ObjectiveTo compare the hepatic bile acid profile between a mouse model of metabolic-associated steatohepatitis （MASH） induced by a high-fat， high-sugar， and high-cholesterol diet combined with intraperitoneal injection of 10% carbon tetrachloride （CCl₄） and MASH cases in clinical practice， and to investigate the feasibility of this model in studying drug interventions on bile acid profile in MASH. MethodsA total of 30 male C57BL/6J mice were randomly divided into control group and model group， with 15 mice in each group. The mice in the control group were given normal diet and drinking water and weekly injections of olive oil， and those in the model group were given a high-fat， high-sugar， and high-cholesterol diet， high-sugar drinking water， and weekly injections of CCl₄+olive oil. At the end of weeks 8， 12， and 16， 5 mice were selected from each group to collect samples. Behavioral assessments were performed， and body weight and liver wet weight were measured； liver pathology and lipid deposition were evaluated by HE staining， SAF scoring， oil Red O staining， the semi-quantitative analysis of stained area， the serum levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST）， and liver triglyceride （TG） content； Sirius Red staining was performed for liver tissue to assess liver fibrosis； ultra-performance liquid chromatography-tandem mass spectrometry and targeted metabolomics were used to measure the hepatic bile acid profile， including cholic acid （CA）， glycocholic acid （GCA）， chenodeoxycholic acid （CDCA）， glycochenodeoxycholic acid （GCDCA）， ursodeoxycholic acid （UDCA）， tauroursodeoxycholic acid （TUDCA）， hyodeoxycholic acid （HDCA）， and glycodeoxycholic acid （GDCA）. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups. ResultsCompared with the control group at the same time point， the model group had disheveled and dull fur， reduced activity， and relatively slow reactions at weeks 8， 12， and 16， as well as significant increases in liver wet weight （P<0.05）， the serum level of ALT （P<0.05）， the content of TG in the liver （P<0.05）， and SAF score （P<0.05）. As for the differentially expressed bile acids in liver tissue， compared with the control group at week 8， the model group had significantly higher levels of CA and CDCA and significantly lower levels of UDCA， TUDCA， HDCA， and GDCA （all P<0.05）； compared with the control group at week 12， the model group had significantly higher levels of CA， GCA， CDCA， and GCDCA and significantly lower levels of UDCA and HDCA （all P<0.05）； compared with the control group at week 16， the model group had significantly higher levels of CA， GCA， CDCA， GCDCA， and TUDCA and significantly lower levels of UDCA， HDCA， and GDCA （all P<0.05）. As for the differentially expressed bile acids in the bile acid pool of liver tissue， compared with the control group at week 8， the model group had significantly higher levels of CA and CDCA and significantly lower levels of UDCA， TUDCA， GDCA， and HDCA （all P<0.05）； compared with the control group at weeks 12 and 16， the model group had significantly higher levels of GCA and GCDCA and significantly lower levels of UDCA， GDCA， and HDCA （all P<0.05）. ConclusionThere are significant changes in the hepatic bile acid profile in a mouse model of MASH induced by a high-fat， high-sugar， and high-cholesterol diet combined with CCl₄， which are similar to the changes in bile acids in MASH cases in clinical practice， suggesting that this model can be used to explore the interventional effect of drugs on the bile acid profile in MASH.

Objective:To analyze the relationship between serum neutrophil elastase (NE) level and assisted pregnancy outcome in infertility patients with polycystic ovary syndrome (PCOS).Methods:A total of 137 infertility patients with PCOS who planned to undergo in vitro fertilization-embryo transfer (IVF-ET) treatment in Xianyang Central Hospital from January 2020 to January 2023 were prospectively selected. Serum NE level was measured before IVF-ET transplantation, and the pregnancy-assisted outcome of infertility patients with PCOS were analyzed. The relationship between serum NE level and assisted pregnancy outcome in PCOS infertility patients was analyzed.Results:The proportion of age ≥ 35 years old and serum NE levels in the failure group were higher than those in the success group: 50.00% (41/82) vs. 30.91%(17/55), (73.64 ± 6.74) mg/L vs. (60.71 ± 5.99) mg/L, while serum anti-Mullerian hormone (AMH) level were lower than those in the success group: (3.61 ± 1.17) μg/L vs. (4.89 ± 1.25) μg/L. The thickness of the endometrium was thicker than that in the success group: (10.63 ± 1.78) mm vs. (7.88 ± 1.28) mm, with statistically significant differences ( P<0.05). Multivariate Logistic regression analysis showed that thick endometrial thickness, high serum NE level and low serum AMH level were associated with assisted pregnancy failure in PCOS infertility patients ( P<0.05). A receiver operating characteristic (ROC) curve was drawn, and the results showed that the AUC of endometrial thickness, serum NE and AMH levels for predicting IVF-ET assisted pregnancy failure in PCOS infertility patients was greater than 0.7, which had certain predictive value. Serum NE had the best predictive effect, and when serum NE was 66.60 mg/L, ideal sensitivity and specificity of 85.40% and 87.30% could be obtained. Conclusions:The level of NE is related to the outcome of assisted pregnancy in PCOS infertility patients, and an increase in serum NE level can increase the risk of assisted pregnancy failure in PCOS infertility patients.

