Abstract:Objective To explore the effect of Zhigancao Decoction on atrial remodeling and the microrNA(miR)-26b-5p/maternal DPP homologous product(SMAD)4 pathway in rat model of atrial fibrillation(AF).Methods The AF rat model was constructed.The successfully modeled rats were randomly divided into the AF group,the verapamil group,the low-dose Zhigancao Decoction(Zhigancao Decoction-L)group,the high-dose Zhigancao Decoction(Zhigancao Decoction-H)group,the Zhigancao Decoction-H+anti-NC group and the Zhigancao Decoction-H+miR-26b-5p inhibitor(anti-miR-26b-5p)group,with 18 rats in each group.Another 18 healthy rats were taken as the control group.Cardiac function of rats and induction rate of AF in vitro were detected in each group.Hematoxylin-eosin(HE)staining and Masson staining were used to observe the pathological changes of atrial tissue.TdT-mediated dUTP nick-end labeling(TUNEL)staining was used to observe cardiomyocyte apoptosis in atrial tissue.Immunohistochemistry was used to detect expressions of type Ⅰ collagen(ColⅠ)and α-smooth muscle actin(α-SMA)in atrial tissue.qRT-PCR was used to explore the relative expression level of miR-26b-5p.Western blot assay was used to detect the expression levels of SMAD4,BCL-2 associated X protein(BAX)and activated caspase-3(C-caspase3).Dual-luciferase assay was performed to verify the targeting relationship between miR-26b-5p and SMAD4.Results Compared with the control group,the atrial tissue in the AF group exhibited severe pathological damage,including abnormal myocardial cell structure,swelling,sparse and disordered arrangement,and significant blue collagen deposition(P＜0.05).In cardiac function indexes of AF group,left ventricular end-systolic diameter(LVESD)and left ventricular end-diastolic diameter(LVEDD)were increased,while left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)were decreased(P＜0.05).Furthermore,the induction rate of AF,collagen area percentage and cell apoptosis rate of atrial fibrillation were increased.The protein expression levels of BAX,C-caspase3,ColⅠ,α-SMA and SMAD4 were enhanced,and the level of miR-26b-5p was decreased(P＜0.05).Compared with the AF group,treatment with verapamil and Zhigancao Decoction reversed the trends of the above indicators,alleviated the pathological damage in atrial tissue and reduced blue collagen deposition.Zhigancao Decoction-H+anti-miR-26b-5p reversed the ameliorative effects of Zhigancao Decoction-H on atrial remodeling in the AF rat model.Starbase website and the dual-luciferase gene report indicated a targeting relationship between miR-26b-5p and SMAD4.Conclusion Zhigancao Decoction may improve atrial remodeling in AF rats by up-regulating miR-26b-5p and thereby inhibiting the expression of SMAD4.

Abstract:Cervical spondylosis is one of the common spinal diseases in clinical practice,and patients with severe symptoms often require surgical treatment.Unilateral biportal endoscopy technique is a minimally invasive spinal technique that develops rapidly in recent years.It has gradually been used to treat cervical spondylosis and achieved good clinical efficacy.It has the advantages of minimal trauma,rapid postoperative recovery and fewer complication.This article reviews the application progress of unilateral biportal endoscopy technique in the treatment of cervical spondylosis,in order to provide reference for clinicians.

