ObjectiveTo investigate the effects of Yiqi Wenyang Huoxue Lishui components on the cardiac function and mitochondrial energy metabolism in the rat model of chronic heart failure （CHF） and explore the underlying mechanism. MethodsThe rat model of CHF was prepared by transverse aortic constriction （TAC）. Eight of the 50 SD rats were randomly selected as the sham group， and the remaining 42 underwent TAC surgery. The 24 SD rats successfully modeled were randomized into model， trimetazidine （6.3 mg·kg^-1）， and Yiqi Wenyang Huoxue Lishui components （60 mg·kg^-1 total saponins of Astragali Radix， 10 mg·kg^-1 total phenolic acids of Salviae Miltiorrhizae Radix et Rhizoma， 190 mg·kg^-1 aqueous extract of Lepidii Semen， and 100 mg·kg^-1 cinnamaldehyde） groups. The rats were administrated with corresponding agents by gavage， and those in the sham and model groups were administrated with the same amount of normal saline at a dose of 10 mL·kg^-1 for 8 weeks. Echocardiography was used to examine the cardiac function in rats. Enzyme-linked immunosorbent assay was employed to determine the serum levels of N-terminal pro-B-type natriuretic peptide （NT-ProBNP）， hypersensitive troponin（cTnI）， creatine kinase （CK）， lactate dehydrogenase （LD）， free fatty acids （FFA）， superoxide dismutase （SOD）， and malondialdehyde （MDA）. The colorimetric assay was employed to measure the levels of adenosine triphosphate （ATP）， adenosine diphosphate （ADP）， and adenosine monophosphate （AMP） in the myocardial tissue. The pathological changes in the myocardial tissue were observed by hematoxylin-eosin staining and Masson staining. The Na⁺-K⁺-ATPase and Ca²⁺-Mg²⁺-ATPase activities in the myocardial tissue were determined by the colorimetric assay. The ultrastructural changes of myocardial mitochondria were observed by transmission electron microscopy. Western blot was employed to determine the protein levels of ATP synthase subunit delta （ATP5D）， glucose transporter 4 （GLUT4）， and carnitine palmitoyltransferase-1 （CPT-1）. The mitochondrial complex assay kits were used to determine the activities of mitochondrial complexes Ⅰ， Ⅱ， Ⅲ， and Ⅳ. ResultsCompared with the sham group， the model group showed a loosening arrangement of cardiac fibers， fracture and necrosis of partial cardiac fibers， inflammatory cells in necrotic areas， massive blue fibrotic tissue in the myocardial interstitium， increased collagen fiber area and myocardial fibrosis， destroyed mitochondria， myofibril disarrangement， sparse myofilaments， and fractured and reduced cristae. In addition， the rats in the model group showed declined ejection fraction （EF） and fractional shortening （FS）， risen left ventricular end-diastolic diameter （LVIDd）， left ventricular end-systolic diameter （LVIDs）， left ventricular end-diastolic posterior wall thickness （LVPWd）， left ventricular end-systolic posterior wall thickness （LVPWs）， left ventricular end-diastolic volume （LVVOLd）， and left ventricular end-systolic volume （LVVOLs）， elevated levels of NT-ProBNP， cTnI， CK， MDA， FFA， and LD， lowered level of SOD， down-regulated protein levels of GLUT4 and CPT-1， decreased activities of Na⁺-K⁺-ATPase， Ca²⁺-Mg²⁺-ATPase， and respiratory complexes Ⅰ-Ⅳ， and declined levels of ATP5D， ATP， ADP， and AMP （P<0.05， P<0.01）. Compared with the model group， the Yiqi Wenyang Huoxue Lishui components and trimetazidine groups showed alleviated pathological damage of the mitochondria and mycardial tissue， risen EF and FS， declined LVIDd， LVIDs， LVPWd， LVPWs， LVVOLd， and LVVOLs， lowered levels of NT-ProBNP， cTnI， CK， MDA， FFA， and LD， elevated level of SOD， up-regulated protein levels of GLUT4 and CPT-1， increased activities of Na⁺-K⁺-ATPase， Ca²⁺-Mg²⁺-ATPase， and respiratory complexes Ⅰ-Ⅳ， and elevated levels of ATP5D， ATP， ADP， and AMP （P<0.05， P<0.01）. ConclusionYiqi Wenyang Huoxue Lishui components can improve the cardiac function， reduce myocardial injury， regulate glucose and lipid metabolism， optimize the utilization of substrates， and alleviate the damage of mitochondrial structure and function， thus improving the energy metabolism of the myocardium in the rat model of CHF.

