Understory planting of medicinal plants is a new planting mode that connects Chinese herbal medicine(CHM) with forest resources.The complex and variable understory environmental factors will inevitably affect the yield and quality of understory CHM.This research summarized the research progress on understory planting of medicinal plants based on forest types and environmental factors within the forest from the perspectives of understory light, air temperature and humidity, soil characteristics, and the interaction between crops within the forest.The results showed that the complex and variable light, temperature and humidity, and soil factors(such as fertility, acidity and alkalinity, and microorganisms) under the forest could affect the yield and quality of medicinal plants to varying degrees through physiological activities such as photosynthesis and respiration, resulting in a significant increase or decrease in yield and quality compared to open field cultivation.In addition, the competition or mutual benefit between different crops within the forest could lead to differences in the yield and quality of understory medicinal plants compared to open field cultivation.A reasonable combination of planting could achieve resource sharing and complementary advantages.Therefore, conducting systematic research on the effects of understory environmental factors on the yield and content of medicinal plants with different growth and development characteristics can provide theoretical guidance and technical references for formulating comprehensive strategies for understory planting of medicinal plants, such as selecting suitable medicinal plant varieties, optimizing planting density, and conducting reasonable forest management, thus contributing to the sustainable development and ecological protection of CHM.
Plants, Medicinal/growth & development* ; Forests ; Soil/chemistry* ; Environment ; Ecosystem ; Temperature

OBJECTIVE: To investigate the clinical efficacy of lengthened proximal femoral nail antirotation (PFNA) and InterTan in the treatment of subtrochanteric femur fractures in the elderly. METHODS: A retrospective analysis was performed on the data of 65 elderly patients diagnosed with subtrochanteric femoral fractures who met the inclusion criteria between October 2016 and January 2022. The enrolled patients were categorized into two groups according to the type of internal fixation used: the lengthened proximal femoral nail antirotation(PFNA) group and the InterTan group. There were 32 patients in the PFNA group, comprising 20 males and 12 females, with ages ranging from 60 to 85 years old with an average of (69.3±6.7 ) years old. Among these patients, 15 patients resulted from traffic accidents and 17 patients were caused by falls. According to the Seinsheimer classification system, there were 11 patients as type Ⅱ, 14 patients as type Ⅲ, 6 patients as type Ⅳ, and 1 patient as type Ⅴ. The InterTan group comprised 33 patients, including 20 males and 13 females, aged from 60 to 85 years old with an average of (69.8±7.8 ) years old. Of these, 15 patients resulted from traffic accidents, while 18 patients were caused by falls. According to the Seinsheimer classification system, 10 patients as type Ⅱ, 15 patients as type Ⅲ, 7 patients as type Ⅳ, and 1 patient as type Ⅴ. The intraoperative blood loss, operative duration, and fracture healing time were recorded and compared between two groups. The quality of fracture reduction was assessed using Chang's criteria. Additionally, the Harris hip score was utilized to evaluate hip function in both groups at 3 months postoperatively and at the final follow-up. RESULTS: All patients were followed up for a period ranging from 10 to 20 months with an average of (14.6±4.5) months. No statistically significant differences were observed between two groups in terms of operation time, intraoperative blood loss, quality of fracture reduction, or reduction methods (P>0.05). Three months after the surgery, the Harris hip score in the InterTan group was 80.0(78.0, 83.5) points, which was significantly higher than that in the PFNA group, which recorded a score of 77.5(75.0, 81.8) points. This difference was statistically significant (P<0.05). At the final follow-up, the Harris hip score in the InterTan group was 80.0(76.5, 87.0), while that in the PFNA group was 78.0(74.3, 82.8). No statistically significant difference was observed between two groups (P>0.05). CONCLUSION The use of lengthened PFNA and InterTan in the treatment of elderly subtrochanteric femur fractures can both achieve good treatment results, with the advantages of simple operation, firm fixation, and low failure rate of internal fixation. The lengthened InterTan can achieve better hip function than PFNA.
Humans ; Male ; Female ; Aged ; Aged, 80 and over ; Bone Nails ; Retrospective Studies ; Hip Fractures/surgery* ; Middle Aged ; Fracture Fixation, Intramedullary/instrumentation* ; Fracture Fixation, Internal/methods* ; Femoral Fractures/surgery*

Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.

Objective To observe the effect of multi-modal hand hygiene(HH)intervention on HH compliance,as well as the relationship between HH compliance and the healthcare-associated(HA)case infection incidence.Methods From 2014 to 2022,the infection control team in a tertiary first-class hospital implemented multi-modal HH intervention for health care workers(HCWs).The changing trend of HH monitoring data,the correlation be-tween HH compliance rate and HA case infection incidence were analyzed retrospectively.Results The consump-tion of HH products in the wards showed a stable upward trend;HH compliance rate increased from 64.98％in 2014 to 85.01％in 2022(P＜0.001),and HA case infection incidence decreased from 1.21％to 0.83％(P＜0.05).HH compliance rate was negatively correlated with HA case infection incidence(r=-0.369,P=0.027).HH compliance rates in different regions and job posts in each quarter were increased(P＜0.001).For 5 different HH moments in each quarter,HH compliance rate fluctuated slightly before sterile manipulation and after touching patient;presented rising trend after touching surroundings around patient,and decreased before touching patient and after touching patient's body fluid since 2020(P＜0.001).Conclusion Multi-modal HH intervention can im-prove the HH compliance of HCWs,improving their HH awareness is conducive to reducing HA case infection incidence.

