BACKGROUND:Angiogenesis is the main treatment target of cardiovascular diseases.Bone morphogenetic protein 2 can modulate angiogenesis,but the regulatory effect of endothelial cell-specific bone morphogenetic protein 2 on angiogenesis is unclear. OBJECTIVE:To investigate the effect of endothelial-specific bone morphogenetic protein 2 on angiogenesis. METHODS:(1)Bioinformatics analysis:Cellular expression specificity and abundance of bone morphogenetic protein 2 were meta-analyzed by the PanglaoDB single-cell transcriptome database.The endothelial cell transcriptome sequencing dataset of the mouse hindlimb model and endocardial transcriptome dataset of mice overexpressing bone morphogenetic protein 2 were reanalyzed to evaluate the effect of endothelial cell bone morphogenetic protein 2 on the angiogenesis pathway.(2)Validation in vivo:After establishing the mouse hindlimb model,we compared the blood perfusion between the affected and sham limb at 7,14,and 21 days.The expression of the colocation of bone morphogenetic protein 2 and CD31 was explored by immunofluorescence and immunohistochemical staining.(3)Validation in vitro:The cultured human umbilical vein endothelial cells in vitro were divided into a control group,a hypoxia group,and a bone morphogenetic protein 2 inhibitor Noggin intervention group.After being cultured for 24 hours,the angiogenesis of endothelial cells in each group was observed. RESULTS AND CONCLUSION:(1)Endothelial cells are an important cell subgroup expressing bone morphogenetic protein 2.Both in the mouse hindlimb ischemia model and endocardial cells overexpressing bone morphogenetic protein 2,bone morphogenetic protein 2 was significantly up-regulated,and the angiogenesis pathway was significantly activated.(2)In the mouse hindlimb model,bone morphogenetic protein 2-positive blood vessels around neoangiogenesis increased significantly at 7 days of ischemia(P<0.05),and decreased significantly after 2 weeks of ischemia(P<0.001).(3)In umbilical vein endothelial cells cultured in vitro,after hypoxic intervention,the migration and sprouting of endothelial cells increased significantly,and the expression of angiogenesis factors vascular endothelial growth factor and platelet-derived growth factor was significantly increased.Noggin significantly reduced hypoxia-induced endothelial cell angiogenesis(P<0.001)and down-regulated the expression of vascular endothelial growth factor and platelet-derived growth factor(P<0.01).(4)These findings verify that endothelial cell-specific bone morphogenetic protein 2 can regulate angiogenesis,and targeting endothelial cell bone morphogenetic protein 2 is a promising way to improve angiogenesis.

Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

Objective To investigate the value of liver imaging reporting and data system version 2018(LI-RADS v2018)features in predicting microvascular invasion(MVI)of hepatocellular carcinoma(HCC).Methods Ninety-two patients diagnosed as LR-5 and pathologically confirmed HCC were included and divided into MVI positive group and MVI negative group.The major and ancillary features of LI-RADS v2018 were compared between the two groups.Logistic univariate and multivariate regression analyses were used to obtain the independent risk factors for MVI,and the value of differential features in predicting MVI was also assessed using the receiver operating characteristic(ROC)curve.Results In the MVI positive group,the pathological grade of HCC was higher than that in the MVI negative group,with larger tumor diameter and higher incidence of mosaic architecture and corona enhancement.However,there was no difference in any other features.In logistic univariate analysis,tumor diameter,mosaic architecture and corona enhancement were independent risk factors for predicting the MVI,with area under the curve(AUC)values of 0.763 and 0.628 and 0.670 for the diagnosis of MVI,respectively.Conclusion In high-risk LR-5 population,tumor diameter,mosaic architecture and corona enhancement can help to predict the MVI.Accurate identification of LI-RADS v2018 features may facilitate personalized management of HCC patients.

Objective:To investigate the internal structure and determinants of hospitalization expenses for uterine leiomyoma patients in DRG pilot and non-DRG pilot hospitals in Beijing,to fumish insights for the forthcoming phase of public hospital reform.Methods:The statistical data of 5 DRG pilot hospitals and 124 non-DRG pilot hospitals in Beijing from 2015 to 2021 were collected to analyze the correlation degree between each detail expense and the average hospitalization expense by using grey correlation analysis,and the influencing factors of the average hospitalization expense of hospitalized patients by using random forest model.Results:The results of the grey correlation analysis revealed that the highest correlations affecting hospitalization expense in the DRG pilot hospital group and the non-DRG pilot hospital group were the average expense in each surgical treatment and the average drug costs for each patient,respectively,and the lowest was the average expense of inspection and test in each patient.The results of random forest model showed that the top two influencing factors of DRG pilot hospital group were consumption ratio and the average length of hospitalization,while the average length of hospitalization,surgical treatment expense ratio and consumption ratio are more important than other influential factors of non-DRG pilot hospital group.Conclusion:DRG payment is conducive to optimizing the hospitalization expense structure of uterine leiomyoma hospitalized patients.The average length of hospitalization,consumption ratio,and surgical treatment expense ratio are important factors affecting the hospitalization expense of uterine leiomyoma hospitalized patients.Public hospitals should continue to optimize the expense structure in the future,pay equal attention to"reducing expenditure"and"open source",implement DRG payment and its supporting measures to enhance the efficiency of medical services,reinforce the comprehensive management of consumables,and empower hospitals and medical personnel.

