OBJECTIVE To analyze the prototype components absorbed into blood and brain of Lithocarpus litseifolius leaves， so as to provide a reference for clarifying the pharmacological material basis of its prevention and treatment of central nervous system dis eases. METHODS The ethanol extract of L. litseifolius leaves， as well as the gastric lavage fluid and perfusion solution were prepared. Using rats as subjects， plasma samples of intestinal wall metabolism， intestinal flora metabolism and hepatic metabolism were prepared via in situ intestinal perfusion and closed intestinal loop method； while comprehensive metabolic plasma samples， brain tissue samples， and cerebrospinal fluid samples were collected after intragastric administration. UPLC-HRMS technology was utilized to analyze and identify chemical components and prototype components absorbed into blood and brain of L. litseifolius leaves. RESULTS A total of 66 chemical constituents were identified in L. litseifolius leaves， primarily consisting of flavonoids， organic acids， and others. A total of 16， 13， 11， and 5 prototype components were identified in intestinal wall metabolism， intestinal flora metabolism， hepatic metabolism， and comprehensive metabolic plasma samples， respectively. Additionally， 4 prototype components were detected in brain tissue and 9 in cerebrospinal fluid. Phloridzin， trilobatin， phloretin-2- O -malonyl hexoside， and phloretin were identified as common components across all sample types. CONCLUSIONS Prototype components absorbed into blood and brain of L. litseifolius leaves， such as phloridzin， trilobatin， phloretin， and other components may serve as the pharmacological material basis for their therapeutic effects on central nervous system diseases.

BACKGROUND: The American Heart Association recently released a new cardiovascular health (CVH) metric, Life's Essential 8 (LE8), for health promotion. However, the association between LE8 scores and the risk of chronic kidney disease (CKD) remains uncertain. We aimed to explore the association of LE8 scores with new-onset CKD and examine whether socioeconomic deprivation and genetic risk modify this association. METHODS: A total of 286,908 participants from UK Biobank and without prior CKD were included between 2006 and 2010. CVH was categorized using LE8 scores: low (LE8 scores <50), moderate (LE8 scores ≥50 but <80), and high (LE8 scores ≥80). The study outcome was new-onset CKD, ascertained by data linkage with primary care, hospital inpatient, and death data. Cox proportional hazard regression models were used to investigate the association between CVH categories and new-onset CKD. RESULTS: During a median follow-up of 12.5 years, 8857 (3.1%) participants developed new-onset CKD. Compared to the low CVH group, the moderate (adjusted hazards ratio [HR], 0.50; 95% confidence interval [CI]: 0.47-0.53) and high CVH (adjusted HR, 0.31; 95% CI: 0.27-0.34) groups had a significantly lower risk of developing new-onset CKD. The population-attributable risk associated with high vs. intermediate or low CVH scores was 40.3%. Participants who were least deprived ( vs.  most deprived; adjusted HR, 0.75; 95% CI: 0.71-0.79) and with low genetic risk of CKD ( vs.  high genetic risk; adjusted HR, 0.89; 95% CI: 0.85-0.94) had a significantly lower risk of developing new-onset CKD. However, socioeconomic deprivation and genetic risks of CKD did not significantly modify the relationship between LE8 scores and new-onset CKD (both P -interaction >0.05). CONCLUSION Achieving a higher LE8 score was associated with a lower risk of developing new-onset CKD, regardless of socioeconomic deprivation and genetic risks of CKD.
Humans ; Renal Insufficiency, Chronic/epidemiology* ; Male ; Female ; Middle Aged ; Genetic Predisposition to Disease/genetics* ; Aged ; Risk Factors ; Adult ; Proportional Hazards Models ; Socioeconomic Factors

