ObjectiveTo investigate the mechanism of ferroptosis mediated by long-chain acyl-CoA synthetase 4 （ACSL4） signalling pathway in rats with coronary heart disease with blood stasis syndrome and the intervention effect of Xuefu Zhuyutang. MethodsSPF male SD rats were randomly divided into normal group， sham-operation group， model group， trimetazidine group （5.4 mg·kg^-1）， low-， medium-， and high-dose group （3.51， 7.02，14.04 g·kg^-1） of Xuefu Zhuyutang. The coronary artery left anterior descending ligation method was used to prepare a model of coronary heart disease with blood stasis syndrome， and continuous treatment for 7 d was conducted， while the sham-operation group was only threaded and not ligated. The general macroscopic symptoms of the rats were observed， and indicators such as electrocardiogram， echocardiography， and blood rheology were detected. The pathological morphology of myocardial tissue was observed by hematoxylin-eosin （HE） staining， and the changes in mitochondria in myocardial tissue were observed by transmission electron microscopy. The level of iron deposition in myocardial tissue was observed by Prussian blue staining. The levels of 12-hydroxyeicosatetraenoic acid （12-HETE） and 15-HETE were detected in serum by enzyme-linked immunosorbent assay. A biochemical colourimetric assay was used to detect the levels of Fe²⁺， lipid peroxidation （LPO）， glutathione （GSH）， and T-GSH/glutathione disulfide （GSSG） in myocardial tissue. DCFH-DA fluorescence quantitative assay was employed to detect the levels of reactive oxygen species （ROS）. Western blot and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was adopted to detect the protein and mRNA expressions of glutathione peroxidase 4 （GPX4）， ferritin heavy chain 1 （FTH1）， ACSL4， and ly-sophosphatidylcholine acyltransferase3 （LPCAT3） in myocardial tissue. ResultsCompared with those in the normal group， the rats in the model group were poor in general macroscopic symptoms. The electrocardiogram showed widened QRS wave amplitude and increased voltage， bow-back elevation of the ST segments， elevated T waves， J-point elevation， and accelerated heart rate. Echocardiography showed a significant reduction in left ventricular ejection fraction （LVEF） and left ventricular fraction shortening （LVFS） （P<0.01）. Blood rheology showed that the viscosity of the whole blood （low， medium， and high rate of shear） was significantly increased （P<0.01）. HE staining showed an abnormal structure of myocardial tissue. There was a large area of myocardial necrosis and inflammatory cell infiltration and a large number of connective tissue between myocardial fibers. Transmission electron microscopy showed that the mitochondria were severely atrophy or swelling. The cristae were reduced or even broken， and the matrix was flocculent or even vacuolated. Prussian blue staining showed that there were a large number of iron-containing particles， and the iron deposition was obvious. The content of 12-HETE and 15-HETE in the serum was significantly increased （P<0.01）. The content of Fe²⁺， LPO， and ROS in myocardial tissue was significantly increased （P<0.01）. The content of GSH was significantly decreased （P<0.01）， and T-GSH/GSSG was decreased （P<0.01）. The protein and mRNA expressions of GPX4 and FTH1 in myocardial tissue were both significantly decreased （P<0.05， P<0.01）， while those of ACSL4 and LPCAT3 increased significantly （P<0.01）. Compared with the model group， the general macroscopic symptoms and electrocardiogram results of rats in low-， medium- and high-dose groups of Xuefu Zhuyutang were alleviated， and the differences in LVEF/LVFS ratios were all significantly increased （P<0.05， P<0.01）. The differences in whole-blood viscosity （low， medium， and high rate of shear） were all significantly decreased （P<0.01）. The results of HE staining and transmission electron microscopy showed that the morphology， structure， and mitochondria of cardiomyocytes were improved. The content of 12-HETE and 15-HETE in serum was reduced to different degrees in low-， medium-， and high-dose groups of Xuefu Zhuyutang （P<0.05， P<0.01）. The content of Fe²⁺， LPO， and ROS was significantly reduced in the medium- and high-dose groups of Xuefu Zhuyutang （P<0.05， P<0.01）， and the content of GSH and T-GSH/GSSG was significantly increased （P<0.05， P<0.01）. The protein and mRNA expressions of GPX4 and FTH1 were significantly increased to varying degrees in the medium- and high-dose groups of Xuefu Zhuyutang （P<0.05， P<0.01）， and ACSL4 and LPCAT3 were decreased to different degrees in the low-， medium-， and high-dose groups of Xuefu Zhuyutang （P<0.05， P<0.01）. ConclusionXuefu Zhuyutang can regulate iron metabolism and anti-lipid oxidation reaction to mediate ferroptosis through the ACSL4 signalling pathway， thus exerting a protective effect on rats with coronary heart disease with blood stasis syndrome.

