Objective To analyze the changes of levels of serum soluble growth stimulation expressed gene 2 (sST2) and albumin (ALB) in patients with chronic heart failure (CHF) and their correlation with prognosis. Methods The data of 216 patients with CHF (CHF group) and 98 healthy subjects with physical examination (healthy control group) were retrospectively analyzed. The changes in levels of serum sST2 and ALB between both groups and among different grades of New York Heart Association (NYHA), and their correlation with NYHA grading and cardiac function and their diagnostic value on the prognosis in patients with CHF were compared. Results The level of serum sST2 and LVEF value of CHF group were significantly higher than those of healthy control group (P<0.05) while the level of serum ALB was significantly lower than that of healthy control group (P<0.05). There were significant differences in the levels of serum sST2 and ALB and LVEF value among patients with different HYHA grades and pairwise comparison between the any two grades (P<0.05). Serum sST2 level in patients with CHF was positively correlated with NYHA grading (P<0.001) and was negatively correlated with LVEF (P<0.001), and serum ALB level was negatively correlated with NYHA grading (P<0.001), and was positively correlated with LVEF (P<0.001). Serum sST2 level of poor prognosis group was significantly higher than that of good prognosis group (P<0.05) while serum ALB level was significantly lower than that of good prognosis group (P<0.05). ROC curve analysis of serum sST2 combined with ALB in diagnosing poor prognosis in CHF patients showed that the AUC and sensitivity were 0.907 and 98.04%, which were higher than the single diagnosis, and the specificity was 81.82%, which was lower than the single diagnosis. Conclusion The levels of serum sST2 and ALB in patients with CHF are correlated with NYHA grading and cardiac function, and the combination of the two indicators has high diagnostic value on predicting the poor prognosis of patients.

Objective To study the five-year survival status and influencing factors of elderly patients with lung cancer complicated with chronic obstructive pulmonary disease (COPD). Methods A cohort study was conducted to follow up 450 patients with lung cancer and chronic obstructive pulmonary disease who were hospitalized in our hospital from January 2018 to December 2023. The endpoint of the follow-up was the end of a five-year period or death. The Life Tables method was used to calculate survival rates and plot survival curves. The Cox proportional hazards model was used to analyze the influencing factors of five-year survival. Results The results indicated that the overall five-year survival rate of patients was 4.89%, and it decreased year by year. Cox regression analysis showed that age, gender, family functioning, and psychological status significantly influenced patient survival rate (all P<0.05). Stratified analysis found that the smoking status, family functioning, and psychological status of male patients all had an impact on survival rate (all P<0.05), while the psychological status of female patients had a more significant impact on survival (P=0.008). Conclusion This study provides a scientific basis for comprehensive intervention of elderly lung cancer patients with COPD. It is recommended that clinical attention should be paid to psychological and family factors to improve patient prognosis.

Objective To explore the predictive effect of serum 25-hydroxyvitamin D3 [25(OH)D3] and blood lipid metabolism indexes on the occurrence of osteoporosis in type 2 diabetes mellitus (T2DM). Methods Totally 98 patients with T2DM in the hospital from January 2022 to January 2024 were classified into osteoporosis group (38 cases) and non-osteoporosis group (60 cases) by means of concurrent osteoporosis status. The levels of serum 25(OH)D3 and blood lipid metabolism indexes [high density lipoprotein (HDL), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), VLDL] were measured in study subjects. The association of serum 25(OH)D3 and blood lipid metabolism indexes with osteoporosis was explored by Logistic regression analysis. The predictive value of serum 25(OH)D3 and blood lipid metabolism indexes on osteoporosis was analyzed by receiver operating characteristic curve (ROC). Results Serum 25(OH)D3 and HDL levels in the osteoporosis group were lower while TG and LDL levels were higher than those in the non-osteoporosis group (P<0.05). The differences in the levels of TC and VLDL were insignificant between groups (P>0.05). After logistic regression analysis, the levels of serum 25(OH)D3, HDL, TG and LDL were closely related to the occurrence of osteoporosis (P<0.05). ROC curve indicated that the area under the curve (AUC), sensitivity and specificity of combined prediction of osteoporosis by serum 25(OH)D3, HDL, TG, and LDL were 0.943, 92.11% and 85.00%, and the efficiency of combined prediction was better than that of each index alone (P<0.05). Conclusion The levels of serum 25(OH)D3, HDL, TG and LDL in T2DM are closely related to osteoporosis. Early combined monitoring of the indicators can provide reference value for clinical prediction of osteoporosis occurrence in patients with T2DM.

