Chemotherapy is an important treatment for tumors， but most patients experience varying degrees of chemotherapy- induced myelosuppression. Four properties theory of traditional Chinese medicine （TCM） has unique advantages in improving chemotherapy-induced myelosuppression. The monomers from TCM with different properties and flavors， such as cold-natured （e.g. Scutellaria baicalensis， Rhus chinensis）， cool-natured （e.g. Ligustrum lucidum， Ophiopogon japonicus）， warm-natured （e.g. Panax ginseng， Epimedium brevicornu， Curcuma longa， Angelica sinensis）， hot-natured （e.g. Cinnamomum cassia， Aconitum carmichaeli）， and neutral-natured （e. g. donkey-hide gelatin， Lycium barbarum， Rhodiola rosea， fungi）， can exert anti- myelosuppressive effects by reducing damage to hematopoietic stem/progenitor cells， improving the bone marrow hematopoietic microenvironment， inhibiting the oxidative stress response， regulating signaling pathways， so as to ultimately repaire inflammatory damage and improve hematopoietic function， thereby playing an anti-myelosuppressive role.

OBJECTIVES: We propose a Contrastive Regional Attention and Prior Knowledge-Infused U-Transformer model (CRAKUT) to address the challenges of imbalanced text distribution, lack of contextual clinical knowledge, and cross-modal information transformation to enhance the quality of generated radiology reports. METHODS: The CRAKUT model comprises 3 key components, including an image encoder that utilizes common normal images from the dataset for extracting enhanced visual features, an external knowledge infuser that incorporates clinical prior knowledge, and a U-Transformer that facilitates cross-modal information conversion from vision to language. The contrastive regional attention in the image encoder was introduced to enhance the features of abnormal regions by emphasizing the difference between normal and abnormal semantic features. Additionally, the clinical prior knowledge infuser within the text encoder integrates clinical history and knowledge graphs generated by ChatGPT. Finally, the U-Transformer was utilized to connect the multi-modal encoder and the report decoder in a U-connection schema, and multiple types of information were used to fuse and obtain the final report. RESULTS: We evaluated the proposed CRAKUT model on two publicly available CXR datasets (IU-Xray and MIMIC-CXR). The experimental results showed that the CRAKUT model achieved a state-of-the-art performance on report generation with a BLEU-4 score of 0.159, a ROUGE-L score of 0.353, and a CIDEr score of 0.500 in MIMIC-CXR dataset; the model also had a METEOR score of 0.258 in IU-Xray dataset, outperforming all the comparison models. CONCLUSIONS The proposed method has great potential for application in clinical disease diagnoses and report generation.
Humans ; Radiology Information Systems ; Radiology

Objective:To explore the effects of short-term particulate matter(PM)exposure and the melatonin receptor 1B(MTNR1B)gene on triglyceride-glucose(TyG)index utilizing data from Fang-shan Family-based Ischemic Stroke Study in China(FISSIC).Methods:Probands and their relatives from 9 rural areas in Fangshan District,Beijing,were included in the study.PM data were obtained from fixed monitoring stations of the National Air Pollution Monitoring System.TyG index was calculated by fasting triglyceride and glucose concentrations.The associations of short-term PM exposure and rs10830963 polymorphism of the MTNR1B gene with the TyG index were assessed using mixed linear models,in which covariates such as age,sex,and lifestyles were adjusted for.Gene-environment inter-action analysis was furtherly performed using the maximum likelihood methods to explore the potential effect modifier role of rs10830963 polymorphism in the association of PM with TyG index.Results:A total of 4 395 participants from 2 084 families were included in the study,and the mean age of the study participants was(58.98±8.68)years,with 53.90％females.The results of association analyses showed that for every 10 μg/m3 increase in PM2.5 concentration,TyG index increased by 0.017(95％CI:0.007-0.027),while for per 10 μg/m3 increment in PM1o,TyG index increased by 0.010(95％CI:0.003-0.017).And the associations all had lagged effects.In addition,there was a positive association between the rs10830963 polymorphism and the TyG index.For per increase in risk allele G,TyG index was elevated by 0.040(95％CI:0.004-0.076).The TyG index was 0.079(95％CI:0.005-0.152)higher in carriers of the GG genotype compared with carriers of the CC genotype.The inter-action of rs10830963 polymorphism with PM exposure had not been found to be statistically significant in the present study.Conclusion:Short-term exposure to PM2.5 and PM10 were associated with higher TyG index.The G allele of rs10830963 polymorphism in the MTNR1B gene was associated with the elevated TyG index.

