AIM: To investigate the correlation between fundus blood flow parameters and carotid artery ultrasound blood flow parameters in patients with hypertensive retinopathy(HRP).METHODS: A total of 50 patients(22 left eyes and 28 right eyes)with HRP admitted to our hospital from June 2021 to June 2023 were retrospectively included as the experimental group, and 50 healthy physical examination subjects(22 left eyes and 28 right eyes)during the same period were included as the healthy group. Pearson correlation was used to analyze the correlation between fundus blood flow parameters and carotid artery ultrasound blood flow parameters.RESULTS: The AUC values of fundus blood flow parameters and carotid artery ultrasound blood flow parameters and their combined diagnosis of HRP were 0.853, 0.844 and 0.935, respectively. Pearson correlation analysis showed that carotid systolic peak blood flow velocity was negatively correlated with foveal avascular zone(FAZ)area, FAZ circumference and non-circularity index, and positively correlated with macular vascular density(all P<0.05). The end-diastolic blood flow velocity was positively correlated with FAZ area and macular vascular density(all P<0.05). The internal carotid artery resistance index was positively correlated with FAZ area(P<0.05).CONCLUSION: The combination of fundus blood flow parameters and carotid artery ultrasound blood flow parameters in the diagnosis of HRP has good application value in the diagnosis of HRP.

ObjectiveTo evaluate the effectiveness of stone needle thermocompression and massage compared to flurbiprofen gel patch in relieving chronic musculoskeletal pain in the shoulder and back， and to explore the potential mediating mechanism through muscle elasticity. MethodsA total of 120 patients with chronic musculoskeletal pain in the shoulder and back were randomly assigned to either stone needle group or flurbiprofen group， with 60 patients in each. The stone needle group received stone needle thermocompression and massage for 30 minutes， three times per week； the flurbiprofen group received flurbiprofen gel patch twice daily. Both groups were treated for 2 weeks. Pain improvement， as the primary outcome， was assessed using the Global Pain Scale （GPS） at baseline， after 2 weeks of treatment， and again 2 weeks post-treatment. To explore potential mechanisms， a mediator analysis was conducted by measuring changes in superficial and deep muscle elasticity using musculoskeletal ultrasound at baseline and after the 2-week treatment period. ResultsThe stone needle group showed significantly greater pain relief than the flurbiprofen group 2 weeks post-treatment. After adjusting for confounders related to pain duration， the between-group mean difference was -8.8 ［95% CI （-18.2， -0.7）， P＜0.05］. Part of the therapeutic effect was mediated by changes in deep muscle elasticity， with a mediation effect size of -1.5 ［95% CI （-2.0， -0.9）， P = 0.024］， accounting for 17.9% of the total effect. ConclusionStone needle thermocompression and massage can effectively relieve chronic musculoskeletal pain in the shoulder and back， partly through a mediating effect of improved deep muscle elasticity.

ObjectiveTo multidimensionally analyze the clinical effects of Qianyang Yuyin granules on elderly hypertensive patients through an "energy-inflammation-aging" network. MethodsRelevant datasets were retrieved from the GEO database. Gene set enrichment analysis （GSEA） was performed on the gene expression profiles of peripheral blood cells from patients with essential hypertension in dataset GSE24752. The GSEA referenced "GO gene sets" and "KEGG gene sets" to identify significantly enriched gene sets. A clinical trial was conducted using a randomized controlled study design. A total of 40 patients meeting the inclusion criteria were enrolled. The control group received standard antihypertensive treatment with angiotensin receptor blockers （ARBs） or combined calcium channel blockers （CCBs）. In contrast，the treatment group received Qianyang Yuyin Granules in addition to the standard treatment for 12 weeks. Blood pressure levels and clinical efficacy were observed，and changes in energy metabolism indicators，DNA damage markers，and senescence-associated secretory phenotype （SASP） in blood were measured using ELISA before and after treatment. ResultsGSEA results indicated significant energy metabolism dysregulation in hypertensive patients. Clinical findings showed that both groups achieved blood pressure control without significant intergroup differences. In terms of clinical efficacy，the treatment group had a significantly higher effective rate compared to the control group （95% vs 65%，P0.05）. After treatment，the treatment group showed a significant increase in NAD⁺ levels （P0.01），with higher levels compared to the control group （P0.05）. The treatment group also exhibited a greater reduction in DNA damage marker 8-OHdG （P0.01） and cell adhesion factors ICAM-1 and VCAM-1 （P0.01） compared to the control group. Pro-inflammatory cytokines IL-1β and IL-6 were significantly reduced in the treatment group （P0.01），with greater reductions compared to the control group （P0.05，P0.01）. Anti-inflammatory cytokines IFN-α，IL-4，and IL-10 were significantly elevated in the treatment group （P0.01），with higher levels compared to the control group （P0.01）. No significant adverse reactions were reported in either group. ConclusionThe "energy- inflammation- aging" network plays an important role in the pathological mechanism of hypertension patients. Qianyang Yuyin granules may delay the aging process by increasing patients' energy metabolism levels，reducing DNA oxidative damage，and maintaining the balance of inflammatory factors.