[Objective]To present a case of complete androgen insensitivity syndrome (CAIS) coexisting with Müllerian duct remnants (MDR) and to review previous reports in the literature to enhance the understanding of the clinical manifestations and pathophysiology of CAIS.[Methods]The study aimed to diagnose complete androgen insensitivity syndrome (CAIS) by conducting physical examinations,chromosomal analysis,whole exome sequencing,laboratory tests including follicle-stimulating hormone (FSH),luteinizing hormone (LH),total testosterone,estradiol,anti-Müllerian hormone (AMH),inhibin B,dehydroepiandrosterone sulfate (DHEAS),androstenedione,17-hydroxyprogesterone,and imaging studies such as pelvic ultrasound and pelvic magnetic resonance imaging (MRI). Laparoscopy revealed the presence of Müllerian duct structures. Additionally,the study reviewed similar cases of CAIS combined with Müllerian duct remnants reported in the literature.[Results]The child presented with female phenotype,elevated levels of FSH,LH,and testosterone. Pelvic MRI showed bilateral cryptorchidism without visible uterus or fallopian tubes. The chromosomal karyotype was 46,XY,and whole exome sequencing identified a pathogenic variant in the androgen receptor (AR) gene,c.2359C>T (p.Arg787*). No abnormalities were found in the AMH and AMHR2 gene tests. Laparoscopic exploration revealed underdeveloped testes and an underdeveloped uterus. Pathology showed the presence of fallopian tube-like structures next to the testicles. A total of 11 cases with genetically confirmed diagnosis of CAIS coexisting with MDR were retrieved from the database. The findings suggest that the initial clinical presentation,biochemical data,and gonadal pathology of CAIS with MDR are similar to those without MDR.[Conclusion]The study reports a patient with CAIS coexisting with MDR,which broadens the clinical spectrum of CAIS and provides a perspective for basic research on Müllerian duct regression that is independent of the AMH-AMHR2 signaling pathway.

Treponema pallidum(Tp),a common sexually transmitted pathogen,can infect the fetus via pla-cental vertical transmission,leading to congenital syphilis(CS).This infection results in adverse pregnancy outcomes,such as stillbirth,miscarriage,preterm birth,and fetal growth restriction.However,the exact pathogenesis remains un-clear.Studies indicate that patients with early syphilis primarily exhibit pro-inflammatory immune responses.The Tp has been proven to induce dysfunction in various immune cells and abnormal expression of cytokines,potentially disrupting im-mune tolerance homeostasis and leading to adverse pregnancy outcomes.Grounded in the current understanding of CS and maternal-fetal immunology by scholars both domestically and internationally,this paper provides a comprehensive review of the potential mechanisms of Tp interacting with the cells of the maternal-fetal interface,ultimately leading to adverse pregnancy outcomes.It summarizes the pathogenesis characteristics,clinical manifestations,and maternal-fetal immune responses of CS.

Objective To explore basement membrane markers and potential drugs for treatment in idiopathic pulmona-ry fibrosis(IPF).Methods IPF-related datasets were downloaded from the Gene Expression Omnibus(GEO)database,processed to construct basement membrane gene expression matrices associated with IPF,and screened for differential basement membrane genes(DEBMs);DEBMs were enriched for function and pathways,and machine learning algorithms were used to ob-tain candidate signature genes,receiver operating characteristic(ROC)curves were used to identify signature genes and con-struct a nomogram.We performed ssGSEA analysis to explore the correlation between signature genes and immune cells and their functions and predicted the corresponding miRNAs and therapeutic drugs by signature genes.Results A total of 56 DEBMs were extracted;enrichment analysis showed that DEBMs were mainly enriched in"extracellular matrix tissue","extracellular structural tissue",etc.,and were closely related to"ECM-receptor interaction"and"local adhesion spot"pathways.The ma-chine learning has identified six candidate signature genes(TIMP3,P3H2,ITGA7,ITGA4,ADAMTS2,COL8A2),all of which meet the requirements of the signature genes by the ROC curve test,and the nomogram diagnostic value was outstanding(AUC=0.991 523);B cells and Macrophages in IPF were significantly different from the normal group.Finally,miRNAs were predicted to be dominated by miR-4305,miR-3684,progesterone,and tert-butyl hydroperoxide as therapeutic agents with strong relevance to IPF.Conclusion Signature genes and predictive miRNAs may serve as novel markers for IPF diagnosis,and pre-dictive drugs may be a potential source of drugs for treating IPF.

