ObjectiveTo investigate the mechanism by which Haizao Yuhu Tang regulates the nuclear receptor subfamily 4 group A member 1 （NR4A1）signaling pathway to modulate CD8-positive T lymphocyte （CD8⁺T） cell exhaustion-mediated immune escape in transgenic mice with papillary thyroid carcinoma （PTC）. MethodsSixty C57BL/6J mice carrying the conditional BRAF^V600E point mutation were randomly assigned to five groups （n=12）： Model， low-dose （7.28 g·kg^-1·d^-1） Haizao Yuhu Tang， medium-dose （14.56 g·kg^-1·d^-1） Haizao Yuhu Tang， high-dose （29.12 g·kg^-1·d^-1） Haizao Yuhu Tang， and vemurafenib （PLX4032， 0.02 g·kg^-1·d^-1）. In addition， 12 BRAF^V600E-negative mice were selected as the control group. All the groups received continuous intervention for 8 weeks. After treatment， the thyroid tumor weight and volume of mice in each group were measured. Hematoxylin and eosin （HE） staining was performed to observe the morphological characteristics of thyroid tumors. Enzyme-linked immunosorbent assay （ELISA） was adopted to quantify the serum levels of interferon-γ （IFN-γ）， interleukin-2 （IL-2）， tumor necrosis factor-α （TNF-α）， C-X-C motif chemokine ligand 9 （CXCL9）， and C-X-C motif chemokine ligand 10 （CXCL10）. Flow cytometry was employed to determine the proportion of cytotoxic CD8⁺T cells in the tumor tissue. Western blot and real-time PCR were employed to determine the protein and mRNA levels， respectively， of molecules related to the NR4A1 signaling pathway. ResultsCompared with the control group， the model group showed significantly increased thyroid tumor volume and weight （P<0.01）. Compared with the model group， the low-dose， medium-dose， and high-dose Haizao Yuhu Tang groups and the vemurafenib group exhibited varying degrees of reduction in thyroid tumor volume and weight （P<0.05， P<0.01）， with the medium-dose Haizao Yuhu Tang group and the vemurafenib group showing the most pronounced therapeutic effects （P<0.01）. Compared with the model group， the low-dose， medium-dose， and high-dose Haizao Yuhu Tang groups and the vemurafenib group showed increased serum levels of IFN-γ， IL-2， TNF-α， CXCL9， and CXCL10， decreased mRNA and protein levels of NR4A1， Programmed cell death-1 （PD-1）， and Programmed cell death-ligand 1 （PD-L1）， and enhanced cytotoxic activity of CD8⁺T cells （P<0.05， P<0.01） Among these groups， the medium-dose Haizao Yuhu Tang group exhibited the optimal therapeutic effects. In addition， compared with that in the model group， T-cell factor-1 （TCF-1） expression was increased in the low-dose， medium-dose， and high-dose Haizao Yuhu Tang groups （P<0.01）， whereas no significant change in TCF-1 expression was observed in the vemurafenib group. ConclusionHaizao Yuhu Tang may restore the cytotoxic function of CD8⁺T cells by inhibiting the NR4A1 signaling pathway， thereby suppressing immune evasion in PTC and delaying PTC growth.

BACKGROUND:Lipophagy is closely related to a variety of chronic metabolic diseases.Exercise can delay the pathological process of non-alcoholic fatty liver by regulating lipophagy,which has become one of the most popular studies in the field of sports medicine.OBJECTIVE:To summarize the regulatory role of lipophagy in non-alcoholic fatty liver disease and the mechanism of exercise-mediated lipophagy in non-alcoholic fatty liver disease.METHODS:CNKI,PubMed,and Web of Science databases were searched for relevant literature published from 1980 to 2025,using the search terms of"lipophagy,lipid metabolism,non-alcoholic fatty liver disease,aerobic exercise,resistance training,combined aerobic resistance exercise"in Chinese and English.Totally 98 documents were included according to inclusion and exclusion criteria.RESULTS AND CONCLUSION:(1)Lipophagy plays an important regulatory role in the prevention and treatment of non-alcoholic fatty liver disease.(2)Different types of exercises affect lipophagy:Aerobic exercise can play a beneficial role can regulate the expression of lipophagy related factors,enhance autophagy flow,improve lysosome biosynthesis and promote the decomposition of lipase.Resistance training can increase the expression of autophagy related factors in adipose tissue.Combined aerobic resistance exercise can increase fat oxidation rate and improve insulin sensitivity.(3)Exercise can treat non-alcoholic fatty liver disease by improving liver inflammation,insulin resistance,and liver function.(4)Exercise plays a key role in the prevention and treatment of non-alcoholic fatty liver by regulating lipophagy,reducing lipid accumulation,inhibiting steatosis,alleviating liver inflammation and fibrosis and improving insulin resistance.

