Objective:To analyze differences in the expression of routine laboratory parameters and cerebrospinal fluid (CSF) examination indicators between patients with non-neurosyphilis (syphilis without nervous system involvement) and those with neurosyphilis, to screen for key predictive factors, and to construct a predictive model for neurosyphilis.Methods:A retrospective analysis was conducted on the clinical data from patients with syphilis at the Fifth People's Hospital of Suzhou from 2019 to 2024. Patients with neurosyphilis and non-neurosyphilis who were hospitalized from November 2019 to June 2022 were included in the model cohort, and those hospitalized from January 2024 to October 2024 were included in the validation cohort. The patients' basic information and laboratory test indicators (including routine blood tests, CSF biochemical analysis, and syphilitic antibody tests) were collected. Statistical analysis was performed using the GraphPad software. The receiver operating characteristic (ROC) curve and the binary logistic regression method were used to analyze the predictive performance of key indicators in patients from the model cohort with SPSS software, and a predictive model for neurosyphilis was constructed. The performance of the neurosyphilis predictive model for neurosyphilis was validated based on relevant indicators from the validation cohort.Results:The model cohort included 99 patients with non-neurosyphilis (including 49 males and 50 females), and they were aged between 19 and 85 years, with an average age of 47 years; 69 patients with neurosyphilis were also included in the model cohort, including 58 males and 11 females, and they were aged between 26 and 73 years, with an average age of 51 years. The neurosyphilis group showed a significant increase in the median levels of CSF adenosine deaminase (1 U/L) and microprotein (711 mg/L), white blood cell counts (0.009 × 10?/L), as well as in the proportion of positive Pandy tests (35/69, 50.7%) compared with the non-neurosyphilis group (0 U/L, 309 mg/L, 0.002 × 10?/L, 2 /99 [2.0%], respectively, all P < 0.001). Based on the ROC curve analysis, the CSF microprotein and white blood cell count had relatively high discriminative ability (area under the ROC curve [AUC] > 0.85), while adenosine deaminase and the Pandy test showed moderate discriminative ability (0.7 < AUC < 0.85). According to the above four indicators, the logistic regression analysis showed that CSF microprotein combined with CSF white blood cell counts could construct the best predictive model for neurosyphilis, with a prediction accuracy rate of 0.980, a sensitivity of 98.5%, and a specificity of 89.9%. The prediction formula was logit (p) = -9.926 + 0.015 × microprotein + 362.33 × CSF white blood cell count, with a cutoff value of ≥ -0.867. The validation cohort enrolled 72 patients with non-neurosyphilis and 51 with neurosyphilis, and there were significant differences in CSF microprotein levels and white blood cell counts between the two groups (both P < 0.001). In the validation cohort, the predictive model demonstrated an accuracy of 86.2%, with a sensitivity of 83.6% and a specificity of 91.1% for predicting neurosyphilis. Conclusion:The predictive model for neurosyphilis constructed by combining CSF microprotein and CSF white blood cell count may contribute to the early differential diagnosis of neurosyphilis.

