Objective To evaluate the efficacy of modified cardiac rehabilitation combined with Xuefu Zhuyu decoction on patients with heart failure of Qi deficiency and blood stasis type,with a focus on analyzing the improvement of galectin-3(Gal-3),soluble suppression of tumorigenicity 2(sST2)levels,cardiac function,traditional Chinese medicine syndromes,and exercise tolerance.Methods 180 patients with heart failure of Qi deficiency and blood stasis type who attended the Department of Rehabilitation Medicine,Huzhou First People's Hospital from October 2021 to March 2023 were selected and randomly divided into treatment group(modified cardiac rehabilitation+Xuefu Zhuyu decoction)and control group(conventional treatment),with a treatment course of 12 weeks.The changes of Gal-3,sST2,left ventricular ejection fraction(LVEF),New York heart association functional classification(NYHA),N-terminal B-type natriuretic peptide(NT-proBNP),traditional Chinese medicine syndrome score and 6-minute walk test(6MWT)were compared between two groups before and after 12 weeks of treatment,and the safety was evaluated.Results After 12 weeks of treatment,Gal-3 and sST2 levels of patients in treatment group were significantly lower than those in control group;LVEF levels of patients in treatment group were significantly higher than those in control group,and the degree of improvement of cardiac function grading in treatment group was significantly better than that in control group;NT-proBNP in treatment group was significantly lower than that in control group;The 6MWT in treatment group was significantly higher than that in control group;The score of traditional Chinese medicine syndrome in treatment group was lower than that in control group;The difference is statistically significant(P＜0.05).After 12 weeks of treatment,the effective rate of treatment group was significantly higher than that of control group(P＜0.05);There was no statistically significant difference in adverse reactions and serious adverse events between two groups of patients(P＞0.05).Conclusion Modified cardiac rehabilitation combined with Xuefu Zhuyu decoction can significantly improve cardiac function,traditional Chinese symptoms,and exercise tolerance in patients with heart failure of Qi deficiency and blood stasis type,reduce Gal-3 and sST2 levels,and has high clinical application value.

Objective:To investigate the relationship between the expression of microtubule-associated protein light chain 3B (LC3B), Beclin-1, and p62 in serum CD 4+ T lymphocytes of patients infected with varicella-zoster virus (VZV) and viral replication. Methods:This study used a cross-sectional design. A total of 106 patients with VZV who received treatment at The First People's Hospital of Huzhou between October 2018 and October 2019 were included in the study group. Additionally, 50 healthy individuals who underwent health examinations during the same period were included in the control group. The expression levels of LC3B, Beclin-1, and p62 in serum CD 4+ T lymphocytes among patients with different VZV DNA copy numbers were compared. The effects of different levels of LC3B, Beclin-1, and p62 on disease severity were evaluated. Spearman correlation analysis was performed to investigate the relationship between the expression of LC3B, Beclin-1, and p62 in the peripheral blood CD 4+ T lymphocytes of VZV-infected patients, viral replication, and disease duration. Results:The relative expression levels of LC3B and Beclin-1 in peripheral blood CD 4+ T lymphocytes of the study group were (60.19 ± 7.59)% and (34.99 ± 4.34)%, respectively, which were significantly higher than those in the control group [(37.71 ± 4.33)%, (16.18 ± 1.92)%, t = 19.48, 29.29, both P < 0.001]. The relative expression level of p62 in the study group was significantly lower than that in the control group [(5.81 ± 0.58)% vs. (10.11 ± 1.24)%, t = -29.57, P < 0.001]. The peripheral blood VZV DNA copy number in the study group was (4.28 ± 0.47). In patients with a VZV DNA copy number ≥ 4.28, the expression levels of LC3B [(72.22 ± 8.83)%] and Beclin-1 [(40.09 ± 5.56)%] were significantly higher than those in patients with a VZV DNA copy number < 4.28 [LC3B: (51.23 ± 6.88)%, Beclin-1: (29.67 ± 3.12)%, t = 13.57, 11.77, both P < 0.001]. The expression level of p62 in patients with a VZV DNA copy number ≥ 4.28 [(4.77 ± 0.36)%] was significantly lower than that in patients with