Long-term spaceflight,characterized by drastic changes in spatial position,disrupts the Earth's inherent environmental periodic signals,such as the day-night light-dark cycle.This leads to a misalignment between the external environmental cycles and the body's endogenous biological rhythms.The cumulative effect of this persistent"time difference"severely disrupts the core biological pathways that regulate the circadian rhythm.It triggers a series of neuroendocrine and behavioral stress responses,exemplified by sleep-wake disorders,which have become a core medical problem constraining the success of long-term space missions and astronaut health.Traditional Chinese Medicine(TCM)posits that aligning with the rhythmic changes of heaven,earth,day,night,and the four seasons,and maintaining the dynamic balance and harmonious functioning of the body's Yin and Yang vital energies,are fundamental principles for safeguarding vitality and resisting external pathogens and internal injuries.However,in the prolonged weightlessness,confinement,and abnormal lighting environment of deep space flight,the bond between the human body and natural rhythms is forcibly severed.Yin and Yang Qi become difficult to sustain,the mechanisms of ascent,descent,exit,and entry are obstructed,the visceral Qi transformation functions are impaired,and the circulation of Qi and Blood becomes disordered,ultimately leading to the onset of various disorders.This paper,grounded in the TCM temporal medicine perspective of"correspondence between heaven and human"(tian ren xiang ying)and the theories of Yin-Yang and Qi-Blood,meticulously reviews the historical classics and modern research on acupoint intervention strategies for addressing rhythm disorders and harmonizing Yin and Yang.Building upon this foundation,it innovatively proposes and argues for an integrated acupoint prescription strategy:the"Bei Xin Wu Xue"combined with the classic paired points Zhaohai(KI6)-Shenmai(BL62)on the lower limbs to regulate the dynamic balance of the Yin and Yang Heel Vessels(Yin/Yang Qiao Mai),and the classic paired points Taichong(LR3)-Yongquan(KI1)to guide Qi downward.This combination aims to work at multiple levels-"Heart-Brain,Yin-Yang,Liver-Kidney"-to calm the Heart Spirit,clear the Brain Mansion,and tonify the Liver and Kidney.The goal is to restore Yin and Yang Qi to an orderly and coordinated state,thereby assisting the disordered biological rhythm system in regaining homeostasis.This provides a novel TCM-inspired approach of"rhythm regulation and equilibrium restoration"(tiao shi fu heng)to safeguard the long-term in-orbit health of astronauts.

Objective To investigate the improvement effect and related mechanism of roxadustat on myocardial ischemia-reperfusion(I/R)injury in mice.Methods Twenty four male C57BL/6N mice were randomly divided into the sham operation group,the control group and the roxadustat group,with eight mice in each group.A mouse myocardial I/R model was established.The control group was given 100 μL saline injection containing 5%dimethyl sulfoxide by gavage.The roxadustat group was given 25 mg/kg roxadustat by gavage.The left anterior descending coronary artery of mice in both groups was ligated for 40 minutes,and then reperfusion for 24 hours to establish the myocardial I/R model.In the sham operation group,only the left anterior coronary artery was pierced without ligation.The area of myocardial infarction in mice was detected by triphenyltetrazolium chloride(TTC)staining.The apoptosis of mouse cardiomyocytes was detected by TdT-mediated dUTP nick and labeling(TUNEL)staining.The expression of apoptosis-related proteins bcl-2 associated X protein(Bax),Caspase3 and inflammatory cell markers F4/80 and myeloperoxidase(MPO)were detected by immunohistochemistry staining.The damage of myocardial cells was observed by hematoxylin-eosin(HE)staining.Results The area of myocardial infarction after myocardial I/R was reduced in the roxadustat group compared to the control group and the sham operation group(P＜0.05).The number of apoptotic cells was higher in the control group and the roxadustat group than that in the sham operation group,and the number of apoptotic cells was lower in the roxadustat group than that in the control group(P＜0.05).The expression levels of Bax and Caspase3 proteins in myocardial tissue were higher in the control group and the roxadustat group than those in the sham operation group,while those of the roxadustat group was lower than those of the control group(P＜0.05).The expression levels of F4/80 and MPO proteins in myocardial tissue were lower in the roxadustat group than those in the control group(P＜0.05).In the control group,the myocardial tissue arrangement was disordered,and there was an increase in interstitial vacuoles.Compared with the control group,the myocardial cells were arranged more neatly in the roxadustat group,and the interstitial vacuoles were reduced.Conclusion Roxadustat can reduce the myocardial infarction area after I/R injury,inhibit myocardial cell apoptosis,alleviate myocardial injury,reduce infiltration of myocardial macrophages and neutrophils,and reduce inflammatory injury.