Synovium is the target organ of rheumatoid arthritis.The excessive proliferation of synovial cells and insufficient apoptosis lead to synovial hyperplasia,which in turn causes damage to the surrounding tissues of the joint and bone destruction."Yang transforming qi and yin forming elements"is derived from Su Wen and is a highly summarized description of the functions of yin and yang,which runs through the entire course of the disease.This article elucidated the theoretical connotation of"yang transforming qi and yin forming elements"and its connection with synovial hyperplasia,proposing that the insufficiency of"yang transforming qi"is the root of synovial hyperplasia,while the excess of"yin forming elements"is the manifestation of synovial hyperplasia.Based on this,it put forward that"assisting yang qi as the priority,and according to the bias of pathogenic factors of yin,supplementing the method of reducing yin forming elements"is an important principle for treating this disease,which could provide new ideas for the treatment of the disease.

Objective To take text analysis of the mental health promotion policies for Chinese medical staff,and provide guidance for the optimization and improvement of subsequent policies.Methods Two-dimensional analysis framework composed of policy tools and two-factor theory were established,and external attribute analysis and content analysis of 19 mental health promotion policies issued by the central level were conducted.Among the policy text types,the most notifications,followed by opinions and the least work plan.A total of 368 policy codes were selected in the included policy texts.Among the 180 codes in the dimension of policy tool,authority,incentive,capacity building,guidance and organizational change accounted for 19.44％,15.56％,28.89％,31.11％and 5.00％respectively.Among the 188 codes in the two-factor theoretical dimension,health care factors and incentives accounted for 63.83％and 36.17％,respectively.There are rich types of policy tools for mental health promotion of Chinese staff workers,but they show an unbalanced state and pay less attention to the motivation of medical staff.

Objective To investigate the expression levels and clinical significance of serum and placental microRNA(miR)-1227-3p and miR-212-3p in puerperas with fetal growth restriction(FGR).Methods A total of 120 puerperas diagnosed with FGR and completed delivery in our hospital were included as the study group.Patients were assigned into the mild group(n=72)and the severe group(n=48)according to the severity of their condition.Another 120 healthy puerperas who underwent prenatal check ups and delivered during the same period in our hospital were included as the control group.QRT-PCR was used to detect serum and placental miR-1227-3p and miR-212-3p.The pregnancy outcomes of both groups were recorded,including neonatal weight,1min Apgar score,placental weight and placental volume.Results Serum and placental miR-1227-3p expression levels,neonatal weight,1 min Apgar score,placental weight and placental volume were significantly lower in the study group than those of the control group(P＜0.05),while serum and placental miR-212-3p expression levels were significantly higher than those of the control group(P＜0.05).The expression levels of miR-1227-3p in serum and placenta of the severe group were obviously lower than those of the mild group(P＜0.05),while the expression level of miR-212-3p was obviously higher than those of the mild group(P＜0.05).The expression levels of miR-1227-3p in serum and placenta were positively correlated with neonatal weight,1 min Apgar score,placental weight and placental volume,and the expression levels of miR-212-3p in serum and placenta were negatively correlated with the above indicators(P＜0.05).Multivariate Logistic regression analysis revealed that elevated serum and placental miR-212-3p levels were risk factors for FGR(P＜0.05),and increased serum and placental miR-1227-3p,neonatal weight,1 min Apgar,placental weight and placental volume were protective factors(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the diagnostic value of combined detection of serum and placenta miR-1227-3p and miR-212-3p levels for FGR was better than that of single diagnosis.Conclusion The combined detection of miR-1227-3p and miR-212-3p in serum and placenta of FGR puerperas has certain value in the clinical diagnosis of FGR.

