The renin-angiotensin-aldosterone system (RAAS) is crucial for regulating blood pressure and maintaining fluid balance, while clock genes are essential for sustaining biological rhythms and regulating metabolism. There exists a complex interplay between RAAS and clock genes that may significantly contribute to the development of various cardiovascular and metabolic diseases. Although current literature has identified correlations between these two systems, the specific mechanisms of their interaction remain unclear. Moreover, the interaction patterns under different physiological and pathological conditions need further investigation. This review summarizes the synergistic roles of the RAAS and clock genes in cardiovascular diseases, explores their molecular mechanisms and pathophysiological connections, discusses the application of chronotherapy, and highlights potential future research directions, aiming to provide novel insights for the prevention and treatment of related diseases.
Humans ; Renin-Angiotensin System/genetics* ; Cardiovascular Diseases/genetics* ; CLOCK Proteins/physiology* ; Animals

Glutamine provides carbon and nitrogen to support the proliferation of cancer cells. However, the precise reason why cancer cells are particularly dependent on glutamine remains unclear. In this study, we report that glutamine modulates the tumor suppressor F-box and WD repeat domain-containing 7 (FBW7) to promote cancer cell proliferation and survival. Specifically, lysine 604 (K604) in the sixth of the 7 substrate-recruiting WD repeats of FBW7 undergoes glutaminylation (Gln-K604) by glutaminyl tRNA synthetase. Gln-K604 inhibits SCFFBW7-mediated degradation of c-Myc and Mcl-1, enhances glutamine utilization, and stimulates nucleotide and DNA biosynthesis through the activation of c-Myc. Additionally, Gln-K604 promotes resistance to apoptosis by activating Mcl-1. In contrast, SIRT1 deglutaminylates Gln-K604, thereby reversing its effects. Cancer cells lacking Gln-K604 exhibit overexpression of c-Myc and Mcl-1 and display resistance to chemotherapy-induced apoptosis. Silencing both c-MYC and MCL-1 in these cells sensitizes them to chemotherapy. These findings indicate that the glutamine-mediated signal via Gln-K604 is a key driver of cancer progression and suggest potential strategies for targeted cancer therapies based on varying Gln-K604 status.
Glutamine/metabolism* ; Myeloid Cell Leukemia Sequence 1 Protein/genetics* ; Humans ; Proto-Oncogene Proteins c-myc/genetics* ; Cell Proliferation ; Signal Transduction ; Neoplasms/pathology* ; F-Box-WD Repeat-Containing Protein 7/genetics* ; Cell Survival ; Cell Line, Tumor ; Apoptosis

Objective:To understand trends and hotspots of TCM research papers published in journals with high IF basing on a bibliometric analysis.Methods:TCM research papers published between January 1, 2014 and December 31, 2024 from 80 journals with IF higher than 16.0 were retrieved from medical, life sciences and comprehensive journals in Journal Citation Reports of 2024. CiteSpace 6.3.R1 and Excel 2021 were used to analyze and visualize annual publication volume, research fields, features of clinical study, institutes, funds and keywords.Results:A total of 51 papers were included, showing an increasing trend in annual publication volume; the main research areas were pharmacology, acupuncture&moxibustion and internal medicine. Multi-center randomized controlled trials were the main clinical studies; China Academy of Chinese Medical Sciences was the leading institute in terms of publication volume; 84 funds were involved, including National Natural Science Foundation of China. Keywords that appeared most frequently were TCM, efficacy, double blind, electroacupuncture, stimulation and management.Conclusion:The number and quality of TCM research papers are improved simultaneously; future research needs to deepen international cooperation, and pay attention to the integration of TCM diagnosis and treatment characteristics and modern scientific research methods.

Objective:Glioblastoma(GBM)and brain metastases(BMs)are the two most common malignant brain tumors in adults.Magnetic resonance imaging(MRI)is a commonly used method for screening and evaluating the prognosis of brain tumors,but the specificity and sensitivity of conventional MRI sequences in differential diagnosis of GBM and BMs are limited.In recent years,deep neural network has shown great potential in the realization of diagnostic classification and the establishment of clinical decision support system.This study aims to apply the radiomics features extracted by deep learning techniques to explore the feasibility of accurate preoperative classification for newly diagnosed GBM and solitary brain metastases(SBMs),and to further explore the impact of multimodality data fusion on classification tasks. Methods:Standard protocol cranial MRI sequence data from 135 newly diagnosed GBM patients and 73 patients with SBMs confirmed by histopathologic or clinical diagnosis were retrospectively analyzed.First,structural T1-weight,T1C-weight,and T2-weight were selected as 3 inputs to the entire model,regions of interest(ROIs)were manually delineated on the registered three modal MR images,and multimodality radiomics features were obtained,dimensions were reduced using a random forest(RF)-based feature selection method,and the importance of each feature was further analyzed.Secondly,we used the method of contrast disentangled to find the shared features and complementary features between different modal features.Finally,the response of each sample to GBM and SBMs was predicted by fusing 2 features from different modalities. Results:The radiomics features using machine learning and the multi-modal fusion method had a good discriminatory ability for GBM and SBMs.Furthermore,compared with single-modal data,the multimodal fusion models using machine learning algorithms such as support vector machine(SVM),Logistic regression,RF,adaptive boosting(AdaBoost),and gradient boosting decision tree(GBDT)achieved significant improvements,with area under the curve(AUC)values of 0.974,0.978,0.943,0.938,and 0.947,respectively;our comparative disentangled multi-modal MR fusion method performs well,and the results of AUC,accuracy(ACC),sensitivity(SEN)and specificity(SPE)in the test set were 0.985,0.984,0.900,and 0.990,respectively.Compared with other multi-modal fusion methods,AUC,ACC,and SEN in this study all achieved the best performance.In the ablation experiment to verify the effects of each module component in this study,AUC,ACC,and SEN increased by 1.6%,10.9%and 15.0%,respectively after 3 loss functions were used simultaneously. Conclusion:A deep learning-based contrast disentangled multi-modal MR radiomics feature fusion technique helps to improve GBM and SBMs classification accuracy.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Hypoxic-ischemic encephalopathy (HIE) is a major cause of newborn mortality and childhood disability. Despite hypothermia treatment being the current standard method, it has its limitations and often produces unsatisfactory outcomes. Additionally, due to time and equipment constraints, hypothermia treatment cannot be promptly administered, leading to high mortality rates or varying levels of neurological impairments even after treatment. Hence, the exploration of alternative and effective treatment methods for HIE has become a challenging and highly researched topic in the field of neonatology. Research has shown that HIE induces intricate changes in the neurological system at the physiological, cellular, and molecular levels. Circular RNA (circRNA) exhibits high expression in the central nervous system and plays a role in regulating physiological and pathophysiological processes. Therefore, circRNA holds promise as a potential therapeutic target for HIE. This article provides a comprehensive overview of the regulatory effects of circRNA on different types of neural cells in HIE, aiming to offer new theoretical foundations for the treatment of HIE.

