The red doctor spirit is the red gene formed and developed in the process of the Communist Party of China （CPC） leading the revolution and construction， and in pioneering and developing the people’s health undertakings. It is also the embodiment of the spiritual lineage of the Chinese Communists in the field of healthcare. The red doctor resources is a valuable resource for medical colleges and universities to conduct ideological and political education， playing a vital role in the cultivation of medical talents and the construction of Chinese-style modernization in health and well-being. Combining with the macro-historical background and adopting the method of “university founding background， typical figures， typical cases， and group portrayal，” the university history research team at Xi’an Medical University has excavated representative cases that demonstrate the connotation of the spirit of red medicine， namely “political firmness and excellent technology，” from the university’s history of arduous struggle in its establishment and development. This exploration shows the historical value and practical significance of the red doctor spirit as reflected in university history. On these foundations， the research team explored and carried out ideological and political theory courses and campus culture construction activities with the characteristics of medical universities， thereby enhancing the affinity and persuasiveness of ideological and political theory courses， promoting the in-depth dissemination of the red doctor spirit， and assisting in the construction of health and well-being culture.

Objective To analyze the epidemic trend of type 2 diabetes in Suzhou from 2013 to 2022 and the early death and life loss of type 2 diabetes due to outdoor PM_2.5. Methods The indicators of death number, mortality rate, years of early life lost (YLL) and years of life lost per thousand (YLL rate) were selected, and the data of the Global Burden of Disease Study 2021 (GBD2021) were used to analyze the death information of type 2 diabetes in Suzhou. Results The number of deaths, mortality, YLL and YLL rate caused by type 2 diabetes in Suzhou from 2013 to 2022, showed an upward trend, and the number of deaths , YLL and YLL rate of type 2 diabetes attributed to PM_2.5 also showed an upward trend (P<0.001). The death toll of type 2 diabetes attributable to PM_2.5 totaled 3887 cases , the YLL was 61 974 person years, and the YLL rate was 0.89‰. Conclusion Type 2 diabetes has seriously threatened the health of residents in Suzhou , and the disease burden due to outdoor PM_2.5 is on the rise. It is important to carry out three-level prevention and improve air quality for type 2 diabetes to improve the health of residents.

Objective:To investigate the prospective association of sleep duration with the development of chronic obstructive pulmonary disease (COPD) in adults in Suzhou.Methods:The study used the data of 53 269 participants aged 30-79 years recruited in the baseline survey from 2004 to 2008 and the follow-up until December 31, 2017 of China Kadoorie Biobank (CKB) conducted in Wuzhong District, Suzhou. After excluding participants with airflow limitation, self-reported chronic bronchitis/emphysema/coronary heart disease history at the baseline survey and abnormal or incomplete data, a total of 45 336 participants were included in the final analysis. The association between daily sleep duration and the risk for developing COPD was analyzed by using a Cox proportional hazard regression model, and the hazard ratio ( HR) values and their 95% CI were calculated. The analysis was stratified by age, gender and lifestyle factors, and cross-analysis was conducted according to smoking status and daily sleep duration. Results:The median follow-up time was 11.12 years, with a total of 515 COPD diagnoses in the follow-up. After adjusting for potential confounders, multifactorial Cox proportional hazard regression analysis showed that daily sleep duration ≥10 hours was associated with higher risk for developing COPD ( HR=1.42, 95% CI: 1.03-1.97). The cross analysis showed that excessive daily sleep duration increased the risk for COPD in smokers ( HR=2.49, 95% CI: 1.35-4.59, interaction P<0.001). Conclusion:Longer daily sleep duration (≥10 hours) might increase the risk for COPD in adults in Suzhou, especially in smokers.

