ObjectiveTo investigate the effects of Tianma Goutengyin on the tumor necrosis factor-α （TNF-α）/signal transducer and activator of transcription 3 （STAT3）/α1-antichymotrypsin C-terminal tail fragment （α1ACT） signaling pathway and A1-type astrocytes in a rat model of vascular dementia. MethodsSeventy-two male Sprague-Dawley rats were randomly divided into six groups （n=12 per group）： Sham-operated group， model group， Tianma Goutengyin high-， medium-， and low-dose groups （5.13， 10.26， and 20.52 g·kg^-1）， and a nimodipine group （8.1 mg·kg^-1）. The vascular dementia model was established by permanent bilateral common carotid artery occlusion， followed by 4 weeks of intervention. Learning and memory ability were evaluated using the novel object recognition test， and behavioral performance was assessed using the forced swimming test. Levels of interleukin-6 （IL-6） and C-C motif chemokine ligand 2 （CCL2） in hippocampal tissue were measured by enzyme-linked immunosorbent assay （ELISA）. Hippocampal neuronal morphology was observed by Nissl staining， and apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling （TUNEL）. Immunohistochemistry was used to detect positive expression of brain-derived neurotrophic factor （BDNF）， glial fibrillary acidic protein （GFAP）， and myelin basic protein （MBP）. Western blot analysis was performed to measure the protein expression levels of TNF-α， TNF receptor 1 （TNFR1）， phosphorylated STAT3 （p-STAT3）， α1ACT， IL-6， complement component 3 （C3）， BDNF， S100 calcium-binding protein A10 （S100A10）， and GFAP in hippocampal tissue. ResultsCompared with the sham-operated group， the model group showed a significantly reduced relative recognition index in the novel object recognition test （P<0.01）， prolonged immobility time and increased immobility frequency in the forced swimming test （P<0.01）. Hippocampal IL-6 and CCL2 levels were significantly increased （P<0.01）. Nissl staining revealed a marked reduction in neuronal number and loss of Nissl bodies （P<0.01）. MBP-positive expression was significantly decreased （P<0.01）， apoptosis was significantly increased （P<0.01）， BDNF-positive expression was significantly reduced （P<0.05）， and GFAP-positive expression was significantly increased （P<0.01）. In addition， the protein expression levels of TNF-α， TNFR1， p-STAT3， α1ACT， IL-6， and C3 were significantly elevated （P<0.01）， while BDNF and S100A10 expression levels were significantly decreased （P<0.01）. Compared with the model group， all Tianma Gouteng yin dose groups exhibited a significant increase in the relative recognition index （P<0.05）， shortened immobility time and reduced immobility frequency （P<0.05， P<0.01）. IL-6 and CCL2 levels were significantly decreased （P<0.01）， neuronal number was significantly increased （P<0.05， P<0.01）， and MBP-positive expression was significantly enhanced （P<0.01）. Apoptosis was significantly reduced （P<0.01）， BDNF-positive expression was significantly increased （P<0.05）， and GFAP-positive expression was significantly decreased （P<0.01）. Moreover， the protein expression levels of TNF-α， TNFR1， p-STAT3， α1ACT， IL-6， and C3 were significantly decreased （P<0.01）， while BDNF and S100A10 protein expression levels were significantly increased （P<0.01）. ConclusionTianma Goutengyin may inhibit A1-type astrocyte activation in rats with vascular dementia through the TNF-α/STAT3/α1ACT signaling pathway， thereby reducing neuronal apoptosis and improving learning and memory function.

Objective It analyzes the current research status of the"one hospital with multiple campuses"construc-tion in public hospitals in China,focuses on research hotspots and evolution trends,and provides references for the research on"one hospital with multiple campuses"in public hospitals.Methods Using CiteSpace 6.3.R1 software,a visual analysis was conducted on 323 academic journal articles related to"one hospital with multiple campuses"in public hospitals from CNKI from 2014 to 2024.Results Over the past decade,the number of publications in this field has shown an overall upward trend;a core author group has initially formed but the density of the collaboration net-work is low;the institutions with the highest number of publications are mainly healthcare institutions and universi-ties;High-frequency keywords include public hospitals,homogenization,financial management,etc;research hot-spots generally show a trend from foundational construction to system integration,from extensive expansion to re-fined internal management,and from single-factor optimization to technology empowerment and multidimensional integration.Conclusion The research on the"one hospital with multiple campuses"construction of public hospitals in our country is clearly driven by policy,with research efforts distributed in a dual-core structure of"medical institu-tions-universities".However,interdisciplinary collaboration needs to be strengthened.Future research can focus on areas such as healthcare professionals,medical quality,the integration of business and finance systems,and inno-vation in emergency management mechanisms,providing support for the high-quality development of public hospi-tals with"one hospital with multiple campuses".

