Objective To explore the clinical value of combining high-resolution CT (HRCT) with serum markers in differentiating malignant solitary pulmonary nodules (SPN). Methods Ninety-two SPN patients admitted to Baoji People’s Hospital between January 2022 and January 2024 were included. According to pathological analysis, they were divided into a benign group (30 cases) and a malignant group (62 cases). The serum levels of TUBA1B and ACSL4 were detected. Diagnostic value was determined using the receiver operating characteristic curve. Kappa test was used for consistency evaluation. Results Significant differences were observed between the benign and malignant groups in HRCT imaging, including the number of cases with spiculation, lobulation, pleural indentation, calcification, and vascular convergence sign (P<0.05). The sensitivity, specificity, and accuracy of HRCT in diagnosing malignant SPN were 74.19%, 86.67%, and 78.26%, respectively. The consistency with clinical diagnosis was moderate, as indicated by a Kappa value of 0.552 (P<0.001). The expression level of TUBA1B in the serum of SPN patients in the malignant group was higher than that in the benign group (P<0.05), while the expression level of ACSL4 was lower than that in the benign group (P<0.05). The areas under the receiver operating characteristic curves of serum TUBA1B and ACSL4 in diagnosing malignant SPN were 0.840 (95%CI = 0.749-0.908) and 0.875 (95%CI = 0.790-0.935), respectively, with sensitivities of 74.19% and 75.81% and specificities of 73.33% and 86.67%, respectively. The sensitivity, specificity, and accuracy of HRCT combined with serum TUBA1B and ACSL4 in diagnosing malignant SPN were 96.77%, 63.33%, and 85.87%, respectively. The consistency with clinical diagnosis was high, as indicated by a Kappa value of 0.721 (P<0.001). The sensitivity and negative predictive value of HRCT combined with serum TUBA1B and ACSL4 in diagnosing malignant SPN were higher than those of individual diagnostic indicators (P<0.05). Conclusion HRCT combined with serum TUBA1B and ACSL4 has high value in the differentiation of benign and malignant SPN.

ObjectiveTo investigate the intervention effect of Tengli Kangliu prescription （TKP） on the carcinogenesis of colorectal adenoma （CRA） induced by azoxymethane （AOM）/dextran sulphate sodium salt （DSS） in C57BL/6 mice and decipher the potential mechanism through regulating the signal transducer and activator of transcription 3 （STAT3） pathway to target M2-type macrophages. MethodsA total of 55 male C57BL/6 mice were randomized into a blank group （n=10）， a model group （n=15）， a celecoxib （0.02 g·kg^-1·d^-1） group （n=15）， a TKP （42.43 g·kg^-1·d^-1） group （n=15）. The mice in the model， TKP， and celecoxib groups were modeled for CRA lesions through the AOM/DSS three-cycle protocol. The intervention in each group began one week after free access to DSS and lasted for 12 weeks， and the blank group received 20 mL·kg^-1·d^-1 normal saline through gavage. Throughout the study period， changes in body mass and survival rate were recorded， alongside measurements of colorectal length and spleen mass. Histological changes of the colonic tissue were observed by HE staining. Immunohistochemical （IHC） staining was performed to detect the positive expression of CD68 and CD11c in the colorectal tissue. Western blot was employed to assess the protein levels of STAT3， phosphorylated （p）-STAT3， B-cell lymphoma 2 （Bcl-2）， and Bcl-2-associated X protein （Bax） in the intestinal tissue. Real-time quantitative PCR was employed to analyze the mRNA levels of arginase 1 （Arg1）， CD206， and vascular endothelial growth factor （VEGF）. Enzyme-linked Immunosorbent assay（ELISA） was employed to measure the serum concentrations of Th2-type cytokines interleukin （IL）-4， IL-6， and IL-13 in mice. ResultsCompared with the blank group， the model group exhibited symptoms including diarrhea， hematochezia， and body mass loss， accompanied by shortened colon length， mucosal damage， and multiple tumors. In addition， the model group showcased up-regulated protein levels of STAT3， p-STAT3， and Bcl-2， down-regulated protein level of Bax， increased positive expression of CD68 and CD11c， and up-regulated mRNA levels of Arg1， CD206， and VEGF in the colon tissue， together with elevated serum levels of IL-4， IL-13， and IL-6 （P<0.05）. Compared with the model group， the above-mentioned indicators were partially reversed in both TKP group and celecoxib group， with superior effects observed in the TKP group （P<0.05）. ConclusionTKP significantly improves the survival quality of the mouse model of AOM/DSS-induced CRA by reducing intestinal inflammation and decreasing colorectal tumor number and size. It may delay the progression of AOM/DSS-induced colorectal tumor-like lesions by inhibiting activation of the STAT3/p-STAT3 signaling pathway in the intestinal tissue， targeting regulation of M2-type macrophages， and improving the tumor microenvironment， thereby suppressing CRA carcinogenesis.

