Animal models combining disease and syndrome are important research tools to explore the nature of traditional Chinese medicine (TCM) syndromes. At present, the construction and evaluation methods of animal models have preliminarily established the foundation for standardized development. Qi-yin deficiency syndrome is a common type of TCM syndrome in cardiovascular diseases. It is an important pathogenic factor causing the onset, pathological damage, and chronic nature of cardiovascular diseases, as well as triggering other illnesses. The establishment of an animal model of cardiovascular disease with the characteristics of Qi-yin deficiency, along with an objective and standardized evaluation system, has become an important part of modern cardiovascular disease research. In recent years, research on the construction and evaluation of animal models of heart Qi-yin deficiency syndrome has increased, but the construction methods and evaluation criteria vary. Compared with other animal models, the literature is limited, lacking statistics and overall analysis. Therefore, based on the scientific connotation of heart Qi-yin deficiency syndrome, this article systematically reviews the evaluation system of its animal model, covering multidimensional methods such as macroscopic characterization assessment, physicochemical indicators and objective evaluation, and syndrome differentiation based on prescriptions. The specific model construction strategies are described, including single-factor induction methods (sleep deprivation, chronic intermittent hypoxia, arterial occlusion, high-salt feeding) and the compound-factor induction methods (sleep deprivation combined with drug method, chronic intermittent hypoxia combined with drug method, exhaustive swimming combined with drug method). Meanwhile, application examples of each model in the research are listed, the existing problems in the current model construction and evaluation are analyzed, and optimization directions are proposed, such as promoting the compound factor induction strategy and improving the objectivity of the evaluation criteria. This article aims to provide theoretical references for constructing an animal model of heart Qi-yin deficiency syndrome that conforms to TCM characteristics, and thereby laying a scientific foundation for the prevention and treatment of cardiovascular diseases with TCM.

OBJECTIVE: To precise classify sacral meningeal cysts, effective guide minimally invasive neurosurgery and postoperative personalized rehabilitation by multiple dimensions radiographic reconstruction MRI. METHODS: From March to December 2021, based on the original 3D-fast imaging employing steadystate acquisition (FIESTA) scanning sequence, 92 patients with sacral meningeal cysts were pre-operatively evaluated by multiple dimensional reconstruction MRI. The shape of nerve root and the leakage of cyst were reconstructed according to the direction of nerve root or leakage track showed on original MRI scans. Sacral canal cysts were accurately classified as including nerve root and without nerve root, so as to accurately design the incision of skin and formulate corresponding open range of the posterior wall of the sacral canal. Under the microscope intraoperation, the shape of the nerve roots inside cysts or leakage track of the cysts without nerve roots were verified and explored. After the reinforcement and shaping operation, several reexaminations of multiple dimensional reconstruction MRI were performed to understand the deformation of the nerve root and hydrops in the operation cavity, so as to formulate a persona-lized rehabilitation plan for the patients. RESULTS: Among the 92 patients with sacral mengingeal cyst, 58 (63.0%) cysts with nerve root cyst, 29 (31.5%) cysts without nerve root cyst, and 5 (5.4%) cysts with mixed sacral canal cyst. In 58 patients with nerve root cysts, the accuracy of preoperative clinical classification on MRI image reached 96.6% (56/58) through confirmation by operating microscope. Only 2 cases of large single cyst with nerve root on the head of cyst were mistaken for without nerve root type. In 29 patients with sacral cyst without nerve root, the accuracy of preoperative image reached 100% through confirmation by operating microscope. The accuracy of judging the internal nerve root and leakage of 12 cases with recurrent sacral cyst was also 100%. Two cases of delayed postoperative hydrops were found one month after operation. After rehabilitation treatment by moxibustion and bathing, the hydrops disappeared 4-6 months after operation. CONCLUSION Multiple dimensional reconstruction MRI can precisely make clinical classification of sacral meningeal cysts before operation, guide minimally invasive neurosurgery effectively, and improve the rehabilitation effect.
Humans ; Magnetic Resonance Imaging/methods* ; Male ; Female ; Sacrum/surgery* ; Adult ; Middle Aged ; Imaging, Three-Dimensional/methods* ; Cysts/rehabilitation* ; Aged ; Adolescent ; Young Adult ; Spinal Nerve Roots/diagnostic imaging* ; Minimally Invasive Surgical Procedures ; Neurosurgical Procedures/methods*

