[Objective]To clarify the associations between plasma fibrinogen(Fbg)and volumetric bone mineral density(vBMD)as well as osteoporosis measured by quantitative computed tomography(QCT),and to explore the role of plasma Fbg in early screening and diagnosis of osteoporosis.[Methods]Patients with hypertension who were hospitalized in the Department of Endocrinology of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2018 to June 2022 and underwent QCT examinations were included for cross-sectional analysis.The study analyzed the correlation between plasma Fbg and osteoporosis in patients.The diagnostic efficacy of plasma Fbg for osteoporosis was evaluated by the area under the receiver operating characteristic(ROC)curve(AUC).[Results]Totally 441 subjects were included in the analysis,with an average age of 46.0±14.5 years and a prevalence of osteoporosis of 6.4%(28/441).As the level of plasma fibrinogen increased,the incidence of osteoporosis significantly increased(P<0.000 1)while the average bone mineral density of L1 and L2 were significantly decreased(P<0.05).Compared with the first quartile of plasma Fbg(1.99g/L-2.37g/L),the risk of osteoporosis in the fourth quartile of plasma Fbg(3.67g/L-4.46g/L)increased by 8.85 times after adjusting for related confounding factors.[Conclusion]This study found a negative correlation between plasma fibrinogen levels and bone density in patients with hypertension.Plasma fibrinogen levels may serve as a potential screening indicator for osteoporosis,aiding in early diagnosis and therapeutic monitoring.This discovery offers a new perspective for the study of bone metabolic diseases and warrants further investigation.

Cushing′s syndrome refers to a group of disorders caused by excessive secretion of adrenal glucocorticoid due to various underlying etiologies. Among these, ACTH-dependent Cushing′s syndrome, in which the source of ACTH-secretion remains unclear for extended periods, poses significant challenges in clinical management. This article presents a patient with ACTH-dependent Cushing′s syndrome where the ACTH-secreting source could not be definitively localized from our hospital. Additionally, the article reviews recent advancements in the diagnosis and treatment of such cases, both domestically and internationally, with the aim of enhancing clinicians′ understanding and improving the management of this condition.

Autoimmune oophoritis is a rare cause of primary ovarian insufficiency(POI), and some patients may also have concurrent adrenal insufficiency. This condition significantly impairs reproductive function and is often difficult to distinguish from common causes of POI, leading to missed or incorrect diagnoses. This paper reports a case of autoimmune oophoritis treated in our department and provides an updated summary of recent advances in the understanding of this condition, with the aim of raising clinical awareness and improving diagnostic accuracy among healthcare professionals.

BACKGROUND:Prosthesis misalignment and patient bone condition are important factors affecting the prognosis of unicompartmental knee arthroplasty,and postoperative osteoarthritic progression of the lateral compartment is a major complication leading to its high revision rate.Therefore,this will become a hot research topic in the future.OBJECTIVE:To analyze the effect of different femoral prosthesis tilt angles on the stress on the structure of the lateral compartment after unicompartmental knee arthroplasty in patients with normal bone and osteoporosis,and to investigate the correlation between osteoporosis and osteoarthritis of the lateral compartment in the postoperative period.METHODS:Using a validated finite element model of the knee,normal bone(M1)and osteoporotic(M2)unicompartmental knee arthroplasty were modeled.The femoral prosthesis tilt models(normal bone group:varus angles of 3°,6°,9°,12°,and 0°,valgus angles of 3°,6°,9°,12°;osteoporosis group:varus angles of 3°,6°,9°,12°,0°,valgus angles of 3°,6°,9°,12°)were established respectively,totaling 18 working conditions.The effects of different femoral prosthesis tilt angles on stress magnitude and distribution in the meniscus,tibial cartilage,and femoral cartilage of interstitial compartment were evaluated.RESULTS AND CONCLUSION:(1)The high stress values on the meniscus surface and tibial cartilage surface of the healthy lateral compartment of the two models increased with the increase of the prosthesis varus angle,and decreased with the increase of the prosthesis valgus angle.Under the same working conditions,the peak stress on the meniscus surface of the osteoporotic group was greater than that of the normal bone group,but that of the tibial cartilage surface of the osteoporotic group was less than that of the normal bone group.(2)The high stress values on the femoral cartilage of the lateral compartment of the two models increased with the increase of the prosthesis varus and valgus angles.Under the same working conditions,the peak stress on the femoral cartilage of the osteoporotic group was greater than that of the normal bone group.(3)It is indicated that when the fixed-bearing femoral prosthesis is varus,the stresses on the lateral compartment structures after medial unicompartmental knee arthroplasty in normal bone and osteoporotic knees will increase,and the increase in the stresses on the lateral intercondylar structures in osteoporotic knees will be more pronounced.Therefore,special attention should be paid to the placement of the prosthesis during unicompartmental knee arthroplasty to avoid varus and valgus of the prosthesis as much as possible.At the same time,the findings confirm that osteoporosis may exacerbate the progression of lateral compartment osteoarthritis after medial unicompartmental knee arthroplasty.

