Heart failure (HF) is the end-stage of all cardiac diseases, characterized by high prevalence, high mortality, and heavy social and economic burden. Early warning of HF exacerbation is of great value for outpatient management and reducing readmission rates. Currently, remote dynamic monitoring technology, which captures changes in hemodynamic and physiological parameters of HF patients, has become the primary method for early warning and is a hot research topic in clinical studies. This paper systematically reviews the progress in this field, which was categorized into invasive monitoring based on implanted devices, non-invasive monitoring based on wearable devices, and other monitoring technologies based on audio and video. Invasive monitoring primarily involves direct hemodynamic parameters such as left atrial pressure and pulmonary artery pressure, while non-invasive monitoring covers parameters such as thoracic impedance, electrocardiogram, respiration, and activity levels. These parameters exhibit characteristic changes in the early stages of HF exacerbation. Given the clinical heterogeneity of HF patients, multi-source information fusion analysis can significantly improve the prediction accuracy of early warning models. The results of this study suggest that, compared with invasive monitoring, non-invasive monitoring technology, with its advantages of good patient compliance, ease of operation, and cost-effectiveness, combined with AI-driven multimodal data analysis methods, shows significant clinical application potential in establishing an outpatient management system for HF.
Humans ; Heart Failure/physiopathology* ; Monitoring, Physiologic/methods* ; Wearable Electronic Devices ; Remote Sensing Technology ; Early Diagnosis ; Electrocardiography ; Hemodynamics

Polycystic ovary syndrome （PCOS）， a common reproductive endocrine disorder in women， is one of the leading causes of ovulatory infertility in women of reproductive age. Due to its heterogeneous etiology， complex symptoms， and challenging treatment， PCOS has become a focal point of research in gynecological and reproductive medicine globally. The pathogenesis of PCOS is complex and may involve regulatory mechanisms such as inflammatory responses， oxidative stress， and cellular autophagy. Crown-like structures （CLSs） refer to pro-inflammatory microenvironments formed by macrophages engulfing adipocytes. The inflammatory disorders induced by CLSs are one of the key factors contributing to the development of PCOS and its complications. Current studies have indicated that the obese status in PCOS accelerates the formation of CLSs， and the density of CLSs can predict the progression of metabolic disorders and influence the outcomes of various metabolic diseases. Traditional Chinese Medicine （TCM） offers the unique advantages of a holistic view， four diagnostic methods， and syndrome differentiation and treatment to ameliorate the symptoms and signs of PCOS through multiple levels， pathways， and targets. Although studies on the mechanisms of metabolic diseases and CLS formation have been reported in China and abroad， there is still a lack of literature on the correlation between CLSs and PCOS， as well as reviews on TCM interventions targeting CLSs for treating this disease. Therefore， this paper summarized the correlation between obese PCOS and CLSs and reviewed recent studies on TCM interventions based on CLS formation （adipose tissue-macrophage inflammatory crosstalk） in the treatment of obese PCOS， aiming to provide new research perspectives for the prevention and treatment of PCOS using TCM.

Polycystic ovary syndrome （PCOS）， a common reproductive endocrine disorder in women， is one of the leading causes of ovulatory infertility in women of reproductive age. Due to its heterogeneous etiology， complex symptoms， and challenging treatment， PCOS has become a focal point of research in gynecological and reproductive medicine globally. The pathogenesis of PCOS is complex and may involve regulatory mechanisms such as inflammatory responses， oxidative stress， and cellular autophagy. Crown-like structures （CLSs） refer to pro-inflammatory microenvironments formed by macrophages engulfing adipocytes. The inflammatory disorders induced by CLSs are one of the key factors contributing to the development of PCOS and its complications. Current studies have indicated that the obese status in PCOS accelerates the formation of CLSs， and the density of CLSs can predict the progression of metabolic disorders and influence the outcomes of various metabolic diseases. Traditional Chinese Medicine （TCM） offers the unique advantages of a holistic view， four diagnostic methods， and syndrome differentiation and treatment to ameliorate the symptoms and signs of PCOS through multiple levels， pathways， and targets. Although studies on the mechanisms of metabolic diseases and CLS formation have been reported in China and abroad， there is still a lack of literature on the correlation between CLSs and PCOS， as well as reviews on TCM interventions targeting CLSs for treating this disease. Therefore， this paper summarized the correlation between obese PCOS and CLSs and reviewed recent studies on TCM interventions based on CLS formation （adipose tissue-macrophage inflammatory crosstalk） in the treatment of obese PCOS， aiming to provide new research perspectives for the prevention and treatment of PCOS using TCM.

