ObjectiveTo investigate the effects of Tongxinluo capsules on traditional Chinese medicine （TCM） syndrome elements and major adverse cardiovascular events （MACEs） in patients with chronic coronary syndrome of Qi deficiency and blood stasis type. MethodsA multicenter and prospective cohort study was conducted. The intervention of Tongxinluo Capsules was used as the exposure factor， and the patients were divided into an exposure group （integrated traditional Chinese and western medicine treatment group） and a non-exposure group （western medicine treatment group）. The patients were followed up for one year. The TCM syndrome element scores were assessed by using a syndrome element diagnosis scale on the day of enrollment and in the third， sixth， and twelfth months， and the incidence of MACE within one year was recorded. ResultsA total of 186 patients were included， with 128 patients in the exposure group and 58 patients in the non-exposure group. There was no significant difference in baseline data between the two groups. Compared with those in the pretreatment period for each group， the Qi deficiency and blood stasis syndrome scores in the treatment and follow-up period were significantly improved （P<0.05）. Compared with the non-exposure group， the exposure group exhibited significantly decreased Qi deficiency syndrome scores in the treatment and follow-up period （P<0.01） and significantly reduced blood stasis syndrome scores in the sixth month （P<0.05）. In the remaining follow-up period， there was no statistically significant difference between the two groups. Compared with that of the non-exposure group， during the treatment period （the third month）， the difference in Qi deficiency and blood stasis syndrome scores of the exposure group was statistically significant （P<0.05， P<0.01）. At the end of the follow-up period， patients in the non-exposure group had a MACE probability of 6.90% （4/58）， higher than 3.13% in the exposure group （4/58）. Compared with patients with angina pectoris who used conventional medicine， patients administered with Tongxinluo Capsules had a relative risk（RR） of 0.45 ［95%confidence interval（95%CI） 0.12-1.75， P=0.26］. There was no significant difference in the incidence of MACE within one year between the two groups. ConclusionTongxinluo capsules can improve the degree of Qi deficiency in patients with chronic coronary syndrome in the short term， and the improvement effect of blood stasis syndrome appears in the medium and long term. They can better improve the Qi deficiency syndrome in the long term. Within one year， the incidence of MACE in the exposure group was lower than that in the non-exposure group.

ObjectiveTo investigate the effects of Tongxinluo capsules on traditional Chinese medicine （TCM） syndrome elements and major adverse cardiovascular events （MACEs） in patients with chronic coronary syndrome of Qi deficiency and blood stasis type. MethodsA multicenter and prospective cohort study was conducted. The intervention of Tongxinluo Capsules was used as the exposure factor， and the patients were divided into an exposure group （integrated traditional Chinese and western medicine treatment group） and a non-exposure group （western medicine treatment group）. The patients were followed up for one year. The TCM syndrome element scores were assessed by using a syndrome element diagnosis scale on the day of enrollment and in the third， sixth， and twelfth months， and the incidence of MACE within one year was recorded. ResultsA total of 186 patients were included， with 128 patients in the exposure group and 58 patients in the non-exposure group. There was no significant difference in baseline data between the two groups. Compared with those in the pretreatment period for each group， the Qi deficiency and blood stasis syndrome scores in the treatment and follow-up period were significantly improved （P<0.05）. Compared with the non-exposure group， the exposure group exhibited significantly decreased Qi deficiency syndrome scores in the treatment and follow-up period （P<0.01） and significantly reduced blood stasis syndrome scores in the sixth month （P<0.05）. In the remaining follow-up period， there was no statistically significant difference between the two groups. Compared with that of the non-exposure group， during the treatment period （the third month）， the difference in Qi deficiency and blood stasis syndrome scores of the exposure group was statistically significant （P<0.05， P<0.01）. At the end of the follow-up period， patients in the non-exposure group had a MACE probability of 6.90% （4/58）， higher than 3.13% in the exposure group （4/58）. Compared with patients with angina pectoris who used conventional medicine， patients administered with Tongxinluo Capsules had a relative risk（RR） of 0.45 ［95%confidence interval（95%CI） 0.12-1.75， P=0.26］. There was no significant difference in the incidence of MACE within one year between the two groups. ConclusionTongxinluo capsules can improve the degree of Qi deficiency in patients with chronic coronary syndrome in the short term， and the improvement effect of blood stasis syndrome appears in the medium and long term. They can better improve the Qi deficiency syndrome in the long term. Within one year， the incidence of MACE in the exposure group was lower than that in the non-exposure group.

