Objective To explore the risk of preeclampsia(PE)and construct an individualized column chart predictive model.Methods A total of 209 PE patients admitted to Huzhou Maternal and Child Health Hospital from January 2020 to July 2023 were selected as research group,and 162 healthy pregnant women who underwent prenatal examination during the same period were selected as control group.Logistic regression model was used for data analysis,and nomogram prediction model based on Logistic regression results was constructed by R statistical software,receiver operating characteristic(ROC)curve and calibration curve were drawn,and Hosmer-Lemeshow goodness-of-fit test was conducted to evaluate prediction efficiency.Results The occurrence of PE had no correlation with body mass index(BMI),gestational age,pregnancy times,abortion history and whether there are multiple pregnancies(P＞0.05),but age,education level,gestational diabetes,gestational hypertension and standardized prenatal examination of pregnant women are related factors(P＜0.05).Age≥30 years old,education below senior high school,gestational diabetes,pregnancy-induced hypertension and irregular prenatal examination were risk factors for PE(P＜0.05).The area under ROC curve of nomograph model was 0.813(95％CI:0.770-0.855).Conclusion The nomogram model based on age,education level,diabetes in pregnancy,hypertension in pregnancy and irregular prenatal examination screened by Logistic regression model has a good predictive effect on the occurrence of PE.

Objective To explore the risk of preeclampsia(PE)and construct an individualized column chart predictive model.Methods A total of 209 PE patients admitted to Huzhou Maternal and Child Health Hospital from January 2020 to July 2023 were selected as research group,and 162 healthy pregnant women who underwent prenatal examination during the same period were selected as control group.Logistic regression model was used for data analysis,and nomogram prediction model based on Logistic regression results was constructed by R statistical software,receiver operating characteristic(ROC)curve and calibration curve were drawn,and Hosmer-Lemeshow goodness-of-fit test was conducted to evaluate prediction efficiency.Results The occurrence of PE had no correlation with body mass index(BMI),gestational age,pregnancy times,abortion history and whether there are multiple pregnancies(P＞0.05),but age,education level,gestational diabetes,gestational hypertension and standardized prenatal examination of pregnant women are related factors(P＜0.05).Age≥30 years old,education below senior high school,gestational diabetes,pregnancy-induced hypertension and irregular prenatal examination were risk factors for PE(P＜0.05).The area under ROC curve of nomograph model was 0.813(95％CI:0.770-0.855).Conclusion The nomogram model based on age,education level,diabetes in pregnancy,hypertension in pregnancy and irregular prenatal examination screened by Logistic regression model has a good predictive effect on the occurrence of PE.

Ankylosing spondylitis is a chronic immunoinflammatory disease that mainly affects the spine and the sacroiliac joint,the mechanism of which is closely related to signaling pathways,such as osteoprotegerin(OPG)/receptor activator of nuclear factor-κB(RANK)/RANK ligand,mitogen-activated protein kinase(MAPK),Wnt/β-catenin(β-catenin),phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/Akt/mTOR).Traditional Chinese medicine has the characteristics of multiple components and targets,and is widely used for the treatment of autoimmune diseases due to its low toxicity,strong specificity,and high efficacy.This review found that monomers and compounds of traditional Chinese medicine can exert anti ankylosing spondylitis effects by intervening in the aforementioned signaling pathways,regulating immune inflammatory responses,and inhibiting biological processes such as bone destruction,ectopic osteogenic differentiation,cell apoptosis,and autophagy.