Abstract:Objective To investigate the effect of andrographolide(Andro)on the proliferation and apoptosis of myeloma cells by regulating the signal transducer and activator of transcription 3(STAT3)/glutathione peroxidase 4(GPX4)pathway.Methods Human multiple myeloma U266 cells were divided into the myeloma group,the Andro low-concentration group,the Andro medium-concentration group,the Andro high-concentration group,the Stattic(STAT3 inhibitor)group and the Andro high-concentration+Colivelin(STAT3 activator)group.Cell proliferation was detected by CCK-8 assay and clone formation assay.Cell apoptosis was detected by flow cytometry.Mitochondrial morphology was observed by transmission electron microscopy.The levels of mitochondrial membrane potential,ferrous ion(Fe²⁺),4-hydroxynonenal(4-HNE),malondialdehyde(MDA)and reduced glutathione(GSH)in cells were detected.The level of reactive oxygen species(ROS)in cells was detected by 2′,7′-dichlorodihydrofluorescein diacetate(DCFH-DA)fluorescent probe.Western blot assay was used to detect the proteins including proliferating cell nuclear antigen(PCNA),B-cell lymphoma-2(Bcl-2)/Bcl-2 associated X protein(Bax),solute carrier family 7 member 11(SLC7A11),p-STAT3 and GPX4.Results Compared with the myeloma group,the mitochondria of U266 cells showed significant morphological changes in the Andro low-,medium-and high-concentration groups,the OD450 value,clone formation rate,mitochondrial membrane potential,GSH level,and the protein levels of PCNA,Bcl-2/Bax,SLC7A11,p-STAT3/STAT3 and GPX4 were decreased,the cell apoptosis rate,the levels of Fe²⁺,4-HNE,MDA and ROS were increased(P＜0.05).Compared with the myeloma group,the changes in the corresponding indexes of U266 cells showed the same trend as above in the Stattic group(P＜0.05).Colivelin reversed the promoting effect of high-concentration Andro on ferroptosis and apoptosis of U266 cells,as well as the inhibitory effect on cell proliferation.Conclusion Andro may induce ferroptosis by inhibiting the STAT3/GPX4 pathway,thereby inhibiting the proliferation and promoting the apoptosis of multiple myeloma cells.

Abstract:Objective To explore the correlation between the characteristics of the endometrial microbiome in patients with recurrent implantation failure(RIF)and the subsequent transplantation outcomes.Methods A total of 438 RIF patients underwent embryo transfer again in our hospital were retrospective selection.According to the pregnancy status of the patients 8 weeks after embryo transfer,patients were divided into the pregnancy group(n=85)and the non-pregnancy group(n=353).The clinical data,characteristics and composition diversity of the endometrial microbiome were compared between the two groups.Binary Logistic regression was used to analyze the influencing factors,and the receiver operating characteristic(ROC)was employed to predict the efficacy of the influencing factors.The interaction between the above-mentioned risk factors and Shannon index in the subsequent transplantation outcomes of RIF patients was further analyzed.Results The levels of basal estradiol(E2),fasting insulin(Fins),total cholesterol(TC)and triglycerides(TG)were significantly higher in the non-pregnant group than those in the pregnant group(P＜0.05).Meanwhile,there were significant differences in the composition of endometrial microorganisms between the two groups(P＜0.05).Among them,the abundance of Fusobacterium phylum,the abundance of Bacillus genus and the α-diversity(Chao1,Shannon,Simpson)index all showed significant differences(all P＜0.05).Binary Logistic regression multivariate analysis showed that the abundance of Fusobacterium phylum increased(OR=1.628,95%CI:1.416-1.841),the abundance of Bacillus genus decreased(OR=0.725,95%CI:0.557-0.934)and E2 increased(OR=1.654,95%CI:1.343-1.965).The elevated insulin(OR=1.691,95%CI:1.393-1.980)and decreased Shannon index(OR=0.388,95%CI:0.075-0.697)were independent risk factors for failure after subsequent transplantation.ROC curve analysis showed that the area under the curve(AUC)of the Shannon index was 0.836(95%CI:0.782-0.890),with the highest predictive efficacy.There was significant interaction among the subgroups of Fusobacteria,Bacillus genus,E2 and insulin in Shannon index on the subsequent transplantation outcomes of patients with RIF.Conclusion The independent risk factors for subsequent transplantation failure in RIF patients can be used as sensitive indicators to predict the subsequent transplantation outcomes of RIF patients,and Shannon index has a higher clinical predictive value.

