Background: Adrenocortical hormones, particularly 11-oxygenated androgens, are pivotal in female reproductive health and fertility. Standardized detection kits and population-specific reference intervals are lacking in China, hindering related clinical applications. Methods: A HPLC-tandem mass spectrometry (HPLC-MS/MS) pipeline was developed, rigorously validated, and applied to simultaneously quantify corticosterone, cortisone, cortisol, 18-OH cortisol, androstenedione (A4), 11β-hydroxyandrostenedione (11-OH A4), dehydroepiandrosterone, and dehydroepiandrosterone sulfate in serum samples from 455 reproductive-aged women (18–45 yrs) in Guangxi, China. Age-dependent concentration trends were analyzed, and reference intervals stratified by age (2.5th to 97.5th percentiles) were established. Correlations with body-composition metrics, ethnicity, and the menstrual cycle were investigated. Results: The HPLC-MS/MS method demonstrated high precision (intra- and inter-assay CVs < 15%), accuracy, and sensitivity. All eight hormones exhibited significant age-related declines (P < 0.001 for seven hormones; P = 0.001 for 11-OH A4). Notably, 11-OH A4 levels were significantly lower in the 35–45-yr (3.05 nmol/L) and 25–34-yr (3.09 nmol/L) age groups than in the 18–24-yr (3.57 nmol/L) age group, whereas no significant difference was observed between the 35–45-yr and 25–34-yr age groups. Weak negative correlations were observed between the body mass index and corticosterone and cortisone levels, whereas ethnicity and the menstrual cycle showed no significant associations with hormone levels. Conclusions We developed an HPLC-MS/MS-based method for simultaneously quantifying eight adrenocortical hormones, including 11-OH A4, and defined age-specific reference intervals for reproductive-aged Chinese women. These findings advance the clinical utility of adrenocortical hormones in diagnosing and managing reproductive disorders.

Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.

Objective:To investigate the relationship between different states of cardiac function and their changes during the course of diabetic foot ulcers(DFU), and to evaluate their impact on patient prognosis.Methods:A retrospective analysis was conducted on 194 DFU patients who were rehospitalized at approximately 3-month intervals. Basic clinical data and cardiac function-related indicators were collected at baseline and follow-up. Patients were followed until death or until November 10, 2024. Outcomes including ulcer healing, recurrence, minor amputation, and death were recorded. Logistic regression models were used to analyze the effects of cardiac function status and its changes on these four outcomes. Results:After treatment, the proportion of patients with NYHA class Ⅱ-Ⅲ decreased significantly from 33.5% at baseline to 21.6%( P=0.009). Serum N-terminal pro-B-type natriuretic peptide(NT-proBNP) level also decreased after treatment compared with baseline [635.85(59.83, 453.28) pg/mL vs 728.67(81.48, 696.15) pg/mL, P=0.055]. Serum NT-proBNP level was significantly higher in the death group compared to the survival group( P=0.002). The proportion of DFU patients with baseline NYHA class Ⅱ-Ⅲ was significantly higher than that in those with class Ⅰ( P=0.012). Regression analysis showed that an improvement in NT-proBNP levels was associated with a lower risk of DFU recurrence( OR=0.378, 95% CI 0.183-0.779, P=0.008), and improvement in NYHA class was associated with a lower mortality risk( OR=0.074, 95% CI 0.020-0.275, P<0.001). Conclusion:Cardiac function status and its changes during the treatment of DFU patients have strong prognostic implications, particularly in predicting the risk of recurrence and death outcomes.

Objective To explore the five-circuit and six-qi features of birth time and onset time of children with acute lymphoblastic leukemia(ALL).Methods A total of 877 cases of children with ALL from Children's Hospital of Soochow University from June 2021 to February 2023 were collected,and their five-circuit and six-qi features of birth time and onset time were analyzed.And then the correlation of five-circuit and six-qi features of birth time and onset time with ALL was explored preliminarily,and the pathogenic characteristics of congenital factors and acquired pathogenic factors were revealed.Results(1)The children who were born in the year with the heavenly stems being bing(the 3rd of the ten heavenly stems)and ding(the 4th of the ten heavenly stems)and with the earthly branches being shen(the 8th of the twelve earthly branches)and you(the 9th of the twelve earthly branches)are prone to suffer from ALL,and the birth year of children with ALL had the five-circuit and six-qi features of the joining of guest circuit with dominant circuit being rebellious.ALL is commonly seen in the year with the heavenly stems being geng(the 7th of the ten heavenly stems)and xin(the 8th of the ten heavenly stems)and with the earthly branches being zi(the 1st of the twelve earthly branches)and chou(the 2nd of the twelve earthly branches),and the onset year of ALL in children had the five-circuit and six-qi features of the yearly circuit being gold-circuit and water-circuit,sitian-zaiquan yearly circuit qi being shaoyin monarch-fire with yangming dryness-gold,taiyin damp-earth with taiyang cold-water,and the qi-circuit assimilation relationship being celestial correspondence,same celestial correspondence,celestial correspondence in convergent year,disharmony,mildly-rebellious,and celestial restriction.Conclusion Gold-dryness and water-cold are the congenital factors and acquired pathogenic factors of ALL.The onset of ALL in children is closely related to qi insufficiency and qi stagnation of wood and fire in five-circuit and six-qi theory.

