ObjectiveBased on ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS）， network pharmacology， molecular docking and cell experiments， the active ingredients， possible targets and molecular mechanisms of Baoxin granules（BXG） regulating ferroptosis in the treatment of heart failure（HF） were explored. MethodsBXG intestinal absorption fluid was prepared by everted gut sac and the chemical composition contained therein were identified by UPLC-Q-TOF-MS. According to the obtained components， the potential targets of BXG were predicted， and the HF-related targets and related genes of ferroptosis were retrieved at the same time， and the intersecting targets were obtained by Venn diagram. In addition， the protein-protein interaction（PPI） network and the component-target network were constructed， and the core components and core targets were obtained by topological analysis. Then Gene Ontology（GO） function and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analysis were performed on the core targets， and molecular docking validation of the key targets and main components was carried out by AutoDockTools 1.5.7. H9c2 cells were used to establish a oxygen-glucose deprivation model， and the protective effect of BXG on cells was investigated by detecting cell viability， cell survival rate and reactive oxygen species（ROS） level. The protein expression levels of signal transducer and activator of transcription 3（STAT3）， phosphorylation（p）-STAT3 and glutathione peroxidase 4（GPX4） were detected by Western blot to clarify the regulatory effect of BXG on ferroptosis. ResultsA total of 61 chemical components in BXG intestinal absorption fluid were identified， and network pharmacology obtained 27 potential targets of BXG for the treatment of HF， as well as 139 signaling pathways. BXG may act on core targets such as STAT3， tumor protein p53（TP53）， epidermal growth factor receptor（EGFR）， JUN and prostaglandin-endoperoxide synthase 2（PTGS2） through core components such as glabrolide and limonin， which in turn intervene in lipid and atherosclerosis， phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt）， endocrine resistance and other signaling pathways to exert therapeutic effects on HF. Molecular docking showed that the docking results of multiple groups of targets and compounds were good. In vitro cell experiments showed that compared with the blank group， the cell viability and survival rate of the model group were significantly decreased， the level of ROS was significantly increased（P<0.01）， the expression levels of STAT3， p-STAT3， p-STAT3/STAT3 and GPX4 proteins were significantly decreased（P<0.05， P<0.01）. Compared with the model group， the cell viability and survival rate of the BXG group were significantly increased， the ROS level was significantly decreased（P<0.01）， the STAT3， p-STAT3， p-STAT3/STAT3 and GPX4 protein levels were significantly increased（P<0.05， P<0.01）. ConclusionBXG may inhibit the occurrence of ferroptosis by up-regulating the expression of STAT3 and GPX4， thus exerting a therapeutic effect on HF， and flavonoids may be the key components of this role.

ObjectiveBased on ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS）， network pharmacology， molecular docking and cell experiments， the active ingredients， possible targets and molecular mechanisms of Baoxin granules（BXG） regulating ferroptosis in the treatment of heart failure（HF） were explored. MethodsBXG intestinal absorption fluid was prepared by everted gut sac and the chemical composition contained therein were identified by UPLC-Q-TOF-MS. According to the obtained components， the potential targets of BXG were predicted， and the HF-related targets and related genes of ferroptosis were retrieved at the same time， and the intersecting targets were obtained by Venn diagram. In addition， the protein-protein interaction（PPI） network and the component-target network were constructed， and the core components and core targets were obtained by topological analysis. Then Gene Ontology（GO） function and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analysis were performed on the core targets， and molecular docking validation of the key targets and main components was carried out by AutoDockTools 1.5.7. H9c2 cells were used to establish a oxygen-glucose deprivation model， and the protective effect of BXG on cells was investigated by detecting cell viability， cell survival rate and reactive oxygen species（ROS） level. The protein expression levels of signal transducer and activator of transcription 3（STAT3）， phosphorylation（p）-STAT3 and glutathione peroxidase 4（GPX4） were detected by Western blot to clarify the regulatory effect of BXG on ferroptosis. ResultsA total of 61 chemical components in BXG intestinal absorption fluid were identified， and network pharmacology obtained 27 potential targets of BXG for the treatment of HF， as well as 139 signaling pathways. BXG may act on core targets such as STAT3， tumor protein p53（TP53）， epidermal growth factor receptor（EGFR）， JUN and prostaglandin-endoperoxide synthase 2（PTGS2） through core components such as glabrolide and limonin， which in turn intervene in lipid and atherosclerosis， phosphatidylinositol 3-kinase/protein kinase B（PI3K/Akt）， endocrine resistance and other signaling pathways to exert therapeutic effects on HF. Molecular docking showed that the docking results of multiple groups of targets and compounds were good. In vitro cell experiments showed that compared with the blank group， the cell viability and survival rate of the model group were significantly decreased， the level of ROS was significantly increased（P<0.01）， the expression levels of STAT3， p-STAT3， p-STAT3/STAT3 and GPX4 proteins were significantly decreased（P<0.05， P<0.01）. Compared with the model group， the cell viability and survival rate of the BXG group were significantly increased， the ROS level was significantly decreased（P<0.01）， the STAT3， p-STAT3， p-STAT3/STAT3 and GPX4 protein levels were significantly increased（P<0.05， P<0.01）. ConclusionBXG may inhibit the occurrence of ferroptosis by up-regulating the expression of STAT3 and GPX4， thus exerting a therapeutic effect on HF， and flavonoids may be the key components of this role.

