ObjectiveTo investigate the mechanism by which Gegen Qinliantang（GQT） improves skeletal muscle insulin resistance. MethodsThe db/m mice were used as the normal group， while db/db mice were assigned to a model group， low-dose （3.12 g·kg^-1）， medium-dose （6.24 g·kg^-1）， and high-dose （12.48 g·kg^-1） GQT groups， and a Western medicine group （semaglutide， 0.045 mg·kg^-1），n=6 in each group. All groups received corresponding interventions. Intraperitoneal glucose tolerance test （IPGTT）， intraperitoneal insulin tolerance test （IPITT）， and hematoxylin-eosin （HE） staining were used to evaluate insulin resistance and therapeutic efficacy. Serum lipid levels were measured using an automatic biochemical analyzer， and apoptosis in skeletal muscle was assessed via TUNEL assay. Transcriptome sequencing combined with gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） analyses was performed to identify differentially expressed genes （DEGs）. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to validate gene expression. Molecular docking was applied to evaluate the binding patterns between active components of GQT and key regulatory genes to elucidate pharmacological mechanisms. ResultsCompared with the model group， the medium-dose and high-dose GQT groups showed significantly reduced fasting blood glucose （FBG） levels （P<0.01）. Triglycerides （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） were markedly decreased （P<0.01）， while high-density lipoprotein cholesterol （HDL-C） was significantly increased （P<0.01）. IPGTT， IPITT， and HE staining demonstrated that GQT enhanced insulin sensitivity and restored skeletal muscle morphology. GQT also alleviated apoptosis in skeletal muscle tissue. Transcriptome analysis revealed that GQT primarily affected biological processes such as oxidative phosphorylation， metabolic pathways， cellular processes， and protein binding. Real-time PCR results showed that CBR2， CDK6， F830016B08Rik， IL-1β， Rab27b， and COLEC12 were key regulatory genes. Molecular docking demonstrated that CBR2， IL-1β， Rab27b， and COLEC12 formed stable binding with the main active components of GQT. The therapeutic effects of high- and medium-dose GQT were comparable to those of the semaglutide group. ConclusionGQT improves skeletal muscle insulin resistance， potentially by regulating apoptosis as part of its underlying biological mechanism.

ObjectiveTo explore the clinical application value of CIE 1976 L*a*b*（Lab） color space in the differential diagnosis of early esophageal cancer and non-cancerous lesions. MethodsWe selected the endoscopic images of patients with esophageal lesions confirmed by pathology who underwent white light imaging endoscopy （WLI） and narrow band imaging endoscopy （NBI）. Five regions of interest （ROI） were selected respectively from the mucosa of the lesion area and the mucosa of the surrounding normal area for labeling. The Lab color space parameters were extracted and counted， and the color difference values（ΔE*）were calculated. ResultsA total of 213 eligible patients were included for analysis in the study. In WLI and NBI modes， there were differences in mucosal color between the early esophageal cancer group and the non-cancer group （P<0.05）. Compared with WLI mode， NBI mode could significantly increase the color difference between early esophageal cancer and non-cancerous lesions （P<0.05）. The lightness component value （L* value） of the early esophageal cancer lesion area was lower than that of the non-cancerous lesion area， and this color difference was more significant in the NBI mode （P<0.05）. In WLI mode， there was no significant difference in yellow-blue component value （b* value） between the mucosa of early esophageal cancer and non-cancerous lesions. However， in the NBI mode， the b* value of the mucosa in the non-cancerous lesion area was higher than that in the early esophageal cancer lesion area （P<0.05）. On the red-green axis， the mucosa of the early esophageal cancer and non-cancerous lesions was red in WLI mode and green in NBI mode. There was no significant difference in red-green component value （a* value） between the two groups. ConclusionThere are color differences between early esophageal cancer and non-cancerous lesions under WLI and NBI. The color of early esophageal cancer is darker under WLI， and the color of non-cancerous lesions is yellower under non-magnified NBI mode. Lab color space is helpful to identify early esophageal cancer and non-cancerous lesions.

BACKGROUND: Over 20 million colonoscopies are performed in China annually. An automatic clinical decision support system (CDSS) with accurate semantic recognition of colonoscopy reports and guideline-based is helpful to relieve the increasing medical burden and standardize the healthcare. In this study, the CDSS was built under a hierarchical-label interpretable classification framework, trained by a state-of-the-art transformer-based model, and validated in a multi-center style. METHODS: We conducted stratified sampling on a previously established dataset containing 302,965 electronic colonoscopy reports with pathology, identified 2041 patients' records representative of overall features, and randomly divided into the training and testing sets (7:3). A total of five main labels and 22 sublabels were applied to annotate each record on a network platform, and the data were trained respectively by three pre-training models on Chinese corpus website, including bidirectional encoder representations from transformers (BERT)-base-Chinese (BC), the BERT-wwm-ext-Chinese (BWEC), and ernie-3.0-base-zh (E3BZ). The performance of trained models was subsequently compared with a randomly initialized model, and the preferred model was selected. Model fine-tuning was applied to further enhance the capacity. The system was validated in five other hospitals with 3177 consecutive colonoscopy cases. RESULTS: The E3BZ pre-trained model exhibited the best performance, with a 90.18% accuracy and a 69.14% Macro-F1 score overall. The model achieved 100% accuracy in identifying cancer cases and 99.16% for normal cases. In external validation, the model exhibited favorable consistency and good performance among five hospitals. CONCLUSIONS The novel CDSS possesses high-level semantic recognition of colonoscopy reports, provides appropriate recommendations, and holds the potential to be a powerful tool for physicians and patients. The hierarchical multi-label strategy and pre-training method should be amendable to manage more medical text in the future.
Humans ; Colonoscopy/methods* ; Deep Learning ; Decision Support Systems, Clinical ; Female ; Male

In the clinical stage, suspected hemolytic plasma may cause hemolysis illness, manifesting as symptoms such as heart failure, severe anemia, etc. Applying a deep learning method to plasma images significantly improves recognition accuracy, so that this paper proposes a plasma quality detection model based on improved "You Only Look Once" 5th version (YOLOv5). Then the model presented in this paper and the evaluation system ‌were introduced‌ into the plasma datasets, and ‌the average accuracy of the final classification reached 98.7%‌. The results of this paper's experiment were obtained through the combination of several key algorithm modules including‌ omni-dimensional dynamic convolution, pooling with separable kernel attention, residual bi-fusion feature pyramid network, ‌and‌ re-parameterization convolution. The method of this paper‌ obtains the feature information of spatial mapping efficiently, and enhances the average recognition accuracy of plasma quality detection. This paper presents a high-efficiency detection method for plasma images, aiming to provide a practical approach to prevent hemolysis illnesses caused by external factors.
Algorithms ; Humans ; Hemolysis ; Plasma ; Deep Learning ; Image Processing, Computer-Assisted/methods*

OBJECTIVES: To investigate the structural changes of rat thoracic aorta and changes in expression levels of Bmal1 and cyclins in thoracic aorta endothelial cells following heat stress. METHODS: Twenty male SD rats were randomized equally into control group and heat stress group. After exposure to 32 ℃ for 2 weeks in the latter group, the rats were examined for histopathological changes and Bmal1 expression in the thoracic aorta using HE staining and immunohistochemistry. In the cell experiments, cultured rat thoracic aortic endothelial cells (RTAECs) were incubated at 40 ℃ for 12 h with or without prior transfection with a Bmal1-specific small interfering RNA (si-Bmal1) or a negative sequence. In both rat thoracic aorta and RTAECs, the expressions of Bmal1, the cell cycle proteins CDK1, CDK4, CDK6, and cyclin B1, and apoptosis-related proteins Bax and Bcl-2 were detected using Western blotting. TUNEL staining was used to detect cell apoptosis in rat thoracic aorta, and the changes in cell cycle distribution and apoptosis in RTAECs were analyzed with flow cytometry. RESULTS: Compared with the control rats, the rats exposed to heat stress showed significantly increased blood pressures and lowered heart rate with elastic fiber disruption and increased expressions of Bmal1, cyclin B1 and CDK1 in the thoracic aorta (P<0.05). In cultured RTAECs, heat stress caused significant increase of Bmal1, cyclin B1 and CDK1 protein expression levels, which were obviously lowered in cells with prior si-Bmal1 transfection. Bmal1 knockdown also inhibited heat stress-induced increase of apoptosis in RTAECs as evidenced by decreased expression of Bax and increased expression of Bcl-2. CONCLUSIONS Heat stress upregulates Bmal1 expression and causes alterations in expressions of cyclins to trigger apoptosis of rat thoracic aorta endothelial cells, which can be partly alleviated by suppressing Bmal1 expression.
Animals ; ARNTL Transcription Factors/genetics* ; Male ; Aorta, Thoracic/metabolism* ; Rats ; Rats, Sprague-Dawley ; Endothelial Cells/metabolism* ; Apoptosis ; Cells, Cultured ; Heat-Shock Response ; Cyclin B1/metabolism* ; CDC2 Protein Kinase/metabolism* ; Cyclins/metabolism* ; RNA, Small Interfering ; bcl-2-Associated X Protein/metabolism*

Corticotomy is a clinical procedure to accelerate orthodontic tooth movement characterized by the regional acceleratory phenomenon (RAP). Despite its therapeutic effects, the surgical risk and unclear mechanism hamper the clinical application. Numerous evidences support macrophages as the key immune cells during bone remodeling. Our study discovered that the monocyte-derived macrophages primarily exhibited a pro-inflammatory phenotype that dominated bone remodeling in corticotomy by CX3CR1^CreERT2; R26^GFP lineage tracing system. Fluorescence staining, flow cytometry analysis, and western blot determined the significantly enhanced expression of binding immunoglobulin protein (BiP) and emphasized the activation of sensor activating transcription factor 6 (ATF6) in macrophages. Then, we verified that macrophage specific ATF6 deletion (ATF6^f/f; CX3CR1^CreERT2 mice) decreased the proportion of pro-inflammatory macrophages and therefore blocked the acceleration effect of corticotomy. In contrast, macrophage ATF6 overexpression exaggerated the acceleration of orthodontic tooth movement. In vitro experiments also proved that higher proportion of pro-inflammatory macrophages was positively correlated with higher expression of ATF6. At the mechanism level, RNA-seq and CUT&Tag analysis demonstrated that ATF6 modulated the macrophage-orchestrated inflammation through interacting with Tnfα promotor and augmenting its transcription. Additionally, molecular docking simulation and dual-luciferase reporter system indicated the possible binding sites outside of the traditional endoplasmic reticulum-stress response element (ERSE). Taken together, ATF6 may aggravate orthodontic bone remodeling by promoting Tnfα transcription in macrophages, suggesting that ATF6 may represent a promising therapeutic target for non-invasive accelerated orthodontics.
Animals ; Mice ; Macrophages/metabolism* ; Tumor Necrosis Factor-alpha/genetics* ; Tooth Movement Techniques/methods* ; Activating Transcription Factor 6/metabolism* ; Bone Remodeling ; Flow Cytometry ; Blotting, Western

Five new flavan-4-ol glycosides jixueqiosides A-E (1-5) and two new flavan glycosides jixueqiosides F and G (6 and 7), along with twelve known flavan-4-ol glycosides (8-19), were isolated from the roots of Pronephrium penangianum. Comprehensive spectral analyses, X-ray single-crystal diffraction, and theoretical electronic circular dichroism (ECD) calculations established structures and absolute configurations. A single crystal structure of flavan-4-ol glycoside (14) was reported for the first time, while the characteristic ECD and NMR data for all isolated flavan-4-ol glycosides (1-5 , 8-19) were analyzed, establishing a set of empirical rules. Activity screening of these isolates showed that 8 and 9 could inhibit the proliferation of MDA-MB-231 and MCF-7 cells with IC₅₀ values of 7.93 ? 2.85 ?mol?L^-1 and 5.87 ? 1.58 ?mol?L^-1 (MDA-MB-231), and 2.21 ? 1.38 ?mol?L^-1 and 3.52 ? 1.55 ?mol?L^-1 (MCF-7), respectively. Western blotting and flow cytometry analyses demonstrated that 8 and 9 dose-dependently induced apoptosis in MDA-MB-231 cells by up-regulating BAX, activating caspase-3 and down-regulating BCL-2. Additionally, compound 8 affected autophagy-related proteins, increasing the ratio of LC3-II/LC3-I and Beclin-1 levels to inhibit MDA-MB-231 cell proliferation. Moreover, anti-inflammatory studies indicated that 2, 3, 7, 13, 14, and 18 moderately inhibited tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6), and nitric oxide (NO) release.
Humans ; Plant Roots/chemistry* ; Glycosides/isolation & purification* ; Anti-Inflammatory Agents/isolation & purification* ; Flavonoids/isolation & purification* ; Cell Proliferation/drug effects* ; Antineoplastic Agents, Phytogenic/isolation & purification* ; Molecular Structure ; Apoptosis/drug effects* ; Cell Line, Tumor ; Tumor Necrosis Factor-alpha/immunology* ; Drugs, Chinese Herbal/pharmacology* ; Interleukin-6/immunology* ; Animals ; Mice

Objective:To examine the validity and reliability of the Chinese version of the Transgender Atti-tudes and Beliefs Scale(TABS)in the general adult population.Methods:A total of 1 656 residents aged≥18 years were recruited by convenient sampling method,and were equally divided into sample 1 and sample 2 accord-ing to age group.The total sample was used for item analysis and internal consistency reliability test.Sample 1 was used for exploratory factor analysis,Sample 2 was used for confirmatory factor analysis,and 60 residents were se-lected for retesting at a 2-week interval.Results:The TABS Chinese version included a total of 26 items,with the content validity index(I-CVI)of each item ranging from 0.83 to 1.00,and the content validity index(S-CVI)of the scale being 0.98.Exploratory factor analysis extracted 3 common factors,namely interpersonal comfort,gender beliefs,and human value,with a cumulative total variance of 57.13％.Confirmatory factor analysis showed that the scale fit was acceptable(x2/df=2.95,RMSEA=0.05,GFI=0.92,AGFI=0.90).The Cronbach α coefficients of the total score of the scale and the scores of the 3 factors were 0.95,0.95,0.88 and 0.86.The retest reliabilities were 0.88,0.78,0.65 and 0.91.Conclusion:The Chinese version of the Transgender Attitudes and Beliefs Scale(TABS)has good validity and reliability in assessing general adults'attitudes toward the transgender community.

To verify whether the two B-cell epitopes Pep1 and Pep4 in the FAdV-4 WZ fiber can be used as candidate epitopes for multivalent epitope vaccines,epitopes Pep1 and Pep4 were tandemly linked with the chicken infectious bronchitis virus strain M41 S1 protein gene in different patterns,and a recombinant fusion plasmid was constructed and expressed in E.coli BL21(DE3).It was confirmed by Western blot and ELISA tests that all four expressed fusion proteins reacted specific-ally with anti-M41 whole virus serum and WZ strain anti-Fiber 2-knob protein serum.After purifi-cation and immunization of BALB/c mice,specific antibodies against the peptide epitopes were de-tected in mouse sera.The results showed that the Pep4 epitope induced a stronger immune re-sponse than the Pep1 epitope.When Pep1 was connected with the amino and carboxyl termini of the fusion protein,respectively,both resulted in the production of the same level of anti-Pep1 anti-bodies in the immunized animals,whereas when Pep4 was connected with the carboxyl terminus of the fusion protein,the immunized animals produced a higher level of anti-Pep4-specific antibodies.This research indicates that the B cell epitopes Pep1 and Pep4 of the reactive WZ strain Fiber 2,when conjugated with proteins to form fusion proteins,can enhance the immunogenicity of Pep1 and Pep4 without affecting the antigenicity of the carrier protein.This study provides technical support and serves as a reference for the design and development of a multivalent epitope vaccine for FAdV-4.

Objective:To improve the quality standards for Portulaca oleracea medicinal materials and decoction pieces.Methods:Fourteen batches of P.oleracea medicinal materials and 20 batches of its decoction pieces from different producing areas across the country were collected.In accordance with the relevant methods in the general chapters of the Chinese Pharmacopoeia(2020 Edition,Volume Ⅰ),the thin-layer chromatography(TLC)identi-fication method was optimized.The contents of impurities,moisture,total ash,acid-insoluble ash,heavy metals and harmful elements,and extracts were determined.Meanwhile,the HPLC feature chromatograms and content determination methods for P.oleracea medicinal materials and decoction pieces were established.Results:The optimized TLC method showed clear spots,good separation effect and reproducibility.The average contents of impurities,moisture,total ash,acid-insoluble ash,and extracts in the 14 batches of P.oleracea medicinal materi-als were 0.01％,8.48％,21.68％,5.33％,and 28.44％respectively.The average contents of impurities,moisture,total ash,acid-insoluble ash,and extracts in the 20 batches of P.oleracea decoction pieces were 0.01％,7.00％,21.09％,3.60％,and 29.63％respectively.The results of the tests for heavy metals and harmful elements showed that the contents of lead,cadmium,arsenic,mercury and copper in 34 batches of samples varied greatly.Moreover,the contents of cadmium,arsenic and copper in some samples exceeded the limit guid-ance values specified in the Pharmacopoeia.Nine common peaks were calibrated in the established HPLC feature chromatogram of P.oleracea,and an HPLC method for simultaneously determining the contents of norepinephrine and dopamine was established.Conclusion:It is recommended to modify the developing solvent for the thin-layer identification of P.oleracea and its proportion to water-saturated n-butanol-acetone-glacial acetic acid-water=4∶1∶1∶1,and change the extraction method of the test sample to ultrasonic extraction for 30 minutes.It is proposed to add the stipulations that the total ash of P.oleracea medicinal materials and decoction pieces should not exceed 25.0％,the acid-insoluble ash should not exceed 6.0％,and the water-soluble extract should not be lower than 20.0％.For P.oleracea decoction pieces,the total ash should not exceed 28.0％,the acid-insoluble ash should not exceed 6.0％,and the water-soluble extract should not be lower than 20.0％.This study provides an experi-mental basis for the improvement of the quality standards of P.oleracea.