Objective To investigate the sleep status in children with autism spectrum disorder (ASD) and its relationship with executive function and neurodevelopment. Methods The medical records of 346 children with ASD in the hospital from April 2023 to January 2025 were retrospectively collected. The sleep status of children was investigated by Children’ s Sleep Habits Questionnaire (CSHQ). According to the score, the children were divided into good sleep group (CSHQ score<41 points, 189 cases) and sleep disorder group (CSHQ score≥41 points, 157 cases). The general data were compared between groups of children. Chinese version of Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P) and developmental behavior assessment scale of children aged 0-6 years (Children's psychological scale-II) were used to analyze the relationship between sleep status and executive function and neurodevelopment in children with ASD. Results The CSHQ score of 346 children was (39.08±3.24) points, including 157 cases with CSHQ score≥41 points and 189 cases with CSHQ score<41 points. The proportion of severe previous medical history and executive function score in sleep disorder group were significantly higher than those in good sleep group, and the evaluation result of developmental quotient was lower than that in good sleep group (P<0.05). Logistic regression analysis showed that executive ability and neurodevelopment were closely related to sleep status in children with ASD (P<0.05). Spearman correlation analysis showed that sleep status in children with ASD was negatively correlated with executive function (r=-0.456, P<0.05), and was positively correlated with the developmental quotient (r=0.547, P<0.05). Conclusion The incidence rate of sleep disorder is high in children with ASD, and sleep status is closely related to executive function and neurodevelopment. Clinically, it is necessary to pay attention to the sleep problems in children with ASD, and take effective intervention measures to improve the sleep quality of children and promote the training of executive function and neurodevelopment.

Objective To explore the current situation of disease perception in patients with tophi and its correlation with the quality of life. Methods A retrospective analysis was conducted on 303 gout patients admitted to the Shanghai Sixth People's Hospital from January 2023 to December 2024. The patients were classified into tophi gout (n=150) and non-tophi gout (n=153) groups based on whether they were tophi gout or not. The current disease perception status and quality of life of the two groups were compared using Simplified Chinese Version of the Disease Cognition Questionnaire (BIPQ) and Short Form of Health Survey (SF-36). Logistic regression was used to analyze the influencing factors of the quality of life of patients with tophi gout. Results Compared with the non-tophaceous gout group, the tophaceous gout group had a higher BIPQ score, and a lower SF-36 score (P<0.05). Among patients with tophaceous gout, 80 cases had good quality of life, and 70 cases had poor quality of life. These patients were included in the good quality of life group (n=80) and the poor quality of life group (n=70), respectively. Compared with the good quality of life group, patients in the poor quality of life group had longer gout course and average duration of each gout attack, as well as higher 20-item tophi impact questionnaire (TIQ-20) score and BIPQ score (P<0.05). Logistic regression analysis showed that the course of gout (OR=1.070, 95% CI: 1.017-1.126, P=0.009), TIQ-20 score (OR=1.048, 95% CI: 1.022-1.075, P<0.001), and BIPQ score (OR=1.055, 95%CI: 1.009-1.104, P=0.019) were risk factors affecting the quality of life in patients with tophaceous gout (P<0.05). Conclusion The course of gout, TIQ-20 score and BIPQ score are risk factors affecting the quality of life of patients with tophi gout.

