ObjectiveTo investigate the effect of Gelian Tiaotang pills on renal fibrosis in db/db mice based on the nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 （NLRP3）/cysteinyl aspartate-specific proteinase （Caspase）-1/gasdermin D （GSDMD） signaling pathway. MethodsForty db/db mice were randomly assigned into model， positive control （0.001 3 g·kg·d^-1 dapagliflozin suspension）， and high-， medium-， and low-dose Gelian Tiaotang pills （3.12， 1.56， and 0.78 g·kg·d^-1 suspension of Gelian Tiaotang pills， respectively） groups， with 8 mice in each group. Eight db/m mice were selected as the normal group. The normal group and model group were given equal volumes of pure water， while the drug interventions groups were administrated with corresponding agents by gavage once a day for 12 consecutive weeks. The general conditions of mice were observed daily. The fasting blood glucose （FBG） and body mass were measured every 4 weeks. Kidneys were weighed after sampling， and the kidney index was calculated. An automatic biochemical analyzer was used to measure the serum levels of triglyceride （TG）， total cholesterol （TC）， serum creatinine （SCr）， and blood urea nitrogen （BUN）. The pathological changes， extracellular matrix deposition， and renal fibrosis degree were examined by hematoxylin-eosin， periodic acid-schiff （PAS）， and Masson staining， respectively. Enzyme-linked immunosorbent assay was employed to measure the levels of interleukin （IL）-1β and IL-18 in the renal tissue. Immunohistochemistry （IHC） was used to detect the localization and expression of fibronectin and collagen Ⅰ in the renal tissue. Western blot was employed to determine the protein levels of NLRP3， Caspase-1， cleaved Caspase-1， GSDMD， and GSDMD-N in the renal tissue. ResultsCompared with the normal group， the model group generally had poor general states and increases in the body mass， kidney weight， kidney index， and levels of FBG， TG， TC， SCr， and BUN （P<0.01）. In addition， glomerular pyknosis， increased matrix， vacuolar degeneration of renal tubular epithelial cells， and interstitial infiltration of inflammatory cells were observed in the model group （P<0.01）， together with rises in the levels of IL-1β and IL-18 in the renal tissue （P<0.01） and up-regulated protein levels of NLRP3， Caspase-1， cleaved Caspase-1， GSDMD， GSDMD-N， fibronectin， and collagen Ⅰ in the renal tissue （P<0.01）. Compared with the model group， 12 weeks of drug interventions reduced the body mass， kidney weight， and kidney index and lowered the levels of FBG， TG， TC， SCr， and BUN in the serum and IL-1β and IL-18 in the renal tissue （P<0.05， P<0.01）. Furthermore， drug interventions ameliorated the renal lesions and down-regulated the protein levels of NLRP3， Caspase-1， cleaved Caspase-1， GSDMD， GSDMD-N， fibronectin， and collagen Ⅰ in the renal tissue （P<0.05， P<0.01）. The high-dose group of Gelian Tiaotang pills had the best effects. ConclusionGelian Tiaotang pills may inhibit pyroptosis and reduce inflammatory responses by regulating the NLRP3/Caspase-1/GSDMD signaling pathway， thus delaying the process of renal fibrosis in diabetes.

BACKGROUND: Hypertension is a serious chronic disease that can significantly lead to various cardiovascular diseases, affecting vital organs such as the heart, brain, and kidneys. Our goal is to predict the risk of new onset hypertension using machine learning algorithms and identify the characteristics of patients with new onset hypertension. METHODS: We analyzed data from the 2011 China Health and Nutrition Survey cohort of individuals who were not hypertensive at baseline and had follow-up results available for prediction by 2015. We tested and evaluated the performance of four traditional machine learning algorithms commonly used in epidemiological studies: Logistic Regression, Support Vector Machine, XGBoost, LightGBM, and two deep learning algorithms: TabNet and AMFormer model. We modeled using 16 and 29 features, respectively. SHAP values were applied to select key features associated with new onset hypertension. RESULTS: A total of 4,982 participants were included in the analysis, of whom 1,017 developed hypertension during the 4-year follow-up. Among the 16-feature models, Logistic Regression had the highest AUC of 0.784(0.775∼0.806). In the 29-feature prediction models, AMFormer performed the best with an AUC of 0.802(0.795∼0.820), and also scored the highest in MCC (0.417, 95%CI: 0.400∼0.434) and F1 (0.503, 95%CI: 0.484∼0.505) metrics, demonstrating superior overall performance compared to the other models. Additionally, key features selected based on the AMFormer, such as age, province, waist circumference, urban or rural location, education level, employment status, weight, WHR, and BMI, played significant roles. CONCLUSION We used the AMFormer model for the first time in predicting new onset hypertension and achieved the best results among the six algorithms tested. Key features associated with new onset hypertension can be determined through this algorithm. The practice of machine learning algorithms can further enhance the predictive efficacy of diseases and identify risk factors for diseases.
Humans ; China/epidemiology* ; Hypertension/diagnosis* ; Machine Learning ; Male ; Female ; Middle Aged ; Adult ; Nutrition Surveys ; Algorithms ; Aged ; Risk Factors

