ObjectiveTo investigate the mechanism by which Wendantang regulates the silent information regulator 3 （SIRT3）/peroxisome proliferator-activated receptor-gamma coactivator-1α （PGC-1α） pathway to influence energy metabolism and thereby prevent and treat myocardial ischemia （MI） in a rat model of hyperlipidemia （HL）. MethodsThirty SD rats were randomly assigned into five groups： control， model， low-dose （3.702 g·kg^-1·d^-1） Wendantang， high-dose （7.404 g·kg^-1·d^-1） Wendantang， and positive control （trimetazidine， 0.006 g·kg^-1·d^-1）， with six rats in each group. The control group was fed normally， while the other groups were fed with a high-fat diet for six weeks for the modeling of HL. Subsequently， the drug intervention groups were administrated with corresponding drugs by gavage， and the control and model groups received an equivalent volume of normal saline for 14 days. One hour after the last gavage， the other groups except the control group were injected intraperitoneally with posterior pituitary hormone （30 U·kg^-1） to induce MI. Electrocardiography （ECG） was employed to detect changes in the electrocardiogram. Hematoxylin-eosin staining was performed to observe cardiac pathological changes. Enzyme-linked immunosorbent assay was employed to measure the serum levels of cardiac troponin I（cTnI）， myoglobin （MYO）， and creatine kinase-MB （CK-MB）. Colorimetry was used to determine the levels of total cholesterol （TC） and triglycerides （TG） in the serum and ATP， malondialdehyde （MDA）， and superoxide dismutase （SOD） in the myocardial tissue. Western blot was employed to determine the protein levels of SIRT3， PGC-1α， adenosine monophosphate-activated protein kinase （AMPK）， and phosphorylated AMPK （p-AMPK） in the myocardial tissue. Real-time PCR was employed to measure the mRNA levels of SIRT3， PGC-1α， and AMPKα in the myocardial tissue. ResultsCompared with the control group， the model group showed significant J-point deviation and elevation in the ECG image， increased heart rate， disarrangement of myocardial fibers with unclear boundaries， elevated levels of CK-MB， cTnI， MYO， TC， and TG （P<0.05， P<0.01）， declined levels of SOD and ATP （P<0.01）， down-regulated mRNA levels of SIRT3， PGC-1α， and AMPK （P<0.05）， and down-regulated protein levels of SIRT3， PGC-1α， and p-AMPK （P<0.05）. Compared with the model group， the low-dose and high-dose Wendantang groups and the trimetazidine group showed inhibited J-point deviation and elevation in the ECG image， slowed heart rate， reduced inflammatory cell infiltration， alleviated disarrangement of myocardial fibers， declined levels of CK-MB， cTnI， MYO， TC， and TG （P<0.05， P<0.01）， elevated level of SOD （P<0.01）， up-regulated mRNA levels of SIRT3， PGC-1α， and AMPK （P<0.05， P<0.01） and up-regulated protein levels of SIRT3， PGC-1α， and p-AMPK （P<0.05， P<0.01）. ConclusionWendantang can effectively intervene in HL-associated MI in rats by reducing oxidative stress in myocardial cells， alleviating lipid metabolism disorders， and improving myocardial energy metabolism via the SIRT3/PGC-1α signaling pathway.