Objective To explore the impact of Shexiang Baoxin Pill(SXBXP,a traditional Chinese patent medicine,broadly applied for the treatment of cardiovascular diseases)on coronary microvascular disease(CMD)and investigate the role and underlying mechanisms of muscone,a key bioactive component of the pills,in the treatment.Methods A total of 16 ob/ob mice(8 weeks old)were randomly and equally divided into an ob/ob-SXBXP group and a ob/ob-Control group,receiving 10 mg/kg·d SXBXP or PBS via oral gavage,and another 8 wild-type mice with the same genetic background(WT group)were subjected as a negative control group.Cell model of CMD was established based on mouse coronary microvascular endothelial cells(MCMEC)under ischemia and hypoxic(HI)condition,and the cells were further treated with 20 μg/mL SXBXP(HI+SX)and 30 μmol/L muscone(HI+Muscone),respectively.Echocardiography was carried out for coronary flow reserve(CFR)and left ventricular function,and laser speckle imaging was applied to evaluate myocardial blood flow(MBF).Microvascular density in the heart was evaluated with CD31 immunofluorescence staining.The expression levels of vascular endothelial growth factor(VEGF)in cardiac microvascular endothelial cells of both mouse and cell models were detected by immunofluorescence staining and Western blot analysis.The proliferation and angiogenesis of MCMEC were observed by 5-ethynyl-2'-deoxyuridine staining and angiogenesis experiments.Results In the ob/ob-Control group of mice,the levels of CFR,MBF,and cardiac microvascular density were significantly lower than those in the WT group(P<0.05),and these indicators were significantly improved in the ob/ob-SXBXP group when compared with the ob/ob-Control group(P<0.05),which indicates that SXBXP improves the CMD phenotype.The expression level of VEGF in cardiac microvascular endothelial cells was significantly lower in the ob/ob-Control mice than the WT mice(P<0.05),while the level in the ob/ob-SXBXP group was significantly higher than that in the ob/ob-Control group(P<0.05),illustrating that SXBXP may ameliorate CMD through VEGF-mediated microvascular angiogenesis.In vitro experiments further revealed that the VEGF expression level and the proliferation and angiogenesis abilities in MCMEC were significantly lower in the HI group than the cells under the normoxia control condition(P<0.05).Both SXBXP and muscone treatment resulted in enhanced expression of VEGF and improved proliferative and angiogenesis abilities of MCMEC(P<0.05).These results suggest that muscone could improve CMD by VEGF-mediated microvascular angiogenesis.Conclusion SXBXP can improve CMD.Muscone,as a key component of SXBXP,promotes microvascular angiogenesis by inducing the expression of VEGF,then enhances myocardial perfusion,and consequently alleviates CMD.

Against the dual backdrop of increasingly mature big data applications and structural constraints in traditional human resource management models,comprehensive digital governance and reform of human resource management systems have become major challenges for public hospitals.By examining the core challenges faced by public hospitals in the big data era,it analyzes the implementation pathway of digital governance for human resource in public hospital,taking Guangdong Second People's Hospital as a practical case.lt summarizes the application effectiveness and the value of big data technology applucations in human resource management,providing support for talent system development.

