cycle MOOC construction of the "clinical epidemiology" course at Southern Medical University, including course design, resource integration, online deployment, and teaching evaluation, this study explored the significance, implementation path, and challenges of MOOC construction. This paper also reflects on the activation of teaching content, teacher-student interaction, and teaching mode, aiming to provide a reference for the construction and continuous enhancement of MOOC in China.

Objective:To investigate the application value of robotic-assisted surgery for pancreatic cancer after neoadjuvant chemotherapy (NAT).Methods:The retrospective and descrip-tive study was conducted. The clinicopathological data of 10 pancreatic cancer patients who underwent robotic-assisted surgery after NAT at The First Affiliated Hospital of Sun Yat-sen University from November 2021 to January 2025 were collected. There were 7 male and 3 female, aged (62±7)years. Observation indicators: (1) NAT conditions; (2) intraoperative conditions; (3) postoperative condi-tions; (4) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. The Kaplan-Meier method was used to calculate survival time. Results:(1) NAT conditions. Of the 10 patients, 4 cases had tumor surrounding the portal vein or superior mesenteric vein more than 180° (no invasion of superior mesenteric artery), 3 cases had concomitant hepatic oligometastasis, and 3 cases had tumor invasion of adjacent organ (2 cases with tumor invasion of left kidney, 1 case with tumor invasion of duodenum). Nine of the 10 patients received chemotherapy of gemcitabine+albumin-paclitaxel, and the other 1 patient received chemo-therapy of fluorouracil + irinotecan + oxaliplatin. After treatment, 3 patients were evaluated as partial remission and 7 patients were evaluated as stable disease. (2) Intraoperative conditions. Of the 10 patients, 5 cases received robotic-assisted pancreatoduodenectomy and 5 cases received robotic-assisted radical antegrade modular pancreatosplenectomy, with no case converted to open surgery. There were 3 cases receiving combined vascular resection and reconstruction, including 2 cases with portal vein resection plus side wall repairing and 1 case with superior mesenteric vein resection plus end to end anastomosis. There were 2 cases receiving combined other organ resection intra-operatively, including 1 case with local hepatectomy and 1 case with left nephrectomy. The operation time of 10 patients was 465(range, 195?565)minutes, volume of intraoperative blood loss was 70(range, 20?350)mL. One case with preoperative anemia required red blood cell transfusion during the operation, while the other cases did not receive any transfusion during the operation. All 10 patients achieved R 0 resection and the number of lymph node dissected was 12±8. Three patients who underwent combined vascular resection and reconstruction had negative margin of the portal vein or superior mesenteric vein. (3) Postoperative conditions. Duration of postoperative hospital stay of 10 patients was (15±8)days, and 1 case developed major complications in grade Ⅲa of Clavein-Dindo classfication. Of the 10 patients, 1 case developed grade B pancreatic fistula, 1 case experienced delayed gastric emptying, and no case had postoperative biliary fistula, chyle leakage, abdominal or anastomotic bleeding, no case underwent reoperation, no case died within postoperative 30 days. (4) Follow-up. All 10 patients were followed up after surgery for 10.0(range, 2.7?40.4)months. All 10 patients underwent postoperative adjuvant chemotherapy, and the time from surgery to the start of adjuvant chemotherapy was (40±12)days. The median overall survival time of 10 patients was 30.4 months, and the median recurrence-free survival time was 10.9 months. Conclusion:Robotic-assisted surgery can be used for pancreatic cancer after neoadjuvant chemotherapy.

The conventional identification and prediction for failures of medical equipment mainly depend on experience and knowledge of manager for equipment,which are not able to be quantified and have lower efficiency. Therefore,it is obvious that the prediction for the failure of medical equipment is not accurate. With the technical development of computer and machine learning,the conventional identification and prediction that depend on experiences can deal with characteristics of failures through machine learning method to improve efficiency,which are hopeful in filling the gap of discipline about the identification and prediction for failures of medical equipment. This article summarized the application situation of machine learning in identifying and predicting failures of the medical equipment and the similarly electric equipment at home and abroad. Based on the key technique of identification and prediction,this article proposed suggestion about corresponding design architecture. According to the characteristics of the failure of medical equipment,this article summarized a series of information about algorithms of various machine learning in scene and accurate rate of identification and prediction,so as to provide references for relevant research of this field.

