Objective To investigate the effects of dapagliflozin on the risk of malignant ventricular arrhythmia(MVA)during hospitalization in patients with acute myocardial infarction(AMI).Methods A retrospective study was conducted to select patients with AMI who underwent percutaneous coronary intervention(PCI)in the department of cardiology of the Third Affiliated Hospital of Nanjing Medical University between January 2018 and November 2023.Clinical datas collected during hospitalization included demographics(gender,age),baseline vital signs(systolic blood pressure,diastolic blood pressure,heart rate),comorbidities(hypertension,diabetes mellitus),body mass index(BMI),smoking,alcohol consumption,ST segment elevation myocardial infarction(STEMI),Killip class≥3,laboratory parameters[white blood cell count(WBC),neutrophil percentage(NEU%),serum creatinine(SCr)],procedural data(number of coronary stents implanted,culprit vessels being the left main coronary artery,left anterior descending artery,right coronary artery,left circumflex artery and intraoperative hypotension),medications[angiotensin converting enzyme inhibitor/angiotensinⅡreceptor blocker(ACEI/ARB),β-blockers,aspirin,ticagrelor,clopidogrel,platelet glycoproteinⅡb/Ⅲa receptor antagonists,Statin],and electrocardiogram characteristics[the number of cases frequent ventricular premature contractions(premature beats)and the number of cases of sinus rhythm].The study endpoint was the occurrence of MVA during hospitalization among enrolled patients.Patients were categorized into the MVA group and the non-MVA group based on the occurrence of MVA during their hospital stay.Differences in clinical characteristics between the two groups were compared.Univariate and multivariate Logistic regression analyses were employed to evaluate the impact of dapagliflozin use on the risk of MVA in patients with AMI.Results A total of 2 893 eligible AMI patients were enrolled and 145 patients(5.01%)experienced MVA during hospitalization.Compared with the MVA group,the proportion of patients taking dapagliflozin was higher in the non-MVA group[13.2%(363/2 748)vs.6.2%(9/145),P=0.014],the proportion of males was higher[74.3%(2 042/2 748)vs.66.9%(97/145),P=0.048],the age was younger(years:64.82±13.91 vs.69.78±14.07,P<0.001),the heart rate at admission was slower(beats/min:80.09±15.72 vs.84.31±20.92,P=0.002),the proportion of patients with Killip grade≥3 was lower[11.5%(317/2 748)vs.38.6%(56/145),P<0.001],the proportion of smoking patients was higher[48.0%(1 319/2 748)vs.33.8%(49/145),P<0.05],SCr level was lower(μmol/L:84.73±58.52 vs.102.87±59.47,P<0.001),and the proportion of patients taking ACEI/ARB and β-blockers was higher[64.9%(1 783/2 748)vs.49.0%(71/145),65.1%(1 788/2 748)vs.53.8%(78/145),both P<0.05],the rate of frequent premature ventricular beats was lower[1.0%(28/2 748)vs.11.7%(17/145),P<0.05],and the proportion of patients with intraoperative hypotension was lower[3.2%(86/2 748)vs.10.6%(15/145),P<0.05].After adjusting numerous confounding factors,multifactorial Logistic regression analysis showed that dapagliflozin may significantly reduced the risk of MVA in patients with AMI after PCI[odds ratio(OR)=0.417,95%confidence interval(95%CI)was 0.200-0.880,P=0.022].Subgroup analysis suggested that there were 1 042 AMI patients with diabetes mellitus,of whom 348 took dapagliflozin,and 8 patients(2.30%)had MVA.The risk of MVA was reduced in patients taking dapagliflozin(Log-Rank:χ2=11.983,P=0.001).Conclusion The use of dapagliflozin significantly reduced the risk of MVA during hospitalization in patients with AMI.

Objective To observe the value of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies.Methods Totally 118 fetuses with intracranial anomalies diagnosed through cranial MRI/induced labor specimen dissection who underwent prenatal ultrasound examination were retrospectively enrolled.Two-dimensional,three-dimensional ultrasound and microvascular flow imaging manifestations of fetal intracranial anomalies were observed,and the accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was analyzed.Results The accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was 93.22％(110/118),of isolated and non-isolated intracranial anomalies was 97.47％(77/79)and 84.62％(33/39),respectively.Six fetuses were missed diagnosis of malformations of cortical development(1 fetus of tuberous sclerosis,4 of abnormal morphology of the sulci gyrus and 1 of schizencephaly)and 1 fetus of intracranial softening lesion,while posterior fossa arachnoid cyst in 1 fetus was misdiagnosed as mega cisterna magna.Conclusion The accuracy of three-dimensional ultrasound combined with microvascular flow imaging for prenatal diagnosis of fetal intracranial anomalies was relatively high.

