Electromagnetic fields can regulate the fundamental biological processes involved in bone remodeling. As a non-invasive physical therapy, electromagnetic fields with specific parameters have demonstrated therapeutic effects on bone remodeling diseases, such as fractures and osteoporosis. Electromagnetic fields can be generated by the movement of charged particles or induced by varying currents. Based on whether the strength and direction of the electric field change over time, electromagnetic fields can be classified into static and time-varying fields. The treatment of bone remodeling diseases with static magnetic fields primarily focuses on fractures, often using magnetic splints to immobilize the fracture site while studying the effects of static magnetic fields on bone healing. However, there has been relatively little research on the prevention and treatment of osteoporosis using static magnetic fields. Pulsed electromagnetic fields, a type of time-varying field, have been widely used in clinical studies for treating fractures, osteoporosis, and non-union. However, current clinical applications are limited to low-frequency, and research on the relationship between frequency and biological effects remains insufficient. We believe that different types of electromagnetic fields acting on bone can induce various “secondary physical quantities”, such as magnetism, force, electricity, acoustics, and thermal energy, which can stimulate bone cells either individually or simultaneously. Bone cells possess specific electromagnetic properties, and in a static magnetic field, the presence of a magnetic field gradient can exert a certain magnetism on the bone tissue, leading to observable effects. In a time-varying magnetic field, the charged particles within the bone experience varying Lorentz forces, causing vibrations and generating acoustic effects. Additionally, as the frequency of the time-varying field increases, induced currents or potentials can be generated within the bone, leading to electrical effects. When the frequency and power exceed a certain threshold, electromagnetic energy can be converted into thermal energy, producing thermal effects. In summary, external electromagnetic fields with different characteristics can generate multiple physical quantities within biological tissues, such as magnetic, electric, mechanical, acoustic, and thermal effects. These physical quantities may also interact and couple with each other, stimulating the biological tissues in a combined or composite manner, thereby producing biological effects. This understanding is key to elucidating the electromagnetic mechanisms of how electromagnetic fields influence biological tissues. In the study of electromagnetic fields for bone remodeling diseases, attention should be paid to the biological effects of bone remodeling under different electromagnetic wave characteristics. This includes exploring innovative electromagnetic source technologies applicable to bone remodeling, identifying safe and effective electromagnetic field parameters, and combining basic research with technological invention to develop scientifically grounded, advanced key technologies for innovative electromagnetic treatment devices targeting bone remodeling diseases. In conclusion, electromagnetic fields and multiple physical factors have the potential to prevent and treat bone remodeling diseases, and have significant application prospects.

Objective To analyze the evaluation and influencing factors of healthy enterprises in Hubei Province from 2020 to 2023. Methods A total of 351 enterprises participated in the healthy enterprise evaluation in Hubei province were selected as the study subjects using the judgmental sampling method. The differences in evaluation results including scales, industry sector, and ownership type of the enterprises were compared. Results The median and the 25th and 75th percentiles [M (P₂₅, P₇₅)] of the evaluation score among the 351 enterprises was 869 (838, 941) points. The evaluation pass rate was 82.3%. The M(P₂₅, P₇₅) of scores for the management system, health environment, health management and services, health culture, and health outcome review were 183 (174, 192), 190 (181, 198), 340 (321, 376), 133 (122, 142), and 26 (24, 28) points, with the score percentage of 91.5%, 86.4%, 85.0%, 88.7%, and 86.7%, respectively. The deduction rate exceeded 50.0% in six items, which predominantly concentrated within the primary indicator of the health management and services, among the tertiary indicators. The result of multiple linear regression analysis revealed that smaller enterprises had significantly lower evaluation scores (P<0.05), and domestically funded enterprises scored significantly lower than those with investment from Hong Kong, Macao and Taiwan, or foreign investments (all P<0.05). Conclusion Health management and services represent a weak area in healthy enterprise development in Hubei Province. It was suggested to improve policy incentives and support for medium-, small- and micro-sized enterprises, and domestically funded enterprises, to enhance healthy enterprise development levels.