Objective To investigate the therapeutic effect of combination treatment of transcatheter arterial chemoembolization(TACE),micro wave ablation(MW A)and targeted immunotherapy for hepatocellular carcinoma(HCC).Methods The clinical data of HCC patients,who were admitted to the Affiliated Central Hospital of Jiangnan University of China to receive TACE from August 2016 to August 2023,were retrospectively analyzed.Based on the inclusion criteria,a total of 252 patients were included in this study.According to the therapeutic scheme,the patients were divided into combination group(receiving TACE,MWA,targeted therapy and immunotherapy,n=41),and control group(receiving TACE alone,n=211).The overall survival(OS)and progression-free survival(PFS)of the two groups were statistically analyzed.After propensity score matching at 1∶1 ratio,the clinical effects of the two groups were analyzed.According to different data,t-test,test,Kaplan-Meier curve,logarithmic rank test,Cox regression analysis,or Cox proportional risk model analysis was used to make statistical analysis.Results Multivariate regression analysis showed that tumor number,maximum diameter,invasion of large vessels,tumor capsule,AFP level,glutamic oxalacetic transaminase,BCLC stage and Child-Pugh stage were the independent risk factors for patient survival.Imaging response and combination treatment were the protective factors for survival.After propensity score matching,a total of 37 pairs of patients were obtained,and the baseline data were comparable between the groups.The differences in OS and PFS between the two groups were statistically significant.Combination treatment of TACE,MWA,targeted therapy and immunotherapy could significantly prolong OS and PFS in HCC patients.Conclusion Compared with TACE alone,combination use of TACE,MWA,targeted therapy and immunotherapy is a more effective therapeutic scheme for HCC,it can remarkably and effectively improve OS and PFS in HCC patients.

With the development of medical technology and interventional equipment,neurointervention has become an important treatment method for cerebrovascular diseases.Intravascular stenting plays a crucial role in the treatment of cerebral artery stenosis and intracranial aneurysms,and its clinical efficacy and safety are constantly improving.However,as the neurointervention enters the mature stage,the long-term effect of the interventional materials placed within the brain and the problem of the non-degradable nature of the stent material have got obvious concern in clinical practice.The application of biodegradable materials holds promise for solving this dilemma,as their degradation products can be absorbed or excreted by the body.The development history of the biodegradable stents shows that biodegradable stents began to be studied as early as in the 1980s.Due to the features of intracranial arteries,the stents used for intracranial stenosis have to meet higher clinical requirements in terms of flexibility,precision and the influence of degradation products,which are still studied by animal experiment and preliminary clinical research.Flow-diverter devises have already achieved definite clinical effect.Due to the disadvantages of conventional metal stents,such as artifacts,which have a long-term influence on the imaging quality,the degradable flow-diverter devices have become a current research hot spot,the materials include metal,metal-polymer mixture,polymer,etc.Researchers are still exploring the material selection,control of degradation time and optimization of pore density.In conclusion,biodegradable stents used for intracranial stenosis and biodegradable flow-diverter devices have broad application prospects,although more studies are need to be conducted before biodegradable stents can be widely used in clinical practice.