Objective:To investigate the predictive value of color Doppler ultrasound combined with electrocardio-gram for right heart dys function in patients with pulmonary heart disease(PHD).Methods:A total of 100 PHD patients admitted in Dongcheng Branch of First Affiliated Hospital of Anhui Medical University between January 2020 and December 2023 were retrospectively analyzed.According to results of 6min walking test(6MWT),pa-tients were divided into good right heart function group(n=64,≥350m)and right heart dysfunction group(n=36,＜350m).The indexes of cardiac color ultrasound[isovolumic relaxation time(IVRT),isovolumetric contraction time(IVCT)and right ventricular Tei index],ECG[24h mean R-R interval standard deviation(SDNN),normal R-R interval standard deviation per 5min(SDANN)and the ratio of low frequency components to high frequency components(LF/HF)]were compared between two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of color Doppler ultrasound,ECG and their combination for right heart dys-function in PHD patients.Spearman correlation coefficient was used to analyze the association of color Doppler ul-trasound,ECG and their combination with right heart dysfunction in PHD patients.Results:Compared with those in good right heart function group,patients in right heart dysfunction group had significant higher IVRT[(120.64±14.08)ms vs.(97.87±10.93)ms],IVCT[(84.28±12.33)ms vs.(71.92±10.61)ms]and Tei index[(0.85±0.11)vs.(0.63±0.07)](P＜0.001 all),and significant lower SDNN[(75.52±12.58)ms vs.(85.58±11.75)ms],SDANN[(63.86±10.92)ms vs.(76.75±11.71)ms]and LF/HF[(1.33±0.19)vs.(1.84±0.27)](P＜0.001 all).ROC curve indicated that the AUC of color Doppler ultrasound combined ECG in diagnosing right heart dysfunction in PHD patients was 0.911(95％CI 0.838～0.959),which was significantly higher than those of color Doppler ultrasound[0.775(95％CI 0.681～0.853),Z=2.404,P=0.016]and ECG[0.688(95％CI 0.588～0.777),Z=3.968,P=0.001]alone.Spearman correlation analysis indicated that there was a significant positive correlation of color Doppler ultrasound(r=0.547),ECG(r=0.375)and their combination(r=0.810)with right heart dysfunction in PHD patients(P＜0.001 all),and the correlation between combined detection and right heart dysfunction in PHD patients was significantly higher.Conclusion:Color Doppler ultrasound combined with ECG possesses high diagnostic performance for right heart dysfunction in PHD patients.