Objective To explore the development path of"one hospital with multiple campuses"in public hospitals in China,and provide a reference for promoting the healthy and high-level construction of"one hospital with multiple campuses".Methods Based on the SPO theory,an analytical framework for studying the development path of"one hospital with multiple campuses"in public hospitals in China was constructed.Taking 41 tertiary public hospitals in 20 provinces that participated in the performance assessment and carried out the construction of"one hospital with multiple campuses"as the analysis objects,the hospital performance assessment data and the development data of"one hospital with multiple campuses"were collected.Crisp-Set Qualitative Comparative Analysis was used to explore different conditional configurations for the development of"one hospital with multiple campuses"in public hospitals in China,and to reveal the development path of"one hospital with multiple campuses"in public hospitals.Results The high-quality development path of"one hospital with multiple campuses"is the result of the combined action of multiple factors.The management structure path,support and promotion path,quality and safety path,and operation performance pathare the four configurations that promote the high-quality development of"one hospital with multiple campuses"in public hospitals.Among them,quality and safety are the necessary conditions for the high-quality development of"one hospital with multiple campuses".Conclusion There are multiple paths for the high-quality development of"one hospital with multiple campuses"in public hospitals.Hospitals need to select appropriate development strategies according to their own situations,ensure the homogenization of medical quality among different hospital districts,and form a joint force for the development of multiple hospital districts.

Objective:To compare and analyze the perioperative characteristics and the differences in maternal and neonatal outcomes of parturients transferring to Caesarean section with different durations in the second stage of labor.Methods:A total of 109 parturients who underwent natural delivery and transitioned to Caesarean section during the second stage of labor at the General Hospital of Northern War Zone from January 2022 to June 2024 were selected. Among them, 51 parturients with a duration of the second stage of labor <2 h were selected as group A, and 58 parturients with a duration of the second stage of labor ≥2 h were selected as group B. The general data of preoperative maternal and neonatal conditions, surgical indications, maternal surgical status, perioperative complications, neonatal characteristics, and adverse outcomes were compared between the two groups .Normally distributed measurement data were described by xˉ±s, and independent sample t test was used on comparison between groups.Counting data were described by composition ratio or rate, and χ2 test was used on comparison between groups. P<0.05 indicated a statistically significant difference. Results:The incidence of intrapartum fever in group A was 17.6% (9/51), and the type Ⅱ and Ⅲ fetal heart rate monitoring was 43.1% (22/51), which were significantly higher than those in group B [5.2%(3/58),13.8%(8/58)] ( χ2=4.31, 11.71, P=0.038, <0.001).The proportion of fetal distress in the surgical indications of group A was 37.3% (19/51), which was significantly higher than that of group B[8.6%(5/58)]( χ2=12.96, P<0.001). The proportion of fetal head descent arrest and relative cephalo-pelvic disproportion in group A were 13.7% (7/51) and 62.7% (32/51), respectively, which were significantly lower than those in group B[50.0%(29/58),94.8%(55/58)] ( χ2=16.14,17.34, P<0.001).The incidence of puerperal morbidity in group A was 35.3% (18/51), which was significantly higher than that in group B[13.8%(8/58)] ( χ2=6.91, P=0.009).The incidence of neonatal hyperbilirubinemia in group A was 15.7% (8/51), and the proportion of newborns transferred to the neonatal intensive care unit due to neonatal hyperbilirubinemia within 7 days after birth was 11.8% (6/51), which were significantly lower than those in group B[32.8%(19/58),29.3%(17/58)]( χ2=4.24,5.02, P=0.039,0.025). Conclusions:Transferring to Caesarean section within 2 hours of the second stage of labor for natural childbirth parturients increases the risk of puerperal morbidity. At the same time, attention should be paid to the presence or absence of prenatal fever and the monitoring of fetal heart rate should be strengthened in the early stage of the second labor. Transfer cesarean section after 2 hours of the second stage of labor requires enhance monitoring of neonatal bilirubin levels.

