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Ferroptosis is a new type of cell death proposed in recent years, and its main characteristics are iron overload and lipid peroxidation. Ferroptosis is involved in the occurrence and development of non-alcoholic fatty liver disease(NAFLD). Iron overload can generate a large amount of reactive oxygen species through the Fenton reaction. Under the action of lipoxygenase, the unsaturated fatty acids on the liver cell membrane undergo lipid peroxidation, which induces liver cell death and leads to the occurrence of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis. Blocking ferroptosis may provide one of the therapeutic strategies to protect liver cells.

Objective To investigate the effects of metformin(Met) on the proliferation of pancreatic cancer cells under different glucose concentration culture conditions, and to find the potential role of miR-139-5p in the process. Methods PANC-1 cells were treated with different concentrations of metformin(0/5/10/20 mmol/L) in 25 mmol/L(high-glucose group,HG) or 5 mmol/L(normal-glucose group,NG) glucose culture, cell proliferation, apoptosis, migration and cell cycle were detected after 48 h. The expression of miR-139-5p was quantitatively detected by RT-qPCR, and the miR-139-5p mimics were transfected into PANC-1 cells to clarify the role of miR-139-5p. Results Metformin inhibited the proliferation, promoted apoptosis, and induced S phase and G2/M phase arrest of PANC-1 cells under in high glucose and normal glucose culture conditions, and its anti-proliferation and pro-apoptosis effects were more significant in the normal glucose groups. The expression of miR-139-5p was up-regulated by metformin treatment in normal but not in high glucose culture. Further studies showed that miR-139-5p mimics inhibited of PANC-1 cells proliferation without metformin pre-incubation and enhanced the anti-proliferation effect of 5 mmol/L metformin. The pro-apoptotic effect of 10 mmol/L metformin in normal glucose culture conditions. Conclusions In normal-glucose culture conditions, metformin can inhibit proliferation, induce apoptosis and cell cycle arrest of PANC-1 cells more significantly than in higher-glucose culture, which may be partly related to the up-regulation of miR-139-5p.

Previous studies have established a link between fluctuations in climate and increased mortality due to coronary artery disease (CAD). However, there remains a need to explore and clarify the evidence for associations between meteorological changes and hospitalization incidences related to CAD and its subtypes, especially in cold regions. This study aimed to systematically investigate the relationship between exposure to meteorological changes, air pollutants, and hospitalization for CAD in cold regions.

Objective To explore how to integrate the history of Peking Union Medical College (PUMC) into the teaching of diabetes in internal medicine, in order to develop an ideological and political theory-based course with PUMC characteristics. Methods The students in '4+4' medical doctor program of PUMC were enrolled into this study. Diabetes mellitus course combined with ideological and political theories course (including the history of insulin development, the life and contribution of Prof. WU Xian and Prof. LIN Kesheng, and the contributions of Prof. CHI Zhisheng, Prof. PAN Xiaoren and Prof. XIANG Hongding to the prevention and treatment of diabetes) was used for the teaching. Feedback (including the level of the political teaching knowledge before and after the course, the effectiveness of the political teaching by students after the course) was collected by questionnaire online, and statistical analysis was conducted. Results A total of 62 students (32 in grade 2020 and 30 in grade 2021) were included in the '4+4' pilot class of clinical medicine at PUMC. A total of 58 questionnaires were collected (30 in grade 2020 and 28 in grade 2021), with a rate of 93.5%(58/62). Before teaching, 55.2%~100% of the students had no knowledge of the course, and after teaching, all students had a general understanding, with the level of understanding significantly better than before (P < 0.001). According to the survey, 82.8% of the students thought that the course increased their interest in learning, 86.2% of the students were satisfied with the overall effect of the course, 89.7% thought that it allowed them to better understand the history of PUMC, 77.6% thought it deepened their understanding of the spirit of medical science, 82.8% thought it increased their understanding of the spirit of professional service to the country and patriotism, and 72.4% thought it increased their sense of social responsibility. Conclusions Integrating the history of PUMC into clinical medicine education is the unique advantage of PUMC medical education. It is conducive to students understanding of ideological and political theories, inculcation of correct values, method ology and humanistic qualities, and cultivation of the truth-seeking and pragmatic spirit of medical science.

