Background At present, the practice of pulmonary rehabilitation for pneumoconiosis in China is in a primary stage. The basis for formulating an individualized comprehensive pulmonary rehabilitation plan is still insufficient, which is one of the factors limiting the development of community-level rehabilitation work. Objective To formulate an exercise prescription based on maximum heart rate measured by cardiopulmonary exercise test (CPET), conduct an individualized comprehensive pulmonary rehabilitation program with the exercise prescription for patients with stable pneumoconiosis, and evaluate its role in improving exercise endurance and quality of life, thus provide a basis for the application and promotion of pulmonary rehabilitation. Methods A total of 68 patients were recruited from the Occupational Disease Prevention Hospital of Jinneng Holding Coal Industry Group Co., Ltd. from April to August 2022 , and were divided into an intervention group and a control group by random number table method, with 34 cases in each group. All the pneumoconiosis patients participated in a baseline test. The control group was given routine drug treatment, while the intervention group received multidisciplinary comprehensive pulmonary rehabilitation treatment on the basis of routine drug treatment, including health education, breathing training, exercise training, nutrition guidance, psychological intervention, and sleep management, whose exercise intensity was determined according to the maximum heart rate provided by CPET. The rehabilitation training lasted for 24 weeks. Patients were evaluated at registration and the end of study respectively. CPET was used to measure peak oxygen uptake per kilogram (pVO₂/kg), anaerobic threshold (AT), carbon dioxide equivalent of ventilation (EqCO₂), maximum metabolic equivalent (METs), and maximum work (W_max). The modified British Medical Research Council Dyspnea Questionnaire (mMRC), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Short Form of Health Survey (SF-36) were used to evaluate the potential effect of the comprehensive pulmonary rehabilitation program. Results Among the included 68 patients, 63 patients were having complete data, then 31 cases were assigned in the control group and 32 cases in the interventional group. Before the intervention, there was no significant difference in pVO₂/kg, AT, EqCO₂, METs, or W_max between the two groups (P>0.05). At the end of the trail, the indicators like pVO₂/kg [(19.81±2.38) mL·(min·kg)⁻¹], AT [(14.48±2.33) mL·(min·kg)⁻¹], METs (5.64±0.69), and W_max [(85.25±14) W] of patients in the intervention group were all higher than those [(13.90±2.37) mL·(min·kg)⁻¹, (11.70±1.94) mL·(min kg)⁻¹, (3.97±0.70), and (61.77±14.72) W, respectively] in the control group (P<0.001); there was no significant difference in EqCO₂ between the two groups (P=0.083). Before the trial, there was no significant difference in mMRC, SAS, SDS, PSQI, or CAT scores between the two groups (P>0.05). At the end of the trail, the mMRC score (1.16±0.57), SAS score (27.93±2.12), SDS score (26.48±1.44), PSQI score (1.08±0.88), and CAT score (4.34±3.28) of patients in the intervention group were lower than those [(2.03±0.83), (35.87±6.91), (34.23±6.65), (5.37±3.03), and (13.87±7.53), respectively] in the control group (P<0.001). The SF-36 scores of bodily pain (94.13±10.72), general health (87.50±5.68), vitality (95.31±5.53), mental health (99.88±0.71), and health changes (74.22±4.42) in the intervention group were higher than those [(71.87±32.72), (65.81±15.55), (74.52±16.45), (86.97±16.56), and (29.84±13.50), respectively] in the control group (P<0.001), and no significant difference was found in social functioning and role emotional scores (P>0.05). Conclusion Comprehensive pulmonary rehabilitation can increase the oxygen intake and exercise endurance of pneumoconiosis patients, ameliorate dyspnea symptoms, elevate psychological state and sleep quality, and improve the quality of life.

Objective To investigate the inhibitory effects of magnesium citrate(MgCit)on oxidative stress in chronic renal failure(CRF).Methods SD rats were divided into CRF model group,MgCit groups(375 and 750 mg/kg),normal control group,and MgCit control group(750 mg/kg).The morphology of mitochondria in thoracic artery vascular smooth muscle cells(VSMCs)was observed by transmission electron microscopy.The content of superoxide dismutase(SOD)and malonaldehyde(MDA)in rat aorta and plasma was detected by the kit.The VSMCs were divided into normal control group,CRF model group,and MgCit groups(1.5 and 3 mmol/L).The levels of superoxide anion(DHE)and apoptosis were quantitatively detected by flow cytometry.Results Compared with the control groups,the mitochondria were swollen and the cristae fractured or disappeared in the model group;MgCit intervention could reduce mitochondrial swelling,but not cristae fracture.In the model group,SOD level in aorta and plasma decreased(P＜0.05)while MDA level increased(P＜0.05).MgCit intervention could increase SOD in aorta and plasma,but decrease MDA level(P＜0.05).In the CRF environment,the DHE content of VSMCs and apoptosis in CRF model group increased(P＜0.05).MgCit intervention could decrease DHE content and inhibit apoptosis(P＜0.05).Conclusion MgCit inhibits oxidative stress levels in vivo and in vitro in CRF.

