ObjectiveTo examine the influences of Shenfu injection on the endogenous metabolic byproducts in the myocardium of the rat model exhibiting chronic heart failure， thus deciphering the therapeutic mechanism of the Qi-reinforcing and Yang-warming method. MethodsSD rats were randomly allocated into a control group and a modeling group. Chronic heart failure with heart-Yang deficiency syndrome in rats was modeled by multi-point subcutaneous injection of isoproterenol， and the rats were fed for 14 days after modeling. The successfully modeled rats were randomized into model， Shenfu injection （6.0 mL·kg^-1）， and trimetazidine （10 mg·kg^-1） groups and treated with corresponding agents for 15 days. The control group and the model group were injected with equal doses of normal saline， and the samples were collected after the intervention was completed. Cardiac color ultrasound was performed. Hematoxylin-eosin （HE） staining was used to observe histopathological morphology， and the serum level of N-terminal pro-brain natriuretic peptide （NT-proBNP） was assessed by enzyme-linked immunosorbent assay （ELISA）. The mitochondrial morphological and structural changes of cardiomyocytes were observed by transmission electron microscopy， and the metabolic profiling was carried out by ultra high performance liquid chromatography-quantitative exactive-mass spectrometry （UHPLC-QE-MS）. Differential metabolites were screened and identified by orthogonal partial least squares-discriminant analysis （OPLS-DA） and other methods， and then the MetaboAnalyst database was used for further screening. The relevant biological pathways were obtained through pathway enrichment analysis. The receiver operating characteristic （ROC） curve was established to evaluate the diagnostic value of each potential biomarker for myocardial injury and the evaluation value for drug efficacy. ResultsThe results of color ultrasound showed that Shenfu Injection improved the cardiac function indexes of model rats （P<0.05）. The results of HE staining showed that Shenfu injection effectively alleviated the pathological phenomena such as myocardial tissue structure disorder and inflammatory cell infiltration in model rats. The results of ELISA showed that Shenfu injection effectively regulated the serum NT-proBNP level in the model rats. Transmission electron microscopy （TEM） showed that Shenfu injection effectively restored the mitochondrial morphological structure. The results of metabolomics showed that the metabolic phenotypes of myocardial samples presented markedly differences between groups. Nine differential metabolites could be significantly reversed in the Shenfu injection group， involving three metabolic pathways： pyruvate metabolism， histidine metabolism， and citric acid cycle （TCA cycle）. The results of ROC analysis showed that the area under the curve （AUC） values of all metabolites were between 0.75 and 1.0， indicating that the differential metabolites had high diagnostic accuracy for myocardial injury， and the changes in their expression levels could be used as potential markers for efficacy evaluation. ConclusionShenfu injection significantly alleviated the damage of cardiac function， myocardium， and mitochondrial structure in the rat model of chronic heart failure with heart-Yang deficiency syndrome by ameliorating energy metabolism remodeling. Reinforcing Qi and warming Yang is a key method for treating chronic heart failure with heart-Yang deficiency syndrome.

Objective To explore the relationship between circadian rhythm genes and the occurrence, development, prognosis, and tumor microenvironment (TME) of lung adenocarcinoma (LUAD). Methods The Cancer Genome Atlas data were used to evaluate the expression, copy number variation, and somatic mutation frequency of circadian gene sets in LUAD. Gene ontology, Kyoto encyclopedia of genes and genomes, and gene set enrichment analysis were used to explore the potential mechanisms by which circadian rhythm genes affected LUAD progression. Cox regression, least absolute shrinkage and selection operator regression, support vector machine recursive feature elimination, and random forest screened circadian genes and established prognostic models, and on this basis constructed nomogram to predict patients’ 1-, 3-, and 5-year survival rates. Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and time-dependent ROC curves were drawn to evaluate the predictive ability of the model, and the external dataset of GEO further verified the prognostic value of the prediction model. In addition, we evaluated the association of the prognostic model with immune cells and immune checkpoint genes. Single cell RNA sequencing (scRNA-seq) analysis was used to explore the molecular characteristics between prognostically relevant circadian genes and different immune cell populations in TME. Results Differentially expressed circadian rhythm genes were mainly enriched in biological processes related to cGMP-PKG signaling pathway, lipid and atherosclerosis, and JAK-STAT signaling pathway. Seven circadian rhythm genes: LGR4, CDK1, KLF10, ARNTL2, RORA, NPAS2, PTGDS were screened out, and a RiskScore model was established. According to the median RiskScore, samples were divided into a high-risk group and a low-risk group. Compared with patients in the low-risk group, patients in the high-risk group showed a poorer prognosis (P<0.001). Immunological characterization analysis showed that there were differences in the infiltration of multiple immune cells between the low-risk group and high-risk group. Most immune checkpoint genes had higher expression levels in the high-risk group than those in the low-risk group, and RiskScore was positively correlated with the expression of CD276, TNFSF4, PDCD1LG2, CD274, and TNFRSF9, and negatively correlated with the expression of CD40LG and TNFSF15. The scRNA-seq analysis showed that RORA and KLF10 were mainly expressed in natural killer cells. Conclusion The prognostic model based on seven feature circadian rhythm genes has certain predictive value for predicting survival of LUAD patients. Dysregulated expression of circadian genes may regulate the occurrence, progression as well as prognosis of LUAD through affecting TME, which provides a possible direction for finding potential strategies for treating LUAD from the perspective of mechanism by which circadian disorder affects immune cells.

