ObjectiveTo examine the influences of Shenfu injection on the endogenous metabolic byproducts in the myocardium of the rat model exhibiting chronic heart failure， thus deciphering the therapeutic mechanism of the Qi-reinforcing and Yang-warming method. MethodsSD rats were randomly allocated into a control group and a modeling group. Chronic heart failure with heart-Yang deficiency syndrome in rats was modeled by multi-point subcutaneous injection of isoproterenol， and the rats were fed for 14 days after modeling. The successfully modeled rats were randomized into model， Shenfu injection （6.0 mL·kg^-1）， and trimetazidine （10 mg·kg^-1） groups and treated with corresponding agents for 15 days. The control group and the model group were injected with equal doses of normal saline， and the samples were collected after the intervention was completed. Cardiac color ultrasound was performed. Hematoxylin-eosin （HE） staining was used to observe histopathological morphology， and the serum level of N-terminal pro-brain natriuretic peptide （NT-proBNP） was assessed by enzyme-linked immunosorbent assay （ELISA）. The mitochondrial morphological and structural changes of cardiomyocytes were observed by transmission electron microscopy， and the metabolic profiling was carried out by ultra high performance liquid chromatography-quantitative exactive-mass spectrometry （UHPLC-QE-MS）. Differential metabolites were screened and identified by orthogonal partial least squares-discriminant analysis （OPLS-DA） and other methods， and then the MetaboAnalyst database was used for further screening. The relevant biological pathways were obtained through pathway enrichment analysis. The receiver operating characteristic （ROC） curve was established to evaluate the diagnostic value of each potential biomarker for myocardial injury and the evaluation value for drug efficacy. ResultsThe results of color ultrasound showed that Shenfu Injection improved the cardiac function indexes of model rats （P<0.05）. The results of HE staining showed that Shenfu injection effectively alleviated the pathological phenomena such as myocardial tissue structure disorder and inflammatory cell infiltration in model rats. The results of ELISA showed that Shenfu injection effectively regulated the serum NT-proBNP level in the model rats. Transmission electron microscopy （TEM） showed that Shenfu injection effectively restored the mitochondrial morphological structure. The results of metabolomics showed that the metabolic phenotypes of myocardial samples presented markedly differences between groups. Nine differential metabolites could be significantly reversed in the Shenfu injection group， involving three metabolic pathways： pyruvate metabolism， histidine metabolism， and citric acid cycle （TCA cycle）. The results of ROC analysis showed that the area under the curve （AUC） values of all metabolites were between 0.75 and 1.0， indicating that the differential metabolites had high diagnostic accuracy for myocardial injury， and the changes in their expression levels could be used as potential markers for efficacy evaluation. ConclusionShenfu injection significantly alleviated the damage of cardiac function， myocardium， and mitochondrial structure in the rat model of chronic heart failure with heart-Yang deficiency syndrome by ameliorating energy metabolism remodeling. Reinforcing Qi and warming Yang is a key method for treating chronic heart failure with heart-Yang deficiency syndrome.

Objective To investigate the association between single nucleotide polymorphisms (SNPs) in the nicotinamide adenine dinucleotide phosphate-oxidase (NOX) 2 and NOX4 genes and susceptibility to noise-induced hearing loss (NIHL). Methods A total of 439 noise-exposed workers were recruited using a convenience sampling method. Based on pure-tone air conduction hearing threshold tests, participants were categorized into normal hearing, mild hearing loss, and moderate hearing loss groups, with 147, 154, 138 individuals, respectively. Peripheral venous blood samples of the workers were collected for DNA extraction. Genotyping of nine SNPs loci in NOX2 and NOX4 genes was performed using multiplex polymerase chain reaction, single-base extension, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Results A total of seven of the nine SNPs loci conformed to Hardy-Weinberg equilibrium among the workers in the normal hearing group (all P>0.05). There was no significant difference in the genotype distribution or allele frequencies for these seven SNPs loci among workers in these three groups (all P>0.05). Ordinal logistic regression analysis showed that, after adjusting for confounders including age, sex, cumulative noise exposure, smoking, alcohol consumption, and earplug use, individuals carrying the GG genotype at rs200522762 had a lower risk of NIHL compared with those carrying the TT genotype under the codominant model (P<0.05). In the recessive model, individuals carrying the GG genotype at the rs200522762 locus had a lower risk than those carrying the GT+TT genotypes (P<0.05). Polymorphisms at the other six SNPs loci were not associated with NIHL risk (all P>0.05). Conclusion The NOX4 rs200522762 polymorphism is associated with susceptibility to NIHL.