a VZV DNA copy number < 4.28 [(6.98 ± 0.79) %, t = -18.76, P < 0.001]. The expression levels of LC3B and Beclin-1 in patients at moderate or advanced stages were significantly higher than those in patients with early-stage VZV ( P < 0.05), while the expression levels of p62 in patients with moderate- or advanced-stage VZV were significantly lower than those in patients with early-stage VZV (both P < 0.05). Additionally, the expression levels of LC3B and Beclin-1 were positively correlated with viral replication ( r = 0.817, 0.839) and disease duration ( r = 0.849, 0.822, all P < 0.001). The expression level of p62 was negatively correlated with viral replication and disease duration ( r = -0.850, -0.822, both P < 0.001). Conclusions:In patients infected with VZV, the autophagy levels in peripheral blood CD 4+ T lymphocytes were significantly upregulated, as evidenced by increased expression of LC3B and Beclin-1 and decreased expression of p62. Autophagy positively influences viral replication, with elevated autophagy levels promoting viral replication.

Objective To observe the value of follicular thyroid imaging reporting and data system(F-TIRADS)for differentiating benign and malignant follicular thyroid lesions.Methods Totally 502 patients with follicular thyroid lesions were retrospectively enrolled,including 104 patients with single malignant lesion(malignant group,containing 77 follicular thyroid carcinomas[FTC]and 27 follicular variant of papillary thyroid carcinomas[FVPTC])and 398 patients with 416 benign lesions(benign group,containing 197 follicular thyroid adenomas[FTA]and 219 thyroid adenomatous hyperplasia).Ultrasonic features of lesions were recorded,and F-TIRADS scores were assigned by 1 junior and 1 senior ultrasound physicians.Taken histopathology results as gold standard,receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the efficacy for differentiating benign and malignant follicular thyroid lesions using F-TIRADS.Results Significant differences of composition,internal echo,boundary,calcification and trabecular structure of lesions were found between groups(all P＜0.001).Taken F-TIRADS score≥ 7 as the optimal cut-off value,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value for differentiating benign and malignant follicular thyroid lesions by the junior physician was 76.92％,77.40％,77.31％,93.06％and 45.98％,while by the senior physician was 78.84％,81.25％,80.76％,93.89％and 51.25％,respectively.The efficacy of the latter was higher than of the former(AUC was 0.827 and 0.859,respectively,P＜0.05).Conclusion F-TIRADS could effectively identifying benign and malignant follicular thyroid lesions.

Objective To explore the value of improved ResNet18 lightweight deep learning(DL)models for automatically detecting gouty arthritis(GA)based on ultrasonogram of the first metatarsophalangeal joint(MTP1).Methods A total of 2 401 ultrasonograms obtained from 260 patients with suspected gout who underwent MTP1 ultrasound examination were included and divided into training set(1 910 ultrasonograms from 209 cases)and test set(491 ultrasonograms from 51 cases)at the ratio of 4∶1.GA lesions on ultrasonograms were manually labeled.After preprocessing,ResNet18 lightweight network was used to construct DL models for identifying the ultrasonogram category was normal or abnormal(with any manifestation of GA).Five-fold cross-validation method was adopted to evaluate the efficacy of the DL models constructed with 2,3,4 or 6 residual blocks,i.e.model 1,2,3 and 4,respectively,and the computational cost and the amount of parameters of each model were recorded.The efficacy of the models were verified using test set,and the best DL model was screened.Results The computational cost of model 1,2,3 and 4 was 7 558.27,2 963.73,4 012.33 and 6 093.39 M,respectively,while the amount of parameters was 4.61,4.91,4.91 and 5.28 M,respectively.Model 2 had the least computational cost with parameters only slightly more than model 1.In test set,no significant difference of accuracy nor the area under the curve was found among 4 models(all P＞0.05).The sensitivity of model 2 was higher than that of model 3,while its specificity was lower only than that of model 3(both P＜0.05),hence model 2 was the best DL model.Conclusion Improved ResNet18 lightweight DL models could be used for automatically detecting GA based on ultrasonogram of MTP1,among which model 2 was the best one.

