Objective To establish and validate the diagnostic model of ferroptosis genes for acute myocardial infarction (AMI) based on bioinformatics. Methods Five AMI gene expression data were obtained from Gene Expression Omnibus (GEO), namely GSE66360, GSE48060, GSE60993, GSE83500, GSE34198. Among them, GSE66360 was used as the training set to perform differential analysis, and intersection of differential genes and ferroptosis genes was taken to obtain differentially expressed ferroptosis genes in AMI. GO and KEGG enrichment analyses were performed using Metascape website. Subsequently, random forest (RF) algorithm was used to screen out key genes with high classification performance according to the Keeny coefficient score, and artificial neural network (ANN) diagnostic model of AMI ferroptosis feature gene was constructed by model group GSE83500. The area under the receiver operating characteristic curve (AUC) of 10-fold cross-validation was used to evaluate the performance and generalization ability of the model, and 3 external independent datasets were used to verify the diagnostic performance of this model. The single sample gene set enrichment analysis was used to explore the difference in immune cell infiltration between infarcted myocardium and normal myocardium after AMI. In addition, correlation analysis between immune cells and key genes was also conducted. Finally, potential drugs that would prevent and treat AMI by regulating ferroptosis were screened out from the Coremin Medical platform. Results A total of 16 differentially expressed ferroptosis genes were obtained in the training set, GO enrichment analysis showed that they mainly participated in biological functions such as cellular response to biological stimuli and chemical stress, and regulation of interleukin 17. KEGG enrichment analysis showed that these genes were significantly enriched in NOD-like receptor signaling pathway, programmed cell necrosis, Leishmaniasis and other pathways. Four genes with good classification performance were screened out using RF algorithm, namely EPAS1, SLC7A5, FTH1, and ZFP36. The results of 10-fold cross-validation showed that the minimum AUC value was 0.746, the maximum value was 0.906, and the average value was 0.805. The AUC of the ANN model was 0.859, and the AUC values of the three independent validation sets were 0.763 (GSE48060), 0.673 (GSE60993), 0.698 (GSE34198). Immune cell infiltration found that macrophages, mast cells and monocytes were significantly active after AMI. Correlation analysis found that there were positive correlations between 4 key genes and activated dendritic cells, eosinophils and γδT cells. A total of 20 potential western medicines were predicted which could prevent and treat AMI by regulating ferroptosis, and the predicted potential Chinese medicine was mainly heat-clearing and detoxifying and blood-activating and removing blood stasis drugs. Conclusion The identified AMI ferroptosis genes by bioinformatics method have certain diagnostic significance, which provides a reference for disease diagnosis and treatment.

Objective To investigate the differences and influencing factors of chronic heart failure(CHF)with qi deficiency and blood stasis syndrome and with other TCM syndrome types.Methods Totally 354 CHF patients from Dongzhimen Hospital of Beijing University of Chinese Medicine were enrolled from January 2019 to December 2023,including 242 cases of qi deficiency and blood stasis syndrome,52 cases of qi and yin deficiency and blood stasis syndrome,and 60 cases of yang qi deficiency and blood stasis syndrome.The general demographic sociological characteristics of patients with each syndrome type,the New York Heart Association cardiac function classification(NYHA classification),and the heart failure classification were collected.The cardiac function-related indexes and laboratory examination indicators were detected.The Minnesota Heart Failure Patients'Life Questionnaire(MLHFQ)was used to evaluate the quality of life of the patients in three areas:physical,emotional and other three domains.The differences of the above factors among patients with different syndrome types were compared,and a disordered multi-categorical logistics regression model of TCM syndrome types was constructed to analyze the association