Objective:To explore the association between spicy food intake and the risk for cardio/cerebrovascular diseases.Methods:Data were collected from the China Kadoorie Biobank project conducted in Pengzhou, Sichuan Province. Using the Cox proportional hazards regression model, we analyzed the associations of the frequency of spicy food intake, spicy level, types of spicy food, and the age when regular intake of spicy food began (intake in 1 day/week), with the risk for cardio/cerebrovascular disease. Furthermore, the associations with the risks for ischemic heart disease (IHD) and cerebrovascular diseases, as well as the risk of ischemic stroke (IS) and hemorrhagic stroke (HS) were analyzed.Results:A total of 54 859 study participants were included in the study, in whom 49 320 had spicy food intake (89.90%). In these participants, 37 680 (68.69%) had spicy food intake in 6-7 days/week, 5 036 (9.18%) had spicy food intake in 1-5 days/week, and 6 604 (12.03%) had spicy food intake once a week; 5 539 (10.10%) had never/almost never had spicy food intake. After adjusting for multiple confounding factors, compared with those who never/almost never had spicy food intake, intake of spicy food was associated with reduced risks for IHD (intake in 6-7 days/week: HR=0.86, 95% CI: 0.78-0.95), cerebrovascular diseases (intake in 6-7 days/week: HR=0.88, 95% CI: 0.81-0.96), and IS (intak in 6-7 days/week: HR=0.85, 95% CI: 0.76-0.95). With the increase of spicy food intake frequency, the risk for cardio/cerebrovascular disease decreased (intake in 1-5 days/week: HR=0.91, 95% CI: 0.85-0.98; intake in 6-7 days/week: HR=0.89, 95% CI: 0.84-0.94) (trend test P<0.001). However, no statistical association was found between spicy food intake and the risk for HS. In terms of spicy level, after adjusting for multiple confounding factors, compared with those who never/almost never had spicy food intake, intake of spicy food was associated with reduced risk for cardio/cerebrovascular disease (moderate: HR=0.86, 95% CI: 0.82-0.90) and cerebrovascular disease (moderate: HR=0.90, 95% CI: 0.84-0.97). With the increase of spicy level, the risk for IHD decreased (moderate: HR=0.86, 95% CI: 0.79-0.93; strong: HR=0.84, 95% CI: 0.74-0.95) (trend test P<0.001). After adjusting for multiple confounding factors, compared with those who never/almost never had spicy food intake, intake of any type of spicy food was associated with reduced risk for cardio/cerebrovascular disease, IHD, and cerebrovascular disease. Regulat intake of spicy food from age 0-10 years was associated with reduced risk for cardio/cerebrovascular disease, IHD, and cerebrovascular disease. Regular intake of spicy food from age 11-20 years reduced the risk for cardio/cerebrovascular disease and IHD. There was no significant association between the regular intake of spicy food from age 21-79 years and the risks for cardio/cerebrovascular disease, IHD and cerebrovascular disease. Conclusion:The intake of spicy food could reduced the risk for cardio/cerebrovascular diseases, IHD, cerebrovascular diseases and IS in residents aged 30-79 years in Sichuan.

Objective:To explore the construction requirements and solutions for a digital full-process management platform for Investigator-Initiated Trials (IIT) in pediatrics in China.Methods:By reviewing literature, the current status and highlights of pediatric IIT digital management systems in Europe and the United States were analyzed. The challenges faced in building a digital full-process management platform for pediatric IIT in China were summarized. The exploration and implementation achievements of our hospital in platform construction were introduced, and future construction priorities were proposed based on practical considerations.Results:The construction and application of digital full-process management platforms for pediatric IIT in Europe and the United States were relatively mature, providing comprehensive digital support for pediatric IIT research, ranging from project management to research design implementation, multi-center data interoperability, and personnel training. In China, the pediatric IIT digital management platform was still under construction, with main challenges including the formulation of construction plans based on hospital-specific conditions, data standardization, and remote recruitment and follow-up platforms.Conclusions:Considering the current status of pediatric IIT digital full-process management systems both domestically and internationally, efforts should be made to further strengthen data standardization, remote subject management, and digital pediatric IIT training from both policy and technical perspectives. This will provide one-stop services and management for projects and researchers, promoting the development of pediatric medical research.

Objective::To evaluate the diagnostic efficacy and clinical application of the Obstetrical Chinese Disseminated Intravascular Coagulation (DIC) Scoring System (OCDSS).Methods::This study is a retrospective study that collected 1063 cases from Wuhan Union Hospital, Yichang Central People’s Hospital, and the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture between July 2017 and June 2024. These cases were divided into DIC and non-DIC groups based on score standard. Diagnosis of DIC, the rate of hysterectomy, neonatal mortality, and severe asphyxia are the main outcome measures. All the laboratory indicators are all determined by clinical laboratory department of the hospital. Data were expressed as mean ± standard deviation or median (interquartile range) and frequencies. Independent sample t-test or non-parametric test were used to compare measurement data, while the chi-square test was used for count data. Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to test the predictive accuracy. Using univariate and multivariate logistic regression analysis to study the high-risk factors. P < 0.050 indicates a statistical significance. Results::Of 1063 participants in this study, 29 participants (2.73%) were diagnosed with obstetrical DIC by OCDSS score standard, and all the participants were diagnosed as DIC with underlying disease. When the Takao, Clark, and Erez score standard is the "gold standard", the OCDSS score standard always shows good sensitivity and specificity, with all the AUC over 0.75. OCDSS score standard also has better predictive of hysterectomy (68.18%, 91.07%, 0.872), severe neonatal asphyxia and death (79.17%, 75.07%, 0.842) than the other three score standards. All the indicators included in the OCDSS score standard contributed to the DIC diagnosis (all the P < 0.001). The indicators in the DIC group were more abnormal than the non-DIC group (all the P < 0.001). Conclusion::OCDSS is a first score standard, especially for pregnancies, it considers the underlying disease, clinical symptoms, and laboratory results. This score system shared a good diagnosis performance for DIC in the Chinese population and may help clinicians make timely decisions.