Urine is produced from the urinary system, and urinary cell-free DNA (cfDNA) carries genomic DNA directly secreted from urinary system.Urine samples are non-invasive, unlimited in quantity and easy to obtain, making urinary cfDNA a promising biomarker for urologic diseases.This article reviews the progress of clinical application of urinary cfDNA in urologic diseases.

Objective:To explore the influencing factors of left ventricular thrombus (LVT) in patients with non-ischemic heart failure (NIHF) and to construct a nomogram prediction model for NIHF patients with LVT.Methods:This study was a case-control study. A total of 2 592 patients with NIHF hospitalized in Beijing Anzhen Hospital affiliated to Capital Medical University from January 2018 to July 2022 were selected. Fifty-one patients with LVT identified by echocardiography and cardiac magnetic resonance were classified into LVT group. One hundred and sixty patients were selected as the non-LVT group using a 1∶3 propensity score matching based on age and gender. Multivariate logistic regression analysis was used to explore the influencing factors of LVT in patients with NIHF. A nomogram prediction model was constructed, and the area under (AUC) the receiver operating characteristic (ROC) curve was calculated to evaluate the predictive effect of the model.Results:A total of 211 patients were enrolled, with a median age of 40 years old and 160 males (76%). Compared with non-LVT group, LVT group had lower systolic blood pressure ((112±20) mmHg vs. (120±19) mmHg; 1 mmHg=0.133 kPa), lower left ventricular ejection fraction (LVEF; (27±12)% vs. (39±14)% ), lower proportion of patients with history of hypertension (28% (14/51) vs. 44% (70/160)) and atrial fibrillation (8% (4/51)vs.39% (62/160)), higher proportion of patients with New York Heart Association functional class Ⅲ to Ⅳ (class Ⅲ: 59% (30/51) vs. 41% (66/160); class Ⅳ: 28% (14/51) vs. 19% (31/160)), and larger left ventricular end-systolic diameter (LVESD; (56±14) mm vs. (50±15) mm). The levels of hemoglobin ((152±23) g/L vs. (142±30) g/L), D-dimer (508 (300, 1 105) μg/L vs. 158 (68, 379) μg/L), and N-terminal pro-brain natriuretic peptide (3 429 (2 462, 4 734) ng/L vs. 1 288 (422, 2 544) ng/L) were higher in LVT group than in non-LVT group ( P all<0.05). LVT group had a higher proportion of patients using beta-blockers (92% (47/51) vs. 78% (124/160)), angiotensin-converting enzyme inhibitors or angiotensin receptor blockers or angiotensin receptor neprilysin inhibitors (88% (45/51) vs. 72% (115/160)), and anticoagulant drugs (98% (50/51) vs. 32% (51/160)) than non-LVT group (all P <0.05). Multivariate logistic regression showed that reduced LVEF ( OR=1.08, 95% CI 1.02-1.15, P=0.008), decreased LVESD ( OR=1.07, 95% CI 1.01-1.12, P=0.013), and increased D-dimer levels ( OR=5.40, 95% CI 1.98-14.74, P=0.001) were independent influencing factors for LVT in patients with NIHF. The ROC curve showed that the AUC of the nomogram for predicting LVT in patients with NIHF was 0.793 (95% CI 0.710-0.876, P<0.001). Conclusion:Reduced LVEF, decreased LVESD, and elevated D-dimer are associated with LVT in NIHF patients. The predictive model developed based on the above indicators has certain value in predicting LVT in NIHF patients.

