BACKGROUND:How to repair bone defect has been a clinical problem for a long time.The effective ingredients of traditional Chinese medicine have good biological activity and therapeutic effect,and the combination of effective ingredients of traditional Chinese medicine and tissue engineering materials has a broad prospect in the field of bone repair.The combination of different effective ingredients of traditional Chinese medicine and scaffolds has similarities in their functional relationships. OBJECTIVE:To collect the cases of the combinations of effective ingredients of traditional Chinese medicine and scaffolds,then analogize tissue engineering scaffolds and effective ingredients of traditional Chinese medicine into two types of traditional Chinese medicine that generate compatibility relationships based on the inspiration of the compatibility of seven emotions and summarize the relationship between the two based on their functional relationships. METHODS:Relevant articles from January 1998 to January 2024 were searched in PubMed and China National Knowledge Infrastructure(CNKI),using English search terms"traditional Chinese medicine,Chinese medicine,traditional Chinese medicine monomers,bone defect,bone repair,bone tissue engineering,tissue engineering,scaffold"and Chinese search terms"traditional Chinese medicine,effective ingredients of traditional Chinese medicine,traditional Chinese medicine monomers,bone tissue engineering,bone tissue engineering scaffold,scaffold,tissue engineering,bone defect,bone repair."A total of 88 articles were included for review and analysis. RESULTS AND CONCLUSION:(1)Both tissue engineering scaffold materials and active ingredients of traditional Chinese medicine have been widely used in the field of bone repair.Although they have obvious advantages in osteogenesis,there are still many shortcomings.Many studies are dedicated to preparing composite materials from the two,hoping to exert a detoxification and synergism through the interaction between the two.(2)Some drugs and materials can promote each other in osteogenesis,antibacterial,and promoting angiogenesis,enhancing their original effects.Inspired by the traditional concept of prescription compatibility,this article summarized it as a"Mutual promotion"relationship and provided examples to support it.(3)Some drugs can enhance the strength of materials,while some materials can achieve sustained release and controlled release effects,increase drug loading and stability,or achieve targeted delivery of drugs loaded on them.The article summarized this unilateral enhancement effect as a"Mutual assistance"relationship.(4)The combination of some traditional Chinese medicine and materials can reduce the toxic side effects of the other party.The article summarizes this detoxification relationship as"Mutual restraint and detoxification."(5)The article provided a new perspective on traditional Chinese medicine composite scaffolds,inspired by the seven emotions compatibility relationship and based on the classification of action relationships.It introduced traditional Chinese medicine concepts into the field of tissue engineering,providing new research ideas for subsequent researchers of composite scaffolds,and providing certain convenience in material selection and matching.

Objective: To evaluate the effects of dietary intervention on blood pressure and renal function in patients with hypertensive nephropathy, so as to provide dietary and nutritional guidances for this population. Methods: Hypertensive nephropathy patients who were treated at Zhucheng People's Hospital from March 2023 to February 2024 were selected as the study subjects and randomly divided into the intervention group and the control group. The control group received routine antihypertensive treatment and health lifestyle guidance. On the basis of the treatment and guidance received by the control group, the intervention group implemented dietary intervention in accordance with the Clinical Practice Guidelines for Nutritional Therapy of Chronic Kidney Disease in China (2021 edition) for a period of 3 months. Systolic blood pressure (SBP), diastolic blood pressure (DBP) were measured before and after the intervention, and serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA), cystatin and β2-microglobulin were detected. Differences of indicators before and after intervention between the two groups were compared using generalized estimation equation. Results: A total of 83 patients with hypertensive nephropathy were followed up, including 43 cases in the intervention group and 40 cases in the control group. There were no statistically significant differences in gender, age, body mass index, duration of hypertension, family history of hypertension, hypertension grade, physical activity index, or smoking status between the two groups (all P>0.05). The differences in SBP, DBP, Scr, BUN, and UA between the two groups, as well as the differences before and after the intervention, were statistically significant, and there was an interaction between the groups and the intervention time (all P<0.05). After intervention, the levels of SBP, DBP, Scr, BUN, and UA in the intervention group were lower than those in the control group (all P<0.05). The differences in cystatin and β2-microglobulin between the two groups and before and after the intervention were not statistically significant, and there was no interaction between the groups and the intervention time (all P>0.05). Conclusion Dietary intervention has a certain effect on reducing blood pressure and improving renal function indicators in patients with hypertensive nephropathy.