Objective To analyze the risk of postoperative ileus in severe ulcerative colitis(UC)patients undergoing total proctocolectomy with ileal pouch-anal anastomosis(TPC-IPAA)and develop and validate a nomogram prediction model.Methods A total of 278 severe UC patients un-dergoing TPC-IPAA from January 2018 to May 2022 were enrolled and divided into ileus group(n=73)and non-ileus group(n=205)based on the occurrence of postoperative ileus.Another 120 severe UC patients undergoing TPC-IPAA from June 2022 to April 2023 were selected as validation cohort(with a 7-to-3 ratio between the modeling cohort and the validation cohort).Factors influen-cing postoperative ileus in severe UC patients undergoing TPC-IPAA were analyzed to construct a No-mogram prediction model.The discrimination,consistency,and clinical utility of the Nomogram model were evaluated by the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DC A).Results There were no significant differences in general characteristics be-tween the modeling cohort and the validation cohort(P＞0.05).Significant differences were ob-served in preoperative American Society of Anesthesiologists(ASA)classification,preoperative al-bumin level,history of abdominal surgery,surgical approach,operation duration,intraoperative blood loss,and postoperative intra-abdominal infection between the ileus group and the non-ileus-group(P＜0.05).Preoperative ASA classification,preoperative albumin level,history of abdomi-nal surgery,operation duration,intraoperative blood loss,and postoperative intra-abdominal infec-tion were independent influencing factors for postoperative ileus in severe UC patients undergoing TPC-IPAA(P＜0.05).The ROC curve showed that the area under the curve of the Nomogram model for predicting postoperative ileus in severe UC patients undergoing TPC-IPAA was 0.782(95％CI,0.723 to 0.842)in the modeling cohort and 0.785(95％CI,0.693 to 0.878)in the validation cohort,indicating good discrimination of the model.The calibration curve demonstrated good consistency of the nomogram model.The DCA curve suggested high clinical utility of the Nomogram model.Conclusion The risk of postoperative ileus in severe UC patients undergoing TPC-IPAA is influenced by preoperative ASA classification,history of abdominal surgery,preopera-tive albumin level,intraoperative blood loss,operation duration,and postoperative intra-abdominal infection.The nomogram prediction model developed based on these factors has high predictive per-formance for the risk of postoperative ileus.

AIM:To study the protective effect of transient receptor potential vanilic acid subtype 1(TRPV1)agonist capsaicin(CAP)on traumatic blood loss shock rats,and to further explore its possible mechanism by network pharmacology.METHODS:Forty-five SD rats were divided into 5 groups by random number table method:normal group,shock group,lactated Ringer's solution(LR)group,CAP pretreatment(single administration before shock)group,CAP pre-final administration(twice administration before and after shock)group,with 9 rats in each group for survival observation.Then 32 SD rats were divided into 4 groups according to the results of survival experiment:normal group,shock group,LR group,CAP pre-final administration group,with 8 rats in each group for blood pressure,hemodynamics,arterial blood gas,vascular reactivi-ty and hepaticand renal blood flow.At the same time,the potential mechanism of CAP in the treat-ment of traumatic hemorrhagic shock was investi-gated by network pharmacology.Furthermore,ap-ply the dataset to validate and analyse the diagnos-tic value of the hub genes.RESULTS:Rats in shock group died within hours of the completion of the shock model,and the mean survival time was 1.25(0.42,6.21)h.LR resuscitation could improve the survival of rats to some extent.The survival rate and survival time of rats in the CAP pretreatment group were slightly increased as compared with the LR group,while twice administration of CAP be-fore and after shock(CAP pre-final administration)resulted in better outcomes than LR resuscitation alone.Further results indicated that CAP pre-final administration significantly reduced the blood lac-tic acid level,improved the vasoconstrictive and di-astolic reactivity,and increased the liver and kidney blood flow of shock rats as compared with LR group.The improvement of hemodynamics and blood gas indexes in CAP group was slightly higher than LR group,but there was no statistical signifi-cance.A total of 37 genes related to CAP anti-trau-matic hemorrhage shock were obtained by net-work pharmacology.KEGG enrichment analysis showed that the Ca ion signaling pathway and Ras signaling pathway were significantly enriched.Vali-dation of the dataset showed that the expression levels of CXCR4,NF-kB1,GFPA and NTF3 hub gene were significantly different in the normal and shock groups,and that CXCR4 has a high diagnostic value for traumatic haemorrhagic shock.CONCLUSIONS:CAP,the TRPV1 agonist,significantly improved vas-cular function,increased organ blood flow,and cor-rected the lactic acidosis in rats with traumatic hemorrhagic shock,thus markedly improved the survival outcomes.The mechanism may be related to Ca ion signal pathway and Ras signal pathway.CXCR4,NF-kB1,GFPA and NTF3 may be having an important role in it.