Objective:To investigate the association between sleep status and the risk for coronary heart disease in adults in Suzhou.Methods:Using the baseline and follow up information of 53 269 local residents aged 30-79 years in China Kadoorie Biobank conducted in Wuzhong District, Suzhou, 51 929 subjects were included in this study after excluding those reporting coronary heart disease, stroke and cancer at the baseline survey. A Cox proportional hazards regression model was used to analyze the association of healthy sleep score (0-3 points) and sleep factors (snoring, insomnia, long sleep duration and nap) with the risk for coronary heart disease.Results:The median follow-up time was 11.12 years, and 1 304 individuals were diagnosed with coronary heart disease during the follow-up. After adjusting for potential confounders, occasional snoring ( HR=1.20, 95% CI: 1.04-1.38), usual snoring ( HR=1.17, 95% CI: 1.02-1.33), insomnia disorder ( HR=1.41, 95% CI: 1.12-1.78), daytime dysfunction ( HR=1.56, 95% CI: 1.20-2.03) and perennial nap ( HR=1.37, 95% CI: 1.19-1.59) were associated with increased risk of coronary heart disease. Compared with those with sleep score of 0 - 1 (low sleep quality), the people with sleep score of 3 had reduced risk of coronary heart disease by 26% ( HR=0.74, 95% CI: 0.63-0.87). Stratified analysis showed that the association of healthy sleep score 3 with risk of coronary heart disease was stronger in low physically active individuals (interaction P<0.05). Conclusions:Snoring, insomnia disorders, daytime dysfunction, and perennial napping were all associated with increased risk for coronary heart disease, and keep healthy sleep mode might reduce the risk for coronary heart disease in adults.

Objective:To investigate the effects of 2 650 MHz radiofrequency (RF) exposure on the behavior and neurotransmitter release of mice.Methods:Adult male C57BL/6N mice were divided into a normal control (CON) group and a radiofrequency radiation (RFR) group using the random number table method. The mice in the RFR group were subjected to single-dose whole-body exposure to a uniform 2 650 MHz RF electromagnetic field for 3 h. During the RF exposure, the field strength in the effective working area of the RF radiation platform was measured using an electromagnetic radiation analyzer, and the changes in the anal temperature of the mice were monitored using an optical fiber thermometer. Moreover, the changes in the cognition, social interaction, and emotion of the mice were determined through the new object recognition test, social preference test, and open field test. Finally, the changes in the hippocampal neurotransmitter release levels of the mice were detected using microdialysis sampling and mass spectrometry, and the changes in the hippocampal tissue structure and ultrastructure were observed via microscopy.Results:Under the test conditions, RF radiation improved the anal temperature of the mice, with a maximum increasing amplitude of 0.61℃, falling within the range of thermal safety. The mice in the RFR group experienced a significant decrease in the frequency and time for exploring new objects ( t=4.50, 2.53, P < 0.05) in the new object recognition test, a significant decrease in the frequency ( t=0.08, P<0.01) and time ( t=0.03, P<0.05) for exploring other mice in the social preference test, and no significant change in the frequency and time for exploring the central area ( P > 0.05) in the open field test. Compared to the CON group, the RFR group showed an increase in the release of 5-hydroxytryptamine (5-HT) ( t=-2.56, P < 0.05) and a decrease in the release of acetylcholine (ACh) ( t=2.21, P < 0.05), no significant difference in the release of glutamate (Glu) and γ-aminobutyric acid (GABA) ( P > 0.05), and no evident damage to the hippocampal tissue and structure and synaptic ultrastructure. Conclusions:2 650 MHz RF radiation may induce cognitive impairment and abnormal social preference in mice, which is attributed to neuronal dysfunctions and neurotransmitter release disorders under RF exposure.