Heart failure （HF） is the end stage of various cardiovascular diseases， manifested as ventricular filling or impaired left ventricular ejection fraction （LVEF）. Type 2 diabetes mellitus （T2DM） is a metabolic disorder， mainly caused by insufficient insulin secretion and insulin resistance. The incidence rates of the two common clinical diseases are increasing year by year. HF and T2DM are mutually causal chronic diseases， and their mutual deterioration can form a HF-T2DM comorbidity. The comorbidity status significantly increases the mortality and readmission risk of patients， and seriously affects the quality of life of patients. At present， western medicine treatment mainly involves the use of anti HF drugs and hypoglycemic drugs， which can significantly alleviate the clinical symptoms of patients. However， these two categories of drugs are numerous in variety and differ in their mechanisms， and blind combination may produce adverse reactions. With its unique theoretical system， traditional Chinese medicine exhibits the advantages of multiple components， multiple targets， and high safety through traditional Chinese medicine monomers， Chinese patent medicine， traditional Chinese medicine compounds， and acupuncture， which significantly delays the development of HF-T2DM and shows great potential in clinical treatment. A large number of clinical studies have shown that the integrated traditional Chinese and western medicine in the treatment of HF-T2DM has a significant effect in improving cardiac function， controlling blood glucose levels， and improving the quality of life of patients. Based on relevant research at home and abroad， this paper reviewed the HF-T2DM pathogenesis， pharmacological effects， research status of traditional Chinese and western medicine， and early prevention strategies， and discussed current problems and future research directions， in order to provide new ideas and useful references for clinical prevention and treatment of HF-T2DM.

Heart failure （HF） is the end stage of various cardiovascular diseases， manifested as ventricular filling or impaired left ventricular ejection fraction （LVEF）. Type 2 diabetes mellitus （T2DM） is a metabolic disorder， mainly caused by insufficient insulin secretion and insulin resistance. The incidence rates of the two common clinical diseases are increasing year by year. HF and T2DM are mutually causal chronic diseases， and their mutual deterioration can form a HF-T2DM comorbidity. The comorbidity status significantly increases the mortality and readmission risk of patients， and seriously affects the quality of life of patients. At present， western medicine treatment mainly involves the use of anti HF drugs and hypoglycemic drugs， which can significantly alleviate the clinical symptoms of patients. However， these two categories of drugs are numerous in variety and differ in their mechanisms， and blind combination may produce adverse reactions. With its unique theoretical system， traditional Chinese medicine exhibits the advantages of multiple components， multiple targets， and high safety through traditional Chinese medicine monomers， Chinese patent medicine， traditional Chinese medicine compounds， and acupuncture， which significantly delays the development of HF-T2DM and shows great potential in clinical treatment. A large number of clinical studies have shown that the integrated traditional Chinese and western medicine in the treatment of HF-T2DM has a significant effect in improving cardiac function， controlling blood glucose levels， and improving the quality of life of patients. Based on relevant research at home and abroad， this paper reviewed the HF-T2DM pathogenesis， pharmacological effects， research status of traditional Chinese and western medicine， and early prevention strategies， and discussed current problems and future research directions， in order to provide new ideas and useful references for clinical prevention and treatment of HF-T2DM.

The pathological changes of myocardial infarction （MI） are mainly characterized by progressive myocardial ischemic necrosis， decline in cardiac diastolic function， thinning of the ventricular wall， and enlargement of the ventricles. The clinical manifestations include myocardial ischemia， heart failure， arrhythmia， shock， and even sudden cardiac death， rendering MI one of the most perilous cardiovascular diseases. Currently， the clinical treatment for MI primarily involves interventional procedures and drug therapy. However， due to their significant side effects and high complication rates associated with these treatments， they fail to ensure a satisfactory quality of life and long-term prognosis for patients. On the other hand， traditional Chinese medicine has demonstrated remarkable potential in improving patient prognosis while reducing side effects. Research has elucidated that various signaling pathways such as nuclear transcription factor-κB （NF-κB）， adenosine 5̒-monophosphate-activated protein kinase （AMPK）， transforming growth factor-β （TGF-β）/Smads， mitogen-activated protein kinase （MAPK）， Wnt/β-catenin （β-catenin）， and phosphatidylinositol 3-kinase （PI3K）/protein kinase B（Akt） play crucial roles in regulating the occurrence and development of MI. Effectively modulating these signaling pathways through its therapeutic interventions， traditional Chinese medicine can enhance MI management by inhibiting apoptosis， providing anti-inflammatory properties， alleviating oxidative stress levels， and resisting myocardial ischemia. Due to its notable efficacy and favorable safety， it has become an area of focus in clinical practice.