Objective:To analyze the biological parameters of the anterior segment of age-related cataracts patients with or without zonular weakness with the new generation of sweep-source anterior optical coherence tomography (OCT) device CASIA2 to provide a basis for the diagnosis of zonular weakness.Methods:A case-control study was conducted.A total of 158 cases (186 eyes) of patients with age-related cataracts having zonular weakness as a zonular weakness group, and 80 cases (80 eyes) of cataract with age-related cataracts without zonular weakness as a normal zonule group were enroll from June 2022 to June 2023 at Beijing Tongren Hospital.All patients underwent routine preoperative ophthalmological examination including slit lamp microsopy, IOLMaster 700, ocular B-ultrasound and OCT.The anterior chamber depth (ACD), anterior chamber volume (ACV), lens thickness (LT), lens vault (LV), anterior chamber angle opening distance at 750 μm (AOD750), lens decentration and tilt, radius of curvature of the anterior lens surface (RAL), and radius of curvature of the posterior lens surface (RPL) of patients were measured with CASIA2 and compared between the two groups.The relationship between zonular weakness and anterior chamber parameters and lens parameters was evaluated by logistic regression analysis.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital (No.TRECKY2018-049), and all enrolled patients signed the informed consent form.Results:In the zonular weakness group, ACD, ACV, RAL, and AOD750 were (2.34±0.56)mm, (85.05±40.19)mm 3, 7.52 (7.13, 8.08)mm, and 0.27 (0.07, 0.30)mm, respectively, which were smaller than (3.13±0.38)mm, (127.75±38.15)mm 3, 9.28(8.51, 9.76)mm, and 0.52 (0.31, 0.65)mm in the normal zonule group, with statistically significant differences (all P<0.05).LT and LV in the zonular weakness group were (5.14±0.45)mm and (1.22±0.53)mm, respectively, which were larger than (4.27±0.52)mm and (0.32±0.30)mm in the normal zonule group, and the differences were statistically significant (both P<0.05).Magnitude of lens decentration and tilt in the zonular weakness were 0.34 (0.13, 0.45)mm and 6.44 (3.67, 7.32)°, respectively, which were significantly larger than 0.19 (0.12, 0.25)mm and 4.88 (3.85, 5.65)° in the normal zonule group (both P<0.05).No obvious pattern was found in the direction of decentration and tilt.Logistic regression analysis showed that LV and lens decentration were risk factors of zonular weakness (odds ratios [ OR]=706.170, 335.339; both P<0.05), and RAL was a protective factor of zonular weakness ( OR=0.239, P<0.05). Conclusions:Age-related cataract patients with zonular weakness often present with a decrease in ACV due to increased anterior convexity of the lens.Decreased RAL, increased lens decentration and elevated LV are risk factors for zonular weakness.

Objective To explore the application value of CT combined with peripheral blood eosinophils(EOS)for distinguishing eosinophilic asthma(EA)from eosinophilic bronchitis(EB).Methods The clinical characteristics,peripheral blood EOS detection and imaging features of 523 patients(328 cases of EA and 195 cases of EB)were retrospectively analyzed.Univariate analysis identi-fied statistically significant parameters,which were further utilized in binary logistic regression to construct an imaging model and a combined model incorporating clinical characteristics,peripheral blood EOS and imaging features.Receiver operating characteristic(ROC)curves were plotted to evaluate the performance of each model.Results Statistically significant differences were observed between the two groups in age,body mass index(BMI),peripheral blood EOS count,peripheral blood EOS percentage,and 11 ima-ging features,including bilateral lung,bronchial wall thickening and bronchial mucus plugs(P＜0.05).The area under the curve(AUC)of the imaging model and the combined model were 0.891 and 0.918,respectively.Conclusion The combined application of CT and peripheral blood EOS detection can improve the efficiency,simplicity,and accessibility of distinguishing EA from EB.

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus