1.Lightweight end-to-end model-based korotkoff sounds phase identification and blood pressure measurement
Zhiyu JIANG ; Wenyi KOU ; Li LI ; Qijun ZHAO ; Yongjun QIAN ; Fan PAN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(02):248-254
Objective To propose a lightweight end-to-end neural network model for automated Korotkoff sound phase recognition and subsequent blood pressure (BP) measurement, aiming to improve measurement accuracy and population adaptability. Methods We developed a streamlined architecture integrating depthwise separable convolution (DSConv), multi-head attention (MHA), and bidirectional gated recurrent unit (BiGRU). The model directly processes Korotkoff sound time-series signals to identify auscultatory phases. Systolic BP (SBP) and diastolic BP (DBP) were determined using phase Ⅰ and phaseⅤdetections, respectively. Given the clinical relevance of phase Ⅳ for specific populations (e.g., children and pregnant women, denoted as DBPⅣ), BP values from this phase were also recorded.Results The study enrolled 106 volunteers with 70 males and 36 females at mean age of (40.0±12.0) years. The model achieved 94.25% phase recognition accuracy. Measurement errors were (0.1±2.5) mm Hg (SBP), (0.9±3.4) mm Hg (DBPⅣ), and (0.8±2.6) mm Hg (DBP). Conclusion Our method enables precise phase recognition and BP measurement, demonstrating potential for developing population-adaptive blood pressure monitoring systems.
2.Isotemporal substitution analysis of 24 hour activity behaviors on fine motor development among preschool children
ZHANG Chu an, WEN Lei, FU Jinmei, ZHANG Zhiyu, ZHANG Shuna, WEN Xinghui, ZHAO Guanggao
Chinese Journal of School Health 2026;47(3):413-416
Objective:
To investigate the relationship between 24 hour activity behaviors and fine motor development in preschool children, and to simulate the effects of reallocating time among different activity behaviors on fine motor development using isotemporal substitution analysis.
Methods:
From March to July 2022, a stratified cluster random sampling method was used to recruit 447 preschool children aged 3-6 years (254 boys and 193 girls) from Pingxiang City, Jiangxi Province. The 24 hour activity behaviors in preschool children were measured using ActiGraph wGT3-BT accelerometers and subjective sleep reports. Fine motor development was assessed using the Gesell Developmental Schedules. A component linear regression model was employed to analyze the impact of 24 hour activity behaviors on the development of fine motor activities, and the potential effects of adjusting activity behaviors were simulated through an isochoric substitution model.
Results:
The daily durations of sedentary behavior (SB) was ( 572.92 ±102.96) min (accounting for 39.79% of 24 h), the duration of light physical activity (LPA) was (131.21± 38.11 ) min ( 9.11% ), the duration of moderate to vigorous physical activity (MVPA) was (65.61±22.21) min (4.56%), and sleep duration was (670.65±57.58) min (46.82%). Sleep composition was positively associated with fine motor development ( β =2.74), while MVPA ( β =-0.84) and SB ( β =-1.93) compositions were negatively associated with fine motor development (all P <0.01). Isochoric substitution analysis showed that sleep had positive effects on the development of fine motor skills when replacing other activity behaviors (all P < 0.05), with the substitution effect for MVPA being the most significant and gradually increasing with the duration of substitution (60 min: β =28.66); sleep replacement of SB and LPA also showed positive effects (60 min: β =4.25, 2.00) (all P < 0.05). On the contrary, the substitution of sleep with MVPA showed negative effects (60 min: β =-7.86), and the substitution of LPA and SB with MVPA also showed negative effects (60 min: β =-5.65, -3.40) (all P <0.05).
Conclusions
The overall composition of 24 hour activity behaviors is associated with fine motor development in preschool children, with sleep playing a crucial role. Ensuring adequate sleep and optimizing the structure of activity behaviors may effectively promote the development of fine motor skills in preschool children.