Osteofascial compartment syndrome(OCS)is a serious complication frequently occurring in the orthopedic department,and delayed treatment may result in irreversible limb damage.With the increase of traffic trauma accidents in modern times,the incidence and disability risk of OCS have increased,so it has been widely concerned by medicine.Based on the clinical characteristics of OCS in traditional Chinese and Western medicine,this paper summarized the commonly used animal models of OCS by referring to CNKI and PubMed literature,and evaluated the data of the animal models'coincidence in combination with clinical diagnostic criteria,analyzed the comprehensive characteristics of the models,and provided a feasible reference for the animal models in the treatment of OCS in modern traditional Chinese and Western medicine.The results showed that the most commonly used OCS model was the rabbit model,which was constructed with pressure damage.Most of the methods are provided by foreign research institutes,but there is no research on the model of combining disease and syndrome of OCS with traditional Chinese and Western medicine,which brings certain obstacles to disease research.Therefore,this study summarized the advantages and disadvantages of the existing model of OCS through a large number of literature analysis,and put forward suggestions for the preparation of the model of combining traditional Chinese and Western medicine with fundamental theories of traditional Chinese and Western medicine.

Objective:To analyze the relationship between serum neutrophil elastase (NE) level and assisted pregnancy outcome in infertility patients with polycystic ovary syndrome (PCOS).Methods:A total of 137 infertility patients with PCOS who planned to undergo in vitro fertilization-embryo transfer (IVF-ET) treatment in Xianyang Central Hospital from January 2020 to January 2023 were prospectively selected. Serum NE level was measured before IVF-ET transplantation, and the pregnancy-assisted outcome of infertility patients with PCOS were analyzed. The relationship between serum NE level and assisted pregnancy outcome in PCOS infertility patients was analyzed.Results:The proportion of age ≥ 35 years old and serum NE levels in the failure group were higher than those in the success group: 50.00% (41/82) vs. 30.91%(17/55), (73.64 ± 6.74) mg/L vs. (60.71 ± 5.99) mg/L, while serum anti-Mullerian hormone (AMH) level were lower than those in the success group: (3.61 ± 1.17) μg/L vs. (4.89 ± 1.25) μg/L. The thickness of the endometrium was thicker than that in the success group: (10.63 ± 1.78) mm vs. (7.88 ± 1.28) mm, with statistically significant differences ( P<0.05). Multivariate Logistic regression analysis showed that thick endometrial thickness, high serum NE level and low serum AMH level were associated with assisted pregnancy failure in PCOS infertility patients ( P<0.05). A receiver operating characteristic (ROC) curve was drawn, and the results showed that the AUC of endometrial thickness, serum NE and AMH levels for predicting IVF-ET assisted pregnancy failure in PCOS infertility patients was greater than 0.7, which had certain predictive value. Serum NE had the best predictive effect, and when serum NE was 66.60 mg/L, ideal sensitivity and specificity of 85.40% and 87.30% could be obtained. Conclusions:The level of NE is related to the outcome of assisted pregnancy in PCOS infertility patients, and an increase in serum NE level can increase the risk of assisted pregnancy failure in PCOS infertility patients.

Osteofascial compartment syndrome(OCS)is a serious complication frequently occurring in the orthopedic department,and delayed treatment may result in irreversible limb damage.With the increase of traffic trauma accidents in modern times,the incidence and disability risk of OCS have increased,so it has been widely concerned by medicine.Based on the clinical characteristics of OCS in traditional Chinese and Western medicine,this paper summarized the commonly used animal models of OCS by referring to CNKI and PubMed literature,and evaluated the data of the animal models'coincidence in combination with clinical diagnostic criteria,analyzed the comprehensive characteristics of the models,and provided a feasible reference for the animal models in the treatment of OCS in modern traditional Chinese and Western medicine.The results showed that the most commonly used OCS model was the rabbit model,which was constructed with pressure damage.Most of the methods are provided by foreign research institutes,but there is no research on the model of combining disease and syndrome of OCS with traditional Chinese and Western medicine,which brings certain obstacles to disease research.Therefore,this study summarized the advantages and disadvantages of the existing model of OCS through a large number of literature analysis,and put forward suggestions for the preparation of the model of combining traditional Chinese and Western medicine with fundamental theories of traditional Chinese and Western medicine.

