Osteoporosis is a prevalent skeletal condition characterized by reduced bone mass and strength, leading to increased fragility. Buqi-Tongluo (BQTL) decoction, a traditional Chinese medicine (TCM) prescription, has yet to be fully evaluated for its potential in treating bone diseases such as osteoporosis. To investigate the mechanism by which BQTL decoction inhibits osteoclast differentiation in vitro and validate these findings through in vivo experiments. We employed MTS assays to assess the potential proliferative or toxic effects of BQTL on bone marrow macrophages (BMMs) at various concentrations. TRAcP experiments were conducted to examine BQTL's impact on osteoclast differentiation. RT-PCR and Western blot analyses were utilized to evaluate the relative expression levels of osteoclast-specific genes and proteins under BQTL stimulation. Finally, in vivo experiments were performed using an osteoporosis model to further validate the in vitro findings. This study revealed that BQTL suppressed receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and osteoclast resorption activity in vitro in a dose-dependent manner without observable cytotoxicity. The inhibitory effects of BQTL on osteoclast formation and function were attributed to the downregulation of NFATc1 and c-fos activity, primarily through attenuation of the MAPK, NF-κB, and Calcineurin signaling pathways. BQTL's inhibitory capacity was further examined in vivo using an ovariectomized (OVX) rat model, demonstrating a strong protective effect against bone loss. BQTL may serve as an effective therapeutic TCM for the treatment of postmenopausal osteoporosis and the alleviation of bone loss induced by estrogen deficiency and related conditions.
Animals ; NFATC Transcription Factors/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Ovariectomy ; Osteoclasts/metabolism* ; Female ; Osteogenesis/drug effects* ; Rats, Sprague-Dawley ; Rats ; NF-kappa B/genetics* ; Osteoporosis/genetics* ; Signal Transduction/drug effects* ; Bone Resorption/genetics* ; Cell Differentiation/drug effects* ; Humans ; RANK Ligand/metabolism* ; Mitogen-Activated Protein Kinases/genetics* ; Transcription Factors

Objective To observe the value of three-dimensional speckle tracking imaging(3D-STI)in evaluation on right ventricle(RV)function for predicting adverse events in patients with unstable angina(UA)after percutaneous coronary intervention(PCI).Methods A total of 155 UA patients who underwent both 3D-STI and conventional echocardiography and planned to accept PCI were prospectively enrolled and divided into adverse event group(n=37)and control group(n=118)based on the occurrence of adverse events after PCI or not.Clinical data and echocardiographic parameters were compared between groups,and new binary variables were generated according to the optimal cut-off values showed by the maximum Youden index of receiver operating characteristic curves of 3D-STI parameters being statistically different between groups.Then the independent predictors of adverse events among UA patients after PCI were analyzed,a combined model was constructed,and its predictive value was assessed.Results In adverse event group,the left ventricular end diastolic volume(LVEDV)was higher,while the left ventricular ejection fraction(LVEF),right ventricular free wall longitudinal strain(RVFWLS)and right ventricular global longitudinal strain(RVGLS)were all lower than those in control group(all P＜0.05).The optimal cut-off values for distinguishing adverse event or not was 110 ml for LVEDV,19.05%for RVFWLS and 19.75%for RVGLS,respectively,and all the 3 generated binary variables were independent predictors for adverse events of UA patients after PCI(all P＜0.05).The area under the curve of combined model for predicting adverse events in UA patients after PCI was 0.864.Conclusion RVFWLS＜19.05%and RVGLS＜19.75%obtained with 3D-STI,as well as LVEDV＞110 ml with conventional echocardiography were all independent predictors of adverse events in UA patients after PCI.

Objective To assess the situation and influencing factors of occupational burnout among the staff at the Center for Disease Control and Prevention (CDC) in Sichuan Province. Methods A total of 1 038 CDC staff members in Sichuan Province were selected as the study subjects using the stratified random sampling method. Occupational burnout of the staff was assessed using the Maslach Burnout Inventory General Survey via an online questionnaire. Results The detection rate of occupational burnout was 42.3% (439/1 038). Binary logistic regression analysis result showed that, after controlling for confounding factors such as education level and alcohol consumption, CDC staffs aged at 20-<31, 31-<41, and 41-<51 years were at higher risk of occupational burnout compared with those ≥51 years (all P<0.05). CDC staffs with 5-<10 or ≥10 years of service had higher occupational burnout risk compared with those with <5 years (both P<0.05). CDC staffs with poor or fair health status, irregular diet, and poor sleep quality had higher risk of occupational burnout compared with those healthy, have regular diet, and good sleep quality (all P<0.05). The risk of occupational burnout increased with higher overtime frequency (all P<0.05). Conclusion Occupational burnout among CDC staffs in Sichuan Province is relatively high. Age, years of service, health status, diet, sleep quality, and overtime frequency are key influencing factors.