OBJECTIVES: To design a deep learning model that balances model complexity and performance to enable its integration into wearable ECG monitoring devices for automated diagnosis of atrial fibrillation. METHODS: This study was performed based on data from 84 patients with atrial fibrillation, 25 patients with atrial fibrillation, and 18 subjects without obvious arrhythmia collected from the publicly available datasets LTAFDB, AFDB, and NSRDB, respectively. A lightweight attention network based on depthwise separable convolution and fusion of channel-spatial information, namely DSC-AttNet, was proposed. Depthwise separable convolution was introduced to replace standard convolution and reduce model parameters and computational complexity to realize high efficiency and light weight of the model. The multilayer hybrid attention mechanism was embedded to compute the attentional weights of the channels and spatial information at different scales to improve the feature expression ability of the model. Ten-fold cross-validation was performed on LTAFDB, and external independent testing was conducted on AFDB and NSRDB datasets. RESULTS: DSC-AttNet achieved a ten-fold average accuracy of 97.33% and a precision of 97.30% on the test set, both of which outperformed the other 4 comparison models as well as the 3 classical models. The accuracy of the model on the external test set reached 92.78%, better than those of the 3 classical models. The number of parameters of DSC-AttNet was 1.01M, and the computational volume was 27.19G, both smaller than the 3 classical models. CONCLUSIONS This proposed method has a smaller complexity, achieves better classification performance, and has a better generalization ability for atrial fibrillation classification.
Atrial Fibrillation/diagnosis* ; Humans ; Electrocardiography ; Deep Learning ; Wearable Electronic Devices ; Neural Networks, Computer

Objective: To explore the network structure of eating behaviors with anxiety, depression and perceived stress in adolescents, so as to provide a basis for effective prevention and intervention of eating behavior problems and negative emotions in adolescents. Methods: Based on the Psychology and Behavior Investigation of Chinese Residents (2021) database, the study was conducted among 3 087 adolescents. Sakata Eating Behavior Scale Short From(EBS-SF) was used to investigate their eating behaviors. The Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder Scale-7 Item(GAD-7), and Perceived Stress Questionnaire-3 Item (PSQ-3) were used to evaluate their depression, anxiety and perceived stress. Network analysis method was applied to construct a network of eating behaviors and negative emotional symptoms among adolescents, so as to evaluate the centrality, bridge strength, stability and accuracy of each item. Results: The total scores of eating behaviors, depression,anxiety and stress perception in adolescents were 17.41±4.53,6.95±6.08,4.86±5.03,9.34±3.80,respectively. The symptom with the highest intensity and expected impact was "I am only satisfied when I buy more food than I need", with a node intensity and expected impact value of 4.37. The nodes Depression and Anxiety were the most closely connected(weight=0.87). There were no statistically significant differences in the network structure( M =0.13,0.11) and network connection strength(female and male:4.16,4.06, s =0.10;urban and rural areas:4.08,4.07, s =0.01) between different sexes and residents ( P >0.05). Conclusion The negative impact of comorbidities such as anxiety, depression, perceived stress and eating behaviors among adolescents can be reduced through targeted prevention and intervention of core symptoms and bridging symptoms.

Objective:To investigate the effect of Zhuyu Tongluo Tang combined with manual release on isokinetic muscle strength and serum TGF-β1 and IGF-1 levels in patients with joint stiffness after ankle fracture surgery.Methods:A prospective study was conducted on 80 patients with ankle fractures who experienced joint stiffness during the recovery period after surgery at Nanchang Hongdu Traditional Chinese Medicine Hospital from March 2021 to March 2024.The patients were randomly divided into control group(n=40)and observation group(n=40)using a random number table method.Both groups of patients received routine intervention,followed by manual release therapy in control group;observation group received treatment in combination with Zhuyu Tongluo Tang on the basis of control group,with a treatment course of 4 weeks.Compared treatment outcomes,isokinetic muscle strength test indicators,American Orthopaedic of Foot and Ankle Society(AOFAS),ankle activity score(AAS),visual analog scale(VAS),traditional Chinese medicine syndrome score,and changes in dorsiflexion angle from two groups of patients before and after 4 weeks of treatment,and measured serum levels of TGF-β1 and insulin-like growth factor-1(IGF-1).Results:After treatment,effective rate of control group was 75.00%,while effective rate of observation group was 92.50%(P<0.05);PT,PT/BW and TW of observation group and control group were significantly increased,and PT,PT/BW and TW of observation group were significantly higher than those of control group(all P<0.05);AOFAS and AAS scores of observation group and control group were significantly increased,while VAS score was significantly decreased.AOFAS and AAS scores of observation group were significantly higher than those of control group,while VAS score was significantly lower than those of control group(both P<0.05);scores and total scores of various traditional Chinese medicine symptoms in observation group and control group were significantly reduced,and observation group was significantly lower than that in control group(both P<0.05);dorsiflexion angle of the foot in both observation group and control group were significantly increased,and the increase in observation group was greater than that in control group(both P<0.05);levels of TGF-β1 and IGF-1 in both obser-vation group and control group were significantly increased,and levels of TGF-β1 and IGF-1 in observation group were significantly higher than those in control group(both P<0.05).Conclusion:Combination of Zhuyu Tongluo Tang and manual release can improve the symptoms of joint stiffness and traditional Chinese medicine syndromes during the recovery period of ankle fractures,increase the functional score and isokinetic muscle strength index of the ankle joint,raise the levels of TGF-β1 and IGF-1,and improve the patient's dorsiflexion angle.This treatment regimen has good clinical efficacy.

