Myocardial infarction （MI） and osteoporosis （OP）， as two prevalent metabolic diseases with high morbidity and mortality rates， are respectively characterized by cardiovascular system dysfunction and bone homeostasis imbalance， collectively posing significant global public health challenges. While clinically often considered as independent diseases， recent studies have revealed shared pathological mechanisms between the two. This study initiated its exploration from the traditional Chinese medicine concept of the "heart-bone" axis， systematically analyzing the correlation between MI and OP from perspectives including hemodynamics， neuroendocrinology， calcium homeostasis， inflammation and vascular injury， as well as hormone levels. By discussing the pathological mechanisms of "heart disease affecting the bones and bone disease affecting the heart"， the study also elucidated advancements in both Western and traditional Chinese medicine treatments. The goal is to provide novel insights and methodologies for the prevention and treatment of "heart-bone comorbidities"， thereby facilitating comprehensive management of cardiovascular and skeletal diseases.

Myocardial infarction （MI） and osteoporosis （OP）， as two prevalent metabolic diseases with high morbidity and mortality rates， are respectively characterized by cardiovascular system dysfunction and bone homeostasis imbalance， collectively posing significant global public health challenges. While clinically often considered as independent diseases， recent studies have revealed shared pathological mechanisms between the two. This study initiated its exploration from the traditional Chinese medicine concept of the "heart-bone" axis， systematically analyzing the correlation between MI and OP from perspectives including hemodynamics， neuroendocrinology， calcium homeostasis， inflammation and vascular injury， as well as hormone levels. By discussing the pathological mechanisms of "heart disease affecting the bones and bone disease affecting the heart"， the study also elucidated advancements in both Western and traditional Chinese medicine treatments. The goal is to provide novel insights and methodologies for the prevention and treatment of "heart-bone comorbidities"， thereby facilitating comprehensive management of cardiovascular and skeletal diseases.

Acute lung injury (ALI) is a significant complication of sepsis, characterized by high morbidity, mortality, and poor prognosis. Neutrophils, as critical intrinsic immune cells in the lung, play a fundamental role in the development and progression of ALI. During ALI, neutrophils generate neutrophil extracellular traps (NETs), and excessive NETs can intensify inflammatory injury. Research indicates that Taohe Chengqi decoction (THCQD) can ameliorate sepsis-induced lung inflammation and modulate immune function. This study aimed to investigate the mechanisms by which THCQD improves ALI and its relationship with NETs in sepsis patients, seeking to provide novel perspectives and interventions for clinical treatment. The findings demonstrate that THCQD enhanced survival rates and reduced lung injury in the cecum ligation and puncture (CLP)-induced ALI mouse model. Furthermore, THCQD diminished neutrophil and macrophage infiltration, inflammatory responses, and the production of pro-inflammatory cytokines, including interleukin-1β (IL-1β), IL-6, and tumor necrosis factor α (TNF-α). Notably, subsequent experiments confirmed that THCQD inhibits NET formation both in vivo and in vitro. Moreover, THCQD significantly decreased the expression of peptidyl arginine deiminase 4 (PAD4) protein, and molecular docking predicted that certain active compounds in THCQD could bind tightly to PAD4. PAD4 overexpression partially reversed THCQD's inhibitory effects on PAD4. These findings strongly indicate that THCQD mitigates CLP-induced ALI by inhibiting PAD4-mediated NETs.
Extracellular Traps/immunology* ; Acute Lung Injury/immunology* ; Animals ; Sepsis/immunology* ; Drugs, Chinese Herbal/pharmacology* ; Mice ; Neutrophils/immunology* ; Male ; Protein-Arginine Deiminase Type 4/genetics* ; Mice, Inbred C57BL ; Humans ; Disease Models, Animal ; Cytokines/metabolism*