Objective:To explore the association between polymorphisms of transforming growth factor-β(TGF-β)signaling pathway and non-syndromic cleft lip with or without cleft palate(NSCL/P)among Asian populations,while considering gene-gene interaction and gene-environment interaction.Methods:A total of 1 038 Asian NSCL/P case-parent trios were ascertained from an international consortium,which conducted a genome-wide association study using a case-parent trio design to investigate the genes affec-ting risk to NSCL/P.After stringent quality control measures,343 single nucleotide polymorphism(SNP)spanning across 10 pivotal genes in the TGF-β signaling pathway were selected from the original genome-wide association study(GWAS)dataset for further analysis.The transmission disequilibrium test(TDT)was used to test for SNP effects.The conditional Logistic regression models were used to test for gene-gene interaction and gene-environment interaction.Environmental factors collected for the study in-cluded smoking during pregnancy,passive smoking during pregnancy,alcohol intake during pregnancy,and vitamin use during pregnancy.Due to the low rates of exposure to smoking during pregnancy and al-cohol consumption during pregnancy(＜3％),only the interaction between maternal smoking during pregnancy and multivitamin supplementation during pregnancy was analyzed.The threshold for statistical significance was rigorously set at P=1.46 × 10-4,applying Bonferroni correction to account for multiple testing.Results:A total of 23 SNPs in 4 genes yielded nominal association with NSCL/P(P＜0.05),but none of these associations was statistically significant after Bonferroni's multiple test correction.How-ever,there were 6 pairs of SNPs rs4939874(SMAD2)and rs1864615(TGFBR2),rs2796813(TGFB2)and rs2132298(TGFBR2),rs4147358(SMAD3)and rs1346907(TGFBR2),rs4939874(SMAD2)and rs1019855(TGFBR2),rs4939874(SMAD2)and rs12490466(TGFBR2),rs2009112(TGFB2)and rs4075748(TGFBR2)showed statistically significant SNP-SNP interaction(P＜1.46 × 10-4).In contrast,the analysis of gene-environment interactions did not yield any significant results after being cor-rected by multiple testing.Conclusion:The comprehensive evaluation of SNP associations and interac-tions within the TGF-β signaling pathway did not yield any direct associations with NSCL/P risk in Asian populations.However,the significant gene-gene interactions identified suggest that the genetic architec-ture influencing NSCL/P risk may involve interactions between genes within the TGF-β signaling path-way.These findings underscore the necessity for further investigations to unravel these results and further explore the underlying biological mechanisms.

Ischemic stroke (IS) is a severe cerebrovascular disease with a high incidence, mortality, and disability rate. The first-line treatment for IS is the use of recombinant tissue plasminogen activator (r-tPA). Regrettably, numerous patients encounter delays in treatment due to the narrow therapeutic window and the associated risk of hemorrhage. Traditional Chinese medicine (TCM) has exhibited distinct advantages in preventing and treating IS. TCM enhances cerebral microcirculation, alleviates neurological disorders, regulates energy metabolism, mitigates inflammation, reduces oxidative stress injuries, and inhibits apoptosis, thereby mitigating brain damage and preventing IS recurrence. This article summarizes the etiology, pathogenesis, therapeutic strategies, and relationship with modern biology of IS from the perspective of TCM, describes the advantages of TCM in the treatment of IS, and further reviews the pharmacodynamic characteristics and advantages of TCM in the acute and recovery phases of IS as well as in post-stroke complications. Additionally, it offers valuable insights and references for the clinical application of TCM in IS prevention and treatment, as well as for the development of novel drugs.