Objective To investigate the correlation between serum microRNA-210(miR-210),tumor necrosis factor-stimulated gene 6(TSG-6),and complement C1q tumor necrosis factor-related protein 3(CTRP3)and their association with myocardial fibrosis and prognosis in patients with dilated cardiomyopathy(DCM).Methods A total of 117 patients with DCM admitted to Taizhou People's Hospital between March and August 2024 were enrolled in the DCM group.Based on cardiac magnetic resonance imaging findings,these patients were further classified into a myocardial fibrosis group(n=96)and a non-fibrosis group(n=21).Additionally,according to the occurrence of acute heart failure during one-year follow-up,they were categorized into a heart failure group(n=47)and a non-heart failure group(n=70).Concurrently,58 age-and sex-matched healthy volunteers were recruited as the control group.Serum levels of miR-210,TSG-6,CTRP3,N-terminal propeptide of type Ⅲ procollagen(PⅢNP),left ventricular ejection fraction(LVEF),and N-terminal pro-B-type natriuretic peptide(NT-proBNP)were measured and compared across all groups.Results The DCM group exhibited significantly higher serum levels of miR-210,TSG-6,PⅢNP,and NT-proBNP,lower CTRP3 levels,and reduced LVEF compared to the healthy controls(P<0.05).Similarly,the fibrosis group showed elevated serum levels of miR-210,TSG-6,PⅢNP,and NT-proBNP,decreased CTRP3 levels,and impaired LVEF relative to the non-fibrosis group(P<0.05).The heart failure group also demonstrated higher serum concentrations of these biomarkers,along with lower CTRP3 and reduced LVEF,compared to the non-heart failure group(P<0.05).Serum miR-210 and TSG-6 levels were positively correlated with PⅢNP and NT-proBNP(P<0.05)and negatively correlated with LVEF(P<0.05).Multivariate analysis revealed that elevated serum miR-210(OR=2.065,95%CI:1.116～3.821)and TSG-6(OR=1.047,95%CI:1.013～1.083)were independent risk factors for heart failure in DCM patients(P<0.05),whereas higher CTRP3 levels(OR=0.911,95%CI:0.849～0.978)were associated with a protective effect(P<0.05).The sensitivity of serum miR-210,TSG-6,and CTRP3 in predicting heart failure in DCM patients was 72.34%,74.47%,and 74.47%,respectively,with specificities of 62.86%,62.86%,and 68.57%,yielding AUC values of 0.669,0.712,and 0.759,respectively.Conclusions Serum levels of miR-210 and TSG-6 are elevated,whereas CTRP3 levels are reduced in patients with DCM.These biomarkers are closely associated with myocardial fibrosis and cardiac function impairment.Moreover,miR-210,TSG-6,and CTRP3 exhibit significant predictive value for the prognosis of DCM.

Objective To explore the relationship between triglyceride-glucose index(TyG)and acute ischemic stroke with large vessel occlusion(AIS-LVO)of anterior circulation.Methods A retrospective study was conducted on patients with anterior circulation AIS-LVO who underwent emergency endovascular thrombectomy at Neurovascular Center of The First Affiliated Hospital of Naval Medical University from Jan.2018 to Dec.2019.According to modified Rankin scale(mRS)score 90 d after operation,the patients were assigned to favorable outcome group(mRS score 0-2)or unfavorable outcome group(mRS score 3-6),and the TyG was compared.According to the median of TyG,the patients were assigned to low-TyG group(TyG＜8.57)or high-TyG group(TyG ≥8.57),and the clinical data,laboratory indexes,and imaging characteristics were compared.Receiver operating characteristic curve was used to evaluate the predictive value of TyG for poor prognosis.Results A total of 135 patients were enrolled,with 72 in the favorable outcome group and 63 in the unfavorable outcome group.The TyG of the unfavorable outcome group was significantly higher than that of the favorable outcome group(8.82+0.63 vs 8.43+0.60,P＜0.001).There were 67 patients in the low-TyG group and 68 in the high-TyG group.Compared with the low-TyG group,the proportion of patients with hyperlipidemia history(P=0.003),systolic blood pressure at admission(P=0.018),fasting blood glucose level(P＜0.001),and triglyceride level(P＜0.001)were significantly higher in the high-TyG group,the infarct core volume was significantly larger(P=0.025),the high density lipoprotein-cholesterol level was significantly lower(P=0.013),and the mRS score 90 d after operation was significantly higher(3[1,5]vs 1[0,5],P=0.049).The TyG had certain predictive value for poor prognosis in anterior circulation AIS-LVO patients(area under curve value=0.662,95％confidence interval 0.571-0.753).Conclusion TyG is elevated in anterior circulation AIS-LVO patients with poor prognosis,and may be a potential prognostic indicator for anterior circulation AIS-LVO patients.