Objective:To investigate the current status of self-regulatory fatigue in patients after hematopoietic stem cell transplantation (HSCT) and analyze its influencing factors.Methods:From March 2022 to September 2023, convenience sampling was used to select 161 HSCT patients who were hospitalized and followed up in the Hematology Department of a Class Ⅲ Grade A hospital in Jinan City. A survey was conducted on patients using the General Information Questionnaire, Self-Regulatory Fatigue Scale (SRF-S), Perceived Social Support Scale, Connor and Davidson Resilience Scale, and Medical Coping Modes Questionnaire. Pearson correlation was used to analyze the correlation between self-regulatory fatigue and perceived social support, psychological resilience, and medical coping styles in patients after HSCT. Multiple linear regression was used to analyze the influencing factors of self-regulatory fatigue in patients after HSCT.Results:A total of 161 questionnaires were distributed, and 156 valid questionnaires were collected, with an effective response rate of 96.89% (156/161). The total SRF-S score of 156 patients after HSCT was (49.06±6.62). Multiple linear regression analysis showed that the current work or life status, perceived social support, psychological resilience, avoidance and surrender coping styles were the influencing factors of self-regulatory fatigue in patients after HSCT ( P<0.05) . Conclusions:After HSCT, patients generally experience self-regulatory fatigue, and psychological distress needs improvement. Medical and nursing staff should regularly evaluate the self-regulatory fatigue of patients and develop targeted intervention measures based on influencing factors to reduce the degree of self-regulatory fatigue of patients, improve their prognosis and psychological state.

Objective:To explore the different categories of home-based functional exercise adherence in patients undergoing total knee arthroplasty (TKA), identify the influencing factors, and provide a reference for the development of personalized intervention strategies.Methods:A cross-sectional study was conducted using convenience sampling to select 320 patients who underwent unilateral primary TKA at The First Affiliated Hospital of Shandong First Medical University between November 2022 and January 2023. The Orthopedic Functional Exercise Compliance Scale, Rehabilitation Self-Efficacy Scale, and Social Support Rating Scale were used for data collection. Latent profile analysis was employed to identify the latent characteristics of home-based functional exercise adherence in TKA patients. Univariate analysis and logistic regression were used to explore the influencing factors among different subgroups.Results:A total of 320 questionnaires were distributed, with 307 valid responses, yielding a recovery rate of 95.94%. The 307 patients were classified into three latent profile categories based on their characteristics: low adherence group (29.32%, 90/307), moderate adherence group (46.58%, 143/307), and high adherence group (24.10%, 74/307). Logistic regression analysis revealed that the number of comorbidities, marital status, home rehabilitation environment, pain score, education level, social support, and rehabilitation self-efficacy were influencing factors for home-based exercise adherence in TKA patients ( P< 0.05) . Conclusions:Home-based functional exercise adherence in TKA patients can be categorized into three latent profiles. Healthcare providers should implement targeted interventions based on the specific characteristics of each patient, with a focus on those with low adherence, to enhance their compliance with home-based exercises.

Objective:To summarize the experience of brain death determination under veno-arterial extracorporeal membrane oxygenation (VA-ECMO) assisted circulatory support, especially apnea test (AT) precautions, and to provide references for brain death determination in this scenario.Methods:In 78 patients who had VA-ECMO at Organ Transplant Center, Zhengzhou People's Hospital from October 2019 to December 2023, 8 organ donors had brain death determination under VA-ECMO assisted circulatory support. Baseline data, clinical data, and VA-ECMO data during AT trial were collected from these 8 patients to summarize the process of brain death determination.Results:Six of the 8 donors met the criteria of brain death; 10 EEG, 12 evoked potentials and 15 ATs were performed. Complications in ATs, including hypotension, decreased oxygenation and arrhythmia, were alleviated after timely improved VA-ECMO flow and applied cardiotonic and pressor drugs.Conclusion:AT is key for successful brain death determination in organ donors under VA-ECMO assisted circulatory support; therefore, complications should be closely monitored and managed.

