Objective To observe the effects of Yitangkang on brown fat thermogenesis and mitochondrial biogenesis of PGC1α-NRF1/2-TFAM pathway in db/db mice;To explore its mechanism of regulating glucose and lipid metabolism.Methods Totally 27 six-week-old db/db mice were randomly divided into model group,Yitangkang group(30 g/kg)and liraglutide group(200 μg/kg),another 9 db/m mice of the same age were set as normal group.All groups received intervention with drugs or saline for 6 weeks.The body mass and FBG were measured weekly.After intervention,oral glucose tolerance test(OGTT)was carried out,the contents of serum TC,TG,LDL-C and HDL-C were detected by biochemical analyzer,HE staining was used to observe the morphology of brown adipose tissue(BAT)in scapular region,RT-qPCR and Western blot were used to detect the expressions of UCP1,PRDM16,PGC1α related to BAT thermogenesis and NRF1,Nrf2,TFAM related to mitochondrial biogenesis.Results Compared with the normal group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C content of model group significantly increased(P<0.01),the content of HDL-C significantly decreased(P<0.01);the diameter of BAT cells in scapular region was larger,white vacuoles appeared,lipid droplets increased,and the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT decreased significantly(P<0.01).Compared with the model group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C contents of Yitangkang group and liraglutide group significantly decreased(P<0.01),the content of HDL-C increased(P<0.01);BAT cells were smaller in diameter,more closely arranged,more regular in shape,and more abundant in capillary,the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT increased significantly(P<0.01).Conclusion Yitangkang can regulate mitochondrial biogenesis through PGC1α-NRF1/2-TFAM pathway to activate brown fat in db/db mice and improve glucose and lipid metabolism in db/db mice.

The management of chronic diseases at the county-level faces the problems of low degree of standardized manage-ment,weak management capacity of chronic diseases at the grassroots level,and shedding management of chronic disease patients.The"county-level chronic disease management center"proposed in the"Thousand Counties Project"can promote the county-town-ship-village medical institutions to jointly provide integrated and continuous chronic disease management services for county resi-dents.The study conducted in-depth interviews and analyses on the construction of the centers in 10 county(district)hospitals.Con-clusion:Firstly,the construction of the centers is in its infancy,and the support of government investment,performance incen-tives,and informatization construction is insufficient;secondly,the service content of the current centers is not clear enough,and the collaborative management model of chronic diseases in counties and villages is not stable.Enlightenment:The county-level med-ical community has built an effective path for the centers and the construction of chronic disease management centers needs to be fur-ther strengthened in terms of finance,medical insurance,interest mechanism,informatization construction and awareness of chronic diseases.

Objective In order to summarize the implementation status and effectiveness of entrusted management projects in municipal hospitals of Beijing,the project aims to better promote the extension of high-quality urban re-sources to county-level hospitals.Methods Through survey questionnaires and focus group interviews,the survey questionnaire includes the size of the hospital,the number of surgeries,Case Mix Index,annual average number of new technologies and projects,personnel training entrusted,and interviews with 50 heads of municipal hospi-tals,district hospitals,and district level government relevant departments.Results Measures for medical homogeni-zation,talent cultivation,management,and cultural homogenization were sorted out.In terms of hospital scale,level evaluation,medical service capabilities,and the proportion of master's degree and above personnel in the managed hospitals,an upward trend was observed.Conclusion The medical cooperation project entrusted by Beijing Municipal Hospitals promotes the integration of regional medical services,and provides reference for the expansion and sinking of high-quality medical resources from the management mechanism,operation mechanism and key measures.