Objective:To investigate the efficacy and prognostic value of baseline 18F-FDG PET/CT metabolism parameters in patients with stage Ⅲ-Ⅳ lung adenocarcinoma before epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) monotherapy. Methods:From January 2012 to June 2020, 61 patients (19 males, 42 females; median age: 64 years) with stage Ⅲ-Ⅳ lung adenocarcinoma who underwent baseline 18F-FDG PET/CT imaging before EGFR-TKI monotherapy in 1 month in Beijing Hospital were retrospectively analyzed. The clinical data and metabolic parameters including SUV max, SUV max of lean body mass (SUL max), peak of SUV of lean body mass (SUL peak), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the hottest lesions on PET were analyzed. Patients were followed up to obtain the efficacy evaluation, progression-free survival (PFS) and overall survival (OS). ROC curve analysis was performed to obtain the optimal cut-off value of metabolic parameters to predict disease remission and prognosis. Kaplan-Meier method, log-rank test and Cox proportional risk regression model were used to analyze the prognostic factors. Results:After EGFR-TKI monotherapy, 42.9%(24/56) patients were in disease remission. The optimal cut-off values for predicting disease remission of SUL peak, SUV max, SUL max, MTV, and TLG were 5.9, 13.1, 11.1, 10.6 ml and 99.6 g, respectively. The remission rates of patients with SUV max>13.1, MTV>10.6 ml and TLG>99.6 g were significantly higher than those of patients with SUV max≤13.1(51.2%(21/41) vs 3/15; χ2=4.37, P=0.037), MTV≤10.6 ml (9/12 vs 36.6%(15/41); χ2=5.53, P=0.019) and TLG≤99.6 g (10/13 vs 35.0%(14/40); χ2=6.96, P=0.008). The follow-up period for survival was 0.05-6.80 years, and 10.3%(6/58) patients had no disease progression, and 44.3%(27/61) patients died. The optimal cut-off values of SUL peak, SUV max, SUL max, MTV, and TLG for PFS were 11.2, 17.0, 13.7, 2.7 ml and 14.8 g, and those for OS were 5.6, 14.3, 8.8, 2.8 ml and 37.3 g, respectively. Patients with never-smoking, SUV max≤17.0 and SUL peak≤11.2 had longer PFS ( χ2 values: 3.87-7.37, all P<0.05); never-smoking history (hazard ratio ( HR)=2.29, 95% CI: 1.08-4.87, P=0.031) and SUL peak≤11.2 ( HR=2.67, 95% CI: 1.35-5.27, P=0.005) were independent predictors for PFS. Patients with stage Ⅲ+ ⅣA, SUV max≤14.3, SUL peak≤5.6, SUL max≤8.8 and TLG≤37.3 g had longer OS ( χ2 values: 5.78-8.83, all P<0.05); stage Ⅲ+ ⅣA ( HR=2.81, 95% CI: 1.08-7.32, P=0.034) and SUL max≤8.8 ( HR=9.66, 95% CI: 1.25-74.91, P=0.030) were independent predictors for OS. Conclusions:Baseline 18F-FDG PET/CT imaging has good prospect in clinical application in patients with stage Ⅲ-Ⅳ lung adenocarcinoma before EGFR-TKI monotherapy. The higher baseline metabolic activity of tumor in the 18F-FDG PET/CT, the higher remission rate. Smoking history and SUL peak are independent predictors for PFS; SUL max and stage are independent predictors for OS.

