OBJECTIVE: Therapeutic angiogenesis has become a promising approach for treating ischemic heart disease (IHD). The present study aims to investigate the effects of Qishen Granule (QSG) on angiogenesis in myocardial ischemia (MI) and the potential mechanism. METHODS: In vivo study was conducted on rat model of myocardial infarction. QSG was performed daily at a dose of 2.352 g/kg for four weeks. Cardiac function was assessed by echocardiogram and pro-angiogenic effects were evaluated by Laser Doppler and CD31 expression. Oxygen-glucose deprivation (OGD) was applied in cultured human umbilical vein endothelial cells (HUVECs). Cell viability, wound healing and tube formation assay were used to test functions of HUVECs. ELISA and Western blots were used to assess protein expressions of bone morphogenetic protein 2-delta-like 4-notch homolog 1 (BMP2-Dll4-Notch1) signaling pathway. RESULTS: The results showed that QSG improved heart function, cardiac blood flow and microvessel density in myocardial ischemic rats. In vitro, QSG protected HUVECs by promoting the cell viability and tube formation. QSG upregulated bone morphogenetic protein-2 (BMP2) and downregulated delta-like 4 (Dll4) and notch homolog 1 (Notch1) expressions both in rats and HUVECs. CONCLUSION QSG protected against MI by promoting angiogenesis through BMP2-Dll4-Notch1 pathway. BMP2 might be a promising therapeutic target for IHD.

Objective To establish a reliable prediction model for radiation pneumonitis(RP)based on multi-regional radiomics analysis of localizable CT images.Methods A retrospective analysis was conducted on 185 patients who received radiotherapy from January 2021 to June 2023 in the Department of Radiotherapy,Xuzhou Cancer Hospital.Patients were classified as having RP or not based on imaging combined with clinical diagnosis.Three regions of interest(ROI)were defined in the localizable CT images:Lung,Lung-PTV and PTV,and their radiomics features were extracted.After feature screening using methods such as Mann-Whitney Utest,recursive feature elimination,and Lasso,a prediction model was established using support vector machine classification algorithm.The model performance was validated using 6 evaluation metrics:the area under the receiver operating characteristic curve(AUC),accuracy,specificity,sensitivity,positive predictive value,and negative predictive value.Results The prediction model consisted of 7 radiomics features.The clinical model of target-to-lung ratio,PTV model,Lung model,and Lung-PTV model achieved AUC values of 0.535,0.801,0.672,and 0.706 in the test set,respectively.The AUC value and accuracy of PTV model reached 0.843 and 0.775 in the training set,while 0.801 and 0.750 in the test set.PTV model was superior to Lung model,Lung-PTV model,and clinical model in predictive performance.The AUC values of the combined PTV+(Lung-PTV)model in the training and test sets were 0.867 and 0.806,respectively,higher than those of PTV model and Lung-PTV model.Conclusion The predictive ability of the prediction models constructed from radiomics features in different ROI for symptomatic RP varies.The radiomics prediction model using PTV as ROI exhibits superior predictive performance,and the combined multi-regional radiomics model can further improve the predictive ability for RP.

OBJECTIVE To understand the clinical characteristics of patients with Mycoplasma pneumoniae(MP)infection,and to explore the related factors of mixed infection,to provide theoretical support for the diag-nosis and treatment of MP infection.METHODS The clinical data of patients diagnosed with MP infection in the 305th hospital of PLA from Dec.2023 to Apr.2024 were collected,and the clinical characteristics of patients in-fected with MP were analyzed.Additionally,the impacts of MP mixed infections with other pathogens on the se-verity of the disease were compared,while the relevant influencing factors of MP mixed with other pathogens were analyzed by the logistic regression model.RESULTS A total of 114 patients with MP infection were collected,both genders had 57 cases(50.00％,respectively),60(52.63％)were adults,73(64.04％)had simple MP infection and 41(35.96％)had mixed infection.The clinical manifestations of MP infection primarily included fever and cough,with most fevers being low to medium intensity.Additionally,the biochemical indexes were predominantly within normal ranges,however,the interleukin 6(IL-6)level was relatively high.The abnormalities of chest X-ray examination accounted for 84.21％of the cases.In mixed infection cases,fever,dizziness,fatigue,headache and muscle pain were more prevalent than single MP infection cases(P＜0.05),and CRP level elevated in the mixed infection group(P=0.001),whereas white blood cell level and lymphocyte count decreased compared to the single MP infection group(P＜0.05).Multivariate logistic regression analysis showed that fever(OR=4.112,95％CI:1.046-16.161)and above 46 years old(OR=8.555,95％CI:1.394-52.493)were the rele-vant influencing factors for MP mixed with other pathogens infection.CONCLUSION Clinical features of MP-infected patients are atypical,but IL-6 levels are relatively high.MP is often mixed with viral infections,and fever and above 46 years old are the risk factors for mixed MP infection.

