Ferroptosis is a unique iron-dependent cell death pattern,a novel death phenotype distinct from apoptosis,va-rious forms of necrosis,and autophagy.Numerous active ingredients extracted from traditional Chinese medicine have been found to exert anti-cancer effects by inducing ferroptosis in various cancers.An increasing number of studies have found that the regulation of ferroptosis can influence the sensitivity of tumor cells to drugs and even reverse drug resistance.When combined with chemo-therapy drugs such as cisplatin,5-FU and gemcitabine,some natural products enhance cancer cells'sensitivity to chemothera-peutic drugs by inducing ferroptosis.This paper mainly summarizes traditional Chinese medicine and its natural products that can exert anti-cancer effects by inducing ferroptosis,providing new insights for cancer treatment and drug resistance reversal.Addition-ally,it contributes to exploring the potential advantages of traditional Chinese medicine,thereby expanding its scope of applica-tion.

Objective To explore the effect of nursing intervention based on 4R crisis theory on hypoglycemia in patients after endoscopic colon polypectomy.Methods Five hundred patients undergoing endoscopic colon polypectomy in The First Affiliated Hospital of Naval Medical University from January 2021 to August 2022 were selected and randomly divided into two groups,with 250 cases in each group.The control group was given routine nursing,and the observation group was given 4R crisis theory-based intervention on the basis of routine nursing.Perioperative blood glucose and hypoglycemia,surgical complications,postoperative rehabilitation and patient's satisfaction were compared between the two groups.Results The blood glucose level in the observation group was higher than that in the control group immediately,1 h and 24 h after operation(P＜0.05).The incidence of hypoglycemia in the observation group was lower than that in the control group(0.80%vs.3.60%,P＜0.05).The incidence of surgical complications in the observation group was lower than that in the control group(1.60%vs.5.20%,P＜0.05).The score of quality of recovery-40(QoR-40)questionnaire in the observation group was higher than that in the control group on day 7 after operation(P＜0.05).The degree of satisfaction for nursing in the observation group was higher than that in the control group(98.80%vs.95.20%,P＜0.05).Conclusion Intervention based on 4R crisis theory can effectively reduce the incidence of postoperative hypoglycemia and surgical complications,further improve the quality of postoperative recovery and the degree of satisfaction for nursing in patients undergoing endoscopic colon polypectomy.

Objective To explore the impact of targeted guidance based on the SHEL risk assessment model on stress response and compliance of patients undergoing gastrointestinal endoscopy.Methods A total of 92 patients who underwent gastrointestinal endoscopy at the Health Management Centre of The First Affiliated Hospital of Naval Medical University from January to December 2022 were selected as research objects.They were divided into two groups according to the time of admission and the nursing method used,with 46 cases in each group.The control group received conventional care,and the observation group was given targeted guidance based on the SHEL risk assessment model besides conventional care.The heart rate,blood pressure,psychological status,degree of cooperation,and pain rate were compared between two groups.Results The increases in heart rate,diastolic blood pressure and systolic blood pressure in the observation group were less than those in the control group during the examination(all P<0.05).After the examination,the scores of the Self Rating Anxiety Scale(SAS-CR)and Self Rating Depression Scale(SDS)in the observation group were significantly lower than those in the control group;the degree of patient compliance in the observation group was significantly higher than that in the control group;and the proportion of patients with discomfort in the observation group was lower than that in the control group(all P<0.05).Conclusion Targeted guidance based on the SHEL risk assessment model can alleviate physiological and psychological stress reactions and improve patient compliance during gastrointestinal endoscopy.

