Objective:To analyze the effect of rosuvastatin combined with sodium tanshinone Ⅱ A sulfonate(STS)on blood lipids,cardiac function and serum inflammatory factors in elderly patients with stable angina pectoris(SAP)and hyperlipidemia(HLP).Methods:This randomized controlled study enrolled 140 elderly patients with SAP and HLP admitted in the Third People's Hospital of Liaocheng between December 2021 and December 2023.Patients were divided into control group(n=70,took rosuvastatin orally)and combination group(n=70,treated with ro-suvastatin combined with STS).Both groups were treated for two weeks.Clinical effects,blood lipids,cardiac function and serum inflammatory factors and incidence of adverse reactions were compared between the two groups.Results:Total effective rate of combination group was significantly higher than that of control group(92.86％vs.80.00％,P=0.026).Compared with patients in control group,those in combination group had significant lower triglyceride(TG)[(1.42±0.39)mmol/L vs.(1.69±0.11)mmol/L],total cholesterol(TC)[(4.37±0.69)mmol/L vs.(5.25±0.43)mmol/L]and low density lipoprotein-cholesterol(LDL-C)[(2.62±0.39)mmol/L vs.(3.19±0.38)mmol/L],and significant higher high-density lipoprotein cholesterol(HDL-C)[(1.24±0.31)mmol/L vs.(1.10±0.22)mmol/L](P＜0.01 all).Compared with patients in control group,those in combination group had significant higher left ventricular ejection fraction(LVEF)[(59.13±5.46)％vs.(55.97±4.02)％,P＜0.001],and significant lower C-reactive protein(CRP)[(2.66±0.68)mg/L vs.(3.50±1.61)mg/L],tumor necrosis factor-α(TNF-α)[(93.34±19.26)pg/ml vs.(111.70±25.00)pg/ml]and interleukin-6(IL-6)[(76.28±23.88)pg/ml vs.(100.64±27.52)pg/ml](P＜0.001 all).There was no significant difference in the total incidence rate of adverse reactions between two groups(25.7％vs.14.3％,P=0.091).Conclusion:Rosuvas-tatin combined with STS is effective in the treatment of elderly patients with SAP and HLP.It is superior to rosuvas-tatin alone in terms of improving blood lipids,cardiac function and serum inflammatory factors.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:Previous studies have shown that insomnia is closely related to erectile dysfunction(ED).However,the causal relationship between them is still unclear.Mendelian randomization(MR)provides a new method for studying the relationship between the two,and the theory of heart-kidney interaction in TCM provides a new idea for exploring the causal relationship between them.Methods:Based on the statistical data collected by genome-wide association studies(GWAS),the causal relationship be-tween insomnia and ED was discussed by MR.Inverse variance weighted(IVW)is the main analysis method,and weighted median(WME),simple mode(SM),weighted mode(WM)and MR Egger method were the supplementary analysis to evaluate the causal effect.MR-Egger intercept test,Cochran Q test and leave-one-out method were used in sensitivity analysis to verify the reliability of MR results.Results:Thirty-nine SNPs significantly related to insomnia were finally included for MR analysis.The results of IVW method in MR analysis showed that insomnia had a significant causal relationship with the increased risk of ED(OR=3.111,95％CI=1.566-6.181,P=1.193 × 10-3).The results obtained by MR-Egger method,WME method,WM method and SM method were consistent with IVW method in the direction of effect.The sensitivity results suggested that the results of this study were robust.Conclusion:Our study reveals the causal relationship between insomnia and ED,which provides a new basis for future clinical practice and prevention and treatment of ED.