Objective To investigate the value of serum olfactomedin-2(OLFM-2),endothelin-1(ET-1)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in predicting vascular restenosis after stent implantation in patients with lower extremity arteriosclerosis obliterans(LASO).Methods A total of 140 LASO patients who received stenting in the interventional pain department of a hospital from January 2017 to December 2019 were selected as the study subjects.Serum levels of OLFM-2,ET-1 and sTREM-1 were detected by enzyme-linked immunosorbent assay.The serum levels of OLFM-2,ET-1 and sTREM-1 in LASO patients were compared before and after treatment.Patients were followed up for 1 year and were divid-ed into restenosis group(n=58)and non-restenosis group(n=82)according to whether they had recurrent vascular stenosis after surgery.Receiver operating characteristic(ROC)curve and Logistic regression were used to analyze the predictive value of postoperative serum OLFM-2,ET-1,and sTREM-1 on vascular resteno-sis after stenting in LASO patients.Results The levels of OLFM-2,ET-1 and sTREM-1 in serum of LASO patients after treatment were significantly higher than those before treatment,and the difference was statisti-cally significant(P＜0.05).The serum levels of OLFM-2,ET-1 and sTREM-1 in restenosis group were sig-nificantly different from those in non-restenosis group(P＜0.05).ROC curve analysis results showed that the optimal critical values of postoperative serum OLFM-2,ET-1 and sTREM-1 to predict the recurrence of vascu-lar stenosis after stent implantation in LASO patients were 27.35 ng/mL,97.36 pg/mL and 317.30 ng/L,re-spectively.The area under the curve(AUC)was 0.823(95％CI:0.722-0.923,P＜0.001),0.787(95％CI:0.679-0.897,P＜0.001)and 0.799(95％CI:0.688-0.910,P＜0.001),respectively,the combined detec-tion of the three could increase the AUC to 0.904(95％CI:0.831-0.977,P＜0.001).In LASO patients,the long length of lower extremity artery lesions,complete occlusion of lower extremity artery,trans-atlantic in-ter-society consensus type C+D and postoperative serum OLFM-2,ET-1 and sTREM-1 levels were independent risk factors for restenosis after stent implantation in LASO patients(P＜0.05).Conclusion Serum levels of OLFM-2,ET-1 and sTREM-1 are significantly increased in patients with vascular restenosis after stent implantation in LASO patients.Postoperative three combined detection of OLFM-2,ET-1,sTREM-1 has a high clinical value in the evaluation of vascular restenosis after stent implantation in LASO patients.

