Objective:To explore the relationship between serum ferritin(SF), triglyceride-glucose(TyG) index, and metabolic dysfunction-associated fatty liver disease(MAFLD), and to assess their interaction on MAFLD risk in the health checkup population.Methods:A cross-sectional analysis was conducted with 1 439 participants from the Health Management Centre of Nanjing Drum Tower Hospital in 2022. Data were collected through physical examination, laboratory tests, and abdominal imaging. Differences in metabolic indicators, SF, and TyG index were compared between MAFLD and non-MAFLD groups. Logistic regression analysis was used to assess the associations of SF and TyG index with MAFLD, and their on MAFLD interaction was evaluated. Results:Both SF and TyG index were significantly higher in the MAFLD group between than those in the non-MAFLD group( P<0.05). After adjusting for sex, age, history of hypertension, history of diabetes, body mass index, waist circumference, haemoglobin, alanine aminotransferase, aspartate aminotransferase, and uric acid, the SF and TyG index were positively associated with the risk of MAFLD[ OR(95% CI), SF: 1.00(1.00-1.00); TyG index: 2.98(2.19-4.06). The additive interaction analysis showed that the risk of MAFLD was significantly higher in the G4 group(SF≥135.4 ng/mL, TyG index≥8.52) compared to the G1 group(SF<135.4 ng/mL, TyG index<8.52) [ OR 4.43(95% CI 2.70-7.25)]. Conclusions:Elevated SF and TyG index were independently associated with increased risk of MAFLD, with a significant synergistic interaction between the two.

Objective To explore the expression levels of CD33⁺ myeloid-derived suppressor cell (MDSC)-mediated T lymphocyte function and related inflammatory factors secreted by T lymphocyte subsets in patients with cervical cancer, and to analyze their correlation with the treatment efficacy of ¹²⁵I particle implantation combined with arterial chemoembolization, as well as predictive value for treatment outcomes and interaction effects. Methods From January 1st, 2021 to January 1st, 2024, our hospital admitted 152 patients with advanced cervical cancer, who were confirmed by pathological examination. All patients received uterine artery chemoembolization combined with ¹²⁵I particle implantation. The predictive value of CD33⁺MDSC levels for clinical treatment response in cervical cancer was assessed using receiver operating characteristic (ROC) curve analysis. Multivariate logistic regression analysis was performed to evaluate both multiplicative and additive interactions between CD33⁺MDSC and T lymphocytes in predicting clinical treatment failure of cervical cancer. Kaplan Meier method was used to analyze the survival differences between cervical cancer patients with high and low CD33⁺MDSC expression levels. Results Compared with the effective group, patients in the ineffective group had decreased expression levels of CD3⁺ T lymphocyte, CD4⁺ T lymphocyte, interleukin 2 (IL-2) and interferon γ (IFN-γ), while showing increased expression levels of CD33⁺MDSC, CD8⁺ T lymphocyte, IL-4 and IL-6, along with increased tumor necrosis factor α (TNF-α) levels, larger maximum tumor diameters, and a higher incidence of lymph node metastasis. The expression levels of CD33⁺MDSCs demonstrated good predictive performance for treatment efficacy in cervical cancer patients. The high CD33⁺MDSC expression group had a significantly shorter overall survival (OS) than the low CD33⁺MDSC expression group (6.0±1.0 months vs. 12.0±1.2 months; t=33.280). The interaction analysis revealed that CD33⁺MDSCs and CD8⁺ T lymphocytes were highly expressed, while CD3⁺ and CD4⁺ T lymphocytes were lowly expressed, which was associated with an increased risk of clinical treatment failure in cervical cancer patients. Conclusion CD33⁺MDSCs can inhibit CD3⁺ and CD4⁺ T lymphocytes. It can upregulate the expression of CD8⁺ T lymphocytes, form an immunosuppressive microenvironment, and reduce the treatment response rate of ¹²⁵I particle implantation combined with arterial chemoembolization. CD33⁺MDSCs may serve as an independent biomarker for predicting the therapeutic efficacy and poor prognosis.
Humans ; Female ; Uterine Cervical Neoplasms/immunology* ; Middle Aged ; Chemoembolization, Therapeutic/methods* ; Sialic Acid Binding Ig-like Lectin 3/immunology* ; Adult ; T-Lymphocytes/immunology* ; Aged ; Treatment Outcome

The prevalence of chronic constipation among the elderly is significant, exerting adverse effects on both their physical and mental health.Presently, pharmacological therapy remains the predominant treatment modality for elderly patients with chronic constipation; however, prolonged use can lead to drug dependence, tolerance, and adverse effects.This article systematically reviews non-pharmacological interventions for chronic constipation in elderly patients, both domestically and internationally, aiming to provide a comprehensive reference for clinical practice.

