1.Research Tackling Paradigm and Technological Layout Strategies Based on Erectile Dysfunction, A Clinical Dominant Disease of Traditional Chinese Medicine
Qi ZHAO ; Yun CHEN ; Baoxing LIU ; Xuejun SHANG ; Fei SUN ; Xiaozhi ZHAO ; Zhigang WU ; Chao SUN ; Peihai ZHANG ; Wanjun CHENG ; Xing ZHOU ; Zhan QIN ; Yufeng PAN ; Weiwei TAO ; Jianhuai CHEN ; Mei MO ; Xiaoxiao ZHANG ; Xing ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(7):291-299
To thoroughly implement the strategic deployment outlined in the Opinions of the Central Committee of the Communist Party of China and the State Council on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine regarding research on dominant diseases of traditional Chinese medicine and to uphold the development philosophy of equal emphasis on traditional Chinese medicine and western medicine,the China Association of Chinese Medicine has fully played a leading academic role by systematically organizing and conducting a series of academic youth salons on clinical dominant diseases of traditional Chinese medicine. On September 13,2024,the 36th Youth Salon on Clinical Dominant Diseases was successfully held in Nanjing,focusing on the advantages of traditional Chinese medicine and the integrative traditional Chinese medicine and western medicine in the diagnosis and treatment of erectile dysfunction (ED). The conference brought together leading experts from traditional Chinese medicine,western medicine,and interdisciplinary fields,facilitating in-depth multidisciplinary discussions that led to key consensus on optimizing traditional Chinese medicine treatment protocols for ED,researching and developing new drugs of traditional Chinese medicine,and advancing interdisciplinary development in traditional Chinese medicine. This salon systematically sorted out the clinical strengths and distinctive features of traditional Chinese medicine in the diagnosis and treatment of ED. Based on current research foundations and clinical needs,it identified key directions for future scientific layout and scientific research tackling: (1) Standardization of syndrome differentiation system of traditional Chinese medicine for ED. (2) Optimization and standardization of intervention methods of integrated traditional Chinese medicine and western medicine. (3) High-quality clinical research guided by evidence-based medicine. (4) In-depth analysis of the pharmacological mechanisms of traditional Chinese medicine in the treatment of ED. (5) Clinical translation and application promotion of new drugs of traditional Chinese medicine. (6) Interdisciplinary integration and innovation in traditional Chinese medicine. For each research direction,key focus areas,expected objectives,and clinical value were further refined,along with the establishment of a scientifically sound priority funding level evaluation system. Therefore,building on the series of salons on the ED-focused dominant diseases of traditional Chinese medicine,this paper provides standardized guidance for clinical practice of traditional Chinese medicine in ED management,effectively contributing to the high-quality development of traditional Chinese medicine. It serves as a valuable reference for national scientific and technological strategic layout, research and development decision-making in new drugs of traditional Chinese medicine,research topic planning,and clinical guideline formulation.
2.Study on the mechanism of Huatan qushi huoxue formula in improving metabolic dysfunction-associated steatohepatitis by inhibiting macrophage pyroptosis
Yajie GUAN ; Qizhen ZHANG ; Junjiao XU ; Yijia SONG ; Dongfang SHANG ; Wenxia ZHAO ; Minghao LIU
China Pharmacy 2026;37(7):864-869
OBJECTIVE To focus on the classic NOD-like receptor protein 3 (NLRP3)/Caspase-1/gasdermin D (GSDMD) pyroptosis pathway and explore the mechanism by which Huatan qushi huoxue formula (HQHF) inhibits macrophage pyroptosis to ameliorate metabolic dysfunction-associated steatohepatitis (MASH). METHODS RAW264.7 cells were divided into 5 groups: Control group (10% blank serum), Model group [10% blank serum+5 μg/mL lipopolysaccharide (LPS)], HQHF-L group (2.5% drug-containing serum+7.5% blank serum+5 μg/mL LPS), HQHF-M group (5% drug-containing serum+5% blank serum+5 μg/mL LPS), and HQHF-H group (10% drug-containing serum+5 μg/mL LPS). After 24 h of routine culture post-administration, cells and supernatants were collected for assays. Cell morphology was observed