Primary liver cancer is one of the most common causes of cancer-related deaths in China,with hepatocellular carcinoma(HCC)accounting for 75%-85%.Approximately 70%of HCC patients are in the advanced stage at the time of diagnosis and miss the opportunity for radical surgery,leading to a poor prognosis.Yttrium-90 microsphere selective internal radiation therapy(90Y-SIRT),an emerging therapeutic modality,delivers radioactive microspheres via the hepatic artery to target tumors and uses beta radiation for localized tumor ablation.Compared to conventional transarterial chemoembolization and pharmacotherapy,90Y-SIRT shows the advan-tages of significant clinical benefits,good safety profiles,and broad applicability across diverse patient populations.This article re-views the advances in the application of 90Y-SIRT in HCC treatment.

γ-Aminobutyric acid(GABA),a pivotal inhibitory neurotransmitter in the central nervous system,plays an essential role in maintaining normal ocular physiological functions.GABA and its receptors are widely distributed through-out the retina,optic nerve,and visual pathways.Research indicates that GABA dysregulation is implicated in the pathogen-esis and progression of certain ophthalmic disorders.This article provides a comprehensive exploration of the relationship between GABA and ophthalmic diseases,including myopia,amblyopia,glaucoma,and dry eye syndrome.Moreover,the potential mechanisms and recent research advances are discussed.The findings may offer novel options and chances for the diagnosis and treatment of ophthalmic diseases.

Objective To investigate the current status of acceptance of disability(AOD)among young and middle-aged spinal cord injury patients and analyze the factors influencing it,in order to provide a basis for nursing managers to develop targeted interventions.Methods From February to July 2024,a convenience sample of 330 young and middle-aged spinal cord injury patients who were hospitalized in 3 tertiary-level hospitals in Henan Province was selected.The survey was conducted using a general information questionnaire,the Brief Adaptation to Disability Scale-Revised,Perceived Social Support Scale,Connor-Davidson Resilience Scale-10 item,Brief Illness Perception Questionnaire,Medical Coping Modes Questionnaire.Results A total of 322 patients were included in the final analysis,yielding a valid response rate of 97.58％.The AOD score for young and middle-aged spinal cord injury patients was(25.99±6.68).Multiple linear regression analysis revealed that gender,education level,type of paralysis,injury duration,pain intensity,social support,psychological resilience,disease perception,and coping styles(confrontation and submission)were influencing factors of AOD(P＜0.05).Conclusion AOD among young and middle-aged spinal cord injury patients is at a moderate level.Healthcare professionals should pay particular attention to male patients,those with low literacy,quadriplegia,shorter injury durations,high pain intensity,low social support,weak psychological resilience,strong disease perception,and yielding coping styles.Timely interventions are recommended to enhance AOD,strengthen rehabilitation outcomes,and improve prognosis.

Perimenopausal anxiety and depression state fall under the categories of"visceral agitation"and"perimenopausal syndrome"in traditional Chinese medicine(TCM).Grounded in the theory of"Yang transforms qi,yin shapes form",this study posits that the pathogenesis of this condition is complex,often presenting with concurrent deficiency and excess syndromes,and is closely associated with yang deficiency-induced stagnation and qi stagnation leading to mental decline.The pathological mechanism is summarized as yang deficiency being the root and qi stagnation the manifestation.This article proposes a"yang-oriented treatment"approach for perimenopausal anxiety-depression disorders,employing a stepwise integrated acupuncture protocol termed"One Needling,Two Moxibustion,Three Consolidation":"One Needling"prioritizes regulating qi flow via acupuncture to soothe the liver and harmonize the spirit;"Two Moxibustion"utilizes refined moxibustion to warm yang,resolve stagnation,and activate yang circulation;"Three Consolidation"combines bloodletting therapy to remove stasis and regenerate tissues with intradermal needle embedding to stimulate yang and regulate visceral functions.This synergistic protocol aims to nourish the heart-mind,awaken the orifices of consciousness,alleviate perimenopausal anxiety and depressive symptoms,and consolidate therapeutic efficacy.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder and its symptoms are subject to the composition of the gut microbiota. However, it is not yet clear how probiotics relieve IBS, and there is no well-acknowledged standards concerning the clinical application of probiotics. This systematic review was conducted on the literature published from January 2020 to December 2023 and included 12 randomized controlled trials on probiotics in the treatment of IBS. Compared with placebo, the probiotic preparations improved the overall efficacy in IBS patients and was also well tolerated, suggesting the potential of probiotics in IBS management. Nevertheless, different probiotic strains, dosages, combinations, and dosing schedules may affect the outcomes. In the future, large-scale, multi-center, long-term follow-up studies are still needed to clarify the effective strains and methods of use and to promote the use of probiotics in the treatment of IBS.

Objective:To explore the relationship between the dark triad, fear of missing out and smartphone addiction, as well as the mediating role of fear of missing out between the dark triad and smartphone addiction.Methods:A total of 408 college students were assessed using dirty dozen, fear of missing out scale, and mobile phone addiction index. SPSS 24.0 software was used for common method bias tests, descriptive statistical analysis, and correlation analysis. Mplus 8.3 software was employed to construct a structural equation model, and the Bootstrap method was used for mediation effect analysis.Results:The dark triad (36.14±9.06) was positively correlated with fear of missing out (22.55±6.60) and smartphone addiction (46.77±13.62) ( r=0.48, 0.45, both P<0.01). Fear of missing out was also positively correlated with smartphone addiction ( r=0.54, P<0.01). Fear of missing out played a partial mediating role in the relationship between the dark triad and smartphone addiction, with a total effect value of 0.495 and a mediating effect value of 0.217. Conclusion:Fear of missing out partially mediates the relationship between the dark triad and smartphone addiction. The dark triad not only directly predicts smartphone addiction but also indirectly influences smartphone addiction through fear of missing out.

Objective:To explore the effect of vitamin D supplement on chronic musculoskeletal pain (CMP) in patients with ankylosing spondylitis (AS) through a cohort study and provide evidence for optimizing vitamin D supplement strategies in AS management.Methods:Based on the large-scale prospective cohort of the UK Biobank, a total of 1 497 middle-aged and older patients diagnosed with AS were included. Patients were categorized into three groups according to their baseline vitamin supplements usage: non-vitamin supplement group ( n=978), vitamin D supplement group ( n=65), and other vitamin supplements group ( n=454). The occurrence of CMP was obtained by baseline pain survey and follow-up data from 2019—2020 and 2022—2023. A generalized linear mixed model (GLMM) was used to analyze the association between vitamin D supplement and CMP occurrence, with odds ratio ( OR) and its 95% confidence intervals ( CI) calculated. To verify robustness of the study findings, propensity score matching was employed to match participants in the vitamin D supplementation group with those in the non-vitamin supplement group and the other vitamin supplements group for sensitivity analysis. Results:After adjusting for confounding factors such as demographic characteristics, lifestyle, and co-morbidities, GLMM analysis did not find significant association between vitamin D supplement and the risk of CMP occurrence in AS patients [ OR(95% CI)=0.85(0.48, 1.48), P=0.555]. However, GLMM analysis indicated that male AS patients had a lower likelihood of developing CMP compared to female patients [ OR(95% CI)=0.69(0.56, 0.86), P<0.001]. Additionally, current smoking [ OR(95% CI)=1.46(1.06, 2.03), P=0.022] and poorer overall health status-categorized as general [ OR(95% CI)=2.32(1.85, 2.90)] or poor [ OR(95% CI)=2.31(1.68, 3.18), P<0.001] were associated with an increased risk of CMP occurrence. In the sensitivity analysis, no significant association was observed between vitamin D supplement and CMP. Conclusion:Vitamin D supplement does not reduce the risk of CMP occurrence in middle-aged and old AS patients. However, female, smoking, and poor overall health status are identified as risk factors for CMP in AS patients. Future research should focus on large-scale real-world studies, particularly in younger AS populations, to further investigate the relationship between vitamin D supplement and CMP, thereby providing more targeted intervention strategies.

Objective:To analyze the association of sedentary time and physical activity with the risk of developing chronic obstructive pulmonary disease (COPD) in non-smoking women aged 40 years and above in Songjiang District, Shanghai.Methods:Based on a natural population-based cohort in Songjiang, a total of 18 707 non-smoking women who were aged 40 years and above and without COPD at baseline survey were enrolled in the study. Cox proportional risk regression model was used to analyze the associations of the duration of sedentary behavior, physical activity with the risk for COPD at baseline survey, and the hazard ratio ( HR) of risk for COPD and its 95% CI were calculated. Stratified analyses were performed based on age, BMI, history of respiratory diseases and so on. Sensitivity analyses were conducted by excluding the cases diagnosed with COPD within one year after the baseline survey. Results:As of March 31, 2024, a total of 691 new COPD cases had been recorded after a median follow-up time of 6.96 years with an incidence density of 53.22 per 10 000 person-years. After adjusting for relevant confounders, in the tertile subgroups of sedentary time, the risk for COPD reduced by 17% in the short sedentary time group compared with the long sedentary time group ( HR=0.83,95% CI:0.70-0.99). Compared with the low physical activity level and long sedentary time group, the risk for COPD reduced by 24% in the high physical activity level and short sedentary time group ( HR=0.76, 95% CI: 0.61-0.95) and by 23% in the low physical activity level and short sedentary time group ( HR=0.77, 95% CI: 0.60-0.97). Compared with the non-physical exercise and long sedentary time group, the risk for COPD reduced by 28% in the non-physical exercise and short sedentary time group ( HR=0.72, 95% CI: 0.60-0.87). These associations remained when the cases diagnosed with COPD within one year of the baseline survey were excluded. Conclusions:Increasing physical activity and reducing sedentary time have beneficial effects to prevent COPD in non-smoking women, and reducing sedentary time alone may also reduce the risk for COPD if increasing physical exercise or other physical activity is not possible.