Objective:To analyze the relationships among sense of coherence, social avoidance and distress, and severity of depressive symptoms in adolescent patients with depression.Methods:A total of 98 adolescent patients with depression hospitalized at the Affiliated Mental Health Center of Zhejiang University School of Medicine (Hangzhou Seventh People's Hospital) from June 2023 to January 2024 were selected by convenience sampling. The Center for Epidemiologic Studies Depression Scale (CES-D), the Sense of Coherence Scale-13 (SOC-13), and the Social Avoidance and Distress Scale (SADS) were used for assessment. Pearson correlation analysis was conducted to examine the correlations among severity of depressive symptoms, sense of coherence, and social avoidance and distress. A structural equation model was established using AMOS 23.0 software, and the mediating effect was verified by the percentile Bootstrap method with the PROCESS macro.Results:The CES-D total score of the 98 patients was (22.36±1.75) ; the SOC-13 total score was (55.02±3.38), with the highest dimension score in manageability (mean 4.38±0.52 per item). The SADS total score was (19.40±1.39), including a score of (10.26±0.98) for social avoidance and (9.14±1.01) for social distress. Pearson correlation analysis indicated that CES-D total score was negatively correlated with SOC-13 total score and positively correlated with SADS total score ( P<0.05). Mediation analysis showed that social avoidance and distress partially mediated the relationship between sense of coherence and severity of depressive symptoms in adolescents with depression, with a mediation effect value of -0.333, accounting for 62.95% of the total effect (-0.333/-0.529) . Conclusions:Adolescent patients with depression had a generally low level of sense of coherence and a high level of social avoidance and distress. Sense of coherence was negatively correlated with social avoidance and distress.

The conventional identification and prediction for failures of medical equipment mainly depend on experience and knowledge of manager for equipment,which are not able to be quantified and have lower efficiency. Therefore,it is obvious that the prediction for the failure of medical equipment is not accurate. With the technical development of computer and machine learning,the conventional identification and prediction that depend on experiences can deal with characteristics of failures through machine learning method to improve efficiency,which are hopeful in filling the gap of discipline about the identification and prediction for failures of medical equipment. This article summarized the application situation of machine learning in identifying and predicting failures of the medical equipment and the similarly electric equipment at home and abroad. Based on the key technique of identification and prediction,this article proposed suggestion about corresponding design architecture. According to the characteristics of the failure of medical equipment,this article summarized a series of information about algorithms of various machine learning in scene and accurate rate of identification and prediction,so as to provide references for relevant research of this field.

Objective:To analyze the effect of dapagliflozin tablet combined with creatine phosphate sodium on blood glucose and cardiac function in patients with type 2 diabetes mellitus (T2DM) complicated with heart failure.Methods:A total of 80 patients with T2DM complicated with heart failure who received treatment in the Rehabilitation University Qingdao Hospital (Qingdao Municipal Hospital) from October 2021 to October 2022 were selected prospectively as the subjects, and they were randomly divided into two groups with 40 cases in each group by envelope method. The control group was treated with conventional methods, and the observation group was treated with dapagliflozin tablet combined with sodium creatine phosphate on the basis of conventional methods. Both groups completed the treatment for 3 months. The clinical efficacy, blood glucose control effect, cardiac function and serum indexes of the two groups were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group: 95.00%(38/40) vs. 75.00%(30/40), there was statistical difference ( χ2 = 6.28, P<0.05). After treatment, the levels of fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin in the observation group were lower than those in the control group: (6.98 ± 0.67) mmol/L vs. (7.81 ± 0.78) mmol/L, (7.87 ± 1.58) mmol/L vs. (9.58 ± 1.49) mmol/L, (6.95 ± 0.57)% vs. (7.41 ± 0.60)%, there were statistical differences ( P<0.05). After treatment, the levels of left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), serum interleukin6 (IL-6), C-reactive protein (CRP) and brain natriuretic peptide (BNP) in the observation group were lower than those in the control group: (61.76 ± 3.55) mm vs. (64.01 ± 3.87) mm, (45.45 ± 3.58) mm vs. (47.71 ± 3.62) mm, (8.99 ± 0.95) ng/L vs.(10.28 ± 1.16) ng/L, (4.28 ± 1.17) mg/L vs. (5.57 ± 1.31) mg/L, (199.90 ± 34.12) ng/L vs. (250.73 ± 35.11) ng/L; the cardiac output (CO) and left ventricular ejection fraction (LVEF) in the observation group were higher than those in the control group: (4.95 ± 1.06) L/min vs. (4.13 ± 0.92) L/min, (44.51 ± 3.68)% vs. (42.15 ± 3.73)%, there were statistical differences ( P<0.05). Conclusions:Dapagliflozin tablets combined with creatine phosphate sodium can improve the effective rate of patients with T2DM complicated with heart failure, reduce the level of blood sugar, help to improve the heart function, and reduce the levels of serum inflammatory factors.