Abstract:With the continuous development of imaging techniques such as magnetic resonance imaging,the detection rate of brain metastases is increasing.Although the incidence rate of cystic brain metastasis is far lower than that of solid brain metastasis,patients with cystic brain metastasis are in urgent condition and have obvious space occupying effect,which is an urgent clinical problem.Previous literature has reported that cystic brain metastasis is more common in breast cancer and lung adenocarcinoma,especially in lung cancer patients with positive driver gene.This article reports a case of small cell lung cancer with cystic brain metastasis,which started with neurological symptoms,and was clinically cured under a multidisciplinary diagnosis and treatment model.Through dynamic imaging evaluation and molecular residual lesion detection,the patient can avoid overtreatment and achieved a relatively higher quality of life on the basis of prolonging survival.

Abstract:Objective To investigate the effects of transcutaneous electrical nerve stimulation(TENS)combined with mobilization with movement(MWM)on clinical efficacy,musculoskeletal ultrasound findings and bone metabolism indicators in patients with knee osteoarthritis(KOA).Methods Ninety KOA patients were collected and randomly divided into the control group(conventional rehabilitation+TENS,n=45)and the observation group(conventional rehabilitation+TENS+MWM,n=45)using a random number table.Clinical efficacy,knee joint function,musculoskeletal ultrasound indices and bone metabolism indices were compared between the two groups.Results The clinical efficacy of the observation group was superior to that of the control group(P＜0.05).At 2 and 6 months post-treatment,Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)were significantly lower in the observation group than those of the control group,and Lysholm Knee Scoring Scale scores were higher in the observation group than those of the control group(P＜0.05).Additionally,articular cartilage thickness,bone gla protein(BGP)and bone-specific alkaline phosphatase(BALP)were higher in the observation group than those of the control group,and synovial thickness,suprapatellar effusion and tartrate-resistant acid phosphatase 5b(TRACP-5b)were lower in the observation group than those of the control group(P＜0.05).Conclusion TENS combined with MWM in the treatment of KOA patients can not only improve knee joint function but also optimize musculoskeletal ultrasound indices and regulate bone metabolism indices.

Abstract:Objective To explore the clinical efficacy of Shen'an decoction in treating chronic renal insufficiency and systematically assess its effects on immune regulation,renal function and lipid metabolism.Methods A prospective randomized controlled study was conducted,and 102 patients with chronic renal insufficiency were selected.Patients were randomly divided into the control group(51 cases,receiving conventional Western medical treatment)and the observation group(51 cases,receiving conventional Western medical treatment combined with Ren'an decoction).The traditional Chinese medicine(TCM)syndrome scores,clinical efficacy,levels of immunoglobulin(Ig)G,IgM,IgA,24-hour urine protein quantification(24 hUP),cystatin C(Cys C),serum creatinine(Scr),blood calcium,blood phosphorus,triglycerides(TG)and total cholesterol(TC)were evaluated before treatment and 8 weeks after treatment.The levels of reactive oxygen species(ROS)and advanced oxidation protein products(AOPPs)were measured by enzyme-linked immunosorbent assay(ELISA).Adverse reactions such as nausea,diarrhea,dizziness and rash during the treatment period were recorded.Results After 8 weeks of treatment,the TCM syndrome scores,24 hUP,Cys C,Scr,blood phosphorus,TG,TC,ROS and AOPPs were significantly lower in both groups than those before treatment,and the observation group was significantly lower than that of the control group(P＜0.05).The levels of IgG,IgM,IgA and blood calcium were significantly higher in both groups than those before treatment,and the observation group was significantly higher than those of the control group(P＜0.05).The total clinical effective rate of the observation group was higher than that of the control group(94.12%vs.80.39%,P＜0.05).There was one case of nausea,one case of dizziness and one case of rash in the observation group,and one case of nausea,one case of diarrhea and two cases of dizziness occurred in the control group.There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The addition of Shen'an decoction in the treatment of patients with chronic renal insufficiency on the basis of conventional Western medical treatment can improve the clinical efficacy,enhance immune function,renal function,lipid metabolism and oxidative stress indicators,with good safety.

Abstract:Submucosal angiomyolipoma(AML)of rectum is clinically rare.This article reports the endoscopic diagnosis and treatment process of a case of rectal AML.By reviewing the clinical data of this patient and combining with literature review,we aim to deepen the current understanding of AML in the digestive tract and avoid misdiagnosis and mistreatment in clinical practice.