[Objective] To compare the clinical efficacy of super pulse thulium laser enucleation of the prostate (SPThuLEP) with "open tunnel" and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH), in order to provide reference for the treatment options of BPH. [Methods] The clinical data of 112 BPH patients treated in our hospital during Jan.2023 and Jul.2023 were retrospectively analyzed, including 65 treated with SPThuLEP with "open tunnel" and 57 with HoLEP.The operation time, postoperative hemoglobin decrease, postoperative bladder irrigation, catheter indwelling time, hospitalization time and complications were compared between the two groups.The changes of maximum urine flow rate (Qmax), international prostate symptom score (IPSS), quality of life score (QoL), postvoid residual (PVR) and prostate-specific antigen (PSA) were compared between the two groups before operation and one month after operation. [Results] All operations were successful without conversion to open or transurethral plasmakinetic resection.The postoperative decrease of hemoglobin in SPThuLEP group was lower than that in HoLEP group [(13.12±6.72) g/L vs. (21.02±6.51) g/L], with statistical difference (P<0.05). There were no significant differences in the operation time [(63.35±15.73) min vs.(61.02±17.55) min], postoperative bladder irrigation time [(1.07±0.45) d vs. (1.06±0.36) d], catheter indwelling time [(2.98±0.56) d vs. (3.01±0.63) d] and hospitalization time [(3.63±0.61) d vs.(3.79±0.76) d] between the two groups (P>0.05). No blood transfusion, secondary bleeding or unplanned hospitalization occurred, and there were no serious complications such as transurethral electroresection syndrome (TURS), urethral stricture and urinary incontinence.One month after operation, the Qmax, IPSS, QoL, PVR and PSA of the two groups were significantly improved compared with those before operation (P<0.05), but with no statistical difference between the two groups (P>0.05). [Conclusion] SPThuLEP with "open tunnel" has comparable efficacy as HoLEP in the treatment of BPH.With advantages of small amount of bleeding and high safety, this minimally invasive technique can be widely popularized in clinical practice.

Objective To investigate and analyze the resources and application frequency of radiological diagnosis and treatment in Jinan City in 2023 and provide a basis for the rational application of radiological diagnosis and treatment resources and strengthening radiological health protection management. Methods The health administrative department issued a work plan. A general survey was conducted on radiological diagnosis and treatment institutions (excluding dental clinics) in Jinan City using a questionnaire. The survey covered the basic information of the radiological diagnosis and treatment institutions, the distribution of the radiological diagnosis and treatment equipment, the number of radiological workers, and the frequency of radiological diagnosis and treatment. Results There were 301 radiological diagnosis and treatment institutions in Jinan City, with 1603 sets of radiological diagnosis and treatment equipment and 5789 radiological workers. These institutions included 41 (13.62%) tertiary hospitals, 57 (18.94%) secondary hospitals, 110 (36.54%) primary hospitals, and 93 (30.90%) ungraded hospitals. Tertiary hospitals had the highest proportions of radiological diagnosis and treatment equipment and workers, accounting for 49.53% and 69.10% of the total, respectively. The frequencies of radiological diagnosis and treatment were 868.86 X-ray diagnostic imaging examinations per 1000 population, 5.07 radiotherapies per 1000 population, 14.19 interventional diagnostic and therapeutic procedures per 1000 population, 7.36 nuclear medical diagnostic procedures per 1000 population, and 0.56 nuclear medical therapeutic procedures per 1000 population. The frequency of CT diagnosis was the highest, reaching 407.76 procedures per 1000 population. Conclusion The radiological diagnosis and treatment resources and activities in Jinan City were mainly concentrated in tertiary hospitals, with unbalanced distribution among hospitals of different grades. It is necessary to apply various medical radiations correctly and reasonably and strengthen radiation protection to reduce the frequency of radiation and the collective effective dose.

