Objective:To develop an integrated health management system based on wearable devices for conducting health management to discharged patients,so as to improve the lifestyle and medication compliance of patients with cardiovascular and cerebrovascular diseases,and control risk factors of disease,and maintain patients'safety.Methods:The wearable devices,mobile terminals,and hospital's medical information platform were systematically integrated to develop an integrated health management system.A total of 75 patients with cardiovascular and cerebrovascular diseases(coronary heart disease and hypertension)who admitted to the Department of Cardiovascular Medicine of The 940th Hospital of People's Liberation Army Joint Service Support Force during March 1 and April 1,2024 were selected,and they were randomly divided into an intervention group and a control group using the random number table method,with 38 cases in the intervention group and 37 cases in the control group.During the 6 months of intervention observation period after discharge,patients in the intervention group used the integrated health management system for self-health management,while the patients of control group were managed with the conventional mode.The rate of medication compliance,changes of health behaviors,and changes of measurement data of body between the two groups were compared after the intervention.Results:The smoking rate of patients in the intervention group was 18.42%(7/38),which was lower than 43.24%(16/37)of the control group,and the difference was statistically significant(x2=3.94,P<0.05).The average rate of medication compliance of patients in the intervention group was(89.00±2.39)%,which was higher than(84.8±2.37)%of the control group,and the difference was statistically significant(t=2.15,P<0.05).The increase in diastolic blood pressure of patients in the intervention group was(1.76±2.06)mmHg,which was lower than(3.05±1.94)mmHg of the control group,and the difference was statistically significant(t=2.49,P<0.05).Conclusion:The integrated health management system based on wearable devices is effective for the self-management of patients with cardiovascular and cerebrovascular diseases,and it has a good effect in controlling the level of blood pressure,improving behavioral habits,and enhancing medication compliance of patients.

Objective To observe the value of 2D SECara-Net and 3D U2-Net models constructed based on 2D maximal intensity projection(MIP)and 3D time-of-flight MR angiography(3D TOF-MRA)images,respectively,also of their combination for MRA detecting unruptured saccular intracranial aneurysms(USIA).Methods Totally 973 patients with single USIA and 300 subjects who underwent healthy physical examination were retrospectively collected and divided into training set(n=923,containing 723 cases of USIA and 200 healthy subjects)and test set(n=350,containing 250 cases of USIA and 100 healthy subjects)at the ratio of 7:3.Pre-processed 3D TOF-MRA and the obtained 2D-MIP images in training set were imported into 3D U2-Net and 2D SECara-Net models for training and adjusting parameters,respectively.The efficiency of 2 models and their combination for detecting USIA were evaluated.Results The sensitivity,specificity and accuracy of 2D SECara-Net model for detecting USIA in test set was 78.80％(197/250),95.00％(95/100)and 83.43％(292/350),of 3D U2-Net model was 82.80％(207/250),86.00％(86/100)and 83.71％(293/350),respectively.The specificity of 2D SECara-Net model was higher than that of 3D U2-Net model(P=0.030),while no significant difference of sensitivity nor accuracy was found between 2 models(both P＞0.05).The specificity of the combination of the 2 models was 99.00％(99/100),higher than that of 3D U2-Net model(P＜0.05),and the sensitivity and accuracy of the combination was 91.20％(228/250)and 93.43％(327/350),respectivelty,both higher than those of 2 single models(all P＜0.05).Conclusion 2D SECara-Net and 3D U2-Net models had similar,sensitivity and accuracy for MRA detecting USIA.Combination of them could improve the detecting efficacy.

In recent years,significant progress has been made in the radiological diagnosis,molecular profiling,and systemic therapy of cholangiocarcinoma(CCA).Nevertheless,there are still many challenges in early identification,precise classification,and effective management.Given the marked heterogeneity between CCA subtypes and the recent research advances,the European Association for the Study of the Liver has developed evidence-based management recommendations for extrahepatic CCA,covering both perihilar and distal subtypes.This guideline particularly emphasizes the need for precise classification systems,the integration of emerging molecular studies,and practical diagnostic and therapeutic strategies reflecting real-world clinical scenarios.