3.Traditional Chinese Medicine Interventions in Oligoasthenospermia-related Signaling Pathways: A Review
Tao ZHANG ; Maobin YU ; Zhiyu WU ; Tang TANG ; Yipeng ZHAO ; Shikuan LU ; Meijun LIU ; Peihai ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(17):314-322
Oligoasthenospermia (OAS) is the common cause of male infertility,bringing fertility problems to many families. Its pathogenesis is complex,involving endocrine disorders,reproductive system infection,oxidative stress injury,immune dysfunction and other aspects. At present,the Western medicine treatment of OAS is mainly based on drugs,surgery,and assisted reproductive technology. However,drug therapy has certain side effects,and long-term use is easy to produce drug resistance. Surgical treatment has certain trauma and risk. Assisted reproductive technology is not widely available because of its high cost. Therefore,there is an urgent need to develop safer,economical,and effective treatment options. Traditional Chinese medicine (TCM) has obvious advantages in the treatment of OAS. It can play a role in the treatment of OAS by reducing oxidative stress,inhibiting inflammatory response,reducing apoptosis,and regulating cell autophagy through multiple pathways and targets. Recent studies have shown that TCM compound prescriptions,single medicinal materials,medicinal pairs,and their active components can ameliorate OAS by regulating several key signaling pathways such as the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) pathway,Janus kinase 2/signal transducer and activator of transcription 3(JAK2/STAT3) pathway,nuclear factor E2-related factor 2/heme oxygenase-1 (Nrf2/HO-1) pathway,stem cell factor/tyrosine kinase receptor (SCF/c-kit) pathway,nuclear factor-κB (NF-κB) pathway,transforming growth factor-β (TGF-β)/Smads pathway,and extracellular regulated protein kinase (ERK) pathway. This article summarizes the role of the above signaling pathways in the occurrence and development of OAS and the therapeutic mechanism of TCM,aiming to provide a scientific basis for the clinical treatment of OAS and the research and development of drugs.
4.Experimental study on the method of establishing a pig left lung orthotopic transplantation model
Heng ZHAO ; Jinteng FENG ; Shan GAO ; Rui ZHAO ; Hongyi WANG ; Ye SUN ; Yixing LI ; Haotian BAI ; Runyi TAO ; Bin HE ; Zhiyu WANG ; Yanpeng ZHANG ; Borui SUN ; Shuo LI ; Guangjian ZHANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(08):1275-1281
Objective To explore the method for establishing a pig left lung orthotopic transplantation model. Methods A total of 4 male Yorkshire pigs weighing (40.0±2.5) kg underwent surgical procedures, including anesthesia, tracheal intubation, donor lung procurement, and recipient lung transplantation. Histological morphology and blood gas analysis of the transplanted lungs were assessed 2 hours after reperfusion to evaluate the histological changes and function of the transplanted lungs. Results The pigs underwent left lung in situ transplantation, effectively simulating conditions relevant to human lung transplantation. Two hours after the transplantation, arterial blood gas analysis showed that arterial partial pressure of oxygen was 155.4-178.6 mm Hg, arterial partial pressure of carbon dioxide was 53.1-62.4 mm Hg, and the oxygenation index was 310.8-357.2 mm Hg. Hematoxylin and eosin staining indicated a low degree of pulmonary edema and minimal cellular infiltration. Conclusion The pig left lung orthotopic transplantation model possesses strong operability and stability. Researchers can replicate this model according to the described methods and further conduct basic research and explore clinical translational applications.
5.Spectrum-effect Relationship of Bupleuri Radix Processed with Trionyx sinensis Blood for Yin Deficiency Based on Saponins
Mengyu HOU ; Xia ZHAO ; Zhiyu GUO ; Ting LIU ; Yuexing MA ; Yaohui YE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):147-155