Hypoxic-ischemic encephalopathy(HIE)is a major cause of newborn mortality and childhood disability.Despite hypothermia treat-ment being the current standard method,it has its limitations and often produces unsatisfactory out-comes.Additionally,due to time and equipment constraints,hypothermia treatment cannot be promptly administered,leading to high mortality rates or varying levels of neurological impairments even after treatment.Hence,the exploration of al-ternative and effective treatment methods for HIE has become a challenging and highly researched topic in the field of neonatology.Research has shown that HIE induces intricate changes in the neurological system at the physiological,cellular,and molecular levels.Circular RNA(circRNA)exhib-its high expression in the central nervous system and plays a role in regulating physiological and pathophysiological processes.Therefore,circRNA holds promise as a potential therapeutic target for HIE.This article provides a comprehensive over-view of the regulatory effects of circRNA on differ-ent types of neural cells in HIE,aiming to offer new theoretical foundations for the treatment of HIE.

Hypoxic-ischemic encephalopathy(HIE)is a major cause of newborn mortality and childhood disability.Despite hypothermia treat-ment being the current standard method,it has its limitations and often produces unsatisfactory out-comes.Additionally,due to time and equipment constraints,hypothermia treatment cannot be promptly administered,leading to high mortality rates or varying levels of neurological impairments even after treatment.Hence,the exploration of al-ternative and effective treatment methods for HIE has become a challenging and highly researched topic in the field of neonatology.Research has shown that HIE induces intricate changes in the neurological system at the physiological,cellular,and molecular levels.Circular RNA(circRNA)exhib-its high expression in the central nervous system and plays a role in regulating physiological and pathophysiological processes.Therefore,circRNA holds promise as a potential therapeutic target for HIE.This article provides a comprehensive over-view of the regulatory effects of circRNA on differ-ent types of neural cells in HIE,aiming to offer new theoretical foundations for the treatment of HIE.

Hypoxic-ischemic encephalopathy(HIE)is a major cause of newborn mortality and childhood disability.Despite hypothermia treat-ment being the current standard method,it has its limitations and often produces unsatisfactory out-comes.Additionally,due to time and equipment constraints,hypothermia treatment cannot be promptly administered,leading to high mortality rates or varying levels of neurological impairments even after treatment.Hence,the exploration of al-ternative and effective treatment methods for HIE has become a challenging and highly researched topic in the field of neonatology.Research has shown that HIE induces intricate changes in the neurological system at the physiological,cellular,and molecular levels.Circular RNA(circRNA)exhib-its high expression in the central nervous system and plays a role in regulating physiological and pathophysiological processes.Therefore,circRNA holds promise as a potential therapeutic target for HIE.This article provides a comprehensive over-view of the regulatory effects of circRNA on differ-ent types of neural cells in HIE,aiming to offer new theoretical foundations for the treatment of HIE.

Objective:To investigate the associations of onset age, diabetes duration, and glycated hemoglobin (HbA1c) levels with ischemic stroke risk in type 2 diabetes patients.Methods:The participants were from Comprehensive Research on the Prevention and Control of the Diabetes in Jiangsu Province. The study used data from baseline survey from December 2013 to January 2014 and follow-up until December 31, 2021. After excluding the participants who had been diagnosed with stroke at baseline survey and those with incomplete information on onset age, diabetes duration, and HbA1c level, a total of 17 576 type 2 diabetes patients were included. Cox proportional hazard model was used to calculate the hazard ratio ( HR) and 95% CI of onset age, diabetes duration, and HbA1c level for ischemic stroke. Results:During the median follow-up time of 8.02 years, 2 622 ischemic stroke cases were registered. Multivariate Cox proportional risk regression model showed that a 5-year increase in type 2 diabetes onset age was significantly associated with a 5% decreased risk for ischemic stroke ( HR=0.95, 95% CI: 0.92-0.99). A 5-year increase in diabetes duration was associated with a 5% increased risk for ischemic stroke ( HR=1.05, 95% CI: 1.02-1.10). Higher HbA1c (per 1 standard deviation increase: HR=1.17, 95% CI: 1.13-1.21) was associated with an increased risk for ischemic stroke. Conclusion:The earlier onset age of diabetes, longer diabetes duration, and high levels of HbA1c are associated with an increased risk for ischemic stroke in type 2 diabetes patients.