Restless legs syndrome(RLS)occasionally occurs during the treatment of depression;however,restless arms syndrome,which manifests solely as or predominantly as discomfort in the upper limbs,is quite rare.This article reports a case of an elderly female patient with depression who developed nocturnal pain in the right upper limb and an urge to move it following the administration of mianserin.After increasing the dosage of mianserin,these symptoms worsened significantly which led to a diagnosis of restless arm syndrome.The above-mentioned discomfort disappeared after mianserin was discontinued.Since restless arm syndrome caused by mianserin is relatively rare,this case is presented to alert clinicians.

Selenium is an essential trace element for human body.The primary functional form of selenium in the organism is selenoproteins(Sep),which plays a crucial role in maintaining normal physiological functions,influencing immune responses,and is also implicated in tumorigenesis and related metabolic disorders.Recent studies have shown that Sep is involved in the pathophysiological process of inflammatory bowel disease(IBD).This article reviewed the mechanisms of Sep in IBD,aiming to explore the pathogenic mechanisms of IBD and provide insights for the diagnosis and treatment of the disease.

Objective To investigate the key targets and pathways of Juhongtai formula granules in improving acute lung injury(ALI).Methods Juhongtai formula granules and their drug-containing serum components were analyzed by UPLC-QTOF-MS/MS,and the active ingredients were screened based on the"Lipinski Rule of Five".The action targets of the above active ingredients were obtained through the TCMSP,Swiss Target Prediction and SuperPred databases,and the ALI-related targets were obtained from the GeneCards,OMIM,PharmGKB,CTD databases and GEO chip.The target protein-protein interaction network was constructed using the String database and Cytoscape to analyze the key targets.The DAVID database was used for GO functional annotation and KEGG pathway enrichment analysis,and the CB-dock2 platform was used for molecular docking verification.After one week of adaptive feeding,the experimental SD rats were randomly divided into the blank group,the model group,the positive control group,the negative control group and the Juhongtai formula granules group,with 6 rats in each group.The rat model of ALI was replicated by tracheal infusion of lipopolysaccharide.The pathological morphology of lung tissues in each group of rats was observed by HE staining,and the mRNA expressions of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1 β(IL-1β)and nitric oxide were detected by reverse transcription quantitative polymerase chain reaction(RT-qPCR).Results In total,44 components of the Juhongtai formula granules were identified,including 26 drug-containing serum components,and 21 key compounds were screened.A total of 22 intersection targets were obtained.The pathway enrichment results indicated the action of these targets on the advanced glycation end product receptor(AGE-RAGE)and TNF signaling pathways.The docking results showed that limonin,kaempferol and naringenin could be matched with prostaglandin peroxidase 2,nitric oxide synthase 2 and TNF.Animal experiments confirmed that the Juhongtai formula granules can alleviate inflammatory infiltration in lung tissue and reduce the expressions of TNF-α,IL6,IL-1β mRNA and nitric oxide.Conclusion Juhongtai formula granules can inhibit ALI-related inflammatory targets through the synergistic effects of multiple components such as limonin and kaempferol,regulate signaling pathways such as AGE-RAGE and TNF,reduce the production of inflammatory factors and nitric oxide,and improve ALI.

Objective:To systematically evaluate the risk prediction model for readmission in patients after percutaneous coronary intervention, and to provide reference for medical staff to apply or optimize relevant risk assessment tools.Methods:China National Knowledge Infrastructure, VIP, Wanfang Data, China Biomedical Literature Database, and Cochrane Library, PubMed, Embase, CINAHL, Scopus and Web of Science were searched for the related studies on readmission risk prediction models in patients with percutaneous coronary intervention from the establishment of the databases to April 25, 2024. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included studies.Results:A total of eleven articles were included, involving sixteen readmission risk prediction models, with readmission rates ranging from 0.70% to 31.44% and the areas under subjects′working characteristic curves ranging from 0.604 to 0.899. Calibration methods were reported in ten models, five studies reported processing methods of missing data, and external validation was used in three studies. The overall risk of bias was higher. The top six predictors of repeated reports in the readmitted model were age, renal insufficiency, sex, congestive heart failure, diabetes and health insurance.Conclusions:The readmission risk prediction models had good predictive performance. However, the quality of the model methodology was limited. It is necessary to improve the research quality in data sources, measurement and definition of predictive factors, processing of missing data and model evaluation. In the future, data mining can be used to apply the readmission prediction model in the early stage of admission, so as to identify high-risk patients as early as possible and effectively prevent the occurrence of readmission.

