Objective:To establish reference ranges for left and right ventricular structure and function parameters using cardiovascular magnetic resonance (CMR) in healthy Tibetan natives residing at ultra-high altitudes, and analyze their influencing factors.Methods:This prospective study enrolled Tibetan healthy volunteers who underwent CMR examinations between September 2021 and August 2022. Participants were stratified into four age groups: 20-29, 30-39, 40-49, and 50-59 years. CMR-derived parameters included left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), left/right ventricular end-diastolic volumes (LVEDV/RVEDV), left/right ventricular end-systolic volumes (LVESV/RVESV), and end-diastolic left ventricular mass (LVM at ED). Normally distributed data were compared between genders using independent samples t-test and among age groups using ANOVA. Non-normally distributed data were analyzed with Kruskal-Wallis test. Linear regression assessed relationships between parameters and gender, age, residential altitude, body surface area (BSA), and body mass index (BMI). Results:The study included 66 volunteers (27 males, 39 females), distributed as follows: 21 (20-29 years), 15 (30-39 years), 15 (40-49 years), and 15 (50-59 years). Reference values were: LVEF (62.6±5.7)%, RVEF (55.0±7.1)%, BSA-indexed LVEDV (60.6±12.1)ml/m2, RVEDV (65.5±14.8)ml/m2, LVESV (22.7±5.9)ml/m2, RVESV (29.6±8.1)ml/m2, and LVM at ED (39.1±8.0)g/m2. Gender and age significantly affected RVEF, RVESV, and LVM at ED ( P<0.05). Multivariate regression revealed:Gender independently predicted RVEF ( β=-5.556, P=0.003), RVESV ( β=5.421, P=0.007), and LVM at ED ( β=8.338, P<0.001). Age negatively influenced RVESV ( β=-0.202, P=0.019). BSA positively correlated with LVM at ED ( β=19.980, P=0.041). No significant associations were found with residential altitude or BMI ( P>0.05). Conclusion:This study establishes preliminary reference ranges for ventricular parameters in Tibetan ultra-high altitude natives, with gender, age, and BSA identified as key determinants of cardiac structural/functional indices.

Objective:To establish reference ranges for left and right ventricular structure and function parameters using cardiovascular magnetic resonance (CMR) in healthy Tibetan natives residing at ultra-high altitudes, and analyze their influencing factors.Methods:This prospective study enrolled Tibetan healthy volunteers who underwent CMR examinations between September 2021 and August 2022. Participants were stratified into four age groups: 20-29, 30-39, 40-49, and 50-59 years. CMR-derived parameters included left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), left/right ventricular end-diastolic volumes (LVEDV/RVEDV), left/right ventricular end-systolic volumes (LVESV/RVESV), and end-diastolic left ventricular mass (LVM at ED). Normally distributed data were compared between genders using independent samples t-test and among age groups using ANOVA. Non-normally distributed data were analyzed with Kruskal-Wallis test. Linear regression assessed relationships between parameters and gender, age, residential altitude, body surface area (BSA), and body mass index (BMI). Results:The study included 66 volunteers (27 males, 39 females), distributed as follows: 21 (20-29 years), 15 (30-39 years), 15 (40-49 years), and 15 (50-59 years). Reference values were: LVEF (62.6±5.7)%, RVEF (55.0±7.1)%, BSA-indexed LVEDV (60.6±12.1)ml/m2, RVEDV (65.5±14.8)ml/m2, LVESV (22.7±5.9)ml/m2, RVESV (29.6±8.1)ml/m2, and LVM at ED (39.1±8.0)g/m2. Gender and age significantly affected RVEF, RVESV, and LVM at ED ( P<0.05). Multivariate regression revealed:Gender independently predicted RVEF ( β=-5.556, P=0.003), RVESV ( β=5.421, P=0.007), and LVM at ED ( β=8.338, P<0.001). Age negatively influenced RVESV ( β=-0.202, P=0.019). BSA positively correlated with LVM at ED ( β=19.980, P=0.041). No significant associations were found with residential altitude or BMI ( P>0.05). Conclusion:This study establishes preliminary reference ranges for ventricular parameters in Tibetan ultra-high altitude natives, with gender, age, and BSA identified as key determinants of cardiac structural/functional indices.