Objective To observe prenatal ultrasonic findings of fetal malformation of cortical development(MCD).Methods Totally 37 singleton fetuses with MCD diagnosed by fetal cranial MRI and/or genetic examination were retrospectively enrolled,and prenatal ultrasonic manifestations were observed.Results Among 37 fetuses,29(29/37,78.38％)were found with abnormal Sylvian fissure,26(26/37,70.27％)with widened/asymmetrical lateral ventricles,22(22/37,59.46％)with abnormal surface sulci,14(14/37,37.84％)with abnormal cavity of septum pellucidum(CSP)/corpus callosum(CC),11(11/37,29.73％)with midline deviation/curvature,11(11/37,29.73％)with widened subarachnoid space,10(10/37,27.03％)with head circumference＜2 standard deviation below mean value,9(9/37,24.32％)with abnormalities in the cerebellar hemisphere/vermis,7(7/37,18.92％)with abnormal echoes in the brain parenchyma,7(7/37,18.92％)with midline cysts and 2(2/37,5.41％)with enlarged ganglion eminence.Conclusion Fetal MCD mainly presented as abnormal Sylvian fissure,widened/asymmetrical lateral ventricles and abnormal surface sulci,which might accompanied by abnormal CSP/CC,midline deviation/curvature,widened subarachnoid space and abnormal head circumference in prenatal ultrasound.

Ultrasound is the preferred imaging method for assessing fetal cranial development.In recent years,significant progresses have been made in imaging technology,resolution and diagnostic accuracy of fetal neurological ultrasound,providing important basis for prenatal diagnosis and prognosis evaluation in clinical practice.The new advances in fetal neurological ultrasound examination were reviewed in this article.

Purpose To investigate the expression and clinical significance of the embryonic lethal abnormal vi-sion-like(ELAVL)family in glioma.Methods Pan-cancer and glioma-specific analyses of mRNA expression profiles of the ELAVL family were analyzed using the TCGA and GTEx databases.The association between ELAVL family ex-pression and survival of glioma patients was evaluated via the gene expression profiling interactive analysis 2(GEPIA2)database.The expression level of ELAVL2 protein in human glioma tissues and non-tumor control brain tissues was ver-ified by immunohistochemistry,and the relationship between its expression and prognosis was analyzed based on the fol-low-up data of patients.Western blot was performed to assess ELAVL2 protein levels in human immortalized astrocytes of UC2 and seven glioma cell lines.Overexpression of ELAVL2 in glioma cells was achieved to evaluate its impact on cell proliferation using in vitro assays.Results Compared to normal tissues,the ELAVL family exhibited distinct ex-pression patterns across various cancers.In glioma,ELAVL1 was significantly upregulated,while ELAVL2,ELAVL3 and ELAVL4 were markedly downregulated.Survival analysis revealed that low ELAVL2 expression was an independent prognostic factor for poor survival in glioma patients(P＜0.05).Immunohistochemistry confirmed that the expression of ELAVL2 decreased with the increase of glioma grade,and its low expression indicated a poor prognosis for patients(P＜0.001).Overexpression of ELAVL2 inhibited glioma cell proliferation in vitro(P＜0.001),suggesting its tumor-suppressive role.Conclusion The ELAVL family members play a critical role in glioma progression.ELAVL2 downregulation serves as a marker for adverse clinical outcomes and represents a potential therapeutic target for glioma therapy.

Objective:To explore the relationship between life events, anxiety, depression, and behavior problems in adolescents.Methods:From September to October 2022, the cluster sampling method was used to select 5 341 adolescents from 4 middle schools in Xinxiang urban area.The subjects and their parents were investigated by the adolescent self-rating life events check list (ASLEC), generalized anxiety disorder scale (GAD-7), patient health questionnaire (PHQ-9), and child behavior checklist (CBCL). SPSS 27.0 software was used for Spearman correlation analysis, and AMOS 28.0 software was used to construct the structural equation model.Results:The scores of anxiety, depression, and behavioral problems were 1 (0, 4), 1 (0, 4), and 3 (0, 10). The total score of life events was 5 (1, 13), and the dimensions scored as follows: interpersonal conflict 1 (0, 4), academic pressure 2 (0, 5), punishment 0 (0, 2), loss 0 (0, 0), health and adaptation problem 0 (0, 1), and others 0 (0, 2). There were positive correlations between life events and its dimensions, depression, anxiety and behavioral problems ( r=0.28-0.69, all P<0.01). In the overall population, anxiety and depression played parallel mediating roles in the impact of life events on behavior problems. Life events could positively predict anxiety ( β=0.68, P<0.01), and anxiety could positively predict behavior problems ( β=0.04, P=0.02). Life events could positively predict depression ( β=0.77, P<0.01), and depression could positively predict behavior problems ( β=0.18, P<0.01). The standardized total effect size of the impact of life events on behavioral problems was 0.622 (95% CI=0.564-0.675). The standardized direct effect size and indirect effect size were 0.460 (95% CI=0.374-0.539) and 0.162 (95% CI=0.108-0.218), accounting for 74.0% and 26.0%of the total effect, respectively. After stratification by gender, the results for male adolescents were consistent with the overall population, while the mediating effect of anxiety was not significant in the female adolescents. Conclusion:Life events can lead to anxiety and depression in adolescents, thereby increasing the risk of behavior problems.