between the above factors and qi deficiency and blood stasis syndrome.Traditional Chinese Medicine Inheritance Calculation Platform 3.0 was used to analyze the frequency,property,taste and meridian tropism of prescription drugs.Results The proportion of patients with NYHAⅡ qi deficiency and blood stasis syndrome was higher than that of the group with qi and yin deficiency and blood stasis syndrome(P<0.05);the left ventricular ejection fraction in patients with yang qi deficiency and blood stasis pattern was significantly lower than that in patients with qi deficiency and blood stasis pattern(P<0.05);and the scores of the body domain,other domain and the total score of the MLHFQ questionnaire in patients with qi deficiency and blood stasis pattern were lower than those of the other two syndrome types(P<0.05);the serum neutrophils(NE%),C-reactive protein(CRP)and interleukin-6(IL-6)in the qi and yin deficiency and blood stasis syndrome were higher than those in the group with qi deficiency and blood stasis syndrome(P<0.05).Multivariate Logistics regression analysis showed that arrhythmia,CRP and IL-6 were independent influencing factors for CHF with qi deficiency and blood stasis syndrome(P<0.05).Totally 284 prescriptions were included,involving 190 kinds of Chinese materia medica.The top 10 were Astragali Radix,Ophiopogonis Radix,Lonicerae Japonicae Flos,Pseudostellariae Radix,Hordei Fructus Germinatus,Galli Gigerii Endothelium Corneumm,Puerariae Lobatue Radix,Scrophulariae Radix,Ziziphi Spinosae Semen and Citri Reticulatae Pericarpium.Conclusion Qi deficiency and blood stasis syndrome is a relatively stable stage of CHF,with cardiac function mainly distributed in grade Ⅱ,Ⅲ,with a relatively high proportion of heart failure with preserved ejection fraction,fewer other underlying diseases,lower inflammatory indicators,and relatively good quality of life.Combined arrhythmia,CRP and IL-6 indicators can be used as an auxiliary basis for syndrome differentiation of qi deficiency and blood stasis syndrome.

Objective:To investigate the personnel, equipment, new technology of various radiotherapy units in Gansu Province, aiming to deeply understand the current status of radiotherapy in Gansu Province.Methods:From March 2023 to March 2024, the data of personnel, equipment and technology of different radiotherapy units in Gansu Province were investigated via online questionnaire survey and offline field visits by Gansu Provincial Quality Control Center for Radiation Oncology. The questionable data were reviewed, logical verification and outlier identification were conducted, and all information was entered according to the principle of double entry. Qualitative data were described by frequency (percentage).Results:As of March 2024, there are 26 radiotherapy units in Gansu Province, including 7 units in Lanzhou, capital city of Gansu Province and none in Linxia Hui Autonomous Prefecture and Gannan Tibetan Autonomous Prefecture. The ratio of radiotherapy physicians and physicists was 2.71 vs. 1, lower than the national level of 3.51 vs. 1. Radiotherapy physicians with intermediate and senior titles accounted for 66.2%, 54% for physicists with intermediate and senior titles and 34.0% for therapists with intermediate and senior titles, respectively. There were 1.70 accelerators per million population in Gansu Province. Among 42 accelerators in Gansu Province, 40 were linac and 2 heavy ion accelerators. In Lanzhou, 7 radiotherapy units had 17 linac, and the remaining 11 cities had 23 linac. All 40 linac could perform 3D conformal radiotherapy and intensity-modulated radiotherapy. The high-end equipment could apply advanced technologies such as volumetric modulated arc radiotherapy, stereotactic body radiotherapy, optical surface-guided radiation therapy and adaptive radiation therapy, etc. Relevant data in this survey were improved compared with those in the national surveys conducted in 2006, 2015 and 2019. Conclusions:The radiotherapy status has developed in Gansu Province, whereas uneven development still exists among regions. According to the actual demands of equipment, talents and technology in each region, the structural adjustment should be oriented to the underdeveloped cities and counties in the province to meet the local medical needs.