Abstract:Objective To explore the effect of ultrasound-guided individualized respiratory management on pulmonary ventilation in neonates with severe respiratory diseases in neonatal intensive care unit(NICU).Methods A total of 96 children with severe respiratory disease in NICU of the hospital were selected as research subjects.According to the random number table method,they were divided into the observation group and the control group,with 48 cases in each group.The control group was treated with routine respiratory management,and the observation group was treated with severe ultrasound-guided individualized nursing management on the basis of the control group.The clinical indexes,blood gas analysis and respiratory dynamics indexes including arterial partial pressure of oxygen[p(O2)],partial pressure of carbon dioxide[p(CO2)],arterial blood pH,airway resistance,chest lung compliance and severity of disease[pediatric critical illness score(PCIS),simple neonatal acute physiology score II(SNAP-II)]and occurrence of complications were compared between the two groups before and after intervention.Results The mechanical ventilation time,antipyretic time,white blood cell count(WBC)recovery time,ICU stay and hospitalization time were significantly shorter in the observation group than those in the control group(P＜0.05).After intervention,p(O2),pH and chest lung compliance were significantly increased in the two groups(P＜0.05),while p(CO2)and airway resistance were significantly decreased(P＜0.05).Moreover,the improvement was better in the observation group than that of the control group.After intervention,the PCIS scores were significantly increased in both groups(P＜0.05),while the SNAP-II scores were significantly reduced(P＜0.05),and the improvement was better in the observation group than that of the control group(P＜0.05).The total complication rate was significantly lower in the observation group than that in the control group(P＜0.05).Conclusion Severe ultrasound-guided individualized respiratory management can significantly enhance the pulmonary ventilation of NICU children with severe respiratory disease,improve the blood oxygen status and accelerate the improvement of disease condition.

Abstract:Objective To assess changes in composition of oral microbiota in oral squamous cell carcinoma(OSCC)by systematic review and Meta-analysis.Methods Computer searches were conducted in databases such as PubMed,Embase,Cochrane Library,Web of Science,Wanfang Data and CNKI to gather research on the oral microbiome of OSCC.The search covered the period from the establishment of databases to March 25 2025.Literature was screened and data extracted according to literature inclusion and exclusion criteria,and Meta-analysis of changes in the abundance of bacterial genera in included studies was performed using Stata 17.0.Results A total of 23 studies involving 1 718 participants were included.These studies were divided into two categories:(1)case-control studies(n=14)and(2)cancer tissue versus paired paracancerous tissue(n=9).At the genus level,Fusobacterium was increased in abundance in OSCC patients(SMD=0.52,95%CI:0.39-0.65,P＜0.001)and cancer tissue(SMD=0.89,95%CI:0.55-1.24,P＜0.001).Porphyromonas was increased abundance in OSCC patients(SMD=0.17,95%CI:0.02-0.33,P=0.030)and cancer tissue(SMD=0.31,95%CI:0.10-0.53,P=0.005).Streptococcus was decreased in OSCC(SMD=-0.43,95%CI:-0.85--0.01,P=0.044)and cancer tissue(SMD=-0.66,95%CI:-0.96--0.37,P＜0.001).Conclusion Fusobacterium and Porphyromonas increase and Streptococcus decrease in OSCC patients and cancer tissue,suggesting that oral flora dysbiosis is associated with the development of OSCC.

Abstract:Pulmonary artery thrombectomy is an important method for treatment of acute pulmonary embolism(PE),and its successful implementation relies on the close collaboration of a multidisciplinary team.This article explores the indications,surgical strategies and key links of multidisciplinary treatment(MDT)for pulmonary artery thrombectomy through the diagnosis and treatment process of a patient with acute pulmonary embolism.The patient sought medical attention due to wheezing and was diagnosed with pulmonary embolism through imaging,with a risk stratification of medium to high risk.With the collaboration of multiple disciplines including respiratory medicine department,cardiology department,cardiac surgery department,radiology department and ultrasound department,percutaneous mechanical thrombectomy was successfully performed.After the surgery,the patient's blood flow was restored,symptoms were significantly relieved,and no serious complications occurred.This article aims to provide a reference framework for MDT in pulmonary artery thrombectomy for clinical doctors,optimize the treatment process for patients with pulmonary embolism,and provide reference for case selection and diagnosis and treatment strategies of thrombectomy treatment of pulmonary embolism.