OBJECTIVE: To investigate the influence of different scanning conditions on the image quality of medical electron accelerator cone-beam computed tomography (CBCT) and provide a reference for the selection of scanning conditions for different body parts. Methods Set different scanning conditions, the Catphan 503 phantom was scanned using CBCT parameters to analyze the influence of spatial resolution, noise, uniformity, spatial geometric accuracy, and low-contrast resolution on the image quality of CBCT. RESULTS: For the head, chest, and abdomen, with the increase in scanning parameter values, the noise value decreased by 47.4%, 26.1%, and 51.3% respectively, and the uniformity values decreased by 30.2%, 26.6%, and 47.9% respectively. The low-contrast resolution values decreased by 50.6%, 34.2%, and 12.0%. The influence of different scanning conditions on spatial geometric accuracy and spatial resolution is not significant. CONCLUSION Different scanning parameters have a certain influence on the image quality of medical electron accelerator CBCT. Lower scanning parameters can be selected based on individual patients to reduce the additional radiation dose, providing a reference for the safe application of CBCT image guidance in radiotherapy.
Cone-Beam Computed Tomography/instrumentation* ; Phantoms, Imaging ; Particle Accelerators

Objective:Exploring the association rules of factors influencing high hospitalization costs for cancer patients, providing references for hospitals to optimize medical cost management measures.Methods:In the inpatient case information system of a tertiary general hospital, the medical record homepages of inpatients in the DRG groups of the oncology department in 2022 were obtained. The upper four scores of hospitalization costs was used as the threshold for patient grouping. Patients with hospitalization costs≥this threshold were the high-cost group, while other patients were control group; 12 factors, including age, gender, and admission condition, etc, were considered as potential influencing factors of high hospitalization costs. FP-Growth and Apriori algorithms were used to excavate the potential association rules between the influencing factors of high hospitalization costs. Logistic regression was used to analyze the independent influencing factors of high hospitalization costs.Results:A total of 5 512 hospitalized patients were included, including 1 378 patients in the high-cost group. Thirteen validated strong association rules for factors influencing high hospitalization costs were obtained, of which the rule antecedents included age (≥70 years), number of days in hospital (≥7 days), other diagnoses (≥5), surgery, planned readmission, use of antibiotics, admission (general/critical), living admission score (61~99), level of care (level 1/level 2), non-day ward, criticality during hospitalisation. Logistic regression results showed that all nine influencing factors except gender, use of antibiotics, and readmission plans were independent influences on high hospitalization costs ( P<0.05). Conclusions:The joint application of FP-Growth and Apriori algorithm could effectively explore the association rules of high hospitalization costs for oncology patients. The early warning information mainly included the number of hospitalization days, the number of other diagnoses, surgeries, and so on. It was suggested that medical institutions can reasonably control the high hospitalization costs through clinical pathway management, diagnosis and treatment process reengineering, admission risk assessment, and multidisciplinary collaborative diagnosis and treatment strategies.

Objective:To systematically evaluate the associations of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) with post-stroke depression (PSD).Methods:PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases were searched to collect literature comparing levels of CRP, IL-6, and TNF-α at the peripheral blood between PSD and non-PSD patients, with retrieval time limit from inception to June 2024. Literature was screened according to inclusion and exclusion criteria, and data were extracted. Newcastle-Ottawa Scale (NOS) was used to assess the quality of included literature. Meta analysis was conducted using Stata 18.0 software, and publication bias was assessed.Results:A total of 21 pieces of literature with 3,177 participants were collected, including 1,425 patients with PSD and 1,752 patients with non-PSD. Meta analysis results showed that CRP level at the peripheral blood in PSD patients was significantly higher than that in non-PSD patients (standardized mean difference [ SMD]=0.930, 95% CI: 0.580-1.280, P<0.001). Subgroup analysis results showed that, among the 7 pieces of literature with CRP detection<14 days after stroke, CRP level at the peripheral blood in PSD patients was significantly higher than that in non-PSD patients ( SMD=0.640, 95% CI: 0.38-0.89, I2=83.9%, P<0.001); among the 4 pieces of literature with CRP detection≧14 days after stroke, CRP level at the peripheral blood in PSD patients was significantly higher than that in non-PSD patients ( SMD=1.450, 95% CI: 0.820-2.090, P<0.001), enjoying higher heterogeneity ( I2=90.6%). IL-6 level at the peripheral blood in PSD patients was significantly higher than that in non-PSD patients ( SMD=2.659, 95% CI: 1.583-3.735, P<0.001). No significant difference in TNF-α level at the peripheral blood was noted between PSD patients and non-PSD patients ( SMD=0.403, 95% CI: -0.208-1.014, P=0.196). Conclusion:CRP and IL-6 levels at the peripheral blood in PSD patients are obviuosly higher than those in non-PSD patients, suggesting that CRP and IL-6 may be potential biomarkers for early identification and intervention of PSD.