Objective To investigate the clinical characteristics of different subtypes of type 1 diabetes mellitus(T1DM) patients and to analyze the risk of macrovascular diseases in different subtypes of T1DM patients. Methods The clinical data among 79 T1DM patients who treated in the Endocrinology Department of Beijing Puren Hospital from March 2002 to July 2021 were retrospectively analyzed. There were 21 patients with idiopathic T1DM and 58 patients with autoimmune T1DM. Excluding 14 patients because of data missing, 65 patients were divided into macrovascular disease group (n=13) and non-macrovascular disease group (n=52). Results 1)Patients with idiopathic T1DM manifested a longer diabetic course,a higher high density lipoprotein cholesterol(HDL-c)level, a lower body mass index(BMI), hemoglobin A1c(HbA1c) and fasting C peptide(FC-P)level. 2)Compared with the group non-macrovascular disease, the macrovascular disease group was elder with higher prevalence of idiopathic T1DM and lower estimated glomerular filtration rate(eGFR) level and incidence of diabetic ketoacidosis(DKA) at the beginning of disease. 3)Macrovascular lesions were positively correlated with age(r=0.432) and diabetic course (r=0.245)(P＜0.05), were negatively correlated with eGFR(r=-0.392), positive islet autoantibody (r=-0.268) and DKA incidence at the beginning of disease(r=-0.313)(P＜0.05). 4)Multivariate regression analysis showed that negative auto-antibody finding was a risk factor for macrovascular disease (OR=0.03, 95% CI:0.001-0.858, P＜0.05) after age, diabetic course, BMI, eGFR, HDL-c and incidence of DKA at onset were adjusted. Conclusions Patients with idiopathic T1DM show a higher risk of macrovascular disease risk than those with autoimmune T1DM.

Objective By summarizing the clinical characteristics and follow-up outcomes of 5 patients with immune checkpoint inhibitor induced diabetes mellitus (ICI-DM) and reviewing the relevant literatures, the article aims at providing reference to clinicians in the diagnosis and treatment of the ICI-DM. Methods Clinical data of 5 patients with ICI-DM who were admitted to Peking Union Medical College Hospital from December 2018 to February 2023 and did retrospectively analyzed. Results Five patients with a mean age of (65±7)years received treatment by the programmed cell death 1 (PD-1) or its ligand inhibitor (PD-L1). The median time from the first immunotherapy to the discovery of elevated plasma glucose was 100 (43, 210)days, and the median cycle of immunotherapy was 7 (2.5, 10.5). The onset of the illness of all the 5 patients started with diabetic ketosis or ketoacidosis. At the onset, urine ketone bodies were positive, random plasma glucose was (36.36±15.89)mmol/L, glycosylated hemoglobin A1c (HbA1c)was (8.6%±0.66%), arterial blood pH was (7.28±0.16), and the median fasting C-peptide level was 0.09 (0.05, 0.32)μg/L. Five patients had an onset plasma glucose level of grade 3 or 4.Then, ICI treatment was discontinued in all patients and insulin therapy started. The daily dosage of insulin was (56±20)IU, supplemented with hypoglycemic drugs. After treatment, urine ketone body turned negative, pH value increased to normal range, and random plasma glucose decreased significantly (the median difference of random blood glucose before and after treatment was 21.30 mmol/L, P=0.043) showing that the treatment was effective. During the follow-up, all patients continued to use insulin. The PD-1 or PD-L1 inhibitors were restarted after hyperglycemia remission. The tumor condition was under control. Conclusions ICI-DM mainly occurs in patients who receive treatment with PD-1 or PD-L1 inhibitors usually with acute hyperglycemia whose laboratory tests indicate insulin secretion defects. Some patients had positive islet cell antibodies, glutamic acid decarboxylase antibodies and autoantibodies.Patients with positive autoantibodies needed early diagnosis and continuous insulin treatment. ICI treatment can be restarted after endocrinologists brought the blood glucose under control.

Objective To investigate the mental health status of eight-year medical doctor program students in Peking Union Medical College and try to put forward feasible psychological support countermeasures. Methods Undergraduates of eight-year program from grades 3 to 8 in Peking Union Medical College were investigated by WeChat and questionnaires(www.wjx.cn). The differences among groups were analyzed by gender and grade. The practice group received strengthened psychological support intervention and compared with the theoretical study group. Results Totally 248 qualified questionnaires were collected and 82(33.1%) and 16(6.5%) students were rated “moderate” and “poor” in psychological self-assessment. The Life Satisfaction with Life Scores (SWLS) from 6th and 7th grade students was significantly lower than that from 3rd, 5th, and 8th grade. For other scales including depression, anxiety, and difficulties in emotional regulation scale, a tendency showed that these undergraduates from two grades had higher scores but the result was not statistically significant. Conclusions The undergraduates of eight-year doctor program still have some mental health problems especially during internship period when facing to greater pressure. Implementation of intervention may support their emotional regulation.