Abstract:Objective To investigate the value of the combined detection of neutrophil CD64(nCD64),C-reactive protein(CRP)and lactate dehydrogenase(LDH)in the diagnosis of refractory Mycoplasma pneumoniae pneumonia(RMPP)in children.Methods A total of 147 children with Mycoplasma pneumoniae infection were enrolled and divided into the RMPP group(n=70)and the general Mycoplasma pneumoniae pneumonia group(GMPP,n=77)based on disease severity and treatment response.The age,gender,white blood cell count(WBC)within 24 hours of admission,serum procalcitonin(PCT),C-reactive protein(CRP)and lactate dehydrogenase(LDH)levels were collected in the study participants.The expression level of nCD64 in peripheral blood was measured using flow cytometry.Multivariate Logistic regression analysis was conducted to identify the independent risk factors associated with RMPP in children.Additionally,a receiver operating characteristic(ROC)curve was constructed to assess the diagnostic performance of the combined detection of nCD64,CRP and LDH for RMPP in children.Results The RMPP group had a longer hospital stay than the GMPP group(P＜0.05).Levels of nCD64,CRP and LDH were significantly higher in the RMPP group compared to those of the GMPP group(P＜0.05),and there were no significant differences in WBC and PCT levels between the two groups.Multivariate Logistic regression analysis showed that elevated nCD64,CRP and LDH were risk factors for RMPP in children(P＜0.05).ROC curve analysis revealed that the areas under the curve(AUC)for nCD64,CRP and LDH in diagnosing RMPP were 0.817,0.863 and 0.805,respectively.The combined detection of three indicators for AUC was 0.948.Conclusion The levels of nCD64,CRP and LDH in blood of children with RMPP are higher than those of children with GMPP.The combined detection of the three indicators has a high diagnostic value for RMPP in children with Mycoplasma pneumoniae pneumonia.

Abstract:Plantar fasciitis(PF)is a primary cause of heel pain(HP).Platelet-rich plasma(PRP),as an emerging biological treatment method,possesses unique biological characteristics,showing significant dual therapeutic advantages in suppressing inflammation and promoting tissue repair.This article reviews the pathogenesis of PF,the biological characteristics of PRP and its application in pain management and functional prognosis assessment of PF,particularly focusing on PRP in improving plantar fascia thickness(PFT).

Abstract:Renal abscess is a rare type of urinary system infectious disease in children,and its clinical manifestations are often atypical,posing significant challenges to clinicians in diagnosis.This article reports a case of renal abscess.The child had intermittent fever and was eventually diagnosed with renal abscess.After anti-infection and puncture drainage,the child recovered.Metagenomic detection of pathogenic microorganisms in renal abscess revealed Bacteroides fragilis.This article discusses the issues of diagnosis,treatment,laboratory testing and prognosis.