Oral squamous cell carcinoma(OSCC)accounts for over 90％of oral malignancies,with more than 370 000 new cases and approximately 188 000 deaths annually worldwide.In China,there are roughly 65 000 new cases and 35 000 deaths each year,showing a significant upward trend compared with 2015 statistics.Despite continuous advancements in treatment modalities,the 5-year survival rate remains stagnant at 50％-60％,where tumor heterogeneity and therapy resistance persist as fundamental barriers to precision oncology.To address these critical challenges,this study established a standardized bioban-king protocol for OSCC patient-derived organoids(PDOs)(Patent:Method for constructing an oral squa-mous cell carcinoma organoid bank,ZL202311378598.3).Through groundbreaking optimization of cul-ture media,enzymatic digestion kinetics,and stepwise cryopreservation,we achieved a biobanking suc-cess rate exceeding 95％and pioneered synchronous cultivation of matched primary tumors,lymph node metastases,and adjacent normal mucosa from individual patients,preserving spatial heterogeneity and stromal interactions.Leveraging this platform,we developed high-throughput drug screening:Quantified heterogeneity-driven differential chemoresponse using adenosine triphosphate(ATP)-based viability as-says;We discovered resistance mechanisms:Identified sialylated cancer IgG(SIA-cIgG)-mediated cis-platin resistance(primary/secondary)through PTPN13 suppression,with anti-SIA-cIgG combination therapy demonstrating synergistic efficacy.Besides,we elucidated metastatic drivers:CRISPR-Cas9-edited organoids revealed WDR54 promoted metastasis via H3K4me3/H4K16ac epigenetic reprogramming,activating epithelial-mesenchymal plasticity(EMP)and inducing partial epithelial-mesenchymal transi-tion(pEMT).This"holographic patient-mirroring"platform provided unprecedented resolution for OSCC precision therapy and had been formally incorporated into the Chinese Stomatological Association Techni-cal Guidelines(Technical guideline for establishing patient-derived oral squamous cell carcinoma or-ganoid banks,CHSA 2024-08).Future integration of immune-competent organoids,3D-bioprinted vas-culature,and multi-omics-AI systems will accelerate personalized oncology.These innovations will accelerate clinical translation of personalized therapeutic regimens,ultimately bridging the gap between bench research and bedside application.

Objective To investigate the current status of home medicine cabinet management and unmet needs for home-based pharmaceutical services among elderly hypertensive patients in Hubei Province,and to provide evidence for optimizing home pharmaceutical care models.Methods From July 2022 to March 2023,310 elderly hypertension patients across Hubei Province were enrolled.Pharmacists conducted home visits to administer structured questionnaires capturing demographics and blood pressure control rates,perform medication categorization and quality assessments of home medicine cabinets and document cabinet management issues in real-time.Results Among 290 valid questionnaires,binary logistic regression revealed better blood pressure control in non-working and non-smoking individuals.Medicine cabinet audits identified three critical issues:failure to separate Chinese and chemical medicines,duplicate medications with similar ingredients and missing original packaging.Post-intervention,all cabinets demonstrated proper medication categorization and storage compliance.Conclusions Significant medication safety hazards exist in elderly hypertensive patients'home medicine cabinets.Pharmacist-led home interventions effectively cleared substandard medications and improved medication safety.Future home pharmaceutical services should focus on optimizing cabinet management protocols,enhancing medication safety awareness and personalizing pharmaceutical care to ensure precise and effective home-based medication management.

