1.Mechanism Exploration of Doxorubicin and Sepsis Induced Myocardial Injury: Differences and Convergences
Tao ZHANG ; Zihan NAN ; Lixia LIU ; Jiaqi LIU ; Xiukai CHEN ; Xiaoting WANG ; Suwen SU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):23-32
Doxorubicin (DOX)-induced cardiotoxicity and sepsis-induced myocardial injury (SIMI) represent significant clinical challenges in patients undergoing chemotherapy, sharing a common pathological basis of oxidative stress and mitochondrial dysfunction. Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, has recently been shown to play a critical role in DOX-induced cardiotoxicity and lipopolysaccharide (LPS)-induced SIMI. This article systematically reviews the mechanisms underlying myocardial injury caused by DOX and sepsis, identifying ferroptosis as a central common pathway. DOX triggers a burst of reactive oxygen species within mitochondria and inhibits glutathione peroxidase 4 (GPX4) activity through redox cycling of its quinone group and high-affinity accumulation in mitochondrial cardiolipin. LPS, by activating pattern recognition receptors and related inflammatory signaling pathways, provokes a cytokine storm and mitochondrial dysfunction. Both can disrupt the core regulatory axis of cysteine-glutathione (GSH)-GPX4, synergistically promoting ferroptosis in cardiomyocytes. Moreover, epigenetic regulation plays a key role in DOX- and LPS-induced cardiomyocyte ferroptosis and may serve as a promising therapeutic target. A deeper understanding of the ferroptosis mechanism and its epigenetic regulatory network in the synergistic injury induced by DOX and sepsis is of great importance for developing novel strategies to mitigate chemotherapy-related cardiotoxicity and improve outcomes in cancer patients with concurrent infections.
2.Explainable Machine Learning Model for Predicting Prognosis in Patients with Malignant Tumors Complicated by Acute Respiratory Failure: Based on the eICU Collaborative Research Database in the United States
Zihan NAN ; Linan HAN ; Suwei LI ; Ziyi ZHU ; Qinqin ZHU ; Yan DUAN ; Xiaoting WANG ; Lixia LIU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):98-108
To develop and validate a model for predicting intensive care unit (ICU) mortality risk in patients with malignant tumors complicated by acute respiratory failure (ARF) based on an explainable machine learning framework. Clinical data of patients with malignant tumors and ARF were extracted from the eICU Collaborative Research Database in the United States, including demographic characteristics, comorbidities, vital signs, laboratory test indicators, and major interventions within the first 24 hours after ICU admission.The study outcome was ICU death.Enrolled patients were randomly divided into a training set and a validation set at a ratio of 7:3.Predictor variables were selected using least absolute shrinkage and selection operator (LASSO) regression.Five machine learning algorithms-extreme gradient boosting (XGBoost), support vector machine (SVM), Logistic regression, multilayer perceptron (MLP), and C5.0 Decision Tree-were employed to construct predictive models.Model performance was evaluated based on the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and other metrics.The optimal model was further interpreted using the Shapley additive explanations (SHAP) algorithm. A total of 3196 patients with malignant tumors complicated by ARF were included.The training set comprised 2, 261 patients and the validation set 935 patients; 683 patients died during ICU stay, while 2513 survived.LASSO regression ultimately selected 12 variables closely associated with patient ICU outcomes, including sepsis comorbidity, use of vasoactive drugs, and within the first 24 hours after ICU admission: minimum mean arterial pressure, maximum heart rate, maximum respiratory rate, minimum oxygen saturation, minimum serum bicarbonate, minimum blood urea nitrogen, maximum white blood cell count, maximum mean corpuscular volume, maximum serum potassium, and maximum blood glucose.After model evaluation, the XGBoost model demonstrated the best performance.The AUCs for predicting ICU mortality risk in the training and validation sets were 0.940 and 0.763, respectively; accuracy was 88.3% and 81.2%;sensitivity was 98.5% and 95.9%.Its predictive performance also remained optimal in sensitivity analyses.SHAP analysis indicated that the top five variables contributing to the model's predictions were minimum oxygen saturation, minimum serum bicarbonate, minimum mean arterial pressure, use of vasoactive drugs, and maximum white blood cell count. This study successfully developed a mortality risk prediction model for ICU patients with malignant tumors complicated by ARF based on a large-scale dataset and performed explainability analysis.The model aids clinicians in early identification of high-risk patients and implementing individualized interventions.
