Objective To comprehensively assess the predictive value of C-reactive protein(CRP)/D-dimer(D-D)and albumin/fibrinogen(FAR)in predicting major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with coronary heart disease(CHD)and to construct a nomogram model for predicting post-procedural MACE in CHD patients.Methods A retrospective study was conducted on 201 CHD patients who underwent PCI at the First Affiliated Hospital of Kunming Medical University between June 2022 and March 2025.These patients were divided into MACE group(n=77)and non-MACE group(n=124)based on whether MACE occurred or not.84 CHD patients from another medical center were also collected as the validation set.The expression levels of CRP/D-D and FAR were compared between the two groups;independent predictors of postoperative MACE in CHD patients were screened by univariate and multivariate logistic regression analyses;the predictive value of CRP/D-D and FAR for the occurrence of postoperative MACE in CHD patients was assessed using ROC curves;A nomogram model was established integrating indicators such as CRP/D-D and FAR,and internal and external validations of the nomogram model were conducted using ROC curves,calibration curves,and decision curve analysis(DCA)curves.Results Compared with CHD patients in the non-MACE group,CRP/D-D and FAR levels were significantly higher in the MACE group(P<0.05).Multivariate analysis showed that age,NTproBNP,WBC,CRP/D-D,and FAR were independent risk factors for postoperative MACE in CHD patients(P<0.05).ROC curve analysis indicated that the AUC predicted by CRP/D-D combined with FAR was higher than that of CRP/D-D alone(Z=3.473,P<0.001),and FAR alone(Z=2.812,P<0.05).The Nomogram model constructed based on the aforementioned factors was validated internally and externally,and the results showed that the Nomogram model had good calibration,excellent discriminative ability,and reliable clinical utility,accurately predicting the risk of postoperative MACE.Conclusion The CRP/D-D ratio and FAR,as emerging composite biomarkers,showed significant predictive ability in predicting the risk of MACE after PCI in patients with CHD,providing a new reliable tool for clinical risk stratification.

Objective To evaluate the safety of the low glucoside composites of Epimedii Folium and clarify the pharmacokinetic characteristics of its five low glucosides.Methods Four groups of KM mice were orally administrated of corn oil,1 968,2 625 and 3 500 mg·kg-1 low glucoside composites of Epimedii Folium,respectively.Then,the living conditions,toxic symptoms,and death of the mice were observed for 7 consecutive days.After the mice were dissected,the viscera/body ratio and the viscera/brain ratio were calculated.Besides,the contents of alanine aminotransferase(ALT)and aspartate transaminase(AST)in plasma were determined by ELISA,and the pathological changes of the liver were observed by HE staining.C57BL/6J mice were intravenously or orally administered of baohuoside I,baohuoside II,sagittatoside A,sagittatoside B and sagittatoside C.Then,blood samples were collected at different time points.The plasma concentrations of the five low glucosides were measured by UHPLC-MS/MS.Results When compared with the control group,no significant differences were found in the body mass,viscera/body ratio,viscera/brain ratio,contents of ALT and AST in plasma after oral administration of different doses of low glucoside composites to mice.Moreover,no pathological changes or damages were found in the liver sections.After intravenous injection,the AUC0-t values of baohuoside Ⅰ,baohuoside Ⅱ,sagittatoside A,sagittatoside B and sagittatoside C in mice were 4.82,82.54,276.64,88.77 and 178.02 min·μg·mL-1,respectively.Meanwhile,the t1/2 values were 60.42,115.27,67.63,131.61 and 129.87 min,respectively.After oral administration,the AUC0-t values of the five low glucosides were 31.64,18.59,3.48,2.41 and 2.42 min·μg·mL-1,respectively.The Cmax values were 147.23,86.76,15.58,24.34 and 26.12 ng·mL-1,respectively.The tmax values were 21.00,78.00,78.00,30.00 and 28.00 min,respectively.The bioavailability of baohuosideⅠ,baohuosideⅡ,sagittatoside A sagittatoside B and sagittatoside C were 1.91%,0.51%,0.05%,0.06%and 0.04%,respectively.Conclusion The low glucoside composites of Epimedii Folium has high safety,and no hepatotoxicity were observed at dose of 3 500 mg·kg-1.The 5 low glucosides are quickly absorbed and rapidly eliminated in mice,and all of them have low bioavailability.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