Objective To explore the effect of Lee-Silverman voice treatment (LSVT) on language re-habilitation of dysarthria in Parkinson's disease (PD).Methods A total of 84 patients with PD dysarthria ad-mitted to our hospital from February 2019 to February 2022 were selected as the research objects.According to the random number table method,they were divided into observation group and control group,with 42 cases in each group.The control group received routine speech rehabilitation training,and the observation group re-ceived LSVT for four weeks.The scores of Western Aphasia Battery (WAB) and Aphasia Quotient (AQ) be-fore and after intervention were compared between the two groups,and the differences of electroglottographic parameters such as jitter,F0,shimmer,normalized noise energy (NNE) and harmonic noise ratio (HNR) were compared between the two groups.Results Before intervention,there was no significant difference in WAB scores (listening comprehension,repetition,spontaneous speech,naming) and AQ scores between the two groups (P>0.05).After intervention,the above scores of the two groups were significantly improved,and the observation group was higher than the control group,the difference was statistically significant (P<0.05). Before intervention,the jitter,F0,shimmer,NNE,HNR of vowels "a""i""u" in the two groups were not sta-tistically significant (P>0.05).After intervention,the above-mentioned electroglottic parameters of the two groups were significantly improved.The jitter and NNE of vowels "a""i""u" in the observation group were lower than those in the control group,and the HNR was higher than that in the control group,the differences were statistically significant (P<0.05).Conclusion LSVT can improve the electroglottographic parameters and speech function of patients with PD dysarthria,and the language rehabilitation effect of PD dysarthria is obvious.

Objective:To investigate the internal structure and determinants of hospitalization expenses for uterine leiomyoma patients in DRG pilot and non-DRG pilot hospitals in Beijing,to fumish insights for the forthcoming phase of public hospital reform.Methods:The statistical data of 5 DRG pilot hospitals and 124 non-DRG pilot hospitals in Beijing from 2015 to 2021 were collected to analyze the correlation degree between each detail expense and the average hospitalization expense by using grey correlation analysis,and the influencing factors of the average hospitalization expense of hospitalized patients by using random forest model.Results:The results of the grey correlation analysis revealed that the highest correlations affecting hospitalization expense in the DRG pilot hospital group and the non-DRG pilot hospital group were the average expense in each surgical treatment and the average drug costs for each patient,respectively,and the lowest was the average expense of inspection and test in each patient.The results of random forest model showed that the top two influencing factors of DRG pilot hospital group were consumption ratio and the average length of hospitalization,while the average length of hospitalization,surgical treatment expense ratio and consumption ratio are more important than other influential factors of non-DRG pilot hospital group.Conclusion:DRG payment is conducive to optimizing the hospitalization expense structure of uterine leiomyoma hospitalized patients.The average length of hospitalization,consumption ratio,and surgical treatment expense ratio are important factors affecting the hospitalization expense of uterine leiomyoma hospitalized patients.Public hospitals should continue to optimize the expense structure in the future,pay equal attention to"reducing expenditure"and"open source",implement DRG payment and its supporting measures to enhance the efficiency of medical services,reinforce the comprehensive management of consumables,and empower hospitals and medical personnel.

Objective:To investigate the internal structure and determinants of hospitalization expenses for uterine leiomyoma patients in DRG pilot and non-DRG pilot hospitals in Beijing,to fumish insights for the forthcoming phase of public hospital reform.Methods:The statistical data of 5 DRG pilot hospitals and 124 non-DRG pilot hospitals in Beijing from 2015 to 2021 were collected to analyze the correlation degree between each detail expense and the average hospitalization expense by using grey correlation analysis,and the influencing factors of the average hospitalization expense of hospitalized patients by using random forest model.Results:The results of the grey correlation analysis revealed that the highest correlations affecting hospitalization expense in the DRG pilot hospital group and the non-DRG pilot hospital group were the average expense in each surgical treatment and the average drug costs for each patient,respectively,and the lowest was the average expense of inspection and test in each patient.The results of random forest model showed that the top two influencing factors of DRG pilot hospital group were consumption ratio and the average length of hospitalization,while the average length of hospitalization,surgical treatment expense ratio and consumption ratio are more important than other influential factors of non-DRG pilot hospital group.Conclusion:DRG payment is conducive to optimizing the hospitalization expense structure of uterine leiomyoma hospitalized patients.The average length of hospitalization,consumption ratio,and surgical treatment expense ratio are important factors affecting the hospitalization expense of uterine leiomyoma hospitalized patients.Public hospitals should continue to optimize the expense structure in the future,pay equal attention to"reducing expenditure"and"open source",implement DRG payment and its supporting measures to enhance the efficiency of medical services,reinforce the comprehensive management of consumables,and empower hospitals and medical personnel.