3.Phenotypic distribution and population genetic frequency analysis of ABO and Rh blood group antigens among voluntary blood donors in Yantai
Hewei SONG ; Xiaojun ZHANG ; Qun XU ; Xiangzhong LIU ; Nan GUO ; Di SUN
Chinese Journal of Blood Transfusion 2026;39(1):69-75
Objective: To investigate the distribution characteristics of ABO and Rh blood group antigen phenotypes among blood donors in the Yantai, Shandong. Methods: Blood samples from 310 180 voluntary blood donors in Yantai collected from January 2019 to December 2023 were tested for ABO and Rh blood group antigens using standard serological methods. RhD-negative samples were further typed for C, c, E, and e antigens. Population genetic analysis of blood groups was performed: allele frequencies were inferred from ABO phenotypes, and Rh allele/haplotype frequencies were estimated based on the proportion of RhD-negative donors and CcEe antigen typing, followed by Hardy-Weinberg equilibrium testing. Results: The phenotypic distribution frequency of ABO blood groups was B(32.72%)>O(28.93%)>A(27.65%)>AB(10.70%). The inferred allele frequencies were r(53.74%)>q(24.78%)>p(21.48%), consistent with Hardy-Weinberg equilibrium (P>0.05). A total of 1 872 Rh-negative donors (0.603%) were identified. The most common Rh phenotypes were ccdee (59.56%) and Ccdee (30.18%). The distribution of Rh antigen phenotypes deviated significantly from Hardy-Weinberg equilibrium (χ
=37.15, P<0.001), with the cde haplotype showing the highest frequency. There was no statistically significant difference in ABO blood group distribution between RhD-positive and RhD-negative donors (P>0.05). Conclusion: The ABO blood group distribution among voluntary blood donors in Yantai is generally stable and consistent with population genetic equilibrium, whereas the Rh antigen phenotype distribution deviates from equilibrium, indicating potential underlying genetic structural differences.
4.Mechanisms of Tianma Goutengyin in Alleviating Neuronal Injury in Vascular Dementia Model Rats by Inhibiting A1 Astrocyte Activation via Regulating TNF-α/STAT3/α1ACT Signaling Pathway
Xiaoyan WANG ; Min ZHAO ; Feng TIAN ; Min XIAO ; Nan QU ; Fugui LIU ; Chixiao LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):56-65
ObjectiveTo investigate the effects of Tianma Goutengyin on the tumor necrosis factor-α (TNF-α)/signal transducer and activator of transcription 3 (STAT3)/α1-antichymotrypsin C-terminal tail fragment (α1ACT) signaling pathway and A1-type astrocytes in a rat model of vascular dementia. MethodsSeventy-two male Sprague-Dawley rats were randomly divided into six groups (n=12 per group): Sham-operated group, model group, Tianma Goutengyin high-, medium-, and low-dose groups (5.13, 10.26, and 20.52 g·kg-1), and a nimodipine group (8.1 mg·kg-1). The vascular dementia model was established by permanent bilateral common carotid artery occlusion, followed by 4 weeks of intervention. Learning and memory ability were evaluated using the novel object recognition test, and behavioral performance was assessed using the forced swimming test. Levels of interleukin-6 (IL-6) and C-C motif chemokine ligand 2 (CCL2) in hippocampal tissue were measured by enzyme-linked immunosorbent assay (ELISA). Hippocampal neuronal morphology was observed by Nissl staining, and apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL). Immunohistochemistry was used to detect positive expression of brain-derived neurotrophic factor (BDNF), glial fibrillary acidic protein (GFAP), and myelin basic protein (MBP). Western blot analysis was performed to measure the protein expression levels of TNF-α, TNF receptor 1 (TNFR1), phosphorylated STAT3 (p-STAT3), α1ACT, IL-6, complement component 3 (C3), BDNF, S100 calcium-binding protein A10 (S100A10), and GFAP in hippocampal tissue. ResultsCompared with the sham-operated group, the model group showed a significantly reduced relative recognition index in the novel object recognition test (P<0.01), prolonged immobility time and increased immobility frequency in the forced swimming test (P<0.01). Hippocampal IL-6 and CCL2 levels were significantly increased (P<0.01). Nissl staining revealed a marked reduction in neuronal number and