Existing studies have shown that Astragalus membranaceus(AM)and its active ingredients astragalus polysaccharides,oninon,and astragalus methyl glycosides can attenuate X-ray radiation-induced injury.However,there are no studies on how isoliquiritigenin(ISL)attenuate the bystander effect of bone marrow mesenchymal stem cells(BMSCs)induced by carbon ion radiation therapy for lung cancer.This study aimed to investigate the AM-derived small molecule ISL to enhance radiotherapy sensitivity by attenuating the carbon ion radiation-induced bystander effect(RIBE)in BMSCs to elucidate its mecha-nism of action.In this study,we established a C57BL/6 mouse lung cancer transplantation tumor model in vivo and a co-culture model of A549 cells and BMSCs in vitro,and the models were successfully treated with carbon ions.In further work,we used flow cytometry,immunofluorescence,Western blot,enzyme-linked immunosorbent assay(ELISA),inhibitor,short hairpin RNA(shRNA),Cell Counting Kit-8(CCK-8),and other methods to illustrate the mechanism.In the next experiments,we found that ISL combined with carbon ion radiotherapy had a significant anti-tumor effect and protected BMSCs from radiation damage.The aim of this study was to investigate the potential of ISL in enhancing the sensitivity of lung cancer cells to radiotherapy and attenuating RIBE in both in vitro and in vivo settings.Traditional Chinese medicine combined with radiation therapy is a promising and innovative treatment for non-small cell lung cancer.These results establish a theoretical foundation for further clinical development of ISL as a potential radiosensitizer option.

Pyroptosis, apoptosis, and necroptosis are three key types of pathways in programmed cell death (PCD). Studies have found a wide range of cross-talk between the three types of pathways, leading to the proposal of the concept of PANoptosis, or the inflammatory PCD pathway regulated by the PANoptosome complex, which has key features of pyroptosis, apoptosis, and/or necroptosis that cannot be explained by any of these single pathways. A growing number of studies have discovered that PANoptosis is involved in many liver-related disease processes, including liver cancer, metabolic-associated fatty liver disease, liver failure, fulminant viral hepatitis, and others. Therefore, this paper reviews the potential mechanism and role of PANoptosis in order to provide directions for studying the pathogenesis and potential therapeutic strategies for a variety of liver-related diseases.

Objective:To investigate the clinicopathological features and molecular characteristics of β-catenin-deficient colorectal cancer.Methods:The clinical, pathological and molecular features of 11 colorectal cancers with β-catenin protein loss diagnosed at the 960th Hospital of People′s Liberation Army of China, from January 2012 to November 2022 were analyzed.Results:Among the 11 patients, 3 were males and 8 were females. Their age ranged from 43 to 74 years, with the median age of 59 years. Six were in the left colon and 5 were in the right colon. One of the 11 cases had lymph node metastasis, 10 cases were well and moderately differentiated adenocarcinoma, and 1 was mucinous adenocarcinoma. Eight cases were of TNM stage T4, 2 of T1 stage and 1 of Tis stage. β-catenin protein was not detected using immunohistochemistry. Sanger sequencing revealed the presence of fragment-deletion mutation in exon 3 of CTNNB1 gene, resulting in loss of β-catenin protein expression.Conclusion:β-catenin deficiency is present in a small number of colorectal cancers and may be associated with exon 3 mutations of CTNNB1 gene.