Objectives:To evaluate the safety and feasibility of simultaneous bilateral adrenal vein sampling(AVS)via the basilic vein approach. Methods:21 consecutive patients with primary aldosteronism(PA)who underwent simultaneous bilateral AVS via the basilic vein in Fuwai Hospital between July 2023 and November 2023 were enrolled in this study.The puncture site,catheter used in AVS,operation time,fluoroscopy time,contrast agent dosages,success rate of bilateral sampling,adverse events,and complications were recorded and analyzed.Successful sampling was determined by a selectivity index(cortisol in the adrenal vein/cortisol in inferior vena cava)greater than or equal to 2. Results:The average age of 21 patients was(49.3±7.7)years,with 13 male patients.The first 5F sheath was successfully inserted into the right basilic vein in all patients,the second 5F sheath insertion failed in two patients and switched to the ipsilateral cephalic vein approach.The 5F MPA1 catheter was inserted into the right adrenal vein and the 5F TIG catheter into the left adrenal vein in all patients.Operation time was 17.50(12.00,22.00)min,fluoroscopy time was 5.90(4.75,10.55)min,and contrast agent dosage was 25.00(25.00,35.00)ml.Bilateral AVS was successful in all patients.Two patients experienced adverse events,one case was catheter entanglement,which resulted in 5F TIG catheter slipped from adrenal vein,and another case was vascular spasm.No complications were recorded. Conclusions:Simultaneous bilateral AVS via basilic vein approach is safe and feasible in most PA patients,further researches with larger patient cohort are needed to validate the results from this study.

Objectives:To investigate long-term clinical outcomes of renal denervation(RDN)for the treatment of resistant hypertension. Methods:This study retrospectively enrolled 58 patients with resistant hypertension who received RDN treatment via femoral artery approach at Fuwai Hospital between February 2012 and November 2019.Follow up was performed at 1,3,6 months,1 year,and annually after RDN,and the last follow-up was June 2023.The baseline data and postoperative follow-up data including office blood pressure,24-hour mean blood pressure and heart rate,types and load of antihypertensive drugs,renal function,and major adverse events(including renal artery stenosis,acute myocardial infarction,stroke,cardiovascular death,and all-cause death)were obtained and analyzed.The impact of RDN on 10-year cardiovascular and cerebrovascular events was evaluated using the Framingham risk assessment model and the Chinese model. Results:A total of 58 patients were enrolled,with 1 patient(1.72%)died from lung cancer.Forty-one patients(70.69%)were visited in the last follow-up and the average follow-up time was(10.21±1.75)years.Compared with baseline,the office systolic/diastolic blood pressure was decreased by(12.59±21.65)/(9.87±14.27)mmHg(P<0.01,1 mmHg=0.133 kPa),24-hour mean systolic/diastolic blood pressure reduced by(11.28±15.33)/(7.94±12.29)mmHg(P<0.01),24-hour mean heart rate reduced by(2.45±9.46)bpm(P>0.05),the types of antihypertensive drugs decreased by 1.17±2.25(P<0.01),the drug load reduced by 1.45±2.37(P<0.001),and the estimated glomerular filtration rate decreased by(6.83±18.37)ml/(min·1.73 m2)(P<0.05)at the last follow-up.The impact of RDN on 10-year cardiovascular events and stroke risk was as follows:Framingham risk assessment showed an absolute risk decrease of 14.25%and 2.12%,respectively,and decreased by 5.72%and 17.46%using the Chinese cardiovascular and cerebrovascular risk assessment. Conclusions:This study showed that RDN could significantly reduce blood pressure levels in patients with resistant hypertension in the long-term follow up,and was expected to further reduce cardiovascular and cerebrovascular risks.