via scanning electron microscopy and phase-contrast microscopy; localization and expression of gasdermin D-N (GSDMD-N) were observed by immunofluorescence. Interleukin-1β (IL-1β) and IL-18 contents in supernatants were detected by ELISA; mRNA and protein expressions of NLRP3, Caspase-1, and GSDMD were measured using real-time PCR and Western blot. RESULTS Compared with the Control group, the Model group showed typical pyroptotic morphology (cell membrane bulging and pore formation), increased aggregation and fluorescence intensity of GSDMD-N on the cell membrane ( P <0.05), significantly increased the contents of IL-1β and IL-18 in cell supernatants ( P <0.05), and significantly up-regulated mRNA and protein expressions of NLRP3, Caspase-1, and GSDMD in cells ( P <0.05). Compared with the Model group, the HQHF-L, HQHF-M and HQHF-H groups showed improved pyroptotic morphology, reduced membrane localization and significantly weakened fluorescence intensity of GSDMD-N ( P <0.05), significantly decreased the contents of IL-1β and IL-18 in cell supernatants ( P <0.05), and significantly down-regulated mRNA and protein expressions of NLRP3, Caspase-1, and GSDMD in cells ( P <0.05). CONCLUSIONS HQHF inhibits LPS-induced macrophage pyroptosis, and its mechanism of improving MASH may be associated with the suppression of the activation of the classical NLRP3/Caspase-1/GSDMD pyroptosis pathway.
3.Stress distribution on the maxilla when wearing the Twin-block appliance for Class Ⅱ malocclusion
Shuai LI ; Hua LIU ; Yonghui SHANG ; Yicong LIU ; Qihang ZHAO ; Wen LIU
Chinese Journal of Tissue Engineering Research 2025;29(5):881-887
BACKGROUND:The Twin-block orthodontic appliance is commonly used for the correction of Class Ⅱ malocclusion.Its mechanism of action in stimulating mandibular growth has been confirmed in many studies,but its impact on maxillary growth is not very clear. OBJECTIVE:By establishing a finite element model to analyze the stress distribution of the maxillary complex,surrounding bone sutures,and maxillary dentition in patients with Class Ⅱ malocclusion wearing Twin-block orthodontic appliances. METHODS:One patient with Class Ⅱ malocclusion who underwent orthodontic treatment at Qingdao Hospital/Qingdao Municipal Hospital of Shandong Rehabilitation University was selected.The bite force data of the patient when wearing the Twin-block orthodontic appliance was measured,and CBCT data were collected.A finite element model was established,including the maxillary complex,peripheral sutures,Twin-block orthodontic appliance,and maxillary dentition.ABAQUS software was used to simulate the stress distribution in the maxilla and maxillary dentition when the patient was wearing the Twin-block appliance. RESULTS AND CONCLUSION:The equivalent stress on the maxillary anterior teeth was significantly smaller than that on the posterior teeth,and the maximum equivalent stress on both sides of the teeth were 4.797 5 Mpa and 8.716 1 Mpa,respectively,which were located at the first premolar.The maximum displacements were presented at the maxillary incisors on both sides of the teeth,which were 0.080 5 mm and 0.081 0 mm,respectively.The maximum equivalent stress on the bone suture was 1.284 Mpa,which was mainly concentrated in the pterygopalatine suture and the frontal-maxillary suture on both sides,and there was almost no difference in the force of the rest of bone sutures;the maximum displacement of the bone suture was 0.07 mm,with the pterygopalatine suture having the largest displacement,followed by the frontal-maxillary suture.The maximal equivalent stress on the maxillary complex was 27.18 Mpa,which was mainly concentrated on both sides of the anterior pyriform foramen of the maxilla,around the nasofrontal suture and around the pterygopalatine suture at the posterior part of the jaws.The maximal displacement of the maxilla was 0.07 mm,which was mainly concentrated on the maxillary alveolar bone.All these findings show that the occlusal force acts on the maxillary complex through the Twin-block appliance,resulting in clockwise rotation of the maxilla and steepening of the dentition plane.Measures should be taken to compensate for this tendency,for example,by considering maxillary molar elongation and intrusion in the process of occlusion,which are not only able to flatten the occlusal plane,but facilitate the mandibular protraction,thereby further improving Class Ⅱ malocclusion orthodontic treatment.