Objective To investigate the current status of home medicine cabinet management and unmet needs for home-based pharmaceutical services among elderly hypertensive patients in Hubei Province,and to provide evidence for optimizing home pharmaceutical care models.Methods From July 2022 to March 2023,310 elderly hypertension patients across Hubei Province were enrolled.Pharmacists conducted home visits to administer structured questionnaires capturing demographics and blood pressure control rates,perform medication categorization and quality assessments of home medicine cabinets and document cabinet management issues in real-time.Results Among 290 valid questionnaires,binary logistic regression revealed better blood pressure control in non-working and non-smoking individuals.Medicine cabinet audits identified three critical issues:failure to separate Chinese and chemical medicines,duplicate medications with similar ingredients and missing original packaging.Post-intervention,all cabinets demonstrated proper medication categorization and storage compliance.Conclusions Significant medication safety hazards exist in elderly hypertensive patients'home medicine cabinets.Pharmacist-led home interventions effectively cleared substandard medications and improved medication safety.Future home pharmaceutical services should focus on optimizing cabinet management protocols,enhancing medication safety awareness and personalizing pharmaceutical care to ensure precise and effective home-based medication management.

Objective To construct a deep learning-based artificial intelligence model to automatically quantify left ventricular ejection fraction (LVEF) using static views of echocardiography. Methods The study included data of 1, 902 adults with left ventricular multi-slice echocardiographic views at end-systole and end-diastole. The collected dataset was divided into development set (1, 610 cases, with 1, 252 cases for model training and 358 cases for parameter adjustment), internal test set (177 cases for internal validation), and external test set (115 cases for external validation and generalization testing). The model achieved left ventricular segmentation and automatic quantification of LVEF through precise identification of the left ventricular endocardial boundary and inspection of key points. The Dice coefficient was employed to evaluate the performance of the left ventricular segmentation model, while the Pearson correlation coefficient and the intraclass correlation coefficient were used to assess the correlation and consistency between the automatically measured LVEF and the reference standard. Results The left ventricular segmentation model performed well, with Dice coefficients ≥ 0.90 for both the internal and external independent test sets; the agreement between the automatically measured LVEF and the cardiologists' manual measurements was moderate, with Pearson correlation coefficients ranging from 0.46 to 0.71 and intragroup correlation analysis agreements from 0.39 to 0.57 for the internal test set; and Pearson correlation coefficients for the independent external test set were 0.26 to 0.54 and intra-group correlation analysis agreement of 0.23 to 0.50. Conclusion In this study, a left ventricular segmentation model with better performance is constructed, and initial application of the model for automatic quantification of LVEF for two-dimensional echocardiography has general performance, which requires further optimisation of the algorithm to improve the model generalisation.

Objective To study the application value of CAD/CAM technology in the teaching of inlay manufacturing.Methods A total of 60 undergraduates interned in the Department of Stomatology,Yan'an Hospital,Kunming Medical University were randomly divided into an experimental group(n=30)and a control group(n=30).We selected appropriate clinical cases for students to prepare for mandibular molar's proximal occlusal inlays.The instructor guided the results of the first preparation in different ways,and the students made the second modification and preparation,and the assessment team scored and evaluated the five aspects of the final preparation,the shape of the preparation,the shape of the occlusal surface,the dovetail retention,and the adjacent surface.Results The scores of all detection indexes in the experimental group were higher than those in the control group(P<0.05).Conclusion The application of CAD/CAM technology in inlay manufacturing teaching can effectively improve students'clinical hands-on ability and achieve better teaching effects than traditional teaching methods.

Diabetic gastroparesis （DGP） is a common diabetic neuropathy that affects the normal function of gastric motility and emptying. Clinically， it often manifests as abdominal distension， nausea and vomiting， early satiety， dyspepsia， etc. The pathogenesis of DGP is multifactorial， closely related to many factors， such as chronic hyperglycemia， neuropathy， autonomic nervous system disorders， inflammation， and oxidative stress. These factors can interact with each other， leading to delayed gastric emptying and the occurrence of related symptoms. Traditional Chinese medicine （TCM） has significant advantages in the prevention and treatment of DGP， including a long history， remarkable efficacy， individualized treatment， diverse therapeutic formulations， and improvement in the quality of life. Additionally， TCM is known for its low adverse reactions， good tolerance， and multi-targeted effects， making it an important approach in the management of DGP. Previous research has found that the main mechanisms of Chinese medicine in the prevention and treatment of DGP include the regulation of gastrointestinal hormones， inhibition of inflammatory responses， reduction of oxidative stress， enhancement of interstitial cells of Cajal activity， inhibition of pyroptosis， and modulation of related signaling pathways such as stem cell factor （SCF）/cellular growth factor receptor （c-Kit）， adenosine monophosphate-activated protein kinase （AMPK）， Ras homologous genome member A （RhoA）/Rho-associated coiled-coil forming kinase （ROCK）. This article primarily summarized the research progress on Chinese medicine in preventing and treating DGP through the inhibition of inflammatory responses， reduction of oxidative stress， enhancement of interstitial cells of Cajal activity， inhibition of pyroptosis， and regulation of related signaling pathways， aiming to provide a reference and basis for further research on the application value of Chinese medicine in the prevention and treatment of DGP.