Objective To investigate the relationship between serum survivin,adenosine triphosphate bind-ing cassette transporter Al(ABCA1)and poor coronary collateral circulation(CCC)in patients with single coronary artery occlusion in acute myocardial infarction(AMI).Methods A total of 155 patients with single coronary artery occlusion in AMI admitted to Handan Fist Hospital from May 2021 to May 2023 were selected as the study objects,and were divided into poor CCC group(n=80)and good CCC group(n=75)according to their CCC status.Serum survivin and ABCA1 levels were compared between the two groups,univariate and multivariate Logistic regression models were used to analyze the influencing factors of poor CCC,and the effi-cacy of serum survivin and ABCA1 in predicting poor CCC was analyzed by receiver operating characteristic curve.Results Compared with good CCC group,serum survivin and ABCA1 in poor CCC group were signifi-cantly decreased,and the difference was statistically significant(P＜0.05).Compared with good CCC group,Gensini score,creatinine kinase isoenzyme-MB(CK-MB),Killip heart function grade≥Ⅱ and history of hy-pertension in poor CCC group were significantly increased,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression model showed that high Gensini score,high CK-MB,Killip heart function grade≥Ⅱ and history of hypertension were risk factors for poor CCC(P＜0.05),while high sur-vivin and high ABCA1 were protective factors(P＜0.05).The area under the curve,sensitivity and specificity of the two indexes combined to predict poor CCC were 0.949,90.70％and 92.52％,which were significantly better than the single detection.Conclusion Serum survivin and ABCA1 are closely relate to poor CCC in pa-tients with single coronary artery occlusion in AMI,the lower the serum levels of survivin and ABCA1,the greater the risk of poor CCC,the combine detection of the two has a high predictive value for poor CCC in pa-tients with single coronary artery occlusion in AMI.

Objective The aim of this study was to investigate the prospective association between physical activity (PA),independently or in conjunction with other contributing factors,and osteoporosis (OP) outcomes. Methods The Physical Activity in Osteoporosis Outcomes (PAOPO) study was a community-based cohort investigation. A structured questionnaire was used to gather the participants' sociodemographic characteristics. Bone mineral density (BMD) measurements were performed to assess OP outcomes,and the relationship between BMD and OP was evaluated within this cohort. Results From 2013 to 2014,8,471 participants aged 18 years and older were recruited from Tangshan,China's Jidong community. Based on their PA level,participants were categorized as inactive,moderately active,or very active. Men showed higher physical exercise levels than women across the activity groups. BMD was significantly higher in the very active group than in the moderately active and inactive groups. Individuals aged>50 years are at a higher risk of developing OP and osteopenia. Conclusion The PAOPO study offers promising insights into the relationship between PA and OP outcomes,encouraging the implementation of PA in preventing and managing OP.