4.Machine learning model based on MR T2WI and diffusion-weighted imaging radiomics for predicting perineural invasion of rectal cancer
Honglin SHANG ; Yuqi ZHAN ; Shaoying MO ; Yuhua FAN ; Yunjun YANG ; Hai ZHAO ; Wei WANG
Chinese Journal of Medical Imaging Technology 2025;41(4):616-621
Objective To observe the value of machine learning model based on MR T2WI and diffusion weighted imaging(DWI)radiomics for predicting perineural invasion(PNI)of rectal cancer.Methods Totally 343 patients with rectal cancer were retrospectively collected and divided into training set(n=275,92 PNI[+]and 183 PNI[-])and test set(n=68,23 PNI[+]and 45 PNI[-])at the ratio of 8∶2.Univariate and multivariate logistic regression(LR)were used to analyze clinical data and screen the independent predictors of PNI in rectal cancer,so as to construct a clinical model.The best radiomics features were extracted and screened based on preoperative T2WI and DWI.Then extremely randomized trees,multilayer perceptron,light gradient boosting machine,extreme gradient boosting,support vector machine(SVM),LR,K-nearest neighbor and random forest algorithms were used to construct ML models,respectively,and the optimal ML model was selected to establish a clinical-radiomics ML model combined with clinical relevant independent predictors.The predictive efficacy and clinical value of each model were evaluated.Results Patients' age was the independent predictor of PNI of rectal cancer(OR=0.988,P<0.001),and the area under the curve(AUC)of the clinical model constructed based on it was 0.435 and 0.458 in training and test sets,respectively.SVM model was the best one among 8 ML models,with AUC in training and test set of 0.887 and 0.854,respectively.The AUC of clinical-radiomics ML model in training and test sets was 0.887 and 0.860,respectively,not different with AUC of SVM model(both P>0.05).Decision curve analysis showed that when the threshold value was 0.20-0.45,clinical net benefit of SVM model was higher than that of other models.Conclusion SVM model based on T2WI and DWI radiomics could effectively predict PNI of rectal cancer.
5.Expression and clinical significance of serum exosome miR-1246 in patients with esophageal squamous cell carcinoma
Wei ZHAO ; Wenxuan CUI ; Beixuan HUANG ; Xiaoya SHANG ; Zhenda WANG ; Yanyan DU ; Hongzheng ZHAO ; Wenjing JIAO ; Ming MA
Chinese Journal of Cancer Biotherapy 2025;32(2):176-188
Objective:To screen for microRNAs(miRNAs)highly expressed in the serum exosomes(Exo)of esophageal squamous cell carcinoma(ESCC)patients and analyze their relationship with the clinicopathological characteristics of the patients,and to explore the potential of Exo-derived miRNAs as clinical auxiliary diagnostic markers for ESCC.Methods:Serum and relevant clinical data of 50 healthy subjects and 45 newly diagnosed ESCC patients admitted to the Fourth Hospital of Hebei Medical University between December 2021 and June 2023 were collected,serving as the control group and the ESCC group respectively.The Gene Expression Omnibus(GEO)database and qPCR were used to screen and identify the candidate miRNA for increased expression in the serum of ESCC patients-miR-1246.The diagnostic efficacy of serum miR-1246 for ESCC was analyzed by the receiver operating characteristic curve.The relationship between miR-1246 and the clinical feature progression of ESCC patients was analyzed by Logistic regression,and the relationship between miR-1246 and the clinicopathological characteristics of ESCC patients was analyzed by the χ2 test.Exosomes in the serum of the subjects were isolated,purified and characterized for verification.The expression of miR-1246 in Exo was detected by qPCR.ESCC KYSE150 and KYSE30 cells were routinely cultured.mimics-NC and miR-1246 mimics were transfected respectively into KYSE150 cells using Lipofectamine 2000.Inhibitor-NC and miR-1246 inhibitor were transfected into KYSE30 cells,which were respectively denoted as the minics-NC,miR-1246 mimics,inhibitor-NC and miR-1246-inhibitor groups.KYSE150 and KYSE30 cells were treated with Exo derived from KYSE150 cells in the mimics-NC and miR-1246 mimics groups.The proliferation,migration and invasion abilities of cells in each group were detected by the CCK-8 assay,scratch wound healing assay and Transwell chamber assay respectively.The expressions of Exo markers,epithelial-mesenchymal transition-related proteins,TET family methylcytosine dioxygenase 2(TET2)and cell adhesion molecule 1(CADM1)proteins in each group of cells were detected