Objective To construct intrauterine adhesion (IUA) mouse models induced by two different concentrations of ethanol injury, compare the phenotypes, and optimize a more stable IUA modeling method. Methods Twenty 8-week-old female C57BL/6N mice were randomly divided into two groups: the 95% ethanol injury group and the 50% ethanol injury group. Using a self-control method, the left uterine horn was infused with ethanol to establish the IUA model, while the right uterine horn was infused with saline as the sham operation. Five mice from each group were euthanized on day 7 and 15 after modeling, and uterine tissues were collected. Hematoxylin-eosin (HE) staining was used to observe the endometrial pathology, and Masson staining was used to assess the degree of endometrial fibrosis. Quantitative real-time PCR was employed to detect the expression levels of fibrosis markers and pro-inflammatory factors in the uterine tissues. Results Compared to the sham operation, these two ethanol injury led to a significant reduction in elasticity of the uterus, an increase in inflammatory infiltration, and a marked increase in the degree of fibrosis on day 7 after modeling (P<0.05). The 95% ethanol injury group showed a significant decrease in endometrial thickness (P<0.05), whereas no significant change was observed in the 50% ethanol injury group when compared to the sham operation (P>0.05). The expression levels of fibrotic marker molecules collagen type Ⅳ alpha 1 chain (Col4A1), α-smooth muscle actin (α-SMA), transforming growth factor-β (TGF-β), and pro-inflammatory factors tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were significantly elevated in the 50% ethanol injury group when compared to the sham operation (P<0.05), although there was an increasing trend of the same markers in the 95% ethanol injury group, the differences were not statistically significant (P>0.05). On day 15 after modeling, the histopathological changes in both ethanol injury groups were not significant when compared to the sham operation, the expression levels of Col4A1, TGF-β, TNF-α and IL-1β remained significantly higher in the 50% ethanol injury group (P<0.05), while only IL-1β was significantly elevated in the 95% ethanol injury group (P<0.05). Conclusion Uterine infusion with 95% ethanol results in more marked histopathological changes in the IUA mouse model compared to the 50% ethanol injury group. The 95% ethanol injury model is suitable for histopathological studies. However, the 50% ethanol injury group shows higher expression levels of fibrosis markers and pro-inflammatory factors compared to the 95% ethanol injury group, suggesting that the 50% ethanol injury model is more suitable for molecular pathological study.

OBJECTIVE: To observe the clinical efficacy of acupoint magnetotherapy as an adjunctive treatment for mild to moderate hypertension with yin deficiency and yang hyperactivity. METHODS: A total of 66 patients with mild to moderate hypertension of yin deficiency and yang hyperactivity were randomly divided into a magnetotherapy group (33 cases, 3 cases dropped out) and a non-magnetotherapy group (33 cases, 4 cases dropped out). Both groups were given antihypertensive drugs based on their clinical conditions. The magnetotherapy group and the non-magnetotherapy group wore surface magnetic therapy bands with or without magnetic poles, respectively, at unilateral Neiguan (PC6) and Waiguan (TE5). Intervention was administered once daily, 8 h each time, for a continuous period of 4 weeks. Traditional Chinese Medicine (TCM) syndrome score, Du's hypertension quality of life (QOL) scale score, office blood pressure, and 24-hour ambulatory blood pressure were assessed before and after the intervention, and the clinical efficacy was evaluated after intervention. RESULTS: After the intervention, both groups showed reductions in TCM syndrome scores, office systolic blood pressure (SBP), and diastolic blood pressure (DBP) compared with those before intervention (P<0.001), and their Du's QOL scores increased (P<0.001). The magnetotherapy group had lower TCM syndrome score and office SBP and DBP than those in the non-magnetotherapy group (P<0.001), while Du's QOL score was higher (P<0.001). After the intervention, all 24-hour ambulatory blood pressure indexes in the magnetotherapy group were reduced compared with those before intervention (P<0.05); in the non-magnetotherapy group, 24-hour average diastolic blood pressure (24hDBP), nighttime average systolic blood pressure (nSBP), and nighttime average diastolic blood pressure (nDBP) were reduced (P<0.05). The 24-hour average systolic blood pressure (24hSBP), 24hDBP, daytime average systolic blood pressure (dSBP), daytime average diastolic blood pressure (dDBP), and nSBP after intervention in the magnetotherapy group were lower than those in the non-magnetotherapy group (P<0.05). The total effective rate in the magnetotherapy group was 93.3% (28/30), which was higher than 75.9% (22/29) in the non-magnetotherapy group (P<0.05). CONCLUSION Acupoint magnetotherapy as an adjunctive treatment for mild to moderate hypertension with yin deficiency and yang hyperactivity could effectively alleviate clinical symptoms and TCM syndromes, improve quality of life, and reduce blood pressure level.
Humans ; Male ; Female ; Middle Aged ; Acupuncture Points ; Hypertension/physiopathology* ; Adult ; Yin Deficiency/physiopathology* ; Aged ; Blood Pressure ; Magnetic Field Therapy ; Acupuncture Therapy ; Treatment Outcome ; Combined Modality Therapy