Objective:To observe the efficacy of different needling depths for knee osteoarthritis(KOA)and the effects on effusion,cartilage thickness,and synovium under ultrasound imaging. Methods:A total of 90 patients with KOA were randomly divided into a conventional acupuncture group,a Western medication group,and a shallow acupuncture group,with 30 cases in each group.In the conventional acupuncture group,the needling depth was 15-30 mm,and the needle was twisted for a few moments after insertion so that a sore,numb,distending,and electrified sensation was obtained;in the shallow acupuncture group,the points were punctured perpendicularly by 2 mm,and no manipulation was performed after insertion.The same points were used in the two acupuncture groups,and the needles were retained for 20 min.The treatment was performed 3 times a week.The Western medication group was given glucosamine sulfate capsules for oral administration,2 capsules once,3 times a day.All three groups were treated for 8 weeks.The Western Ontario and McMaster Universities osteoarthritis index(WOMAC)and the visual analog scale(VAS)were scored before treatment,after 4 weeks and 8-week treatment,respectively;while the changes in knee cartilage,synovial membrane,and joint fluid were observed by knee ultrasound before and after 8-week treatment.The clinical efficacy was evaluated after 8-week treatment. Results:After 8-week treatment,the effusion and the synovial thickness improved significantly in both the conventional and shallow acupuncture groups compared with that before treatment(P<0.01);the effusion improved in the Western medication group compared with that before treatment(P<0.05);the synovial thickness improved better in the conventional acupuncture group than in the Western medication group(P<0.05).There was no statistically significant difference in the cartilage thickness among the three groups compared with that before treatment(P>0.05).The WOMAC(pain,stiffness,and function)and VAS scores decreased in all three groups after 4-and 8-week treatment compared with those before treatment(P<0.05).After 4-and 8-week treatment,the pain scores in WOMAC of the conventional acupuncture group were lower than those of the Western medication group and the shallow acupuncture group(P<0.05),and the VAS scores of the conventional acupuncture group were lower than those of the shallow acupuncture group(P<0.05).After 8-week treatment,the stiffness and functional scores in WOMAC of the conventional acupuncture group were lower than those of the Western medication group(P<0.05). Conclusion:Conventional acupuncture,oral Western medication,and shallow acupuncture all relieved knee pain and improved knee stiffness and functional movement.Among them,conventional acupuncture had the best efficacy in relieving knee pain and the best efficacy in improving joint function after 8-week treatment.Both conventional acupuncture and shallow acupuncture significantly reduced synovial thickness lesions in the knee;all three groups improved joint effusion and were more effective with conventional and shallow acupuncture.

Objective To investigate the predictive value of preoperative bi-parametric MRI radiomics for the International Society of Urological Pathology(ISUP)grading of prostate cancer(PCa).Methods One hundred and sixty-five patients with PCa confirmed by pathology were analyzed retrospectively.According to the ISUP grading system,PCa patients were divided into five subgroups:G1 group(Gleason score=6),G2 group(Gleason score=3+4),G3 group(Gleason score=4+3),G4 group(Gleason score=8)and G5 group(Gleason score=9 or 10).A total of 3 948 radiomics features were extracted from T2WI,diffusion weighted imaging(DWI),and apparent diffusion coefficient(ADC)images of each patient.Patients were classified into two categories based on Gleason score≥4+3 or ≤3+4.A radiomics signature(Rad-score)was constructed after reduction of dimension by the minimum redundancy maximum relevance(mRMR)and the least absolute shrinkage and selection operator(LASSO).The Spearman rank correlation test was used to evaluate the correlation between Rad-score and ISUP grading groups.The Kruskal-Wallis test was used to compare the difference of Rad-score among the five groups.Results Eleven most valuable features were selected as the Rad-score after reducing the dimension by mRMR and LASSO algorithm.Moderate correlation existed between Rad-score and ISUP grading(r=0.53,P＜0.05).There were significant differences in Rad-score between G1 and G2 groups and G3,G4 and G5 groups(P＜0.05),no significant difference existed between the remained two groups(P＞0.05).The area under the curve(AUC)of receiver operating characteristic(ROC)curve for Rad-score were 0.827,0.762,0.563,0.657,0.698 for G1,G2,G3,G4 and G5 groups,respectively.Conclusion The radiomics based on bi-parametric MRI can be used to predict grade 1,2 PCa patients in the ISUP grading system.

Traumatic brain injury (TBI) is much more complex considering the unique pathophysiological changes under high-altitude hypoxic environment. Moreover, because of limited source of medical transportation and facilities at high altitude, TBI patients often lack urgent and standard treatment and have to be transported to the district medical center at high altitude or even the neurotrauma center at plain region as soon as possible. The transportation has high risk and takes serious effect on lives and prognosis of the TBI patients. Up to date, the evacuation and support process for TBI patients in the western plateau region of China has been improved through years of practice, but there are still deficiencies compared to the Critical Care Air Transport Team (CCATT). The authors sought to discuss certain issues related to medical evacuation and support after TBI at high altitude from aspects of early damage control operation and timely safety medical transportation, aiming to improve the survival rate, neurological outcomes and life quality for these patients.