Objective To observe the value of follicular thyroid imaging reporting and data system(F-TIRADS)for differentiating benign and malignant follicular thyroid lesions.Methods Totally 502 patients with follicular thyroid lesions were retrospectively enrolled,including 104 patients with single malignant lesion(malignant group,containing 77 follicular thyroid carcinomas[FTC]and 27 follicular variant of papillary thyroid carcinomas[FVPTC])and 398 patients with 416 benign lesions(benign group,containing 197 follicular thyroid adenomas[FTA]and 219 thyroid adenomatous hyperplasia).Ultrasonic features of lesions were recorded,and F-TIRADS scores were assigned by 1 junior and 1 senior ultrasound physicians.Taken histopathology results as gold standard,receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the efficacy for differentiating benign and malignant follicular thyroid lesions using F-TIRADS.Results Significant differences of composition,internal echo,boundary,calcification and trabecular structure of lesions were found between groups(all P＜0.001).Taken F-TIRADS score≥ 7 as the optimal cut-off value,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value for differentiating benign and malignant follicular thyroid lesions by the junior physician was 76.92％,77.40％,77.31％,93.06％and 45.98％,while by the senior physician was 78.84％,81.25％,80.76％,93.89％and 51.25％,respectively.The efficacy of the latter was higher than of the former(AUC was 0.827 and 0.859,respectively,P＜0.05).Conclusion F-TIRADS could effectively identifying benign and malignant follicular thyroid lesions.

Objective To explore the value of improved ResNet18 lightweight deep learning(DL)models for automatically detecting gouty arthritis(GA)based on ultrasonogram of the first metatarsophalangeal joint(MTP1).Methods A total of 2 401 ultrasonograms obtained from 260 patients with suspected gout who underwent MTP1 ultrasound examination were included and divided into training set(1 910 ultrasonograms from 209 cases)and test set(491 ultrasonograms from 51 cases)at the ratio of 4∶1.GA lesions on ultrasonograms were manually labeled.After preprocessing,ResNet18 lightweight network was used to construct DL models for identifying the ultrasonogram category was normal or abnormal(with any manifestation of GA).Five-fold cross-validation method was adopted to evaluate the efficacy of the DL models constructed with 2,3,4 or 6 residual blocks,i.e.model 1,2,3 and 4,respectively,and the computational cost and the amount of parameters of each model were recorded.The efficacy of the models were verified using test set,and the best DL model was screened.Results The computational cost of model 1,2,3 and 4 was 7 558.27,2 963.73,4 012.33 and 6 093.39 M,respectively,while the amount of parameters was 4.61,4.91,4.91 and 5.28 M,respectively.Model 2 had the least computational cost with parameters only slightly more than model 1.In test set,no significant difference of accuracy nor the area under the curve was found among 4 models(all P＞0.05).The sensitivity of model 2 was higher than that of model 3,while its specificity was lower only than that of model 3(both P＜0.05),hence model 2 was the best DL model.Conclusion Improved ResNet18 lightweight DL models could be used for automatically detecting GA based on ultrasonogram of MTP1,among which model 2 was the best one.