Objective To Investigate the effect of copper ions on the radiosensitivity of nasopharyngeal carcinoma(NPC)and identify potential targets to improve the efficacy of NPC radiation therapy.Methods The content of copper ions in normal nasopharyngeal epithelial cell line NP69 and a variety of NPC cell lines was detected by a copper microplate assay.After adding 0,5,10,20,50,100,200 μmol/L copper ion solution and 0,0.05,0.1,0.2,0.5,1.0,2.0 mmol/L TEPA solution,CCK-8 assay was used to determine the effect of intracellular copper ion content on the survival rate of NPC cells before and after irradiation.And determine the drug concentration to be used in subsequent experiments.CCK-8 assay was used to determine the effect of intracellular copper ion content on the survival rate of NPC cells before and after irradiation,and to determine the drug concentration used in the copper ion group and TEPA group in the subsequent experiments.CCK-8 assay and clone formation assay were used to detect the changes in radiosensitivity of NPC cells after drug treatment.The DNA damage and MAPK-ERK signaling pathway-related protein expression of NPC cells in each group before and after irradiation were detected by Western blot.Results The content of copper ions in NPC cells was significantly higher than that in normal naso-pharyngeal epithelial cells(P＜0.05).When the concentration of copper ion solution was lower than 50 μmol/L,the radiation resistance of CNE1 cells was improved,and the radiation sensitivity of SUNE1 cells was increased by 0.1～0.2 mmol/L TEPA(P＜0.05).Compared with the control group,the NPC cell radiotherapy resistance of copper ion group was enhanced,and the NPC cell radiotherapy sensitivity of copper ion group was enhanced(P＜0.05).Compared with the control group,the activation degree of MAPK-ERK pathway in copper ion group was up-regulated(P＜0.05).MAPK-ERK pathway inhibitor SCH772984 effectively reversed copper-mediated NPC radiotherapy resistance(P＜0.05).Conclusion The increased copper ion content in NPC cells promoted the radiotherapy resistance of NPC cells by activating the MAPK-ERK signaling pathway.

OBJECTIVE To optimize the extraction technology of volatile components from Wuyao decoction. METHODS On the basis of single factor investigation ，the extraction technology of volatile components from Wuyao decoction was optimized and validated by Box-Behnken design-response surface technology using the contents of bomyl acetate ，cyperotundone，α-cyperone， ligustilide and dehydrocostuslactone ， extraction rate of volatile oil as indexes ， with extraction time ， soaking time and liquid-material ratio as factors. On this basis ，the extraction state of the decoction was quantified. RESULTS The optimal extraction technology was as followed ：the ratio of liquid -material was 13∶1（mL/g），soaking time was 0.5 h，and the extraction time was 6 h in the boiling state. The comprehensive scores of the three validation experiments were 0.948 7，0.948 4 and 0.948 6 respectively （RSD＝0.02％，n＝3），and the deviation from the predicted value （0.947 9）was no more than 1％. The boiling state of the decoction in 180 ℃ oil bath was taken as the sudden boiling state. CONCLUSIONS The optimized extraction technology is stable and feasible.