BACKGROUND: Neoadjuvant therapy enhances the possibility of achieving radical resection and improves the prognosis for locally advanced gastric cancer (GC). However, there is a lack of evidence regarding the optimal extent of resection for locally advanced proximal GC after neoadjuvant therapy. METHODS: In this study, 330 patients underwent resection in Peking University Cancer Hospital, with curative intent after neoadjuvant therapy for histologically confirmed proximal GC from January 2009 to December 2022. RESULTS: In this study, 45 patients underwent proximal gastrectomy (PG), while 285 underwent total gastrectomy (TG). After propensity-score matching, 110 patients (71 TG and 39 PG) were included in the analysis. No significant differences between PG and TG regarding short-term outcomes and long-term prognosis were found. Specifically, PG demonstrated comparable overall survival to TG ( P = 0.47). Subgroup analysis revealed that although not statistically significant, PG showed a potential advantage over TG in overall survival for patients with tumor-long diameters less than 4 cm ( P  = 0.31). However, for those with a long diameter larger than 4 cm, TG had a better survival probability ( P  = 0.81). No substantial differences were observed in baseline characteristics, surgical safety, postoperative recovery, and postoperative complications. CONCLUSION For locally advanced proximal GC with objective response to neoadjuvant therapy (long diameter <4 cm), PG is an alternative surgical procedure.
Humans ; Stomach Neoplasms/drug therapy* ; Gastrectomy/methods* ; Neoadjuvant Therapy/methods* ; Male ; Female ; Middle Aged ; Propensity Score ; Aged ; Adult ; Retrospective Studies

Idiopathic pulmonary fibrosis (IPF), a chronic interstitial lung disease, is characterized by aberrant wound healing, excessive scarring and the formation of myofibroblastic foci. Although the role of alternative splicing (AS) in the pathogenesis of organ fibrosis has garnered increasing attention, its specific contribution to pulmonary fibrosis remains incompletely understood. In this study, we identified an up-regulation of serine/arginine-rich splicing factor 7 (SRSF7) in lung fibroblasts derived from IPF patients and a bleomycin (BLM)-induced mouse model, and further characterized its functional role in both human fetal lung fibroblasts and mice. We demonstrated that enhanced expression of Srsf7 in mice spontaneously induced alveolar collagen accumulation. Mechanistically, we investigated alternative splicing events and revealed that SRSF7 modulates the alternative splicing of pyruvate kinase (PKM), leading to metabolic dysregulation and fibroblast activation. In vivo studies showed that fibroblast-specific knockout of Srsf7 in conditional knockout mice conferred resistance to bleomycin-induced pulmonary fibrosis. Importantly, through drug screening, we identified lomitapide as a novel modulator of SRSF7, which effectively mitigated experimental pulmonary fibrosis. Collectively, our findings elucidate a molecular pathway by which SRSF7 drives fibroblast metabolic dysregulation and propose a potential therapeutic strategy for pulmonary fibrosis.