Objective:To investigate the relationship between the expression of microtubule-associated protein light chain 3B (LC3B), Beclin-1, and p62 in serum CD 4+ T lymphocytes of patients infected with varicella-zoster virus (VZV) and viral replication. Methods:This study used a cross-sectional design. A total of 106 patients with VZV who received treatment at The First People's Hospital of Huzhou between October 2018 and October 2019 were included in the study group. Additionally, 50 healthy individuals who underwent health examinations during the same period were included in the control group. The expression levels of LC3B, Beclin-1, and p62 in serum CD 4+ T lymphocytes among patients with different VZV DNA copy numbers were compared. The effects of different levels of LC3B, Beclin-1, and p62 on disease severity were evaluated. Spearman correlation analysis was performed to investigate the relationship between the expression of LC3B, Beclin-1, and p62 in the peripheral blood CD 4+ T lymphocytes of VZV-infected patients, viral replication, and disease duration. Results:The relative expression levels of LC3B and Beclin-1 in peripheral blood CD 4+ T lymphocytes of the study group were (60.19 ± 7.59)% and (34.99 ± 4.34)%, respectively, which were significantly higher than those in the control group [(37.71 ± 4.33)%, (16.18 ± 1.92)%, t = 19.48, 29.29, both P < 0.001]. The relative expression level of p62 in the study group was significantly lower than that in the control group [(5.81 ± 0.58)% vs. (10.11 ± 1.24)%, t = -29.57, P < 0.001]. The peripheral blood VZV DNA copy number in the study group was (4.28 ± 0.47). In patients with a VZV DNA copy number ≥ 4.28, the expression levels of LC3B [(72.22 ± 8.83)%] and Beclin-1 [(40.09 ± 5.56)%] were significantly higher than those in patients with a VZV DNA copy number < 4.28 [LC3B: (51.23 ± 6.88)%, Beclin-1: (29.67 ± 3.12)%, t = 13.57, 11.77, both P < 0.001]. The expression level of p62 in patients with a VZV DNA copy number ≥ 4.28 [(4.77 ± 0.36)%] was significantly lower than that in patients with a VZV DNA copy number < 4.28 [(6.98 ± 0.79) %, t = -18.76, P < 0.001]. The expression levels of LC3B and Beclin-1 in patients at moderate or advanced stages were significantly higher than those in patients with early-stage VZV ( P < 0.05), while the expression levels of p62 in patients with moderate- or advanced-stage VZV were significantly lower than those in patients with early-stage VZV (both P < 0.05). Additionally, the expression levels of LC3B and Beclin-1 were positively correlated with viral replication ( r = 0.817, 0.839) and disease duration ( r = 0.849, 0.822, all P < 0.001). The expression level of p62 was negatively correlated with viral replication and disease duration ( r = -0.850, -0.822, both P < 0.001). Conclusions:In patients infected with VZV, the autophagy levels in peripheral blood CD 4+ T lymphocytes were significantly upregulated, as evidenced by increased expression of LC3B and Beclin-1 and decreased expression of p62. Autophagy positively influences viral replication, with elevated autophagy levels promoting viral replication.

Objective To evaluate the efficacy of modified cardiac rehabilitation combined with Xuefu Zhuyu decoction on patients with heart failure of Qi deficiency and blood stasis type,with a focus on analyzing the improvement of galectin-3(Gal-3),soluble suppression of tumorigenicity 2(sST2)levels,cardiac function,traditional Chinese medicine syndromes,and exercise tolerance.Methods 180 patients with heart failure of Qi deficiency and blood stasis type who attended the Department of Rehabilitation Medicine,Huzhou First People's Hospital from October 2021 to March 2023 were selected and randomly divided into treatment group(modified cardiac rehabilitation+Xuefu Zhuyu decoction)and control group(conventional treatment),with a treatment course of 12 weeks.The changes of Gal-3,sST2,left ventricular ejection fraction(LVEF),New York heart association functional classification(NYHA),N-terminal B-type natriuretic peptide(NT-proBNP),traditional Chinese medicine syndrome score and 6-minute walk test(6MWT)were compared between two groups before and after 12 weeks of treatment,and the safety was evaluated.Results After 12 weeks of treatment,Gal-3 and sST2 levels of patients in treatment group were significantly lower than those in control group;LVEF levels of patients in treatment group were significantly higher than those in control group,and the degree of improvement of cardiac function grading in treatment group was significantly better than that in control group;NT-proBNP in treatment group was significantly lower than that in control group;The 6MWT in treatment group was significantly higher than that in control group;The score of traditional Chinese medicine syndrome in treatment group was lower than that in control group;The difference is statistically significant(P＜0.05).After 12 weeks of treatment,the effective rate of treatment group was significantly higher than that of control group(P＜0.05);There was no statistically significant difference in adverse reactions and serious adverse events between two groups of patients(P＞0.05).Conclusion Modified cardiac rehabilitation combined with Xuefu Zhuyu decoction can significantly improve cardiac function,traditional Chinese symptoms,and exercise tolerance in patients with heart failure of Qi deficiency and blood stasis type,reduce Gal-3 and sST2 levels,and has high clinical application value.