Objective To evaluate the efficacy and safety of enteric-coated metformin hydrochloride capsules(Junlida?)in patients with T2DM and poor glycemic control under lifestyle interventions.Methods In this study,419 patients with T2DM were recruited from 15 research centers from July 2020 to March 2022,and randomly divided into observation(Obs)group(n=209)and control group(Con,n=210)using a multicenter,randomized,double-blind,non-inferiority trial design.Patients in the Obs group were treated with enteric-coated Metformin hydrochloride capsules(Junlida?),and patients in the Con group were treated with Metformin hydrochloride tablets(Glucophage?).The optimal effective dose of 2 g/d was achieved within 4 weeks,and the reasonable dose was maintained until the end of treatment.The treatment period was 24 weeks.HbA1c and its compliance rate,FPG,and body weight were compared between the two groups in full analysis set(FAS)and protocol set(PPS).Safety and adverse events(AE)were evaluated in safety set(SS).Results A total of 414 participants were randomized(207 cases in Obs group and 207 cases in Con group).414 cases in FAS population(207 cases in Obs group and 207 cases in Con group),and 328 cases in PPS population(164 cases in Obs group and 164 cases in Con group),and 414 cases in SS population(207 cases in Obs group and 207 cases in Con group).After treatment,HbA1c,FPG and body weight were lower in both groups(P<0.05)in FAS and PPS.HbA1c compliance rate was not significantly different between the two groups in FAS and PPS(P>0.05).The results of non-inferiority test showed that the lower limit was>-0.4%in both FAS(-0.154,95%CI-0.384～0.069)and PPS(-0.139,95%CI-0.390～0.112),and the Obs group reached non-inferiority end point.The achievement rate,compliance rate,safety index and incidence of AE were not significantly different between the two groups(P>0.05).Conclusions Junlida? demonstrated non-inferiority to Glucophage? in glycemic control and can be safely and effectively used in patients with diabetes.

Background Psychological disturbances such as work-family conflict and depressive mood are prevalent among occupational groups and are closely related to eating behavior. Therefore, investigating the influencing factors of eating behavior is of great significance for promoting the health behaviors of occupational populations. Objective To clarify the current situation of eating behavior among the occupational populations aged 18 to 60 years in China, and to explore the relationship between work-family conflict, depressive mood, and eating behavior, and to test the mediating role of depressive mood in the relationship. Methods The study used a data set containing occupational populations aged 18 to 60 years extracted from the 2021 Psychology and Behavior Investigation of Chinese Residents. The Work-Family Conflict Scale, the Chinese version of the Sakata Eating Behavior Scale Short Form, and the Patient Health Questionnaire-Depression Scale were used. Potential influencing factors of eating behavior of the occupational populations were evaluated by multiple linear regression. Structural equation modeling was used to analyze the relationships between work-family conflict, depressive mood, and eating behavior, and the Bootstrap method was used to test the mediating effect of depressive mood on the relationship of work-family conflict and eating behavior. Results Among the occupational populations, the proportion of reporting high work-family conflict was 48.4%, and the proportion of reporting mild depression and above was 48.7%. The total score of eating behavior was (16.16±4.64), and the proportion of high abnormal eating behavior tendency was 39.1%. There were significant differences in eating behavior score among different age, educational level, marital status, number of offspring, occupation, smoking, and drinking groups (P<0.05). The partial correlation analysis showed that work-family conflict and depressive mood were positively correlated with abnormal eating behavior (r=0.367, 0.386, P<0.001); work-family conflict was positively correlated with depressive mood (r=0.466, P<0.001). The results of the multiple linear regression showed that depressive mood, work-family conflict, age, smoking, drinking, and education level were associated with eating behavior (P<0.05). The structural equation modeling indicated that work-family conflict positively associated with depressive mood (b=0.529, P<0.001), depressive mood positively associated with abnormal eating behavior (b=0.292, P<0.001), and work-family conflict positively associated with abnormal eating behavior (b=0.270, P<0.001). Depressive mood played a partial mediating role in the relationship between work-family conflict and eating behavior, and the effect value was 0.154 (95%CI: 0.132, 0.179) that accounted for 36.32% of the total effect. Conclusion Work-family conflict could directly affect the eating behavior among occupational populations, and also indirectly affect eating behavior through a mediating effect of depressive mood. Therefore, optimizing the allocation of tasks between work and family, providing psychological support in need, alleviating work-family conflict and depressive mood may improve the eating behavior and mental health of working populations.