Objective:To analyze the effect of rosuvastatin combined with sodium tanshinone Ⅱ A sulfonate(STS)on blood lipids,cardiac function and serum inflammatory factors in elderly patients with stable angina pectoris(SAP)and hyperlipidemia(HLP).Methods:This randomized controlled study enrolled 140 elderly patients with SAP and HLP admitted in the Third People's Hospital of Liaocheng between December 2021 and December 2023.Patients were divided into control group(n=70,took rosuvastatin orally)and combination group(n=70,treated with ro-suvastatin combined with STS).Both groups were treated for two weeks.Clinical effects,blood lipids,cardiac function and serum inflammatory factors and incidence of adverse reactions were compared between the two groups.Results:Total effective rate of combination group was significantly higher than that of control group(92.86％vs.80.00％,P=0.026).Compared with patients in control group,those in combination group had significant lower triglyceride(TG)[(1.42±0.39)mmol/L vs.(1.69±0.11)mmol/L],total cholesterol(TC)[(4.37±0.69)mmol/L vs.(5.25±0.43)mmol/L]and low density lipoprotein-cholesterol(LDL-C)[(2.62±0.39)mmol/L vs.(3.19±0.38)mmol/L],and significant higher high-density lipoprotein cholesterol(HDL-C)[(1.24±0.31)mmol/L vs.(1.10±0.22)mmol/L](P＜0.01 all).Compared with patients in control group,those in combination group had significant higher left ventricular ejection fraction(LVEF)[(59.13±5.46)％vs.(55.97±4.02)％,P＜0.001],and significant lower C-reactive protein(CRP)[(2.66±0.68)mg/L vs.(3.50±1.61)mg/L],tumor necrosis factor-α(TNF-α)[(93.34±19.26)pg/ml vs.(111.70±25.00)pg/ml]and interleukin-6(IL-6)[(76.28±23.88)pg/ml vs.(100.64±27.52)pg/ml](P＜0.001 all).There was no significant difference in the total incidence rate of adverse reactions between two groups(25.7％vs.14.3％,P=0.091).Conclusion:Rosuvas-tatin combined with STS is effective in the treatment of elderly patients with SAP and HLP.It is superior to rosuvas-tatin alone in terms of improving blood lipids,cardiac function and serum inflammatory factors.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Aim To clarify the differential proteins of mammary tissues in Xihuang pills(XHP)against hy-perplasia of mammary glands(HMG)based on quanti-tative proteomics technology and validate them,and to explore the mechanism of action.Methods SD rats were randomly divided into blank group,model group and XHP group,with 10 rats in each group.Except for the blank group,estrogen and progesterone were injec-ted intramuscularly to establish a rat model of mamma-ry hyperplasia for 30 d.After XHP was administered for 14 d,the rats in each group were observed to have morphological changes in the apparent morphology of the mammary tissues,and pathological changes in the mammary tissues were stained with hematoxylin-eosin staining(HE),and the differentially expressed pro-teins(DEPs)in the groups were screened by quantita-tive proteomics technology and subjected to bioinforma-tics analysis,and Western blot to verify the key DEPs.Results Compared with the model group,the appar-ent pathological morphology of the XHP group was sig-nificantly improved,the diameter of the nipple height of the rats was significantly reduced(P＜0.01),and the degree of histopathology was significantly allevia-ted.Quantitative proteomics identified 4,299 DEPs in mammary tissue,and bioinformatics analysis of 14 DEPs with consistent changes between the XHP group and the blank group relative to the model group re-vealed that they were related to the regulation of mus-cular systemic processes,regulation of muscle contrac-tion,DNA replication,and pre-initiation of DNA repli-cation.Western blot results showed that,compared with the model group,rat mammary tissue of the XHP group showed significantly lower levels of ACLY and ALDOC protein expression levels were significantly re-duced and BIN1 protein expression levels were signifi-cantly increased(P＜0.01).Conclusions XHP may exert its anti-mammary hyperplasia effect through the regulation of BIN1,ACLY and ALDOC protein lev-els,the regulation of DNA replication,the regulation of pre-initiation of DNA replication and muscular sys-temic processes,and the regulation of muscle contrac-tion.

Activation of nuclear factor erythroid 2-related factor 2(Nrf2)by Kelch-like ECH-associated protein 1(Keap1)alkylation plays a central role in anti-inflammatory therapy.However,activators of Nrf2 through alkylation of Keap1-Kelch domain have not been identified.Deoxynyboquinone(DNQ)is a natural small molecule discovered from marine actinomycetes.The current study was designed to investigate the anti-inflammatory effects and molecular mechanisms of DNQ via alkylation of Keap1.DNQ exhibited signif-icant anti-inflammatory properties both in vitro and in vivo.The pharmacophore responsible for the anti-inflammatory properties of DNQ was determined to be the α,β-unsaturated amides moieties by a chemical reaction between DNQ and N-acetylcysteine.DNQ exerted anti-inflammatory effects through activation of Nrf2/ARE pathway.Keap1 was demonstrated to be the direct target of DNQ and bound with DNQ through conjugate addition reaction involving alkylation.The specific alkylation site of DNQ on Keap1 for Nrf2 activation was elucidated with a synthesized probe in conjunction with liquid chromatography-tandem mass spectrometry.DNQ triggered the ubiquitination and subsequent degra-dation of Keap1 by alkylation of the cysteine residue 489(Cys489)on Keap1-Kelch domain,ultimately enabling the activation of Nrf2.Our findings revealed that DNQ exhibited potent anti-inflammatory capacity through α,β-unsaturated amides moieties active group which specifically activated Nrf2 signal pathway via alkylation/ubiquitination of Keap1-Kelch domain,suggesting the potential values of targeting Cys489 on Keap1-Kelch domain by DNQ-like small molecules in inflammatory therapies.