Objective To compare the diagnostic efficacy of biparametric magnetic resonance imaging(bp-MRI)and multiparametric magnetic resonance imaging(mp-MRI)for prostate cancer among radiologists with different levels of experience.Methods A retrospective analysis was conducted on MRI data of 112 suspected prostate cancer patients.Six radiologists(2 in the primary,intermediate,and advanced groups)used the bp-MRI and mp-MRI protocol scores to analyze the diagnostic efficacy.Results The area under the curve(AUC)of diagnostic efficacy in the advanced group of the bp-MRI protocol was greater than that in the intermediate group(P=0.024),and the intermediate group was greater than that in the primary group(P=0.046).The intermediate group of the mp-MRI protocol was greater than the primary group(P=0.043),while there was no difference between the intermediate and advanced groups(P=0.221).As the experience of the radiologists increased,sensitivity also increased,but there was no significant change in specificity.There was no difference between the two protocols in the advanced group(AUC=0.826-0.866;P＞0.05);while the mp-MRI protocol performance was better in the primary and intermediate groups(AUC=0.705-0.815;P＜0.05).Conclusion Experienced radiologists can choose the bp-MRI protocol,while inexperienced radiologists are more suitable for the mp-MRI protocol.Based on the accumulated experience of radiologists,protocol optimization and adjustment can be carried out at appropriate times.

Objective: To analyze the correlation between behavior and lifestyle factors and anxiety symptoms of left-behind children, and to provide evidence for mental health intervention of left-behind children. Methods: 1 188 children aged from 13 to 18 (617 non-left-behind children and 571 left-behind children) in B County of Shangrao City, Jiangxi Province were evaluated with Generalized Anxiety Disorder Scale (GAD-7). Meanwhile, physical activity, TV watching time, computer usage time, dietary behavior, sleep and other behavioral lifestyle factors of left-behind children were investigated by questionnaire. Results: The detection rate of anxiety among left-behind children (66.0%) was higher than that of non-left-behind children (60.5%). The detection rates of mild, moderate, and severe anxiety were 26.3%, 15.4% and 24.3%, respectively. Under the condition of controlling age and gender, Logistic regression analysis showed that left-behind childrens anxiety symptoms and computer usage time>3 h/d (mild anxiety, OR=3.00, 95%CI=1.27-4.16; moderate anxiety, OR=4.09, 95%CI=1.55-10.78; severe anxiety, OR=3.44, 95%CI=1.46-8.11), mobile phone usage time >3 h/d (mild anxiety, OR=4.93, 95%CI=2.71-8.94; moderate anxiety, OR=5.93, 95%CI=2.98-11.79; severe anxiety, OR=7.11, 95%CI=3.85-13.15), skipping breakfast behavior (moderate anxiety, often skipping, OR=6.09, 95%CI=1.59-23.36; severe anxiety, often skipping, OR=5.49, 95%CI =1.68-7.97, sometimes eat breakfast, OR=2.68, 95%CI=1.10-6.53) was positively correlated; with appropriate sleeping time (moderate anxiety, OR=0.28, 95%CI=0.13-0.60) was negatively correlated. Conclusion The unhealthy behavior and lifestyle of left-behind children may be a potential risk factor for anxiety symptoms.