This study aims to investigate whether the dietary supplement coenzyme Q10(CoQ10)alleviates bisphenol A(BPA)-induced mouse Leydig cell line(TM3)damage through autophagy pathway.Cell activity was measured by CCK-8 assay when treated with different concentrations of BPA for 24 h.TM3 cells were then divided into 5 groups:CON group,BPA group,Torin2 group,CQ group and BPA+CoQ10 group,with three repeats in each group.The morphology of TM3 cells were observed under inverted light microscope.Western blot was used to determine the protein ex-pression of p62 and LC3-Ⅰ/Ⅱ.The autophagy level of TM3 cells was detected by MDC cell auto-phagy staining,the mRNA expression levels of Atg7,Beclin 1,p62 and Atg5 genes were deter-mined by RT-qPCR,and the apoptosis rate of TM3 cells was detected by flow cytometry.The results showed that compared with 0 μmol/L BPA treatment group,the viability of TM3 cells de-creased significantly after 24 h treatment with 60 μmol/L BPA(P＜0.01).Compared with CON group,the number of TM3 cells markedly reduced in the BPA-treated group,the expression of au-tophagy-related proteins(p62,LC3-Ⅱ)significantly increased(P＜0.01),comparable to the CQ group.The MDC fluorescence intensity dramatically enhanced(P＜0.01),the mRNA expression levels of autophagy-related genes(Atg7,Beclin1,p62,Atg5)significantly elevated(P＜0.01),and the apoptosis rate significantly increased(P＜0.01).Compared with BPA group,the expression levels of autophagy-related genes Atg7 and Beclin1 mRNA(P＜0.05),p 62 and Atg5 mRNA(P＜0.01)in TM3 cells treated with BPA+CoQ10 significantly decreased.Moreover,the expres-sion levels of autophagy-related protein p62(P＜0.01)and LC3-Ⅱ(P＜0.05),MDC fluorescence intensity(P＜0.05)and apoptosis rate(P＜0.01)also markedly reduced.In conclusion,CoQ10 could subsequently reduce the apoptosis of TM3 cells by improving the abnormal autophagy flux induced by BPA.

BACKGROUND:Competitive athletes exercising in high-temperature,high-humidity,or low-oxygen environments experience intensified skeletal muscle deoxygenation and reduced fat oxidation,which can impair athletic performance.OBJECTIVE:To evaluate the impact of high-temperature,high-humidity,and low-oxygen environments on the fat oxidation rates of athletes during incremental load exercise,and to analyze the differences in deoxyhemoglobin kinetic parameters in skeletal muscle,thereby clarifying the relationship between fat oxidation capacity and skeletal muscle oxygenation under varying environmental conditions.METHODS:Twelve male modern pentathlon athletes were recruited for tests under three environmental conditions:normal(23 ℃,RH45％,FiO2=21.0％),high temperature and high humidity(35 ℃,RH70％,FiO2=21.0％),and low oxygen(23 ℃,RH45％,FiO2=15.6％).Resting metabolism and incremental load exercise were tested.Gas exchange data during and post-exercise were collected to calculate fat oxidation rate,carbohydrate oxidation rate,energy expenditure,and excess post-exercise oxygen consumption.Simultaneous measurements of SmO2 and total hemoglobin in the vastus lateralis muscle were used to calculate deoxyhemoglobin(HHb)levels.Deoxyhemoglobin change parameters-linear fittng slope(ΔEHHb),slope before the inflection point(ΔEHHB-1),and slope after the inflection point(ΔEHHB-2)-were determined using a bilinear function model.Fat oxidation curves were fitted using a SIN function model to identify the intensity(FATmax)that induced maximal fat oxidation(MFO),along with the curve's expansion,symmetry,and translation.RESULTS AND CONCLUSION:(1)Energy metabolism:No significant differences in maximal fat oxidation were observed across environments in each group(P>0.05).Compared with the normal environment group,both high temperature and high humidity group and low oxygen group showed significantly decreased time to maximal fat oxidation and FATmax(P<0.05).The percentage of maximal fat oxidation corresponding to peak oxygen uptake was lower in the low oxygen environment group(P<0.05).Fat oxidation was consistently low in the low oxygen environment group during exercise,while in the high temperature and high humidity environment group,it decreased only at higher exercise loads.Additionally,the expansion parameter was significantly reduced in both high temperature and high humidity and low oxygen environment groups(P<0.05).(2)Deoxyhemoglobin dynamics:The ΔEHHb was significantly higher in the high temperature and high humidity environment group,and ΔEHHB-1 was significantly increased in both high temperature and high humidity and low oxygen environment groups(P<0.05).(3)Correlation analysis:ΔEHHb was significantly negatively correlated with symmetry;ΔEHHB-1 was negatively correlated with FATmax and maximal fat oxidation;ΔEHHB-2 was positively correlated with maximal fat oxidation,and V?O2@BP was positively correlated with symmetry,expansion,and FATmax.(4)These findings indicate that incremental load exercise in high temperature,high humidity,and low oxygen environments accelerates skeletal muscle deoxygenation,thereby inhibiting fat oxidation capacity.Compared with high temperature and high humidity,low oxygen environments may more rapidly disrupt the balance between oxygen delivery and utilization in athletes'skeletal muscle,leading to a greater reliance on anaerobic glycolysis and a consequent reduction in fat oxidation capacity during exercise.