Objective:To construct a hypoglycemia random forest prediction model for older adults with type 2 diabetes, and assess the model′s prognostication performance through internal and external verification.Methods:From August 2022 to January 2023, 300 older adults with type 2 diabetes in Beijing Hospital were selected. The demographic characteristics, medical history, laboratory tests, and other data of the patients were collected, and the data set was randomly divided into the training set and verification set in a ratio of 7∶3. The hypoglycemia prediction model for older adults with type 2 diabetes was constructed and optimized based on the random forest algorithm. The calibration curve was used to evaluate the model′s calibration, and the ROC was used to evaluate the model′s discrimination. The clinical applicability of the model was assessed by the decision curve analysis. The risk factors for hypoglycemia in the older adults were explored by prioritizing the contributions of variables in prediction. The Bootstrap method was used for internal validation, and the validation set was used for external validation.Results:Among the 300 older adults with type 2 diabetes, 128 cases (42.67%) experienced hypoglycemia within one week. The predictive contributions of risk factors in the model were ranked as follows: the number of episodes of hypoglycemia in one month, HDL-C, heart disease, diabetes knowledge and education, combination therapy, age, duration of diabetes, staple food restriction, glycosylated hemoglobin, and gender. The internal and external calibration curves of the hypoglycemia random forest model for the older adults with type 2 diabetes fluctuated around the diagonal, indicating that the calibration degree of the predictive model is good. The AUROC of internal verification was 0.823 (95% CI 0.752-0.894), the sensitivity and specificity were 0.867 and 0.698, respectively. The external verification was 0.859 (95% CI 0.817 - 0.902), and sensitivity and specificity were 0.789 and 0.804, respectively, showing that the overall discrimination of the prediction model was good. The DCA curves were far from the all-positive line and all-negative line, which indicated that the prediction model had good clinical applicability. Conclusions:The predictive effect of this model is good, and it is suitable for predicting the risk of hypoglycemia in older adults with type 2 diabetes, and it provides a reference for early hypoglycemia screening and predictive intervention for this kind of patients.

Objective To investigate the effects of lentivirus-mediated RNA interference (RNAi) targeting DNA binding protein A (dbpA) on the proliferation and the biological behavior of colorectal cancer cell line SW620.Methods The experiment was divided into 3 groups:KD group (siRNA-dbpA,lentivirus interference group),CON group (non-specific sequence group) and NC group (blank control group).The lentiviral vector siRNA-dbpA was constructed and verified by PCR and DNA sequencing.SW620 cells were transfected with siRNA-dbpA plasmid,nontargeting siRNA plasmid,or empty plasmid.After 48 h the transfection,the cells were examined for dbpA expression using Western blot.After 72 hrs transfection,flow cytometry was used to detect the cell apoptosis and cell cycle changes.The cell growth inhibition rate was detected by MTT (4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide) assay,and then clone formation was detected,and the ability of SW620 cells to form tumors in vivo after dbpA was silenced was studied in nude mice.Results PCR analysis and DNA sequencing demonstrated that the RNAi sequence targeting dbpA gene was successfully inserted into the lentiviral vector.siRNA-dbpA transfection resulted in reduced expression of dbpA in SW620 cells.After transfection,the apoptosis rate of siRNA-dbpA-transfected cells increased to 26.60％ ± 0.38％,significantly higher than that in cells transfected with the nontargeting plasmid or the empty plasmid 12.54％ ± 0.25％ and 4.46％ ± 0.19％,respectively (F =28.159,P ＜0.01).The growth inhibition test indicate that the OD value of the fifth day in siRNA-dbpA group was 0.194 ±0.037,significantly lower than that in the other two groups 0.814 ±0.043 and 1.625 ±0.061,respectively(F =23.214,P ＜ 0.01).The colony formation number is 37 ± 3,64 ± 5and 175 ± 10 respectively,siRNA-dbpA is significantly higher than that in the other two groups(F =40.254,P ＜ 0.01).After the completion of nude mouse transplantation tumor model,through the detection of tumor volume,KD group (group siRNA-dbpA) tumor volume after 14 d and CON and NC group had obvious difference (F =38.256,P ＜ 0.05),and after 21d is more significant difference in tumor size (F =40.241,P ＜ 0.01),can be clearly observed after 35 d KD group (group siRNA-dbpA) growing tumors had differences with the control group (F =30.257,P ＜ 0.05).Conclusion Lentivirus-mediated RNAi targeting dbpA can effectively suppress the expression of dbpA in colorectal tumor in nude mice,it is proved that dbpA silencing has a significant inhibitory effect on the growth of living tumor cells and decrease the proliferation of the colorectal cells.