Aim To explore the effect of age on myocardial remodeling after percutaneous coronary intervention(PCI)in patients with acute anterior myocardial infarction.Methods This study was a cross-sectional study analyzing clinical data of regular follow-up at 1,3,6 and 12 months after PCI for acute anterior myocardial infarction.According to the age of the patients,they were divided into a low age group(＜65 years old)and a high age group(≥65 years old).The differences in baseline data,biochemical indexes,coronary angiography,inflammatory factor levels,and cardiac ultrasound indexes between the two groups were analyzed,and the correlation analysis between age and inflammatory factors and the multivariate linear regression analysis of diastolic function were performed.Results A to-tal of 87 patients with acute anterior myocardial infarction were selected,aged(62±13)years,including 67 males(77.0％),43 in the low age group and 44 in the high age group.Compared with the low age group,the levels of inflam-matory factors such as C-reactive protein,interleukin-1β(IL-1β),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)increased in the high age group,while ultrasound indicators such as mitral valve annulus septal e',mitral valve flow velocity E/A,and mitral valve annulus sidewall e'decreased(P＜0.05).Older age was an independent risk factor for a decrease in mitral valve flow velocity E/A,mitral valve annulus sidewall e'and mitral valve annulus septal e'in patients with acute anterior myocardial infarction 6 months after PCI(P＜0.05).Conclusion Age is an independent risk factor for reduced diastolic function after PCI in acute anterior myocardial infarction,inflammatory factor such as IL-1β,IL-6 and TNF-α may play a role in the impaired diastolic function after PCI in age-related acute anterior myocardial infarction.

Aim To apply coronary angiography derived index of microcirculatory resistance(caIMR)to evaluate the effect of coronary microcirculation perfusion on myocardial remodeling after interventional therapy in patients with acute anterior ST segment elevation myocardial infarction(STEMI).Methods This was a cross-sectional study.The analysis was performed among the patients who were hospitalized for acute anterior STEMI in the First Department of the Second Affiliated Hospital of Dalian Medical University from January 2021 to July 2022 and received percutaneous coro-nary intervention(PCI)with regtelar follow-up visits.The patients were divided into low caIMR(L-caIMR)group,me-dium caIMR(M-caIMR)group and high caIMR(H-caIMR)group according to the results of caIMR.The results of ech-ocardiography at perioperative period,1 month,3 months,6 months and 1 year were analyzed and compared,including left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),interventricular septum thickness(IVST),mitral orifice flow velocity E/A,mitral annular septum e'and mitral annular wall e',etc.The difference of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and other inflammatory factors in peripheral blood of the three groups were also compared.Results A total of 75 patients diagnosed with acute anterior STEMI were recrui-ted,including 55 males.The L-caIMR group,M-caIMR group,and H-caIMR group had 26,26 and 23 cases,respec-tively.Compared with the L-caIMR group,the LAD and IVST in the M-caIMR group and the H-caIMR group exhibited an increasing tendency one month after PCI,and the increase in the H-caIMR group was more significant than that in the M-caIMR group(P＜0.05).The ejection fraction in the H-caIMR group was notably lower than that in the L-caIMR group and the M-caIMR group at 1 and 3 months after PCI(P＜0.05).Compared with the L-caIMR group,the mitral flow velocity E/A at 6 months after PCI,and the e'at the septal side and the lateral wall of the mitral annulus at 1,3,and 6 months after PCI were significantly reduced in the M-caIMR and H-caIMR groups(P＜0.05).Compared with the L-caIMR group,the levels of IL-1β,IL-6,and TNF-α showed an increasing trend in the M-caIMR group and the H-caIMR group,and the increase was greater in the H-caIMR group than that in the M-caIMR group(P＜0.05).Multivariate anal-ysis revealed that caIMR was a factor influencing the levels of IL-1 β and IL-6(P＜0.05).Conclusion CMD may be involved in the process of myocardial remodeling in patients with acute anterior STEMI after PCI,in which inflammation plays a role.

Objective:Based on HyperArc stereotactic radiotherapy(SRT)technique,six-dimensional free bed combined with double mask fixation was used to treat intracranial tumors,and the positioning errors of within batch and between batches were analyzed,so as to provide basis for the accuracy of clinical treatment of this technique.Methods:A total of 13 patients with intracranial tumors who admitted to Peking Union Medical College Hospital from March to July 2023 were retrospectively selected,and they were treated by using HyperArc SRT technique.The validation images of cone-beam computed tomography(CBCT)of within batch and between batches during treatment were analyzed.The positioning errors of three translational direction[left and right(x),head and foot(y)and abdominal and dorsal(z)]and rotational direction were analyzed.The each positioning error was set as group A,and the remaining error after the positioning error was corrected through six-dimensional free bed was set as group B,and the error post treatment was set as group C.The difference between group B and group C was defined as the change of within batch.According to the margin formula,the positioning error of within batch was used to calculate the required range of margin.Results:Under the mode of six-dimensional free bed correction combined with double mask fixation,a total of 59 times of HyperArc SRT on head were performed.In the comparison of the average errors on the six-dimensional direction among groups A,B and C,the errors of group A on x direction and y direction were respectively(0.119±0.039)and(-0.133±0.047)cm,and the differences of them between group A and group B[(0.004±0.002)and(0.018±0.005)cm]were significant(t=2.890,-3.224,P<0.05).There were no significant differences on other directions between the two groups(P>0.05).The error of RX direction of group B was(0.033±0.021)°,and the difference of that between group B and group C[(0.122±0.045)°]was significant(t=-2.306,P<0.05),while there were no significant differences on other directions(P>0.05).In the margin of the design of the plan of intracranial tumors,the x,y and z directions were respectively 0.6,0.9 and 0.4 mm.Conclusion:In the radiotherapy of using HyperArc SRT technique for intracranial tumors,the use of six-dimensional free bed combined with double mask treatment can significantly shorten the margin,and ensure accurate irradiation for gross tumor volume(GTV)and simultaneously reduce the irradiation volume and dose of surrounding normal tissue.