BACKGROUND: Immunotherapies such as adoptive immune cell infusion and immune-modulating agents are widely used for cancer treatment, and the concomitant symptoms, including cytokine release syndrome (CRS) or immune-related adverse events (irAEs), are frequently reported. However, clinical manifestations induced by mismatched donor granulocyte colony-stimulating factor mobilized peripheral blood mononuclear cell (GPBMC) infusion in patients receiving microtransplant (MST) have not yet been well depicted. METHODS: We analyzed 88 cycles of mismatched GPBMC infusion in patients with acute myeloid leukemia receiving MST and 54 cycles of chemotherapy without GPBMC infusion as a comparison. Clinical symptoms and their correlation with clinical features, laboratory findings, and clinical response were explored. RESULTS: Fever (58.0% [51/88]) and chills (43.2% [38/88]) were the significant early-onset symptoms after GPBMC infusion. Patients possessing less human leukocyte antigen-matching loci with the donor or those with unrelated donors experienced more chills (3 [2-5] loci vs. 5 [3-5] loci, P  = 0.043 and 66.7% [12/18] vs. 37.1% [26/70], P  = 0.024). On the other hand, those with decreased CD4 + /CD8 + T-cell ratio developed more fever (0.8 [0.7-1.2] vs. 1.4 [1.1-2.2], P  = 0.007). Multivariable analysis demonstrated that younger patients experienced more fever (odds ratio [OR] = 0.963, 95% confidence interval [CI]: 0.932-0.995, P  = 0.022), while patients with younger donors experienced more chills (OR = 0.915, 95% CI: 0.859-0.975, P  = 0.006). Elevated ultra-sensitive C-reactive protein levels in the absence of cytokine storm were observed following GPBMC infusion, which indicated mild and transient inflammatory response. Although no predictive value of infusion-related syndrome to leukemia burden change was found, the proportion of host pre-treatment activated T cells was positively correlated with leukemia control. CONCLUSIONS Mismatched GPBMC infusion in MST induced unique infusion-related symptoms and laboratory changes, which were associated with donor- or recipient-derived risk factors, with less safety and tolerance concerns than reported CRS or irAEs.
Humans ; Leukocytes, Mononuclear ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Leukemia, Myeloid, Acute/therapy* ; Unrelated Donors ; Granulocyte Colony-Stimulating Factor ; Graft vs Host Disease

As a home treatment and economical and practical treatment mode, peritoneal dialysis (PD) is an effective renal replacement therapy for end-stage kidney disease. The number of PD patients in the world is increasing, and prognosis has been significantly improved. However, compared with the general population, the quality of life of PD patients is not satisfactory, and the disease burden is still very high. There is significant heterogeneity in the reports of clinical outcomes of PD in different countries and regions. The heterogeneity seriously affects the validity of clinical research evidence and the continuous improvement of the quality of PD centers. New progress has been made in the study of standardized clinical outcome of PD in recent years. The article reviews the heterogeneity of PD clinical outcome report, standardized clinical outcome classification and core outcome to standardize the report of PD clinical outcome, improve the clinical research quality and management level of PD, and finally improve the prognosis of patients.