Structure-from-Motion (SfM) techniques have been widely used for 3D geometry reconstruction from multi-view images. Nevertheless, the efficiency and quality of the reconstructed geometry depends on multiple factors, i.e., the base-height ratio, intersection angle, overlap, and ground control points, etc., which are rarely quantified in real-world applications. To answer this question, in this paper, we take a data-driven approach by analyzing hundreds of terrestrial stereo image configurations through a typical SfM algorithm. Two main meta-parameters with respect to base-height ratio and intersection angle are analyzed. Following the results, we propose a Skeletal Camera Network (SCN) and embed it into the SfM to lead to a novel SfM scheme called SCN-SfM, which limits tie-point matching to the remaining connected image pairs in SCN. The proposed method was applied in three terrestrial datasets. Experimental results have demonstrated the effectiveness of the proposed SCN-SfM to achieve 3D geometry with higher accuracy and fast time efficiency compared to the typical SfM method, whereas the completeness of the geometry is comparable.

Abstract Background Although a number of medicines are available for the management of hypertension, the organ damage induced by hypertension is not resolved. The aim of this study was to investigate the protection of ginsenoside Rg1 (Rg1) against vascular remodeling and organ damage in spontaneously hypertensive rats (SHR). Methods Male SHR were treated with 5, 10 or 20 mg/kg Rg1 through intraperitoneal injection per day for 1 month. SHR or Wistar-Kyoto rats (WKY) receiving vehicle (saline) was used as control. Blood pressure detection and pathological stain, transmission electron microscope, immunohistochemical assay were used to elucidate the protection of Rg1. Results Blood pressures were not different between control SHR rats and Rg1 treated SHR rats, but Rg1 improved the aortic outward remodeling by lowering the lumen diameter and reducing the media thickness according the histopathological and ultrastructural detections. Rg1 also protected the retinal vessels against inward remodeling detected by immunohistochemical assay. Furthermore, Rg1 attenuated the target heart and kidney damage with improvement on cardiac and glomerular structure. Conclusions These results suggested that Rg1 held beneficial effects on vascular structure and further protected against the organ-damage induced by hypertension. These findings also paved a novel and promising approach to the treatment of hypertensive complications.

Abstract Background Ophiocordyceps sinensis (syn. Cordyceps sinensis), endemic to alpine regions on the Tibetan plateau, is one of the most valuable medicinal fungi in the world. Huge commercial demand has led to excessive harvest and a dramatic decline in its numbers. The diversity of terrains and climates on the Tibetan Plateau and the broad insect host range (more than 50 species in the family Hepialidae) may have resulted in substantial intraspecific genetic diversity for this fungus. The objective of this study was to evaluate the population distribution of O. sinensis from geographically diverse regions of the Tibetan Plateau based on nrDNA ITS and MAT1-2-1 gene sequences. Understanding of the genetic diversity and genesis of O. sinensis will provide important information for the evolution and conservation of this fungus. Results Significant sequence variations in the ITS and MAT1-2-1 genes (27 and 23 informative sites, eight and seven haplotypes, respectively) were observed. Phylogenetic analysis based on ITS sequences, MAT1-2-1 sequences, or their combined data set, clustered isolates from northern regions in one clade (clade I), whereas isolates from southern regions were dispersed in all four clades (clade I-IV). Single-strand conformation polymorphism (SSCP) analyses of 2639 ITS clones from seven samples revealed 91 different SSCP patterns that were subsequently sequenced. ITS heterogeneity was found in XZ-LZ07-H1 (Nyingchi population), and 17 informative sites and five haplotypes were detected from 15 clones. The five haplotypes clustered into three clades (clade I, II, and IV). Conclusions Significant genetic divergence in O. sinensis was observed and the genetic diversification was greater among southern isolates than that among northern isolates. The polymorphism of nrDNA ITS sequences suggested that O. sinensis spread from a center of origin (the Nyingchi District) to southern regions and subsequently to northern areas. These results suggest that southern populations are important reservoirs of genetic diversity and should be taken into account in conservation programs.