Objective To explore the potential categories of fatigue trajectory in patients with diabetic peripheral neuropathy and analyze the influencing factors.Methods Convenience sampling method was used to select 426 patients with diabetic peripheral neuropathy who were hospitalized in a tertiary hospital in Jiangsu Province from April 2022 to April 2023.General information and disease related data of the patients were collected,and the Chinese version of Multi-dimensional Fatigue Scale,Pittsburgh Sleep Quality Index Scale,Social support Rating Scale,pain number rating scale and Tampa scale of kinetophobia were used to investigate at discharge(T1).The Chinese version of multi-dimensional fatigue scale was used to investigate 3 months after discharge(T2),6 months after discharge(T3),and 12 months after discharge(T4).A mixed growth model was used to identify the potential categories of fatigue trajectory and logistic regression were employed to analyze the influencing factors of fatigue.Results 414 patients finished the study.Three categories of fatigue trajectory in the patients with diabetic peripheral neuropathy were identified:significantly increasing group(19.6%),slowly increasing group(47.8%),and decreasing group(32.6%).Logistic regression analysis showed that age,sleep,social support,number of comorbidities,body mass index(BMI),pain and fear of exercise were the factors influencing the potential categories of fatigue trajectory in the DPN patients.Conclusions There are three potential categories of fatigue trajectories in DPN patients.Age,sleep disorders,social support,comorbidities,BMI,pain score,and exercise fear were influencing factors of fatigue in patients with DPN.

Objective To observe the value of feature pyramid network(FPN)for automatic segmentation and semantic feature classification of spontaneous intracerebral hemorrhage(sICH)hematoma showed on non-contrast CT.Methods Non-contrast CT images of 408 sICH patients in hospital A(training set)and 103 sICH patients in hospital B(validation set)were retrospectively analyzed.Deep learning(DL)segmentation model was constructed based on FPN to segment the hematoma region,and its efficacy was assessed using intersection over union(IoU),Dice similarity coefficient(DSC)and accuracy.Then DL classification model was established to identify the semantic features of sICH hematoma.Receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the efficacy of DL classification model for recognizing semantic features of sICH hematoma.Results The IoU,DSC and accuracy of DL segmentation model for 95％sICH hematoma in training set was 0.84±0.07,0.91±0.04 and(88.78±8.04)％,respectively,which was 0.83±0.07,0.91±0.05 and(88.59±7.76)％in validation set,respectively.The AUC of DL classification model for recognizing irregular shape,uneven density,satellite sign,mixed sign and vortex sign of sICH hematoma were 0.946-0.993 and 0.714-0.833 in training set and validation set,respectively.Conclusions FPN could accurately,effectively and automatically segment hematoma of sICH,hence having high efficacy for identifying semantic features of sICH hematoma.

Objective To explore the potential categories of self-management behavior in prediabetes patients and analyze the influencing factors of different potential categories.Methods A convenient sampling method was used to select pre-diabetic patients treated in physical examination centers and endocrinology outpatient clinics in 2 tertiary A hospitals in Jiangsu Province from September 2022 to June 2023.General data questionnaire,Prediabetic Disease Knowledge Questionnaire,Prediabetes Self-management Scale,Diabetes Self-efficacy Scale and Social Support Rating Scale were used for investigation.Results A total of 445 subjects were included in this study,with an average age of(44.92±4.98)years.4 potential categories of self-management behavior were identified,namely low self-management(16.4％),static self-management(19.1％),dynamic self-management(25.6％)and high self-management(38.9％).Occupational status,marital status,family per capita monthly income,family history of diabetes,disease knowledge,self-efficacy and social support were the influencing factors of self-management behavior in prediabetes patients(P＜0.05).Conclusion There are significant category characteristics of self-management behavior in patients with prediabetes.Medical staff can identify the category characteristics and influencing factors early,and provide bases for medical staff to formulate targeted clinical intervention measures to help patients improve their self-management level.

Objective To study the value of postmortem imaging on the diagnosis of intestinal perforation.Method Postmortem imaging(PMCT and PMCTA)data of 2 intestinal perforation deaths(and 4 controlled cases)were reviewed retrospectively.Diagnosing capacities of intestinal perforation by postmortem imaging method were further investigated.Results PMCT is sensitive in detecting the free air and liquid induced by intestinal perforation.PMCT can sometimes detect the gravity-dependent purulent secretions in the abdominopelvic cavity.PMCTA can visualize the extravasation of contrast agent from the perforation,which can be used to locate the accurate perforation region.Conclusion Postmortem imaging method(PMCT and PMCTA)is an important tool for the diagnosis of intestinal perforation,which can not only be used as a forensic diagnosis method,but is also useful to locate the perforation site before an forensic autopsy.