ObjectiveTo analyze the pharmacodynamic activity of Bupleuri Radix processed with Trionyx sinensis blood in the treatment of Yin deficiency and study the spectrum-effect relationship of this medicine. MethodsHigh performance liquid chromatography was employed to establish the fingerprints of 15 batches of Bupleuri Radix processed with Trionyx sinensis blood, and the similarity was evaluated according to the SOP of Similarity Evaluation System of Chromatographic Fingerprint of TCM (version 2012). A mouse model of Yin deficiency induced by thyroxine was established. The relationship between the active components and the effect on Yin deficiency was explored by grey correlation analysis and partial least squares method based on the changes in the serum levels of triiodothyronine (T3), thyroxine (T4), cyclic adenosine phosphate (cAMP), and cyclic guanosine phosphate (cGMP). The components screened out based on the spectrum-effect relationship were used for retrieval of the targets from the Traditional Chinese Medicine Systems Pharmacology and Analysis Database (TCMSP), The Encyclopedia of Traditional Chinese Medicine (ETCM), and Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine (TCMIP). Furthermore, the Online Mendelian Inheritance in Man (OMIM), GeneCards, TTD, DisGeNET, and Drugbank were employed to establish the active component-target against Yin deficiency network of Bupleuri Radix processed with Trionyx sinensis blood. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were carried out for the core targets. Real-time PCR was conducted to verify the predicted key pathways and mechanisms. ResultsThe fingerprints of the 15 batches of Bupleuri Radix processed with Trionyx sinensis blood showed the similarities of 0.976-0.999 with the control fingerprint. Compared with the model group, the drug administration group showed elevated levels of T3 and T4 and lowered levels of cAMP, cGMP and cAMP/cGMP. The results of grey correlation analysis showed that active components in terms of the correlations followed the trend of saikosaponin B1 > saikosaponin B2 > saikosaponin C > saikosaponin D > saikosaponin A. The partial least squares analysis showed that saikosaponins A, D, B1, and B2 had higher VIP values. Network pharmacology predicted a total of 30 common targets, which were enriched in 276 GO terns and 115 KEGG pathways. The results of Real-time PCR showed that the model group had lower mRNA levels of Caspase-9, kinase insert domain receptor (KDR), and mammalian target of rapamycin (mTOR) and higher mRNA level of mouse double minute 2 homolog (MDM2) than the blank group and the drug administration group. ConclusionBupleuri Radix processed with Trionyx sinensis blood has therapeutic effect on Yin deficiency syndrome, which provides a new idea for studying Bupleuri Radix processed with Trionyx sinensis blood.
6.Effects of forkhead box protein A1 knockout on microRNA expression profiles of benzoapyrene malignant transformed cells THBEc1
Zhiyu LIU ; Yujin FU ; Yitong LIN ; Juanling FU ; Biyun YAO ; Peng ZHAO
Chinese Journal of Pharmacology and Toxicology 2025;39(3):169-182
OBJECTIVE To explore the potential mechanisms of forkhead box protein A1(FOXA1)in benzo[a]pyrene(BaP)-induced carcinogenesis by investigating the effect of FOXA1 by knockout on microRNA(miRNA)expression profiles in BaP malignant transformed cells THBEc1 and establishing regulatory networks between FOXA1,miRNA and their target genes.METHODS FOXA1 knockout THBEc1 cells THBEc1-ΔFOXA1-c34 and control cells THBEc1-ctrl were used as study models.Western blotting was employed to determine FOXA1 protein expression levels.Next-generation sequencing(NGS)tech-nology was used to identify differentially expressed miRNAs between THBEc1-ΔFOXA1-c34 and THBEc1-ctrl cells,with subsequent validation by RT-qPCR.Five databases(ENCORI,miRDB,mirDIP,miRWalk and TargetScan 8.0)were used in conjunction with NGS results of mRNA between THBEc1-ΔFOXA1-c34 and THBEc1-ctrl to predict different expressed genes(DEGs)regulated by the identified differentially expressed miRNAs.GO and KEGG enrichment analyses were conducted on the DEGs using the DAVID database.Interaction network analysis of the proteins encoded by the DEGs was performed using STRING 12.0 and Cytoscape 3.10.2 software.RESULTS No FOXA1 expression was detected in THBEc1-ΔFOXA1-c34 cells.A differential analysis of miRNA expressions revealed 33 miRNAs with a fold change of>2 or<0.5 and a false discovery rate of<0.05 between THBEc1-ΔFOXA1-c34 and THBEc1-ctrl cells,13 of which were down-regulated and 20 were up-regulated in THBEc1-ΔFOXA1-c34 cells.A regulatory network was formed by 11 down-regulated miRNAs and 32 up-regulated mRNAs,while a second network included 16 up-regulated miRNAs and 56 down-regulated mRNAs.The 27 differentially expressed miRNAs participated in various biological processes through the regulation of 88 DEGs,primarily associated with cell growth,proliferation,migration,apoptosis,angiogenesis,epithe-lial-mesenchymal transition,and signal transduction(TGF-β,Hippo,NF-kappa B and MAPK pathways).CONCLUSION The miRNA expression profile in BaP-malignant transformed THBEc1 cells is altered following FOXA1 knockout that may disrupt TGF-β and MAPK signaling pathways by changing miRNA expression levels,thereby inhibiting cell proliferation and migration.