by WB assay.The targeting binding relationship between miR-1246 and TET2 and CADM1 was verified by the dual-luciferase reporter gene assay.Results:Bioinformatics screening showed that the miRNA with the most significant differential expression in the serum of ESCC patients was miR-1246.The serum Exo extracted from the patients conformed to the typical Exo characteristics.The expression level of serum Exo-miR-1246 in ESCC patients at stages Ⅰ-Ⅱ was significantly higher than that in healthy subjects(P<0.01);the level of serum Exo-miR-1246 in ESCC patients at stages Ⅲ-Ⅳ was significantly higher than that in patients at stages Ⅰ-Ⅱ(P<0.01).ROC curve analysis showed that Exo-miR-1246 in serum had a high value for auxiliary differential diagnosis of ESCC(P<0.05),and the auxiliary diagnostic efficacy of Exo-miR-1246 for the clinical progression of ESCC patients was higher than that of CEA and SCC-Ag(P<0.05).The combined detection of the three could further improve the efficacy of auxiliary diagnosis of patient staging(P<0.01).Exo-miR-1246 might be an independent risk factor for the clinical progression of ESCC patients(P<0.05).The expression level of serum Exo-miR-1246 was associated with the T-stage,N-stage and clinical stage of ESCC(P<0.01).Overexpression of miR-1246 could promote the proliferation,migration,invasion,epithelial-mesenchymal transition and inhibit apoptosis of ESCC cells,while inhibition of miR-1246 had the opposite effect.Database data analysis found that TET2 and CADM1 were the target genes of miR-1246.The dual-luciferase reporter gene assay confirmed that miR-1246 could directly bind to TET2 and CADM1 mRNA and inhibit their expressions(P<0.01).Treatment of KYSE150 and KYSE30 cells with Exo derived from cells overexpressing miR-1246 had the same effect as overexpressing miR-1246 in these cells.Conclusion:Exo-derived miR-1246 has the potential to be a clinical auxiliary diagnostic marker for ESCC.It may affect the occurrence and development of ESCC by regulating the expression levels of TET2 and CADM1.
6.Comparative efficacy of arthroscopic figure-of-eight transtibial tension-reduction technique combined with interference screw fixation versus interface screw fixation alone in the treatment of anterior cruciate ligament rupture
Jian YANG ; Feng SHANG ; Xing ZHAO ; Xiaorui ZHOU ; Xi WANG ; Shengkang XU
Chinese Journal of Trauma 2025;41(5):481-488
Objective:To compare the efficacy of arthroscopic figure-of-eight transtibial tension-reducing technique combined with interference screw fixation versus interface screw fixation alone in the treatment of anterior cruciate ligament (ACL) rupture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 43 patients with ACL rupture admitted to Taihe Hospital between January 2022 and October 2023, including 24 males and 19 females, aged 17-61 years [(38.0±12.6)years]. Based on the tibial fixation method, 20 patients were treated with interference screw fixation alone (interference screw group) and 23 patients with figure-of-eight transtibial tension-reduction technique combined with interference screw fixation (figure-of-eight tension-reduction combined with interference screw group). An Endobutton suspension plate was used in femoral fixation in both groups. The following parameters were compared between the two groups: operative duration and graft diameter; coronal and sagittal tibial tunnel measurements by MRI within 72 hours postoperatively and at the last follow-up; knee range of motion, visual analogue scale (VAS) scores, International Knee Documentation Committee (IKDC) scores, and Lysholm scores preoperatively, at 1 month postoperatively, and at the last follow-up; perioperative complication rates.Results:All the patients were followed up for 11-28 months [(14.1±3.4)months]. There were no significant differences in operative duration or graft diameter between the two groups ( P>0.05). No significant differences were observed in coronal or sagittal tibial tunnel measurements between the two groups within 72 hours postoperatively ( P>0.05). Whereas at the last follow-up, the coronal and sagittal tibial tunnel measurements in the figure-of-eight tension-reduction combined with interference screw group were (11.6±0.7)mm and (11.7±1.1)mm, significantly lower than (13.5±0.6)mm and (13.4±1.9)mm in the interference screw group ( P<0.01). Preoperative knee range of motion, IKDC scores, Lysholm scores, and VAS scores showed no significant differences between the two groups ( P>0.05). At 1 month postoperatively