Redox-sensitive cysteine(RSC)thiol plays an important role in many biological processes such as photosynthesis,cellular metabolism,and transcription.Therefore,it is necessary to identify red-ox-sensitive cysteine accurately.However,traditional redox-sensitive cysteine identification is very ex-pensive and time-consuming.At present,there is an urgent need for a mathematical calculation method to identify sequence information and redox-sensitive cysteines quickly and accurately.Here,we devel-oped an effective predictor called iRSC-PseAAC,which used the dimension reduction algorithm LDA combined with the support vector machine to predict redox-sensitive cysteine sites.In the cross-validation results,the specificity(Sp),sensitivity(Sn),accuracy(Acc)and Matthews correlation coefficient(MCC)were 0.841,0.868,0.859 and 0.692 respectively.In the independent dataset results,the Sp,Sn,Acc and MCC were 0.906,0.882,0.890 and 0.767 respectively.compared with existing prediction methods,iRSC-PseAAC had obvious improvement effect.The method proposed for this study can also be used for many problems in computational proteomics.

Cancer stem cells,a small population of cells with self-renewal and multidirectional differenti-ation potential in tumor tissues,can initiate primary tumors and mediate treatment resistance,tumor re-currence,and metastasis,but the mechanism of how they affect colorectal cancer at the cellular level is unknown.Therefore,in this study,we explored the effect of cancer stem cells and their exosomes on the malignant phenotype of colorectal cancer.First,CD 166+CD44+cancer stem cells(CSCs)were isolated from colorectal cancer tumor tissues,and then cancer stem cell-derived exosomes(CSCexo)and colorec-tal cancer SW480 cell-derived exosomes(Sexo)were extracted by ultracentrifugation.Then,exosomes were subjected to NTA particle size analysis,electron microscopic observation and identification by West-ern blotting.Subsequently,the successfully isolated CSC and CSCexo were co-cultured with colorectal cancer SW480 cells.The apoptosis rate of SW480 cells after co-culture was found to decrease from 20％to about 13％by CCK-8,apoptosis assay(P＜0.01)and the invasive ability was significantly increased(P＜0.001)after co-culture with CSC or CSCexo.In addition,in vivo animal experiments revealed that the tumor growth rate of the S-exo treatment group was slower than that of the CSCexo treatment group,and that CSCexo inhibited the drug efficacy of 5-FU against colorectal cancer tumors.PET/CT imaging,immunohistochemical analysis,and Western blotting experiments showed that CSCexo enhanced the up-take of the glucose analog 18F-FDG and the expression of the glycolytic enzymes HK2,PFKFB2,PKM2,and LDHA in colorectal cancer.In addition,interfering with the expression of glycolytic enzymes with siRNAs blocked the drug resistance induced by CSCexo.In summary,this study demonstrates that color-ectal cancer stem cells deliver exosomes that affect tumor glucose metabolism pathways and promote chemotherapy resistance and invasive ability,revealing the mechanism of formation and dynamic changes in the malignant tumor microenvironment.

Objectives:To investigate the feasibility of using bedside echocardiography on the evaluation of potential donors with different causes of brain death for adult heart transplantation. Methods:Bedside echocardiographic and clinical data of consecutive potential donors for adult heart transplantation evaluated by the team of our institution from February 2018 to December 2020 were retrospectively analyzed.Based on different causes of brain death,the potential donors were divided into stroke(ischemic or hemorrhagic,n=398)and non-stroke(head trauma,brain tumor,anoxia,n=272)groups.The clinical and echocardiographic features were compared between the two groups.A total of 350 donors were assigned to our hospital by the China Organ Transplant Response System and met the inclusion criteria for donor selection.There were 195 cases in the stroke group and 155 in the non-stroke group.Retrieval operations were performed and the retrieval rate of hearts for transplantation in stroke donors was compared to that in non-stroke donors. Results:(1)Among the 670 potential heart donors,compared with the non-stroke group,donors in the stroke group were significantly older,had higher body mass index,larger left ventricular end-diastolic diameter,thicker interventricular septum,higher rates of echocardiographic abnormalities,higher prevalence of hypertension(all P<0.001).Among the 670 potential heart donors,17.5%(117 cases)did not meet the echo selection criteria,the common causes were left ventricular hypertrophy(59 cases,50.4%),left ventricular ejection fraction<50%(27 cases,23.1%),wall motion abnormalities(21 cases,17.9%),and left ventricular dilation(14 cases,12.0%).(2)Among the 350 donors who had met the selection criteria and assigned to our hospital by the China Organ Transplant Response System and underwent retrieval operation,70.3%(246 cases)were successfully procured,110 cases(44.7%)in the stroke group and 136 cases(55.3%)in the non-stroke group.The retrieval rate of stroke donors(110/195,56.4%)was lower compared with that of non-stroke(136/155,87.7%,P<0.001),104 cases(29.7%)were not retrieved,and the leading cause of unsuccessful organ retrieval was the occlusion of at least one major coronary artery(91 cases,87.5%). Conclusions:Bedside echocardiography is of great value as a screening tool for cardiac donors.Cardiac structures of the potential donor with stroke as the cause of brain death were different from those with non-stroke causes.The retrieval rate of stroke donors was lower than that of non-stroke donors,even if the initial criteria for donor selection were fulfilled.