A porous composite scaffold is prepared through freeze-drying method using sodium alginate as the matrix and calcium citrate double salt as the functional enhancer.To thoroughly investigate the structure and properties of the composite scaffold,advanced instruments including Fourier transform infrared spectrometer,X-ray diffractometer,scanning electron microscope,and thermogravimetric analyzer are utilized for comprehensive structural characterization.Meanwhile,key properties such as porosity,mechanical performance,swelling ratio,gel fraction,and in vitro degradation rate are systematically tested and analyzed.The results show that the composite of sodium alginate and calcium citrate double salt is a physical complex.The porosity of the scaffold mainly ranges from 200 to 600 μm,and as the addition of double salt increases,the pore size firstly increases and then slightly decreases,while the pore distribution become more uneven.In terms of mechanical properties,with the gradual increase of the content of double salt in the scaffold,the mechanical properties of the scaffold are significantly improved.However,its swelling ratio and gel fraction exhibit decreasing trends.Additionally,the degradation rate of the alginate scaffold is relatively fast,while the addition of calcium citrate double salt does not significantly improve the degradation rate.This study not only provides valuable insights into the preparation and property research of porous composite scaffold composed of sodium alginate/calcium citrate double salt,but also offers important reference for their potential applications in biomedicine.

OBJECTIVE To investigate the inhibitory effect mechanism of Anzheng Kangliu Decoction against colorectal cancer by suppressing glycolysis through regulation of the phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR)signaling pathway.METHODS Human colorectal cancer SW620 cells were treated with Anzheng Kangliu De-coction,and cell proliferation and migration abilities were assessed.Forty-two BALB/c nude mice were randomly divided into a blank control group,model group,5-fluorouracil(5-FU)group(0.025 g·kg-1),Anzheng Kangliu Decoction low-dose group(7.67 g·kg-1),medium-dose group(15.34 g·kg-1),and high-dose group(30.68 g·kg-1).The inhibitory effect of Anzheng Kan-gliu Decoction on subcutaneous xenograft tumors was evaluated by observing body weight,tumor volume,tumor mass,HE staining,im-munohistochemical staining of Ki67 and other indicators.High-throughput transcriptome sequencing was performed to identify differen-tially expressed genes and pathways in tumor tissues between the model group and the Anzheng Kangliu Decoction medium-dose group,elucidating the potential mechanism of Anzheng Kangliu Decoction against colorectal cancer.Glucose and lactate assay kits were used to measure glucose consumption and lactate production in SW620 cells and tumor tissues after Anzheng Kangliu Decoction intervention.Western blot was employed to detect the expression levels of p-PI3K/PI3K,p-Akt/Akt,p-mTOR/mTOR,hexokinase 2(HK2),and lactate dehydrogenase A(LDHA)in SW620 cells and tumor tissues following Anzheng Kangliu Decoction treatment.RE-SULTS In vitro cell experiments demonstrated that,compared with the blank control group,Anzheng Kangliu Decoction intervention significantly inhibited the proliferation and migration of SW620 cells(P<0.01),reduced glucose consumption and lactate production(P<0.05,P<0.01),and downregulated the protein expression levels of p-PI3K/PI3K,p-Akt/Akt,p-mTOR/mTOR,HK2,and LDHA(P<0.05,P<0.01).In vivo animal experiments revealed that,compared with the model group,Anzheng Kangliu Decoction suppressed the growth of subcutaneous xenograft tumors in nude mice(P<0.01),increased tumor tissue necrosis,decreased glucose consumption and lactate production in tumor tissues(P<0.05,P<0.01),and reduced the protein expression levels of p-PI3K/PI3K,p-Akt/Akt,p-mTOR/mTOR,HK2,and LDHA(P<0.05,P<0.01).CONCLUSION Anzheng Kangliu Decoction exerts an in-hibitory effect on colorectal cancer,and its mechanism may be associated with the suppression of glycolysis through regulation of the PI3K/Akt/mTOR signaling pathway.