Objective To compare the clinical effects of improved rivet double pulley fixation method and traditional Kirschner wire tension band in the treatment of patellar lower pole fractures.Methods 78 patients with patellar inferior pole fractures who underwent surgery in our department between January 2020 and January 2024 and met the inclusion criteria were collected.Divided into two groups according to different fixing methods,the observation group(39 cases)were fixed by modified rivet double pulley,the control group(39 cases)were fixed by steel wire tension band.The operation time,hospital stay,medical expenses,knee motion of the two groups at 1.5 months,3 months and 6 months after surgery,and knee lyshom function score at 3 months and 6 months after surgery were compared between the two groups.Results The observation group had a surgery time of(62.58±6.37)minutes compared to the control group[(60.20±11.18)minutes],and the observation group had a hospital stay of(6.45±1.35)days compared to the control group[(6.40±1.30)days].There was no significant difference in surgical time and hospitalization time between the two group(P＞0.05).The total medical expenses of the observation group were significantly lower than those of the control group(P＜0.05).Knee joint activity in observation group was higher than that in control group at 1.5 months,3 months and 6 months after surgery(P＜0.05),and knee lyshom function scores in observation group at 3 months and 6 months after surgery were significantly higher than those in control group(P＜0.0 5).Conclusion Compared with Kirschner wire tension band fixation for the treatment of patellar lower pole fractures,the improved riveting double pulley surgery does not require secondary surgery to remove internal fixation,resulting in lower overall medical costs,better postoperative knee joint mobility,and better postoperative knee joint function scores.The improved riveting double pulley surgery has more advantages in treating patellar lower pole fractures compared to traditional Kirschner wire tension band fixation.

Objective To investigate the expression characteristics of granzyme B(GZMB)and C-X-C motif chemokine ligand 9(CXCL9)in gastric cancer(GC)tissues,explore their association with the tumor immune microenvironment(TME),and evaluate their clinical prognostic significance.Methods Bioinformatic analyses were conducted using public databases(TIMER,GEPIA,UALCAN)to validate the expression levels of GZMB and CXCL9 across various cancer types,with a focus on GC.Paired tumor and adjacent normal tissue samples were collected from 89 GC patients who underwent radical gastrectomy at Nanyang First People's Hospital between 2018 and 2019.The mRNA expression levels of GZMB and CXCL9 were measured using quantitative real-time PCR(qRT-PCR),and their associations with clinicopathological characteristics were statistically analyzed.Immune cell infiltration levels were estimated using the TIMER and GSCA databases.Diagnostic performance was evaluated through receiver operating characteristic(ROC)curve analysis,while survival outcomes were assessed using data from the Kaplan-Meier Plotter database and patient follow-up records.Results Both database analysis and qRT-PCR results demonstrated that GZMB and CXCL9 expression levels were significantly elevated in GC tissues compared to adjacent non-tumor tissues(P<0.05).Clinical correlation analysis revealed no significant associations between mRNA expression levels of GZMB and CXCL9 and clinicopathological parameters,including gender,age,pathological type,tumor differentiation,TNM stage,tumor size,or lymph node metastasis(P>0.05).Immune infiltration analysis indicated that both genes were significantly positively correlated with CD8+T cell and dendritic cell infiltration(P<0.05),while showing a negative correlation with B cell infiltration(P<0.05).ROC curve analysis showed that the combined detection of GZMB and CXCL9 yielded an AUC of 0.890(95%CI:0.843～0.936),which was higher than that of GZMB alone(AUC=0.832,95%CI:0.772～0.891)or CXCL9 alone(AUC=0.782,95%CI:0.715～0.850).Survival analysis further revealed that patients with high expression of GZMB and CXCL9 had significantly improved overall survival compared to those with low expression(P<0.05).Conclusion GZMB and CXCL9 are highly expressed in GC and are strongly associated with the infiltration of anti-tumor immune cells.These molecules represent promising diagnostic biomarkers for GC,and their elevated expression is correlated with a more favorable prognosis in patients.