【Objective】 To investigate the role and mechanism of dapagliflozin (Dapa), a sodium glucose co-transporter 2 inhibitor, in acute liver injury. 【Methods】 Eight-week-old C57BL6/J mice were given a single intraperitoneal injection of CCl4 to induce acute liver injury. The mice were preventively given 5 mg/kg Dapa by gavage 24 h and 2 h before CCl4 injection, while those in the control group were given an equal volume of solvent gavage. After 24 h, the mice were anesthetized and sacrificed. H&E staining, plasma biochemistry, RT-qPCR, and Western blotting were used to detect the severity of liver injury and the expressions of macrophage-related genes. 【Results】 In the CCl4 group, hepatic infiltration of inflammatory cells increased, and liver and renal functions significantly deteriorated, which was further aggravated by Dapa. CCl4 could promote the expressions of M1 macrophages and fibrosis-related genes in the liver, but reduce those of M2 and antioxidant-related genes, and the latter was further inhibited by Dapa. In addition, the protein expression of arginase 1 decreased and that of SGLT2 increased after Dapa intervention, while NF-κB pathway did not change significantly, suggesting that Dapa might directly affect the energy metabolism homeostasis in the liver and aggravate acute liver injury induced by CCl4. 【Conclusion】 Dapa can exacerbate hepatic and renal damage in acute stage of liver injury, inhibit macrophages M2 polarization, and aggravate oxidative stress and inflammatory injury induced by CCl4.

Background Diagnosis of pneumoconiosis by radiologist reading chest X-ray images is affected by many factors and is prone to misdiagnosis/missed diagnosis. With the rapid development of artificial intelligence in the field of medical imaging, whether artificial intelligence can be used to read images of pneumoconiosis deserves consideration. Objective Three deep learning models for identifying presence of pneumoconiosis were constructed based on deep convolutional neural network. An optimal model was selected by comparing diagnostic efficiency of the three models. Methods Digital radiography (DR) chest images were collected between June 2017 and December 2020 from 7 hospitals and standard radiograph quality control protocol was also followed. The DR chest images with positive results were classified into the positive group, while those without pneumoconiosis were classified into the negative group. The collected chest radiographs were labeled by experts who had passed the assessment of reading radiographs,and the experts were constantly assessed for consistency in the labeling process based on an expectation-maximization algorithm. The labeled data were cleaned, archived, and preprocessed, and then were grouped into a training set and a verification set. Three deep convolutional neural network models TMNet, ResNet-50, and ResNeXt-50 were constructed and trained by ten-fold cross-validation method to obtain an optimal model. Five hundred cases of DR chest radiographs that were not included in the training set and the validation set were collected, and identified by five senior experts as the gold standard, named the test set. The accuracy rate, sensitivity, specificity, area under curve (AUC), and other indexes of the three models were derived after testing, and the efficiency of the three models was evaluated and compared. Results A total of 24867 DR chest radiographs of the training set and the validation set were collected in this study, including 6978 images in the positive group and 17889 images in the negative group. There were 312 cases of pulmonary abnormalities such as pneumothorax and pulmonary tuberculosis. A total of nine experts labeled the chest radiographs, the labeling consistency rate of pneumoconiosis (non-staging) was above 88%, and the labeling consistency rate of pneumoconiosis staging ranged from 84.68% to 93.66%. The diagnostic accuracy, sensitivity, specificity, and AUC of TMNet were 95.20%, 99.66%, 88.61%, and 0.987, respectively. The indicators of ResNeXt were 87.00%, 89.93%, 82.67%, and 0.911, respectively. Those of ResNet were 84.00%, 85.91%, 81.19%, and 0.912, respectively. All these indexes of TMNet were higher than those of ResNeXt-50 and ResNet-50 models. The AUC differences between TMNet and the other two models were both statistically significant (P<0.001). Conclusion All the three convolutional neural network models can effectively diagnose the presence of pneumoconiosis, among which TMNet provides the best efficiency.

Recent research indicates that lactate promotes the switching of vascular smooth muscle cells (VSMCs) to a synthetic phenotype, which has been implicated in various vascular diseases. This study aimed to investigate the effects of lactate on the VSMC phenotype switch and the underlying mechanism. The CCK-8 method was used to assess cell viability. The microRNAs and mRNAs levels were evaluated using quantitative PCR. Targets of microRNA were predicted using online tools and confirmed using a luciferase reporter assay. We found that lactate promoted the switch of VSMCs to a synthetic phenotype, as evidenced by an increase in VSMC proliferation, mitochondrial activity, migration, and synthesis but a decrease in VSMC apoptosis. Lactate inhibited miR-23b expression in VSMCs, and miR-23b inhibited VSMC's switch to the synthetic phenotype. Lactate modulated the VSMC phenotype through downregulation of miR-23b expression, suggesting that overexpression of miR-23b using a miR-23b mimic attenuated the effects of lactate on VSMC phenotype modulation. Moreover, we discovered that SMAD family member 3 (SMAD3) was the target of miR-23b in regulating VSMC phenotype. Further findings suggested that lactate promotes VSMC switch to synthetic phenotype by targeting SMAD3 and downregulating miR-23b. These findings suggest that correcting the dysregulation of miR-23b/ SMAD3 or lactate metabolism is a potential treatment for vascular diseases.