The organ system-integrated curriculum system overcomes the limitations of single teaching methods and the drawbacks of neglecting holism and interconnectedness, effectively transforming knowledge into competency. Tianjin Medical University has pioneered the "double-track integrated teaching reform" to align with the objective of training undergraduate clinical medical talents. This system is centered on the eight major human body systems, breaking traditional disciplinary boundaries and achieving systematic integration of basic medical and clinical courses. First implemented in 2019 in the "5+3" clinical and pediatric programs, the system has undergone three rounds of teaching practice since 2021, forming a distinctive integrated curriculum system. Using the circulatory system as a model, the reform reorganized teaching content, developed specialized textbooks, and assembled interdisciplinary teaching teams, fostering a shared instructional approach through cross-disciplinary training. The teaching model integrates theoretical and practical learning with curriculum-based ideological and political education, employing problem-based learning to encourage self-directed study and leveraging an online-offline mixed approach to enhance teaching effectiveness. An innovative closed-loop assessment system incorporating formative evaluation has been established, integrating multidimensional feedback from exam analysis, student and faculty questionnaire surveys, and teaching supervision to continuously optimize curriculum development. The reform has significantly enhanced medical students' professional competencies and overall capabilities, providing an innovative paradigm for training high-level medical professionals in the new era.

Objective To observe the value of three-dimensional speckle tracking imaging(3D-STI)in evaluation on right ventricle(RV)function for predicting adverse events in patients with unstable angina(UA)after percutaneous coronary intervention(PCI).Methods A total of 155 UA patients who underwent both 3D-STI and conventional echocardiography and planned to accept PCI were prospectively enrolled and divided into adverse event group(n=37)and control group(n=118)based on the occurrence of adverse events after PCI or not.Clinical data and echocardiographic parameters were compared between groups,and new binary variables were generated according to the optimal cut-off values showed by the maximum Youden index of receiver operating characteristic curves of 3D-STI parameters being statistically different between groups.Then the independent predictors of adverse events among UA patients after PCI were analyzed,a combined model was constructed,and its predictive value was assessed.Results In adverse event group,the left ventricular end diastolic volume(LVEDV)was higher,while the left ventricular ejection fraction(LVEF),right ventricular free wall longitudinal strain(RVFWLS)and right ventricular global longitudinal strain(RVGLS)were all lower than those in control group(all P＜0.05).The optimal cut-off values for distinguishing adverse event or not was 110 ml for LVEDV,19.05%for RVFWLS and 19.75%for RVGLS,respectively,and all the 3 generated binary variables were independent predictors for adverse events of UA patients after PCI(all P＜0.05).The area under the curve of combined model for predicting adverse events in UA patients after PCI was 0.864.Conclusion RVFWLS＜19.05%and RVGLS＜19.75%obtained with 3D-STI,as well as LVEDV＞110 ml with conventional echocardiography were all independent predictors of adverse events in UA patients after PCI.

The organ system-integrated curriculum system overcomes the limitations of single teaching methods and the drawbacks of neglecting holism and interconnectedness, effectively transforming knowledge into competency. Tianjin Medical University has pioneered the "double-track integrated teaching reform" to align with the objective of training undergraduate clinical medical talents. This system is centered on the eight major human body systems, breaking traditional disciplinary boundaries and achieving systematic integration of basic medical and clinical courses. First implemented in 2019 in the "5+3" clinical and pediatric programs, the system has undergone three rounds of teaching practice since 2021, forming a distinctive integrated curriculum system. Using the circulatory system as a model, the reform reorganized teaching content, developed specialized textbooks, and assembled interdisciplinary teaching teams, fostering a shared instructional approach through cross-disciplinary training. The teaching model integrates theoretical and practical learning with curriculum-based ideological and political education, employing problem-based learning to encourage self-directed study and leveraging an online-offline mixed approach to enhance teaching effectiveness. An innovative closed-loop assessment system incorporating formative evaluation has been established, integrating multidimensional feedback from exam analysis, student and faculty questionnaire surveys, and teaching supervision to continuously optimize curriculum development. The reform has significantly enhanced medical students' professional competencies and overall capabilities, providing an innovative paradigm for training high-level medical professionals in the new era.

Construct Validity and Reliability of the Malay Version of Rosenberg Self Esteem Scale (RSES) among youth in Southern Malaysia: A Confirmatory Factor Analysis IntroductionThe Rosenberg Self-Esteem Scale (RSES) is widely used to measure self-esteem among adults and youth. This study aims to determine the construct validity and reliability of the Rosenberg Self-Esteem Scale Malay version (RSES-M) among Malaysian youth using Confirmatory Factor Analysis (CFA).MethodologyWe administered the Malay-language RSES to 378 Form Four students in the Kota Tinggi District, selected through multistage sampling. The construct validity of RSES-M was assessed using confirmatory factor analysis (CFA), while internal consistency was measured using Cronbach alpha. AMOS version 26 and SPSS version 20 were used for statistical analysis. We compared three measurement models of the RSES-M for the best relative fit: one uni-dimensional model and two different two-domain models (with different items assigned to each domain for each model).ResultsThe findings indicate that the best model for the RSES-M was a two-domain model, with domain one representing positive self-esteem and domain two representing negative self-esteem. The item “I wish I could respect myself more” demonstrated a strong fit within the CFA model when included under the positive domain of self-esteem (Model 3) compared to negative domain ((Model 2) (Chi-Square/degree of freedom (df) = 3.341, goodness of fit (GFI) = 0.967, Comparative Fit Index (CFI) = 0.905, Incremental Fit Index (IFI) = 0.906, and the Root Mean Squared Error of Approximation (RMSEA) = 0.079 and substantial reliability (Cronbach's alpha for domain one = 0.765, and domain two = 0.648). This finding diverges from the original RSES developed by Morris Rosenberg in 1965, which conceptualised the RSES as a unidimensional construct, and other studies that categorised the item "I wish I could respect myself more" under the negative self-esteem domain.