BACKGROUND:Competitive athletes exercising in high-temperature,high-humidity,or low-oxygen environments experience intensified skeletal muscle deoxygenation and reduced fat oxidation,which can impair athletic performance.OBJECTIVE:To evaluate the impact of high-temperature,high-humidity,and low-oxygen environments on the fat oxidation rates of athletes during incremental load exercise,and to analyze the differences in deoxyhemoglobin kinetic parameters in skeletal muscle,thereby clarifying the relationship between fat oxidation capacity and skeletal muscle oxygenation under varying environmental conditions.METHODS:Twelve male modern pentathlon athletes were recruited for tests under three environmental conditions:normal(23 ℃,RH45％,FiO2=21.0％),high temperature and high humidity(35 ℃,RH70％,FiO2=21.0％),and low oxygen(23 ℃,RH45％,FiO2=15.6％).Resting metabolism and incremental load exercise were tested.Gas exchange data during and post-exercise were collected to calculate fat oxidation rate,carbohydrate oxidation rate,energy expenditure,and excess post-exercise oxygen consumption.Simultaneous measurements of SmO2 and total hemoglobin in the vastus lateralis muscle were used to calculate deoxyhemoglobin(HHb)levels.Deoxyhemoglobin change parameters-linear fittng slope(ΔEHHb),slope before the inflection point(ΔEHHB-1),and slope after the inflection point(ΔEHHB-2)-were determined using a bilinear function model.Fat oxidation curves were fitted using a SIN function model to identify the intensity(FATmax)that induced maximal fat oxidation(MFO),along with the curve's expansion,symmetry,and translation.RESULTS AND CONCLUSION:(1)Energy metabolism:No significant differences in maximal fat oxidation were observed across environments in each group(P>0.05).Compared with the normal environment group,both high temperature and high humidity group and low oxygen group showed significantly decreased time to maximal fat oxidation and FATmax(P<0.05).The percentage of maximal fat oxidation corresponding to peak oxygen uptake was lower in the low oxygen environment group(P<0.05).Fat oxidation was consistently low in the low oxygen environment group during exercise,while in the high temperature and high humidity environment group,it decreased only at higher exercise loads.Additionally,the expansion parameter was significantly reduced in both high temperature and high humidity and low oxygen environment groups(P<0.05).(2)Deoxyhemoglobin dynamics:The ΔEHHb was significantly higher in the high temperature and high humidity environment group,and ΔEHHB-1 was significantly increased in both high temperature and high humidity and low oxygen environment groups(P<0.05).(3)Correlation analysis:ΔEHHb was significantly negatively correlated with symmetry;ΔEHHB-1 was negatively correlated with FATmax and maximal fat oxidation;ΔEHHB-2 was positively correlated with maximal fat oxidation,and V?O2@BP was positively correlated with symmetry,expansion,and FATmax.(4)These findings indicate that incremental load exercise in high temperature,high humidity,and low oxygen environments accelerates skeletal muscle deoxygenation,thereby inhibiting fat oxidation capacity.Compared with high temperature and high humidity,low oxygen environments may more rapidly disrupt the balance between oxygen delivery and utilization in athletes'skeletal muscle,leading to a greater reliance on anaerobic glycolysis and a consequent reduction in fat oxidation capacity during exercise.