Objective:To analyze differences in the expression of routine laboratory parameters and cerebrospinal fluid (CSF) examination indicators between patients with non-neurosyphilis (syphilis without nervous system involvement) and those with neurosyphilis, to screen for key predictive factors, and to construct a predictive model for neurosyphilis.Methods:A retrospective analysis was conducted on the clinical data from patients with syphilis at the Fifth People's Hospital of Suzhou from 2019 to 2024. Patients with neurosyphilis and non-neurosyphilis who were hospitalized from November 2019 to June 2022 were included in the model cohort, and those hospitalized from January 2024 to October 2024 were included in the validation cohort. The patients' basic information and laboratory test indicators (including routine blood tests, CSF biochemical analysis, and syphilitic antibody tests) were collected. Statistical analysis was performed using the GraphPad software. The receiver operating characteristic (ROC) curve and the binary logistic regression method were used to analyze the predictive performance of key indicators in patients from the model cohort with SPSS software, and a predictive model for neurosyphilis was constructed. The performance of the neurosyphilis predictive model for neurosyphilis was validated based on relevant indicators from the validation cohort.Results:The model cohort included 99 patients with non-neurosyphilis (including 49 males and 50 females), and they were aged between 19 and 85 years, with an average age of 47 years; 69 patients with neurosyphilis were also included in the model cohort, including 58 males and 11 females, and they were aged between 26 and 73 years, with an average age of 51 years. The neurosyphilis group showed a significant increase in the median levels of CSF adenosine deaminase (1 U/L) and microprotein (711 mg/L), white blood cell counts (0.009 × 10?/L), as well as in the proportion of positive Pandy tests (35/69, 50.7%) compared with the non-neurosyphilis group (0 U/L, 309 mg/L, 0.002 × 10?/L, 2 /99 [2.0%], respectively, all P < 0.001). Based on the ROC curve analysis, the CSF microprotein and white blood cell count had relatively high discriminative ability (area under the ROC curve [AUC] > 0.85), while adenosine deaminase and the Pandy test showed moderate discriminative ability (0.7 < AUC < 0.85). According to the above four indicators, the logistic regression analysis showed that CSF microprotein combined with CSF white blood cell counts could construct the best predictive model for neurosyphilis, with a prediction accuracy rate of 0.980, a sensitivity of 98.5%, and a specificity of 89.9%. The prediction formula was logit (p) = -9.926 + 0.015 × microprotein + 362.33 × CSF white blood cell count, with a cutoff value of ≥ -0.867. The validation cohort enrolled 72 patients with non-neurosyphilis and 51 with neurosyphilis, and there were significant differences in CSF microprotein levels and white blood cell counts between the two groups (both P < 0.001). In the validation cohort, the predictive model demonstrated an accuracy of 86.2%, with a sensitivity of 83.6% and a specificity of 91.1% for predicting neurosyphilis. Conclusion:The predictive model for neurosyphilis constructed by combining CSF microprotein and CSF white blood cell count may contribute to the early differential diagnosis of neurosyphilis.

Introduction: Shoulder problems have been a challenge among the aging population. Although reports surfaced on factors affecting shoulder dysfunction, however, such studies in relation to other factors like neck pain (NP) factor are limited especially among the elderly in the urban population. This study investigated the prevalence and factors associated with shoulder complex dysfunction among the outpatient elderly attending private physiotherapy clinics. Methods: A total of 75 elderly aged ≥ 60 years old from four private physiotherapy clinics were recruited by simple random sampling method. The elderly were evaluated using the QuickDASH questionnaire to assess shoulder complex dysfunctions and NP scale. Results: A total of 92% of participants have shoulder complex dysfunction. A positive correlation of NP to shoulder complex dysfunction ( r (75) = 0.83, p<.001) with significant associations of sex ( z= -2.549, p=0.011), smoking ( z= -2.388, p=0.017), lifestyle ( z= -5.780, p=0.000), hypertension ( z= -2.808, p=0.005), osteoarthritis ( z= -2.966, p=0.003), and NP scale ( z= -2.173, p=0.031). The predicting factor of shoulder complex dysfunction is sex (β = 0.156, t (74) = 2.240, p= 0.028) and NP scale (β = 0.704, t (74) = 7.853, p= 0.000). Conclusion: There is a high prevalence of shoulder complex dysfunction among the outpatient elderly attending private physiotherapy clinics with a predicting associating factor of sex and NP.