Objective:To assess the feasibility of wavelet index (WLI) in monitoring the depth of sedation with propofol in pediatric patients.Methods:This was a prospective observational trial. One hundred and sixty-five pediatric patients, aged >1-12 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing elective surgery requiring general anesthesia with endotracheal intubation or laryngeal mask airway from July to December 2016 in our hospital, were divided into 11 age groups ( n=15 each): >1-2 yr group, >2-3 yr group, >3-4 yr group, >4-5 yr group, >5-6 yr group, >6-7 yr group, >7-8 yr group, >8-9 yr group, >9-10 yr group, >10-11 yr group, and >11-12 yr group. General anesthesia was induced by injection of propofol 3 mg/kg for more than 30 s. WLI and BIS values were recorded immediately before administration and at 30, 40, 50, 60, 90, 120, 180 and 240 s after the end of administration. If there were differences among age groups, age groups with no statistically significant differences were combined and re-grouped. Pearson linear correlation analysis and Bland-Altman consistency analysis were performed. Results:A total of 149 pediatric patients were actually included. There were no significant differences in BIS values between 4 groups aged > 1-5 yr and between 7 groups aged > 5-12 yr ( P>0.05). Regrouping was performed based on the aforementioned results, 4 groups of children aged > 1-5 yr were divided into > 1-5 yr group ( n=60), and 7 groups of children aged > 5-12 yr were divided into > 5-12 yr group ( n=89). WLI values and BIS values were significantly decreased at each time point after administration compared with immediately before administration in group aged > 1-5 yr and in group aged >5-12 yr ( P<0.05). The BIS values were the lowest at 60 s after the end of the administration, and the WLI values were the lowest at 120 and 180 s after the end of the administration in two groups ( P<0.05). There were no statistically significant differences between WLI values and BIS values at 90 s and 240 s after the end of the administration ( P>0.05), and there was statistically significant difference at the other time points in group aged > 1-5 yr ( P<0.05). There was no significant difference between WLI values and BIS values at 180 s and 240 s after the end of the administration ( P>0.05), but there were significant differences at the other time points in group aged > 5-12 yr ( P<0.05). The Pearson correlation coefficients between WLI values and BIS values were 0.61 and 0.56 in group aged > 1-5 yr and group aged > 5-12 yr, respectively ( P<0.001). Bland-Altman agreement analysis: In group aged > 1-5 yr and group aged > 5-12 yr, the 95% agreement limits were -0.484-0.621 and -0.551-1.015, respectively, and there were 4.6% (23/504) and 5.1% (40/777) of the points outside the 95% agreement limits, respectively, and both limits exceeded the clinically acceptable range. Conclusions:WLI is feasible for monitoring the depth of sedation with propofol in pediatric patients aged > 1-12 yr, but the accuracy is lower than BIS.