7.Research progress on the mechanism of macrophages in erectile dysfunction
Tang TANG ; Yipeng ZHAO ; Tao ZHANG ; Ziyang MA ; Jintao WEI ; Zhiyu WU ; Peihai ZHANG
Immunological Journal 2025;41(7):519-528
Erectile Dysfunction(ED)is a relatively common clinical condition characterized by male sexual dysfunction.Macrophages,as key components of the immune and inflammatory response systems,play crucial roles in immune surveillance,tissue repair,and the maintenance of tissue homeostasis in processes related to erectile function.Immune inflammation is recognized as one of the pathological factors contributing to ED,and inflammatory markers—including macrophages—are widely believed to be closely associated with the onset of the disorder.This review summarizes the multifaceted roles of macrophages in vascular injury,neural repair,hormonal balance,and immune microenvironment remodeling in the context of erection.It aims to provide a theoretical foundation for further investigation into the involvement of macrophages in ED and discusses the potential of macrophage-targeted therapies for treating ED.
8.Analysis of risk factors for the onset of second primary cancer after cervical cancer and the construction of a prognostic prediction nomogram model
Zhiyu TIAN ; Weihong ZHAO ; Xiaodong GU
Cancer Research and Clinic 2025;37(5):328-333
Objective:To investigate the risk factors of secondary primary cancer (SPC) after cervical cancer and to construct a nomogram model for predicting the prognosis.Methods:The data of 3 790 patients with primary cervical cancer from the 3rd edition of the International Classification of Diseases Oncology (ICD-O-3) number C53.9 between 2000 and 2020 in the Surveillance, Epidemiology and End Results (SEER) database were retrospectively analyzed, and SPC occurred in 2 036 cases out of 3 790 patients. Standardized incidence rate (SIR) of patients with cervical cancer was calculated by using SEER*Stat software; Cox proportional hazards model was used to make the univariate and multivariate analysis on the influencing factors of the overall survival (OS) in patients with SPC after cervical cancer. By using the "rms" package of R software, nomogram models for predicting 1-, 3-, and 5-year OS rates in SPC patients after cervical cancer were constructed based on prognostic independent influencing factors. The prediction efficacy and consistency of the model were verified by using the receiver operating characteristic (ROC) curve and the calibration curve.Results:The cervical cancer patients with the age of diagnosis of 20-34 years old (SIR: 1.76, 95% CI: 1.57-1.98), black race (SIR: 1.75, 95% CI: 1.61-1.90), the interval period of 2 primary tumors: 6-11 months (SIR: 1.69, 95% CI: 1.50-1.90), histologic grade Ⅳ (SIR: 1.62, 95% CI: 1 30-2.00), chemotherapy (SIR: 1.63, 95% CI: 1.56-1.71), radiotherapy (SIR: 1.59, 95% CI: 1.53-1.66), unmarried (SIR: 1.47, 95% CI: 1.41-1.54) had high SIR. Multivariate Cox regression analysis results of 2 036 SPC patients after cervical cancer showed that unmarried, SEER stage of regional lesion phase, distant metastasis phase and unknown, histologic grade of Ⅱ, Ⅲ, Ⅳ and the unknown, unknown lymph node dissection, other sites expert for lymphoma in SPC sites were independent risk factors of OS in SPC patients after cervical cancer (all P < 0.05); receiving surgery for SPC (compared to those not receiving surgery, HR = 0.38, 95% CI: 0.32-0.45, P = 0.001), radiotherapy (compared to those not receiving radiotherapy or unknown, HR = 0.66, 95% CI: 0.56-0.78, P = 0.001), and chemotherapy (compared to those not receiving chemotherapy or unknown, HR = 0.86, 95% CI:0.74-0.99, P = 0.034) were independent protective factors of OS in SPC patients after cervical cancer. The results of Kaplan-Meier survival analysis showed that the differences in the OS of SPC patients after cervical cancer with different marriage status, SEER stage, histologic grade, lymph node dissection, surgery for SPC, primary sites of SPC and whether receiving radiochemotherapy were all statistically significant (all P < 0.001). Based on the 8 variables including marital status, SEER stage, histologic grade, whether lymph nodes have been cleared, whether SPC has been treated with surgery, radiotherapy, chemotherapy, and the primary sites of SPC, a nomogram model for predicting the 1-, 3- and 5-year OS rates of SPC patients after cervical cancer was established. The results of ROC curve analysis showed that the area under the curve of the model for predicting 1-, 3-, and 5-year OS rates was 0.841, 0.847, and 0.847, respectively. The calibration curves showed a good consistency between the predicted results of model and the actual results. Conclusions:A prognostic prediction nomogram model for SPC after cervical cancer constructed based on the data in the SEER database has a high clinical application value and calibration.