loss of Nissl bodies (P<0.01). MBP-positive expression was significantly decreased (P<0.01), apoptosis was significantly increased (P<0.01), BDNF-positive expression was significantly reduced (P<0.05), and GFAP-positive expression was significantly increased (P<0.01). In addition, the protein expression levels of TNF-α, TNFR1, p-STAT3, α1ACT, IL-6, and C3 were significantly elevated (P<0.01), while BDNF and S100A10 expression levels were significantly decreased (P<0.01). Compared with the model group, all Tianma Gouteng yin dose groups exhibited a significant increase in the relative recognition index (P<0.05), shortened immobility time and reduced immobility frequency (P<0.05, P<0.01). IL-6 and CCL2 levels were significantly decreased (P<0.01), neuronal number was significantly increased (P<0.05, P<0.01), and MBP-positive expression was significantly enhanced (P<0.01). Apoptosis was significantly reduced (P<0.01), BDNF-positive expression was significantly increased (P<0.05), and GFAP-positive expression was significantly decreased (P<0.01). Moreover, the protein expression levels of TNF-α, TNFR1, p-STAT3, α1ACT, IL-6, and C3 were significantly decreased (P<0.01), while BDNF and S100A10 protein expression levels were significantly increased (P<0.01). ConclusionTianma Goutengyin may inhibit A1-type astrocyte activation in rats with vascular dementia through the TNF-α/STAT3/α1ACT signaling pathway, thereby reducing neuronal apoptosis and improving learning and memory function.
5.Network analysis of basic psychological needs and psychological behavioral problems among junior and senior high school students in Taizhou City
LIN Nan, LI Li, FU Chaowei, LIN Haijiang, YANG Yuting, LIU Yixuan, WANG Tingting, WANG Jingyi
Chinese Journal of School Health 2026;47(3):388-393
Objective:
To explore the network structure of middle school students basic psychological needs and psychological behavioral problems, and identify the core nodes within the network, as well as examine demographic subgroup differences, so as to provide support for targeted mental health interventions for adolescents.
Methods:
In September and October of 2023, a total of 2 000 junior and senior high school students were selected with multistage cluster random sampling from 8 schools in Jiaojiang District and Tiantai County, Taizhou City. An online self administered questionnaire was used to assess emotional and behavioral problems, perceived autonomy, self awareness, loneliness, and social support. The instruments included the Strengths and Difficulties Questionnaire (SDQ), Perceived Choice and Awareness of Self Scale (PCASS), Mental Health Literacy Questionnaire (MHLQ), University of California,Los Angeles Loneliness Scale (UCLA-LS), and the Multidimensional Scale of Perceived Social Support (MSPSS). A network analysis approach was employed to construct a network representing adolescents basic psychological needs and psychological behavioral problems, focusing on centrality measures and demographic subgroup differences.
Results:
A total of 418 students (20.9%) reported abnormal emotional and behavioral problems. Perceived autonomy and competence were negatively correlated with emotional problems (weights: 0.12, 0.14) and hyperactivity (weights: 0.10, 0.16). Social support showed negative correlation with peer relationship issues, hyperactivity, and conduct problems (weights: 0.16, 0.13, 0.10). Loneliness was positively correlated with emotional symptoms and peer relationship problems (weights: 0.28, 0.18). In the overall network, perceived relationships (social support and loneliness), emotional symptoms, and hyperactivity emerged as central nodes. Significant differences in network structure were observed between gender subgroups ( P =0.02). Girls internalizing issues were more influenced by loneliness and perceived autonomy frustration, while social support exhibited higher centrality in boys.
Conclusions
Perceived relationships, emotional problems, and hyperactivity are key nodes in the network of adolescents basic psychological needs and psychological behavioral problems. Loneliness demonstrates a prominent influence within the network, and the overall network exhibits gender differences.