Objective To investigate the expression levels and diagnostic value of long noncoding RNA(LncRNA)GUSBP3 and LncRNA SAM4 in peripheral blood of Kazakh type 2 diabetes mellitus(T2DM)patients in Xinjiang.Methods From January to September 2019,Kazakh T2DM patients in The First Affiliated Hospital of Shihezi University were recruited through outpatient or inpatient department(T2DM group,n=30).And 30 healthy people were selected as normal control(NC)group during the same period.The general data,biochemical indicators and differentially expressed LncRNA levels were compared between the two groups.Spearman correlation analysis was used to analyze the correlation between the target genes and each index.Logistic regression was used to analyze the influencing factors for T2DM.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of target genes.Results The differentially expressed LncRNA were LncRNA GUSBP3 and LncRNA SAM4 in the two groups.DBP,FPG,HbA1c,fructosamine,FIns,islet β cell function index,serum creatinine(Scr),LncRNA GUSBP3 and LncRNA SAM4 were higher in the T2DM group than in the NC group(P<0.05).Spearman correlation analysis showed that the expression of LncRNA GUSBP3 was positively correlated with Scr and serum uric acid(SUA)(r=0.328,0.322,P<0.05),and negatively correlated with FIns(r=-0.295,P<0.05).The expression of LncRNA SAM4 was positively correlated with SUA(r=0.275,P<0.05)and negatively correlated with LDL-C(r=-0.212,P<0.05).Logistic regression analysis showed that DBP(OR 1.175,95%CI 1.011～1.367),FIns(OR 0.852,95%CI 0.739～0.982),LncRNA GUSBP3(OR 0.378,95%CI 0.149～0.958)was influencing factors for T2DM in Kazakh population.The area under the ROC curve of LncRNA GUSBP3 was 0.789 for T2DM diagnosis.Conclusions The expression levels of LncRNA GUSBP3 and LncRNA SAM4 were higher in Kazakh patients with T2DM than in healthy people,and their expression levels are related to some biochemical indicators.DBP,FIns and LncRNA GUSBP3 are the influencing factors for T2DM in Kazakh population.LncRNA GUSBP3 may be a biomarker for the diagnosis of T2DM in Kazakh in Xinjiang.

Cushing′s syndrome refers to a group of disorders caused by excessive secretion of adrenal glucocorticoid due to various underlying etiologies. Among these, ACTH-dependent Cushing′s syndrome, in which the source of ACTH-secretion remains unclear for extended periods, poses significant challenges in clinical management. This article presents a patient with ACTH-dependent Cushing′s syndrome where the ACTH-secreting source could not be definitively localized from our hospital. Additionally, the article reviews recent advancements in the diagnosis and treatment of such cases, both domestically and internationally, with the aim of enhancing clinicians′ understanding and improving the management of this condition.

Autoimmune oophoritis is a rare cause of primary ovarian insufficiency(POI), and some patients may also have concurrent adrenal insufficiency. This condition significantly impairs reproductive function and is often difficult to distinguish from common causes of POI, leading to missed or incorrect diagnoses. This paper reports a case of autoimmune oophoritis treated in our department and provides an updated summary of recent advances in the understanding of this condition, with the aim of raising clinical awareness and improving diagnostic accuracy among healthcare professionals.