Objective:To analyze the rules of medication and principles of formulas for the treatment of coronavirus disease 2019 (COVID-19) using the traditional Chinese medicine inheritance support platform (V2.5).Methods:The clinical data, including gender, age, clinical symptoms, frequency of traditional Chinese medicine medication and prescription information, of patients with COVID-19 and asymptomatic infection who were admitted to Hebei COVID-19 designated hospital supported by medical team of First Affiliated Hospital of Hebei University of Chinese Medicine from January to March 2021 were collected. The information data were input into the traditional Chinese medicine inheritance support platform (V2.5). The data mining and analysis were realized by the integrated association rules and complex entropy clustering analysis methods of the software, including the analysis of the frequency of each drug use, drug meridian, taste, and prescription rules, and the new prescriptions were developed.Results:A total of 564 patients (564 prescriptions) were enrolled, involving 200 Chinese herbs, including 357 cases of common COVID-19 and 207 cases of asymptomatic infection. The proportion of women with common COVID-19 was high, and the high incidence age group was 51-70 years old. There was no significant difference in gender of asymptomatic infection, and the high incidence age group was 1-20 years old. The main clinical manifestations of most patients were head heavy and cough, followed by low fever and cough with sputum, the main tongue coating and pulse pattern were similar in both types of patients. The frequency of traditional Chinese medicine used in patients with common type of COVID-19 from high to low was liquorice root (326 times), indian bread (264 times), pinellia tuber (263 times), bitter apricot seed (236 times), baical skullcap root (229 times), gypsum (205 times), agastache rugosus (201 times), dried tangerine peel (194 times), ephedra (184 times), and Chinese thorowax root (163 times), while that used by asymptomatic infection were baical skullcap root (174 times), liquorice root (142 times), medicated leaven (137 times), agastache rugosus (127 times), pinellia tuber (114 times), Chinese thorowax root (100 times), officinal magnolia bark (91 times), atractylodes rhizome (89 times), peony root (84 times), and milkvetch root (83 times). The two types of patients were mainly treated with warm, cold and flat drugs, and the nature and taste were mainly pungent, bitter and sweet. The meridian tropism of drugs was mainly lung, spleen and stomach. High frequency drug formulation mainly included drugs for resolving turbidity and detoxification. At the same time, seven new prescriptions for common COVID-19 and four new prescriptions for asymptomatic infection were developed.Conclusions:The primary reason for the COVID-19 occurrence and development is turbidity-toxin and the qi of plague, and resolving turbidity and detoxication are the basic treating principle. On the basis, for patients with common COVID-19, symptomatic treatment such as relieving exterior syndrome, clearing heat, resolving phlegm, and antitussive drugs should be taken into account at the same time, while the treatment of asymptomatic infections should focus more on supporting the body and eliminating the harmful pathogens.

Objective:To analyze the hot spots complained by outpatients in a tertiary hospital, so as to provide a basis for improving patients′ medical experience and the quality of medical service and medical safety.Methods:The data were selected from the outpatient complaint information severity of a tertiary hospital from November 1, 2020 to April 30, 2021. Complaints were classified and graded with severity. The hot spots of erious plaints and high-risk hidden events were analyzed. The database was established by double entry method. The data were analyzed with descriptive statistic, and the correlation among variants was tested by chi-square.Results:A total of 4 160 valid complaints involving 6 340 questions were included. In terms of the complaint departments and problems, clinical departments(3 682, 88.51%) and environment problems(2 451, 38.66%) accounted for the highest proportions respectively. There was a correlation between the severity of complaint and medical treatment( P<0.001). The distributions of severe complaints in each type of problems were significantly different( P<0.001). In terms of severe complaints, listening and communication(62, 26.38%)accounted for the highest proportions. A total of 161 complaints were in line with definitions of " high-risk hidden incidents" , of which environment-related problems topped the rest, accounting for 45.24%. Conclusions:Outpatient complaints of the tertiary hospital mainly focused on the admission and diagnosis sectors of clinical departments, mostly on environment, listening and communication. In the future, the hospital should focus on optimizing the outpatient environment and establish an effective doctor-patient communication mechanism for better doctor-patient relationship, to avoid occurrence of high-risk hidden events, and improve both medical service quality and safety.

T he recent development of imaging and sequencing technologies enables systematic advances in the clinical study of lung cancer.Meanwhile,the human mind is limited in effectively handling and fully utilizing the accumulation of such enormous amounts of data.Machine learning-based approaches play a critical role in integrating and analyzing these large and complex datasets,which have extensively characterized lung cancer through the use of different perspectives from these accrued data.In this review,we provide an overview of machine learning-based approaches that strengthen the varying aspects of lung cancer diagnosis and therapy,including early detection,auxiliary diagnosis,prognosis prediction,and immunotherapy practice.Moreover,we highlight the challenges and opportunities for future applications of machine learning in lung cancer.