Objective To investigate the effect of dietary intake on the childbirth outcomes of primipara women with full-term labor analgesia. Methods A total of 400 primipara women with full-term labor analgesia were randomly divided into observation group and control group. The observation group received intake management and individualized dietary guidance, while the control group ate and drank according to their own wishes. The childbirth quality, the incidence of vomiting, the use of oxytocin due to uterine atony, the rate of intrapartum fever, the rate of perineal incision, the rate of cesarean section, the rate of vaginal assisted delivery, and the rate of postpartum hemorrhage were compared between the two groups. The duration of the first stage of labor, the duration of the second stage of labor, the duration of labor analgesia, and the amount of postpartum hemorrhage within 2 hours were also compared. Neonatal Apgar score, random blood glucose, umbilical artery blood pH value, umbilical artery blood lactic acid (Lac) value, the incidence of neonatal asphyxia, the incidence of neonatal fever, and the incidence of neonatal hypoglycemia were compared between the two groups. Results The observation group had lower incidences of vomiting, oxytocin use rate due to uterine atony, intrapartum fever rate, perineal incision rate, transferring cesarean section rate, and vaginal assisted delivery compared to the control group(P < 0.05). The observation group had lower rates of postpartum hemorrhage, shorter duration of the first and second stages of labor, shorter duration of labor analgesia, and less postpartum hemorrhage within 2 hours compared to the control group, and the incidences of neonatal hyperglycemia and hypoglycemia in the observation group were lower than those in the control group (P < 0.05). There were no statistically significant differences in umbilical artery blood pH value, Lac value, neonatal Apgar score, random blood glucose, neonatal asphyxia rate, and neonatal fever rate between the two groups (P>0.05). Conclusion Intake management and individualized dietary guidance during labor can reduce the incidence of uterine atony, shorten the duration of labor, decrease the incidence of dystocia, reduce postpartum hemorrhage within 2 hours and decrease the incidence of neonatal glucose abnormality.