BACKGROUND:Prosthesis misalignment and patient bone condition are important factors affecting the prognosis of unicompartmental knee arthroplasty,and postoperative osteoarthritic progression of the lateral compartment is a major complication leading to its high revision rate.Therefore,this will become a hot research topic in the future.OBJECTIVE:To analyze the effect of different femoral prosthesis tilt angles on the stress on the structure of the lateral compartment after unicompartmental knee arthroplasty in patients with normal bone and osteoporosis,and to investigate the correlation between osteoporosis and osteoarthritis of the lateral compartment in the postoperative period.METHODS:Using a validated finite element model of the knee,normal bone(M1)and osteoporotic(M2)unicompartmental knee arthroplasty were modeled.The femoral prosthesis tilt models(normal bone group:varus angles of 3°,6°,9°,12°,and 0°,valgus angles of 3°,6°,9°,12°;osteoporosis group:varus angles of 3°,6°,9°,12°,0°,valgus angles of 3°,6°,9°,12°)were established respectively,totaling 18 working conditions.The effects of different femoral prosthesis tilt angles on stress magnitude and distribution in the meniscus,tibial cartilage,and femoral cartilage of interstitial compartment were evaluated.RESULTS AND CONCLUSION:(1)The high stress values on the meniscus surface and tibial cartilage surface of the healthy lateral compartment of the two models increased with the increase of the prosthesis varus angle,and decreased with the increase of the prosthesis valgus angle.Under the same working conditions,the peak stress on the meniscus surface of the osteoporotic group was greater than that of the normal bone group,but that of the tibial cartilage surface of the osteoporotic group was less than that of the normal bone group.(2)The high stress values on the femoral cartilage of the lateral compartment of the two models increased with the increase of the prosthesis varus and valgus angles.Under the same working conditions,the peak stress on the femoral cartilage of the osteoporotic group was greater than that of the normal bone group.(3)It is indicated that when the fixed-bearing femoral prosthesis is varus,the stresses on the lateral compartment structures after medial unicompartmental knee arthroplasty in normal bone and osteoporotic knees will increase,and the increase in the stresses on the lateral intercondylar structures in osteoporotic knees will be more pronounced.Therefore,special attention should be paid to the placement of the prosthesis during unicompartmental knee arthroplasty to avoid varus and valgus of the prosthesis as much as possible.At the same time,the findings confirm that osteoporosis may exacerbate the progression of lateral compartment osteoarthritis after medial unicompartmental knee arthroplasty.

Objective:To investigate the predictive value of color Doppler ultrasound combined with electrocardio-gram for right heart dys function in patients with pulmonary heart disease(PHD).Methods:A total of 100 PHD patients admitted in Dongcheng Branch of First Affiliated Hospital of Anhui Medical University between January 2020 and December 2023 were retrospectively analyzed.According to results of 6min walking test(6MWT),pa-tients were divided into good right heart function group(n=64,≥350m)and right heart dysfunction group(n=36,＜350m).The indexes of cardiac color ultrasound[isovolumic relaxation time(IVRT),isovolumetric contraction time(IVCT)and right ventricular Tei index],ECG[24h mean R-R interval standard deviation(SDNN),normal R-R interval standard deviation per 5min(SDANN)and the ratio of low frequency components to high frequency components(LF/HF)]were compared between two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of color Doppler ultrasound,ECG and their combination for right heart dys-function in PHD patients.Spearman correlation coefficient was used to analyze the association of color Doppler ul-trasound,ECG and their combination with right heart dysfunction in PHD patients.Results:Compared with those in good right heart function group,patients in right heart dysfunction group had significant higher IVRT[(120.64±14.08)ms vs.(97.87±10.93)ms],IVCT[(84.28±12.33)ms vs.(71.92±10.61)ms]and Tei index[(0.85±0.11)vs.(0.63±0.07)](P＜0.001 all),and significant lower SDNN[(75.52±12.58)ms vs.(85.58±11.75)ms],SDANN[(63.86±10.92)ms vs.(76.75±11.71)ms]and LF/HF[(1.33±0.19)vs.(1.84±0.27)](P＜0.001 all).ROC curve indicated that the AUC of color Doppler ultrasound combined ECG in diagnosing right heart dysfunction in PHD patients was 0.911(95％CI 0.838～0.959),which was significantly higher than those of color Doppler ultrasound[0.775(95％CI 0.681～0.853),Z=2.404,P=0.016]and ECG[0.688(95％CI 0.588～0.777),Z=3.968,P=0.001]alone.Spearman correlation analysis indicated that there was a significant positive correlation of color Doppler ultrasound(r=0.547),ECG(r=0.375)and their combination(r=0.810)with right heart dysfunction in PHD patients(P＜0.001 all),and the correlation between combined detection and right heart dysfunction in PHD patients was significantly higher.Conclusion:Color Doppler ultrasound combined with ECG possesses high diagnostic performance for right heart dysfunction in PHD patients.