Objective:To investigate the preferences and influencing factors of Traditional Chinese Medicine(TCM)health management services among community healthcare workers,providing a reference for promoting and spreading TCM health management services in communities.Methods:Based on a discrete choice experiment,a questionnaire survey was conducted among 596 community healthcare workers across 9 administrative districts in Beijing.A mixed logit model was used to analyze their preferences.Results:Changes in post-tax monthly income,expected efficacy,single-service duration,technical difficulty,patient compliance,and insurance coverage significantly influenced community doctors'service preferences.Changes in post-tax monthly income had the highest relative importance(35.11%),followed by insurance coverage(34.87%).Preferences varied among healthcare workers with different professional titles,backgrounds,weekly working hours,and whether the service was included in performance evaluations.Conclusion:Both economic and non-economic factors influence community healthcare workers'service preferences to varying degrees.Optimizing the combination of TCM health management service attributes can enhance community healthcare workers'willingness to provide such services.It is recommended to use a combination of economic and non-economic incentive measures and develop differentiated strategies for healthcare workers with different characteristics to meet their service preferences and promote the development of TCM health management services in communities.

Aim To investigate the effects of astragalo-side Ⅳ(AS-Ⅳ)on proliferation,apoptosis and the discoid domain receptor 1/phosphatidylinositol 3-ki-nase/protein kinase B(DDR1/PI3K/Akt)signaling pathway of HL-60 cells in acute myeloid leukemia.Methods The experiment was divided into the control group(Control),AS-Ⅳ intervention group,control+DDR1 gene interference group(Control+sh-DDR1),AS-Ⅳ+DDR1 gene overexpression group(AS-Ⅳ+OVE-DDR1)and AS-Ⅳ+OVE-DDR1+PI3K inhibi-tor group(AS-Ⅳ+OVE-DDR1+LY294002).After 72 h of AS-Ⅳ intervention,the proliferation inhibition rate was measured by CCK-8;apoptosis was detected by flow cytometry and Hoechst33258 staining;and the expression levels of DDR1/PI3K/Akt signaling path-way proteins,proliferation and apoptosis-related pro-teins were detected by Western blot.Results Com-pared with the Control group,the AS-Ⅳ group showed significantly lower proliferation rate and higher apopto-sis rate(P＜0.01),cells showed apopt otic morpholog-ical changes such as nuclear sequestration and nuclear fragmentation,and the expression of DDR1,p-PI3K,p-Akt,CyclinD1 and Bcl-2 proteins were significantly lower and caspase-3 protein expression was significant-ly higher(P＜0.01).Compared with the AS-Ⅳ group,cell proliferation rate was significantly higher and apoptosis rate was significantly lower in the AS-Ⅳ+OVE-DDR1 group(P＜0.01),and DDR1,p-PI3K,p-Akt,CyclinD1,and caspase-3 protein expression were significantly higher and Bcl-2 protein expression was significantly lower in the AS-Ⅳ+OVE-DDR1 group(P＜0.01).Compared with the AS-Ⅳ+OVE-DDR1 group,the cell proliferation rate was significantly lower and apoptosis rate was significantly higher in the AS-Ⅳ+OVE-DDR1+LY294002 group(P＜0.01),and DDR1,p-PI3K,p-Akt,CyclinD1,and caspase-3 protein expression were significantly lower and Bcl-2 protein expression was significantly higher in the AS-Ⅳ+OVE-DDR1+LY294002 group(P＜0.01).Conclu-sion AS-Ⅳ can inhibit proliferation and promote ap-optosis in acute myeloid leukemia HL-60 cells by a mechanism related to the inhibition of DDR1/PI3K/Akt signaling pathway.