Objective:To investigate the effect of Xuefu Zhuyu Decoction on myocardial protection and the interaction between Cadherin-NrF2 pathway and ferroptosis in patients with chronic heart failure resulting from qi deficiency and blood stasis. Methods:A case-control study was conducted on 100 patients with heart failure resulting from qi deficiency and blood stasis who received treatment at The First People's Hospital of Huzhou from February 2021 to May 2022. These patients were divided into a basic western medicine group and a Xuefu Zhuyu Decoction group with 50 patients per group using the random number table method. The basic western medicine group received conventional treatment, while the Xuefu Zhuyu Decoction group received treatment with Xuefu Zhuyu Decoction in addition to conventional treatment. Both groups were treated continuously for 8 weeks. Interleukin-13, intercellular adhesion molecule-1, nitric oxide, cystatin C, thromboxane B2, soluble cluster of differentiation 40 ligand, vascular endothelial cadherin were detected before and after treatment, and soluble tyrosine kinase receptor AXL (sAXL), soluble stromal lysin-2, and ferric ion levels were determined. The mRNA expression levels of glutathione peroxidase 4 and NrF2 were detected. Syndrome scores were evaluated. Clinical efficacy was compared between the two groups. Results:After treatment, the levels of interleukin-13 [(7.63 ± 1.85) ng/L], intercellular adhesion molecule-1 [(41.71 ± 6.25) ng/L], and cystatin C [(0.61 ± 0.17) ng/L] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(10.56 ± 2.13) ng/L, (50.11 ± 8.34) ng/L, (1.03 ± 0.22) ng/L, t = 7.34, 5.69, 10.68, all P < 0.05]. The levels of soluble cluster of differentiation 40 ligand [(14.61 ± 1.19) μg/L] and thromboxane B2 [(40.18 ± 7.24) ng/L] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(16.03 ± 1.47) μg/L, (53.37 ± 10.16) ng/L, t = 5.30, 7.47, both P < 0.05], while the level of nitric oxide [(59.92 ± 6.16) μmol/L] in the Xuefu Zhuyu Decoction group was significantly higher than that in the basic Western medicine group [(53.17 ± 5.49) μmol/L, t = 5.78, P < 0.05]. The level of ferric ion [(0.23 ± 0.08) μg/L] in the Xuefu Zhuyu Decoction group was significantly higher than that in the basic western medicine group [(0.16 ± 0.05) μg/L, t = 5.24, P < 0.05]. The levels of vascular endothelial cadherin [(3.02 ± 0.72) ng/L], NrF2 mRNA [(2.11 ± 0.43)], and glutathione peroxidase 4 mRNA [(4.65 ± 0.74)] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(4.34 ± 1.05) ng/L, (2.93 ± 0.56), (5.16 ± 0.88), t = 7.33, 8.21, 3.13, all P < 0.05]. The levels of Galectin-3 [(62.48 ± 6.09) μg/L], soluble stromal lysin-2 [(0.98 ± 0.24) ng/L], and sAXL [(42.16 ± 7.54) ng/L] in the Xuefu Zhuyu Decoction group were significantly lower than those in the basic western medicine group [(70.96 ± 8.15) μg/L, (1.57 ± 0.46) ng/L, (56.11 ± 10.02) ng/L, t = 5.89, 8.04, 7.86, all P < 0.05]. The Xuefu Zhuyu Decoction group had lower scores for shortness of breath or wheezing [(1.06 ± 0.24) points], palpitations [(0.92 ± 0.15) points], fatigue [(0.75 ± 0.17) points], low voice [(0.68 ± 0.16) points], spontaneous sweating [(0.83 ± 0.21) points], fatigue and laziness [(0.73 ± 0.20) points], prone to fatigue [(0.66 ± 0.14) points], and dark complexion or lips [(0.61 ± 0.16) points] compared with the basic western medicine group [(1.65 ± 0.49) points, (1.15 ± 0.27) points, (1.16 ± 0.31) points, (1.12 ± 0.29) points, (1.28 ± 0.32) points, (1.28 ± 0.37) points, (1.01 ± 0.21) points, (0.96 ± 0.25) points, t = 7.64, 5.26, 8.20, 9.39, 8.31, 9.24, 9.80, 8.33, all P < 0.05]. The total response rate of the Xuefu Zhuyu Decoction group was significantly higher than that of the basic western medicine group [(96.00% (48/50) vs. 88.00% (44/50), Z = 1.91, P < 0.05). Conclusion:Treating patients with heart failure with Xuefu Zhuyu Decoction can inhibit inflammation, improve vascular endothelial cell function, regulate Cadherin-NrF2 pathways, reduce oxidative stress injury, further inhibit ferroptosis, reduce the levels of Galectin-3, soluble stromal lysin-2, and sAXL, protect myocardium, relieve clinical symptoms, and improve its efficacy.