Objective:Bioinformatics was used to analyze the gene expression profile of renal chromophobe cell carcinoma (RCCC) to find out the key genes of RCCC.Methods:Chromophobe renal cell carcinoma gene chip data GSE15641 and GSE11151 were downloaded from the GEO database. Using R software packages such as " Affy" and " limma" in R software to screen differentially expressed genes, combining with David and STRING online bioinformatics tools to analyze the regulatory network of differentially expressed genes and construct protein-protein interaction (PPI) network, the Hub gene was screened through the Cytohubba plug-in of Cytoscape software.Results:A total of 261 differentially expressed genes were screened, including 194 down-regulated genes and 67 up-regulated genes. Gene enrichment (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed to explore their biological functions. In GO enrichment analysis, biological processes were mainly enriched in cell secretion, gluconeogenesis and cell proliferation regulation; in cell composition, they were mainly enriched in exosomes, plasma membranes and their components; in molecular function, they were mainly enriched in heparin binding; in KEGG pathway analysis, they were mainly enriched in metabolic pathway, antibody biosynthesis pathway and renin angiotensin system pathway. PPI network was constructed by using online bioinformatics tools. The top 10 Hub genes were screened by using cytohubba plug-in in Cytoscape software, which were pipecolic acid and sarcosine oxidase (PIPOX), hydroxyacid oxidase 2 (HAO2), kynurenine 3-monooxygenase (KMO), solute carrier family 2 member 2 (SLC2A2), formimidoyltransferase cyclodeaminase (FTCD), angiogenin (ANG), APOBEC1 complementation factor (A1CF), aldehyde dehydrogenase 8 family member A1 (ALDH8A1), vitamin D binding protein (GC), histidine rich glycoprotein (HRG).Conclusions:Bioinformatics analysis of differentially expressed genes in renal chromophobe cell carcinoma can effectively explore the interaction information of these differentially expressed genes, and provide new ideas for the treatment of renal chromophobe cell carcinoma.

Objective:To investigate the value of histogram analysis of ultrasound gray scale in differential diagnosis of triple negative breast invasive ductal carcinoma (TN-IDC) and non-triple-negative breast invasive ductal carcinoma (NTN-IDC).Methods:Totally 195 patients with invasive ductal carcinoma confirmed by pathology in Hubei Cancer Hospital from September 2017 to July 2020 were retrospectively analyzed.According to immunohistochemical results after surgery, 195 patients were divided into TN-IDC group ( n=44) and NTN-IDC group ( n=151). All cases were retrospectively analyzed to observe the ultrasonoscopy histogram features of tumors and obtain the histogram parameters, including mean, variance, skewness, kurtosis and percentile gray-scale values. The histogram parameters of TN-IDC were compared with those of NTN-IDC. The ROC curves were constructed to observe the efficiency of differential diagnosis. Results:The values of variance, 90th and 99th percentiles in TN-IDC group were much lower than those in NTN-IDC group (all P<0.05). The values of mean, skewness, kurtosis and other percentile (1st, 10th, and 50th) values between the two groups were not significantly different(all P>0.05). The optimal cutoff value for the accurate identification of TN-IDC and NTN-IDC groups was 552.85 for variance[sensitivity 75.0%, specificity 79.5%, positive predictive value(PPV) 51.6%, negative predictive value(NPV) 91.6%, accuracy 78.5%, and area under curve 0.829, respectively]. The optimal cutoff value for the accurate identification of TN-IDC and NTN-IDC groups was 74 for 90th percentile (sensitivity 68.2%, specificity 57.6%, PPV 31.9%, NPV 86.1%, accuracy 60.0%, and area under curve 0.648, respectively). The optimal cutoff value for the accurate identification of the two groups was 107 for 99th percentile (sensitivity 75.0%, specificity 77.5%, PPV 49.3%, NPV 91.4%, accuracy 76.9%, and area under curve 0.772, respectively). Conclusions:Histogram analysis of ultrasound gray scale can provide certain value for the differential diagnosis of TN-IDC and NTN-IDC, the variance and 99th percentile values could perform better.