Objuective To analyze the evaluation indicators of TCM syndrome efficacy in patients with angina pectoris at a clinical research center,and to preliminarily form a pool of items to evaluate the efficacy of TCM syndromes in angina pectoris,with the aim of providing a reference for evaluating the efficacy of TCM syndromes in angina pectoris.Metods By searching the literature on the clinical efficacy of angina pectoris published from January 1,2008,to December 31,2023,in the China National Knowledge Infrastructure(CNKI),VIP database(VIP),and Wanfang database(WF),the eligible literature was sorted and summarized,and items such as syndrome type,symptoms,and physical signs were recorded one by one in Excel to establish a database.SPSS Modeler 18.0 was used to perform Bayesian network model and association rule analysis on the evaluation items.The items that met both the Bayesian network model and association rule conditions were combined to preliminarily form a pool of items to evaluate the efficacy of TCM in angina pectoris.Results A total of 94 qualified articles were included,containing 21 types of differential diagnoses,with a total frequency of 100.Except for qi deficiency and blood stasis syndrome(28 times,28%),phlegm and blood stasis syndrome(14 times,14%),blood flow stasis obstruction syndrome(14 times,14%),and qi stagnation and blood stasis syndrome(10 times,10%),the frequency of other syndromes was relatively low,so only the first four syndromes were data mined.There were a total of 38 types of symptoms and physical signs for clinical efficacy evaluation,with a total frequency of 599 times.A preliminary pool of items for evaluating the efficacy of TCM in four types of angina pectoris was formed:① Qi deficiency and blood stasis syndrome main items included chest pain(contribution rate 0.96);secondary items included chest tightness(contribution rate 0.93),palpitations(contribution rate 0.77),dark purple(light purple)tongue or ecchymosis(contribution rate 0.77),and shortness of breath(contribution rate 0.83).② Phlegm and blood stasis syndrome main items included chest pain(contribution rate:0.94);secondary items included chest tightness(contribution rate:0.94)and palpitations(contribution rate:0.69).③ Blood flow stasis obstruction syndrome,main items include chest pain(contribution rate 0.94);secondary items include chest tightness(contribution rate 0.81),palpitations(contribution rate 0.69),purple dark(light purple)tongue or ecchymosis(contribution rate 0.94),rough pulse(contribution rate 0.81),fixed pain location,refusal to press,and aggravation at night(contribution rate 0.81).④ Qi stagnation and blood stasis syndrome,main items include chest pain(contribution rate 0.92);secondary items include chest tightness(contribution rate 0.92),palpitations(contribution rate 0.83),purple dark(light purple)tongue or ecchymosis(contribution rate 0.75),rough pulse(contribution rate 0.67),costal pain(contribution rate 0.75).Conclusion The pool of evaluation indicators for the efficacy of TCM syndromes in patients with angina pectoris can provide a reference for conducting scientific and standardized evaluations of the efficacy of TCM syndromes,provide a basis for selecting core indicators,and lay the foundation for further building a core indicator set(COS).