ObjectivePhotoacoustic pump-probe imaging can effectively eliminate the interference of blood background signal in traditional photoacoustic imaging, and realize the imaging of weak phosphorescence molecules and their triplet lifetimes in deep tissues. However, background differential noise in photoacoustic pump-probe imaging often leads to large fitting results of phosphorescent molecule concentration and triplet lifetime. Therefore, this paper proposes a novel triplet lifetime fitting method for photoacoustic pump-probe imaging. By extracting the phase of the triplet differential signal and the background noise, the fitting bias caused by the background noise can be effectively corrected. MethodsThe advantages and feasibility of the proposed algorithm are verified by numerical simulation, phantom and in vivo experiments, respectively. ResultsIn the numerical simulation, under the condition of noise intensity being 10% of the signal amplitude, the new method can optimize the fitting deviation from 48.5% to about 5%, and has a higher exclusion coefficient (0.88>0.79), which greatly improves the fitting accuracy. The high specificity imaging ability of photoacoustic pump imaging for phosphorescent molecules has been demonstrated by phantom experiments. In vivo experiments have verified the feasibility of the new fitting method proposed in this paper for fitting phosphoometric lifetime to monitor oxygen partial pressure content during photodynamic therapy of tumors in nude mice. ConclusionThis work will play an important role in promoting the application of photoacoustic pump-probe imaging in biomedicine.

Osteoarthritis （OA） and stroke are common clinical diseases that reduce patients' quality of life and place a burden on families and society. Ruyi Zhenbaowan， a classic prescription in Tibetan medicine， have the functions of clearing heat， awakening the brain and opening orifices， relaxing tendons and promoting meridian circulation， and eliminating yellow water. Clinically， they are used to treat osteoarthritis， post-stroke sequelae， neuropathic pain， and other related conditions. Modern pharmacological studies have demonstrated their anti-inflammatory， analgesic， and nerve-repairing effects. However， current research remains insufficient regarding the appropriate indications， timing， and efficacy of this medicine in treating relevant diseases. To enhance clinicians' understanding of this medicine and promote its standardized and rational clinical use， a panel of national experts， including clinical specialists， Tibetan medicine practitioners， pharmacologists， and methodologists， formulated this consensus based on clinical experience and evidence-based practice. The Cochrane systematic review framework， the Grading of Recommendations Assessment， Development and Evaluation （GRADE） system， and the nominal group method were employed to generate seven graded recommendations and 19 consensus-based suggestions. These recommendations clearly define the key points in the clinical application of Ruyi Zhenbaowan， including therapeutic indications， dosage and administration， treatment duration， and medication safety. The consensus specifically addresses the clinical efficacy， appropriate timing of administration， dosage strategies， treatment cycles， and combination medication strategies for treating osteoarthritis and stroke and provides an overview of safety considerations. The aim is to provide standardized guidance for hospitals and healthcare institutions nationwide to ensure the rational application of Ruyi Zhenbaowan in the treatment of osteoarthritis and stroke， reduce medication-related risks， and further leverage its clinical advantages. This consensus has been approved and issued by the China Association of Chinese Medicine， with the standard number GS/CACM 369-2024.