Objective: To explore the correlation between lipoprotein-associated phospholipase A2 (Lp-PLA2) level and albuminuria in patients with type 2 diabetes mellitus (T2DM) ． Methods : 200 T2DM patients were chosen to collect general data and relevant laboratory indicators． According to the urinary albumin / creatinine ratio ( UACR) ，they were divided into normal group (UACR＜30 mg / g，n = 66) ，microalbuminuria group (30 mg / g≤ UACR＜300 mg / g，n = 64) and macroalbuminuria group (UACR≥300 mg / g，n = 70) ．On the basis of Lp-PLA2 tertile，they were divided into low Lp-PLA2 group (Lp-PLA2 ＜104 ng / ml，n = 66) ，medium Lp-PLA2 group ( 104 ng / ml≤Lp-PLA2 ＜161 ng / ml，n = 67) and high Lp-PLA2 group (Lp-PLA2 ≥161 ng / ml，n = 67) ．Group differences were compared by analysis of variance and nonparametric test．Associations between Lp-PLA2 and other indicators were performed by Pearson correlation and Spearman correlation. Related factors of albuminuria in T2DM patients were explored by multivariate Logistic regression analysis． In addition ，receiver operating characteristic (ROC) curve analysis was applied to evaluate the predictive value of Lp-PLA2 for albuminuria in T2DM patients. Results: Lp-PLA2 was significantly higher in the macroalbuminuria group than that in both the normal group and the microalbuminuria group，and the differences were statistically significant (P＜0. 05) ．Compared with the normal group，Lp-PLA2 in the microalbuminuria group increased(P＜0. 05) ．With the increase in Lp-PLA2 tertile， there was gradual increase in UACR , and the difference was statistically significant (P＜0. 05) ．Correlation analysis showed that Lp-PLA2 was positively correlated with duration of DM，systolic blood pressure (SBP) ，glycosylated hemoglobin (HbA1c) ，fasting blood glucose (FBG) ，blood urea nitrogen (BUN) ，serum creatinine (Scr) ，UACR and negatively correlated with estimated glomerular filtration rate ( eGFR) (P ＜0. 05 ) ． Multivariate Logistic regression analysis showed that Lp-PLA2 ［OR = 1. 046，95% CI( 1. 031，1. 060) ］was an independent risk factor for albuminuria (P＜0. 05) ．The AUC of Lp-PLA2 for predicting albuminuria was 0. 902 ［95% CI(0. 862，0. 942) ］. The cut-off value of Lp-PLA2was 148 ng / ml，the sensitivity was 65. 7% and specificity was 98. 5%． Conclusion Lp-PLA2 is closely related to the albuminuria in T2DM patients，which provides a new method for the diagnosis and treatment of diabetic kidney disease (DKD) .

MicroRNAs (miRNAs) are mediators of the aging process. The purpose of this work was to analyze the miRNA expression profiles of spermatozoa from men of different ages with normal fertility. Twenty-seven donors were divided into three groups by age (Group A, n = 8, age: 20-30 years; Group B, n = 10, age: 31-40 years; and Group C, n = 9, age: 41-55 years) for high-throughput sequencing analysis. Samples from 65 individuals (22, 22, and 21 in Groups A, B, and C, respectively) were used for validation by quantitative real-time polymerase chain reaction (qRT-PCR). A total of 2160 miRNAs were detected: 1223 were known, 937 were newly discovered and unnamed, of which 191 were expressed in all donors. A total of 7, 5, and 17 differentially expressed microRNAs (DEMs) were found in Group A vs B, Group B vs C, and Group A vs C comparisons, respectively. Twenty-two miRNAs were statistically correlated with age. Twelve miRNAs were identified as age-associated miRNAs, including hsa-miR-127-3p, mmu-miR-5100_L+2R-1, efu-miR-9226_L-2_1ss22GA, cgr-miR-1260_L+1, hsa-miR-652-3p_R+1, pal-miR-9993a-3p_L+2R-1, hsa-miR-7977_1ss6AG, hsa-miR-106b-3p_R-1, hsa-miR-186-5p, PC-3p-59611_111, hsa-miR-93-3p_R+1, and aeca-mir-8986a-p5_1ss1GA. There were 9165 target genes of age-associated miRNAs. Gene Ontology (GO) analysis of the target genes identified revealed enrichment of protein binding, membrane, cell cycle, and so on. The Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of age-related miRNAs for target genes revealed 139 enriched pathways, such as signaling pathways regulating stem cell pluripotency, metabolic pathways, and the Hippo signaling pathway. This suggests that miRNAs play a key role in male fertility changes with increasing age and provides new evidence for the study of the mechanism of age-related male fertility decline.
Humans ; Male ; Young Adult ; Adult ; Middle Aged ; MicroRNAs/genetics* ; Signal Transduction/genetics* ; Spermatozoa/metabolism* ; Gene Expression Profiling