Objective:To explore the evaluation effect of ultrasonography and Pirani score on tarsal deformity, treatment effect and pseudo-correction of congenital clubfoot in infants and young children, and the correlation between the two methods.Methods:This is a retrospective case series study. The clinical data of 26 children (40 feet) with congenital clubfoot who were evaluated by ultrasonography in the Third Affiliated Hospital of Zhengzhou University from January 2020 to January 2023 were retrospectively collected. There were 16 males and 10 females. The age at the first ultrasound examination was ( M(IQR)) 9.0 (18.0) days (range: 1 to 46 days). All patients were treated with Ponseti method by the same physician. The Pirani scores before and after treatment and at the last examination, and the talonavicular angle, calcaneocuboid angle and tibiocalcaneal angle measured by ultrasound were collected, and the treatment and follow-up were recorded. Paired sample t test, repeated measures analysis of variance or Kruskal-Wallis test were used for data comparison, and Spearman correlation analysis was used for correlation analysis. The receiver operating characteristic curve was used to calculate the efficacy of ultrasound in evaluating different Pirani scores. Results:The number of plaster fixation in 26 children was 4.0 (1.0) times (range: 2 to 8 times). The medial talonavicular angle and posterior tibiocalcaneal angle were significantly improved after treatment and at the last follow-up compared with those before treatment, and the differences were statistically significant (all P<0.01). There was no difference in lateral calcaneocuboid angle before and after treatment and at the last follow-up ( F=1.971, P>0.05). Pseudo-correction occurred in 2 cases (2 feet) during the treatment, with an incidence of 5%. Correlation analysis showed that there was a moderate positive correlation between talonavicular angle and Pirani midfoot score ( r=0.480, P<0.01). There was no correlation between calcaneocuboid angle and Pirani midfoot score ( r=0.114, P=0.105). There was a moderate negative correlation between tibial heel angle and Pirani hindfoot score ( r=-0.566, P<0.01). The cut-off point of Pirani midfoot score of 1.5 was 38.78°, the sensitivity was 0.90, the specificity was 0.56, and the area under the curve was 0.75. The cut-off value of angle was 27.51 °, the sensitivity was 0.16, the specificity was 0.92, and the area under the curve was 0.44.The cut-off points of Pirani midfoot score of 3.0 were 45.08°and 9.96°, the sensitivity was 0.94 and 0.91, the specificity was 0.37 and 0.42, and the area under the curve was 0.59 and 0.62, respectively. The cut-off values of Pirani hindfoot score of 2.0 and 3.0 were 167.46° and 160.15°, respectively. The sensitivity was 0.75 and 0.67, the specificity was 0.81 and 0.83, and the area under the curve was 0.78 and 0.71, respectively. Conclusion:Ultrasound can complement with Pirani score, visually and dynamically observe the morphology and position changes of talonavicular joint, calcaneocuboid joint and tibiotalocalcaneal joint, monitor the recovery and pseudo-correction of tarsal bones, and better evaluate the therapeutic effect.

Objective:To explore the evaluation effect of ultrasonography and Pirani score on tarsal deformity, treatment effect and pseudo-correction of congenital clubfoot in infants and young children, and the correlation between the two methods.Methods:This is a retrospective case series study. The clinical data of 26 children (40 feet) with congenital clubfoot who were evaluated by ultrasonography in the Third Affiliated Hospital of Zhengzhou University from January 2020 to January 2023 were retrospectively collected. There were 16 males and 10 females. The age at the first ultrasound examination was ( M(IQR)) 9.0 (18.0) days (range: 1 to 46 days). All patients were treated with Ponseti method by the same physician. The Pirani scores before and after treatment and at the last examination, and the talonavicular angle, calcaneocuboid angle and tibiocalcaneal angle measured by ultrasound were collected, and the treatment and follow-up were recorded. Paired sample t test, repeated measures analysis of variance or Kruskal-Wallis test were used for data comparison, and Spearman correlation analysis was used for correlation analysis. The receiver operating characteristic curve was used to calculate the efficacy of ultrasound in evaluating different Pirani scores. Results:The number of plaster fixation in 26 children was 4.0 (1.0) times (range: 2 to 8 times). The medial talonavicular angle and posterior tibiocalcaneal angle were significantly improved after treatment and at the last follow-up compared with those before treatment, and the differences were statistically significant (all P<0.01). There was no difference in lateral calcaneocuboid angle before and after treatment and at the last follow-up ( F=1.971, P>0.05). Pseudo-correction occurred in 2 cases (2 feet) during the treatment, with an incidence of 5%. Correlation analysis showed that there was a moderate positive correlation between talonavicular angle and Pirani midfoot score ( r=0.480, P<0.01). There was no correlation between calcaneocuboid angle and Pirani midfoot score ( r=0.114, P=0.105). There was a moderate negative correlation between tibial heel angle and Pirani hindfoot score ( r=-0.566, P<0.01). The cut-off point of Pirani midfoot score of 1.5 was 38.78°, the sensitivity was 0.90, the specificity was 0.56, and the area under the curve was 0.75. The cut-off value of angle was 27.51 °, the sensitivity was 0.16, the specificity was 0.92, and the area under the curve was 0.44.The cut-off points of Pirani midfoot score of 3.0 were 45.08°and 9.96°, the sensitivity was 0.94 and 0.91, the specificity was 0.37 and 0.42, and the area under the curve was 0.59 and 0.62, respectively. The cut-off values of Pirani hindfoot score of 2.0 and 3.0 were 167.46° and 160.15°, respectively. The sensitivity was 0.75 and 0.67, the specificity was 0.81 and 0.83, and the area under the curve was 0.78 and 0.71, respectively. Conclusion:Ultrasound can complement with Pirani score, visually and dynamically observe the morphology and position changes of talonavicular joint, calcaneocuboid joint and tibiotalocalcaneal joint, monitor the recovery and pseudo-correction of tarsal bones, and better evaluate the therapeutic effect.