Aim To investigate the enhanced efficacy and reduced toxicity of GanoExtra in combination with cyclophosphamide(CTX)on inhibiting lung metastasis and immune function in mice.Methods The CCK-8 method was used to verify the cytotoxic effects of Gano-Extra on MCF-7 and 4T1 tumor cells.In vivo experi-ment,a mouse model of lung metastasis of breast canc-er was established by injecting 4T1 tumor cells into the tail vein,which was divided into four groups including 4T1 model group,CTX group,GanoExtra group and GanoExtra+CTX group.The control group was set.After 21 days,the mice were euthanized under anes-thesia,and the body weight of the mice was recorded.Average lung index and spleen index were calculated.The mouse spleen lymphocyte transformation experi-ment was used to determine the activity of spleen cells.The NK cell activity assay was used to determine the activity of NK cells.Blood cells were determined in mouse blood samples.Flow cytometry was used to de-termine the levels of CD4+and CD8+T cells in blood samples.ELISA was used to measure the levels of TNF-α and IL-6 in serum.HE staining was used to ob-serve the pathological morphological changes in tumors and various tissues;and CFSE staining was used to de-termine the proliferative effect of GanoExtra on CD8+cells.Results In vitro GanoExtra at 50 mg·L-1 sig-nificantly inhibited the activity of MCF-7 and 4T1 tumor cells.In the breast cancer pulmonary metastasis model,compared with the model group,the spleen in-dex and blood WBCs content were significantly re-duced,while the activity of NK cells,spleen cells,and the proportion of RBCs,CD 3+and CD 8+T cells in the blood were significantly increased.At the end of the treatment,compared with the CTX group,the number of lung metastases and lung index of the Gano-Extra+CTX group were significantly reduced,and the levels of HGB,CD8+cells,IL-6,and TNF-α in the blood of mice were significantly increased.GanoExtra at 10 mg·L-1 significantly promoted the proliferation of CD8+T cells in vitro.Conclusions GanoExtra can enhance the inhibitory effect of CTX on tumor metasta-sis,alleviate adverse reactions such as splenomegaly and pulmonary enlargement caused by CTX,and have a health-promoting function of promoting the prolifera-tion of CD8+T cells to enhance the immune efficacy of the body.

Objective To explore the biomechanical characteristics of different orthopedic angles at distal femora in genu valgum treated with distal femur osteotomy(DFO).Methods The MRI and CT image data of a typical female volunteer with supracondylar femur deformity and symptomatic genu valgum were collected to construct a three-dimensional bone-joint finite element model of genu valgum,with seven postoperative models at different orthopedic angles.The mechanical lateral distal femoral angle(mLDFA),medial proximal tibial angle(MPTA),mechanical femorotibial angle,and lower limb alignment crossing distance of the genu valgum model were measured.The redistribution of contact force and von Mises stress of knee cartilage and meniscus in the medial and lateral compartments of knee joint in standing extension were observed and analyzed.Results The lower limb alignment crossing distance was obviously affected by the orthopedic angle,which crossed the 50%boundary at the orthopedic angles of 6° to 7°.The mechanical femorotibial angle was affected by the orthopedic angle,which gradually turned negative at the orthopedic angles of 5° to 6°.MPTA was not affected by the orthopedic angles.mLDFA was affected by the orthopedic angle,the mLDFA increased by 1°with every 1° increase in the orthopedic angle.When the orthopedic angle on the coronal plane was 7°,the femoral-tibial mechanical axis crossed through 48.6%of the coronal plane of the knee joint space,the contact force distribution of the medial and lateral compartments of the knee joint was 40%on the lateral compartment,and 60%on the medial compartment,the von Mises stresses distribution of articular cartilages on the medial and lateral compartments were the most uniform,the peak stress on the lateral compartment of the femoral cartilage of the knee joint was 5.2 MPa,with 5.5 MPa on the medial compartment,and the peak stress on the lateral compartment of the tibial side was 6.0 MPa,with 6.2 MPa on the medial compartment.Conclusion The orthopedic angle has a significant effect on the redistribution of medial and lateral compartment contact force and cartilage stress in the treatment of genu valgum with DFO.After orthopedics,the femoral-tibial mechanical axis crosses slightly medial to the midpoint of the tibial plateau,with a slight varus,the stress distribution of articular cartilage is more balanced,and the contact force distribution of the medial and lateral compartments are close to the normal state of the human knee joint.