Objective To explore the effects of long non-coding RNA(LncRNA)metastasis associated in lung denocarcinoma transcript 1(MALAT1)on high glucose-induced cardiomyocyte injury by regulating miR-320-3p-protein kinase B3(Akt3)axis.Methods H9c2 cells were divided into normal control(NC)group and high glucose(HG)group.After transfection,the cells were cultured in HG group were further divdided into subgroups as follows:HG+MALAT1 knock-down(HG+sh-MALAT1)group,HG+sh-NC group,HG+miR-320-3p mimic group,HG+mimic-NC group,HG+sh-MALAT1+miR-320-3p inhibitor group and HG+sh-MALAT1+pcDNA3.1-Akt3 group.Cell activity,apoptosis rate,B-cell lymphoma 2-related protein X(Bax),B-cell lymphoma factor 2(Bcl-2),cleaved caspase-3,Akt3 protein,MALAT1,miR-320-3p,Akt3 mRNA expression,interleukin(IL-1β),IL-6,tumor necrosis factor-α(TNF-α)were compared among the groups.Results The apoptosis rate of cardiomyocytes,the expressions of IL-1β,IL-6,TNF-α,Bax,cleaved caspase-3/caspase-3 protein,MALAT1 and Akt3 mRNA increased(P<0.05),while the expression of Bcl-2 protein and miR-320-3p decreased in HG group(P<0.05).After knocking down LncRNA MALAT1,apoptosis rate of HG-induced cardiomyocytes and levels of inflammatory factors were decreased(P<0.05).MALAT1 could negatively regulate expression of miR-320-3p,and miR-320-3p could negatively regulate expression of Akt3 protein.The overexpression of miR-320-3p could decrease apoptosis rate and inflammation level,while overexpression of Akt3 or inhibition of miR-320-3p expression could increase apoptosis rate of cardiomyocytes and inflammation level(P<0.05).Conclusions LncRNA MALAT1 can promote the expression of Akt3 protein by inhibiting miR-320-3p expression,thereby reduce activity of HG-induced cardiomyocytes and aggravate cardiomyocytes injury.

Objective To observe the value of 2D SECara-Net and 3D U2-Net models constructed based on 2D maximal intensity projection(MIP)and 3D time-of-flight MR angiography(3D TOF-MRA)images,respectively,also of their combination for MRA detecting unruptured saccular intracranial aneurysms(USIA).Methods Totally 973 patients with single USIA and 300 subjects who underwent healthy physical examination were retrospectively collected and divided into training set(n=923,containing 723 cases of USIA and 200 healthy subjects)and test set(n=350,containing 250 cases of USIA and 100 healthy subjects)at the ratio of 7:3.Pre-processed 3D TOF-MRA and the obtained 2D-MIP images in training set were imported into 3D U2-Net and 2D SECara-Net models for training and adjusting parameters,respectively.The efficiency of 2 models and their combination for detecting USIA were evaluated.Results The sensitivity,specificity and accuracy of 2D SECara-Net model for detecting USIA in test set was 78.80％(197/250),95.00％(95/100)and 83.43％(292/350),of 3D U2-Net model was 82.80％(207/250),86.00％(86/100)and 83.71％(293/350),respectively.The specificity of 2D SECara-Net model was higher than that of 3D U2-Net model(P=0.030),while no significant difference of sensitivity nor accuracy was found between 2 models(both P＞0.05).The specificity of the combination of the 2 models was 99.00％(99/100),higher than that of 3D U2-Net model(P＜0.05),and the sensitivity and accuracy of the combination was 91.20％(228/250)and 93.43％(327/350),respectivelty,both higher than those of 2 single models(all P＜0.05).Conclusion 2D SECara-Net and 3D U2-Net models had similar,sensitivity and accuracy for MRA detecting USIA.Combination of them could improve the detecting efficacy.