6.Effect and Mechanism of Liangyi Paste on Hepatic Lipid Deposition in Naturally Aged Mice with High-fat Diet via Cuproptosis/Oxidative Stress Pathway
Meiling ZHANG ; Yuanguang DONG ; Xiaofei SUN ; Jiaxin WANG ; Yu LIU ; Jingxuan ZHU ; Qun WANG ; Nan SONG ; Guoyuan SUI ; Lianqun JIA
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(9):91-99
ObjectiveTaking the cuproptosis/oxidative stress pathway as the entry point, this study investigated the effect and mechanism of Liangyi Paste on hepatic lipid deposition in naturally aged mice fed with a high-fat diet. MethodsAfter adaptive feeding, 80 ten-week-old male C57BL/6 mice were used. Thirty of them were randomly divided into three groups (10 mice per group): The 12-month-old control group (12MCON), the 15-month-old control group (15MCON), and the 15-month-old group with a high-fat diet (15MHFD). The 12MCON and 15MCON groups were continuously fed a standard diet, while the 15MHFD group started receiving a high-fat diet at 12 months of age. Tissue samples were collected at the corresponding time points for each group. The remaining 50 mice were randomly divided into five groups (10 mice per group): the 20-month-old control group (20MCON), the model group, and the low-, medium-, and high-dose Liangyi Paste groups (2.91 , 5.82 , 11.64 g·kg-1·d-1, respectively). The 20MCON group was continuously fed a standard diet, while the other groups started receiving a high-fat diet at 15 months of age. At 18 months of age, the Liangyi Paste groups were administered the corresponding doses of Liangyi Paste by gavage, while the 20MCON and model groups were given an equal volume of saline by gavage. After 8 weeks of continuous gavage (when the mice reached 20 months of age), tissue samples were collected. Hepatic TG levels were measured using assay kits; liver histology and lipid deposition were observed via hematoxylin-eosin (HE) and oil red O staining; reactive oxygen species (ROS) were detected by enzyme-linked immunosorbent assay (ELISA); Cu2+, superoxide dismutase (SOD), and malondialdehyde (MDA) levels were measured by colorimetry; mRNA and protein expression of genes related to cuproptosis and oxidative stress pathways were analyzed by Real-time polymerase chain reaction(Real-time PCR) and Wes automated protein expression system. ResultsCompared with 12MCON, the 15MCON group showed significantly increased hepatic TG, Cu2+, ROS, and MDA levels (P<0.01), decreased SOD (P<0.01), hepatocyte swelling, and disordered arrangement. The mRNA and protein levels of ferredoxin 1 (FDX1), dihydrolipoamide S-acetyltransferase (DLAT), heat shock protein 70 (HSP70), dihydrolipoamide dehydrogenase (DLD), pyruvate dehydrogenase E1 subunit-β (PDHB), nuclear factor erythroid 2-related factor 2 (Nrf2), and peroxisome proliferator-activated receptor γ (PPARγ) were significantly elevated (P<0.05, P<0.01). Compared with 15MCON group, the 15MHFD and 20MCON groups exhibited further increases in TG, Cu2+, ROS, and MDA (P<0.01), reduced SOD (P<0.01), and aggravated hepatocyte swelling and disorder. There were increased lipid droplets with mild vacuolization in the 15MHFD group, and no significant lipid deposition was observed in the 20MCON group. FDX1, DLAT, HSP70, DLD, PDHB, Nrf2, and PPARγ mRNA and protein levels were significantly increased (P<0.05, P<0.01). Compared with 20MCON group, the model group demonstrated markedly elevated TG, Cu2+, ROS, and MDA (P<0.01), reduced SOD (P<0.01), severe hepatic steatosis, and upregulated expression of FDX1, DLAT, HSP70, DLD, PDHB, Nrf2, and PPARγ mRNA and proteins (P<0.05, P<0.01). All abnormalities were significantly reversed after Liangyi Paste treatment. ConclusionLiangyi paste can ameliorate hepatic lipid deposition in naturally aged mice with a high-fat diet by modulating the cuproptosis/oxidative stress pathway.
7.Application of rehabilitation therapy techniques for post-stroke dysphagia: a bibliometric analysis
Ping LIU ; Nan ZHOU ; Xiaojie XUE ; Weibo SHAO
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):294-303
ObjectiveTo analyze the current status, hotspot and development trends of rehabilitation technologies for post-stroke dysphagia (PSD). MethodsLiteratures related to rehabilitation technologies for PSD were retrieved from CNKI, VIP and Web of Science Core Collection from inception to July, 2025. Visualization analysis was conducted using CiteSpace 6.3.R1 and VOSviewer 1.2.20. ResultsA total of 1 265 articles were included, consisting of 794 Chinese and 471 English publications. The annual volume of Chinese literature peaked in 2019 (74 articles) and English literature peaked in 2022 (61 articles). Research hotspots included low-frequency surface neuromuscular electrical stimulation, repetitive transcranial magnetic stimulation, surface electromyography biofeedback and transcranial direct current stimulation. Keyword clustering and timeline analysis indicated that researches evolved from early traditional rehabilitation methods to the diversified and integrated application of combined rehabilitation technologies. ConclusionResearch on rehabilitation technologies for PSD is developing rapidly. Future efforts should focus on researches of multi-technology integration, individualized treatment protocols and long-term efficacy assessments.