Objective:To analyze the clinical value and predictive difference of serum Golgi protein 73 (GP73) and serum autophagy-related protein p62 levels in the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (ACLF).Methods:Clinical data of admitted cases to our hospital from October 2018 to April 2020 were retrospectively analyzed. Simultaneously, there were 32 cases with HBV-related ACLF in group A, 65 cases with hepatitis B virus-related cirrhosis in group B and C (Child-Pugh Class A, 34 cases as B group, and Child-Pugh B/C class, 31 cases as group C), and another 30 healthy subjects served as the control group (group D). The serum GP73 and p62 levels of the four selected groups were measured. ACLF group patients were followed up for 3 months to analyze the prognosis of the patients. The serum GP73 and p62 levels of patients who died and survived during hospitalization were compared. The data were analyzed by one-way analysis of variance, independent sample t-test, and Pearson’s correlation analysis. Receiver operating characteristic curve (ROC) was used to analyze the predictive value of GP73 and p62 levels in surviving patients.Results:GP73 levels in the four groups A, B, C and D were (284.30 ± 70.55) ng/ml, (125.33 ± 20.57) ng/ml, (159.82 ± 31.20) ng/ml, and (45.46 ± 10.22) ng/ml, respectively. The p62 levels were (1.30 ± 0.35) ng/ml, (2.88 ± 0.58) ng/ml, (2.02 ± 0.545) ng/ml, and (4.68 ± 1.03) ng/ml, respectively. GP73 detection value was significantly higher in group A than the other three groups ( P < 0.05). Group D had significantly lower value than the other three groups ( P < 0.05), and group C had significantly higher value than group B ( P < 0.05). The detection value of p62 in group A was significantly lower than the other three groups ( P < 0.05). Group D had significantly higher value than the other three groups ( P < 0.05), and group B had slightly higher value than group C, and the differences were statistically significant ( P < 0.05). There was a negative correlation between GP73 and p62 ( r = -0.695, P < 0.001). Survived patients GP73 level in the ACLF group was significantly lower than dead patients [(212.17 ± 22.47) ng/ml and (340.08 ± 32.91) ng/ml, t = 12.493, P < 0.05], and p62 level was significantly higher than dead patients [(1.46 ± 0.28) ng/ml and (1.18 ± 0.35) ng/ml, t = 2.445, P < 0.05]. According to the ROC curve analysis results, the area under the curve (AUC) of GP73 was 0.865, the AUC of p62 was 0.750, and the combined AUC of the both was 0.968. Conclusion:Both GP73 and p62 have a certain predictive value for the short-term prognosis of HBV-related ACLF patients, but the combination of the two indicators has a higher predictive value.

Psoriasis is characterized by abnormal proliferation of keratinocytes, as well as infiltration of immune cells into the dermis and epidermis, causing itchy, scaly and erythematous plaques of skin. The understanding of this chronic inflammatory skin disease remains unclear and all available treatments have their limitations currently. Here, we showed that IMMH002, a novel orally active S1P modulator, desensitized peripheral pathogenic lymphocytes to egress signal from secondary lymphoid organs and thymus. Using different psoriasis animal models, we demonstrated that IMMH002 could significantly relieve skin damage as revealed by PASI score and pathological injure evaluation. Mechanistically, IMMH002 regulated CD3 T lymphocytes re-distribution by inducing lymphocytes' homing, thus decreased T lymphocytes allocation in the peripheral blood and skin but increased in the thymus. Our results suggest that the novel S1P agonist, IMMH002, exert extraordinary capacity to rapidly modulate T lymphocytes distribution, representing a promising drug candidate for psoriasis treatment.

Objective To investigate the effect of hyperbaric oxygen ( HBO ) combined with escitalopram oxalate on the patients with post-stroke depression ( PSD) and the expression levels of serum Hp and retinol-binding protein 4 (RBP4). Methods Sixty patients with PSD treated in the Qingdao Mental Health Center from January 2017 to January 2018 were enrolled as research subjects. By random double-blind lottery method, the patients were divided into the control group and the observation group, each consisting of 30 patients. The patients in the control group were treated only with escitalopram oxalate, while the patients in the observation group received HBO in addition to the treatment received by the control group. The expression levels of monoamine neurotransmitters and inflammatory factors were detected before and after treatment, and the scores of depression and neurological function were assessed as well. At the same time, the expression levels of Hp and RBP4 were also detected. Results Three months after treatment, monoamine neurotransmitter level of the observation group significantly elevated, while inflammatory factor level obviously decreased, with the change rate of the observation group all being higher than those of the control group, and statistical significance could be seen when comparisons were made between the 2 groups (P<0. 05 or P<0. 01). Scores of Montgomery Asberg Depression Rating Scale ( MADRS ) and Chinese Stroke Scale ( CSS ) scores in the observation group were significantly lower than those in the control group, and improvement was superior to that in the control group, and statistical significance could be noticed when comparisons were made between them (P<0. 05 or P<0. 01). The levels of serum Hp and RBP4 in the observation group significantly decreased as compared with those before treatment, and were also lower than those in the control group, also with statistical significance (P<0. 05 or P<0. 01). Conclusion HBO combined with escitalopram oxalate could improve patient depression and clinical efficacy by the approaches of increasing serum monoamine neurotransmitter level and decreasing inflammatory factor and serum Hp/RBP4 levels in the treatment of the patients with post-stroke depression.