OBJECTIVES: Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal cell carcinoma (RCC), and developing personalized treatment strategies is crucial for improving patient prognosis. This study aims to develop and validate a preoperative computer tomography (CT) radiomics-based predictive model to estimate Ki-67 expression in ccRCC patients, thereby assisting in clinical treatment decisions and prognosis prediction. METHODS: A retrospective analysis was conducted on 214 ccRCC patients who underwent surgical treatment at Gansu Provincial Hospital between January 2018 and November 2023. Patients were classified into high Ki-67 expression (n=123) and low Ki-67 expression (n=91) groups based on postoperative immunohistochemical staining results. The dataset was randomly divided in a 7꞉3 ratio into a training set (n=149) and a validation set (n=65). Preoperative contrast-enhanced urinary CT images and clinical data were collected. After preprocessing, 5 mm arterial-phase CT images were manually segmented layer by layer to delineate the region of interest (ROI) using ITK-SNAP 3.8 software. Radiomic features were then extracted using the FeAture Explorer (FAE) package. Dimensionality reduction and feature selection were performed using the least absolute shrinkage and selection operator (LASSO) algorithm, yielding the optimal feature set. Three classification models were constructed using logistic regression (LR), multilayer perceptron (MLP), and support vector machine (SVM). The receiver operating characteristic (ROC) curve, area under the curve (AUC), decision curve analysis (DCA), and calibration curves were used for model evaluation. RESULTS: A total of 107 radiomic features were extracted from 5 mm arterial-phase CT images, and twenty-one features significantly associated with Ki-67 expression were selected using the LASSO algorithm. Predictive models were developed using LR, MLP, and SVM classifiers. In the training and validation sets, the AUC values for each model were 0.904 (95% CI 0.852 to 0.956) and 0.818 (95% CI 0.710 to 0.926) for the LR model, 0.859 (95% CI 0.794 to 0.923) and 0.823 (95% CI 0.716 to 0.929) for the MLP model, and 0.917 (95% CI 0.865 to 0.969) and 0.857 (95% CI 0.760 to 0.953) for the SVM model. DCA demonstrated that all models had good clinical net benefit, while calibration curves indicated high accuracy of the predictions, supporting the robustness and reliability of the models. CONCLUSIONS A CT radiomics-based model for predicting Ki-67 expression in ccRCC was successfully developed. This model provides valuable guidance for treatment planning and prognostic assessment in ccRCC patients.
Humans ; Carcinoma, Renal Cell/surgery* ; Kidney Neoplasms/surgery* ; Tomography, X-Ray Computed/methods* ; Ki-67 Antigen/metabolism* ; Retrospective Studies ; Female ; Male ; Middle Aged ; Aged ; Prognosis ; Adult ; Preoperative Period ; Radiomics

Objective:To investigate the intention of medical students to be vaccinated against COVID-19 and to analyze the influencing factors.Methods:A self-filled electronic questionnaire survey was conducted among medical students from a medical school in Shanghai randomly selected from June 21 to 29, 2021. The questionnaire contained items of basic information, intention for COVID-19 vaccination, awareness of COVID-19 prevention measures and awareness of COVID-19 vaccine. Logistic regression was used to analyze the influencing factors.Results:The average age of the 966 respondents was (20.4±2.9) years, and 63.6% (614/966) of them were female;23.7% (229/966) of them had family members or relatives who had participated in anti-pandemic work or volunteer service;90.6% (875/966) of the respondents expressed they were very willing or willing to be vaccinated against COVID-19. The majority of the respondents thought that “COVID-19 infection is very serious” (94.3%, 911/966), “good protection can effectively prevent COVID-19 infection” (92.4%, 893/966), and “they can fully implement all kinds of protection measures” (73.5%, 710/966). About half of the respondents (51.8%, 501/966) knew about the adverse reactions and contraindications of COVID-19 vaccine. The low protected capability (47.4%, 458/966), short duration of protection (50.6%, 489/966), and many side effects (48.7%, 470/966) were the major concerns about COVID-19 vaccine. Logistic regression analysis showed that people thought that “COVID-19 infection is very serious” ( OR=5.30, 95 %CI:2.60-10.81, P<0.001), thought that “good protection can effectively prevent COVID-19 infection” ( OR=2.46, 95 %CI:1.26-4.81, P=0.009), thought that “they can fully implement all kinds of protection measures” ( OR=2.55, 95 %CI:1.53-4.25, P<0.001) were more willing to receive COVID-19 vaccination. While those concerned about vaccine quality did the opposite ( OR=0.29, 95 %CI:0.13-0.65, P=0.003). Conclusions:Medical students have a high intention of vaccination against COVID-19. The vaccine-related knowledge quality should be emphasized in future publicity to further enhance the intention of COVID-19 vaccination.