and at the last follow-up, the figure-of-eight tension-reduction combined with interference screw group demonstrated significantly greater knee range of motion [100.0(95.0, 100.0)° and 130.0(120.0, 135.0)°], compared with 72.5(60.0, 95.0)° and 120.0(105.0, 133.3)° in the interference screw group ( P<0.05). VAS scores at 1 month postoperatively and at the last follow-up were 2.0(2.0, 2.0)]points and 1.0(1.0, 1.0)points in the figure-of-eight tension-reduction combined with interference screw group, significantly lower than 3.0(2.3, 4.0)points and 2.0(1.0, 2.0)points in the interference screw group ( P<0.05). IKDC scores at 1 month postoperatively and at the last follow-up were (58.8±5.7)points and (72.4±6.7)points in the figure-of-eight tension-reduction combined with interference screw group, significantly higher than (51.1±5.2)points and (67.4±7.9)points in the interference screw group ( P<0.05). Lysholm scores at 1 month postoperatively and at the last follow-up were (58.9±12.7)points and (89.1±6.0)points in the figure-of-eight tension-reduction combined with interference screw group, significantly higher than (41.2±15.0)points and (78.3±12.3)points in the interference screw group ( P<0.05). No perioperative complications were observed in either group. Conclusion:Compared with interface screw fixation alone, arthroscopic figure-of-eight transtibial tension-reduction technique combined with interference screw fixation for ACL rupture can enhance graft stability, restore knee joint range of motion, alleviate pain, and improve knee function recovery.
7.Analysis of the distribution and drug resistance of common gram-negative bacteria isolated from clinical specimens in a tuberculosis specialized hospital
Yanling GUO ; Shang MA ; Wenfu JU ; Guirong WANG ; Yan ZHAO
Chinese Journal of Microbiology and Immunology 2025;45(10):881-890
Objective:To summarize the drug resistance characteristics of clinical pathogen isolates in a tuberculosis specialized hospital from 2017 to 2023,and understand the distribution characterisitics of pathogens and their resistance to antimicrobial agents.Methods:The isolates from January 2017 to December 2023 were identified and subjected to drug susceptibility tests using the VITEK 2-compact system. The susceptibilities of the isolates to antimicrobial agents were determined by the minimum inhibitory concentration(MIC)methods according to the CLSI(2023)guideline. The data of detection of different kinds of bacteria,specimen distribution and the detection rates of major drug-resistant gram-negative bacteria in hospital antimicrobial resistance were analyzed. Chi square test were performed to analyze one or more sets of data related to detection rate or drug resistance rate by SPSS 17.0.Results:A total of 9 993 isolates were detected,among which 9 079(90.9%)were gram-negative bacteria and 914(9.1%)were gram-positive bacteria. From 2017 to 2022,among all gram-negative isolates,the top three most frequently isolated pathogens were Klebsiella pneumonia,followed by Pseudomonas aeruginosa and Acinetobacter baumannii. The overall resistance rates to carbapenems in Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumonia,and Escherichia coli were 43.7%(495/1 133),19.4%(276/1 423),8.4%(279/3 304),3.6%(19/521),respectively. The overall detection rates of ceftriaxone/ciprofloxacin-resistant Klebsiella pneumonia(CTX/CRO-R-KPN),or Escherichia coli(CTX/CRO-R-ECO),and quinolone-resistant Escherichia coli(QNR-ECO)were 19.5%(644/3 304),57.6%(300/521),77.4%(403/521),respectively. The difference in resistance rates between imipenem-resistant and imipenem-susceptible Klebsiella pneumoniae was statistically significant( P<0.05). Except for CTX/CRO-R-ECO( χ2=7.9 ,P>0.05),significant differences were observed in the detection rates of other major drug-resistant gram-negative bacteria in hospital( P<0.05). The detection of some drug-resistant strains showed an upward trend in recent years. Carbapenem-resistant Acinetobacter baumannii, Pseudomonas aeruginosa,and Escherichia coli exhibited higher resistance rate to other antibiotics. Conclusions:The detection rates of major drug-resistant gram-negative bacteria have increased in the past two years. Carbapenem-resistant strains exhibit relatively high resistance rate to cephalosporin and quinolone antibiotics. Although carbapenem antibiotics remain effective against Enterobacteriaceae,strengthened antimicrobial resistance monitoring and control of multidrug-resistant bacteria spread are necessary.
