Objective:To explore the therapeutic methods and drug-symptom patterns of Traditional Chinese Medicine (TCM) for idiopathic pulmonary fibrosis (IPF) at different stages under the guidance of the " three-stage differentiated management" principle.Methods:Under the three-stage principle, 133 IPF prescriptions treated by prof. Yan Jun from 2017.2-2023.12 were analyzed. Disease and category information of each eligible case was entered into the " FangNet" platform. Association and cluster analyses were performed for core herbs, key herb pairs, and symptom-drug relationships, aiming to uncover the clinical medication characteristics and rules in the three stages.Results:(1) Early inflammatory stage: phlegm-stasis harassment, incipient but unformed masses, superficial disease location; priority was dispelling wind, dispersing pathogen, clearing lung and resolving phlegm-commonly used: ephedra, stemona, processed pinellia, peucedanum, armeniaca. (2) Mid injury stage: formed phlegm-stasis, struggle of pathogen and healthy Qi, impaired lung collaterals, obstructive phlegm-stasis, excess pathogen with intact healthy Qi; emphasis on expelling pathogen, resolving phlegm, activating blood and dredging collaterals-e.g., angelica, pheretima, bombyx, scorpio. (3) Late fibrotic stage: healthy Qi deficiency with excess pathogen, phlegm-stasis masses entrenched in collaterals; treatment focuses on tonifying lung and dissolving masses, combining dredging and tonifying to regulate Qi and blood-e.g., pinellia, rhodiola, ginseng, gecko.Conclusions:Phlegm-stasis as excess pathogen and dual deficiency of lung-kidney run through all three stages of IPF. The rise and fall of healthy Qi vs pathogen and the degree of mass formation determine stage-specific therapeutic strategies and drug-pattern adjustments.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:Observation of the therapeutic effect of Yugu Ju detergent combined with fusidic acid cream on the repair of wounds infected with Staphylococcus aureus,as well as its impact on serum inflammatory markers TNF-α,IL-6,IL-1β,oxidative stress markers MDA,ROS,SOD and Nrf2 levels.Methods:96 patients with skin defects and SA U infection caused by trauma admitted to the hospital from June 2021 to December 2023 were randomly divided into a control group and an observation group.Both groups were treated with debridement,while the control group was treated with external application of fusidic acid cream.The treatment group received external washing with Yugu Ju detergent in addition to the control group.One course of treatment lasted for 7 days,with three consecutive courses of treatment.Observe the wound healing rate,bacterial clearance rate,and changes in TNF-α,IL-6,IL-1β,SOD,MDA,ROS,and Nrf2 before and after treatment to evaluate clinical efficacy and safety.Results:The total clinical effective rate of the observation group after treatment was 93.75％(45/48),while that of the control group was 75％(36/48).The observation group was significantly better than the control group(P＜0.05);The wound healing rate and bacterial clearance rate of the observation group at each time point after treatment were higher than those of the control group(P＜0.05);After treatment,the Nrf2 and SOD values in the observation group were higher than those in the control group,while the TNF-α,IL-6,IL-1β,MDA,and ROS values were lower than those in the control group(P＜0.05).No adverse reactions occurred during the treatment of both groups.Conclusion:The combination of Yugu Ju detergent and Fusidic acid cream can inhibit SA U and promote the healing of infectious wounds,which may be related to the activation of Nrf2 expression to inhibit oxidative stress and inflammatory response.It is safe and effective,and worthy of promotion and application.

T-cell acute lymphoblastic leukemia (T-ALL) is a highly aggressive hematologic malignancy with a poor prognosis, despite advancements in treatment. Many patients struggle with relapse or refractory disease. Investigating the role of the super-enhancer (SE) regulated gene ubiquitin-specific protease 20 (USP20) in T-ALL could enhance targeted therapies and improve clinical outcomes. Analysis of histone H3 lysine 27 acetylation (H3K27ac) chromatin immunoprecipitation sequencing (ChIP-seq) data from six T-ALL cell lines and seven pediatric samples identified USP20 as an SE-regulated driver gene. Utilizing the Cancer Cell Line Encyclopedia (CCLE) and BloodSpot databases, it was found that USP20 is specifically highly expressed in T-ALL. Knocking down USP20 with short hairpin RNA (shRNA) increased apoptosis and inhibited proliferation in T-ALL cells. In vivo studies showed that USP20 knockdown reduced tumor growth and improved survival. The USP20 inhibitor GSK2643943A demonstrated similar anti-tumor effects. Mass spectrometry, RNA-Seq, and immunoprecipitation revealed that USP20 interacted with hypoxia-inducible factor 1 subunit alpha (HIF1A) and stabilized it by deubiquitination. Cleavage under targets and tagmentation (CUT&Tag) results indicated that USP20 co-localized with HIF1A, jointly modulating target genes in T-ALL. This study identifies USP20 as a therapeutic target in T-ALL and suggests GSK2643943A as a potential treatment strategy.