[Objective]To summarize the clinical experience of Professor FAN Binghua in treating sacroiliac joint dysfunction. [Method] From following Professor FAN Binghua's clinical and studying experienced cases ,summarizing the academic viewpoints and methods of Professor FAN Binghua in treating sacroiliac joint dysfunction, and with one classical case for experiencing details and methods when Professor FAN Binghua cures sacroiliac joint dysfunction. [Result]Based on theory of relationship between symptoms and etiology, Professor FAN comes up with concept of where there is symptom, there is reason and curing etiology should be put forward,starting with clinical symptoms to cure sacroiliac joint dysfunction, applying examinations of specialty to find out the internal close relationship between symptom and etiology and eliminate the similar disease, then curing the etiology in right way.[Conclusion]Pro.FAN has flexible thoughts, clear pertinence, and strong practicality, and histhree principls in cliniccan be guidence in clinic, and it is worth drawing reference and learning.

The development of behavioral medicine is a new and efficient way to improve the level of national health and the behavior intervention is the core content.There are three methods including story-tellingmethod,behavior-image method and patient-centered assessment and counseling for exercise and nutri-tion intervention(PACE)which have been proven to be effective.The psychological theory of homophily,self-regulation and problem solving provide a scientific explanation for the effectiveness of these three kinds of be-havior intervention.Ripple effect amplifies the effect of behavioral intervention and its psychological mecha-nism is self-determinism and self-regulation theory.In the future,the research of behavior intervention and its psychological mechanism needs to make new breakthroughs in aspects of theory,method and technology.

OBJECTIVESTo investigate the regression pattern of mid and low rectal cancer treated with neoadjuvant chemoradiotherapy and then to provide the pathological proofs for reasonable resectional margin in rectal cancer surgery.

METHODSForty cases of mid and low rectal cancer patients received concurrent chemoradiotherapy and then underwent radical operation. The whole-mount serial sections of resected rectal cancer specimen were stained with cytokeratin antibody using immunohistochemical techniques to show the residual cancer cells under the mucosa. The microscopic measurement was performed to determine the reverse infiltration of cancer cells in the rectal wall and to describe the cancer cells scatter ways in the cancer mass. The Ki-67 immunohistochemical stain was also performed to show the proliferation activity of residual cancer cells after neoadjuvant chemoradiotherapy.

RESULTSThe length of specimen was shrinking continuously during the pathologic section production and the shrink rate was 18%. There were remanent cancer cells which showed positive Ki-67 expression and the chemoradiotherapy decreased the Ki-67 expression significantly. The lower edge of remaining ulcers or scars could be used as the reference point from which the cancer infiltration could be measured. According to our measurement, the average reverse infiltration of cancer cells in the whole-mount section was (6.1±4.7) mm, the deepest one was 11.0 mm in the section which could be converted into fresh bowel length of 12.98 mm. The pathology showed that the residual cancer cells scattered in the fibrous tissue of ulcers, scars and manifested a regression of spatial distribution.