Objective:To study the changes of cord blood neutrophil gelatinase-associated lipocalin (NGAL) under different levels of hypoxia at birth and its correlations with hypoxic organ damage (including liver, kidney and heart).Methods:From April to October 2022, all neonates born in our hospital were prospectively enroll in the study. The neonates without perinatal risk factors were assigned into the control group. The neonates with intrauterine distress or hypoxia during labor were assigned into the hypoxia group (no asphyxia at birth) and the asphyxia group (with asphyxia at birth). Cord blood was collected from the umbilical artery and cord blood gas (CBG) and NGAL were measured. Liver enzymes, kidney function and cardiac enzymes as biomarkers for hypoxic organ damage were measured 24~48 h after birth. The correlations of NGAL and the biomarkers were analyzed.Results:A total of 161 neonates were enrolled, including 91 in the control group, 49 in the hypoxia group and 21 in the asphyxia group. NGAL in the asphyxia group was significantly higher than the hypoxia group and the control group [(1.81±0.71) ng/ml vs. (1.22±0.53) ng/ml, (0.88±0.47) ng/ml], NGAL in the hypoxia group significantly higher than the control group ( P<0.05). NGAL was negatively correlated with Apgar score, pH and BE of CBG ( r<-0.3, P<0.05) and positively correlated with lactate, ALT, creatinine ( r>0.3, P<0.05). No significant correlations existed between NGAL and gender, gestational age, birth weight, mother's age, BMI and CK-MB ( P<0.05). ROC curve showed that sensitivity and specificity of NGAL for predicting hypoxic organ damage were 84.3% and 60.3%, respectively, with a cut-off value of 1.07 ng/ml. Conclusions:Cord blood NGAL may increase with the deterioration of hypoxia at birth and may be associated with hypoxic organ damage.

Objective:Based on UPLC-Q-TOF/MS, to screen a panel of plasma metabolite biomarkers for TB diagnosis and evaluate its diagnostic efficacy.Methods:102 active TB patients [49 males, 53 females, age 40.0(24.0, 48.5) years] from Shanghai Pulmonary Hospital and Shanghai East Hospital from January 2017 to January 2018, 100 TB-IGRA positive patients [55 males, 45 females, age 44.0(37.0, 52.0) years] and 96 healthy controls [55 males, 41 females, age 43.0(32.2, 52.8) years] from Shanghai East Hospital were randomly enrolled. UPLC-Q-TOF/MS technology was used to detect small molecule metabolites in plasma. Combined with multivariate statistical methods VIP and univariate statistic analysis Student's t-test, the main differential metabolites in the plasma of patients with active tuberculosis were filtered. The ROC curve was analyzed for the differential metabolites, and the AUC value, specificity, and sensitivity for diagnosis were used to screen metabolic biomarkers with diagnostic potential. Results:All the samples examined resulted in 10 266 variables, and 1 153 substances were identified by qualitative retrieval through the human metabolome database. After pairwise comparison of samples from the three groups, differential metabolites that simultaneously satisfied VIP > 1 and P<0.05 were plotted into a Venn diagram, and the resulting intersection set contained 38 major differential metabolites. The ROC curve analysis of 38 major metabolites showed that the area under the curve of lactic acid, dopamine, 9-pentadecenoic acid, and 12,13-dihydroxy octadecadienoic acid in the diagnosis of active tuberculosis were 0.92, 0.98, 0.94, and 0.94, respectively, the specificity was both more than 90% and the sensitivity was both more than 80%. The specificity and sensitivity of four metabolites in the combined diagnosis of active tuberculosis were both 94%. Conclusion:Lactic acid, dopamine, 9-pentadecenoic acid, and 12, 13-dihydroxy octadecadienoic acid can be used as potential metabolic biomarkers for tuberculosis diagnosis.

As an important medical support component for the army to preserve and enhance combat effectiveness and minimize the reduction rate of combat personnel, war trauma treatment has been highly valued. Modern war puts forward higher requirements for the pertinence, practicality, and efficiency of war trauma treatment training. With the comprehensive development of national defense and military modernization, the contradiction between the increasing demand of modern war medical service and the relatively backward training mode of war trauma treatment becomes more and more prominent. As a new practical technology, virtual reality technology can simulate the elements of war trauma treatment in a panoramic manner, enabling the trainees to have a real sense of the battlefield in the four-dimensional space of high simulation, which has unique advantage in the field of war trauma treatment training. At present, the western developed countries represented by the the United States of America have applied virtual reality technology in the field of war trauma treatment training and achieved gratifying training results through the actual combat tests. This paper reviews the application of virtual reality technology in the field of war trauma treatment training at home and abroad, in order to provide a new idea and method for improving the level of war trauma treatment training in our army.