Abdominal aortic aneurysm(AAA)is characterized by a localized and irreversible enlargement of the abdominal aorta,which poses a significant risk to life in the event of rupture.Currently,the primary treatment for AAA is surgical intervention,as there are no effective pharmacological therapies available to prevent or slow postoperative vascular dilation.Therefore,understanding the detailed pathogenesis of AAA and identifying effective prevention and treatment strategies is essential.This review begins by examining the pathological and molecular mechanisms involved in AAA,fo-cusing on key research areas such as the phenotypic switching of vascular smooth muscle cells,inflammation and metabolic reprogramming.Based on a large of animal and clinical studies,this review then explores therapeutic strategies and prom-ising drugs for AAA,including mesenchymal stem cell therapy,nanomaterial applications,and immunomodulatory inter-ventions.The review aims to provide researchers with new ideas and directions for the prevention and treatment of AAA.

Purpose To investigate the expression and clinical significance of the embryonic lethal abnormal vi-sion-like(ELAVL)family in glioma.Methods Pan-cancer and glioma-specific analyses of mRNA expression profiles of the ELAVL family were analyzed using the TCGA and GTEx databases.The association between ELAVL family ex-pression and survival of glioma patients was evaluated via the gene expression profiling interactive analysis 2(GEPIA2)database.The expression level of ELAVL2 protein in human glioma tissues and non-tumor control brain tissues was ver-ified by immunohistochemistry,and the relationship between its expression and prognosis was analyzed based on the fol-low-up data of patients.Western blot was performed to assess ELAVL2 protein levels in human immortalized astrocytes of UC2 and seven glioma cell lines.Overexpression of ELAVL2 in glioma cells was achieved to evaluate its impact on cell proliferation using in vitro assays.Results Compared to normal tissues,the ELAVL family exhibited distinct ex-pression patterns across various cancers.In glioma,ELAVL1 was significantly upregulated,while ELAVL2,ELAVL3 and ELAVL4 were markedly downregulated.Survival analysis revealed that low ELAVL2 expression was an independent prognostic factor for poor survival in glioma patients(P＜0.05).Immunohistochemistry confirmed that the expression of ELAVL2 decreased with the increase of glioma grade,and its low expression indicated a poor prognosis for patients(P＜0.001).Overexpression of ELAVL2 inhibited glioma cell proliferation in vitro(P＜0.001),suggesting its tumor-suppressive role.Conclusion The ELAVL family members play a critical role in glioma progression.ELAVL2 downregulation serves as a marker for adverse clinical outcomes and represents a potential therapeutic target for glioma therapy.

This article comprehensively discusses the concept of workplace ostracism, measurement tools, theoretical basis, the current situation of workplace ostracism among nurses, and research on related variables. It proposes targeted strategies to address workplace ostracism among nurses, aiming to reduce the occurrence of workplace ostracism incidents among nurses. This is of great significance for constructing a harmonious work environment and promoting individual mental health.

Objective:To explore the impact of disease perception control on preoperative self-preparation in patients with carotid artery stenosis, and analyze the mediating role of resourcefulness.Methods:Using convenience sampling, 157 patients with carotid artery stenosis were selected from three tertiary hospitals in Shandong Province between January 2022 and November 2024. Data were collected using a General Information Questionnaire, Brief Illness Perception Questionnaire, Resourcefulness Scale, and Preoperative Self-readiness Scale in Patients Undergoing Elective Surgery. Pearson correlation analysis was conducted to examine the relationships among preoperative self-preparation, resourcefulness, and disease perception control. A mediation model was constructed using the PROCESS macro to investigate the mediating effect of resourcefulness between disease perception control and preoperative self-preparation, with Bootstrap method used for testing mediation effects.Results:A total of 157 questionnaires were distributed, with 147 valid responses received (93.63% response rate). The preoperative self-preparation score for carotid artery stenosis patients was (65.02±23.35). Disease perception control directly influenced preoperative self-preparation and indirectly affected preoperative self-preparation through resourcefulness. The mediation effect accounted for 48.88% of the total effect (-0.807/-1.651) .Conclusions:The results of this study show that both disease perception control and resourcefulness significantly influence preoperative self-preparation in patients with carotid artery stenosis. Future research should further investigate these factors to improve preoperative self-preparation through the enhancement of disease perception control and resourcefulness.