ObjectiveTo investigate the situation and development trend of the disease burden of acute hepatitis B in China in 1990 — 2019. MethodsThe Global Burden of Disease 2019 was used to analyze the incidence rate， mortality rate， and disability-adjusted life year （DALY） rate of acute hepatitis B in different sex and age groups and predict the trend of the incidence rate of acute hepatitis B. ResultsIn 2019， the incidence rate， mortality rate， and DALY rate of acute hepatitis B in China were 1 623.71/100 000， 0.20/100 000， and 10.04/100 000 respectively， which were reduced by 42.03%， 79.38%， and 80.21%， respectively， compared with the data in 1990， and women showed lower incidence rate， mortality rate， and DALY rate of acute hepatitis B than men. In 2019， the 20～<54 years group had the highest incidence rate （2 285.85/100 000） and DALY rate （10.53/100 000）， and the ≥55 years group had the highest mortality rate of 0.52/100 000. The Joinpoint regression model analysis showed that the incidence rate， mortality rate， and DALY rate of acute hepatitis B in China tended to decrease from 1990 to 2019， with an average annual percent change of -1.9%， -5.2%， and -5.5%， respectively （P<0.05）. The grey prediction model GM （1，1） showed that the incidence rate of acute hepatitis B will decrease from 2020 to 2030 in China. ConclusionThe disease burden of acute hepatitis B tended to decrease from 1990 to 2019 in China， indicating that the prevention and treatment measures for acute hepatitis B have achieved a marked effect in China； however， due to the large population base of China， active preventive measures should be further adopted to reduce the disease burden of acute hepatitis B.

Objective:To investigate the effect of arthroscopically-assisted open reduction and internal fixation of intra-articular distal radius fracture.Methods:A retrospective cohort study was made on clinical data of 44 patients with distal radial intraarticular fracture admitted to Jing′an District Central Hospital, Fudan University between June 2017 and August 2020. There were 13 males and 31 females, at age of 35-85years [(62.5±12.9)years]. According to AO/OTA fracture classification system, there were 7 patients with type B and 37 with type C. Open reduction and internal fixation with volar plate was used in all patients, among which 22 were operated on using arthroscopy assistance (arthroscopy group) and 22 were operated on with traditional intraoperative fluoroscopy (fluoroscopy group). The operation time in both groups and triangular fibrocartilage complex (TFCC) injury and fracture displacement in arthroscopy group were recorded. Patient-rated wrist evaluation (PRWE) score, disabilities of the arm, shoulder and hand (DASH) questionnaire and range of wrist motion were compared between the two groups at 12 months after operation. The incidence of complications was observed.Results:All patients were followed up for 12-15 months [(13.3±1.1)months]. The operation time in arthroscopy group was (104.0±40.5)minutes, longer than (71.3±32.1)minutes in fluoroscopy group ( P<0.05). In arthroscopy group, 14 patients (64%) with TFCC injury were diagnosed intraoperatively, with the fracture displacement gap and step for 0.8 (0.3, 0.8)mm and 1.0 (0.3, 1.5)mm under arthroscopic vision, which were reduced to 0.3 (0.0, 0.5)mm and 0.5 (0.0, 0.5)mm after arthroscopically-assisted reduction (all P<0.05). The PRWE score in arthroscopy group was (9.8±4.9)points at 12 months after operation, lower than (13.4±5.8)points in fluoroscopy group ( P<0.05). The DASH questionnaire in arthroscopy group was (9.0±5.0)points at 12 months after operation, lower than (13.0±6.1)points in fluoroscopy group ( P<0.05). The dorsal extension and posterior rotation of the wrist in arthroscopy group were (73.8±8.9)° and (82.5±8.0)°, higher than (65.8±14.2)° and (76.3±10.4)° in fluoroscopy group (all P<0.05). There were no postoperative complications such as loosened or broken screws, vascular nerve damage, incision infection or traumatic arthritis in both groups. Conclusion:Arthroscopic-assisted open reduction and internal fixation of intra-articular distal radius fracture can increase the accuracy of joint surface reduction, improve postoperative wrist function and confirm the diagnosis of TFCC injury during operation.

In order to investigate the apoptosis triggered by porcine circovirus type 2 (PCV2) in lymphocytes and the underlying mechanism, the levels of apoptosis and the expression levels of miRNA were examined by flow cytometry, Western blotting and real-time PCR (qPCR). The mimics or inhibitors of miR-125a-5p, an apoptosis-related miRNA, were transfected into PK-15 cells, and the apoptosis rate was examined upon overexpression or inhibition of mir-125a-5p. The target gene of mir-125a-5p was predicted by bioinformatics method, and the regulation of mir-125a-5p on the target gene was analyzed by luciferase reporter assay. The expressions of Bcl-2, Bax, cytochrome C and caspase-3 were detected by Western blotting. The results showed that exosomes secreted by PK-15 cells infected with PCV2 significantly increased the lymphocyte apoptosis rate, which was dose-dependent in certain concentration range. The expression of miR-125a-5p was dramatically increased. The apoptosis rate was increased significantly in the cells transfected with miR-125a-5p. It was predicted that there were binding sites of miR-125a-5p at Bcl-2 3'UTR by TargetScan. The luciferase activity of wild-type pmir-Bcl-2 3'UTR was inhibited significantly by miR-125a-5p mimics, but that of mutant pmir-Bcl-2 3'UTR was not changed. By Western blotting, Bcl-2 was reduced significantly, while Bax, cytochrome C and caspase-3 increased significantly, and the ratio of Bcl-2/Bax was significantly decreased. These results showed that PCV2 up-regulated the expression of miR-125a-5p through exosomes, then inhibited the expression of Bcl-2 at both mRNA and protein level, activated mitochondrial apoptosis pathway and induced apoptosis in lymphocytes.
3' Untranslated Regions ; Animals ; Apoptosis/genetics* ; Caspase 3/genetics* ; Cell Proliferation/genetics* ; Circovirus/genetics* ; Cytochromes c/genetics* ; Luciferases/genetics* ; Lymphocytes/metabolism* ; MicroRNAs/metabolism* ; Swine ; bcl-2-Associated X Protein/genetics*