Objective:To study the expression and regulatory mechanisms of pyroptosis in pulpitis.Methods:The activation sta-tus of cell deathes in pulpitis was analyzed using GSE77459 and GSE92681 datasets.Subsequently,pulp tissue and gingival crevic-ular fluid samples were collected from the subjects with pulpitis(infected)and healthy(non-infected)(n=10)respectively.The levels of GSDMD,NLRP3,caspase-1 and apoptosis proteins were detected by RT-qPCR and Western blot;the levels of IL-1βand IL-18 were assessed by ELISA;and the levels of reactive oxygen species(ROS)and mitochondrial membrane potential were exam-ined by probe method.Results:The levels of pyroptosis in the samples of patients with pulpitis in both GSE77459 and GSE92681 datasets were significantly higher than those in the control group(P＜0.05).RT-qPCR and Western blot analyses revealed that compared to controls,the expression of GSDMD,NLRP3 and caspase-1 in the samples of pulpitis was significantly higher(P＜0.05);the levels of IL-1β,IL-18,ROS and mitochondrial membrane potential in pulpitis were significantly elevated;the levels of eleaved caspase-3,caspase-8 and caspase-9 were significantly increased.Conclusion:The elevated level of pyroptosis in pulpitis that promotes inflammation may be related to mitochondrial dysfunction.

In recent years,an increasing amount of evidence has shown that intestinal flora disturbance plays a critical role in the pathogenesis of primary biliary cholangitis(PBC).Intestinal flora participates in the development and progression of PBC by modulating bile acid metabolism,affecting immune system functions,and mediating interactions within the gut-liver axis.This article summarizes the pathophysiological features of PBC,elaborates on the mechanism of action of intestinal flora in PBC,and analyzes the potential treatment strategies based on intestinal flora regulation,in order to provide new theoretical bases for the early diagnosis and precise treatment of PBC.

As the world's second largest vector of pathogens,ticks can spread a variety of pathogens by sucking the host's blood.Ticks not only threaten human life and health,but also cause great economic losses in animal husbandry.Artificial breeding of ticks can provide a stable environment for the growth and reproduction of ticks,thereby generating sufficient exper-imental materials for understanding ticks'biological characteristics,studying tick-borne pathogens,and developing anti-tick drugs and vaccines.Current methods of breeding ticks in the laboratory can be roughly divided into two categories:breeding methods using host animals or artificial membranes.The selection of breeding method must be comprehensively considered,ac-cording to tick types,blood-sucking habits,living environments,and other aspects.The development processes of the two methods,and their respective advantages and disadvantages,are described and discussed,to assist laboratories in artificial breeding of ticks.

As a non-invasive imaging modality,cardiac magnetic resonance(CMR)enables a"one-stop"in vivo assessment of cardiac morphology,structure,functional status and histological features,plays an irreplaceable role in the diagnosis,prognosis and risk stratification of cardiovascular diseases.In 2024,CMR has made continuous progress towards precision medicine.Upgraded technologies such as tissue characterization imaging and myocardial strain analysis,are gradually transformed into standard clinical practice.Artificial intelligence and other new algorithms have improved the quality and efficiency of CMR.The application of CMR in non-ischemic heart disease,ischemic heart disease and other areas is highly valued in the new version of various guidelines,highlighting the importance of CMR in the clinical management of cardiovascular diseases.This article aims to systematically review representative achievements of CMR in 2024 from the perspectives of both technological innovation and clinical translation,providing the latest update in this field.