Objuective To analyze the evaluation indicators of TCM syndrome efficacy in patients with angina pectoris at a clinical research center,and to preliminarily form a pool of items to evaluate the efficacy of TCM syndromes in angina pectoris,with the aim of providing a reference for evaluating the efficacy of TCM syndromes in angina pectoris.Metods By searching the literature on the clinical efficacy of angina pectoris published from January 1,2008,to December 31,2023,in the China National Knowledge Infrastructure(CNKI),VIP database(VIP),and Wanfang database(WF),the eligible literature was sorted and summarized,and items such as syndrome type,symptoms,and physical signs were recorded one by one in Excel to establish a database.SPSS Modeler 18.0 was used to perform Bayesian network model and association rule analysis on the evaluation items.The items that met both the Bayesian network model and association rule conditions were combined to preliminarily form a pool of items to evaluate the efficacy of TCM in angina pectoris.Results A total of 94 qualified articles were included,containing 21 types of differential diagnoses,with a total frequency of 100.Except for qi deficiency and blood stasis syndrome(28 times,28%),phlegm and blood stasis syndrome(14 times,14%),blood flow stasis obstruction syndrome(14 times,14%),and qi stagnation and blood stasis syndrome(10 times,10%),the frequency of other syndromes was relatively low,so only the first four syndromes were data mined.There were a total of 38 types of symptoms and physical signs for clinical efficacy evaluation,with a total frequency of 599 times.A preliminary pool of items for evaluating the efficacy of TCM in four types of angina pectoris was formed:① Qi deficiency and blood stasis syndrome main items included chest pain(contribution rate 0.96);secondary items included chest tightness(contribution rate 0.93),palpitations(contribution rate 0.77),dark purple(light purple)tongue or ecchymosis(contribution rate 0.77),and shortness of breath(contribution rate 0.83).② Phlegm and blood stasis syndrome main items included chest pain(contribution rate:0.94);secondary items included chest tightness(contribution rate:0.94)and palpitations(contribution rate:0.69).③ Blood flow stasis obstruction syndrome,main items include chest pain(contribution rate 0.94);secondary items include chest tightness(contribution rate 0.81),palpitations(contribution rate 0.69),purple dark(light purple)tongue or ecchymosis(contribution rate 0.94),rough pulse(contribution rate 0.81),fixed pain location,refusal to press,and aggravation at night(contribution rate 0.81).④ Qi stagnation and blood stasis syndrome,main items include chest pain(contribution rate 0.92);secondary items include chest tightness(contribution rate 0.92),palpitations(contribution rate 0.83),purple dark(light purple)tongue or ecchymosis(contribution rate 0.75),rough pulse(contribution rate 0.67),costal pain(contribution rate 0.75).Conclusion The pool of evaluation indicators for the efficacy of TCM syndromes in patients with angina pectoris can provide a reference for conducting scientific and standardized evaluations of the efficacy of TCM syndromes,provide a basis for selecting core indicators,and lay the foundation for further building a core indicator set(COS).

The management of chronic diseases at the county-level faces the problems of low degree of standardized manage-ment,weak management capacity of chronic diseases at the grassroots level,and shedding management of chronic disease patients.The"county-level chronic disease management center"proposed in the"Thousand Counties Project"can promote the county-town-ship-village medical institutions to jointly provide integrated and continuous chronic disease management services for county resi-dents.The study conducted in-depth interviews and analyses on the construction of the centers in 10 county(district)hospitals.Con-clusion:Firstly,the construction of the centers is in its infancy,and the support of government investment,performance incen-tives,and informatization construction is insufficient;secondly,the service content of the current centers is not clear enough,and the collaborative management model of chronic diseases in counties and villages is not stable.Enlightenment:The county-level med-ical community has built an effective path for the centers and the construction of chronic disease management centers needs to be fur-ther strengthened in terms of finance,medical insurance,interest mechanism,informatization construction and awareness of chronic diseases.