Objective:To investigate the associations of brain white matter integrity deficits, and to explore the association of fractional anisotropy (FA) abnormality with clinical symptoms and cognitive impairments, as well as the prediction effect of the FA alterations on symptoms and cognitive function outcomes in the acute stage of schizophrenia from the whole brain level based on magnetic resonance diffusion tensor imaging (DTI).Methods:From November 2019 to December 2020, thirty-eight patients with first-episode schizophrenia and 38 healthy controls were recruited in this study. Wisconsin card classification test (WCST), digit span test (DST forward/backward), verbal fluency test, Stroop (A/B/C), trail making test (TMT-A/B), as well as positive and negative syndrome scale (PANSS) were utilized to evaluate patients' cognitive function and clinical symptoms both before and after 8 weeks of risperidone monotherapy. T1-weighted images and DTI data of all the subjects were collected . FSL and SPM8 were used to preprocess MRI data and compare the between-group differences of FA. Support vector machine (SVM) analysis was used to evaluate the accuracy of abnormal FA values in differentiating schizophrenic patients from healthy controls. Finally, stepwise multiple regression analysis or generalized linear models were used to explore the associations between white matter integrity and symptoms or cognition.Results:Before treatment, patients' FA values of right medial temporal lobe (mTL), cuneus, anterior cingulate gyrus (ACG) and inferior parietal lobe (IPL) were significantly lower than those in healthy controls ( P<0.01, GRF corrected), and patients' FA values of bilateral middle cingulate gyrus (mCG) were significantly higher than those in the control group ( P<0.01, GRF corrected). SVM analysis showed that four combinations could distinguish the patients from the control with the most accurate rate of 89.47%. Patients' baseline decreased FA values in the right IPL were positively associated with their increased total response time in WCST ( β=0.489, P=0.003, FDR corrected), correct response time in WCST ( β=0.450, P=0.008, FDR corrected), error response time in WCST ( β=0.435, P=0.008, FDR corrected), TMT-B ( β=0.296, P=0.042, FDR corrected), Stroop-C ( β=0.345, P=0.035, FDR corrected), and PANSS-P ( β=0.321, P=0.042, FDR corrected). Reduced FA values in the right mTL in patient group were significantly negatively related to the total time spent on the TMT-A ( β=-0.425, P=0.009, FDR corrected) and TMT-B ( β=-0.325, P=0.026 with FDR correction). Increased FA values in right mCG in patient group demonstrated positive associations with total response time in the WCST ( β=0.585, P=0.002, FDR corrected), correct response time in WCST ( β=0.524, P=0.003, FDR corrected), error response time in WCST ( β=0.536, P=0.003, FDR corrected) and total time consuming in TMT-B ( β=0.484, P=0.004, FDR corrected), as well as negative associations with DST-forward ( β=-0.319, P=0.042, FDR corrected). After treatment, patients' percentage changes in total response time of WCST ( β=0.715, P<0.001, FDR corrected), correct response time of WCST ( β=0.752, P<0.001, FDR corrected), as well as total time-consuming of TMT-A ( β=1.333, P=0.001, FDR corrected) showed positive correlations with baseline increased FA values in the left mCG. Percentage alteration of Stroop-B was negatively correlated with baseline FA values in the right cuneus ( β=-0.745, P=0.015, FDR corrected). Conclusions:The combination of abnormal FA values in multiple brain regions may be potential biomarkers to distinguish schizophrenic patients from healthy volunteers. There was regional dependence in the associations of the impairment of white matter integrity with the cognitive impairment, the severity of psychopathological symptoms as well as the prognosis of patients in the acute stage.

Objective:To examine the relationship between pre-pregnancy BMI, gestational diabetes (GDM) and different indicators of childhood obesity at the age of 4.Methods:Based on Ma’anshan Birth Cohort Study, singleton children who were born in Ma’anshan of Anhui province from October 2013 to April 2015, were followed for 4 years, consecutively. During the first questionnaire survey, data including pre-pregnancy weight, height and socio-demography were collected. During 24-28 week of gestation, 75 g oral glucose tolerance test was conducted for them. Childhood height, weight, waist circumference and body composition were measured at the age of 4. Comparisons between groups were performed using chi-square test, analysis of variance or t-test. The relationship between pre-pregnancy overweight/obesity, GDM and childhood obesity-related characteristics were analyzed by logistic regression model and generalized linear model analysis. Results:The prevalence rates of overweight and obesity in children at the age of 4 were 13.08% and 6.03%, respectively. After adjustment for characteristics related to mothers and their children, significantly increased risk of obesity ( OR=3.27, 95% CI: 2.15-4.98), larger waist circumference ( OR=2.32, 95% CI: 1.72-3.14) and higher waist-to-weight ratio ( OR=2.29, 95% CI: 1.73-3.02) were seen in the offspring of women with pre-pregnancy overweight/obesity. Body composition (skeletal muscle, body fat, body fat percentage) of the offspring were strongly correlated with pre-pregnancy overweight/obesity of the mothers ( P<0.05). Maternal GDM was associated with higher risk of childhood obesity ( OR=1.78, 95% CI: 1.14-2.79), on mothers without GDM during pregnancy. However, neither larger waist circumference, or higher waist-to-weight ratio seemed to increase the risk. Moreover, maternal GDM was not associated with body composition measures (skeletal muscle, body fat, body fat percentage). Conclusion:Pre-pregnancy BMI and maternal GDM were independent risk factors for obesity in 4-year-old children, and pre-pregnancy BMI was correlated with various indicators of body composition in children.

