OBJECTIVE To explore the potential mechanism by which drug-containing serum of Dianxianqing granules （DXQ） inhibits microglial ferroptosis. METHODS Male SD rats were given normal saline and Dianxianqing granules solution via intragastric administration to prepare normal serum and DXQ， respectively. Mice microglia BV2 cells were collected and successfully transfected with a negative control small interfering RNA （si-NC）， and then they were included in the si-NC group and cultured under normal conditions. Cells successfully transfected with small interfering RNA targeting glutathione peroxidase 4 （GPX4） （si-GPX4） were divided into the si-GPX4 group， the CsA group （treated with 1 μmol/L cyclosporine A）， and the DXQ- L， DXQ-M and DXQ-H groups （treated with 5%， 7% and 10% DXQ， respectively）. These groups were subsequently treated with their corresponding drug solutions and ferroptosis inducer Erastin （10 μmol/L）. The intracellular levels of total iron ions， glutathione （GSH）， reactive oxygen species （ROS）， and the expression of mitochondrial superoxide were determined in each group after 48 h of treatment. Additionally， mitochondrial membrane potential， the opening degree of mitochondrial permeability transition pore （MPTP）， and mRNA expressions of GPX4 and cyclophilin D （CypD） were detected. Furthermore， the expressions of ferroptosis-related proteins[GPX4， transferrin receptor 1 （TfR1） and ferritin heavy chain 1 （FTH1）]， as well as MPTP-related proteins [adenine nucleotide translocator （ANT）， cytochrome C （CytC）， mitochondrial calcium uniporter （MCU） and CypD] were assessed. RESULTS Compared with si-NC group， the levels of total iron ions and ROS， the expression level of mitochondrial superoxide， the opening degree of MPTP， protein and its mRNA expressions of CypD as well as protein expressions of TfR1 and MCU were increased or up-regulated significantly （P＜0.01）； however， GSH content， mitochondrial membrane potential， protein and mRNA expressions of GPX4， and protein expressions of FTH1， ANT and CytC were decreased or down-regulated significantly （P＜0.01）. Compared with the si-GPX4 group， the cells in the DXQ-M， DXQ-H groups showed a general improvement in the above quantitative indicators （P＜0.01 or P＜0.05）. CONCLUSIONS DXQ can enhance antioxidant capacity by activating the GSH/GPX4 pathway， regulate the expressions of TfR1 and FTH1 protein to correct iron ion homeostasis， inhibit excessive opening of MPTP to improve mitochondrial function， and ultimately suppress microglial ferroptosis.

OBJECTIVE To investigate the application and influencing factors of sodium-dependent glucose transporters 2 inhibitors（SGLT-2i） in patients with heart failure with preserved ejection fraction（HFpEF） in the real world. METHODS Data from 358 patients with HFpEF who were hospitalized at the First Affiliated Hospital of Chongqing Medical University from May 2023 to May 2024 were retrospectively collected. The patients were divided into the SGLT-2i group and the non-SGLT-2i group based on whether they were prescribed SGLT-2i upon discharge. Baseline characteristics， comorbidities， and differences in drug treatment were compared between the two groups. Based on univariate analysis， multivariate Logistic regression analysis was performed to identify independent influencing factors of SGLT-2i use in patients with HFpEF， followed by further stratified analysis. RESULTS Among 358 HFpEF patients， the overall utilization rate of SGLT-2i was 33.5%. Combined with type 2 diabetes [OR＝9.063，95%CI（4.924-16.679） ] ， atrial fibrillation [OR＝3.135，95%CI（1.590-6.178） ] ， coronary artery heart disease [OR＝1.888，95%CI（1.072-3.327） ] and the use of loop diuretics [OR＝3.822， 95%CI （1.588-9.200） ] were all independent influencing factors for the use of SGLT-2i in patients with HFpEF （ P ＜0.05）. The results of the stratified descriptive analysis were consistent with those of the multivariate analysis， showing a higher utilization rate of SGLT-2i among patients with concomitant T2DM，atrial fibrillation， coronary artery heart disease， and those receiving loop diuretics （ P ＜0.05）； whereas the utilization rate of SGLT-2i was comparable across patients with different levels of renal function （ P ＞0.05）. CONCLUSIONS In the real-world clinical practice， the utilization of SGLT-2i in patients with HFpEF remains suboptimal， and treatment coverage still needs to be improved. Their use of SGLT-2i is primarily influenced by the presence of type 2 diabetes， atrial fibrillation， coronary artery heart disease， and the use of loop diuretics.

From the perspective of the knowledge history,the development of traditional Chinese medicine(TCM)knowledge re-lated to esophageal cancer began with early records of"difficulty in swallowing"during the Qin and Han dynasties.Through the accu-mulation of symptom-treatment experience during the Wei and Jin dynasties,it shifted towards theoretical exploration during the Song and Yuan dynasties,clarifying the pathogenesis of stomach cold,phlegm qi,and blood stasis,and so on.By the Ming and Qing dynas-ties,a rudimentary system for the syndrome differentiation of esophageal cancer was gradually formed,and the characteristic of"esopha-geal stricture"in this disease was identified.Finally,in the late Qing dynasty,Western medicine introduced the concept of"cancerous swelling".The current theory of cancer toxin pathogenesis,with cancer toxin pathogenesis at its core,innovatively integrates related knowledge,representing a reconstruction and transformation of traditional knowledge in the context of the new era.The relevant knowl-edge from past dynasties serves as both the premise and foundation for the innovation of the cancer toxin pathogenesis theory,and it also inspires new vitality in clinical practice through this theory,providing insights and methodologies for the innovation of modern TCM theory.

Objective:To determine the prevalence and associates of hyperuricemia (HUA) among the middle- and older-aged population of the island and mountainous areas in Taizhou City of Zhejiang Province.Methods:A cross-sectional study was conducted on individuals aged 45 and above in the island and mountainous area of Taizhou City. The study included questionnaires, physical examinations, and laboratory tests. Data were primarily collected on sociodemographic characteristics, chronic disease history, lifestyle factors, waist circumference, blood pressure, and serum uric acid levels. The association between hyperuricemia and these factors was analyzed by logistic regression.Results:A total of 971 individuals were included in the study, comprising 468 from island and 503 from mountainous area. The prevalence of hyperuricemia was 17.9%, with a significantly higher prevalence in the island area (25.6%) compared to the mountainous area (10.7%). Stratified by gender and age, differences in the prevalence of hyperuricemia between island and mountainous areas were observed in males aged 55 to 64, females aged 45 to 54, 55 to 64, 75 and above (all P<0.05). Multiple logistic regression analysis showed that high intake of sea food (>3 times/week) was positively associated with hyperuricemia ( OR=2.10, 95% CI:1.33-3.34). Furthermore, separate regionally stratified logistic regression analyses showed that in the island area, male gender ( OR=3.15, 95% CI:1.78-5.66), central obesity ( OR=2.38, 95% CI:1.46-3.93), and hypertriglyceridemia ( OR=2.00, 95% CI:1.22-3.30) were positively correlated with hyperuricemia (all P<0.05). In the mountainous area, the age group of 65 and above ( OR=3.50, 95% CI:1.09-12.50), male ( OR=6.79, 95% CI:2.87-17.81), those employed in enterprises and institutions ( OR=6.57, 95% CI:1.92-23.73) and hypertension ( OR=3.68, 95% CI:1.66-8.87) were positively correlated with hyperuricemia (all P<0.05). Conclusions:The prevalence of hyperuricemia among the middle- and older-aged population in the island of Taizhou City is significantly higher than that in the mountainous areas. Targeted comprehensive behavioral interventions such as routine screening of chronic diseases, low-fat diet, alcohol control, reduced seafood intake, enhanced exercise, weight management, and blood pressure control are warranted.

From the perspective of the knowledge history,the development of traditional Chinese medicine(TCM)knowledge re-lated to esophageal cancer began with early records of"difficulty in swallowing"during the Qin and Han dynasties.Through the accu-mulation of symptom-treatment experience during the Wei and Jin dynasties,it shifted towards theoretical exploration during the Song and Yuan dynasties,clarifying the pathogenesis of stomach cold,phlegm qi,and blood stasis,and so on.By the Ming and Qing dynas-ties,a rudimentary system for the syndrome differentiation of esophageal cancer was gradually formed,and the characteristic of"esopha-geal stricture"in this disease was identified.Finally,in the late Qing dynasty,Western medicine introduced the concept of"cancerous swelling".The current theory of cancer toxin pathogenesis,with cancer toxin pathogenesis at its core,innovatively integrates related knowledge,representing a reconstruction and transformation of traditional knowledge in the context of the new era.The relevant knowl-edge from past dynasties serves as both the premise and foundation for the innovation of the cancer toxin pathogenesis theory,and it also inspires new vitality in clinical practice through this theory,providing insights and methodologies for the innovation of modern TCM theory.

Based on the holistic view of "spleen-vessels-heart-spirit" system， this article explores the pathogenesis and progression of atrial fibrillation. It is proposed that the onset of atrial fibrillation is due to failure of the spleen to transport and disharmony of blood vessels； phlegm and blood stasis obstructing the collaterals and damage to the heart structure are the basis of its pathogenesis； the unclear mind and disorder of body and spirit are the causes of its progression. Based on the characteristics of pathological changes in different stages of the disease， it is proposed that early treatment should focus on restoring the middle jiao， clearing and promoting blood vessels， using modified Yigong Powder （异功散）； during the progression of the disease， treatment should remove blood stasis and phlegm， nourish heart and protect the pulse， using self-prescribed modified Mengshi Tongmai Decoction （礞石通脉汤）； meanwhile， calming mind and stabilizing palpitations， and regulating spirit should be sequentially incorporated， with self-prescribed Jiazao Ningmai Decoction （甲枣宁脉汤） or Shenying Dingji Decoction （参英定悸汤） and modified as appropriate. Clinical treatment should focus on the whole disease course of atrial fibrillation， implementing stage-based treatments to enable early intervention and holistic regulation.

ObjectiveTo avoid stress responses in experimental monkeys caused by direct capture, and to improve the adaptability and experimental efficiency of marmosets in behavioral, two-photon imaging, and electrophysiological experiments, a device for immobilizing marmosets without the need for capture is developed. MethodsA set of compatible transport cage and monkey chair was produced through 3D graphic design and printing. First, the transport cage was aligned with the feeding outlet of the experimental housing cage, and the marmoset was gently guided into the transport cage. Then, the transport cage was connected to the monkey chair, and the marmoset was gently guided into the chair for immobilization. Subsequent experiments were carried out afterward. The effectiveness was evaluated by observing the efficiency of transport and immobilization, the marmoset cooperation level, and stress responses. ResultsAfter testing and improvements, the device successfully completed immobilization of marmosets without the need for capture, significantly improving the fluency and efficiency of the experiment. As the number of operations increased, the marmosets became more cooperative, and the operation speed was significantly enhanced. After using the device, the stress responses were noticeably reduced, with marmosets showing lower stress levels. In particular, compared to traditional capture methods, the use of this device significantly reduced marmoset anxiety and discomfort, increasing their cooperation levels during the experiment. ConclusionThe monkey chair device designed allows for restraint of marmosets without the need for capture, ensuring smooth progress of subsequent experiments while also safeguarding animal welfare. This device is easy to operate, highly practical, cost-effective, and has great potential for widespread application.

Objective: To explore the association between mental health and muscle strength among Chinese adolescents aged 13- 18, providing a theoretical foundation and intervention strategies for mental health promotion. Methods: Data were obtained from the 2019 Chinese National Survey on Students Constitution and Health, including 98 631 Chinese adolescents aged 13- 18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well being was measured with the Warwick-Edinburgh Mental Well being Scale (WEMWBS). Based on the gender and age specific Z scores of various test items [grip strength, standing long jump, pull ups (for males), and sit ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual factor Model (DFM) of mental health, participants were categorized into four groups:troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents. Results: In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance ( χ 2=176.13, 780.42, both P <0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age ( χ 2 trend = 258.47) and a gradual upward trend with increasing muscle strength levels ( χ 2 trend =123.14)，and both boys and girls exhibited similar trends ( χ 2 trend =103.83, 168.46; 57.00 , 67.34) (all P <0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% ( OR = 1.29); for every unit increase in the Z-score for pull ups, the likelihood of being in a completely mental health state increased by 6% ( OR =1.06) among boys; for every 1 unit increase in sit up Z score, the likelihood of being in a completely mental health state increased by 19% ( OR =1.19) among girls (all P <0.05). Conclusions The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.

Objective:To construct a novel clinical prognosis signature for hepatocellular carcinoma (HCC) patients using T cell-related ubiquitination genes.Methods:Transcriptome and clinical data of 371 liver cancer and 50 normal samples were obtained from the TCGA database, and microarray sequencing data of 221 liver cancer samples were selected from the GSE14520 dataset. Single-cell RNA sequencing (scRNA-seq) data of HCC patients were analyzed to identify T cell-related marker genes. These were combined with ubiquitination-related genes. Weighted gene co-expression network analysis (WGCNA) was performed on TCGA transcriptome data to select key genes, resulting in the identification of T cell-related ubiquitination genes. A prognostic model was then constructed using LASSO-Cox regression. Finally, a nomogram was created by combining risk scores and clinical parameters. Count data were expressed by examples and percentages(%). Spearman correlation test was used for correlation analysis. Kaplan-Meier method and Log-rank test were used for survival analysis.Results:Initially, 1 458 T cell-related marker genes were identified. Intersection with 797 ubiquitination-related genes led to the identification of 94 common genes. WGCNA analysis revealed the prognosis-related module MEturquoise. After performing differential gene analysis, Kaplan-Meier analysis, and COX regression, 16 candidate genes were confirmed. LASSO-COX algorithm accurately selected five key genes- UBE2S, PSMD1, FBXL5, UBE2E1, and PSMA7—to construct the prognostic model. Kaplan-Meier analysis indicated that the risk score of the prognostic model was significantly associated with the prognosis of HCC patients (Log-rank test=0.001). Both univariate and multivariate COX regression analysed demonstrated that the risk score was an independent prognostic factor for HCC patients( P<0.05). Finally, a nomogram was constructed by combining the risk score and clinical parameters, providing a more accurate prediction of patient prognosis. Conclusion:The T cell-related ubiquitination gene prognostic model can effectively predict the prognosis of patients with liver cancer.

Objective:To evaluate the accuracy and output stability of online general natural language processing(NLP)models for staging diagnosis and identifying medium-and high-risk factors in cervical cancer patients based on pathology reports.Methods:Surgical pathological reports of 65 patients with cervical cancer who received postoperative adjuvant radiotherapy at Shanghai General Hospital from January 2022 to December 2023 were retrospectively selected.These reports were input into two online NLP models,Kimi and ChatGPT-4o,and their output staging diagnosis results were recorded.Then,the results were classified into 3 categories and scored as follows:correct(2 points),basically correct(1 point)and incorrect(0 point).Each pathologic report was tested 5 times to assess the stability of the outputs form Kimi and ChatGPT-4o,and the consistency between the NLP models and clinical physicians in cervical cancer staging was compared.Prompt-based questioning was used to evaluate Kimi's ability to extract medium-and high-risk factors from the pathology reports of cervical cancer patients.Results:There was no statistical significant difference in the staging diagnosis results between the two NLP models and the clinical physicians(x2=5.740,P=0.057).Kimi and ChatGPT-4o respectively produced 56 and 47 correct results,6 and 15 basically correct results,and 3 and 3 incorrect results.Their mean scores were 7.08±2.70 and 7.97±2.97,and the difference between them was statistically significant(P=0.040).In the extraction of risk factors from 65 cervical cancer patients,involving a total of 390 factors,Kimi made only three false-positive errors,with all other factors correctly identified.Conclusion:Online general NLP models can stably output the stage of cervical cancer patients with diagnostic accuracy comparable to clinical physicians.With the assistance of prompt-based questioning,these NLP models can accurately extract medium-and high-risk factors from pathology reports of cervical cancer patients,demonstrating promising clinical application potential.