ObjectiveTo identify immunogenic cell death （ICD）-related genes in hepatocellular carcinoma （HCC）， and to establish a scoring model based on these genes for predicting the prognosis and tumor microenvironment characteristics of HCC. MethodsThe Cancer Genome Atlas database was used to obtain HCC datasets， and heatmaps were used to display the expression of 57 ICD-related genes in HCC. A cluster analysis was conducted based on the expression of ICD-related genes， and two ICD subtypes （low and high ICD expression groups） were analyzed in terms of gene ontology enrichment analysis， Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis， somatic mutation， and immune cell infiltration. The LASSO Cox regression risk model was constructed to evaluate its clinical application value， and a nomogram model was established to predict the 1-， 3-， and 5-year survival rates of patients. In addition， qRT-PCR was used to validate the expression levels of key genes in the model. The independent-samples t test was used for comparison between two groups， and the univariate and multivariate Cox regression analyses were used to determine prognostic factors among clinicopathological features. The Kaplan-Meier survival curve was used for prognostic analysis， and the Spearman rank correlation test was used for correlation analysis. ResultsThe low ICD expression group had a poorer prognosis， while the high ICD expression group had relatively favorable clinical outcomes （P=0.004）. Further analysis showed that the high ICD expression group was associated with an immune-active microenvironment， and the genes were mainly enriched in immune-related pathways such as immunoglobulin receptor binding， hematopoietic cell lineage， and B cell receptor. The results of somatic mutation analysis showed that the high ICD expression group had higher expression levels of CD274， CTLA4， HAVCR2， TIGIT， PDCD1， and PDCD1LG2 （all P<0.05）. A risk prediction model was established using 8 ICD-related genes， i.e.， HSP90AA1， ATG5， BAX， PPIA， HSPA4， TLR2， TREM1， and LY96， and this model showed a good predictive value across different clinical characteristics. The univariate and multivariate Cox regression analyses showed that age and risk score were independent prognostic factors for overall survival in the training set （both P<0.05）. The results of qRT-PCR showed that the relative expression levels of HSPA4 and REM1 in HCC tumor samples were significantly higher than those in adjacent tissue samples （both P<0.001）. For the patients with an increase in ICD risk score， the ICD risk score was negatively correlated with γδT cells （r=-0.29， P<0.05）， plasma cells （r=-0.3， P<0.05）， and CD8⁺T lymphocytes （r=-0.37， P<0.05） and was positively correlated with memory B cells （r=0.38， P<0.05）， resting dendritic cells （r=0.47， P<0.05）， and M0 macrophages （r=0.49， P<0.05）. ConclusionThis study identifies the ICD-related genes that are associated with the prognosis of HCC， which provides insights into the immune characteristics of different ICD expression profiles. The risk model and the nomogram model established in this study have a significant value for predicting the prognosis of HCC patients and guiding immunotherapy for HCC patients.

【Objective】 To understand the obesity status of Kazakh children and adolescents in the agricultural and pastoral areas of Xinjiang and its association with lifestyle, so as to provide reference and help for maintaining good body shape and health intervention for Kazakh children and adolescents in agricultural and pastoral areas. 【Methods】 From April to June 2022, 6 242 Kazakh children and adolescents aged 10 - 20 years were tested for obesity and surveyed by lifestyle questionnaires using stratified whole-group sampling in the farming and herding areas of Yili Kazakh Autonomous Prefecture and Altay Region, Xinjiang. χ² test and Logistic regression analysis were used to analyze data. 【Results】 The obesity detection rate of Kazakh children and adolescents in Xinjiang farming and herding areas was 18.71%, with higher rates in boys (22.24%) compared to girls (15.12%), and the difference was statistically significant (χ² =52.04, P<0.01). Significant differences were observed in the obesity rates based on grade level, fruit consumption frequency, screen time of television, feeling hopeful for the future, fatigue, loneliness, and sadness (χ² =24.29, 4.61, 694.51, 7.15, 10.33, 6.51, 8.07, P<0.01). Logistic regression analysis showed that female students (OR=0.63, 95%CI: 0.56 - 0.69) and students who felt hopeful about the future (OR=0.96, 95%CI: 0.94 - 0.99) were protective factors against obesity (P<0.05); while high school and lower grades (senior high school OR=1.38, 95%CI: 1.24 - 1.57; junior high school OR=1.82, 95%CI: 1.58 - 2.06; primary school OR=2.67, 95%CI: 2.33 - 2.99), fruit consumption ≥1time/d (OR=1.07, 95%CI: 1.03 - 1.16), watching TV ≥2h/d (OR=1.07, 95%CI: 1.02 - 1.17), frequent feeling of fatigue (OR=1.07, 95%CI: 1.03 - 1.12), loneliness (OR=1.08, 95%CI: 1.02~1.19) and sadness (OR= 1.09, 95%CI: 1.04 - 1.14) of students were risk factors for the development of obesity (P<0.05). 【Conclusions】 The obesity rate of Kazakh children and adolescents in the agricultural and pastoral areas of Xinjiang is high and closely associated with lifestyle. Therefore, it is crucial to improve unhealthy lifestyles in order to reduce obesity and promote the physical and mental well-being of this population.