Objective:To develop a self-locked DNAzyme nanoprobe-based fluorescence amplification strategy for wash-free and ultrasensitive detection of breast cancer-derived small extracellular vesicles (sEV).Method:A DNAzyme self-locked probe was designed to recognize the epithelial cell adhesion molecule (EpCAM) specifically expressed on breast cancer-derived sEVs. Upon binding to EpCAM, the DNAzyme-lock structure was opened, restoring the DNAzyme cleavage activity. The activated DNAzyme then cyclically cleaved the RNA site on the substrate strand. Fluorescently labeled substrate strands were used to detect sEVs at varying concentrations, and the detection limit and linear range were determined.Results:The DNAzyme self-locked probe successfully identified breast cancer-derived sEVs and generated a fluorescent signal through cyclic cleavage. The proposed method achieved wash-free detection of sEVs, with the fluorescence intensity showing a strong linear correlation with sEV concentration ( R2=0.98). The linear detection range was 1.0×10 2-1.0×1.0 7 particles/μl, with a detection limit of 59 particles/μl. Conclusion:This study established a wash-free and highly sensitive strategy for quantifying breast cancer-derived sEVs, which provides a promising technical approach for the early diagnosis of cancer.

Objective:To investigate the value of ultra micro angiography（UMA）imaging in evaluating the inflammation activity of pediatric Crohn's disease（CD）patients.Methods:In this prospective study，71 pediatric CD patients confirmed by clinical symptoms，laboratory and ileocolonoscopical results who planed to accept infliximab injection treatments in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from April to December 2024 were included. The CD patients were included and divided into 3 groups according to the pediatric Crohn's disease activity index（PCDAI）score：inactive CD group（ n=44），mild CD group（ n=17），and moderate-to-severe CD group（ n=10）. Before treatment，pediatric CD patients underwent B mode ultrasound（BMUS），the parameters such as bowel wall thickness（BWT），bowel wall stratification，mesenteric lymph nodes（MLNs），and existence of mesenteric fat hypertrophy（MFH）were recorded. Color Doppler flow imaging（CDFI）and UMA were used to evaluate the blood flow in the most thickened diseased bowel wall using Limberg scores. The diffierences of the above parameters among the 3 groups were compared. The diagnostic performance of UMA and CDFI in assessing the inflammatory activity of pediatric CD was evaluated. Results:There were statistically significant differences in BWT among the 3 groups（all P<0.05）. However，there were no statistically significant differences in MLNs among the 3 groups（all P>0.05）. Compared with the inactive CD，there were statistically significant differences in bowel wall stratification and MFH in both the mild and moderate-to-severe CD groups（all P<0.05）. When assessing bowel wall blood flow signals using CDFI，there was no statistically significant difference in blood flow signals in the bowel wall of the mild CD compared with the inactive CD（ P>0.05）. However，the blood flow signals in the bowel wall of the moderate-to-severe CD was significantly increased（ P<0.05）. There was also statistically significant difference in blood flow signals in the bowel wall between the mild and moderate-to-severe CD groups（ P<0.05）. When assessing bowel wall blood flow using UMA，there were statistically significant differences in blood flow signals in the bowel wall among all 3 groups（all P<0.05）. As the degree of inflammation increased，the blood flow signals in the bowel wall also increased significantly. ROC analysis revealed that diagnostic performance of the UMA-BMUS model was significantly better than that of the CDFI-BMUS model（AUC 0.945 vs. 0.873，sensitivity 88.9% vs. 74.1%，specificity 97.7% vs. 95.5%；all P<0.05）. Conclusions:By sensitively depicting the low-velocity and tiny blood flow signals of the inflamed bowel wall，UMA is an effective noninvasive imaging method to make semi-quantitative evaluation of the activity of pediatric Crohn's disease.