Atherosclerosis(AS)is a chronic inflammatory disease involving disorders of lipid and iron metabolism.The establishment of suitable animal models is required to further the study of the etiology,pathogenesis,prevention,and therapeutic measures of AS.The main animal models of AS related to iron and lipid metabolism are mice and miniature piglets,especially male ApoE-/-mice.Single-factor high-fat diet-induced iron and lipid metabolism disorders are a common type of AS model,manifesting as elevated blood lipid levels,large plaques and iron deposition in the aorta,and significant increases in serum and liver iron levels.This review compares the effects of different intervention factors on iron and lipid metabolism in AS animal models,and summarizes the method of establishing AS animal models using dietary induction,chemical intervention,and gene modification,to provide references and inspiration for future research into AS and metabolic diseases and the development of new drugs.

Objective:To investigate the impact of the number of examined lymph nodes (ELN) on survival outcomes in gastric cancer patients with postoperative pathological stage pN3b.Methods:This retrospective cohort study included 279 pN3b gastric cancer patients who underwent D2 gastrectomy at Nanfang Hospital, Southern Medical University (September 2008 to April 2023), with 35 patients receiving combination chemotherapy and anti-PD-1 therapy (immunotherapy group) and 244 receiving adjuvant chemotherapy alone (nonimmunotherapy group). Additionally, 422 patients with pN3b from the SEER database (2005 to 2020) were collected as an external validation cohort to determine the optimal cutoff value for the number of lymph nodes examined in the nonimmunotherapy group. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS) in the nonimmunotherapy group of the Nanfang Hospital cohort, stratified by whether the number of examined lymph nodes was above or below the ELN optimal cutoff value. These findings were subsequently validated in the SEER cohort.Results:The optimal ELN cutoff value (34 nodes) was determined using X-tile software and by constructing an ELN-HR fitting model with inflection point identification. In the nonimmunotherapy group, patients with ELN >34 exhibited significantly prolonged survival compared to ELN ≤34 (median OS: 25.0 (95%CI:20.5-29.5) to 17.0 (95%CI:12.7-21.3) months, P=0.004; median RFS: 19.0 (95%CI:15.6-22.4) to 13.0 (95%CI:9.5-16.5) months, P=0.048). Multivariate Cox analysis also showed ELN >34 to be an independent protective factor for both OS (HR=0.576, 95%CI: 0.397-0.836) and RFS (HR=0.701, 95%CI: 0.492-0.998). In the SEER cohort, ELN >34 was associated with a 5-month OS extension (19 to 14 months, P=0.065), with multivariate analysis supporting its independent prognostic significance (HR=0.729, 95%CI: 0.580-0.915, P=0.006). Notably, in the immunotherapy group, patients with ELN >34 ( n=30) achieved a median OS of 41 months, but the median OS had not been reached in the ELN ≤34 group ( n=5) (1 death at 48 months). Conclusion:Higher ELN (>34) correlates with improved survival in nonimmunotherapy-treated pN3b gastric cancer patients. However, in pN3b gastric cancer patients treated with immunotherapy, the optimal ELN threshold requires further exploration to determine.

Objective:To investigate the impact of the number of examined lymph nodes (ELN) on survival outcomes in gastric cancer patients with postoperative pathological stage pN3b.Methods:This retrospective cohort study included 279 pN3b gastric cancer patients who underwent D2 gastrectomy at Nanfang Hospital, Southern Medical University (September 2008 to April 2023), with 35 patients receiving combination chemotherapy and anti-PD-1 therapy (immunotherapy group) and 244 receiving adjuvant chemotherapy alone (nonimmunotherapy group). Additionally, 422 patients with pN3b from the SEER database (2005 to 2020) were collected as an external validation cohort to determine the optimal cutoff value for the number of lymph nodes examined in the nonimmunotherapy group. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS) in the nonimmunotherapy group of the Nanfang Hospital cohort, stratified by whether the number of examined lymph nodes was above or below the ELN optimal cutoff value. These findings were subsequently validated in the SEER cohort.Results:The optimal ELN cutoff value (34 nodes) was determined using X-tile software and by constructing an ELN-HR fitting model with inflection point identification. In the nonimmunotherapy group, patients with ELN >34 exhibited significantly prolonged survival compared to ELN ≤34 (median OS: 25.0 (95%CI:20.5-29.5) to 17.0 (95%CI:12.7-21.3) months, P=0.004; median RFS: 19.0 (95%CI:15.6-22.4) to 13.0 (95%CI:9.5-16.5) months, P=0.048). Multivariate Cox analysis also showed ELN >34 to be an independent protective factor for both OS (HR=0.576, 95%CI: 0.397-0.836) and RFS (HR=0.701, 95%CI: 0.492-0.998). In the SEER cohort, ELN >34 was associated with a 5-month OS extension (19 to 14 months, P=0.065), with multivariate analysis supporting its independent prognostic significance (HR=0.729, 95%CI: 0.580-0.915, P=0.006). Notably, in the immunotherapy group, patients with ELN >34 ( n=30) achieved a median OS of 41 months, but the median OS had not been reached in the ELN ≤34 group ( n=5) (1 death at 48 months). Conclusion:Higher ELN (>34) correlates with improved survival in nonimmunotherapy-treated pN3b gastric cancer patients. However, in pN3b gastric cancer patients treated with immunotherapy, the optimal ELN threshold requires further exploration to determine.