Objective:To evaluate the clinical effect of derotational distal femoral osteotomy (DDFO) combined with medial patellofemoral ligament (MPFL) reconstruction assisted by digital orthopedic technique in the treatment of recurrent patellar dislocation with enlarged femoral anteversion angle (FAA).Methods:TThe clinical data of 18 patients (4 men and 14 women; mean age 22.1±0.7 years; range, 18-26 years) with recurrent patellar dislocation (FAA≥30°) admitted to Digital Orthopedic Technology Clinical Application Center in Tianjin hospital from May 2022 to December 2023 were retrospectively analyzed. The average number of patella dislocations were 3.6±0.4 (range, 2-8 times), with a mean symptom duration of 4.3±0.4 years (range, 2-7 years). According to Dejour classification of femoral trochlea dysplasia, there were 5 cases of type A, 3 cases of type B, 6 cases of type C and 4 cases of type D. All patients underwent 3D CT scanning and digital modeling before operation. Based on the modeling results, personalized osteotomy and orthopedic integration guide were designed and printed to direct intraoperative DDFO and MPFL reconstruction. Radiological parameters, knee function and complications were assessed during follow-up. Knee function assessments included visual analogue scale (VAS), Intemational Knee Documentation Committee Knee Form (IKDC), Kujala, Lysholm and Tegner score. The radiological parameters included FAA, patellar tilt angle (PTA), tibial tuberosity-trochlear groove distance (TT-TG) and caton-deschamps index (CDI).Results:All patients underwent surgery and were followed up for 15.4±2.8 months (range, 12-20 months). Complications occurred in 3 patients, including deep venous thrombosis in 2 cases and wound effusion in 1 case. No other complications such as wound infection, nerve injury, vascular injury, fracture nonunion or patella dislocation were recorded. The VAS score improved from 5.4±0.3 preoperatively to 2.1±0.2 at one year postoperatively. The IKDC score improved from 44.4±2.7 to 79.2±1.9 points. The Kujala score improved from 51.8±2.6 to 86.1±1.6, the Lysholm from 49.8±2.5 to 84.9±1.5, and the Tegner score from 2.2±0.2 to 4.1±0.2. The FAA decreased from 39.7°±1.2° to 14.9°±0.2°, the PTA from 33.1°±2.6° to 12.6°±1.4°, and the TT-TG from 20.2±0.6 to 13.9±0.4 mm. The differences between time of all the above-mentioned parameters were statistically significant ( P<0.05). The CDI remained stable, which changed from 1.03±0.02 preoperatively to 1.07±0.01 one year after operation ( P>0.05). Conclusions:After the application of DDFO combined with MPFL reconstruction assist by personalized osteotomy and orthopedic integrated guide, the patient's knee function and imaging parameters were significantly improved at one-year follow-up. In the treatment of recurrent patellar dislocation with enlarged FAA, good early clinical efficacy could be achieved with this operation.

Objective:To investigate the impact of bundled management of late-pregnancy induction strategies on induction time and maternal and perinatal clinical outcomes.Methods:This was a historical control study, including 61 pregnant women before the implementation of the bundled management strategies for induction protocol in September 2024, and 78 pregnant women after the implementation in December 2024, who received regular prenatal check-ups and finally admitted to Peking University Third Hospital for elective induction of labor at term. The rate of successful induction, the rate of reaching active phase, induction to labor length, duration of labor, hospital stay, and adverse maternal and preinatal outcomes and other information were compared between two groups. Logistic regression model was used to analyze the factors affecting the rates of successful labor induction and reaching active phase. Kaplan-Meier survival curves were plotted for induction to labor length and duration of labor, and the Cox proportional hazards regression model was used to analyze the impact of the bundled management strategies for induction strategies on the above indicators.Results:(1) Compared with the group before implementation, the group after implementation had a shorter induction to labor length (median: 47.4 vs 35.1 h), a shorter duration of labor (median: 14.0 vs 10.5 h), and a shorter hospital stay (median: 6 vs 4 d). The rate of successful induction increased [87% (53/61) vs 97% (76/78)], and the rate of reaching active phase increased [70% (43/61) vs 86% (67/78)]; the differences were statistically significant (all P<0.05). (2) Multivariate logistic regression analysis showed that the implementation of the bundled management strategies promoted successful induction ( OR=7.299, 95% CI: 1.189-44.800; P=0.032) and reaching active phase ( OR=2.640, 95% CI: 1.003-6.951; P=0.049). A pre-pregnancy body mass index<18.5 kg/m2 promoted successful induction ( OR=9.142, 95% CI: 1.154-72.423; P=0.036). (3) Kaplan-Meier curve analysis indicated that compared with the group before the implementation, the group after the implementation had a significantly shorter induction to labor length ( χ2=13.883, P<0.001) and a shorter duration of labor ( χ2=5.72, P=0.017). Cox proportional hazards regression analysis showed that the implementation of the bundled management strategies for induction protocol was a protective factor for shortening induction to labor length ( HR=1.806, 95% CI: 1.186-2.749; P=0.006) and duration of labor ( HR=1.677, 95% CI: 1.066-2.637; P=0.025). A cervical Bishop score >3 at admission was a protective factor for shortening the induction to labor length ( HR=1.627, 95% CI: 1.110-2.384; P=0.013), and parity was a protective factor for shortening the duration of labor ( HR=3.370, 95% CI: 1.806-6.288; P<0.001). Conclusions:By the implementation of the bundled management strategies for induction protocol, it is possible to promote successful induction of labor and reaching the active phase for pregnant women undergoing induction. This approach also shortens induction to labor length and the duration of labor, without increasing the risk of maternal and perinatal complications.