OBJECTIVE: To compare the short-term clinical efficacy and safety of closed reduction with Kirschner wire fixation versus open reduction with plate fixation for treating osteoporotic Colles' fractures in middle-aged and elderly patients. METHODS: Between January 2018 and January 2023, 119 patients with Colles fractures were retrospectively analyzed, including 39 males and 80 females, aged from 48 to 74 years old with an average of(60.58±6.71) years old. The time from injury to operation ranged 1 to 13 days with an average of (5.29±2.52) days. According to the surgical method, they were divided into Kirschner wire fixation group (Kirschner wire group) and plate internal fixation group (plate group). In Kirschner wire group, there were a total of 68 patients, comprising 21 males and 47 females. The average age was (61.15±6.24) years old, ranged from 49 to 74 years old. Among them, 41 cases involved the left side while 27 cases involved the right side. In the plate group, there were a total of 51 patients, including 18 males and 33 females. The average age was (59.78±5.71) years old ranged from 48 to 72 years old. Among them, there were 31 cases on the left side and 20 cases on the right side. The following parameters were recorded before and after the operation:operation time, intraoperative blood loss, hospitalization days, hospitalization expenses, postoperative complications, and radiographic parameters of distal radius (distal radius height, ulnar deviation angle, palmar tilt angle). The clinical efficacy was evaluated at 3 and 12 months after the operation using Gartland-Werley and disabilites of the arm shoulder and hand (DASH) scores. RESULTS: The patients in both groups were followed up for a duration from 12 to 19 months with an average of(13.32±2.02) months. The Kirschner wire group exhibited significantly shorter operation time compared to the plate group 27.91(13.00, 42.00) min vs 67.52(29.72, 105.32) min, Z=-8.74, P=0.00. Intraoperative blood loss was also significantly lower in the Kirschner wire group than in the plate group 3.24(1.08, 5.40) ml vs 21.91(17.38, 26.44) ml, Z=-9.31, P=0.00. Furthermore, patients in the Kirschner wire group had a shorter length of hospital stay compared to those in the plate group (8.38±2.63) days vs (11.40±2.78) days, t=-3.12, P=0.00. Additionally, hospitalization cost was significantly lower in the Kirschner wire group than in the plate group 10 111.29(6 738.98, 13 483.60) yuan vs 15 871.11(11 690.40, 20 051.82) yuan, Z=-5.62, P=0.00. The incidence of complications was 2 cases in the Kirschner wire group and 1 case in the plate group, with no statistically significant difference(P>0.05). At 3 months postoprative, the radial height of the Kirschner wire group was found to be significantly smaller than that of the plate group, with measurements of (11.45±1.69) mm and (12.11±1.78) mm respectively (t=-2.06, P=0.04). However, there were no statistically significant differences observed in ulnar deviation angle and palmar tilt angle between the two groups (P>0.05). The DASH score and Gartland-Werley score in the Kirschner group were significantly higher than those in the plate group at 3 months post-operation (19.10±9.89) vs (13.47±3.51), t=4.34, P=0.00;(11.15±3.61) vs (6.41±2.75), t=8.13, P=0.00). However, there was no significant difference between the two groups at 12 months post-operation (P>0.05). CONCLUSION Compared to plate internal fixation, closed reduction with Kirschner wire support fixation yields a slightly inferior recovery of radial height;however, there is no significant disparity in the functional score of the affected limb at 12 months post-operation. Nonetheless, this technique offers advantages such as shorter operation time, reduced intraoperative blood loss, decreased hospitalization duration, and lower cost.
Humans ; Female ; Male ; Middle Aged ; Aged ; Fracture Fixation, Internal/instrumentation* ; Bone Wires ; Bone Plates ; Retrospective Studies ; Colles' Fracture/surgery* ; Minimally Invasive Surgical Procedures/methods* ; Open Fracture Reduction/methods* ; Osteoporotic Fractures/surgery*