Periodontitis imparting the increased risk of atherosclerotic cardiovascular diseases is partially due to the immune subversion of the oral pathogen, particularly the Porphyromonas gingivalis (P. gingivalis), by inducing apoptosis. However, it remains obscure whether accumulated apoptotic cells in P. gingivalis-accelerated plaque formation are associated with impaired macrophage clearance. Here, we show that smooth muscle cells (SMCs) have a greater susceptibility to P. gingivalis-induced apoptosis than endothelial cells through TLR2 pathway activation. Meanwhile, large amounts of miR-143/145 in P.gingivalis-infected SMCs are extracellularly released and captured by macrophages. Then, these miR-143/145 are translocated into the nucleus to promote Siglec-G transcription, which represses macrophage efferocytosis. By constructing three genetic mouse models, we further confirm the in vivo roles of TLR2 and miR-143/145 in P. gingivalis-accelerated atherosclerosis. Therapeutically, we develop P.gingivalis-pretreated macrophage membranes to coat metronidazole and anti-Siglec-G antibodies for treating atherosclerosis and periodontitis simultaneously. Our findings extend the knowledge of the mechanism and therapeutic strategy in oral pathogen-associated systemic diseases.
Animals ; Mice ; Endothelial Cells ; Toll-Like Receptor 2 ; Macrophages ; Apoptosis ; Atherosclerosis ; Myocytes, Smooth Muscle ; MicroRNAs

OBJECTIVE To prepare celastrol -loaded albumin nanoparticles （CLT-AN），and to investigate their activity against rheumatoid arthritis （RA）in vivo . METHODS CLT-AN was prepared by ultrasonic method . The formulation technology was optimized by single -factor test by taking particle size ，polydispersity index （PDI）and stability as indexes ，with the dosage of CLT ， the dosage of soybean oil and the ultrasonic power as factors . The physical and chemical properties of CLT -AN were investigated by transmission electron microscopy （TEM）and laser particle size analyzer ；in vitro stability and release profile were studied . A rat model of adjuvant -induced arthritis was constructed to investigate the effects of CLT -AN on joint swelling ，the levels of serum inflammatory factors [tumor necrosis factor α（TNF-α）and interleukin -1β（IL-1β）] and pathological state of joint tissue . RESULTS The optimized formulation was CLT 6.5 g，soybean oil 45 mg，ultrasonic power 490 W，ultrasonic time 8 min. CLT- AN prepared by the best formulation showed uniform and spherical morphology . Its particle size ，PDI，Zeta potential were （96.8± 1.1）nm，0.174±0.020，and（－18.6±1.7）mV，respectively. The encapsulation efficiency and drug -loading efficiency were （94.61±0.46）% and（2.42±0.21）%. There were no significant changes in particle size ，PDI，Zeta potential and encapsulation efficiency of CLT -AN within 5 days of storage at room temperature . CLT-AN was slowly released in vitro ，and the cumulative release reached 73.56% in 72 h. Compared with CLT ，CLT-AN could significantly inhibit the joint swelling of model rats ，reduced the levels of inflammatory factors TNF -α and IL -1β in serum ，and improved the pathological state of inflammatory joint tissue . CONCLUSIONS CLT-AN prepared by ultrasonic method has the appropriate particle size ，good stability ，significant sustained - release characteristics ，and excellent therapeutic efficacy against RA .