Objective: To investigate the surgical indications and perioperative clinical outcomes of pelvic exenteration (PE) for locally advanced, recurrent pelvic malignancies and complex pelvic fistulas. Methods: This was a descriptive study.The indications for performing PE were: (1) locally advanced, recurrent pelvic malignancy or complex pelvic fistula diagnosed preoperatively by imaging and pathological examination of a biopsy; (2)preoperative agreement by a multi-disciplinary team that non-surgical and conventional surgical treatment had failed and PE was required; and (3) findings on intraoperative exploration confirming this conclusion.Contraindications to this surgical procedure comprised cardiac and respiratory dysfunction, poor nutritional status,and mental state too poor to tolerate the procedure.Clinical data of 141 patients who met the above criteria, had undergone PE in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to September 2022, had complete perioperative clinical data, and had given written informed consent to the procedure were collected,and the operation,relevant perioperative variables, postoperative pathological findings (curative resection), and early postoperative complications were analyzed. Results: Of the 141 included patients, 43 (30.5%) had primary malignancies, 61 (43.3%) recurrent malignancies, 28 (19.9%) complex fistulas after radical resection of malignancies,and nine (6.4%)complex fistulas caused by benign disease. There were 79 cases (56.0%) of gastrointestinal tumors, 30 cases (21.3%) of reproductive tumors, 16 cases (11.3%) of urinary tumors, and 7 cases (5.0%) of other tumors such mesenchymal tissue tumors. Among the 104 patients with primary and recurrent malignancies, 15 patients with severe complications of pelvic perineum of advanced tumors were planned to undergo palliative PE surgery for symptom relief after preoperative assessment of multidisciplinary team; the other 89 patients were evaluated for radical PE surgery. All surgeries were successfully completed. Total PE was performed on 73 patients (51.8%),anterior PE on 22 (15.6%),and posterior PE in 46 (32.6%). The median operative time was 576 (453,679) minutes, median intraoperative blood loss 500 (200, 1 200) ml, and median hospital stay 17 (13.0,30.5)days.There were no intraoperative deaths. Of the 89 patients evaluated for radical PE surgery, the radical R0 resection was achieved in 64 (71.9%) of them, R1 resection in 23 (25.8%), and R2 resection in two (2.2%). One or more postoperative complications occurred in 85 cases (60.3%), 32 (22.7%)of which were Clavien-Dindo grade III and above.One patient (0.7%)died during the perioperative period. Conclusion: PE is a valid option for treating locally advanced or recurrent pelvic malignancies and complex pelvic fistulas.
Humans ; Pelvic Exenteration/methods* ; Pelvic Neoplasms/surgery* ; Retrospective Studies ; Neoplasm Recurrence, Local/surgery* ; Postoperative Complications

Novel coronavirus Omicron variant infection can cause severe illness and even death in certain populations. Omicron variant infection may lead to systemic inflammatory response, coagulation disorder, multi-organ dysfunction and other pathophysiological changes, which are different from other Novel coronavirus variants to a certain extent, so therapeutic strategies should not be the same. The National Medical Center for Major Public Health Events invited experts in fields of infectious diseases, respiratory medicine, intensive care, pediatrics and fever clinic to develop this quick guideline based on the current best evidence and extensive clinical practices. This quick guideline aims to standardize the diagnosis and treatment of novel coronavirus Omicron infection, and to improve the disease management abilities of clinicians.

Objective To explore the nutritional efficacy of compound protein powder formulations from different sources. Methods Three groups of compound protein powder formulations were obtained through scientific blending using soy protein, whey protein and yeast protein as raw materials. The effects of the compound protein powders on nitrogen metabolism, serum biochemical indicators, and pathological changes of liver tissue and epididymal fat in rats were evaluated. Results Compared with the control (casein), the net protein utilization, biological evaluation, and protein efficacy ratio of the compound protein powders in rats were significantly improved, and the changes in these indicators in the formula with the highest whey protein content were most significant among all three formulas. The compound protein powders effectively increased the levels of albumin and globulin, while decreased the content of total cholesterol, indicating beneficial effects on improving immunity and controlling lipid metabolism, with the formula group 2 being the most effective among all three groups. The pathological examination showed that the three groups of protein powder did not have adverse effects on liver tissue and epididymal fat. Conclusion The present study demonstrates that the compound protein powder formulation has nutritional value, which suggests a potential of the application of the compound protein powder formulation in the elderly, and people with special nutritional needs, such as sports people.