Aim To investigate the effects of astragalo-side Ⅳ(AS-Ⅳ)on proliferation,apoptosis and the discoid domain receptor 1/phosphatidylinositol 3-ki-nase/protein kinase B(DDR1/PI3K/Akt)signaling pathway of HL-60 cells in acute myeloid leukemia.Methods The experiment was divided into the control group(Control),AS-Ⅳ intervention group,control+DDR1 gene interference group(Control+sh-DDR1),AS-Ⅳ+DDR1 gene overexpression group(AS-Ⅳ+OVE-DDR1)and AS-Ⅳ+OVE-DDR1+PI3K inhibi-tor group(AS-Ⅳ+OVE-DDR1+LY294002).After 72 h of AS-Ⅳ intervention,the proliferation inhibition rate was measured by CCK-8;apoptosis was detected by flow cytometry and Hoechst33258 staining;and the expression levels of DDR1/PI3K/Akt signaling path-way proteins,proliferation and apoptosis-related pro-teins were detected by Western blot.Results Com-pared with the Control group,the AS-Ⅳ group showed significantly lower proliferation rate and higher apopto-sis rate(P＜0.01),cells showed apopt otic morpholog-ical changes such as nuclear sequestration and nuclear fragmentation,and the expression of DDR1,p-PI3K,p-Akt,CyclinD1 and Bcl-2 proteins were significantly lower and caspase-3 protein expression was significant-ly higher(P＜0.01).Compared with the AS-Ⅳ group,cell proliferation rate was significantly higher and apoptosis rate was significantly lower in the AS-Ⅳ+OVE-DDR1 group(P＜0.01),and DDR1,p-PI3K,p-Akt,CyclinD1,and caspase-3 protein expression were significantly higher and Bcl-2 protein expression was significantly lower in the AS-Ⅳ+OVE-DDR1 group(P＜0.01).Compared with the AS-Ⅳ+OVE-DDR1 group,the cell proliferation rate was significantly lower and apoptosis rate was significantly higher in the AS-Ⅳ+OVE-DDR1+LY294002 group(P＜0.01),and DDR1,p-PI3K,p-Akt,CyclinD1,and caspase-3 protein expression were significantly lower and Bcl-2 protein expression was significantly higher in the AS-Ⅳ+OVE-DDR1+LY294002 group(P＜0.01).Conclu-sion AS-Ⅳ can inhibit proliferation and promote ap-optosis in acute myeloid leukemia HL-60 cells by a mechanism related to the inhibition of DDR1/PI3K/Akt signaling pathway.

BACKGROUND:H uman pluripotent stem cell-derived cardiomyocytes offer an ideal cellular resource for studying heart diseases,conducting drug screening,developing in vitro heart models,and exploring potential cell therapies.However,human pluripotent stem cell-derived cardiomyocytes are characterized by immaturity with limited specific gene expression,low Ca2+processing levels,and underdeveloped structural,metabolic,and electrophysiological features.These limitations significantly impede the application of human pluripotent stem cell-derived cardiomyocytes.OBJECTIVE:To review the academic progress and clinical application of promoting the maturation of human pluripotent stem cell-derived cardiomyocytes by in vitro synthetic microenvironment.METHODS:CNKI,WanFang,VIP,PubMed,Web of Science,and Medline databases were searched,with"human pluripotent stem cells,human myocardial cells,hPSC-CMs,mature,OA,human pluripotent stem cell-derived cardiomyocytes,hPSC-CMs"as English search terms and"human pluripotent stem cells,cardiomyocytes,mature,OA,hPSC-CMs"as Chinese search terms.All relevant literature published from January 2002 to July 2024 was retrieved and 82 articles were included in the review.RESULTS AND CONCLUSION:(1)In recent years,in vitro synthetic microenvironments have attracted extensive attention due to their excellent intrinsic properties such as stiffness,plasticity,nanoscale morphology,and chemical functionality.(2)Human pluripotent stem cell-derived cardiomyocytes can be used as an effective platform for the treatment of cardiovascular diseases.(3)Mechanical stimulation,electrical stimulation,addition of biochemical molecules,and three-dimensional culture methods are effective methods to promote the maturation of human pluripotent stem cell-derived cardiomyocytes,which can further promote the clinical application of human pluripotent stem cell-derived cardiomyocytes.

Objective To predict the poorly differentiated subtype of stage T1 invasive lung adenocarcinoma based on the morphological and quantitative characteristics of preoperative CT images.Methods The CT images,clinical information and pathological report of 333 cases with stage T1 lung adenocarcinoma in the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University and the Second Affiliated Hospital of Naval Medical University were retrospectively analyzed.All data were divided into histological subtypes according to the WHO Classification of Chest Tumors(5th Edition).CT signs include the maximum diameter,minimum diameter,location,nodule type,CT value,proportion of solid components,burr sign,lobular sign,vacuole sign,air bronchial sign,halo sign,bronchial truncation sign,vascular cluster sign,pleural depression sign.Clinical factors included gender,age,smoking history,tumor markers,and spread through air spaces.Independent predictors of poorly differentiated subtypes of lung adenocarcinoma were obtained via univariate and multivariate logistic regression analysis,and the clinical model,CT model and combined model were constructed based on the analysis results.Results In univariate logistic regression analysis,gender,smoking history,tumor markers,spread through air spaces,maximum diameter,minimum diameter,location,nodule type,CT value,proportion of solid components,burr sign,vacuole sign and vascular cluster sign were significantly related to poorly differentiated subtypes.Multivariate logistic regression analysis showed that gender,tumor markers,vacuole sign,minimum diameter,and nodule type were independent influencing factors of poorly differentiated subtypes of lung adenocarcinoma.Clinical model,CT model and combined model were constructed based on the analysis results.Area under the curve(AUC)of the clinical model,CT model and combined model were 0.772[95％confidence interval(CI)0.712-0.831],0.776(95％CI 0.714-0.837)and 0.825(95％CI 0.776-0.874)for the poorly differentiated subtypes,respectively.The combined model had a higher AUC,with the better prediction.There was significant difference in predicting lung adenocarcinoma poorly differentiated subtypes between the clinical model and combined model(P=0.019).Conclusion Logistic regression model based on CT signs has good diagnostic value in predicting poorly differentiated lung adenocarcinoma in stage Ⅰ.