Objective:To investigate the levels and clinical significances of miRNA-155-5p (miR-155-5p) and hypoxia inducible factor-1α (HIF-1α) in the bone marrow of patients with acute myeloid leukemia (AML)-M 5. Methods:A cross sectional study was conducted. The bone marrow samples were collected from 32 AML-M 5 patients who were admitted to the First Affiliated Hospital of Hebei North University from November 2023 to December 2024, and the bone marrow samples collected from 11 patients with megaloblastic anemia from November 2023 to May 2025 were used as controls. Reverse transcription real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to determine relative expression of miR-155-5p at the transcription level in bone marrow mononuclear cells, and enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of HIF-1α protein in bone marrow supernatant. The levels of miR-155-5p and HIF-1α in bone marrow were compared between AML patients and control group, as well as among AML patients with different prognostic risks. Spearman method was used to analyze the relationship between miR-155-5p level and HIF-1α level in bone marrow of AML patients and their levels with bone marrow and peripheral blood cell indicators. Results:Among the 32 AML-M 5 patients, 20 patients (62.5%) were male and 12 patients (37.5%) were female, with a median age [ M ( Q1, Q3)] of 63 (51, 70) years; according to the clinical response criteria recommended by the European Leukemia Network (ELN) in 2022, there were 12 cases (37.5%) of complete response (CR) and 8 cases (25.0%) of non-complete response (NCR); according to the risk stratification criteria recommended by ELN in 2022, there were 8 cases (25.0%) with good prognosis, 13 cases (40.6%) with moderate prognosis and 11 cases (34.4%) with poor prognosis. In the control group, there were 5 males and 6 females, with a median age of 68 (63, 72) years. There was no statistically significant difference in gender and age between the two groups (both P > 0.05). The transcription level relative expression of miR-155-5p in the bone marrow mononuclear cells of AML-M 5 patients [5.13 (2.83, 8.84) vs. 0.87 (0.56, 1.69)] and the concentration of HIF-1α protein in the bone marrow supernatant of AML-M 5 patients [(116±32) pg/ml vs. (58±22) pg/ml] were higher than those in the control group, and the differences were statistically significant (both P < 0.001). The relative expression of miR-155-5p at the transcription level in the initial diagnosis group and NCR group and the concentration of HIF-1α in the initial diagnosis group, NCR group and CR group were higher than those in the control group (all P < 0.01), the relative expression of miR-155-5p at the transcription level in the CR group was higher than that in the control group, but the difference was not statistically significant ( P > 0.05); the relative expression of miR-155-5p at the transcription level in the newly diagnosis group was higher than that in the CR group, and the difference was statistically significant ( P < 0.01). However, there was no statistically significant difference between the newly diagnosis group and the NCR group or between the NCR group and the CR group (all P > 0.05). The concentration of HIF-1α in the newly diagnosis group and NCR group was higher than that in the CR group, and the differences were statistically significant (both P < 0.05). However, there was no statistically significant difference between the newly diagnosis group and the NCR group ( P > 0.05). There was no statistically significant difference in the relative expression of miR-155-5p at the transcription level and HIF-1α concentration in bone marrow among AML-M 5 patients with poor prognosis, moderate prognosis and good prognosis (both P > 0.05). The level of miR-155-5p in the bone marrow of AML-M 5 patients was positively correlated with the level of HIF-1α ( r = 0.446, P = 0.010); the level of miR-155-5p in bone marrow was positively correlated with the proportion of bone marrow primitive cells ( r = 0.583, P < 0.001), peripheral blood leukocyte count ( r = 0.464, P = 0.008), peripheral blood monocyte count ( r = 0.464, P = 0.007), and peripheral blood monocyte-to-leukocyte ratio ( r = 0.457, P = 0.009). The concentration of HIF-1α in the bone marrow of AML-M 5 patients was positively correlated with the proportion of bone marrow primitive cells ( r = 0.568, P = 0.001) and peripheral blood mononuclear cells-to-white blood cells ratio ( r = 0.375, P = 0.034), but not with peripheral blood white blood cell count ( r = 0.159, P = 0.385) or peripheral blood mononuclear cell count ( r = 0.300, P = 0.095). Conclusions:The levels of miR-155-5p and HIF-1α in the bone marrow of AML-M 5 patients are relatively high, and the levels of both are lower in patients with remission. However, the levels of both may not be related to the risk of prognosis. The levels of miR-155-5p and HIF-1α in the bone marrow of AML-M 5 patients are positively correlated, and their levels are also positively correlated with major hematological indicators in the bone marrow and peripheral blood.