To achieve the goals of carbon peak and carbon neutrality (double carbon), China has been updating and developing low-carbon coal-fired power generation technology. While reducing carbon dioxide emissions, it has achieved a significant reduction in emissions of pollutants such as particulate matter, sulfur dioxide, and nitrogen oxides. However, at the same time, with the relative increase in emissions of certain pollutants such as sulfur trioxide, ammonia, and volatile organic compounds, the types and proportions of pollutant emissions have changed. This study summarized the technological improvements in coal-fired power generation both domestically and internationally, as well as the types and proportions of pollutants emitted by different coal-fired power generation modes. It also reviewed the epidemiological research progress on the impact of pollutants emitted from coal-fired power generation on the cardiopulmonary health of the population, expounded environmental impact of different coal-fired power models, and analyzed the changes in population exposure load and cardiopulmonary health benefits of low-carbon coal-fired power generation emissions, aiming to provide references for achieving carbon reduction and emission reduction goals and protecting the health of the population.

To achieve the goals of carbon peak and carbon neutrality (double carbon), China has been updating and developing low-carbon coal-fired power generation technology. While reducing carbon dioxide emissions, it has achieved a significant reduction in emissions of pollutants such as particulate matter, sulfur dioxide, and nitrogen oxides. However, at the same time, with the relative increase in emissions of certain pollutants such as sulfur trioxide, ammonia, and volatile organic compounds, the types and proportions of pollutant emissions have changed. This study summarized the technological improvements in coal-fired power generation both domestically and internationally, as well as the types and proportions of pollutants emitted by different coal-fired power generation modes. It also reviewed the epidemiological research progress on the impact of pollutants emitted from coal-fired power generation on the cardiopulmonary health of the population, expounded environmental impact of different coal-fired power models, and analyzed the changes in population exposure load and cardiopulmonary health benefits of low-carbon coal-fired power generation emissions, aiming to provide references for achieving carbon reduction and emission reduction goals and protecting the health of the population.

Objective To systematically review the efficacy of anti-inflammatory drugs in the treatment of diabetic nephropathy(DN).Methods Databases including PubMed,The Cochrane Library,EMbase,Web of Science,Scopus,Ovid,ProQuest,CBM,CNKI,WanFang Data,VIP and Duxiu data were electronically searched to collect randomized controlled trials(RCTs)of anti-inflammatory drugs for DN from inception to April 5,2022.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.RevMan 5.4 software were then used to perform Meta-analysis.Results A total of 29 literature and 26 RCTs involving 4 095 patients were included.The results of Meta-analysis showed that compared with conventional treatment,conventional treatment combined with anti-inflammatory drugs could effectively reduce urinary albumin to creatinine ratio[SMD=-0.17,95％CI(-0.31,-0.03),P=0.02],urinary albumin excretion rate[SMD=-0.37,95％CI(-0.56,-0.18),P=0.000 1],urinary protein excretion rate[SMD=-0.97,95％CI(-1.29,-0.64),P=0.000 01],and glycosylated hemoglobin[SMD=-0.17,95％CI(-0.27,-0.08),P=0.000 4],while there was no significant difference in reducing serum creatinine[SMD=-0.04,95％CI(-0.19,0.1),P=0.57],urea nitrogen[MD=-0.23,95％CI(-0.50,0.04),P=0.09]and fasting blood glucose[SMD=-0.15,95％CI(-0.32,0.02),P=0.08].There was no statistically significant difference in changing glomerular filtration rate(GFR)[SMD=-0.04,95％CI(-0.15,0.07),P=0.47]with multiple drugs,except for a few drugs.Conclusion Conventional treatment combined with anti-inflammatory drugs can better improve the level of proteinuria in patients with DN,but the improvement of renal function is not obvious.Due to the limitations of the number of included studies and the duration of treatment,the above conclusion needs to be verified by more high-quality studies.