Premature constriction of fetal ductus arteriosus(DA)may cause stenosis or atresia of DA,resulting in right ventricular outflow tract obstruction and right heart failure or even death,which is usually caused by exposure to prostaglandin synthase inhibitors or intake of polyphenolic substances during pregnancy.Prenatal ultrasound can effectively and dynamically observe opening and constriction status of fetal DA,monitor blood flow using color Doppler,hence evaluate changes of cardiac function.The research progresses of prenatal ultrasound for premature constriction of fetal DA were reviewed in this article.

Objective:To investigate influences of echinacoside(ECH)on myocardial cell apoptosis,inflammatory injury and mammalian target of rapamycin(mTOR)/signal transducer and activator of transcription 3(STAT3)signaling pathway in rats with coronary heart disease(CHD).Methods:A total of 12 SD rats were taken as control group(NC group),48 CHD rat models were successfully constructed,and randomly divided into model(Model)group,ECH group(50 mg/kg),mTOR activator MHY1485 group(10 mg/kg),ECH+MHY1485 group(50 mg/kg ECH+10 mg/kg MHY1485).After 4 weeks,electrocardiogram was recorded through biological function experimental system.Kits were used to detect myocardial C-reactive protein(CRP)and IL-6 levels.Myocardial pathology and apoptosis were measured by HE and TUNEL staining.qRT-PCR was used to detect myocardial Bcl-2,Bax mRNA expressions.Western blot was used to detect myocardial mTOR/STAT3 pathway protein expression.Results:Compared with NC group,Model group rats had obvious necrosis,edema and inflammatory cell infiltration,ST segment deviation,IL-6,CRP levels,cardiomyocyte apoptosis rate,Bax mRNA expression,mTOR and p-STAT3/STAT3 protein levels were significantly increased(P<0.05),Bcl-2 mRNA expression was significantly decreased(P<0.05).Compared with Model group,myocardial injury in ECH group was alleviated,ST segment shift,IL-6,CRP levels,cardiomyocyte apoptosis rate,Bax mRNA expression,mTOR and p-STAT3/STAT3 protein levels were were significantly decreased(P<0.05),Bcl-2 mRNA expression was significantly increased(P<0.05).The above indexes of MHY1485 group rats showed opposite trend.MHY1485 eliminates beneficial effects of ECH on CHD rats.Conclusion:ECH may reduce myocardial inflammatory injury and apoptosis in CHD rats by down-regulating mTOR/STAT3 pathway.

Objective:To explore the association between child abuse and suicidal ideation in patients with bi-polar disorder.The mediation of self-esteem and depression in this association was also investigated.Methods:A to-tal of 292 patients with bipolar disorder who met the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)were enrolled.Their child abuse,suicidal ideation,self-esteem,depres-sion,and mania were assessed with the Childhood Trauma Questionnaire(CTQ),Beck Scale for Suicide Ideation-Chinese Version(BSICV),Self-Esteem Scale(SES),17-item Hamilton Depression Rating Scale(HAMD-17)and Young Mania Rating Scale(YMRS).The mediating effects were evaluated using PROCESS for SPSS.Results:The BSICV scores were positively associated with the scores of CTQ(r=0.37,P＜0.01)and HAMD-17(r=0.53,P＜0.01)and negatively associated with SES scores(r=-0.50,P＜0.01)in patients with bipolar disorder.Self-esteem and depression played mediating roles between child abuse and suicidal ideation,respectively(95％CI:0.01-0.09,0.01-0.10).Besides,self-esteem and depression sequentially mediated the relationship between child a-buse and suicidal ideation(95％CI:0.02-0.06).Conclusion:Child abuse,low self-esteem,and depression may be related factors of suicidal ideation in patients with bipolar disorder.