Background Long-term occupational polycyclic aromatic hydrocarbons (PAHs) exposure is an important risk factor for cognitive impairment. At the same time, it can also cause a decrease of brain-derived neurotrophic factor (BDNF). However, it is not clear whether BDNF plays a key role in the cognitive impairment of workers caused by occupational PAHs exposure. Objective To analyze the correlation between the levels of PAHs in the plasma of coke oven workers and cognitive impairment, and to explore the possible mediating effect of plasma BDNF level on the relationship between PAHs and cognitive impairment. Methods A cross-sectional survey was carried out to select 138 pairs of workers from a coking plant (exposure group) and an energy plant (control group) in a large enterprise in Taiyuan, and the matching variables included age, education level and smoking status. The basic data of the workers were collected by questionnaire. The cognitive function of the workers was assessed by the Montreal Cognitive Assessment (MoCA) scale. Fasting elbow venous blood was collected, the plasma concentrations of 16 PAHs were determined by high performance gas chromatography-mass spectrometry (GC-MS), and the plasma concentration of BDNF was detected by enzyme-linked immunosorbent assay (ELISA). Multiple linear regression model was used to analyze the relationship between 12 PAHs levels in plasma and MoCA scores, and Bootstrap method was used to analyze the mediating effect of BDNF in the relationship between these two indicators. Results The average (\begin{document}$\bar x \pm s $\end{document}) age of workers in the two groups was (48.46±5.04) years, the length of service was (21.45±9.78) years, and 58.7% of the participants reported their education level at secondary vocational school, high school, and above. The median level (25th and 75th percentiles) [M(P₂₅, P₇₅)] of plasma Σ₁₂PAHs concentration of workers in the exposure group [20.937 (9.454, 38.387) μg·L⁻¹] was significantly higher than that of the control group [9.997 (4.952, 23.770)μg·L⁻¹] and the MoCA score (22.82±2.38) of the exposure group was significantly lower than that of the control group (24.60±5.67) (P<0.05). The plasma BDNF showed no significant difference between the exposure group [(29.99±9.80) μg·L⁻¹] and the control group [(31.48±9.09) μg·L⁻¹](P>0.05). Taking plasma PAHs as independent variable and MoCA score as dependent variable, after adjusting selected covariates, the results of multiple linear regression model showed that the MoCA score changed by −0.020 (95%CI: −0.035 - −0.005) for every 1 μg·L⁻¹ increase of plasma Σ₁₂PAHs. Low (<P₃₃), medium ( P₃₃~P₆₆) and high (>P₆₆) dummy variables were set according to the intertertile boundaries (8.31, 23.76) μg·L⁻¹ of the plasma level of Σ₁₂PAH of the workers. The change of MoCA score in the high concentration group versus the low concentration group was −1.167 (95%CI: −1.866 - −0.467). The MoCA score changed by 0.066 (95%CI: 0.012 - 0.119) for each 1 μg·L⁻¹ increase in plasma BDNF level. The results of dichotomous logistic regression analysis showed that the risk of cognitive impairment in the high concentration group was 2.635 (95% CI: 1.085 - 6.398) times higher than that in the low concentration group. The results of mediating effect analysis showed that plasma BDNF level was an intermediate variable between PAHs and cognitive impairment, and 45.50% of PAHs-induced cognitive impairment risk was mediated by reduced BDNF level. Conclusion The level of plasma PAHs in coke oven workers is negatively correlated with MoCA score, and PAHs may mediate cognitive impairment by reducing plasma BDNF level.

Background: Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances. Proton pump inhibitors (PPIs) are the main treatment to improve the reflux symptoms in GERD patients. Aims: To investigate the efficacy of PPIs on nighttime reflux symptoms and associated sleep disturbances in general GERD population in North China. Methods: In this multicenter, prospective observational study, adult GERD patients with nighttime heartburn or regurgitation were recruited from 11 tertiary hospitals in North China during July 2017 to March 2018. All the patients received oral PPIs treatment. Data on nighttime reflux symptoms and associated sleep disturbances were obtained by patient diary and self-report questionnaire, the quality of sleep was defined by the Pittsburgh Sleep Quality Index (PSQI). The efficacy of PPIs was estimated by the relief rate after 4-week treatment. Results: Of the 750 GERD patients analyzed, 585 (78.0%) reported nighttime reflux-associated sleep disturbances, and 427 (56.9%) were defined as poor sleepers with a PSQI score >5. After 4-week PPIs treatment, 51.3% of the patients achieved a relief of nighttime reflux symptoms. The complete relief rates for nighttime reflux symptoms and associated sleep disturbances were 32.5% and 51.5%, respectively. PSQI score was significantly improved from 6.82 ± 3.38 at baseline to 4.56±2.50 after 4-week PPIs treatment (P<0.05). Conclusions: PPIs treatment provides an effective relief of nighttime reflux symptoms and associated sleep disturbances and improving the sleep quality in general GERD population in North China.