Wearable monitoring, which has the advantages of continuous monitoring for a long time with low physiological and psychological load, represents a future development direction of monitoring technology. Based on wearable physiological monitoring technology, combined with Internet of Things (IoT) and artificial intelligence technology, this paper has developed an intelligent monitoring system, including wearable hardware, ward Internet of Things platform, continuous physiological data analysis algorithm and software. We explored the clinical value of continuous physiological data using this system through a lot of clinical practices. And four value points were given, namely, real-time monitoring, disease assessment, prediction and early warning, and rehabilitation training. Depending on the real clinical environment, we explored the mode of applying wearable technology in general ward monitoring, cardiopulmonary rehabilitation, and integrated monitoring inside and outside the hospital. The research results show that this monitoring system can be effectively used for monitoring of patients in hospital, evaluation and training of patients' cardiopulmonary function, and management of patients outside hospital.
Humans ; Artificial Intelligence ; Internet of Things ; Wearable Electronic Devices ; Monitoring, Physiologic/methods* ; Electrocardiography ; Internet

Radiomics can extract high-throughput and quantitative image features from medical images and mine the information related to the pathophysiology of tumors,which can help clinical decision-making and improve the diagnostic and predictive performance.Radiomics has been widely used in the study of prostate cancer (PCa),demonstrating application values in the diagnosis and differential diagnosis,pathology classification,invasion assessment,efficacy prediction,and prognosis analysis of PCa.Here we reviewed the recent research progress of magnetic resonance imaging-based radiomics in PCa.
Humans ; Magnetic Resonance Imaging/methods* ; Male ; Prognosis ; Prostatic Neoplasms/pathology*

Objective::The effectiveness of statins in reducing atherosclerotic calcification remains controversial. The aim of this study was to confirm that simvastatin reduces atherosclerotic calcification and stabilizes plaque by restricting endoplasmic reticulum stress (ERS)-mediated apoptosis.Methods::Twenty-four 8-week-old male apolipoprotein E (ApoE) -/- mice (C57BL/6J genetic background) were selected and randomly divided into model ( n = 12) and simvastatin ( n = 12) groups. Twelve male C57BL/6J mice were selected as control group ( n = 12). The mice were adaptively fed for 2 weeks and were put on a high-fat diet thereafter. After 9 weeks, they were treated with simvastatin (20 mg/kg) or phosphate-buffered saline daily for 8 weeks. Aortic sinus samples were obtained from ApoE -/- and C57BL/6J mice for hematoxylin and eosin, von Kossa, alizarin Red S, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling, and immunohistochemical staining after in vivo treatment with simvastatin. In addition, mouse vascular smooth muscle cells were analyzed after exposure to simvastatin in vitro.Results::Administration of simvastatin in vivo drastically attenuated the atherosclerosis, calcification, and apoptosis, and decreased the serum levels of triglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. The expression levels of glucose-regulated protein, 78 kDa (GRP78), C/EBP homologous protein (CHOP), and caspase 12 (CASP12) in the aortic sinus decreased in the simvastatin group compared with the model group. In vitro, simvastatin or simvastatin plus ERS inhibitor (taurine) attenuated calcification and apoptosis, and reduced the expression of ERS-related proteins GRP78, CHOP, and CASP12. Conclusion::Treatment with simvastatin suppressed atherosclerotic calcification. This effect may be mediated through the inhibition of ERS-related apoptosis.

Objective::The effectiveness of statins in reducing atherosclerotic calcification remains controversial. The aim of this study was to confirm that simvastatin reduces atherosclerotic calcification and stabilizes plaque by restricting endoplasmic reticulum stress (ERS)-mediated apoptosis.Methods::Twenty-four 8-week-old male apolipoprotein E (ApoE) -/- mice (C57BL/6J genetic background) were selected and randomly divided into model ( n = 12) and simvastatin ( n = 12) groups. Twelve male C57BL/6J mice were selected as control group ( n = 12). The mice were adaptively fed for 2 weeks and were put on a high-fat diet thereafter. After 9 weeks, they were treated with simvastatin (20 mg/kg) or phosphate-buffered saline daily for 8 weeks. Aortic sinus samples were obtained from ApoE -/- and C57BL/6J mice for hematoxylin and eosin, von Kossa, alizarin Red S, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling, and immunohistochemical staining after in vivo treatment with simvastatin. In addition, mouse vascular smooth muscle cells were analyzed after exposure to simvastatin in vitro.Results::Administration of simvastatin in vivo drastically attenuated the atherosclerosis, calcification, and apoptosis, and decreased the serum levels of triglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. The expression levels of glucose-regulated protein, 78 kDa (GRP78), C/EBP homologous protein (CHOP), and caspase 12 (CASP12) in the aortic sinus decreased in the simvastatin group compared with the model group. In vitro, simvastatin or simvastatin plus ERS inhibitor (taurine) attenuated calcification and apoptosis, and reduced the expression of ERS-related proteins GRP78, CHOP, and CASP12. Conclusion::Treatment with simvastatin suppressed atherosclerotic calcification. This effect may be mediated through the inhibition of ERS-related apoptosis.