8.Analysis of the potential disease burden of occupational polycyclic aromatic hydrocarbons exposure-associated lung cancer in China from 1990 to 2021
Jingyuan ZHAO ; Yang LIU ; Nan SHANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2025;43(6):430-434
Objective:To assess the disease burden of lung cancer associated with occupational exposure to polycyclic aromatic hydrocarbons (PAHs) in China from 1990 to 2021 using the 2021 Global Burden of Disease (GBD) data.Methods:In July 2024, data on occupational PAHs exposure-associated lung cancer from 1990 to 2021 were extracted from the GBD database, including mortality rates, age-standardized mortality rates, number of deaths, disability-adjusted life years (DALYs) rates, age-standardized DALYs rates, and number of DALYs for different genders and ages. Descriptive statistics were used to analyze trends in lung cancer mortality rates, age-standardized mortality rates, DALYs rates, and age-standardized DALYs rates over different years, genders, and ages. Joinpoint regression models were used to calculate the annual percent change (APC) and average annual percent change (AAPC), and to identify change points and trends in different periods within the data.Results:From 1990 to 2021, the mortality rate of lung cancer associated with occupational PAHs exposure increased from 0.085 per 100000 to 0.259 per 100000, and the age-standardized mortality rate increased from 0.107 per 100000 to 0.162 per 100000. The DALYs rate increased from 2.746 per 100000 to 7.389 per 100000, and the age-standardized DALYs rate increased from 3.330 per 100000 to 4.679 per 100000. The number of lung cancer deaths and DALYs both peaked in the 65-69 age group. Joinpoint regression analysis showed significant upward trends in mortality, age-standardized mortality, DALYs rate, and age-standardized DALYs rate from 1990 to 2021, with AAPCs of 3.655%, 1.382%, 3.256%, and 1.108%, respectively (all P<0.001). From 2016 to 2021, both the mortality rate and age-standardized mortality rate increased, with APCs of 4.163% and 1.735%, respectively. From 2015 to 2021, the DALYs rate increased (APC: 3.137%), and from 2016 to 2021, the age-standardized DALYs rate also rose (APC: 1.578%). For females, both mortality and DALYs rates increased from 2015 to 2021 (APCs: 6.269% and 5.426%, respectively). Among males, the mortality rate increased from 2018 to 2021 (APC: 3.477%) . Conclusion:From 1990 to 2021, the disease burden of lung cancer related to occupational PAHs exposure in China has significantly increased, particularly among the elderly population. Public health policies should enhance screening and prevention efforts targeting the high-risk populations.
9.Development and evaluation of a health management model for the elderly in rural areas
Jingyuan ZHAO ; Nan SHANG ; Pei WANG ; Tian LI
Chinese Journal of Health Management 2025;19(12):1007-1012
Objective:To develop a health management model tailored for the elderly population in rural areas and to evaluate its effectiveness.Methods:This before-and-after controlled intervention study was conducted from January 2024 to June 2024 in rural areas of Jiaocheng County, Shanxi Province. A multi-stage stratified random sampling method was used to include 5 000 permanent residents aged ≥65 years. A baseline health survey was first conducted to collect multidimensional data, including demographic characteristics, chronic disease information, cognitive and psychological scales, sleep quality, and health service utilization. Using the comprehensive health index as the outcome variable, seven machine learning models, including LightGBM, were constructed to identify key factors influencing health status and explore intervention pathways. Subsequently, under the framework of a "five-level linkage+shared database, " comprehensive interventions such as health communication, integrated medical and elderly care, and dynamic follow-ups were implemented. Differences in major health indicators were compared before and after the 6-month intervention.Results:At baseline, the prevalence rates of hypertension, diabetes, and coronary heart disease were 58.2%, 24.8%, and 16.1%, respectively. The rate of cognitive impairment was 36.9%, and the positive rates for depression and anxiety were 27.3% and 17.4%, respectively. Machine learning analysis showed that the Naive Bayes model had the best predictive performance (area under the curve=0.966), with key influencing factors including number of follow-ups, number of health lectures, and medical check-up frequency. After six months of intervention, systolic blood pressure decreased from (142.95±15.84) to (138.37±17.20) mmHg (1 mmHg=0.133 kPa), fasting glucose from (6.43±1.26) to (6.09±1.40) mmol/L, and MMSE scores increased from (25.04±3.28) to (25.71±3.29) points. The positive rates of anxiety and depression declined from 17.4% to 12.8% and 27.3% to 20.6%, respectively. Follow-up compliance improved from 76.5% to 80.5%, and health record completeness from 69.8% to 75.8% (all P<0.001). Conclusions:The integrated health management model based on the"five-level linkage+shared database,"incorporating health education and the integration of medical and elderly care, effectively improves chronic disease control and enhances cognitive and psychological health among older adults in rural areas of Shanxi Province. This model also strengthens service adherence and management efficiency.