Abstract:Objective To explore related factors of intra-amniotic infection(IAI)during the delivery period in pregnant women with gestational diabetes mellitus(GDM),and to analyze the predictive value of these related factors for IAI.Methods A retrospective study was conducted on 360 GDM pregnant women,including 120 cases with IAI(IAI group)and 240 pregnant women with GDM who did not develop IAI(control group).Clinical data,fetal monitoring during labor,placental pathology,pregnancy outcomes and glycosylated hemoglobin(HbA1c)results were collected for both groups.Multivariate Logistic regression was used to investigate influencing factors of IAI.The predictive value of combined HbA1c levels,parity and rupture time for IAI was evaluated using receiver operating characteristic(ROC)curves,and the area under the curve(AUC)was calculated.Results In the IAI group,the proportion of primigravida,first-time delivery,artificial rupture of membranes,oxytocin use,rupture time and HbA1c levels were significantly higher than those in the control group(P＜0.05).The IAI group had a smaller gestational age at delivery,higher rates of forceps-assisted delivery,cesarean section and amniotic fluid contamination(P＜0.05).In the IAI group,the proportion of abnormal intrapartum baseline fetal heart rate and the incidence of late decelerations were higher than those in the control group(P＜0.05),while the incidence of variable deceleration and the proportion of category Ⅱ fetal heart rate monitoring were lower in the IAI group than those in the control group(P＜0.05).There were no significant differences in baseline variability or acceleration of fetal heart rate between the two groups(P＞0.05).The proportions of mild neonatal asphyxia and neonatal transfer to intensive care were high in the IAI group than those of the control group(P＜0.05).Multivariate Logistic regression showed that elevated HbA1c levels(OR=3.342,95%CI:1.539-7.257)and prolonged rupture time(OR=1.001,95%CI:1.000-1.001)were independent risk factors for IAI in GDM pregnant women,while multiparity was a protective factor(OR=0.113,95%CI:0.046-0.278).The AUC for predicting IAI during labor by combining HbA1c,parity and rupture time was 0.819(95%CI:0.772-0.865),with a sensitivity of 0.742 and specificity of 0.767.Conclusion HbA1c levels,rupture time and parity are independent influencing factors for IAI during labor in pregnant women with GDM.The combination of these three factors has high clinical value in predicting IAI in GDM patients.

Abstract:Objective To explore the factors influencing the occurrence of acute acalculous cholecystitis(AAC)in patients with severe acute pancreatitis(SAP),and construct a prediction model.Methods The clinical data of 220 patients with SAP were retrospectively collected.Patients were divided into the AAC group(64 cases)and the non-AAC group(156 cases)according to whether AAC occurred during hospitalization.The general clinical data including age,gender,smoking,drinking,body mass index(BMI),cause of SAP,fasting time,underlying diseases and concurrent sepsis were compared between the two groups.Laboratory indexes[systemic inflammatory response index(SIRI),C-reactive protein to albumin ratio(CAR),white blood cell count to mean platelet volume ratio(WMR)]were also compared between the two groups.Multivariate Logistic regression was used to analyze the factors influencing the occurrence of AAC in patients with SAP during hospitalization.Based on the influencing factors,a nomogram prediction model was constructed.The performance of the prediction model was evaluated using the receiver operating characteristic(ROC)curve,the calibration curve and clinical decision analysis(DCA).Results Compared with the non-AAC group,the AAC group showed a longer fasting time,a higher proportion of combined sepsis and higher levels of TBil,SIRI,CAR and WMR at admission(P＜0.05).Multivariate Logistic regression analysis showed that long fasting time,high levels of SIRI,CAR,WMR and TBil were independent risk factors for AAC in patients with SAP(P＜0.05).Based on the five variables,a regression equation was developed as follows:Logit(P)=-11.364+0.444×fasting time+0.217×SIRI+0.278×CAR+1.869×WMR+0.053×TBil,and a nomogram prediction model was constructed.ROC curves showed that the area under the curve(AUC)and 95%CI,sensitivity and specificity of the nomogram risk prediction model for predicting AAC were 0.872(95%CI:0.824-0.921),76.56%and 87.18%,respectively.Bootstrap validation results showed good consistency between the calibration curve and the actual curve,and Homser-Lemeshow test showed good goodness of fit.DCA showed that the nomogram prediction model could bring clinical benefits to patients when the threshold was between 0.04 and 0.99.Conclusion The nomogram prediction model constructed based on these risk factors demonstrates good predictive performance and can provide reference for early identification of patients at high risk of AAC in clinical practice.