Atherosclerosis(AS)is a chronic inflammatory disease involving disorders of lipid and iron metabolism.The establishment of suitable animal models is required to further the study of the etiology,pathogenesis,prevention,and therapeutic measures of AS.The main animal models of AS related to iron and lipid metabolism are mice and miniature piglets,especially male ApoE-/-mice.Single-factor high-fat diet-induced iron and lipid metabolism disorders are a common type of AS model,manifesting as elevated blood lipid levels,large plaques and iron deposition in the aorta,and significant increases in serum and liver iron levels.This review compares the effects of different intervention factors on iron and lipid metabolism in AS animal models,and summarizes the method of establishing AS animal models using dietary induction,chemical intervention,and gene modification,to provide references and inspiration for future research into AS and metabolic diseases and the development of new drugs.

The prevalence of chronic constipation among the elderly is significant, exerting adverse effects on both their physical and mental health.Presently, pharmacological therapy remains the predominant treatment modality for elderly patients with chronic constipation; however, prolonged use can lead to drug dependence, tolerance, and adverse effects.This article systematically reviews non-pharmacological interventions for chronic constipation in elderly patients, both domestically and internationally, aiming to provide a comprehensive reference for clinical practice.

Objective:To explore the relationship between serum ferritin(SF), triglyceride-glucose(TyG) index, and metabolic dysfunction-associated fatty liver disease(MAFLD), and to assess their interaction on MAFLD risk in the health checkup population.Methods:A cross-sectional analysis was conducted with 1 439 participants from the Health Management Centre of Nanjing Drum Tower Hospital in 2022. Data were collected through physical examination, laboratory tests, and abdominal imaging. Differences in metabolic indicators, SF, and TyG index were compared between MAFLD and non-MAFLD groups. Logistic regression analysis was used to assess the associations of SF and TyG index with MAFLD, and their on MAFLD interaction was evaluated. Results:Both SF and TyG index were significantly higher in the MAFLD group between than those in the non-MAFLD group( P<0.05). After adjusting for sex, age, history of hypertension, history of diabetes, body mass index, waist circumference, haemoglobin, alanine aminotransferase, aspartate aminotransferase, and uric acid, the SF and TyG index were positively associated with the risk of MAFLD[ OR(95% CI), SF: 1.00(1.00-1.00); TyG index: 2.98(2.19-4.06). The additive interaction analysis showed that the risk of MAFLD was significantly higher in the G4 group(SF≥135.4 ng/mL, TyG index≥8.52) compared to the G1 group(SF<135.4 ng/mL, TyG index<8.52) [ OR 4.43(95% CI 2.70-7.25)]. Conclusions:Elevated SF and TyG index were independently associated with increased risk of MAFLD, with a significant synergistic interaction between the two.

Objective:Exploring the effect of recovery-oriented family psychoeducation on the level of social support and family resilience of patients with schizophrenia in remission stage, providing theoretical basis for clinical application.Methods:Using a randomized controlled trial method and convenience sampling method, 60 patients with schizophrenia in remission who visited the outpatient department of the Affiliated Mental Health Center of Shanghai Jiao Tong University School of Medicine from April 2020 to March 2022 were selected as the study subjects, and they were divided into experimental group and control group, with 30 patients in each group according to their residence places. The control group was given routine health education; the experimental group was given the rehabilitation oriented family psychoeducation, before intervention and 3 months after intervention, Social Support Rating Scale and Family Resilience Questionnaire were used to evaluate the intervention effect.Results:A total of 60 patients were included in the control group, including 13 males and 17 females, aged (27.0 ± 6.5)years.In the experimental group, there were 14 males and 16 females, aged (28.0 ± 5.6) years. After intervention, the scores of subjective support, objective support and social support utilization in Social Support Rating Scale of the experimental group were 14.33 ± 3.36, 8.43 ± 1.63 and 9.60 ± 2.49, respectively, the control group were 16.20 ± 3.83, 10.00 ± 2.59 and 8.33 ± 2.28, respectively, and the differences were statistically significant ( t=2.00, 2.80, -2.05, all P<0.05). After intervention, the total score of Family Resilience Questionnaire and the scores of perseverance, support and harmony were 78.77 ± 9.61, 24.90 ± 3.07, 15.10 ± 2.23 and 23.63 ± 3.04, respectively. Higher than the control group 72.67 ± 15.96, 23.43 ± 4.92, 14.03 ± 3.60, 21.13 ± 5.13, the differences were statistically significant ( t values were -2.29--1.37, all P<0.05). Conclusions:Recovery-oriented family psychoeducation can improve the level of social support and family resilience of schizophrenia patients in remission.