OBJECTIVE: To study the effect of down-regulating miR-488 targeting Jag1 on the injury of hypoxia-reoxygenation myocardial H9c2 cells. METHODS: A hypoxic-reoxygenated myocardial H9c2 cell injury model was constructed. miR-488 inhibitor was used to transfect the cells. CCK-8 method and flow cytometry were used to detect cell proliferation and apoptosis in each group. Lactate dehydrogenase (LDH), superoxide dismutase (SOD), malonaldehyde (MDA), catalase (CAT) levels were detected. Western blotting was used to detect the expression of Bcl-2 associated X Protein (Bax) and B cell lymphoma/lewkmia-2 (Bcl-2). Target genes of miR-488 were predicted, and a luciferase reporter system was used to verify the targeting relationship between the two. Myocardial H9c2 cells were co-transfected with miR-488 inhibitor and Jag1 siRNA, and treated with hypoxia and reoxygenation, cell proliferation, apoptosis, LDH, SOD, MDA, CAT levels, and Bax, Bcl-2 protein expression were detected. RESULTS: The expression of miR-488 in the hypoxia-reoxygenated myocardial H9c2 cells was increased, along with reduced cell proliferation, increased apoptosis, increased Bax protein expression, decreased Bcl-2 protein expression, increased MDA, decreased CAT and SOD, and increased LDH level in the supernatant of cell culture. When myocardial H9c2 cells were transfected with miR-488 inhibitor and treated with hypoxia and reoxygenation, the expression of miR-488 was decreased, along with increased cell proliferation, decreased apoptosis, decreased Bax protein expression, increased Bcl-2 protein expression, decreased MDA, increased CAT and SOD, and decreased LDH level in the supernatant of cell culture. Down-regulation of miR-488 could target and down-regulate Jag1 expression. And Jag1 siRNA could reverse the effect of miR-488 inhibitor on the proliferation, apoptosis, LDH, SOD, MDA, CAT levels and the expression of Bax and Bcl-2 of hypoxic-reoxygenated myocardial H9c2 cells. CONCLUSION Down-regulating miR-488 targeted Jag1 can attenuate hypoxia-reoxygenation induced myocardial H9c2 cell injury.
Apoptosis/genetics* ; Down-Regulation ; Humans ; Hypoxia/genetics* ; Jagged-1 Protein/genetics* ; MicroRNAs/genetics* ; Myocardial Reperfusion Injury ; Myocytes, Cardiac

Objective:To investigate the current situation of medication near-miss reporting barriers for pediatric nurses for pediatric nurses and analyze its influencing factors.Methods:Using a multi-stage cluster sampling method, clinical pediatric nurses from 13 hospitals of Henan Province were selected as research objects from July to October 2020. General situation questionnaire, Hospital Safety Atmosphere Questionnaire, Medication Near-miss Reporting Barriers Scale, Multiple Leadership Style of Head Nurse Scale and Patient Safety Competency Nursing Staff Self-rating Scale were used for investigation, and related factors affecting medication near-miss reporting barriers for pediatric nurses were analyzed. A total of 1 104 questionnaires were distributed and 1 070 were effectively returned, with the effective recovery rate of 96.92%.Results:The reporting rate of 1 070 pediatric nurses who actively reported medication near-miss reporting barriers was 14.42%, and the score of Medication Near-miss Reporting Barriers Scale was (98.1±21.46) . The total scores of Hospital Safety Atmosphere Questionnaire was (77.36±12.97) , score of Multiple Leadership Style of Head Nurse Scale was (74.4±15.89) , and score of Patient Safety Competency Nursing Staff Self-rating Scale was (107.81±2.59) . The results of multiple linear regression analysis showed that educational background, entry length, job title, marital status, leadership style, patient safety competence, and hospital safety atmosphere were the main influencing factors of medication near-miss reporting barriers for pediatric nurses ( P<0.05) . Conclusions:The medication near-miss reporting barriers for pediatric nurses are common, which are influenced by educational background, years of employment, leadership style, hospital safety atmosphere and other factors. Nursing managers should strengthen pediatric nurses' awareness of medication near-miss reporting, implement transformational leadership style and improve patient safety competence and hospital safety atmosphere, so as to promote drug use safety of children.