OBJECTIVE To understand the epidemiological characteristics and change of drug resistance of Klebsiel-la pneumoniae strains from a hospital so as to adjust the use of antibiotics and control the transmission of hospital-associated infection caused by the K.pneumoniae.METHODS The K.pneumoniae strains were isolated from the patients who were hospitalized in The 305 Hospital of PLA from 2018 to 2022.The data of drug susceptibility tes-ting were exported by using WHONET 5.6,the clinical data and changing trend of drug resistance were retro-spectively analyzed with the use of SPSS 25.0 software.RESULTS Totally 9157 strains of bacteria were isolated from the patients who were hospitalized from 2018 to 2022,1502(16.40％)of which were K.pneumoniae,and the isolation rate showed a downward trend(x2=15.054,P＜0.001).Sputum(77.16％)was the major type of specimen;the strains were mainly isolated from intensive care unit(55.26％).The patients aged more than 79 years old were dominant,accounting for 65.58％.The result of drug susceptibility testing showed that there were significant differences in the drug resistance rates to the commonly used antibiotics from 2018 to 2022(P＜0.05).The drug resistance rates to aztreonam,ertapenem and tigecycline showed upward trends with the years(P＜0.05),while the drug resistance rates to the rest of drugs such as cefoperazone-sulbactam,ceftazidime and amika-cin showed downward trends(P＜0.05).CONCLUSIONS There is significant difference in the clinical distribution of the K.pneumoniae strains in recent 5 years.The key populations and departments should be attached great im-portance to.The drug resistance rates of the K.pneumoniae strains to many types of antibiotics show downward trends,but the situation of drug resistance is still serious.It is necessary to continue to implement the prevention and control policies for drug resistance and reasonably use antibiotics based on the result of drug susceptibility testing.

Objective To establish a reliable prediction model for radiation pneumonitis(RP)based on multi-regional radiomics analysis of localizable CT images.Methods A retrospective analysis was conducted on 185 patients who received radiotherapy from January 2021 to June 2023 in the Department of Radiotherapy,Xuzhou Cancer Hospital.Patients were classified as having RP or not based on imaging combined with clinical diagnosis.Three regions of interest(ROI)were defined in the localizable CT images:Lung,Lung-PTV and PTV,and their radiomics features were extracted.After feature screening using methods such as Mann-Whitney Utest,recursive feature elimination,and Lasso,a prediction model was established using support vector machine classification algorithm.The model performance was validated using 6 evaluation metrics:the area under the receiver operating characteristic curve(AUC),accuracy,specificity,sensitivity,positive predictive value,and negative predictive value.Results The prediction model consisted of 7 radiomics features.The clinical model of target-to-lung ratio,PTV model,Lung model,and Lung-PTV model achieved AUC values of 0.535,0.801,0.672,and 0.706 in the test set,respectively.The AUC value and accuracy of PTV model reached 0.843 and 0.775 in the training set,while 0.801 and 0.750 in the test set.PTV model was superior to Lung model,Lung-PTV model,and clinical model in predictive performance.The AUC values of the combined PTV+(Lung-PTV)model in the training and test sets were 0.867 and 0.806,respectively,higher than those of PTV model and Lung-PTV model.Conclusion The predictive ability of the prediction models constructed from radiomics features in different ROI for symptomatic RP varies.The radiomics prediction model using PTV as ROI exhibits superior predictive performance,and the combined multi-regional radiomics model can further improve the predictive ability for RP.