Objective:To investigate the safety and efficacy of four-hook needle combined with holographic image in robot-assisted partial nephrectomy for completely intrarenal tumors.Methods:The clinical data of 8 patients with completely intrarenal tumors treated by robot-assisted partial nephrectomy with four-hook needle combined with holographic image admitted to General Hospital of Central Theater Command from October 2023 to December 2023 were retrospectively analyzed. There were 6 males and 2 females, with average age of (44.5±12.0) years old. Tumors of 6 cases were in the left side and 2 cases in the right side. The maximum diameter of the tumor was (23.2±8.1) mm. The R. E.N.A.L. score was (9.0±1.4). The preoperative serum creatinine (Scr) was (73.1±14.7) μmol/L. CT-guided four-hook needle was used to locate the edge of completely intrarenal tumor before surgery. During the operation, the tumor was precisely resected under the guidance of hologram and four-hook needle. Perioperative data of patients were collected and analyzed.Results:All the tumor were successfully resected under the guidance of four-hook needle and hologram without conversion to radical nephrectomy or open surgery. The mean operative time was (117.0±14.5) min, the mean hot ischemia time was (20.2±5.1) min, the mean intraoperative blood loss was (75.0±17.3) ml, and the average hospitalization time was (9.5±1.3) days.The one week postoperative Scr was (73.2±14.8) μmol/L, which had no significant difference with that of before operation ( P=0.952). None of them received blood transfusion. The pathology results of 8 patients were clear cell renal cell carcinoma, and the surgical margins were negative. Conclusions:For completely intrarenal tumors, the four-hook needle combined with the hologram can guide the surgeon to quickly locate the tumor, accurately resect the tumor, reduce perioperative complications, and is safe and effective.

Objective To investigate the prognostic value of red cell distribution width(RDW)on neurological prognosis in patients with cardiac arrest(CA).Methods Retrospective analysis the case data,RDW and biochemical indicators of 107 CA patients treated in our department(January 2020 to November 2023).According to cerebral performance category(CPC),patients were divided into good neurological prognosis group and bad neurological prognosis group.The differences in clinical data and RDW between the two groups were compared.Multivariate Logistic regression analysis was used to investigate the risk factors on neurological prognosis.Predictive effect of RDW on poor neurological prognosis in CA patients was assessed by receiver operating characteristic(ROC)curve.According to the optimal cut-off value of RDW,it was divided into high RDW group(≥ 13.45％)and low RDW group(＜13.45％)to compare the incidence of poor neurological prognosis.Results Totally 107 CA patients were included,34 patients in the good neurological prognosis group and 73 patients in the bad neurological prognosis group,the incidence of poor prognosis of neurological function was 68.22％.Compared with good neurological prognosis group,the acute physiology and chronic health evaluation Ⅱ score,RDW,cardiopulmonary resuscitation(CPR)time,age,serum sodium and glutamic-pyruvic transaminase in bad neurological prognosis group were significantly increased(P＜0.05).Multivariate Logistic regression analysis showed that RDW,age and CPR time were independent risk factors for poor prognosis of neurological function(P＜0.05).ROC curve analysis showed that the area under the curve of RDW to predict poor neural function prognosis in CA patients was 0.766.When the optimal threshold of RDW was 13.45％,the sensitivity was 73％and the specificity was 71％.The incidence of poor prognosis of neurological function in high RDW group was 84.13％,which was significantly higher than 45.45％in low RDW group(P＜0.05).Conclusion Elevated RDW is an independent risk factor for increased risk of poor neurological outcomes in patients with CA.It has certain predictive value for neurological outcomes in patients with CA.