Objective:To investigate the effects of TP53 genetic status(wild-type/mutated/null)on the drug resistance of decitabine(DAC)in myelodysplastic syndromes(MDS)and identify key resistance-associated genes.Methods:Two myeloid cell lines with distinct TP53 status(M-07e:wild-type;SKM-1:mutated;)were treated with gradient DAC concentrations(0-10 μmol/L)for 0-72 h.Cell viability was detected by CCK-8 assay.RNA-Seq transcriptomics,and methylation profiling were integrated to analyze differentially expressed genes.Results:Decitabine(DAC)treatment induced time-and dose-dependent inhibition of cell viability in CCK-8 assays,with SKM-1 cells exhibiting the highest resistance(IC50=5 μmol/L vs M-07e=0.5 μmol/L,P＜0.01).Transcriptomic analysis revealed 662 upregulated and 452 downregulated genes in DAC-treated M-07e cells,while SKM-1 cells showed 515 upregulated and 73 downregulated genes.By proteomic profiling,117 upregulated and 136 downregulated proteins were identified in M-07e cells,while 91 upregulated and 46 downregulated proteins were identified in SKM-1 cells following DAC exposure.Through integrated analysis of upregulated genes and proteins expression profiles,181 candidate genes were screened out,while methylation studies identified 884 hypomethylated genes with high-sensitivity loci and CpG density.Notably,31 genes overlapped between these datasets,and functional annotation indicated these drug-resistance-associated genes are primarily involved in positive regulation of cell differentiation,negative regulation of binding processes,and negative regulation of cellular component organization.Conclusion:TP53 mutations drive DAC resistance via epigenetic reprogramming.Targeting these genes may improve outcomes in TP53-mutated MDS.

Objective:To analyze the predictive role of WT1 expression levels pre-and early post-transplantation on relapse and overall survival(OS)in patients with acute myeloid leukemia(AML)undergoing allogeneic hematopoietic stem cell transplantation(allo-HSCT)during their first complete remission(CR1).Methods:A retrospective analysis was conducted on the clinical data of 107 adult AML patients who underwent allo-HSCT during their CR1 at our center between May 2012 and December 2021.The predictive role of bone marrow WT1 expression levels before transplantation and at 3 and 6 months post-transplantation on relapse and OS was explored in combination with relevant clinical factors.Results:The median follow-up time for the 107 patients was 70(range:11-117)months.Among the patients,15 cases died.Kaplan-Meier survial analysis showed that the 3-year overall survival(OS)rate was 85.0％.20 patients experienced relapse,with a median time to relapse of 8(range:0.5-44)months and a l-year cumulative relapse rate of 13.1％.The overall median value of WT1 before transplantation,3 months after transplantation,and 6 months after transplantation was 0.26％(range:0％-23.64％),with an upper quartile value of 0.74％.No statistically significant differences in WT1 expression levels were observed among the pre-transplantation,3-month post-transplantation,and 6-month post-transplantation time points(P=0.227).Univariate analysis showed that patients with WT1 levels＞0.74％at 3 months post-transplantation had a higher 1-year relapse rate(P=0.029)and lower 3-year OS rate(P＜0.001)compared to patients with WT1 levels ≤0.74％.Other significant factors affecting 1-year relapse included stem cell source(P=0.041)and chronic graft-versus-host disease(cGVHD)(P=0.013).For 3-year OS,additional influencing factors were genetic high risk(P=0.048)and stem cell source(P=0.016).Multivariate analysis revealed that WT1 level＞0.74％at 3 months post-transplantation had a trend to affect 1-year relapse rate(HR=3.309,95％CI:0.958-11.431,P=0.058),while the absence of cGVHD was an independent risk factor for 1-year relapse(HR=3.473,95％CI:0.749-16.100,P=0.037).Only WT1 level＞0.74％at 3 months post-transplantation was an independent risk factor for 3-year OS(HR=6.886,95％CI:2.402-19.738,P＜0.001).Conclusion:High WT1 expression level at 3 months post-transplantation in AML patients undergoing allo-HSCT during CR1 affects the 1-year relapse rate and 3-year OS,and is an independent risk factor affecting 3-year OS.These findings suggest that dynamic monitoring of WT1 expression levels has certain value in prognostic assessment of AML patients who received allo-HSCT during CR1.