Background Depressive moods among occupational population are prevalent, which seriously affect their mental-physical health and socioeconomic productivity. This has become an urgent public health concern. Objective To understand current situation of depressive mood among an occupational population aged 18 to 60 covering 120 cities of China, and to explore the relationship between work-family conflict and depressive mood as well as the role of life stress in the relationship, as to provide a scientific basis for developing measures to reduce depressive mood in the occupational population. Methods Using the data of the Psychology and Behavior Investigation of Chinese Residents in 2021, an occupational population aged 18 to 60 years was selected as study subjects. A total of 3785 subjects were included in the study. The Work-Family Conflict Scale, Subjective Life Stress Scale, and Patient Health Questionnaire-Depression Scale were used to assess the work-family conflict, life stress, and depressive mood of the subjects. Harman's single-factor method was used to evaluate common method bias in the survey data. One-way ANOVA was applied to test the difference in work-family conflict, life stress, and depressive mood among occupational population by demographic characteristics, and chi-square test was used to analyze the difference in reporting depressive mood. Partial correlation analysis was used to evaluate the correlation between selected variables. Process plug-in was used to test potential mediating effect of life stress on work-family conflict and depressive emotion. Results The scores of work-family conflict, life stress, and depressive mood among the occupational population were 24.60±8.28, 9.28±3.78, and 5.43±5.30, respectively. The prevalence rates of depressive mood was 48.7% (1888/3875). The score of depressive mood among occupational population who never smoked was significantly higher than that of those who smoked (P<0.01). The partial correlation analysis showed that work-family conflict and life stress were positively correlated with depressive mood (r=0.472 and 0.447, P<0.001); work-family conflict was positively correlated with life stress (r=0.361, P<0.001). The mediation analysis results showed that work-family conflict positively associated with life stress (b=0.361, P<0.001); life stress positively associated with depressive mood (b=0.318, P<0.001); work-family conflict positively associated with depressive mood (b=0.357, P<0.001), and played a partial mediating role in the relationship between work-family conflict and depressive mood with an effect size of 0.115 (95%CI: 0.099, 0.130) that accounted for 24.36% of the total effect. Conclusion Work-family conflict may not only directly affect depressive mood among occupational population, but also indirectly affect depressive mood through a mediating effect of life stress.

Objective:To evaluate the effectiveness of anti-G straining maneuver (AGSM) in pilots by surface electromyography (sEMG), and to explore the relationships between characteristics of sEMG and anti-G endurance in pilots.Methods:Thirty-eight male high-performance fighter pilots who completed the human centrifuge test at the Air Force Medical Center were selected. Among them, 25 completed the 8.0 G for 10 s anti-G endurance test and 13 completed the 9.0 G for 10 s anti-G endurance test. The sEMG tester was used to keep track of the changes of sEMG in rectus abdominis, rectus femoris, anterior tibial and gastrocnemius muscles while pilots were engaged in AGSM. The anti-G endurance was evaluated according to the changes of visual fields and consciousness. The pilots were divided into 3 groups: the good vision and consciousness group, peripheral visual field narrowing group and endurance endpoint group. The differences in the integral electromyogram (iEMG), mean power frequency (MPF) and muscle input rates between the 3 groups were investigated.Results:A total of 25 pilots completed the 8.0 G for 10 s anti-G endurance test. Among them, 8 (32.0%) were in the good vision and consciousness group, 13 (52.0%) in the peripheral visual field narrowing group and 4 (16.0%) reached the endurance endpoint. Among the 13 pilots who completed the 9.0 G for 10 s anti-G endurance test, 3 (23.1%) were in the good vision and consciousness group, 6 (46.1%) in the peripheral visual field narrowing group, and 4 (30.8%) in the endurance endpoint group. The results of sEMG showed that the iEMG values of the anterior tibialis muscle in pilots under the 9.0 G for 10 s load were significantly different across endurance groups ( H=7.54, P=0.023), and that the iEMG values of the tibialis anterior muscle in the good vision and consciousness group were higher than those in the endurance endpoint group ( P=0.036). The negative slopes of MPF for the rectus abdominis, rectus femoris, anterior tibialis, and gastrocnemius muscles were higher in the good vision and consciousness group than in the other 2 groups, but the differences were not statistically significant ( P>0.05). During the 8.0 G for 10 s anti-G endurance test, there were significant differences in lower limb muscle contribution rates between the 3 groups ( F=4.19, P=0.029). The endurance endpoint group exhibited a lower contribution rate than the good vision and consciousness group ( P=0.025). During the 9.0 G for 10 s anti-G endurance test, there were significant differences in tibialis anterior muscle contribution rates between the 3 groups ( F=4.16, P=0.049). The endurance endpoint group demonstrated a lower contribution rate than the good vision and consciousness group ( P=0.049). Conclusions:The full and balanced activation of abdominal muscles and lower limb muscles, especially the effective mobilization of calf muscles, plays a pivotal role in improving pilots′ AGSM efficiency in high G environments.

Objective:To find out whether the performance of a China-made high performance human centrifuge can satisfy the need of high G training by conducting physiological experiments.Methods:The dynamic physical performance of the anti-G equipment with the human centrifuge was tested before 5 subjects underwent the gradual-onset rate (GOR) run and rapid onset rate (ROR) run experiments. The G onset rate of GOR was 0.1 G/s. The relaxed G-tolerance under GOR (GOR tolerance 1) and the anti-G straining maneuver aided G-tolerance under GOR (GOR tolerance 2) were tested respectively. The G onset rate of ROR was 3 G/s, and the closed-loop mode and pre-programed mode were employed respectively. The closed-loop mode involved 5 G 10 s and 8 G 10 s, where the subjects were required to manipulate the joystick to ensure that the real-time curve of the load matched the target curve. In the pre-programmed mode, the subjects were exposed to 8 G 10 s passively, without any operation requirements. A subjective evaluation form was filled out by subjects after the experiments, in which the 14 indexes for evaluation were about the gondola facilities and environment, running processes, medical monitoring and overall assessment.Results:Both the oxygen mask and anti-G suit achieved full pressurization within 2.0 s. The GOR tolerance 1 was [4.0(3.8, 4.6)] G while the GOR tolerance 2 was (6.2±0.5) G, suggesting a statistically significant difference ( Z=-2.63, P=0.008). The HP anti-G straining maneuver effect was (2.0±0.6) G. All the 5 subjects finished the 5 G 10 s experiment in a closed-loop mode. Three of them attempted 8 G 10 s in the closed-loop mode (1 subject achieved only 7.6 G peak acceleration, and the other 2 achieved full 8 G 10 s exposure), while the remaining 2 completed the 8 G 10 s in the pre-programmed mode. In the closed-loop mode, it was found that the stick force was too strong, the guiding G and real time G curve were not easy to distinguish for some of the subjects because the curve colors were similar, and that the subjects could not see the G curves clearly in case of a grayout. Both seat comfort and the voice quality of communication got the highest subjective assessment score [5.0(4.0, 5.0)] while the sensation of tumble got the lowest score (2.8±0.8). The median or mean scores of other subjective evaluation indexes ranged from 3.0 to 4.6 points. The overall score of subjective assessment was [4.0(3.5, 4.0)] points. Conclusions:The China-made high performance human centrifuge can meet the requirements of 8.0 G high G training, which can be made more effective and comfortable if the strong stick force and feeling of tumble during stop running are overcome.