Restless legs syndrome(RLS)occasionally occurs during the treatment of depression;however,restless arms syndrome,which manifests solely as or predominantly as discomfort in the upper limbs,is quite rare.This article reports a case of an elderly female patient with depression who developed nocturnal pain in the right upper limb and an urge to move it following the administration of mianserin.After increasing the dosage of mianserin,these symptoms worsened significantly which led to a diagnosis of restless arm syndrome.The above-mentioned discomfort disappeared after mianserin was discontinued.Since restless arm syndrome caused by mianserin is relatively rare,this case is presented to alert clinicians.

Objective:To explore the incidence of Crohn's disease-like pouch (CDP) after ileal pouch-anal anastomosis (IPAA) and analyze the clinical characteristics and risk factors in ulcerative colitis (UC) patients.Methods:A retrospective cohort study was conducted. One hundred and eighty-two UC patients undergoing IPAA at Jinling Hospital affiliated to Nanjing University from November 2003 to November 2024 were enrolled. Patients were categorized into CDP and non-CDP groups. Clinical features and prognosis were compared, and multivariate Cox regression was performed to identify risk factors for CDP.Results:A total of 182 UC patients were included, with a median follow-up time of 45.00 (30.00, 75.25) months. The patients were divided into two groups based on the diagnosis of CDP, with 23 patients (12.64%) in the CDP group and 159 patients (87.30%) in the non-CDP group. Compared to the non-CDP group, patients in the CDP group had a lower body mass index (BMI) ( Z=-2.87, P=0.004), and were more likely to develop early postoperative pouchitis (χ 2=4.50, P=0.034). The median time from ileostomy closure to the development of CDP was 12 .00 (6.00, 28.00) months. Cox regression analysis showed that a preoperative BMI<18.5 kg/m 2 ( HR=2.84, 95% CI: 1.24~6.49, P=0.013) and early postoperative pouchitis ( HR=3.11, 95% CI: 1.22~7.93, P=0.018) were associated with an increased risk of CDP. Conclusions:Preoperative low BMI and pouchitis occurring within 3 months postoperatively are significant risk factors for CDP. Close monitoring and early intervention are recommended for high-risk patients.

Objective To investigate the key targets and pathways of Juhongtai formula granules in improving acute lung injury(ALI).Methods Juhongtai formula granules and their drug-containing serum components were analyzed by UPLC-QTOF-MS/MS,and the active ingredients were screened based on the"Lipinski Rule of Five".The action targets of the above active ingredients were obtained through the TCMSP,Swiss Target Prediction and SuperPred databases,and the ALI-related targets were obtained from the GeneCards,OMIM,PharmGKB,CTD databases and GEO chip.The target protein-protein interaction network was constructed using the String database and Cytoscape to analyze the key targets.The DAVID database was used for GO functional annotation and KEGG pathway enrichment analysis,and the CB-dock2 platform was used for molecular docking verification.After one week of adaptive feeding,the experimental SD rats were randomly divided into the blank group,the model group,the positive control group,the negative control group and the Juhongtai formula granules group,with 6 rats in each group.The rat model of ALI was replicated by tracheal infusion of lipopolysaccharide.The pathological morphology of lung tissues in each group of rats was observed by HE staining,and the mRNA expressions of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1 β(IL-1β)and nitric oxide were detected by reverse transcription quantitative polymerase chain reaction(RT-qPCR).Results In total,44 components of the Juhongtai formula granules were identified,including 26 drug-containing serum components,and 21 key compounds were screened.A total of 22 intersection targets were obtained.The pathway enrichment results indicated the action of these targets on the advanced glycation end product receptor(AGE-RAGE)and TNF signaling pathways.The docking results showed that limonin,kaempferol and naringenin could be matched with prostaglandin peroxidase 2,nitric oxide synthase 2 and TNF.Animal experiments confirmed that the Juhongtai formula granules can alleviate inflammatory infiltration in lung tissue and reduce the expressions of TNF-α,IL6,IL-1β mRNA and nitric oxide.Conclusion Juhongtai formula granules can inhibit ALI-related inflammatory targets through the synergistic effects of multiple components such as limonin and kaempferol,regulate signaling pathways such as AGE-RAGE and TNF,reduce the production of inflammatory factors and nitric oxide,and improve ALI.