Objective: To screen and identify the key active molecules, signaling pathways, and therapeutic targets of Shuxuening (SXN) injection for treating liver cirrhosis (LC) and to evaluate its therapeutic potential using a mouse model. Methods: Target genes of SXN and LC were retrieved from public databases, and enrichment analysis was performed. A protein–protein interaction (PPI) network was constructed using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING), and hub genes were identified using Molecular Complex Detection (MCODE). LC was induced in rats and mice via intraperitoneal injections of diethylnitrosamine and carbon tetrachloride (CCl4) for 12 weeks. Starting at week 7, SXN was administered intraperitoneally to the mice in the treatment group. Serum and liver tissues of the mice were collected for the detection of indicators, pathological staining, and expression analysis of hub targets using quantitative real-time polymerase chain reaction (qRT-PCR). Results: We identified 368 overlapping genes (OLGs) between SXN and LC targets. These OLGs were subsequently used to build a PPI network and to screen for hub genes. Enrichment analysis showed that these genes were associated with cancer-related pathways, including phosphoinositide-3-kinase/Akt and mitogen-activated protein kinase signaling and various cellular processes, such as responses to chemicals and metabolic regulation. In vivo experiments demonstrated that SXN treatment significantly improved liver function and pathology in CCl4-induced LC mice by reducing inflammation and collagen deposition. Furthermore, qRT-PCR demonstrated that SXN regulated the expression of MAPK8, AR and CASP3 in the livers of LC mice. Conclusion This study highlighted the therapeutic effects of SXN in alleviating LC using both bioinformatics and experimental methods. The observed effect was associated with modulation of hub gene expression, particularly MAPK8, and CASP3.

Objective:To evaluate the efficacy of multimodal prehabilitation in patients with refractory functional constipation undergoing Jinling procedure(modified Duhamel surgery).Methods:In this prospective randomized controlled trial,80 patients with refractory functional constipation scheduled for Jinling procedure at the Department of General Surgery,the General Hospital of Eastern Theater Command between January 2020 and December 2021 were enrolled.Participants were randomly assigned to either the observation group(n=40,multimodal prehabilitation)or control group(n=40,routine nursing care).Outcome measures included:time to first flatus,time to first ambulation,defecation volume on postoperative day 5,length of hospitalization,nutritional markers(hemoglobin,albumin,total protein at postoperative day 7),anxiety/depression scores(Hospital Anxiety and Depression Scale,HADS),and total complication rates.Results:Compared to controls,the first ventilation time(48.02±6.15)h,first ambulation time(49.92±5.58)h,defecation volume on the fifth day(234.50±51.03)mL,hospital stay(13.15±2.64)d,anxiety score(43.68±3.45)points,depression score(43.81±1.58)points,and the total incidence of postoperative complications(15%)were significantly lower in the observation group(all p values<0.05).By contrast,the serum levels of hemoglobin(115.60±11.60)g/l,albumin(41.19±5.79)g/L and total protein(61.64±4.94)g/L on day 7 post-operatively were significantly higher in the observation group than those in the control group(P<0.05).Conclusions:Multimodal prehabilitation enhances postoperative intestinal recovery,reduces complications,improves nutritional status,and shortens hospital stays in refractory functional constipation patients undergoing Jinling procedure,supporting its clinical adoption.