Objective:To evaluate the effect of nalbuphine combined with propofol for esophageal dilation with gastroscope in the pediatric patients.Methods:A total of 150 pediatric patients with esophageal stenosis, aged 6 months-2 yr, weighing 6-15 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective painless balloon dilation with gastroscope under general anesthesia, were randomized into 3 groups ( n=50 each) according to the random number table method: nalbuphine 0.1 mg/kg plus propofol group (N 1P group), nalbuphine 0.2 mg/kg plus propofol group (N 2P group), and fentanyl plus propofol group (FP group). Nalbuphine 0.1 and 0.2 mg/kg and fentanyl 1 μg/kg were intravenously injected in N 1P, N 2P and FP groups, respectively, and 2 min later propofol 1.5-2.0 mg/kg was intravenously injected for sedation until the eyelash reflex disappeared in the three groups.Propofol 1.0 mg/kg was added when body movement occurred during surgery.The amount of propofol consumed during surgery, occurrence of body movement and respiratory depression, occurrence of adverse reactions such as postoperative nausea and vomiting, and laryngospasm, emergence time, Face Legs Activity Cry Consolability (FLACC) pain scale score and surgeons′ satisfaction were recorded. Results:Compared with group N 1P, the consumption of propofol, body movement classification ratio and FLACC score were significantly decreased, and the emergence time was shortened in group N 2P ( P<0.05), and no significant change was found in the parameters mentioned above in group FP ( P>0.05). There was no significant difference in the incidence of perioperative adverse reactions and degree of surgeons′ satisfaction among the three groups ( P>0.05). Conclusion:Nalbuphine combined with propofol can provide satisfactory anesthetic efficacy with fewer adverse reactions when used for esophageal dilation with gastroscope in the pediatric patients.

Objective To study the association between H cy,hs-CRP,IMA and transient ischemic attack (TIA).Methods One hundred and twenty-six TIA patients were divided into low risk group (n=42),moderate risk group (n=43) and high risk group (n=43) according to their AB-CD2 score with 20 healthy subjects undergoing physical examinarion served as control group.Their clinical data were recorded and their serum Hcy,IMA and hs-CRP levels were compared.Results The serum levels of TC,TG,LDL,Hcy,IMA and hs-CRP were significantly higher while those of HDL were significantly lower in low risk group,moderate risk group and high risk group than in control group (P＜0.05),in moderate risk group and high risk group than in low risk group (P＜0.05),and in high risk group than in moderate risk group (P＜0.05).The serumlevels of Hcy,hs-CRP and IMA were positively associated with ABCD2 score in TIA patients (r=0.36,r =0.31,r =0.24,P＜0.05) but not associated with each other (P＞0.05).Multivariate logistic regression analysis showed that hyperlidemia and Hcy were the risk factors for TIA (P＜0.05,P＜0.01).Conclusion Serum Hcy,hs-CRP,IMA levels are positively associated with AB-CD2 score.Hyperlipidemia and Hcy are the risk factor for TIA.Measurement of serum Hcy,hsCRP,IMA levels is beneficial to the assessment of TIA.