Aim To investigate the effect of high-fat diet on the tight junction function injury of Sertoli cells through the NF-κB/NLRP3 signaling pathway in mice and to explore the underlying mechanism.Methods Male C57BL/6J mice were fed with high-fat or normal diet for five months.The body and gonadal organ weight of mice were measured,and their indices were calculated.The sperm concentration,the sperm viabili-ty,the testicular histomorphology and the expression levels of tight junction proteins ZO-1,Occludin and Claudin-11 were measured.TM4 cells were treated with palmitic acid(PA)for 24 h.Cell viability was detected by CCK-8 method.Then,TM4 cells were di-vided into different groups treated with PA(0,50,100,200 and 300 μmnol·L-1),and the expression lev-els of tight junction proteins ZO-1,Occludin and Clau-din-11 were detected by Western blot.The tight junc-tion permeability of TM4 cells were detected by transepithelial electrical resistance(TEER)and FITC-dextran.The expression levels of mRNA and proteins for the NF-κB/NLRP3 pathway-related factors were de-tected by RT-qPCR and Western blot.Results The results from animal experiments showed that high-fat diet increased body weight and seminal vesicle weight of mice,and decreased testicular index,epididymal in-dex,sperm concentration and sperm motility of mice.High-fat diet also caused testicular tissue structure damage and down-regulated the expression levels of tight junction proteins ZO-1 and Occludin,without af-fecting the expression of Claudin-11.In vitro,PA sig-nificantly down-regulated the expression levels of ZO-1,Occludin and Claudin-11 in TM4 cells,increased the cell permeability,as well as up-regulated the mRNA and protein expression levels of NLRP3/NF-κB signa-ling pathway-related factors in TM4 cells.Conclusions High-fat diet can impair the function of tight junction of testicualr Sertoli cells,and the machanism may be related to the activation of the NF-κB/NLRP3 signaling pathway,resulting in Sertoli cell inflammation in mice.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

OBJECTIVE: Recombination events are common and serve as the primary driving force of diverse human adenovirus (HAdV), particularly in children with acute respiratory tract infections (ARIs). Therefore, continual monitoring of these events is essential for effective viral surveillance and control. METHODS: Respiratory specimens were collected from children with ARIs between January 2022 and December 2023. The penton base, hexon, and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type. In cases with inconsistent typing results, genes were cloned into the pGEM-T vector to detect recombination events. Metagenomic next-generation sequencing (mNGS) was performed to characterize the recombinant HAdV genomes. RESULTS: Among 6,771 specimens, 277 (4.09%, 277/6,771) were positvie for HAdV, of which 157 (56.68%, 157/277) were successfully typed, with HAdV-B3 being the dominant type (91.08%, 143/157), and 14 (5.05%, 14/277) exhibited inconsistent typing results, six of which belonged to species B. The penton base genes of these six specimens were classified as HAdV-B7, whereas their hexon and fiber genes were classified as HAdV-B3, resulting in a recombinant genotype designated P7H3F3, which closely resembled HAdV-B114. Additionally, a partial gene encoding L1 52/55 kD was identified, which originated from HAdV-B16. CONCLUSION A novel recombinant, P7H3F3, was identified, containing sequences derived from HAdV-B3 and HAdV-B7, which is similar to HAdV-B114, along with additional sequences from HAdV-B16.
Humans ; Adenoviruses, Human/isolation & purification* ; Respiratory Tract Infections/epidemiology* ; Child, Preschool ; Child ; Recombination, Genetic ; Male ; Beijing/epidemiology* ; Infant ; Female ; Phylogeny ; Adenovirus Infections, Human/epidemiology* ; Acute Disease ; Genome, Viral