Objective:To assess the predictive value of dosiomics in predicting the occurrence of bone marrow suppression (BMS) in patients with pelvic tumors during radiotherapy.Methods:A retrospective analysis was conducted on the clinical data and radiotherapy planning documents of 129 patients with pelvic region tumors who underwent radiotherapy at the First Affiliated Hospital of Nanjing Medical University from January 2019 to January 2023. The region of interest (ROI) was outlined for bone marrow in the pelvic region by Accu Contour software in planning CT, and the ROI was exported together with the dose distribution file. According to a stratified randomization grouping method, the patients were divided into the training set and test set in an 8 vs. 2 ratio. The dosiomic features were extracted from the ROI, and the two independent samples t-test and the least absolute shrinkage and selection operator (LASSO) algorithm was employed to identify the best predictive characteristics. Subsequently, the dosiomic scores were calculated. Clinical predictors were identified through both univariant and multivariate logistic regression analyses. Predictive models were constructed by using clinical predictors alone and combining clinical predictors and dosiomic scores. The efficacy of predictive model was assessed by plotting the receiver operating characteristic (ROC) curve and evaluating its performance through the area under the ROC curve (AUC), the calibration curve, and decision curve analysis (DCA). Results:Fourteen dosiomic features that showed a strong correlation with the occurrence of BMS were screened and utilized to calculate the dosiomic scores. Based on both univariant and multivariate logistic regression analyses, chemotherapy, planning target volume (PTV) and V 5 Gy were identified as clinical predictors. According to the combined model, the AUC values for the training set and test set were 0.911 and 0.868, surpassing those of the clinical model (AUC=0.878 and 0.824). Furthermore, the analysis of both the calibration curve and DCA suggested that the combined model had higher calibration and net clinical benefit. Conclusion:The combined model has a high diagnostic value for predicting BMS in patients with pelvic tumors during radiotherapy.

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Cervical cancer is a serious threat to women's life and health. Studies have shown that the incidence of cervical cancer in China ranks second in the world. With increasing application of cervical cancer screening technology, cervical cancer mortality shows a downward trend, but the incidence of cervical cancer in young women shows an upward trend. The affected population tends to be young. Young women are the population at high risk for a human papillomavirus (HPV) infection because they have high levels of estrogen and active sexual behavior. Persistent high-risk HPV infection is the key factor that promotes development of precancerous lesions toward cervical cancer. This paper reviews the clinical characteristics of HPV infection in young women and the research progress in diagnosis and treatment strategy of precancerous lesions.

Bronchopulmonary dysplasia(BPD)is the most common chronic respiratory disease in premature in-fants,there is a lack of effective treatment now. In recent years,animal studies showed that treatment of mesenchymal stem cells (MSCs)can ameliorate hyperoxia-induced lung injury by promoting the restoration of alveolar epithelium and reducing the inflammation of lung through regeneration,paracrine and immunomodulatory,moreover,there has been a clinical trial shows that MSCs in the treatment of BPD is safe and feasible. Which may benefit the recovery of BPD and bring a hope for radical treatment of BPD. Now,focusing on the biological characteristics of MSCs,the mechanism and application of MSCs in the treatment of BPD in animal models and clinical trials as well as the existing problems in the latest research were reviewed.

Objective To analyze the clinical features and common etiology of lung nodules in children. Methods The etiology, diagnosis, radiological features from 98 hospitalized children of lung nodules were analyzed. Results Of them, 58 were male and 40 were female aged from 0.2 years old to 14.8 years old. Pulmonary infection were found in 41 cases (41.8%) including tuberculosis in 15 cases (15.3%), pulmonary fungal infection in 13 cases (13.3%), pneumonia in 11 cases (11.2%), lung trematode in 2 cases (2.0%). Pulmonary metastases were found in 28 cases (28.6%), multiple pulmonary arteriovenous fistula in 1 case (1.0%), and pulmonary contusion in 1 case (1.0%) and unknown etiology in 27 cases (27.6%). Conclusions The etiology of lung nodules is complicated, in which infectious diseases are the most commonly seen, followed by pulmonary metastases. Biopsy is the golden standard of diagnosis.