AIM:This study aims to investigate whether vitamin E succinate(VES)induces autophagy in hu-man gastric cancer cells through the promotion of mitochondria-associated endoplasmic reticulum membranes(MAMs).METHODS:Human gastric cancer cell lines MKN28 and MKN45 were cultured in vitro.Cell viability was assessed us-ing the CCK8 assay,and two cell growth curves were plotted to determine the treatment concentration of VES.Control groups,VES dose groups(MKN28:5,10,20,and 40 mg/L;MKN45:10,20,40,and 80 mg/L),an autophagy-posi-tive control group(rapamycin,RAPA,100 nmol/L),and a MAMs-positive control group(oligomycin A,10 mg/L)were set up.Cells were harvested after 24 h of treatment for subsequent experiments.The formation of autophagosomes and MAMs was observed using transmission electron microscopy.The expression levels of autophagy-related proteins,includ-ing beclin-1,LC3-II/LC3-I,and p62,were detected by Western blot.MAMs labeled with split green fluorescent protein(GFP)were visualized by fluorescence microscopy.The expression of mitofusin 2(MFN2),a key molecule of MAMs,was also detected by Western blot.To inhibit MFN2 specifically,the cells were treated with mitochondrial fusion inhibitor 8(MFI8)and simultaneously transfected with an MFN2 plasmid to achieve MFN2 overexpression(OE-MFN2).The cells were divided into control group,MFI8(20 μmol/L)group,VES groups(20 mg/L for MKN28 cells and 40 mg/L for MKN45 cells),VES+MFI8 group,OE-MFN2+MFI8 group and OE-MFN2+VES+MFI8 group.The MAMs were visualized by fluorescence microscopy,and the expression changes of MFN2,beclin-1 and LC3-II/I were detected by Western blot.RESULTS:The results of the CCK8 assay showed that VES significantly inhibited the viability of both human gastric can-cer cell lines(P<0.05).After VES treatment,the formation of typical autophagosomes and MAMs was observed in both cell lines by transmission electron microscopy.Fluorescence microscopy showed a significant increase in GFP signals of MAMs.Western blot analysis showed that with increasing doses of VES,the expression levels of MFN2,beclin-1,and LC3-II/I were significantly up-regulated,while that of p62 was significantly down-regulated(P<0.05).Compared with VES group,the cells pretreated with MFI8 followed by VES exposure showed markedly reduced GFP signals of MAMs and much lower protein levels of MFN2,beclin-1 and LC3-II/LC3-I(P<0.05).Transfection with an MFN2 overexpression plasmid rescued MFN2 expression.Compared with VES+MFI8 group,the cells in OE-MFN2+VES+MFI8 group had much higher protein expression levels of MFN2,beclin-1 and LC3-II/LC3-I(P<0.05).CONCLUSION:The VES may partici-pates in the regulation of autophagy in human gastric cancer cells by promoting the formation of MAMs.