Objective To propose a lead attention network-based ST-T change recognition algorithm to detect ECG ST-T changes accurately.Methods Firstly,heartbeat signals were extracted through R-wave localization,and a 12-lead heartbeat matrix was generated by correlation-based screening and merging to realize data augmentation.Secondly,a lead attention module was constructed by combining depthwise convolution(DWConv)with the channel attention squeeze-and-excitation block(SE-block)structure to perceive the differences in ST-T status among electrocardiogram leads.Thirdly,the mapping output by two independent attention modules was fused and splicing with the original signal residual was carried out,so that attention information extraction and original information transfer were enhanced effectively.Finally,SE-ResNet was used as the backbone network to extract signal features to complete the classification and identification of ST-T changes.To validate the recognition performance of the proposed algorithm for ST-T changes in ECG,the 12-lead ECG data of 97 472 patients containing different ECG rhythms were collected for ablation and comparison experiments at the First Affiliated Hospital of Army Medical University.Results The proposed algorithm achieved an AUC of 0.965 with a sensitivity of 90.51%,specificity of 90.23%,positive predictive value of 89.24%and overall accuracy of 90.36%on an independent test set.Comparative analysis demonstrated superior performance to four benchmark architectures,including VGG16,ResNet18,MobileNetV3-Small and ShuffleNet,in terms of both classification accuracy and computational efficiency.Conclusion The algorithm designed can accurately detect ST-T changes and can be used for wearable ECG automatic analysis to assist in the early warning of cardiovascular diseases in both acute and chronic patients and highland residents.[Chinese Medical Equipment Journal,2025,46(7):1-11]

Objective:Observation of the therapeutic effect of Yugu Ju detergent combined with fusidic acid cream on the repair of wounds infected with Staphylococcus aureus,as well as its impact on serum inflammatory markers TNF-α,IL-6,IL-1β,oxidative stress markers MDA,ROS,SOD and Nrf2 levels.Methods:96 patients with skin defects and SA U infection caused by trauma admitted to the hospital from June 2021 to December 2023 were randomly divided into a control group and an observation group.Both groups were treated with debridement,while the control group was treated with external application of fusidic acid cream.The treatment group received external washing with Yugu Ju detergent in addition to the control group.One course of treatment lasted for 7 days,with three consecutive courses of treatment.Observe the wound healing rate,bacterial clearance rate,and changes in TNF-α,IL-6,IL-1β,SOD,MDA,ROS,and Nrf2 before and after treatment to evaluate clinical efficacy and safety.Results:The total clinical effective rate of the observation group after treatment was 93.75％(45/48),while that of the control group was 75％(36/48).The observation group was significantly better than the control group(P＜0.05);The wound healing rate and bacterial clearance rate of the observation group at each time point after treatment were higher than those of the control group(P＜0.05);After treatment,the Nrf2 and SOD values in the observation group were higher than those in the control group,while the TNF-α,IL-6,IL-1β,MDA,and ROS values were lower than those in the control group(P＜0.05).No adverse reactions occurred during the treatment of both groups.Conclusion:The combination of Yugu Ju detergent and Fusidic acid cream can inhibit SA U and promote the healing of infectious wounds,which may be related to the activation of Nrf2 expression to inhibit oxidative stress and inflammatory response.It is safe and effective,and worthy of promotion and application.

Objective To propose a lead attention network-based ST-T change recognition algorithm to detect ECG ST-T changes accurately.Methods Firstly,heartbeat signals were extracted through R-wave localization,and a 12-lead heartbeat matrix was generated by correlation-based screening and merging to realize data augmentation.Secondly,a lead attention module was constructed by combining depthwise convolution(DWConv)with the channel attention squeeze-and-excitation block(SE-block)structure to perceive the differences in ST-T status among electrocardiogram leads.Thirdly,the mapping output by two independent attention modules was fused and splicing with the original signal residual was carried out,so that attention information extraction and original information transfer were enhanced effectively.Finally,SE-ResNet was used as the backbone network to extract signal features to complete the classification and identification of ST-T changes.To validate the recognition performance of the proposed algorithm for ST-T changes in ECG,the 12-lead ECG data of 97 472 patients containing different ECG rhythms were collected for ablation and comparison experiments at the First Affiliated Hospital of Army Medical University.Results The proposed algorithm achieved an AUC of 0.965 with a sensitivity of 90.51%,specificity of 90.23%,positive predictive value of 89.24%and overall accuracy of 90.36%on an independent test set.Comparative analysis demonstrated superior performance to four benchmark architectures,including VGG16,ResNet18,MobileNetV3-Small and ShuffleNet,in terms of both classification accuracy and computational efficiency.Conclusion The algorithm designed can accurately detect ST-T changes and can be used for wearable ECG automatic analysis to assist in the early warning of cardiovascular diseases in both acute and chronic patients and highland residents.[Chinese Medical Equipment Journal,2025,46(7):1-11]

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.