OBJECTIVE To understand the epidemiological characteristics and change of drug resistance of Klebsiel-la pneumoniae strains from a hospital so as to adjust the use of antibiotics and control the transmission of hospital-associated infection caused by the K.pneumoniae.METHODS The K.pneumoniae strains were isolated from the patients who were hospitalized in The 305 Hospital of PLA from 2018 to 2022.The data of drug susceptibility tes-ting were exported by using WHONET 5.6,the clinical data and changing trend of drug resistance were retro-spectively analyzed with the use of SPSS 25.0 software.RESULTS Totally 9157 strains of bacteria were isolated from the patients who were hospitalized from 2018 to 2022,1502(16.40％)of which were K.pneumoniae,and the isolation rate showed a downward trend(x2=15.054,P＜0.001).Sputum(77.16％)was the major type of specimen;the strains were mainly isolated from intensive care unit(55.26％).The patients aged more than 79 years old were dominant,accounting for 65.58％.The result of drug susceptibility testing showed that there were significant differences in the drug resistance rates to the commonly used antibiotics from 2018 to 2022(P＜0.05).The drug resistance rates to aztreonam,ertapenem and tigecycline showed upward trends with the years(P＜0.05),while the drug resistance rates to the rest of drugs such as cefoperazone-sulbactam,ceftazidime and amika-cin showed downward trends(P＜0.05).CONCLUSIONS There is significant difference in the clinical distribution of the K.pneumoniae strains in recent 5 years.The key populations and departments should be attached great im-portance to.The drug resistance rates of the K.pneumoniae strains to many types of antibiotics show downward trends,but the situation of drug resistance is still serious.It is necessary to continue to implement the prevention and control policies for drug resistance and reasonably use antibiotics based on the result of drug susceptibility testing.

OBJECTIVE To understand the clinical characteristics of patients with Mycoplasma pneumoniae(MP)infection,and to explore the related factors of mixed infection,to provide theoretical support for the diag-nosis and treatment of MP infection.METHODS The clinical data of patients diagnosed with MP infection in the 305th hospital of PLA from Dec.2023 to Apr.2024 were collected,and the clinical characteristics of patients in-fected with MP were analyzed.Additionally,the impacts of MP mixed infections with other pathogens on the se-verity of the disease were compared,while the relevant influencing factors of MP mixed with other pathogens were analyzed by the logistic regression model.RESULTS A total of 114 patients with MP infection were collected,both genders had 57 cases(50.00％,respectively),60(52.63％)were adults,73(64.04％)had simple MP infection and 41(35.96％)had mixed infection.The clinical manifestations of MP infection primarily included fever and cough,with most fevers being low to medium intensity.Additionally,the biochemical indexes were predominantly within normal ranges,however,the interleukin 6(IL-6)level was relatively high.The abnormalities of chest X-ray examination accounted for 84.21％of the cases.In mixed infection cases,fever,dizziness,fatigue,headache and muscle pain were more prevalent than single MP infection cases(P＜0.05),and CRP level elevated in the mixed infection group(P=0.001),whereas white blood cell level and lymphocyte count decreased compared to the single MP infection group(P＜0.05).Multivariate logistic regression analysis showed that fever(OR=4.112,95％CI:1.046-16.161)and above 46 years old(OR=8.555,95％CI:1.394-52.493)were the rele-vant influencing factors for MP mixed with other pathogens infection.CONCLUSION Clinical features of MP-infected patients are atypical,but IL-6 levels are relatively high.MP is often mixed with viral infections,and fever and above 46 years old are the risk factors for mixed MP infection.