Objective To observe the effects of Yitangkang on brown fat thermogenesis and mitochondrial biogenesis of PGC1α-NRF1/2-TFAM pathway in db/db mice;To explore its mechanism of regulating glucose and lipid metabolism.Methods Totally 27 six-week-old db/db mice were randomly divided into model group,Yitangkang group(30 g/kg)and liraglutide group(200 μg/kg),another 9 db/m mice of the same age were set as normal group.All groups received intervention with drugs or saline for 6 weeks.The body mass and FBG were measured weekly.After intervention,oral glucose tolerance test(OGTT)was carried out,the contents of serum TC,TG,LDL-C and HDL-C were detected by biochemical analyzer,HE staining was used to observe the morphology of brown adipose tissue(BAT)in scapular region,RT-qPCR and Western blot were used to detect the expressions of UCP1,PRDM16,PGC1α related to BAT thermogenesis and NRF1,Nrf2,TFAM related to mitochondrial biogenesis.Results Compared with the normal group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C content of model group significantly increased(P<0.01),the content of HDL-C significantly decreased(P<0.01);the diameter of BAT cells in scapular region was larger,white vacuoles appeared,lipid droplets increased,and the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT decreased significantly(P<0.01).Compared with the model group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C contents of Yitangkang group and liraglutide group significantly decreased(P<0.01),the content of HDL-C increased(P<0.01);BAT cells were smaller in diameter,more closely arranged,more regular in shape,and more abundant in capillary,the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT increased significantly(P<0.01).Conclusion Yitangkang can regulate mitochondrial biogenesis through PGC1α-NRF1/2-TFAM pathway to activate brown fat in db/db mice and improve glucose and lipid metabolism in db/db mice.

This study aims to investigate whether the dietary supplement coenzyme Q10(CoQ10)alleviates bisphenol A(BPA)-induced mouse Leydig cell line(TM3)damage through autophagy pathway.Cell activity was measured by CCK-8 assay when treated with different concentrations of BPA for 24 h.TM3 cells were then divided into 5 groups:CON group,BPA group,Torin2 group,CQ group and BPA+CoQ10 group,with three repeats in each group.The morphology of TM3 cells were observed under inverted light microscope.Western blot was used to determine the protein ex-pression of p62 and LC3-Ⅰ/Ⅱ.The autophagy level of TM3 cells was detected by MDC cell auto-phagy staining,the mRNA expression levels of Atg7,Beclin 1,p62 and Atg5 genes were deter-mined by RT-qPCR,and the apoptosis rate of TM3 cells was detected by flow cytometry.The results showed that compared with 0 μmol/L BPA treatment group,the viability of TM3 cells de-creased significantly after 24 h treatment with 60 μmol/L BPA(P＜0.01).Compared with CON group,the number of TM3 cells markedly reduced in the BPA-treated group,the expression of au-tophagy-related proteins(p62,LC3-Ⅱ)significantly increased(P＜0.01),comparable to the CQ group.The MDC fluorescence intensity dramatically enhanced(P＜0.01),the mRNA expression levels of autophagy-related genes(Atg7,Beclin1,p62,Atg5)significantly elevated(P＜0.01),and the apoptosis rate significantly increased(P＜0.01).Compared with BPA group,the expression levels of autophagy-related genes Atg7 and Beclin1 mRNA(P＜0.05),p 62 and Atg5 mRNA(P＜0.01)in TM3 cells treated with BPA+CoQ10 significantly decreased.Moreover,the expres-sion levels of autophagy-related protein p62(P＜0.01)and LC3-Ⅱ(P＜0.05),MDC fluorescence intensity(P＜0.05)and apoptosis rate(P＜0.01)also markedly reduced.In conclusion,CoQ10 could subsequently reduce the apoptosis of TM3 cells by improving the abnormal autophagy flux induced by BPA.