OBJECTIVES: To analyze the differentially expressed exosomal miRNAs in patients with chronic heart failure (CHF) complicated by hyperuricemia (HUA) and explore their potential as novel diagnostic molecular markers and their target genes. METHODS: This study was conducted among 30 CHF patients with HUA (observation group) and 30 healthy volunteers (control group) enrolled between September, 2020 and September, 2023. Peripheral blood samples were collected from 6 CHF patients with HUA for analyzing exosomal miRNAs by high-throughput sequencing, and the results were validated in the remaining 24 patients using qRT-PCR. GO and KEGG enrichment analyses were performed to predict the the target genes of the identified differential miRNAs. We also validated the differentially expressed miRNAs by animal experiment. RESULTS: A total of 42 differentially expressed exosomal miRNAs were detected in observation group by high-throughput sequencing; among them, miR-27a-5p was significantly upregulated (P=0.000179), and miR-139-3p was significantly downregulated (P=0.000058). In the 24 patients with both CHF and PUA, qRT-PCR validated significant upregulation of miR-27a-5p (P=0.004) and downregulation of miR-139-3p (P=0.005) in serum exosomes. When combined, miR-27a-5p and miR-139-3p had a maximum area under the curve (AUC) of 0.899 (95% CI: 0812-0.987) for predicting CHF complicated by HUA. GO and KEGG enrichment analyses suggested that the differential expressions of miR-27a-5p and miR-139-3p was associated with the activation of the AMPK-mTOR signaling pathway to activate the autophagic response. We obtained the same conclusion from animal experiment. CONCLUSIONS Upregulated exosomal miR-27a-5p combined with downregulated exosomal miR-139-3p expression can serve as a novel molecular marker for diagnosis of CHF complicated by HUA, and their differential expression may promote autophagy in cardiomyocytes by activating the AMPK-mTOR signaling pathway.
Humans ; Hyperuricemia/diagnosis* ; Heart Failure/genetics* ; MicroRNAs/metabolism* ; Exosomes/metabolism* ; Chronic Disease ; Male ; Female ; Middle Aged ; Animals

Magnetic stimulation has made significant strides in the treatment of psychiatric disorders. Nonetheless, current magnetic stimulation techniques lack the precision to accurately modulate specific nuclei and cannot realize deep brain magnetic stimulation. To address this, we utilized superparamagnetic iron oxide nanoparticles as mediators to achieve precise targeting and penetration. We investigated the effects of magnetic fields with varying frequencies on neuronal activity and compared the activation effects on neurons using a 10-Hz precise magneto-stimulation system (pMSS) with repetitive transcranial magnetic stimulation in mice. Oxytocin levels, dendritic morphology and density, and mouse behavior were measured before and after pMSS intervention. Our findings suggest that pMSS can activate oxytocinergic neurons, leading to upregulation of oxytocin secretion and neurite outgrowth. As a result, sociability was rapidly improved after a one-week pMSS treatment regimen. These results demonstrate a promising magneto-stimulation method for regulating neuronal activity in deep brain nuclei and provide a promising therapeutic approach for autism spectrum disorder.
Animals ; Autism Spectrum Disorder/physiopathology* ; Paraventricular Hypothalamic Nucleus/physiology* ; Disease Models, Animal ; Transcranial Magnetic Stimulation/methods* ; Male ; Social Behavior ; Mice ; Oxytocin/metabolism* ; Mice, Inbred C57BL ; Neurons/physiology*

This study aimed to comprehensively examine the association of gallstones, cholecystectomy, and cancer risk. Multivariable logistic regressions were performed to estimate the observational associations of gallstones and cholecystectomy with cancer risk, using data from a nationwide cohort involving 239 799 participants. General and gender-specific two-sample Mendelian randomization (MR) analysis was further conducted to assess the causalities of the observed associations. Observationally, a history of gallstones without cholecystectomy was associated with a high risk of stomach cancer (adjusted odds ratio (aOR)=2.54, 95% confidence interval (CI) 1.50-4.28), liver and bile duct cancer (aOR=2.46, 95% CI 1.17-5.16), kidney cancer (aOR=2.04, 95% CI 1.05-3.94), and bladder cancer (aOR=2.23, 95% CI 1.01-5.13) in the general population, as well as cervical cancer (aOR=1.69, 95% CI 1.12-2.56) in women. Moreover, cholecystectomy was associated with high odds of stomach cancer (aOR=2.41, 95% CI 1.29-4.49), colorectal cancer (aOR=1.83, 95% CI 1.18-2.85), and cancer of liver and bile duct (aOR=2.58, 95% CI 1.11-6.02). MR analysis only supported the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer. This study added evidence to the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer, highlighting the importance of cancer screening in individuals with gallstones.
Humans ; Mendelian Randomization Analysis ; Gallstones/complications* ; Female ; Male ; Cholecystectomy/statistics & numerical data* ; Middle Aged ; Risk Factors ; Aged ; Adult ; Neoplasms/etiology* ; Stomach Neoplasms/epidemiology*