Hypertrophic cardiomyopathy(HCM)is the most common type of primary cardiomyopathy that causes sudden cardiac death in adolescents and athletes.With over 1 million HCM patients,China has the largest population of HCM patients in the world,and the total number of cases is increasing year on year.Myocardial fibrosis is the most important histopathological characterization in HCM and is regarded as the primary cause of malignant ventricular arrhythmia,cardiac remodeling,and heart failure.At present,cardiac magnetic resonance imaging(MRI)serves as the gold-standard imaging modality for noninvasive evaluation of myocardial fibrosis.Several techniques,such as late gadolinium enhancement and T1 mapping,are showing considerable promise for potential applications.These techniques have emerged as viable imaging approaches to the elucidation of HCM tissue characterization.They are also helpful in predicting the long-term prognosis of patients.Herein,we summarized recent advances in using cardiac MRI to assess myocardial fibrosis in HCM from four perspectives,including late gadolinium enhancement,T1 mapping,T1p mapping,and MRI-based radiomics and machine learning models.

Objective:To evaluate the clinical effect of modified posterior pharyngeal flap surgery in the treatment of velopharyngeal insufficiency.Methods:Clinical data of patients with cleft lip and palate diagnosed with velopharyngeal insufficiency and undergoing modified posterior pharyngeal flap surgery in Peking University School and Hospital of Stomatology from January 2018 to May 2022 were retrospectively analyzed. The traditional posterior pharyngeal flap surgery was improved by combining the modern concept and method of soft palate muscle reconstruction, and performed modified posterior pharyngeal flap surgery to correct velopharyngeal insufficiency. Preoperative and postoperative follow-up were performed including speech evaluation (classifying as none, mild, moderate, moderate to severe hypernasality and nasal emission), nasopharyngeal fiberscope (classifying velopharyngeal insufficiency as mild, moderate, or severe), lateral cephalometric radiographs (resting position and /i/ position), and the Nasal Obstruction Symptom Evaluation (NOSE) scale. The recovery of velopharyngeal function and nasal ventilation after the operation were statistically analyzed. The difference of resting velar length (RVL), effective working length (EWL) and angel of velar lifting (AVL) before and after the operation was compared by paired t-test to evaluate the clinical effect of surgery. P<0.05 indicates a statistically significant difference. Results:A total of 83 patients with velopharyngeal insufficiency were enrolled, including 44 males and 39 females, aged (13.04±11.31) years (4-53 years). 83 patients were followed up for 6-18 months after surgery, and all patients had primary wound healing without postoperative bleeding, perforation, or posterior pharyngeal flap detachment; 78 cases achieved complete velopharyngeal closure, the surgical success rate was 94%, three patients still had mild hypernasality and nasal emission after surgery, one patient still had moderate hypernasality and nasal emission after surgery, and one patient had severe hypernasality after surgery. The RVL was (29.27±6.01) mm before the operation and (36.88±6.51) mm after the operation.The EWL of the soft palate was (18.53±5.04) mm before the operation and (25.76±5.17) mm after the operation.The angel of velar lifting was 11.42°±11.65° before the operation and 15.91°±8.54° after operation. The differences were statistically significant ( P<0.01). 98%(81/83) patients had subjective nasal obstruction symptom in the short period after surgery (within one month), the nasal obstruction symptom evaluation (NOSE) score was 8.61±3.64. The long-term postoperative follow-up showed that the NOSE score was 3.06±2.92, and the difference was statistically significant ( P<0.01). Conclusion:Modified posterior pharyngeal flap surgery can significantly increase the resting velar length and effective working length, improve the movement ability of the soft palate, acquire functional reconstruction of velopharyngeal closure, improve speech function and achieve effectively surgical results.