10.The regulatory role of endoplasmic reticulum stress-related long non-coding RNA Gm9795 in hepatocellular carcinoma
Mingming WANG ; Weiwei SHANG ; Guoping ZHAO
Tumor 2025;45(2):111-125
Objective:To investigate the role of endoplasmic reticulum stress(ERS)-related long non-coding RNA(lnc RNA)Gm9795 in the progression of hepatocellular carcinoma(HCC).Methods:This retrospective cohort study included 80 HCC patients who underwent routine surgical procedures at Nanjing Jiangning Hospital from 2014 to 2020.Colecting clinical datas from all patients and using real-time fluorescence quantitative PCR to detect the expression level of Gm9795 in 80 patients'cancer and adjacent tissues,as well as in HCC cells(HepG2,Hep3B,HCCLM3,and Huh7).The correlation between Gm9795 expression and overall survival time and recurrence free survival time of HCC patients was analysised.Constructing HCCLM3 cells overexpressing Gm9795 through lentiviral infection,and constructing Huh7 cells silencing Gm9795 expression through liposome transfection.The proliferation ability of cells was evaluated using CCK-8 assay and colony formation assay,while the migration and invasion ability of cells were detected using Transwell assay.Identification of Gm9795 specific binding protein by mass spectrometry(MS).The effect of overexpressing or silencing Gm9795 expression on the expression of C/EBP homologous protein(CHOP)gene was detected by Western blotting.The CHOP gene was simultaneously transferred into HCCLM3 cells overexpressing Gm9795,and the effects of up-regulating CHOP expression level on the proliferation,migration,and invasion of HCCLM3 cells were evaluated using CCK-8 assay,colony formation assay,and Transwell assay.Results:Compared with adjacent tissues,the expression level of Gm9795 was significantly up-regulated in HCC tissues(P<0.001).The expression levels of Gm9795 in all HCC cells were significantly higher than in normal hepatocytes LO2(all P<0.05).Higher expression levels of Gm9795 were associated with aggressive clinical pathological features,including tumor size,multiple tumors,Barcelona Clinic Liver Cancer(BCLC)staging,and portal vein tumor thrombus(all P<0.05).The results of multivariate analysis showed that high expression level of Gm9795 was an independent prognostic factor for overall survival and recurrence free survival in HCC patients(both P<0.05).The higher expression of Gm9795 was significantly correlated with shorter overall survival and recurrence free survival in the cohort(both P<0.01).Compared with the Vector group,the proliferation,migration,and invasion of HCCLM3 cells were significantly enhanced in the Gm9795 overexpression group(all P<0.01);Compared with the siNC group,the proliferation,migration,and invasion of Huh7 cells were significantly reduced in the siGm9795-1 and siGm9795-2 groups(all P<0.01).CHOP was identified as a Gm9795 specific binding protein by MS.Compared with the Gm9795+Vector group,the Gm9795+CHOP group showed significant reductions in proliferation,migration,and invasion of HCCLM3 cells(all P<0.01).Conclusions:Gm9795 is up-regulated in HCC tissues,and the high expression of Gm9795 is an independent prognostic factor for the overall survival of HCC patients.Gm9795 promotes the proliferation and invasion of HCC cells in vitro,and its mechanism may be related to the inhibition of ERS mediated by CHOP signaling pathway.

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