OBJECTIVE To investigate the pharmacodynamic effects of the Citri Grandis Exocarpium extract on anorexia model immature rats.METHODS Ten immature rats were randomly selected as the control group and given regular diet， while anorexia model was induced in the remaining 50 immature rats using the etiological simulation method. The immature model rats were divided into the model group， Jianwei xiaoshi tablet group （0.65 g/kg）， Citri Grandis Exocarpium extract low-dose， medium- dose and high-dose groups （0.5， 1.0， 2.0 g/kg）. After 14 d of continuous intragastric administration， the body mass and food intake of rats in each group were observed， and the gastric acid concentration， pepsinase activity， serum levels of gastrin （GAS）， motilin （MTL） and gastric inhibitory peptide （GIP） were measured. The histopathological changes in the gastric tissue were observed.RESULTS Compared with control group， the food intake， gastric acid concentration， pepsin activity， the levels of GAS and MTL were significantly decreased and GIP level was significantly increased in the immature rats of model group （P＜0.05）； gastric histopathological examination showed significant gastric mucosal congestion and loosening and detachment of epithelial cells. Compared with model group， all administration groups showed different degrees of improvement in the above indexes and decreased gastric histopathological damage after drug intervention.CONCLUSIONS Citri Grandis Exocarpium extract improves gastric motility and protects gastric mucosa in the immature rats by regulating the concentration of gastric acid， pepsin activity， the levels of GAS， MTL and GIP， thus improving anorexia in immature rats.

[摘 要] 目的：探讨叉头框蛋白D3（forkhead box protein D3，FOXD3）在胃贲门腺癌（gastric cardia adenocarcinoma，GCA）中的表达及其对SGC-7901细胞生物学行为的影响。方法：从河北医科大学第四医院生物标本库中选取2014年6月至2016年12月手术切除的49例GCA组织及相应癌旁组织标本，qRT-PCR检测FOXD3在GCA组织、癌旁组织以及在5种胃癌细胞系中（BGC-823、SGC-7901、HGC-27、MGC-803及NCI-N87）的表达。向SGC-7901细胞转染pc-DNA3.1-FOXD3或pc-DNA3.1，采用细胞增殖实验、克隆形成实验、划痕愈合实验和Transwell小室侵袭实验分别检测FOXD3过表达对SGC-7901细胞增殖、克隆形成、迁移和侵袭的影响，qRT-PCR及WB法检测细胞转染前后上皮-间质转化（epithelial-mesenchymal transition，EMT）相关分子mRNA及蛋白的表达情况，流式细胞术检测转染前后细胞周期改变。结果：GCA组织中FOXD3 mRNA的表达量明显降低，其表达水平与患者临床分期和淋巴结转移密切关联；FOXD3在胃癌细胞系中的表达均低于正常细胞（均P<0.01）。FOXD3过表达能明显抑制SGC-7901细胞的增殖、克隆形成、迁移和侵袭能力（均P<0.01），提高SGC-7901细胞中E-cadherin的表达水平，减少N-cadherin、β-catenin和vimentin的表达水平（均P<0.01），使细胞周期阻滞在G0/G1期（P<0.01）。结论: FOXD3在GCA组织中的表达明显下调，其过表达可以抑制胃癌细胞的生物学行为，FOXD3可作为抑癌基因为肿瘤治疗提供新思路。

[Abstract] Objective: To investigate the expression of lncRNA linc01503 in esophageal squamous cell carcinoma (ESCC) tissues and cell lines, as well as its effect on the proliferation, invasion and epithelial-mesenchymal transition (EMT) of ESCC cells. Methods: A total of 119 pairs of tumor tissues and corresponding para-cancerous tissues of ESCC patients were obtained from the Fourth Affiliated Hospital of Hebei Medical University between Jan. 2012 and Dec. 2014. The expression of linc01503 in ESCC tissues and cell lines (Kyse150, Kyse170, Eca109, TE1 and TE13) was detected by qPCR. The ESCC cells were transfected with pGPU6-shRNA-linc01503 or treated with TGF-β. The expressions of EMT related genes before and after transfection as well as linc01503 expression before and after TGF-β treatment were detected with qPCR. MTS and Transwell assay were performed to assess the effect of linc01503 on proliferation and invasion of ESCC cells. Results: The expression of linc01503 was significantly elevated in ESCC tissues and cell lines (all P<0.05). High expression of linc01503 was correlated with lymph node metastasis, depth of infiltration, TNM stage and the survival of ESCC patients (all P<0.05). Treatment with TGF-β promoted EMT of ESCC cells and induced a significant up-regulation of linc01503 expression. Knockdown of linc01503 significantly inhibited proliferation and invasion ability of ESCC cells; Meanwhile, the low expression of linc01503 increased the expression of E-cadherin but decreased the expressions of N-cadherin and vimentin (all P<0.05). Conclusion: lncRNA linc01503, as one of the downstream effect genes of TGF- β, promotes the proliferation, invasion and EMT process of ESCC cells.