9.Diagnosis and treatment of colorectal liver metastases: Chinese expert consensus-based multidisciplinary team (2024 edition).
Wen ZHANG ; Xinyu BI ; Yongkun SUN ; Yuan TANG ; Haizhen LU ; Jun JIANG ; Haitao ZHOU ; Yue HAN ; Min YANG ; Xiao CHEN ; Zhen HUANG ; Weihua LI ; Zhiyu LI ; Yufei LU ; Kun WANG ; Xiaobo YANG ; Jianguo ZHOU ; Wenyu ZHANG ; Muxing LI ; Yefan ZHANG ; Jianjun ZHAO ; Aiping ZHOU ; Jianqiang CAI
Chinese Medical Journal 2025;138(15):1765-1768
10.Construction of an in vitro simulated one compartment extravascular administration model and comparisons with a classic in vitro administration model in lanthanum nitrate induced HepG2 cell death
Dawei FU ; Yujin FU ; Lailai YAN ; Jie CHEN ; Zhiyu LIU ; Juanling FU ; Biyun YAO ; Weidong HAO ; Peng ZHAO
Chinese Journal of Pharmacology and Toxicology 2025;39(4):285-295,中插1-中插2
OBJECTIVE To establish an in vitro simulated one compartment extravascular adminis-tration model with lanthanum nitrate as the test substance,and explore the differences between this model and the classic in vitro administration model in lanthanum nitrate induced HepG2 cell death.METHODS An in vitro administration device was designed based on compartment model theories which consisted of four functional chambers:the liquid storage chamber,mixing chamber,toxicant exposure chamber,and waste liquid receiving chamber.The four chambers were connected by peristaltic pump hoses.The peristaltic pumps were employed to ensure unidirectional and constant speed trans-mission of liquid between these chambers.According to the preset toxicokinetic parameters such as T1/2a and T1/2,an in vitro simulated one compartment extravascular administration model of lanthanum nitrate was constructed using the device.The content of lanthanum nitrate in the toxicant exposure chamber at different time points was measured using inductively coupled plasma mass spectrometry.The concentration-time curves of lanthanum nitrate were analyzed using PKsolver and GraphPad Prism 8.0 software.The constructed in vitro simulated one compartment extravascular administration model was evaluated by comparing the measured and theoretical values of toxicokinetic parameters.HepG2 cells were treated with lanthanum nitrate in the in vitro simulated one compartment extravascular administration model and classic in vitro administration model,respectively,and cell death was measured using the Hoechst 33342/propidium iodide staining method.RESULTS Within the Cmax range of 3.91-1 000.00 μmol·L-1,the measured concentration-time curves of lanthanum nitrate in the toxicant expo-sure chamber almost conformed with the corresponding calculated theoretical curves(the correlation coefficients were all>0.998 0).The measured values of toxicokinetic parameters,including Ke,T1/2,Ka,T1/2a,Tmax,Cmax,CL and AUC0-∞,were close to the corresponding theoretical values.The fitting coeffi-cients(R2)of the concentration-time curves for each experimental group were all>0.990 0,which was consistent with one compartment model for extravascular administration.In the simulated one compart-ment extravascular administration model,no significant death of HepG2 cells was observed in any lanthanum nitrate dose group.In the classic in vitro administration model,the cell death rate of the 0.500 mmol·L-1 lanthanum nitrate group was higher than that of the solvent control group,but no significant cell death was observed in the 0.119 mmol·L-1 group or 0.243 mmol·L-1 group.When Cmax or Cadministration was 0.500 mmol·L-1,classic in vitro administration induced a higher cell death rate than simulated one compart-ment extravascular administration.However,there was no statistically significant difference in lanthanum nitrate induced HepG2 cell death between the two administration models when the AUC was equal.CONCLUSION The device designed in this study can be used to in vitro simulate one compartment extravascular administration,making in vitro toxicity testing more similar to in vivo scenarios,and providing data for optimizing administration methods of in vitro toxicity testing.There are differences in lanthanum nitrate induced HepG2 cell death between simulated one compartment extravascular administration and classic in vitro administration,indicating that different in vitro exposure modes can affect toxicity.


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