OBJECTIVE To provide a reference for optimizing and promoting the quality standards of Shechuan naolitong granules. METHODS Fifteen batches of Shechuan naolitong granules were used as samples to establish HPLC fingerprints using the Similarity Evaluation System for Chromatographic Fingerprint of Traditional Chinese Medicine （2012 edition）. Similarity evaluation and common peak identification were performed， and orthogonal partial least squares discriminant analysis （OPLS-DA） was used to assess quality differences among different batches and to screen quality differential components. Using salvianolic acid B（SAB） as the internal reference， quantitative analysis of multi-components by single-marker （QAMS） was developed to simultaneously determine geniposidic acid （GA）， chlorogenic acid （CA）， vaccarin （VA）， ferulic acid （FA） and senkyunolide I （SI）. The results were compared with those obtained by the external standard method. RESULTS A total of 13 common peaks were identified in the HPLC fingerprints of 15 batches of samples， and the similarities of the spectra were all above 0.96. Seven chromatographic peaks were identified as GA （peak 3）， CA （peak 6）， VA （peak 8）， FA （peak 9）， SI （peak 11）， SAB（peak 12） and TA（peak 13）. OPLS-DA indicated that the differential quality markers among 15 batches were peaks 5， 11 （SI）， and 12 （SAB）.Using SAB as the internal reference， the relative correction factors for GA， CA， VA， FA and SI were calculated as 1.058 4， 0.594 3， 0.643 3， 0.342 7 and 0.262 8， respectively. The mean content of GA， CA， VA， FA， SI and SAB across the 15 batches of samples were 0.155 0， 0.085 4， 0.140 3， 0.071 8， 0.072 7， 1.276 3 mg/g， respectively， showing no significant difference compared with the ESM （P＞0.05）. CONCLUSIONS The established HPLC fingerprint and QAMS are simple， efficient and economical， providing a reference for the quality control and further development of Shechuan naolitong granules.

Objective:To investigate the efficacy of anatomical resection (AR) in the early stages of treating solitary hepatocellular carcinoma (HCC) combined with liver cirrhosis with a diameter of ≤5 cm in comparison to different surgical methods of preferential hepatic parenchymal preservation (non-anatomical liver resection, NAR).Methods:The clinical data of 1 390 cases with solitary HCC combined with liver cirrhosis at an early stage who underwent liver resection at Mengchao Hepatobiliary Hospital of Fujian Medical University and six other medical centers from September 2013 to May 2019 were retrospectively analyzed. Patients were divided into the AR group (486 cases) and the NAR group (904 cases) and the wide surgical margin (WSM) group (745 cases) and the narrow surgical margin (NSM) group (645 cases) according to whether they received AR and the width of the surgical margin (1 cm). The basic information of the patients, preoperative evaluation index data, and postoperative follow-up (follow-up every 3 months) were collected. The Kaplan-Meier method was used to plot the survival curve.The log-rank test was used to compare the difference in survival between the two groups. The Cox proportional hazards regression model was used to analyze the factors affecting the prognosis. Propensity score matching (PSM) was applied to reduce intergroup bias.Results:The overall survival (OS) rates for all patients at 1, 3, and 5 years were 95.5%, 79.9%, and 63.5%, respectively. The recurrence-free survival (RFS) rates were 81.5%, 59.0%, and 43.7%, respectively. There was a statistically significant difference in RFS rate between the AR group and the NAR group prior to PSM, but no statistically significant difference in OS rate (RFS rate: 47.0% vs. 41.9%, P<0.05; OS rate: 64.4% vs. 62.9%, P>0.05). The postoperative RFS rate and OS rate were significantly superior in the WSM group than those of the NSM group (RFS rate: 47.8% vs. 37.2%, P<0.001; OS rate: 69.0% vs. 57.3%, P<0.001). There was no statistically significant difference in OS rate and RFS rate between the AR group and the NAR group following PSM (RFS: 46.3% vs. 45.1%, P>0.05; OS rate: 64.0% vs. 64.3%, P>0.05).The 5-year OS and RFS rates in the WSM group were 66.8% and 60.2%, respectively. The 5-year OS and RFS rates for the NSM group were 48.7% and 41.4%, respectively, with a statistically significant difference ( P<0.05). Cox multivariate analysis indicated that serum albumin, tumor diameter, microvascular invasion, and surgical margin were independent prognostic factors affecting OS and RFS. The Child-Pugh grade and satellite lesions were independent prognostic factors affecting OS. Conclusion:Anatomical liver resection is not an independent risk factor for prognosis, but the state of the resection margin determines the prognosis of patients with solitary HCC combined with cirrhosis. Therefore, hepatic resection margins should be prioritized in such patients.