Peptides that are composed of dextrorotary (d)-amino acids have gained increasing attention as a potential therapeutic class. However, our understanding of the in vivo fate of d-peptides is limited. This highlights the need for whole-body, quantitative tracking of d-peptides to better understand how they interact with the living body. Here, we used mouse models to track the movement of a programmed death-ligand 1 (PD-L1)-targeting d-dodecapeptide antagonist (DPA) using positron emission tomography (PET). More specifically, we profiled the metabolic routes of [⁶⁴Cu]DPA and investigated the tumor engagement of [⁶⁴Cu/⁶⁸Ga]DPA in mouse models. Our results revealed that intact [⁶⁴Cu/⁶⁸Ga]DPA was primarily eliminated by the kidneys and had a notable accumulation in tumors. Moreover, a single dose of [⁶⁴Cu]DPA effectively delayed tumor growth and improved the survival of mice. Collectively, these results not only deepen our knowledge of the in vivo fate of d-peptides, but also underscore the utility of d-peptides as radiopharmaceuticals.

The construction of nursing clinical teaching base in traditional Chinese medicine (TCM) universities is an extremely important link in nursing education of TCM universities. Building a clinical base with high performance, high quality and high satisfaction has also become an important goal for the development of the nursing discipline of TCM universities. This article reviews and analyzes the current situation of the construction of the nursing clinical teaching base of TCM universities, aiming at providing ideas and plans for the construction of nursing clinical teaching base of TCM universities, so as to improve the quality of clinical teaching and the teaching level of the TCM nursing clinical teaching base.

Objective    To investigate the clinical characteristics and prognosis of resectable esophageal small cell carcinoma after surgical resection. Methods    A retrospective study of patients with resectable esophageal small cell carcinoma undergoing surgical resection from January 2009 to June 2015 in the Department of Thoracic Surgery, Sichuan Provincial Fourth People's Hospital and Department of Thoracic Surgery, West China Hospital of Sichuan University was performed. Survival analysis was conducted by Kaplan-Meier analysis and log-rank test. Cox regression model was used for identifying independent prognostic factors. Results    A total of 53 patients with resectable esophageal small cell carcinoma were included for analysis. The mean age was 58.4 ± 8.3 years and there were 42 male patients and 11 female patients. Forty-two patients were diagnosed as pure esophageal small cell carcinoma while 11 patients were diagnosed with mixed esophageal small cell carcinoma, who were all mixed with squamous cell carcinoma. Most of the esophageal small   cell carcinomas were located in the middle (58.5%) and lower (32.1%) segments of the esophagus. Thirty patients (56.6%) were found to have lymph node metastasis, and 7 patients (13.2%) were found to have lymphovascular invasion. According to the 2009 TNM staging criteria for esophageal squamous cell carcinoma, there were 12 patients with stage Ⅰ disease, 19 patients with stage Ⅱ disease, and 22 patients with stage Ⅲ disease. Most of the patients underwent left thoracotomy with two-field lymphadenectomy. Postoperatively, only twenty-two patients (41.5%) received adjuvant chemoradiotherapy. The median survival time of these patients was 20.1 months, and the 1- and 3-year survival rate was 75.5% and 33.1%, respectively. For prognosis, age, gender, pathological type, tumor location, and lymphovascular invasion had no significant impact on long-term survival of these patients. However, TNM stage (1 year survival rate: stage Ⅰ: 91.7%; stage Ⅱ: 78.9%; stage Ⅲ: 63.6%; P=0.004) and postoperative adjuvant therapy (1 year survival rate: 81.8% vs. 71.0%; P=0.005) had significant impact on the survival of patients with esophageal small cell carcinoma. In multivariate analysis, TNM stage and postoperative adjuvant therapy were independent prognostic factors for long-term prognosis of patients with esophageal small cell carcinoma. Conclusion    Esophageal small cell carcinoma is very rare, with high malignancy and poor prognosis. For patients with resectable esophageal small cell carcinoma, the TNM staging system of esophageal squamous cell carcinoma can be used to direct the choice of treatment options. For early stage esophageal small cell carcinoma (stage Ⅰ/Ⅱ), surgery plus postoperative adjuvant chemoradiotherapy can be the prior therapeutic choice, while for locally advanced esophageal small cell carcinoma (stage Ⅲ), chemoradiotherapy should be the preferred treatment.