Objective:To evaluate the clinical effectiveness of high tibial osteotomy (HTO) assisted by digital orthopedic techniques in the treatment of varus knee osteoarthritis secondary to tibial fracture malunion.Methods:The clinical data were retrospectively analyzed of the 16 patients who had been admitted to Clinical Application Center of Digital Orthopedic Technology, Tianjin Hospital for varus knee osteoarthritis secondary to tibial fracture malunion from April 2022 to October 2023. There were 6 men and 10 women, with an age of (56.3±1.6) years and a mean body mass index of (23.8±0.9) kg/m 2. HTO was performed for all the patients using patient-specific instrumentation integrated osteotomy and orthopedic guide which was designed and printed with digital orthopedic techniques. If preoperative imaging indicated symptomatic meniscus injury (tear), intraarticular free body, or intercondylar fossa stenosis in a patient, arthroscopic clearance was first conducted before subsequent performance of HTO at one stage. Clinical effectiveness was evaluated by measuring and comparing hip-knee-ankle angle (HKA), medial proximal tibial angle (MPTA), posterior tibial slope (PTS), lower limb weight-bearing line (WBL) ratio, Western Ontario and McMaster University (WOMAC) osteoarthritis index, visual analogue scale (VAS) pain score and knee range of motion (ROM) before surgery and 12 months after surgery. Results:The operative time was (41.3±2.1) min and intraoperative fluoroscopy was performed only once in all the patients. All the wounds healed by the first stage with no such complications as hinge point fracture, wound infection, vascular injury, nerve injury, delayed union or nonunion of fracture, lower limb deep venous thrombosis, loosening of internal fixation, or plate rupture. The follow-up time for the 16 patients was (16.3±0.7) months. At 12 months after surgery, the HKA (179.5°±0.5°), MPTA (91.7°±0.5°), WBL ratio (61.2%±0.4%), WOMAC osteoarthritis index [(12.8±0.8) points], VAS pain score [(1.8±0.3) points] and knee ROM (121.8°±1.8°) were significantly better than those before surgery [166.6°±1.3°, 81.8°±0.4°, 29.6%±1.0%, (38.4±2.1) points, (4.8±0.3) points, and 110.5°±2.1°] ( P < 0.05). There was no significant difference in PTS between pre-surgery and 12 months after surgery ( P > 0.05). Conclusions:When HTO is used to treat varus knee osteoarthritis secondary to tibial fracture malunion, assistance of digital orthopedic techniques can improve HKA, MPTA, lower limb alignment, and knee ROM to reduce and recover knee function for the patients.

Objective To address personnel management challenges in large comprehensive hospitals by developing a comprehensive personnel information management system for refined multi-campus administration.Methods A centralized data-base was employed to construct a personnel information management system compatible with both"interactive management"and"independent management"modes.The system progressively implemented functions including personnel information manage-ment,meal card and subsidy administration,and shift scheduling.Results The system achieved effective interconnections be-tween subsystems,significantly improving personnel management efficiency,data governance,risk prevention capabilities,and operational decision-making.Personnel data were efficiently utilized across multiple scenarios.Conclusion The multi-campus comprehensive personnel information management system meets the refined requirements of multi-campus personnel administration and provides valuable experience for the development and expansion of subsequent hospital operation management information sys-tems.