OBJECTIVE: To compare and analyze the risk of formaldehyde hazards in a plywood manufacturing factory using two risk assessment methods,and to evaluate the occupational health risk. METHODS: Occupational health investigation and formaldehyde detection for workplaces were carried out in a plywood manufacturing factory in Shandong province. The risk ratings of different posts were assessed by US Environmental Protection Agency( EPA) inhalation risk( EPA assessment model) and Singapore Semi-quantitative Assessment Model( MOM assessment model). The risk classification results of the 2 risk assessment methods were compared and analyzed. RESULTS: The concentration of airborne formaldehyde on the positions of shaving,woods feeding,gluing,hot milling,hot pressing,sanding and reprocessing were 0. 25,0. 13,1. 47,0. 72,0. 92 and 0. 58 mg/m~3,respectively. By the EPA assessment model,all of the positions were evaluated as high carcinogenic risk. Through the MOM assessment model,the feeding position was evaluated as medium risk,the positions of shaving,hot milling,hot pressing sanding and reprocessing were high risk,and the position of gluing was higher risk. CONCLUSION: It suggests that there is a high formaldehyde exposure in several posts in the plywood production processing. EPA assessment model is a suitable for occupational health risk assessment for formaldehyde exposure.

OBJECTIVEThe aim of this study was to investigate the use of the lesion-specific endonucleases-modified comet assay for analysis of DNA oxidation in cell lines.

METHODSDNA breaks and oxidative damage were evaluated by normal alkaline and formamidopyrimidine-DNA-glycosylase (FPG) modified comet assays. Cytotoxicity were assessed by MTT method. The human bronchial epithelial cell (16HBE) were treated with benzo (a) pyrene (B(a)P), methyl methanesulfonate (MMS), colchicine (COL) and vincristine (VCR) respectively, and the dose is 20 µmol/L, 25 mg/ml, 5 mg/L and 0.5 mg/L for 24 h, respectively. Oxidative damage was also detected by levels of reactive oxygen species in treated cells.

RESULTSFour genotoxicants give higher cytotoxicity and no significant changes on parameters of comet assay treated by enzyme buffer. Cell survival rate were (59.69 ± 2.60) %, (54.33 ± 2.81) %, (53.11 ± 4.00) %, (51.43 ± 3.92) % in four groups, respectively. There was the direct DNA damage induced by test genotoxicants presented by tail length, Olive tail moment (TM) and tail DNA (%) in the comet assay. The presence of FPG in the assays increased DNA migration in treated groups when compared to those without it, and the difference was statistically significant which indicated that the clastogen and aneugen could induce oxidative damage in DNA strand. In the three parameters, the Olive TM was changed most obviously after genotoxicants treatment. In the contrast group, the Olive TM of B(a) P,MMS, COL,VCR in the contrast groups were 22.99 ± 17.33, 31.65 ± 18.86, 19.86 ± 9.56 and 17.02 ± 9.39, respectively, after dealing with the FPG, the Olive TM were 34.50 ± 17.29, 43.80 ± 10.06, 33.10 ± 12.38, 28.60 ± 10.53, increased by 58.94%, 38.48%, 66.86% and 68.21%, respectively (t value was 3.91, 3.89, 6.66 and 3.87, respectively, and all P < 0.05), and the correlation between Olive TM and reactive oxygen species was better than other parameters (r = 0.77, P < 0.05).

CONCLUSIONThis study indicates that FPG-comet assay appears more specific for detecting oxidative DNA damage induced by genotoxicants exposure, and the application of comet assay will be expanded. The endonuclease modified comet assay will be used widely in the toxicology and molecular epidemiology study.

Cell Line ; Comet Assay ; methods ; DNA Damage ; Endonucleases ; Humans ; Mutagens ; toxicity ; Oxidation-Reduction ; Oxidative Stress ; Reactive Oxygen Species ; metabolism