Objective To investigate the effect of hyperbaric oxygen ( HBO ) combined with escitalopram oxalate on the patients with post-stroke depression ( PSD) and the expression levels of serum Hp and retinol-binding protein 4 (RBP4). Methods Sixty patients with PSD treated in the Qingdao Mental Health Center from January 2017 to January 2018 were enrolled as research subjects. By random double-blind lottery method, the patients were divided into the control group and the observation group, each consisting of 30 patients. The patients in the control group were treated only with escitalopram oxalate, while the patients in the observation group received HBO in addition to the treatment received by the control group. The expression levels of monoamine neurotransmitters and inflammatory factors were detected before and after treatment, and the scores of depression and neurological function were assessed as well. At the same time, the expression levels of Hp and RBP4 were also detected. Results Three months after treatment, monoamine neurotransmitter level of the observation group significantly elevated, while inflammatory factor level obviously decreased, with the change rate of the observation group all being higher than those of the control group, and statistical significance could be seen when comparisons were made between the 2 groups (P<0. 05 or P<0. 01). Scores of Montgomery Asberg Depression Rating Scale ( MADRS ) and Chinese Stroke Scale ( CSS ) scores in the observation group were significantly lower than those in the control group, and improvement was superior to that in the control group, and statistical significance could be noticed when comparisons were made between them (P<0. 05 or P<0. 01). The levels of serum Hp and RBP4 in the observation group significantly decreased as compared with those before treatment, and were also lower than those in the control group, also with statistical significance (P<0. 05 or P<0. 01). Conclusion HBO combined with escitalopram oxalate could improve patient depression and clinical efficacy by the approaches of increasing serum monoamine neurotransmitter level and decreasing inflammatory factor and serum Hp/RBP4 levels in the treatment of the patients with post-stroke depression.

Objective To observe the effect of Puerarin on the level of tau phosphorylation in the olfactory bulb of Alzheimer's disease rat brain, and explore the underlying molecular mechanism.Methods ① Twenty-two male SD rats were randomly divided into the normal control group, model control group and Puerain-treated group.The levels of tau-1, PS396 and tau-5 in the olfactory bulb were detected by Western blotting.② Twenty male SD rats were randomly divided into model control group, low-dose Puerarin (40 mg·kg-1·d-1), medium-dose puerarin (80 mg·kg-1·d-1) and high-dose puerarin (160 mg·kg-1·d-1) groups.The levels of tau-1 and PS396 phosphorylation in the olfactory bulb were detected by Western blotting.③ The level of GSK-3β phosphorylation in the olfactory bulb of the normal control group, model control group A and puerain-treated group was detected by Western blotting.Results ① It was shown by Western blotting that the relative expression of tau-1 was significantly decreased in the olfactory bulb of the model group A(0.49±0.07)rat brain compared with the normal control group(0.85±0.03)(P<0.01), and the level of tau-1 was obviously higher in the puerarin-treated group(0.58±0.03)compared with that of the model group A(P<0.05).The differences of the levels of tau-5 and PS396 in the olfactory bulb were insignificant among the 3 groups.②Compared with the model group B, the expression of tau-1 in the olfactory bulb was significantly enhanced in the low-, medium-and high-dose of puerarin group: (0.39±0.09)vs(0.69±0.11),(0.55±0.11),(0.70±0.04);and the level of PS396 was significantly decreased in the olfactory bulb of low-dose puerarin group(0.36±0.07) compared with the model group B(0.55±0.05)(P<0.01).③Compared with the normal control group(0.96±0.07), the ratio of pS9-GSK-3β/tGSK-3β was obviously decreased in the olfactory bulb of the model group A(0.51±0.12),while that was significantly increased in the puerarin group(0.62±0.03) compared with the model group A(P<0.01).Conclusion Puerarin can attenuate AD-like tau hyperphosphorylation in the olfactory bulb of Alzheimer's disease rat brains, and decreased activity of GSK-3β might be involved in the effects of puerarin on tau hyperphosphorylation.