Objective To evaluate the application of fractional exhaled nitric oxide (FeNO) in the reducing treatment of bronchial asthma.Methods From October 2015 to September 2016,60 asthmatic patients with FeNO＞25 ppb were randomized into FeNO group and control group with 30 cases in each group.Patients in both groups were treated with combined inhaled corticosteroids and long-acting beta 2 agonist (ICS/LABA) starting with low doses;the dosage was adjusted according to the symptom control alone in control group,while in FeNO group the dosage was adjusted according to the symptom control and FeNO level.After 1 year-follow up,the Asthma Control Test (ACT) scores,Asthma Life Questionnaire (mini AQLQ)scores,pulmonary function,FeNO levels,blood eosinophil counts,total IgE,hierarchical control level,cumulative corticosteroid use and cumulative months of leukotriene receptor antagonists (LTRA) use were compared before and after treatment within group,and between two groups.Stratified analysis was carried out in the patients complicated with allergic rhinitis.Results After treatment,ACT scores,mini AQLQ scores and FEV1/pred (％) were significantly higher than those before treatmentin both groups (t=10.755,10.189,8.632 and 13.311,8.102,12.456,respectively,all P＜0.05),while the FeNO,EOS and total IgE levels were significantly lower than those before treatment (t=8.005,3.313,3.924 and 8.967,3.885,3.270,respectively,all P＜0.05),and the numbers of patients with good control were significantly increased (Z=-5.035 and-4.976 respectively,P＜0.05).Compared with control group,FeNO level was lower,mini AQLQ scores of symptom scores and emotional scores were higher and the average numbers of asthma attacks per patient per year were less after treatment in FeNO group (t=2.912,4.214,4.589,U=2.154,all P＜0.05).However,there was no significant difference in cumulative corticosteroid use and cumulative months of LTRA use between two groups (U=564.000 t=1.921 and 0.165,respectively,P＞0.05).For patients complicated with allergic rhinitis,the numbers of acute asthma attack were increased and the cumulative dosage of systemic corticosteroid use was higher in control group than those in FeNO group (both P＜0.05).Conclusion The reducing treatment strategy based on FeNO level and symptom control is of clinical value for patients with bronchial asthma,especially for those complicated with allergic rhinitis.

Objective To explore the clinical value of 3D fast spin echo with an extended echo train acquistion (CUBE) T1WI enhancement sequence for purulent meningitis by comparing to contrast?enhanced T2WI?FLAIR sequence in the detection of lesions. Methods From August 2016 to July 2017, children with clinically suspected purulent meningitis underwent cranial magnetic resonance examination in our hospital. There were 35 children, 19 males and 16 females, aged 2 months to 3 years (median age 8 months) in total.A GE Discovery MR 750 3.0 T scanner was used to perform routine plain and enhanced scan in all children. After enhancement, the sequences of CUBE T1WI and FLAIR T2WI were applied randomly. Using the FLAIR T2WI enhancement sequence as the reference, we evaluated the detection rate of CUBE T1WI enhancement sequence for dura mater and leptomeningeal thickening. The number of enhanced lesions detected was tested by χ2 test. Results The enhanced FLAIR T2WI sequence showed 21 cases with dural enhancement, showing a rate of 60.0%. The enhanced CUBE T1WI sequence showed 31cases with dural enhancement, showing a rate of 88.6%. There were significant differences between the dural lesions detected(χ2＝6.058, P<0.01). The enhanced FLAIR T2WI sequence showed 16 cases of leptomeningeal enhancement,showing a rate of 45.7%. The enhanced CUBE T1WI sequence showed 19 cases of leptomeningeal enhancement,showing a rate of 54.3%.The enhanced CUBE T1WI sequence was not significantly higher than that of enhanced T2WI?FLAIR sequence in displaying leptomeningeal enhancement (χ2=0.229, P>0.05). Conclusion Enhancement of the CUBE T1WI sequence enables better visualization of meningeal thickening than FLAIR T2WI. It has great clinical value in the diagnosis of purulent meningitis in children.