In the past few decades, microbubbles were widely used as ultrasound contrast agents in the field of tumor imaging. With the development of research, ultrasound targeted microbubble destruction technology combined with drug-loaded microbubbles can achieve precise drug release and play a therapeutic role. As a micron-scale carrier, microbubbles are difficult to penetrate the endothelial cell space of tumors, and nano-scale drug delivery system—nanobubbles came into being. The structure of the two is similar, but the difference in size highlights the unique advantages of nanobubbles in drug delivery. Based on the classification principle of shell materials, this review summarized micro/nanobubbles used for ultrasound diagnosis or treatment and discussed the possible development directions, providing references for the subsequent development.

BACKGROUND:Establishing a nomogram prediction model for postoperative pulmonary infection in hip fractures and taking early intervention measures is crucial for improving patients'quality of life and reducing medical costs. OBJECTIVE:To construct a nomogram risk prediction model of postoperative pulmonary infection in elderly patients with hip fracture,and provide theoretical basis for feasible prevention and early intervention. METHODS:Case data of 305 elderly patients with hip fractures who underwent surgical treatment at Wuxi Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine between January and October 2020(training set)were retrospectively analyzed.Using univariate and multivariate logistic regression analysis and Hosmer-Lemeshow goodness of fit test,receiver operating characteristic curve was utilized to analyze the diagnostic predictive efficacy of independent risk factors and joint models for postoperative pulmonary infections.Tools glmnet,pROC,and rms in R Studio software were applied to construct a nomogram model for predicting the risk of postoperative pulmonary infection in elderly patients with hip fractures,and calibration curves were further drawn to verify the predictive ability of the nomogram model.Receiver operating characteristic curves,calibration curves,and decision curves were analyzed for 133 elderly patients with hip fractures(validation set)receiving surgery at the same hospital from November 2022 to March 2023 to further predict the predictive ability of the nomogram model. RESULTS AND CONCLUSION:(1)The postoperative pulmonary infection rate in elderly patients with hip fractures in this group was 9.18%(28/305).(2)Single factor and multivariate analysis,as well as forest plots,showed that preoperative hospitalization days,leukocyte count,hypersensitive C-reactive protein,and serum sodium levels were independent risk factors(P<0.05).The Hosmer-Lemeshow goodness of fit test showed good fit(χ2=4.57,P=0.803).Receiver operating characteristic curve analysis was conducted on the independent risk factors and their joint models mentioned above,and the differentiation of each independent risk factor and joint model was good,with statistical significance(P<0.05).(3)The graphical calibration method,C-index,and decision curve were used to validate the nomogram prediction model.The predicted calibration curve was located between the standard curve and the acceptable line,and the predicted risk of the nomogram model was consistent with the actual risk.(4)The validation set used receiver operating characteristic curve,graphic calibration method,and decision curve to validate the prediction model.The results showed good consistency with clinical practice,indicating that the model had a good fit.The nomogram risk prediction model constructed for postoperative pulmonary infection in elderly patients with hip fractures has good predictive performance.The use of the nomogram risk prediction model can screen high-risk populations and provide a theoretical basis for early intervention.

Objective To study chest computed tomography(CT)manifestations in neonates with chronic granulomatous disease(CGD)to provide clues for early diagnosis of this disease.Methods A retrospective analysis was conducted on the clinical data and chest CT scan results of neonates diagnosed with CGD from January 2015 to December 2022 at Anhui Provincial Children's Hospital.Results Nine neonates with CGD were included,with eight presenting respiratory symptoms as the initial sign.Chest CT findings included:consolidation in all 9 cases;nodules in all 9 cases,characterized by multiple,variably sized scattered nodules in both lungs;masses in 4 cases;cavities in 3 cases;abscesses in 6 cases;bronchial stenosis in 2 cases;pleural effusion,interstitial changes,and mediastinal lymphadenopathy each in 1 case.CT enhancement scans showed nodules and masses with uneven or ring-shaped enhancement;no signs of pulmonary emphysema,lung calcification,halo signs,crescent signs,bronchiectasis,or scar lesions were observed.There was no evidence of rib or vertebral bone destruction.Fungal infections were present in 8 of the 9 cases,including 6 with Aspergillus infections;three of these involved mixed infections with Aspergillus,with masses most commonly associated with mixed Aspergillus infections(3/4).Conclusions The primary manifestations of neonatal CGD on chest CT are consolidation,nodules,and/or masses,with Aspergillus as a common pathogen.These features can serve as early diagnostic clues for neonatal CGD.