Objective To develop and evaluate a questionnaire in knowledge,attitude and practices for the patients with dry eye disease in order to provide an evaluation tool for investigation of the status about the knowledge,attitude and practices among the patients. Methods Between January and May 2022,an initial questionnaire item pool was established through literature review and analysis,together with the group discussions based on the theoretic model of knowledge,attitude and practices. A total of 12 medical and nursing experts participated in the two rounds of Delphi expert consultations. Based on the results of consultation,an initial questionnaire was modified and developed. Between June and December 2022,190 patients with dry eye disease in our hospital were selected by convenience sampling to evaluate the reliability and validity of the questionnaire. Results Based on the included 9 pieces of literature and the results from the 3 group discussions,a preliminary questionnaire was developed with 3 dimensions and 44 items. After the first round of consultation,five items were revised,and 10 items were omitted. The second round of consultation achieved consensus among the experts. A predictive pilot questionnaire containing 34 items across three dimensions of knowledge,attitude and practice was then formulated. The Kendall's concordance coefficients in the two rounds of consultation were 0.346 and 0.413,respectively (both P<0.001),with an authority coefficient of 0.90. 176 patients completed the survey in the discrimination analysis by high and low score groups,one entry that did not meet the criteria was removed. Structural validity was then analysed by exploratory factor analysis. Five common factors with eigenvalue>1 were extracted by principal component analysis,and the cumulative contribution rate of variance was 65.677％. Item 8 of the knowledge dimension was removed due to a double load. In the content validity analysis,the item level validity was 0.92-1.00,and the scale level validity was 0.94-1.00. The Cronbach's α coefficient was 0.894,and the test-retest reliability was 0.987. The finalised evaluation questionnaire consisted of 32 items,including knowledge sub-dimension 1 (knowledge about dry eye disease),knowledge sub-dimension 2 (risk factors of dry eye disease),attitude sub-dimension 1 (prevention and control attitude for dry eye disease),and attitude sub-dimension 2 (self-management attitude of dry eye disease),as well as the behaviour dimension (prevention and control behaviour for dry eye disease). Conclusion The questionnaire developed by Delphi method demonstrates good reliability and validity. Therefore,it can be used as a tool in the investigation of the status of knowledge,attitude and practice of the patients with dry eye disease.

Objective To develop and evaluate a questionnaire in knowledge,attitude and practices for the patients with dry eye disease in order to provide an evaluation tool for investigation of the status about the knowledge,attitude and practices among the patients. Methods Between January and May 2022,an initial questionnaire item pool was established through literature review and analysis,together with the group discussions based on the theoretic model of knowledge,attitude and practices. A total of 12 medical and nursing experts participated in the two rounds of Delphi expert consultations. Based on the results of consultation,an initial questionnaire was modified and developed. Between June and December 2022,190 patients with dry eye disease in our hospital were selected by convenience sampling to evaluate the reliability and validity of the questionnaire. Results Based on the included 9 pieces of literature and the results from the 3 group discussions,a preliminary questionnaire was developed with 3 dimensions and 44 items. After the first round of consultation,five items were revised,and 10 items were omitted. The second round of consultation achieved consensus among the experts. A predictive pilot questionnaire containing 34 items across three dimensions of knowledge,attitude and practice was then formulated. The Kendall's concordance coefficients in the two rounds of consultation were 0.346 and 0.413,respectively (both P<0.001),with an authority coefficient of 0.90. 176 patients completed the survey in the discrimination analysis by high and low score groups,one entry that did not meet the criteria was removed. Structural validity was then analysed by exploratory factor analysis. Five common factors with eigenvalue>1 were extracted by principal component analysis,and the cumulative contribution rate of variance was 65.677％. Item 8 of the knowledge dimension was removed due to a double load. In the content validity analysis,the item level validity was 0.92-1.00,and the scale level validity was 0.94-1.00. The Cronbach's α coefficient was 0.894,and the test-retest reliability was 0.987. The finalised evaluation questionnaire consisted of 32 items,including knowledge sub-dimension 1 (knowledge about dry eye disease),knowledge sub-dimension 2 (risk factors of dry eye disease),attitude sub-dimension 1 (prevention and control attitude for dry eye disease),and attitude sub-dimension 2 (self-management attitude of dry eye disease),as well as the behaviour dimension (prevention and control behaviour for dry eye disease). Conclusion The questionnaire developed by Delphi method demonstrates good reliability and validity. Therefore,it can be used as a tool in the investigation of the status of knowledge,attitude and practice of the patients with dry eye disease.