8.Application of rehabilitation therapy techniques for post-stroke dysphagia: a bibliometric analysis
Ping LIU ; Nan ZHOU ; Xiaojie XUE ; Weibo SHAO
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):294-303
ObjectiveTo analyze the current status, hotspot and development trends of rehabilitation technologies for post-stroke dysphagia (PSD). MethodsLiteratures related to rehabilitation technologies for PSD were retrieved from CNKI, VIP and Web of Science Core Collection from inception to July, 2025. Visualization analysis was conducted using CiteSpace 6.3.R1 and VOSviewer 1.2.20. ResultsA total of 1 265 articles were included, consisting of 794 Chinese and 471 English publications. The annual volume of Chinese literature peaked in 2019 (74 articles) and English literature peaked in 2022 (61 articles). Research hotspots included low-frequency surface neuromuscular electrical stimulation, repetitive transcranial magnetic stimulation, surface electromyography biofeedback and transcranial direct current stimulation. Keyword clustering and timeline analysis indicated that researches evolved from early traditional rehabilitation methods to the diversified and integrated application of combined rehabilitation technologies. ConclusionResearch on rehabilitation technologies for PSD is developing rapidly. Future efforts should focus on researches of multi-technology integration, individualized treatment protocols and long-term efficacy assessments.
9.Application of rehabilitation therapy techniques for post-stroke dysphagia: a bibliometric analysis
Ping LIU ; Nan ZHOU ; Xiaojie XUE ; Weibo SHAO
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):294-303
ObjectiveTo analyze the current status, hotspot and development trends of rehabilitation technologies for post-stroke dysphagia (PSD). MethodsLiteratures related to rehabilitation technologies for PSD were retrieved from CNKI, VIP and Web of Science Core Collection from inception to July, 2025. Visualization analysis was conducted using CiteSpace 6.3.R1 and VOSviewer 1.2.20. ResultsA total of 1 265 articles were included, consisting of 794 Chinese and 471 English publications. The annual volume of Chinese literature peaked in 2019 (74 articles) and English literature peaked in 2022 (61 articles). Research hotspots included low-frequency surface neuromuscular electrical stimulation, repetitive transcranial magnetic stimulation, surface electromyography biofeedback and transcranial direct current stimulation. Keyword clustering and timeline analysis indicated that researches evolved from early traditional rehabilitation methods to the diversified and integrated application of combined rehabilitation technologies. ConclusionResearch on rehabilitation technologies for PSD is developing rapidly. Future efforts should focus on researches of multi-technology integration, individualized treatment protocols and long-term efficacy assessments.
10.Expert consensus on the construction of integrated outpatient clinic for cervical cancer prevention and treatment in General Hospitals
Nan YU ; Dongli KONG ; Lei WANG ; Yihan LU ; Hongbo WANG ; Dongru LIU ; Ling PENG
Journal of Public Health and Preventive Medicine 2026;37(2):1-6
Objective To implement the disease prevention and control strategy of being "proactive and grassroots-focused," and to enhance the overall effectiveness of general hospitals in the tertiary prevention of cervical cancer, this consensus aims to provide an actionable guiding framework for the standardized construction of "Integrated Outpatient Clinics for Cervical Cancer Prevention and Control" in general hospitals at all levels. Methods This consensus systematically elaborates on the specific elements for establishing such integrated clinics and formulates the corresponding standards. Results It is anticipated that the consensus will promote the establishment of standardized, homogeneous, and high-efficiency frontline positions for cervical cancer prevention and control within general hospitals, thereby contributing to the strategic vision of accelerating the elimination of cervical cancer. Conclusion The formulation and promotion of the consensus aim to provide robust clinical practice support for accelerating the realization of China's strategic vision of eliminating cervical cancer.


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