Abstract:Objective To investige clinicopathological features and prognostic factors in patients with isocitrate dehydrogenase(IDH)wild-type glioblastoma(GBM).Methods A total of 137 patients with GBM diagnosed by surgical pathology at the General Hospital of Ningxia Medical University from January 2014 to July 2024 were retrospectively enrolled in this study.Clinical data,including age,gender,ethnicity,presence of epilepsy,neurological function status and Karnofsky Performance Status(KPS)score prior to radiotherapy,were collected.Tumor-related parameters,such as extent of resection,histological classification,tumor location,maximum tumor diameter,IDH mutation status,Ki-67 proliferation index,methylation status of the O6-methylguanine-DNA methyltransferase(MGMT)promoter and postoperative treatment regimens—including concurrent chemoradiotherapy and the number of adjuvant chemotherapy cycles were also recorded.Multivariate Cox proportional hazards regression analysis was conducted to identify independent prognostic factors.Kaplan-Meier survival curves were used to evaluate overall survival according to clinical characteristics.Results The median overall survival(OS)of the 137 GBM patients was 20.9 months,and their 1-year,2-year and 3-year survival rates were 79.7%,36.9%and 16.4%,respectively.Pre-radiotherapy KPS score,MGMT promoter methylation status,receipt of postoperative concurrent chemoradiotherapy and the number of adjuvant chemotherapy cycles were significantly associated with median survival of GBM patients(P＜0.05).Multivariate Cox analysis revealed that absence of MGMT promoter methylation,lack of postoperative concurrent chemoradiotherapy after surgery and the number of adjuvant chemotherapy cycles＜6 were independent risk factors for reduced survival in patients with GBM(P＜0.05).Patients with a pre-radiotherapy KPS score＜80,MGMT promoter unmethylation,lack of postoperative concurrent chemoradiotherapy and the number of adjuvant chemotherapy cycles＜6 demonstrated significantly lower cumulative overall survival rates compared to those with these characteristics(P＜0.05).Conclusion MGMT promoter unmethylation,lack of postoperative concurrent chemoradiotherapy and adjuvant chemotherapy cycles<6 are independent risk factors affecting overall survival in patients with IDH wild-type GBM.

Abstract:Objective To explore the effect of dexmedetomidine on the proliferation,invasion and cell cycle of gallbladder cancer cells by regulating the C-C chemokine ligand 2(CCL2)-C-C chemokine receptor 2(CCR2)pathway.Methods GBC-SD cells were devided into the control group,the low concentration dexmedetomidine group(2 µmol/L),the high concentration dexmedetomidine group(4 µmol/L)and the high concentration dexmedetomidine+CCL2 group(4 µmol/L dexmedetomidine and 10 µg/L CCL2 protein).The clone formation experiment and Edu experiment were performed to measure cell proliferation.Transwell experiment was performed to measure cell invasion and migration.Flow cytometry was performed to measure cell cycle and apoptosis.Western blot assay was used to measure the proliferating cell nuclear antigen(PCNA),Cyclin D1,matrix metalloproteinase(MMP)-2,MMP-9,Bcl-2 associated X protein(Bax),cysteine-dependent aspartate-specific protease-3(Caspase-3),CCL2 and CCR2 proteins.The nude mouse transplant tumor experiment was used to determine the growth of gallbladder cancer transplant tumors.Results After treatment with low and high concentrations of dexmedetomidine,the number of cell clone formed,the positive rate of Edu,the numbers of invasions and migrations,the expression levels of PCNA,CyclinD1,MMP-2,MMP-9,CCL2 and CCR2 proteins,the proportions of G2/M and S phase cells decreased,the proportion of G0/G1 phase cells,apoptosis rate and expression levels of Bax and Caspase-3 proteins increased,and the effect of high-concentration dexmedetomidine was more significant(P＜0.05).The inhibitory effects of dexmedetomidine on the proliferation,invasion,migration and cell cycle of gallbladder cancer cells,as well as its promoting effect on cell apoptosis could be reversed by CCL2 protein(P＜0.05).In vivo experiments showed that dexmedetomidine could reduce tumor mass,tumor volume of nude mice and expression levels of CCL2 and CCR2 proteins(P＜0.05).Conclusion Dexmedetomidine inhibits the proliferation and invasion of gallbladder cancer cells,and blocks the cell cycle in the G0/G1 phase by suppressing the CCL2-CCR2 pathway.