Objective:To establish an ultra-high performance liquid chromatography-tandem mass spectrometry(UPLC-MS-MS)method for the determination of 2-mercaptobenzothiazole(MBT)genotoxic impurities in cefazoxime sodium for injection and to analyze the detection of domestic samples from 28 manufacturers.Methods:The UPLC analysis was performed on a Phenomenex Luna Omega C18 column,(2.1 mm × 100 mm,1.6 μm)with the column temperature 30 ℃.The mobile phases A was 2 mmol·L-1 ammonium acetate(contai-ning 0.001％formic acid)and the mobile phase B was acetonitrile with gradient elute.The flow rate was 0.3 mL·min-1.The injection volume was 5 μL.The electrospray ionization(ESI)source in positive mode and multiple reaction monitoring(MRM)were used for the detection of MBT,and external standard method for quanti-tative analysis.Results:The linear relationship of MBT was good in the concentration range of 1.4-58.12 ng·mL-1(r=0.999).The limit of detection was 1.453 pg and the limit of quantification was 7.265 pg.The average recoveries of low,medium and high concentrations were 106.8％,107.1％and 109.0％,respectively with the relative standard deviation(RSD)all less than 2.0％.The relative standard deviation(RSD)of repeatability was less than 6.0％.The content of MBT in the samples from 28 domestic enterprises was all less than 10 ppm,but there were obvious differences in the detected amount among all enterprises which is due to different production processes.Conclusion:The established method can be used for the qualitative and quantitative detection of MBT in cefazoxime sodium for injection and the partical enterprises which have been detected MBT impurities need to further raise the warning.

Objective:To explore and compare early postoperative clinical outcomes between dynamic and classical superior capsular reconstruction for the treatment of irreparable post-superior massive rotator cuff tears (MIRCTs).Methods:29 patients with MIRCTs treated with autologous fascia dynamic SCR (14) and classical SCR (15) at Department of Sports Medicine of the First Affiliated Hospital of Army Medical University from September 2019 to March 2022 were retrospectively analyzed on preoperative and final follow-up pain visual analogue scale (VAS), Constant-Murley score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) score, range of motion (ROM), acromiohumeral distance (AHD), Sugaya classification and Goutallier classification.Results:All 29 patients were followed up with an average follow-up time of 36.50±8.18 months for dynamized SCR and 29.33±9.15 months for classical SCR, respectively. There was no significant difference between the two groups in terms of gender, age, course of disease and preoperative AHD ( P>0.05). At the final follow-up, there was no significant difference in the degree of improvement in forward flexion (81.79°±36.14° vs. 69.00°±40.19°, t=0.899, P=0.377), abduction [87.50°(71.25°, 122.50°) vs. 80.00°(45.00°, 95.00°), Z=-1.400, P=0.172] and internal rotation [5.00°(5.00°, 6.00°) vs. 4.00°(1.00°, 6.00°), Z=-0.871, P=0.400]; external rotation improved significantly in the dynamic SCR group compared to classical SCR group [37.50°(30.00°, 41.25°) vs. 25.00°(15.00°, 30.00°), Z=-2.285, P=0.019]. Although both groups showed clinical improvements, no significant difference was found between the dynamic SCR group and the classical SCR group on VAS [4.00(3.75, 5.00) vs. 4.00(3.00, 5.00), Z=-0.029, P=0.949], ASES score (50.99±7.98 vs. 46.47±13.73, t=1.074, P=0.293), Constant-Murley score [62.50(54.00, 69.50) vs. 56.00(47.00, 62.00), Z=-1.956, P=0.112] and UCLA score (20.21±3.53 vs. 18.40±3.87, t=1.315, P=0.199). At the final follow-up, patients in the dynamic SCR group had a higher degree of improvement in AHD (3.66±2.22 mm vs. 2.00±1.75 mm, t=2.247, P=0.033). There was no significant difference in Sugaya grading between the two groups at the final follow-up ( Z=-0.370, P=0.747). As for the degree of improvement in Goutallier's grading, there was an improvement in the dynamic SCR group at the final follow-up versus the preoperative period ( Z=-2.101, P=0.036), while there was no significant difference in the degree of improvement in the classical SCR group at the final follow-up versus the preoperative period ( Z=-0.700, P>0.05). Conclusion:Both dynamic SCR and classical SCR for MIRCTs significantly improved shoulder function. Significant improvements in external rotation, AHD and Goutallier grading were observed in the dynamic SCR group compared to the classical SCR group.