Objective:To explore the trends and outcomes for heart transplantation (HT) in elderly recipients and further examine the related risk factors.Methods:Between June 2004 and December 2021, retrospective review was conducted for the relevant clinical data and age distribution of 1044 HT recipients aged ≥18 year at Fuwai Hospital. The study population was assigned into two groups of elder (≥60 year, n=877) and non-elder (<60 year, n=157). Subgroup analysis was made between recipients aged <65 year (n=107) and those aged ≥ 65 year (n=50) in elder group. Baseline demographic profiles, clinical data, in-hospital and one-year post-transplant mortality and long-term survival were compared between two groups. Then a further comparison of long-term survival was conducted among the groups of non-elder, elder aged <65 year and elder aged ≥65 year. Cox proportional risk regression and multivariate Logistic regression models were utilized for examining the relevant risk factors for cumulative survival rate and short-term mortality. Kaplan-Meier analysis was employed for plotting survival curves and Log-rank test for comparison. Multivariate Cox proportional risk regression model was utilized for examining the relevant risk factors for cumulative survival rate and multivariate Logistic regression model for analyzing the relevant risk factors for short-term mortality. After adjusting for other confounding factors, the impact of recipient age on survival post-HT was determined.Results:The number of elderly HT recipients spiked annually at our center while average age of adult recipients and average age of elderly recipients have remained relatively constant. The median follow-up period was 6.5 years. Regarding baseline data, statistically significant differences existed in ratio of males [84.7%(113/157) vs 77.5%(687/877)], hypertension history [20.4%(32/157) vs 8.9%(79/877)], smoking history [47.1%(74/157) vs 36.1%(320/877)], diabetic history [33.8%(53/157) vs 14.7%(130/877)], preoperative ICD/CRT/CRT-D implantation [28.0%(44/157) vs 18.0%(160/877)], value of creatinine [(105.3±25.3) vs (96.8±35.0) μmol/L], IMPACT score [(6.9±2.4) vs (4.2±2.9) point], serum total bilirubin [19.7(13.6, 30.3) vs 23.7(15.8, 36.8) μmol/L], mean pulmonary arterial pressure [(26.0±10.3) vs (29.7±11.0) mmHg (1 mmHg=0.133 kPa)] and ischemic duration [(274.7±105.6) vs (296.0±120.4) min] (all P<0.05). No significant inter-group difference existed in in-hospital mortality [4.5%(7/157) vs 4.7%(42/887)] or 1-year mortality [5.7%(9/157) vs 6.5%(58/887)] ( P=0.88, P=0.70); in-hospital mortality and 1-year postoperative mortality of recipients aged ≥65 years 10.0%(5/50) and 14.0%(7/50) were both higher than those aged <65 year [1.9%(2/107), 1.9%(2/107)]. The differences were both statistically significant ( P=0.02, P<0.01). Kaplan-Meier survival analysis indicated that long-term survival rate was lower in elder group than that in non-elder group and the difference was statistically significant ( P=0.046). Long-term survival rate of elders aged ≥65 year was lower than that of non-elders aged <65 year and the difference was statistically significant ( P<0.01). Regression analysis indicated that age of recipient ≥65 year, preoperative creatinine ≥133 μmol/L, preoperative total bilirubin ≥25.65 μmol/L and preoperative support of extracorporeal membrane oxygenation (ECMO) were independent risk factors for short/long-term mortality post-HT. Conclusion:Although long-term prognosis of elderly recipients is slightly worse than that of non-elderly ones, in-hospital mortality and one-year postoperative mortality are similar between two groups. For elderly recipients with fewer comorbidities and better preoperative status, they should not be excluded from HT based solely upon age. The long-term prognosis of recipients aged ≥65 year remains poor and HT decisions should be made carefully.