Objective:To explore the influencing factors of fetal growth restriction (FGR) in patients with preeclampsia (PE) and construct a Nomogram prediction model.Methods:From Aug. 2021 to May. 2023, 273 PE patients admitted to our hospital were regarded as the study subjects, and grouped into a modeling group (n=191) and a validation group (n=82). Multivariate logistic regression analysis was applied to determine the influencing factors of FGR in PE patients. R4.3.1 was applied to construct a Nomogram model for predicting FGR in PE patients. Receiver operating characteristic (ROC) curve and the Hosmer Lemeshoe (H-L) goodness of fit test were applied to evaluate the discrimination and consistency of the Nomogram model in predicting FGR in PE patients.Results:There was no statistically obvious difference in gestational age, blood pressure, hemoglobin, urinary protein (UP), uric acid, umbilical artery systolic/diastolic blood pressure (S/D), D-dimer (D-D), or birth frequency between the modeling group and the validation group ( P>0.05). Compared with no concurrent FGR group, the onset of pregnancy in the concurrent FGR group was earlier, the levels of UP, S/D, and D-D, and the proportion of oligohydramnios were obviously higher, and the platelet count (PLT) was obviously lower ( t/χ 2=2.588, 1.437, 6.262, 5.464, 9.881, 3.326, P<0.05). Multivariate Logistic regression analysis showed that UP, S/D, D-D, and oligohydramnios were risk factors for FGR in PE patients ( OR=1.004, 3.807, 1.006, 4.348, P<0.05), while PLT was a protective factor ( OR=0.980, P<0.05). Nomogram model showed that when the total score of the above 5 influencing factors in PE patients was 149, the probability of concurrent FGR was 60%; when the total score was 167, the probability of concurrent FGR was 90%, and the probability of exceeding 167 was over 90%. Modeling group H-L test χ 2=6.736, P=0.565, validation group χ 2=5.812, P=0.668. The area under the ROC curve (AUC) of the modeling group and the validation group was 0.924 (95% CI: 0.883-0.965) and 0.932 (95% CI: 0.880-0.984), respectively. The sensitivity was 83.93% and 90.48%, and the specificity was 89.63% and 81.97%, respectively. Decision curve analysis (DCA) was applied to evaluate the clinical application value of the Nomogram model in predicting FGR in PE patients. Conclusion:The Nomogram model constructed based on the five indicators of UP, S/D, D-D, PLT, and oligohydramnios for predicting the risk of FGR in PE patients has high discrimination and consistency.

Children with short bowel syndrome (SBS) mainly rely on long-term parenteral nutrition to obtain adequate nutrients until the length and function of the small intestine are improved. In recent years, the clinical application of human glucagon-like peptide 2 analogue Teduglutide has made it more likely for SBS patients to discontinue parenteral nutrition as early as possible and achieve intestinal functional autonomy. This paper reports two cases of SBS children who were treated with Teduglutide combined with parenteral and enteral nutrition for intestinal rehabilitation, and finally got rid of parenteral nutrition. According to the author, there have been no reports of pediatric children using Teduglutide in China.

Children with short bowel syndrome (SBS) mainly rely on long-term parenteral nutrition to obtain adequate nutrients until the length and function of the small intestine are improved. In recent years, the clinical application of human glucagon-like peptide 2 analogue Teduglutide has made it more likely for SBS patients to discontinue parenteral nutrition as early as possible and achieve intestinal functional autonomy. This paper reports two cases of SBS children who were treated with Teduglutide combined with parenteral and enteral nutrition for intestinal rehabilitation, and finally got rid of parenteral nutrition. According to the author, there have been no reports of pediatric children using Teduglutide in China.

Background/Aims: The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. Methods: We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. Results: A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers.The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. Conclusions We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.

The aim of the present study was to explore the role of group II and III metabotropic glutamate receptors (mGluRs) in carotid body plasticity induced by chronic intermittent hypoxia (CIH) in rats. Sprague Dawley (SD) rats were treated with CIH in Oxycycler A84 hypoxic chamber for 4 weeks, and the tail artery blood pressure was measured at the end of model preparation. RT-qPCR was performed to examine the mRNA expression levels of mGluR2/3/8 in rat carotid body. Carotid sinus nerve activity was detected by ex vivo carotid sinus nerve discharge recording technique, and acute intermittent hypoxia (AIH) was administered to induce carotid body sensory long-term facilitation (sLTF), in order to observe the role of group II and group III mGluRs in carotid body plasticity induced by CIH. The results showed that: 1) After 4 weeks of CIH exposure, the blood pressure of rats increased significantly; 2) CIH down-regulated the mRNA levels of mGluR2/3, and up-regulated the mRNA level of mGluR8 in the carotid body; 3) AIH induced sLTF in carotid body of CIH group. In the CIH group, activation of group II mGluRs had no effect on sLTF of carotid body, while activation of group III mGluRs completely inhibited sLTF. These results suggest that CIH increases blood pressure in rats, and group III mGluRs play an inhibitory role in CIH-induced carotid body plasticity in rats.
Rats ; Animals ; Carotid Body/metabolism* ; Rats, Sprague-Dawley ; Hypoxia ; Receptors, Metabotropic Glutamate/metabolism* ; RNA, Messenger/metabolism*