BACKGROUND:Competitive athletes exercising in high-temperature,high-humidity,or low-oxygen environments experience intensified skeletal muscle deoxygenation and reduced fat oxidation,which can impair athletic performance.OBJECTIVE:To evaluate the impact of high-temperature,high-humidity,and low-oxygen environments on the fat oxidation rates of athletes during incremental load exercise,and to analyze the differences in deoxyhemoglobin kinetic parameters in skeletal muscle,thereby clarifying the relationship between fat oxidation capacity and skeletal muscle oxygenation under varying environmental conditions.METHODS:Twelve male modern pentathlon athletes were recruited for tests under three environmental conditions:normal(23 ℃,RH45％,FiO2=21.0％),high temperature and high humidity(35 ℃,RH70％,FiO2=21.0％),and low oxygen(23 ℃,RH45％,FiO2=15.6％).Resting metabolism and incremental load exercise were tested.Gas exchange data during and post-exercise were collected to calculate fat oxidation rate,carbohydrate oxidation rate,energy expenditure,and excess post-exercise oxygen consumption.Simultaneous measurements of SmO2 and total hemoglobin in the vastus lateralis muscle were used to calculate deoxyhemoglobin(HHb)levels.Deoxyhemoglobin change parameters-linear fittng slope(ΔEHHb),slope before the inflection point(ΔEHHB-1),and slope after the inflection point(ΔEHHB-2)-were determined using a bilinear function model.Fat oxidation curves were fitted using a SIN function model to identify the intensity(FATmax)that induced maximal fat oxidation(MFO),along with the curve's expansion,symmetry,and translation.RESULTS AND CONCLUSION:(1)Energy metabolism:No significant differences in maximal fat oxidation were observed across environments in each group(P>0.05).Compared with the normal environment group,both high temperature and high humidity group and low oxygen group showed significantly decreased time to maximal fat oxidation and FATmax(P<0.05).The percentage of maximal fat oxidation corresponding to peak oxygen uptake was lower in the low oxygen environment group(P<0.05).Fat oxidation was consistently low in the low oxygen environment group during exercise,while in the high temperature and high humidity environment group,it decreased only at higher exercise loads.Additionally,the expansion parameter was significantly reduced in both high temperature and high humidity and low oxygen environment groups(P<0.05).(2)Deoxyhemoglobin dynamics:The ΔEHHb was significantly higher in the high temperature and high humidity environment group,and ΔEHHB-1 was significantly increased in both high temperature and high humidity and low oxygen environment groups(P<0.05).(3)Correlation analysis:ΔEHHb was significantly negatively correlated with symmetry;ΔEHHB-1 was negatively correlated with FATmax and maximal fat oxidation;ΔEHHB-2 was positively correlated with maximal fat oxidation,and V?O2@BP was positively correlated with symmetry,expansion,and FATmax.(4)These findings indicate that incremental load exercise in high temperature,high humidity,and low oxygen environments accelerates skeletal muscle deoxygenation,thereby inhibiting fat oxidation capacity.Compared with high temperature and high humidity,low oxygen environments may more rapidly disrupt the balance between oxygen delivery and utilization in athletes'skeletal muscle,leading to a greater reliance on anaerobic glycolysis and a consequent reduction in fat oxidation capacity during exercise.

Subthreshold depression belongs to the category of psychological sub-health.Because it does not meet the diagnostic criteria of depression,it may cause misdiagnosis,missed diagnosis,excessive medical treatment,violation of patient autonomy,poor effect or unclear adverse reactions.The ethical problems in clin-ical diagnosis and treatment are worthy of attention.This article aimed to explore the ethical issues that may exist in the clinical diagnosis and treatment of subthreshold depression,a sub-depression state,and propose so-lutions.

Strain is the fundamental unit in microbial taxonomy. The functional diversity among strains has great influence on host phenotypes. With the development of microbiome research, knowing the composition and functional capacities of complex microbial communities at the strain level has become increasingly valuable in scientific research and clinical applications. This review introduces the principles of bioinformatics algorithms for strain analysis based on metagenomic data, the applications in microbiome research and directions of future development.
Algorithms ; Computational Biology ; Metagenome ; Metagenomics ; Microbiota/genetics*