Abstract:Objective To analyze the temporal trends of gout disezse burden in China from 1990 to 2021,and construct an age-period-cohort(APC)model to explore the independent effects of age,period,and birth cohort on epidemiological indicators,and predict the future burden of gout disease in China from 2022 to 2035.Methods Data on gout disease burden in China during 1990-2021 were extracted from the Global Burden of Disease(GBD)2021 database.Joinpoint regression analysis was used to assess temporal trends.The APC model was applied to evaluate the age,period and cohort effects on prevalence risk and disability-adjusted life years(DALYs).A Bayesian age-period-cohort(BAPC)model was employed to project the age-standardized prevalence rate(ASPR)and age-standardized DALY rate(ASDR)of gout in China from 2022 to 2035.Results From 1990 to 2021,the incidence,prevalence and DALYs of gout in China all increased substantially,with overall rising trends in the age-standardized incidence rate(ASIR),ASPR and ASDR.Compared with 1990,the incidence,prevalence and DALYs in 2021 increased by 160.45%,181.12%,and 175.93%,respectively,while their age-standardized rates increased by 23.74%,26.48%and 25.89%.Joinpoint regression analysis revealed that average annual percentage changes(AAPCs)of 0.73%for ASIR,0.82%for ASPR and 0.80%for ASDR during 1990-2021.In 2021,the number of cases and DALYs reached their peaks in males aged 55-59 years and females aged 65-69 years.Both prevalence and DALY rates increased steadily with age,with marked rises starting at age 30 in men and age 40 in women.Overall,males showed higher prevalence,DALYs and corresponding rates than those of females across all age groups.APC model results indicated that the age effect,period effect and cohort effects on prevalence and DALY rates presented an overall upward tread.Decomposition analysis showed that population aging contributed the most to the increase in incidence and DALYs from 1990 to 2021.BAPC projections suggested that by 2035,the ASPR and ASDR of gout in China reached 890.50 per 100,000 and 27.26 per 100,000,respectively.Conclusion The ASPR and ASDR of gout in China are projected to continue increasing from 2022 to 2035.Targeted public health strategies for high-risk populations are urgently needed to reduce the growing burden of gout.

Abstract:Objective To elucidate the correlation between specific nucleocapsid(N)protein mutant of the SARS-CoV-2 B.1.1.7 variant and clinical stratification in COVID-19 patients,revealing their impact on N protein liquid-liquid phase separation(LLPS)and host innate immune response.Methods Based on whole-genome sequencing data of the SARS-CoV-2 B.1.1.7 lineage from the GISAID database,non-synonymous mutation sites significantly associated with mild/severe clinical phenotypes were screened.For high-frequency N protein mutant,IFN-β promoter transcriptional activity was quantitatively measured using a dual-luciferase reporter system.qPCR was used to detect the mRNA expression levels of interferon(IFN)-β,interleukin(IL)-6 and tumor necrosis factor(TNF)-α.LLPS characteristics were observed by confocal microscopy.The ubiquitination status of host MAVS was detected by Western blot assay.Results A total of 17 640 non-synonymous mutation sites were identified,among which 65 were associated with mild cases and 20 were related to severe cases,with a mutation frequency>1%.The N protein mutation sites associated with severe cases were D3L,M234I and R203K-G204R-T205I.N protein and the mutants NM234I,NR203K-G204R-T205I inhibited the promoter activity of IFN-β(P＜0.05).Compared to the wild type N protein,NR203K-G204R-T205I mutation significantly reduced the mRNA levels of IFN-β,IL-6 and TNF-α(P＜0.05),and altered the phase separation state by dispersing the formation of LLPS condensates.However,N mutant did not affect the ubiquitination modification of host MAVS.Conclusion N protein mutants of the SARS-CoV-2 B.1.1.7 variant can influence the clinical prognosis of COVID-19 patients by altering LLPS status and suppressing the innate immune responses.These finding provides a theoretical basis for the design of antiviral drugs targeting the N protein.