CONCLUSIONSThe rectal cancers show regression in different degrees after neoadjuvant chemoradiotherapy. The residual cancer cells in the fiber tissues manifest proliferation activity. The distal end of resection should be at least 2 cm away from the lower edge of ulcers or scars of primary tumor in the rectal wall in patients after neoadjuvant chemoradiotherapy. The circumferential resection margin should include all the fibrous scar of the tumor area to ensure the remove of tumor cells completely.

Aged ; Chemoradiotherapy ; Female ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Rectal Neoplasms ; pathology ; surgery ; therapy

Objectives To investigate the regression pattern of mid and low rectal cancer treated with neoadjuvant chemoradiotherapy and then to provide the pathological proofs for reasonable resectional margin in rectal cancer surgery. Methods Forty cases of mid and low rectal cancer patients received concurrent chemoradiotherapy and then underwent radical operation. The whole-mount serial sections of resected rectal cancer specimen were stained with cytokeratin antibody using immunohistochemical techniques to show the reridual cancer cells under the mucosa. The microscopic measurement was performed to determine the reverse infiltration of cancer cells in the rectal wall and to describe the cancer cells scatter ways in the cancer mass. The Ki-67 immunohistochemical stain was also performed to show the proliferation activity of residual cancer cells after neoadjuvant chemoradiotherapy. Results The length of specimen was shrinking continuously during the pathologic section production and the shrink rate was 18%. There were remanent cancer cells which showed positive Ki-67 expression and the chemoradiotherapy decreased the Ki-67 expression significantly. The lower edge of remaining ulcers or scars could be used as the reference point from which the cancer infiltration could be measured. According to our measurement, the average reverse infiltration of cancer cells in the whole-mount section was (6.1±4.7) mm, the deepest one was 11.0 mm in the section which could be converted into fresh bowel length of 12.98 mm. The pathology showed that the residul cancer cells scattered in the fibrous tissue of ulcers, scars and manifested a regression of spatial distribution. Conclusions The rectal cancers show regression in different degrees after neoadjuvant chemoradiotherapy. The residual cancer cells in the fiber tissues manifest proliferation activity. The distal end of resection should be at least 2 cm away from the lower edge of ulcers or scars of primary tumor in the rectal wall in patients after neoadjuvant chemoradiotherapy. The circumferential resection margin should include all the fibrous scar of the tumor area to ensure the remove of tumor cells completely.

Objectives To investigate the regression pattern of mid and low rectal cancer treated with neoadjuvant chemoradiotherapy and then to provide the pathological proofs for reasonable resectional margin in rectal cancer surgery. Methods Forty cases of mid and low rectal cancer patients received concurrent chemoradiotherapy and then underwent radical operation. The whole-mount serial sections of resected rectal cancer specimen were stained with cytokeratin antibody using immunohistochemical techniques to show the reridual cancer cells under the mucosa. The microscopic measurement was performed to determine the reverse infiltration of cancer cells in the rectal wall and to describe the cancer cells scatter ways in the cancer mass. The Ki-67 immunohistochemical stain was also performed to show the proliferation activity of residual cancer cells after neoadjuvant chemoradiotherapy. Results The length of specimen was shrinking continuously during the pathologic section production and the shrink rate was 18%. There were remanent cancer cells which showed positive Ki-67 expression and the chemoradiotherapy decreased the Ki-67 expression significantly. The lower edge of remaining ulcers or scars could be used as the reference point from which the cancer infiltration could be measured. According to our measurement, the average reverse infiltration of cancer cells in the whole-mount section was (6.1±4.7) mm, the deepest one was 11.0 mm in the section which could be converted into fresh bowel length of 12.98 mm. The pathology showed that the residul cancer cells scattered in the fibrous tissue of ulcers, scars and manifested a regression of spatial distribution. Conclusions The rectal cancers show regression in different degrees after neoadjuvant chemoradiotherapy. The residual cancer cells in the fiber tissues manifest proliferation activity. The distal end of resection should be at least 2 cm away from the lower edge of ulcers or scars of primary tumor in the rectal wall in patients after neoadjuvant chemoradiotherapy. The circumferential resection margin should include all the fibrous scar of the tumor area to ensure the remove of tumor cells completely.