Objective:To investigate the agreement of ultrasound derived fat fraction (UDFF) with magnetic resonance imaging proton density fat fraction (MRI PDFF) on evaluating hepatic steatosis, and the performance of UDFF on diagnosing metabolic dysfunction associated steatotic liver disease (MASLD).Methods:One hundred and twenty-five volunteers and one hundred and seven inpatients who underwent abdominal ultrasound examination in Zhongda Hospital Southeast University from November 2023 to February 2024 were prospectively enrolled.UDFF and MRI PDFF were applied to evaluate hepatic steatosis. Spearman correlation test and Bland-Altman plot were applied to analyze the agreement of UDFF and MRI PDFF. Receiver operating characteristic curve (ROC) was applied to calculate the performance of UDFF on diagnosing MASLD.Results:In our participants, compared to individuals without hepatic steatosis, patients with MASLD had higher body mass index (BMI), waist-to-hip ratio, prevalence of diabetes mellitus, levels of alanine transaminase (ALT), aspertate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT), triglyceride, and UDFF (all P<0.05). The percentage of hepatic steatosis measured by UDFF and MRI PDFF was strongly correlated[ρ=0.873(95% CI=0.837-0.901), P<0.001]. UDFF performed excellent for diagnosing MASLD with an area under the curve (AUC) of 0.983(95% CI=0.956-0.995, P<0.001), and was better than semi-quantitative assessment based on two-dimensional ultrasound as well as ultrasound attenuation parameter. The optimal cut off value of UDFF to diagnose MASLD was ≥6%. Conclusions:The percentage of hepatic steatosis measured by UDFF and MRI PDFF agrees with each other, and UDFF obtains an excellent performance on diagnosing MASLD, so that UDFF should be considered a reliable imaging technique for quantitively evaluating hepatic steatosis and diagnosing MASLD.

Objective To construct a machine learning prediction model for postoperative liver injury in patients with non-liver surgery based on preoperative and intraoperative medication indicators.Methods A case-control study was conducted on 315 patients with liver injury after non-liver surgery selected from the databases developed by 3 large general hospitals from January 2014 to September 2022.With the positive/negative ratio of 1 ∶3,928 cases in corresponding period with non-liver surgery and without liver injury were randomly matched as negative control cases.These 1243 patients were randomly divided into the modeling group(n=869)and the validation group(n=374)in a ratio of 7∶3 using the R language setting code.Preoperative clinical indicators(basic information,medical history,relevant scale score,surgical information and results of laboratory tests)and intraoperative medication were used to construct the prediction model for liver injury after non-liver surgery based on 4 machine learning algorithms,k-nearest neighbor(KNN),support vector machine linear(SVM),logic regression(LR)and extreme gradient boosting(XGBoost).In the validation group,receiver operating characteristic(ROC)curve,precision-recall curve(P-R),decision curve analysis(DCA)curve,Kappa value,sensitivity,specificity,Brier score,and F1 score were applied to evaluate the efficacy of model.Results The model established by 4 machine learning algorithms to predict postoperative liver injury after non-liver surgery was optimal using the XGBoost algorithm.The area under the receiver operating characteristic curve(AUROC)was 0.916(95%CI:0.883～0.949),area under the precision-recall curve(AUPRC)was 0.841,Brier score was 0.097,and sensitivity and specificity was 78.95%and 87.10%,respectively.Conclusion The postoperative liver injury prediction model for non-liver surgery based on the XGBoost algorithm has effective prediction for the occurrence of postoperative liver injury.