Narrative medicine,as an interdisciplinary field at the intersection of humanistic education and medical edu-cation,is an effective means of implementing medical humanities.It not only fosters deeper empathy and communication between doctors and patients but also plays an important role in clinical practice and the cultivation of humanistic qualities.This study starts from the core connotation of integrating narrative medicine into the doctor-patient relationship,focusing on the value logic of narrative medicine empowering humanistic care.Utilizing a typical case from a hospital in Tianjin that practices humanistic care based on narrative medicine,the study examines the organizational structure,practical activities,humanistic care initiatives,health education,supportive measures,and outcomes of the narrative medicine healthcare management team.The conclusion drawn is that exploring mechanisms for medical communication and the cultivation of humanistic qualities can facilitate the mutual transformation of narrative and empathy skills,the organic combination of narrative medicine with evidence-based medicine,and the complementary relationship between clinical medicine and humanistic education.This approach aims to alleviate the increas-ingly prominent conflicts between doctors and patients,bridge the gap between humanity and technology,and promote the imple-mentation of medical humanities in clinical settings.

Objective The aim of this study was to compare the effect of injection of indocyanine green(ICG)through peripheral vein and gallbladder in laparoscopic cholecystectomy(LC)of difficult gallbladder.Methods Patients with difficult gallbladder who underwent LC by the same surgical team from May to October 2023 in the Department of Hepatobiliary Surgery,the First Affiliated Hospital of Anhui University of Science and Technology were divided into three groups according to A random number table.Group A was injected ICG through peripheral vein before operation,group B was injected ICG through gallbladder during operation,and group C was the control group.The differences of operation time,intraoperative blood loss,hospitalization time,hospitalization cost and postoperative complications among the three groups were compared,and the effects of fluorescence mode cholangio-gram in group A and group B were compared.One-way analysis of variance was used to compare the normal distri-bution of the measurement data among groups,and LSD-t test was used to compare the two groups.The counting data was compared by chi-square test.The Boferroni test was appied to compare the two groups.Results There were no differences in length of stay,hospitalization cost and postoperative complications among the three groups(P＞0.05).The operative time and intraoperative blood loss of group A and group B were lower than those of group C(P＜0.05),but there was no difference between group A and group B(P＞0.05).The total imaging rate of the first three tubes of free gallbladder triangle(early stage)in group A was 41.67%,which was significantly lower than that in group B(63.89%)(P＜0.05).Conclusion ICG is beneficial for the identification of extrahepatic bile duct structures during LC of difficult gallbladder,and ICG injection through the gallbladder is helpful for the early identification of extrahepatic bile duct.

Natural products are important sources for the discovery of anti-tumor drugs. Evodiamine is the main alkaloid component of the traditional Chinese herb Wu-Chu-Yu, and it has weak antitumor activity. In recent years, a number of highly active antitumor candidates have been discovered with a significant progress. This article reviews the research progress of evodiamine-based antitumor drug design strategies, in order to provide reference for the development of new drugs with natural products as leads.

AIM To establish a UPLC-MS/MS method for the simultaneous content determination of liquiritin apioside,alibiflorin,swertiamarin,methyl gallate,benzoylpaeoniflorin,sweroside,6′-O-β-D-glucosylgentiopicroside,isoliquiritigenin,loganic acid,liquiritigenin,gallic acid,paeoniflorin,oxypaeoniflorin,gentiopicroside,glycyrrhizic acid,isoliquiritoside and liquiritin in Yangxue Ruanjian Capsules.METHODS The analysis was performed on a 40℃thermostatic Waters BEH C18column(2.1 mm×100 mm,1.7 μm),with the mobile phase comprising of 2 mmol/L ammonium acetate(containing 0.1%formic acid)-acetonitrile flowing at 0.3 mL/min in a gradient elution manner,and electron spray ionization source was adopted in negative ion scanning with multiple reaction monitoring mode.RESULTS Seventeen constituents showed good linear relationships within their own ranges(r>0.999 6),whose average recoveries were 91.33%-104.03%with the RSDs of 1.58%-3.50%.CONCLUSION This rapid,accurate and stable method can be used for the quality control of Yangxue Ruanjian Capsules.