Objective To explore the impact of hypothyroidism on left ventricular ( LV ) mechanics using two-dimensional speckle tracking imaging ( 2D-STI ) . Methods Forty-two patients with newly diagnosed overt hypothyroidism ( HT ) were prospectively collected as the case group and 47 subjects matching by age ,gender and hypertension history were enrolled as control group . All participants received comprehensive echocardiography examination ,and 2D-STI was used to assess LV global longitudinal strain ( GLS) and mechanical dispersion ( MD ) . The inter-group difference in GLS and MD ,correlations with thyroid hormones and reproducibility were evaluated . Results LV GLS at both sectional ( apical 4- ,3- ,2-chamber views) and global levels were significantly impaired in the HT group than the control group [ ( - 21 .3 ± 3 .2) ％ vs ( - 23 .9 ± 2 .9) ％ ,( - 20 .4 ± 3 .8 ) ％ vs ( - 22 .7 ± 2 .9 ) ％ ,( - 21 .2 ± 3 .9) ％ vs ( - 23 .9 ± 2 .5) ％ ,( - 20 .9 ± 3 .4) ％ vs ( - 23 .5 ± 2 .3) ％ ;all P < 0 .01] . Similarly ,MD at both sectional ( apical 4- ,3- ,2-chamber views) and global levels were significantly prolonged in the HT group than the control group[ 3 .4 ms vs 0 .9 ms ,2 .2 ms vs 0 .7 ms ,2 .3 ms vs 1 .7 ms and 12 .2 ms vs ( 5 .9 ± 2 .6) ms ;all P < 0 .01] . No significant correlation was found between MD and GLS ,left ventricular ejection fraction ( LVEF) ( r = 0 .12 , P = 0 .27 ; r = - 0 .17 , P = 0 .10) . Weak correlations were found between MD and FT3 ,FT4 ,TSH( r = - 0 .34 , P = 0 .01 ; r = - 0 .38 , P = 0 .005 ; r = 0 .31 , P = 0 .02) . Conclusions Primary overt HT is associated with impaired LV deformation and increased systolic dyssynchrony . LV MD is a promising parameter for assessment of myocardial impairment in HT .

Objective To investigate the influencing factors for left atrial appendage (LAA) spontaneous echo contrast (SEC) or thrombosis in patients with non-valvular atrial fibrillation(NVAF) and normal left ventricular ejection fraction(LVEF).Methods This study prospectively enrolled 255 patients with NVAF [paroxysmal atrial fibrillation(PaAF) 196 cases and persistent atrial fibrillation(PeAF) 59 cases].Patients were divided into two groups according to the findings on transesophageal echocardiography (TEE):positive group with the presence of the LAA SEC or thrombosis (group Ⅰ) and negative group (group Ⅱ) without this two presences.The clinical and echocardiographic data were compared between the two groups.The multivariate logistic regression analysis was used to explore the independent risk factors for development of LAA SEC or thrombosis.Receiver operating characteristic (ROC) curve was performed to determine the predictive value of the factors.Results A total of 255 patients were enrolled.There were 26 cases(10.2％) in group Ⅰ,and 229 cases (89.8％) in group Ⅱ.The age,NT-proBNP,occurrence rate of PeAF,left atrial volume index(LAVI),and LAA orifice long diameter and depth were higher in group Ⅰ than those in group Ⅱ (all P ＜0.01).The left atrial appendage emptying velocity(LAAV),global left atrial longitudinal strain(GLALS) and LVEF were lower in group Ⅰ compared with those in group Ⅱ (all P ＜ 0.01).Multivariate logistic regression analysis and ROC curve showed that GLALS＜12.2％ and LAAV＜ 31.2 cm/s were independent risk factors of LAA SEC or thrombosis in patients with NVAF and perserved LVEF.Conclusions The impairment of left atrial and LAA function are potential risk factors for cardiogenic embolism.GLALS and LAAV can be used as useful referenced parameters for prediction of stroke in patients with NVAF.