Objective:To investigate the clinical characteristics of circadian rhythm disorder of blood pressure and its impact on orthostatic hypotension (OH) in Parkinson′s disease (PD).Methods:A total of 165 PD patients from Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from August 2019 to October 2021 were consecutively enrolled. Medical history and scores of motor and non-motor symptoms of patients were collected. Twenty-four-hour ambulatory blood pressure and OH data were collected, and the OH questionnaire was completed. The incidence of each type of circadian rhythm disorder of blood pressure was investigated. The t test, chi-square test and Mann-Whitney U test were used to determine between-group differences of circadian rhythm disorder of blood pressure. The linear trends in clinical characteristics were tested by linear regression analysis. Logistic regression analysis was used to analyze the relationship between different circadian rhythm disorders of blood pressure and OH as well as symptomatic OH (SOH). Results:In 165 PD patients, the incidence of reverse dipping pattern was 39.39% (65/165), nocturnal hypertension was 43.64% (72/165), and awakening hypotension was 31.52% (52/165). Compared with patients without reverse dipping pattern, patients with reverse dipping pattern were older [(71.72±7.81) years vs (65.29±9.68) years, t=-4.491, P<0.001], had later onset age [(66.67±9.10) years vs (62.16±10.66) years, t=-2.809, P=0.006], longer duration [36.00(20.50, 95.50) months vs 24.00(12.00, 41.75) months, Z=-3.393, P<0.001], higher dose of levodopa (LD) [(426.15±267.38) mg/d vs (284.00±235.58) mg/d, t=-3.590, P<0.001], higher levodopa equivalent dose (LED) [(514.80±360.03) mg/d vs (341.44±284.57) mg/d, t=-3.440, P=0.001], higher Unified Parkinson′s Disease Rating Scale (UPDRS)-Ⅱ scores (12.92±6.38 vs 9.54±5.59, t=-3.434, P=0.001), higher UPDRS-Ⅲ scores (28.34±11.60 vs 21.41±12.18, t=-3.508, P=0.001) and higher percentages of hallucinations [18.46% (12/65) vs 7.00% (7/100), χ2 =5.079, P=0.024]. Compared with patients without awakening hypotension, patients with awakening hypotension were older [(70.83±7.09) years vs (66.44±10.16) years, t=-2.811, P=0.006]. Compared with patients without nocturnal hypertension, patients with nocturnal hypertension had longer duration [39.50(15.00, 96.00) months vs 24.00 (12.00, 36.00) months, Z=-2.944, P=0.003], higher LD [(398.61±251.19) mg/d vs (294.62±254.25) mg/d, t=-2.619, P=0.010], higher LED [(493.28±344.02) mg/d vs (345.05±298.59) mg/d, t=-2.959, P=0.004], higher percentages of hallucinations [19.44% (14/72) vs 5.38% (5/93), χ2 =7.882, P=0.005], higher UPDRS-Ⅱ scores (12.08±6.33 vs 10.00±5.86, t=-2.086, P=0.039), higher UPDRS-Ⅲ scores (26.50±11.72 vs 22.42±12.66, t=-2.034, P=0.044), and greater blood pressure variability (BPV) (20.66±5.47 vs 17.44±5.36, t=-3.798, P<0.001). Trend analysis showed that the variety of circadian rhythm was positively correlated with age and duration, use of levodopa and monoamine oxidase B inhibitors and amantidine, morning and daily LD and LED, UPDRS-Ⅱ, UPDRS-Ⅲ and Hamilton Anxiety Scale scores, hallucinations, OH and SOH, and BPV in PD ( P<0.05). Multivariate Logistic regression analysis showed that awakening hypotension ( OR=3.35, 95% CI 1.55-7.22, P=0.002) and nocturnal hypertension ( OR=2.44, 95% CI 1.20-4.97, P=0.014) were risk factors for OH, and LED ( OR=1.21, 95% CI 1.01-1.43, P=0.035), UPDRS-Ⅲ scores ( OR=1.09, 95% CI 1.02-1.16, P=0.009) and w-BPV ( OR=1.14, 95% CI 1.01-1.29, P=0.029) were independent risk factors for SOH. Conclusions:Circadian rhythm disorder of blood pressure was correlated with age, duration, severity of motor symptoms. Awakening hypotension and nocturnal hypertension are independent risk factors for OH in PD.

Objective:To determine the evolution of gait impairment over the course of Parkinson′s disease (PD) by assessing the changes of gait characteristics in different disease stages, which could be helpful for disease monitoring.Methods:A total of 276 PD patients [PD group, Hoehn-Yahr (H-Y) stage 1-3] and 63 healthy controls (control group) enrolled in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2019 to September 2021 were included in this cross-sectional study. The gait spatiotemporal variables were recorded by a portable inertial measurement unit system. Exploratory factor analysis was performed to obtain gait domains representing different gait characteristics. One way analysis of variance was used to evaluate the differences of gait variables and gait domains among the control group and 3 different H-Y stages of the PD group, as well as the differences among the control group and 2 motor subtypes of PD in different stages. The sensitivity of different gait variables and gait domains in evaluating the severity of gait impairments at different disease stages was compared.Results:Eleven gait spatiotemporal variables were grouped in 4 gait domains: pace (step length, gait speed and stride length), rhythm/phase (cadence, stride time and double support time), pace-related variability/asymmetry [step length coefficient of variation (CV), gait speed CV and step length asymmetry] and rhythm/phase-related variability/asymmetry (swing time CV and swing time asymmetry). As the disease progresses, most evolution trends of the 4 gait domains in the tremor-dominant PD patients were consistent with those in the non-tremor-dominant subtype. Compared with the control group, PD patients at H-Y stage 1 began to show the mild impairment of rhythm/phase-related variability/asymmetry (effect size 0.42; standardized score -0.03±0.69 vs -0.33±0.49, P<0.05), especially swing time asymmetry in tremor-dominant patients; the pace domain was damaged moderately in PD patients at H-Y stage 2 (effect size 0.64; standardized score 0.12±0.80 vs 0.64±0.81, P<0.05), especially in non-tremor-dominant PD patients, but not in PD patients at H-Y stage 1 ( P>0.05). Pace-related variability/asymmetry showed great impairment in PD patients at H-Y stage 3 (effect size 0.62; standardized score 0.27±1.12 vs -0.27±0.52, P<0.05), but not in PD patients at H-Y stages 1 and 2 ( P>0.05). Conclusions:The characteristic impairments of gait in PD evolve in the process of disease progression. The rhythm/phase-related variability/asymmetry domain may be a marker to distinguish early PD from healthy controls. The pace domain and the pace-related variability/asymmetry domain are important markers to evaluate the progression of PD.

Objective:To identify and quantify spatiotemporal and kinematic gait parameters in a group of early-stage Parkinson′s disease (PD) patients compared with healthy subjects.Methods:Eight patients with PD (PD group, Hoehn-Yahr stage≤2.5) and seven age-matched healthy subjects (control group) were enrolled from the Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between May 2017 and August 2018 for the study. The spatiotemporal and kinematic gait parameters were obtained by Vicon 3D optical motion analysis system under three conditions: single-task walking, dual-task walking and turning. The linear mixed model was used to compare the gait parameters between the two groups and analyze the interactive effects.Results:Arm swing amplitude in the PD group was lower than that in the control group ((0.63±0.15) m vs (0.89±0.27) m in single-task walking, (0.64±0.16) m vs (0.99±0.22) m in dual-task walking, β=-0.353, 95% CI -0.558--0.148, P=0.002). The PD group showed significantly higher arm swing asymmetry than the control group (12.48%±5.48% vs 6.96%±4.39% in single-task walking, 17.13%±4.05% vs 7.67%±5.23% in dual-task walking, β=8.992, 95% CI 4.148-13.836, P=0.001). A notable interactive effect of groups and task factors in arm swing asymmetry was found. The arm swing asymmetry of the PD group increased more than the control group in dual-task walking than in single-task walking (β=3.916, 95% CI 1.367-6.466, P=0.003). As for the gait characteristics of the lower limbs, stride length and step length of the PD group were lower than those of the control group ((1.10±0.17) m vs (1.31±0.10) m in stride length, β=-0.169, 95% CI -0.300--0.038, P=0.015; (0.55±0.09) m vs (0.65±0.04) m in step length, β=-0.081, 95% CI -0.150--0.013, P=0.023). For both groups, statistically significant differences were not observed in step width, stride length and step length between single-task and dual-task walking ( P>0.05). The PD group completed the turning process faster than the control group ((1.66±0.30) s vs (1.37±0.23) s, β=0.302, 95% CI 0.049-0.555, P=0.023). As for the rotation-onset pattern, no statistically significant differences were found between the PD and the control group for the onset of the head, trunk and pelvic rotation ( P>0.05). Participants started to rotate their heads before the pelvis in all groups (β=-0.060, 95% CI-0.107--0.014, P=0.011). Conclusions:The quantified gait parameters can more accurately reflect the gait characteristics of early PD. Patients with PD exhibited smaller arm swing magnitude, greater arm swing asymmetry, shorter stride length, and slower turning speed compared to the controls. Arm swing asymmetry further differs between subjects with early PD and controls under dual-task walking.