Objective:To delineate the clinical characteristics and outcomes associated with severe cardiac toxicity during the preconditioning phase of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with aplastic anemia (AA).Methods:This retrospective case series study included 31 patients with severe AA who underwent allo-HSCT and were diagnosed with severe cardiac toxicity at the Hematology Department of Peking University People′s Hospital from August 2012 to June 2022. The clinical manifestations of severe cardiac toxicity observed during the preconditioning process were assessed. Patient survival was assessed using the Kaplan-Meier method.Results:In this cohort of 31 patients, the median follow-up period was 9 days (range: 4-365 days). Severe cardiac toxicity manifested within 6 days after the initial cyclophosphamide (Cy) administration. Twenty patients died within 30 days of initiating Cy preconditioning, of which 16 patients died due to severe cardiac toxicity within 25 days. Patients whose cardiac function improved within 30 days post-preconditioning showed a median survival duration of 222 days ( n=11). Troponin I (TNI) levels in patients who died within 30 days of initiating Cy preconditioning began increasing on day 5 post-Cy, peaking sharply by day 9 after a notable rise on day 8. B-type natriuretic peptide (BNP) levels in patients who died within 30 days of initiating Cy preconditioning started to rise from day 1, stabilized between days 2 and 5, and then doubled daily from days 6 to 8, remaining elevated thereafter. Notably, the initial increases in BNP and TNI correlated with electrocardiogram (ECG) signs of low voltage and T-wave inversion in 83.87% of cases ( n=26). Most patients ( n=28, 90.32%) were administered corticosteroid therapy. In those with restored cardiac function, the ejection fraction returned to >50% within 30 days of initiating Cy preconditioning. Conclusions:Patients with severe cardiac toxicity during the preconditioning phase of allo-HSCT typically exhibit early, sustained, and marked elevations in myocardial damage markers, including BNP and TNI, accompanied by ECG abnormalities following Cy administration, with BNP often increasing first. These indicators are associated with rapid disease progression and high mortality. Prompt initiation of treatment upon clinical diagnosis is critical for improving survival outcomes.

Objective:To analyze the prevalence and risk factors of musculoskeletal diseases among interventional surgeons in top three hospitals, and to provide suggestions for prevention of musculoskeletal diseases.Methods:In June 2022, a self-designed questionnaire was used to collect general information of doctors engaged in interventional surgery (121) and non-interventional surgery (124) in some top three hospitals in Tianjin. The standard version of the Nordic Musculoskeletal Questionnaire was used to investigate information related to musculoskeletal diseases. The prevalence and risk factors of musculoskeletal diseases among interventional and non-interventional surgeons were analyzed.Results:The prevalence of musculoskeletal diseases among interventional surgeons and non-interventional surgeons was 59.50% (72/121) and 62.90% (78/124) . Compared with non-interventional surgeons, interventional surgeons had a higher prevalence of musculoskeletal diseases in the shoulders and upper back, and a lower prevalence of musculoskeletal diseases in the waist. The differences were statistically significant ( P<0.05) . Multivariate logistic regression analysis showed that age, weekly time of physical exercise, time of intervention operation, and wearing protective clothing were independent risk factors for musculoskeletal diseases ( P<0.05) . Conclusion:The prevalence rate of musculoskeletal diseases among doctors engaged in interventional surgery is relatively high in some top three hospitals in Tianjin, and proper enhancement of physical exercise and shortening of interventional time are conducive to reducing musculoskeletal diseases.

Objective To analyze the results of national personal dose monitoring intercomparison and assessment of Hubei Provincial Hospital for Occupational Disease in 2016—2021, to investigate the influencing factors for monitoring results, and to improve the ability of personal dose monitoring. Methods The assessment was completed according to the requirements of The National Comparison Scheme for Individual Dose Monitoring Ability and Testing Criteria of Personnel Dosimetry Performance for External Exposure (GBZ 207—2016). Results The assessment results were qualified in 2016—2017 and 2020 and excellent in 2018—2019 and 2021. Conclusion The ability of personal dose monitoring in our laboratory has been continuously improved. The monitoring results are accurate and the data processing is standardized, which meet the requirements of relevant standards for personal external exposure dose monitoring.