【Objective】 To investigate the negative emotions among university students during home quarantine under the epidemic of coronavirus disease 2019 (COVID-19) so as to provide scientific basis for psychological counseling. 【Methods】 We conducted an online questionnaire survey to collect 405 undergraduates’ and postgraduates’ DASS-21 scale scores and responses to epidemic prevention knowledge, and analyzed the university students’ negative emotions during the epidemic and influencing factors. 【Results】 Of the 405 students surveyed, 178 individuals (44.0%) had depression, 171(42.2%) felt anxious, and 119(29.4%) felt stressed. Individuals in the DASS21+ group spent much time on entertainment on the cell phone daily than those in the DASS21- group (P<0.001), and the degree of impact by COVID-19 on daily life was significantly higher (P<0.001). Correlation analysis showed that entertainment time on the cell phone, the severity of COVID-19, and the impact of the epidemic were positively related to DASS-21 scores, with correlation coefficients of 0.231, 0.143 and 0.259, respectively (all P<0.01). Binary logistic regression analysis found that mobile entertainment time for over 5 hours per day (OR=3.370, 95% CI: 1.369-8.294, P=0.008) was a risk factor for negative emotions during quarantine at home. 【Conclusion】 During quarantine at home in the epidemic of COVID-19, nearly half of university students are prone to breed negative emotions, like depression, anxiety or stress, which may be related to long-term mobile phone entertainment.

Objective To investigate the relationship of glycated hemoglobin (HbA1c),fibrinogen (Fbg)and cystatin C (Cys C)with the severity of coronary artery lesions in non-diabetic patients.Methods We enrolled 358 patients who received coronary angiography (CAG)in this study.They were divided into coronary artery disease (CAD)group and non-CAD group according to CAG results.Moreover,according to different clinical types of CAD,all the CAD patients were further classified into stable angina pectoris (SAP)group and acute coronary syndrome (ACS)group.We calculated Gensini score and divided CAD group into A,B and C subgroups by Gensini score.HbA1 c,Fbg,Cys C and other clinical data were measured and compared between groups,and the correlation analysis was used to find the relationship of HbA1c,Fbg and Cys C with Gensini score.Results The levels of HbA1 c,Fbg and Cys C were significantly higher in groups A,B and C than in non-CAD group.When Gensini score increased,the three indexes were increased too (P<0.05).The levels of HbA1c,Fbg and Cys C were significantly higher in ACS group than in SAP and non-CAD group (P<0.05).After adjustment for the influencing factors, HbA1 c was still associated with Fbg (P<0 .0 5 ).The levels of HbA1 c and Fbg were closely related to Gensini score (P<0.05).Conclusion In non-diabetes patients,HbA1c and Fbg are significantly related to the severity of coronary artery stenosis,and Cys C may not be an independent risk factor of coronary artery stenosis.

Atherosclerosis is the most common type of arteriosclerosis.Vulnerable plaque is prone to rupture. Coronary vulnerable plaque rupture can lead to the occurrence of acute coronary syndrome (ACS ).This paper summarizes non-invasive detection and invasive detection of vulnerable plaque,as well as research on serological indexes of vulnerable plaque.It may provide a comprehensive basis for detecting vulnerable plaque.

Objective To investigate the relationship of high sensitivity C reactive protein (hs-CRP), interleukin-6 (IL-6)and soluble IL-6 receptor (sIL-6R)with the severity of clinical symptoms and coronary artery lesions in coronary heart disease (CHD)patients.Methods A total of 522 CHD patients were recruited and divided into three groups:stable angina pectoris (SAP),unstable angina pectoris (UAP)and acute myocardial infarction (AMI)groups.Another 102 healthy individuals served as normal controls (NCs).We calculated Gensini score according to the result of coronary angiography (CAG),collected clinical data and compared the groups. Multiple linear regression analysis was used to investigate the relationship of hs-CRP,IL-6 and sIL-6 R with Gensini score.Results The plasma hs-CRP,IL-6 levels were significantly higher and sIL-6R level was signficantly lower in SAP,UAP and AMI groups than in NC group (P<0 .0 5 ).There was a positive correlation between IL-6 level and Gensini score but a negative correlation between sIL-6 R and Gensini score presented by multiple linear regression analysis (P<0.05 ).Conclusion In CHD patients,plasma hs-CRP,IL-6 and sIL-6R levels are significantly related to the severity of clinical manifestations and coronary artery stenosis.These indicators may help predict the severity of CHD.