In recent years,significant progress has been made in the radiological diagnosis,molecular profiling,and systemic therapy of cholangiocarcinoma(CCA).Nevertheless,there are still many challenges in early identification,precise classification,and effective management.Given the marked heterogeneity between CCA subtypes and the recent research advances,the European Association for the Study of the Liver has developed evidence-based management recommendations for extrahepatic CCA,covering both perihilar and distal subtypes.This guideline particularly emphasizes the need for precise classification systems,the integration of emerging molecular studies,and practical diagnostic and therapeutic strategies reflecting real-world clinical scenarios.

Objective To explore the effects of long non-coding RNA(LncRNA)metastasis associated in lung denocarcinoma transcript 1(MALAT1)on high glucose-induced cardiomyocyte injury by regulating miR-320-3p-protein kinase B3(Akt3)axis.Methods H9c2 cells were divided into normal control(NC)group and high glucose(HG)group.After transfection,the cells were cultured in HG group were further divdided into subgroups as follows:HG+MALAT1 knock-down(HG+sh-MALAT1)group,HG+sh-NC group,HG+miR-320-3p mimic group,HG+mimic-NC group,HG+sh-MALAT1+miR-320-3p inhibitor group and HG+sh-MALAT1+pcDNA3.1-Akt3 group.Cell activity,apoptosis rate,B-cell lymphoma 2-related protein X(Bax),B-cell lymphoma factor 2(Bcl-2),cleaved caspase-3,Akt3 protein,MALAT1,miR-320-3p,Akt3 mRNA expression,interleukin(IL-1β),IL-6,tumor necrosis factor-α(TNF-α)were compared among the groups.Results The apoptosis rate of cardiomyocytes,the expressions of IL-1β,IL-6,TNF-α,Bax,cleaved caspase-3/caspase-3 protein,MALAT1 and Akt3 mRNA increased(P<0.05),while the expression of Bcl-2 protein and miR-320-3p decreased in HG group(P<0.05).After knocking down LncRNA MALAT1,apoptosis rate of HG-induced cardiomyocytes and levels of inflammatory factors were decreased(P<0.05).MALAT1 could negatively regulate expression of miR-320-3p,and miR-320-3p could negatively regulate expression of Akt3 protein.The overexpression of miR-320-3p could decrease apoptosis rate and inflammation level,while overexpression of Akt3 or inhibition of miR-320-3p expression could increase apoptosis rate of cardiomyocytes and inflammation level(P<0.05).Conclusions LncRNA MALAT1 can promote the expression of Akt3 protein by inhibiting miR-320-3p expression,thereby reduce activity of HG-induced cardiomyocytes and aggravate cardiomyocytes injury.

Objective:To develop an integrated health management system based on wearable devices for conducting health management to discharged patients,so as to improve the lifestyle and medication compliance of patients with cardiovascular and cerebrovascular diseases,and control risk factors of disease,and maintain patients'safety.Methods:The wearable devices,mobile terminals,and hospital's medical information platform were systematically integrated to develop an integrated health management system.A total of 75 patients with cardiovascular and cerebrovascular diseases(coronary heart disease and hypertension)who admitted to the Department of Cardiovascular Medicine of The 940th Hospital of People's Liberation Army Joint Service Support Force during March 1 and April 1,2024 were selected,and they were randomly divided into an intervention group and a control group using the random number table method,with 38 cases in the intervention group and 37 cases in the control group.During the 6 months of intervention observation period after discharge,patients in the intervention group used the integrated health management system for self-health management,while the patients of control group were managed with the conventional mode.The rate of medication compliance,changes of health behaviors,and changes of measurement data of body between the two groups were compared after the intervention.Results:The smoking rate of patients in the intervention group was 18.42%(7/38),which was lower than 43.24%(16/37)of the control group,and the difference was statistically significant(x2=3.94,P<0.05).The average rate of medication compliance of patients in the intervention group was(89.00±2.39)%,which was higher than(84.8±2.37)%of the control group,and the difference was statistically significant(t=2.15,P<0.05).The increase in diastolic blood pressure of patients in the intervention group was(1.76±2.06)mmHg,which was lower than(3.05±1.94)mmHg of the control group,and the difference was statistically significant(t=2.49,P<0.05).Conclusion:The integrated health management system based on wearable devices is effective for the self-management of patients with cardiovascular and cerebrovascular diseases,and it has a good effect in controlling the level of blood pressure,improving behavioral habits,and enhancing medication compliance of patients.