Objective:To investigate the effects of TP53 genetic status(wild-type/mutated/null)on the drug resistance of decitabine(DAC)in myelodysplastic syndromes(MDS)and identify key resistance-associated genes.Methods:Two myeloid cell lines with distinct TP53 status(M-07e:wild-type;SKM-1:mutated;)were treated with gradient DAC concentrations(0-10 μmol/L)for 0-72 h.Cell viability was detected by CCK-8 assay.RNA-Seq transcriptomics,and methylation profiling were integrated to analyze differentially expressed genes.Results:Decitabine(DAC)treatment induced time-and dose-dependent inhibition of cell viability in CCK-8 assays,with SKM-1 cells exhibiting the highest resistance(IC50=5 μmol/L vs M-07e=0.5 μmol/L,P＜0.01).Transcriptomic analysis revealed 662 upregulated and 452 downregulated genes in DAC-treated M-07e cells,while SKM-1 cells showed 515 upregulated and 73 downregulated genes.By proteomic profiling,117 upregulated and 136 downregulated proteins were identified in M-07e cells,while 91 upregulated and 46 downregulated proteins were identified in SKM-1 cells following DAC exposure.Through integrated analysis of upregulated genes and proteins expression profiles,181 candidate genes were screened out,while methylation studies identified 884 hypomethylated genes with high-sensitivity loci and CpG density.Notably,31 genes overlapped between these datasets,and functional annotation indicated these drug-resistance-associated genes are primarily involved in positive regulation of cell differentiation,negative regulation of binding processes,and negative regulation of cellular component organization.Conclusion:TP53 mutations drive DAC resistance via epigenetic reprogramming.Targeting these genes may improve outcomes in TP53-mutated MDS.

Objective:To analyze the predictive role of WT1 expression levels pre-and early post-transplantation on relapse and overall survival(OS)in patients with acute myeloid leukemia(AML)undergoing allogeneic hematopoietic stem cell transplantation(allo-HSCT)during their first complete remission(CR1).Methods:A retrospective analysis was conducted on the clinical data of 107 adult AML patients who underwent allo-HSCT during their CR1 at our center between May 2012 and December 2021.The predictive role of bone marrow WT1 expression levels before transplantation and at 3 and 6 months post-transplantation on relapse and OS was explored in combination with relevant clinical factors.Results:The median follow-up time for the 107 patients was 70(range:11-117)months.Among the patients,15 cases died.Kaplan-Meier survial analysis showed that the 3-year overall survival(OS)rate was 85.0％.20 patients experienced relapse,with a median time to relapse of 8(range:0.5-44)months and a l-year cumulative relapse rate of 13.1％.The overall median value of WT1 before transplantation,3 months after transplantation,and 6 months after transplantation was 0.26％(range:0％-23.64％),with an upper quartile value of 0.74％.No statistically significant differences in WT1 expression levels were observed among the pre-transplantation,3-month post-transplantation,and 6-month post-transplantation time points(P=0.227).Univariate analysis showed that patients with WT1 levels＞0.74％at 3 months post-transplantation had a higher 1-year relapse rate(P=0.029)and lower 3-year OS rate(P＜0.001)compared to patients with WT1 levels ≤0.74％.Other significant factors affecting 1-year relapse included stem cell source(P=0.041)and chronic graft-versus-host disease(cGVHD)(P=0.013).For 3-year OS,additional influencing factors were genetic high risk(P=0.048)and stem cell source(P=0.016).Multivariate analysis revealed that WT1 level＞0.74％at 3 months post-transplantation had a trend to affect 1-year relapse rate(HR=3.309,95％CI:0.958-11.431,P=0.058),while the absence of cGVHD was an independent risk factor for 1-year relapse(HR=3.473,95％CI:0.749-16.100,P=0.037).Only WT1 level＞0.74％at 3 months post-transplantation was an independent risk factor for 3-year OS(HR=6.886,95％CI:2.402-19.738,P＜0.001).Conclusion:High WT1 expression level at 3 months post-transplantation in AML patients undergoing allo-HSCT during CR1 affects the 1-year relapse rate and 3-year OS,and is an independent risk factor affecting 3-year OS.These findings suggest that dynamic monitoring of WT1 expression levels has certain value in prognostic assessment of AML patients who received allo-HSCT during CR1.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.