The purpose of the present study was to explore the role of carotid body metabotropic glutamate receptor 1 (mGluR1) in chronic intermittent hypoxia (CIH)-induced carotid body plasticity. Sprague Dawley (SD) rats were exposed to CIH (6%-21% O₂, 4 min/cycle, 8 h/day) for 4 weeks. The blood pressure of rats was monitored non-invasively by tail-cuff method under consciousness. RT-qPCR was used to examine the mRNA expression level of mGluR1 in rat carotid body. Western blot was used to detect the protein expression level of mGluR1 in rat carotid body. The role of mGluR1 in CIH-induced carotid body sensory long-term facilitation (sLTF) was investigated by ex vivo carotid sinus nerve discharge recording, and the carotid body sLTF was evoked by a 10-episode of repetitive acute intermittent hypoxia (AIH: 1 min of 5% O₂ interspersed with 5 min of 95% O₂). The results showed that: 1) CIH increased the systolic blood pressure (P < 0.001), diastolic blood pressure (P < 0.005) and mean arterial blood pressure (P < 0.001) of rats; 2) CIH decreased the mRNA and protein levels of mGluR1 in the rat carotid body (P < 0.01); 3) 4 weeks of CIH induced carotid body sLTF significantly, exhibiting as an increasing baseline sensory activity during post-AIH, which was inhibited by application of an agonist of group I metabotropic glutamate receptors, (S)-3,5-dihydroxyphenylglycine (DHPG), during sLTF induction (P < 0.005). In summary, these results suggest that activation of mGluR1 inhibits CIH-induced carotid body plasticity in rats.
Rats ; Animals ; Carotid Body/metabolism* ; Rats, Sprague-Dawley ; Hypoxia ; Receptors, Metabotropic Glutamate/metabolism* ; RNA, Messenger/metabolism*

OBJECTIVES: Major depressive disorder (MDD) patients with anhedonia tend to have a poor prognosis. The underlying imaging basis for anhedonia in MDD remains largely unknown. The relationship between nodal properties and anhedonia in MDD patients need to be further investigated. Herein, this study aims to explore differences of cerebral functional node characteristics in MDD patients with severe anhedonia (MDD-SA) and MDD patients with mild anhedonia (MDD-MA) before and after the antidepressant treatment. METHODS: Ninety participants with current MDD were recruited in this study. 24-Item Hamilton Depression Scale (HAMD-24) and Snaith-Hamilton Pleasure Scale (SHAPS) were used to assess the severity of depression and anhedonia at baseline and the end of 6-months treatment. The MDD patients who scored above the 25th percentile on the SHAPS were assigned to an MDD-SA group (n=19), while those who scored below the 25th percentile were assigned to an MDD-MA group (n=18). All patients in the 2 groups received antidepressant treatment. Functional magnetic resonance imaging (fMRI) images of all the patients were collected at baseline and the end of 6-months treatment. Graph theory was applied to analyze the patients' cerebral functional nodal characteristics, which were measured by efficiency (e_i) and degree (k_i). RESULTS: Repeated measures 2-factor ANCOVA showed significant main effects on group on the e_i and k_i values of left superior frontal gyrus (LSFG) (P=0.003 and P=0.008, respectively), and on the e_i and k_i values of left medial orbital-frontal gyrus (LMOFG) (P=0.004 and P=0.008, respectively). Compared with the MDD-MA group, the significantly higher e_i and k_i values of the LSFG (P=0.015 and P=0.021, respectively), and the significantly higher e_i and k_i values of the LMOFG (P=0.015 and P=0.037, respectively) were observed in the MDD-SA group at baseline. Meanwhile, higher SHAPS scores could result in higher e_i and k_i values of LSFG (P=0.019 and P=0.026, respectively), and higher e_i value of LMOFG (P=0.040) at baseline; higher SHAPS scores could result in higher e_i values of LSFG (P=0.049) at the end of 6-months treatment. The multiple linear regression analysis revealed that sex were negatively correlated with the e_i and k_i values of LSFG (r= -0.014, P=0.004; r=-1.153, P=0.001, respectively). The onset age of MDD was negatively correlated with the k_i value of LSFG (r=-0.420, P=0.034) at the end of 6-months treatment. We also found that SHAPS scores at baseline were positively correlated with the HAMD-24 scores (r=0.387, P=0.022) at the end of 6-months treatment. CONCLUSIONS There are obvious differences in nodal properties between the MDD-SA and the MDD-MA patients, such as the high e_i of LSFG in the MDD-SA patients, which may be associated with the severity of anhedonia. These nodal properties could be potential biomarkers for the prognosis of MDD. The increased e_i and k_i values in the LSFG of MDD-SA patients may underlie a compensatory mechanism or protective mechanism. The mechanism may be an important component of the pathological mechanism of MDD-SA. The poor prognosis in the MDD-SA patients suggests that anhedonia may predict a worse prognosis in MDD patients. Sex and onset age of MDD may affect the nodal properties of LSFG at baseline and the end of 6-months treatment.
Anhedonia ; Antidepressive Agents/therapeutic use* ; Depressive Disorder, Major/drug therapy* ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Prefrontal Cortex