Objective: To analyze the causes of local necrosis and hemodynamics after pedicle peroneal perforator flap and try to find out prevention strategies. Methods: Retrospective 17 tissue defect cases admitted by Plastic and Reconstructive Surgery of Ningbo First Hospital, which treated by pedicle perforator flap with kinds of complications. 3 of 17 were naked the perforators to reduce reverse pressure. Patients involved 12 male, 5 female, ages from 22 to 46, with defected area from 5.0 cm×11.0 cm to 8.0 cm×14.0 cm, located in lateral ankle. Results: 3 to 5 days postoperative 12 cases with distal local necrosis, all of which were designed interregional, one with performator naked, turned back after drainage and wound dressing, 3 cases were gradually swelling and purple postoperative, two of them were perforator naked. 1 weeks later, the distal skin of flap necrosis and were gradually turning black scab appeared.With scab cutting and fascia survived, no bony tissues exposure, after 0.5% povidone iodine wet dressing regularly, endothelial cells crawled to cover. 2 cases with larger ranger of swelling and purple, not be better even pedicale releasing was conducted, 2 weeks later most part of the flap necrosis and the distal turned black eschar. After debridement and skin grafting, wounds healed later.All patients were followed up for 3 months with no flap transplantation required. Conclusions Coaxial homology, within 2 choke vessel areas, perforator skeletonization, kick out the small saphenous vein, might be the ways to reduce the complication of the cross area designing trans pedicled peroneal perforator flap.

Objective To explore the effect of sinomenine on the expression of tumor necrosis factor-α (TNF-α),cathepsin G (Cat-G) and cathepsin S (Cat-S) in rats with collagen induced arthritis (CIA).Methods The 60 SPF male Wistar rats were randomly divided into normal group,model group,high dose group,medium dose group,low dose group,and dexamethasone group (with 1 0 in each group).In the normal control group,the rats were given ordinary feed.For the other five groups,the rats were used to build a CIA model and give pharmacologic intervention in the following 20 days.After 20 days of inflammation,sinomenine would be divided into three different dose groups,with 120 mg/kg,90 mg/kg and 60 mg/kg,respectively,and each group was given a gavage daily.For the dexamethasone group,7.5 mg/kg dexamethasone was given for gavage once a day.In terms of the model group and normal group,the rats were perfused with the same volume of saline once daily.Then,taken the pictures of foot paw X-ray and foot paw pictures of rats in each group,measured the content of TNF-α,Cat-G,Cat-S in blood serum,observed the pathological changes in the synovial tissue of rats in each group by tissue section,measured the content of TNF-α,Cat-G,Cat-S in in spleen of rats by Immunohistochemical staining.Results The results of X-ray showed that there were obvious soft tissue swelling,joint deformity and osteolysis in the paws of the model group,and the above symptoms were alleviated in different degrees in each treatment group compared with the model group.Compared with the model group,the expression of TNF-α (376.48 ± 22.21 pg/ml,369.45 ± 82.68 pg/ml,425.17 ± 153.51 pg/ml vs.457.63 ± 152.67 pg/ml),Cat-G (1 398.05 ± 167.32 pg/ml,1 337.65 ± 209.34 pg/ml,1 412.78 ± 67.65 pg/ml vs.2 283.03 ± 185.21 pg/ml),and Cat-S (662.18 ± 169.66 pg/ml,406.80 ± 41.93 pg/ml,452.76 ± 50.49 pg/ml vs.838.11 ± 141.86 pg/ml) in blood serum of sinomenine high dose group,medium dose group and low dose group significantly decreased (P＜0.05).The expression of TNF-α (0.28 ± 0.05,0.21 ± 0.03,0.34 ± 0.04 vs.0.50 ± 0.04),Cat-G (0.28 ± 0.02,0.18 ± 0.06,0.27 ± 0.02 vs.0.37 ± 0.03),and Cat-S (0.22 ± 0.02,0.18 ± 0.03,0.27 ± 0.02 vs.0.35 ± 0.03) in spleen tissue significantly decreased (P＜0.05).The results of HE staining showed that the synovial tissue of normal rats was normal,the synovial tissue cells of model rats were damaged,the expression of inflammatory cells was significantly increased,and pannus hyperplasia was observed.Inflammatory cell infiltration and pannus hyperplasia were decreased in each group after administration.Conclusions Sinomenine has a sound and comprehensive intervention effect on rheumatoid arthritis,and the mechanism may be related to the inhibition of the expression ofTNF-α,Cat-G and Cat-S.