Objective: To observe the protective effect of ischemic post-conditioning on myocardial reperfusion injury with the potential mechanism in experimental rabbits. Methods: A total of 36 healthy New Zealand rabbits were divided into 6 groups:①Sham group,②Ischemic reperfusion control (CON) group,③Myocardial ischemic post-conditioning (MpostC) group,④Remote ischemic post-conditioning (RPostC) group,⑤MPostC+5-HD group,⑥RPostC+5-HD group.n=6 in each group. The ischemic reperfusion injury model was established by left ventricular descending artery occlusion for 45 min followed by reperfusion for 120 min. Bilateral external iliac artery was occluded for 5 min to induce the short skeletal muscle ischemia. The indexes of cardiac function and plasma CK , LDH activities were measured at baseline, end of ischemia and 1, 2 h after reperfusion respectively, the sizes of myocardial infarction (MI) were examined and compared among different groups. Results: ①Compared with CON group, the indexes of cardiac function were improved in MPostC and RPostC groups at 1, 2 h after reperfusion,P<0.05, and compared with MPostC group and RPostC group, the indexes of cardiac function were improved in MPostC+5-HD and RPostC+5-HD groups,P<0.05.②Compared with CON group, plasma CK, LDH activities were decreased in MPostC and RPostC groups at 2 h after reperfusion,P<0.05, and compared with MPostC group and RPostC group, the CK, LDH activities were increased in MPostC+5-HD and RPostC+5-HD groups,P<0.05.③The ischemic ranges and areas were similar between CON group and the other 5 groupsP>0.05. The MI ranges and areas in MPostC and RPostC groups were much less than that in CON group,P<0.05, and compared with MPostC group and RPostC group, the MI ranges and areas increased in MPostC+5-HD and RPostC+5-HD groups,P<0.05. The MI ranges and areas were similar between CON group and MPostC+5-HD, RPostC+5-HD groups,P>0.05. Conclusion: Classical ischemic post-conditioning and remote organ ischemic post-conditioning both have protective effect on myocardial reperfusion injury in experimental rabbit, which might be related to the activation of mitochondrial ATP-sensitive potassium channels.

Objective: To investigate the preventive effect of alprostadil (prostaglandin E1) combining hydration therapy on contrast induced nephropathy (CIN) after percutaneous coronary intervention (PCI) in elder patients. Methods: A total of 175 patients with coronary artery disease (CAD) elder than 75 years received PCI in our hospital from 2011-03 to 2014-03 were retrospectively studied, those including 122/175 (69.71 %) with male gender. The patients were at the mean age of (74.7 ± 3.9) years and randomly allocated into 2 groups: Control group, based on routine treatment, the patients received regular hydration of intravenous normal saline 1 ml/(kg?h) at 6 hours prior and 12 hours after PCI,n=84 and Alprostadil+hydration group, based on routine treatment and regular hydration, the patients received intravenous alprostadil 10μg in 100ml normal saline twice a day at 1 day prior PCI and the 3rd day after PCI,n=91. The serum levels of creatinine (SCr) were examined prior PCI and 3 days continuously after PCI, creatinine clearance rates (Ccr) were calculated and the CIN occurrence rates were compared between 2 groups. Results: At the 3rd day after PCI, the mean SCr level in Alprostadil+hydration group (92.08 ± 21.65) μmol/L was lower than Control group (99.43 ± 22.77) μmol/L,P<0.05, the mean Ccr level in Alprostadil+hydration group (63.78 ± 20.58) ml/min was higher than Control group (57.09 ± 22.31) ml/min,P<0.05. The occurrence rate of CIN after PCI was higher in Control group (13.1%, 11/84 patients) than Alprostadil+hydration group (3.3%, 3/91 patients),P<0.05. Conclusion: Alprostadil combining hydration therapy may obviously protect renal function and reduce the incidence rate of CIN in elder CAD patients after PCI treatment.

Objective To explore the clinical efficacy of Naikan cognitive therapy(NCT) for alcohol dependent patients.Methods 64 cases of alcohol-dependent patients were randomly assigned to the study group (32 cases) and the control group (32 cases).The study group was treated with NCT for successive 7 days on the basis of taking original drugs; and the control group was only given the original drug therapy.The obsessive compulsive drinking scale (OCDS),self-report symptom inventory(SCL-90),nurses observation scale for inpatient evaluation(NOSIE) were administered to all subjects at pre-and post-treatment.Results ①After the treatments,the scores of OCDS in study group (49.51 ± 1.63) were lower than that in control group(53.92 ± 1.82),and the statistical difference had the significance (P ＜ 0.01).②After the treatments,the total scores and some factor scores of SCL-90 in study group were lower than in control group (t =-2.413,P =0.019 ; t =-2.033,P =0.047 ; t =-2.065,P =0.044 ; t =-2.038,0.046),and the difference was statistically significant.③After the treatments,in the study group,the scores of the total estimated factor and total positive factor(187.10 ± 18.80;78.51 ±12.22) were higher than in control group (175.51 ± 11.71 ; 68.22 ± 11.87),total negative factor score (15.55 ±9.46) were lower than in control group (20.51 ± 9.33),and the difference was statistically significant.Conclusion NCT can effectively inhibit alcohol craving,and reduce the drinking wine relevant questions.It can help to improve psychological symptoms in patients with alcohol dependence,especially depression and anxious symptoms.