Objective To construct a recombinant vector for Mycobacterium tuberculosis(Mtb) Rv2153c(MurG), express it in prokaryotic cells, and then immunize C57 BL/6 mice to assess the immunogenicity.Methods The recombinant vector pProRv2153c was constructed, expressed in prokaryotic cells and purified. The purified product was identified by SDS-PAGE and Western blot, and the levels of related cytokines in peripheral blood of Chinese Mtb infected patients induced by recombinant Rv2153c protein were measured by multiplexed microsphere-based flow cytometric assay(MFCIA). The female C57 BL/6 mice were randomly divided into PBS, Rv2153c/SAS subunit vaccine, SAS and BCG groups with 6 mice in each group. After 9 weeks of immunization, the levels of specific antibodies in peripheral blood and secreted cytokines in splenocyte supernatant were detected.Results The recombinant vector pPro-Rv2153c was constructed correctly as identified by double enzyme digestion. The expressed Rv2153c protein had a relative molecular mass of about 43 200, and had specific reaction with Monoclonal Mouse Anti-His Tag and MurG Antibody. After stimulation with recombinant Rv2153c protein, the levels of IFNγ, TNF-α and IL-6 in subjects with active pulmonary tuberculosis(ATB) were significantly higher than those in latent tuberculosis infection(LTBI) and healthy control(HC) subjects. The serum specific antibody titers in Rv2153c/SAS group were significantly higher than those in the rest of the groups, and the ratio of IgG2a to IgG1 was greater than 1. In addition, the levels of secreted IFNγ, TNF-α and IL-2 in splenocyte supernatant of Rv2153c/SAS group were also significantly higher than those of other groups.Conclusion The recombinant Rv2153c protein can be specifically recognized by peripheral blood T cells of subjects infected with Mtb in China, and can induce strong antigen-specific Th1-type cellular immune response in the combined adjuvant SAS immunized mice, confirming the possible use of Rv2153c as a candidate target antigen for novel TB vaccine.

Introduction: Staphylococcus aureus is the leading biofilmforming microorganisms in orthopaedic implant infections. The biofilms formed are difficult to eradicate and resistance to antibiotics. This current study aims to determine the effectiveness of povidone-iodine; an antiseptic solution in eradicating S. aureus biofilm on stainless steel alloy. In addition to the usual Colony-Forming Unit (CFU) used for verification, Scanning Electron Microscope (SEM) is used to validate the formation and eradication of the biofilms. Materials and methods: This is an in vitro study where the biofilm is formed by inoculating clinically isolated S. aureus, incubated for 24 hours onto stainless steel alloy 316L implants. The implants are then irrigated using povidoneiodine solution with varying concentrations (5 and 10%) and durations (30, 60, and 180 seconds). The anti-biofilm effect was evaluated using plating and SEM methods to confirm its effectiveness. The process is repeated after 24 hours of postirrigation reincubation to detect any rebound growth. Results: No biofilm seen after irrigation with povidoneiodine at 5% and 10% concentrations at 30, 60 and 180 seconds, respectively, in both CFU count and SEM. This result is replicated after 24 hours of reincubation, in assessing for rebound growth. Conclusion: Our study supports that a minimum of 5% povidone-iodine with a minimum irrigation time of 30 seconds are effective at eliminating S. aureus biofilm on stainless steel alloy implants. Both CFU count and SEM yield similar value in validating the presence of biofilm. Additionally, SEM allows visualisation of the morphology of the biofilm.

Introduction: The occurrence of rotator cuff tendinopathy, which is invariably symptomatic, increases as populations age, being largely observed among patients with diabetes. The objective of the present study is to find out the occurrence of rotator cuff tendinopathy in elderly diabetic patients who were asymptomatic, composed of healthy individuals and those with diabetes mellitus. Materials and methods: The participants in this study included 87 elderly diabetic patients and 56 controls (mean age: 69.3±4.9 and 71.8±3.6, respectively), who were asymptomatic from shoulder. All patients, including, underwent shoulder MRI examination using 1.5 tesla MRI. Results: We recorded greater tendons thickness in the diabetic patients as compared with the controls (supraspinatus tendon: 6.6±0.7mm vs 5.3±0.8mm, p<0.001; biceps tendon: 3.9±0.7mm vs 3.1±0.8mm, p<0.002). Moreover, higher incidence of supraspinatus tendon tear was noted in diabetics as compared to biceps tendon (major tears: 32 (36.7%) vs 6 (10.7%), p=0.052; minor tears: 51 (58.6%) vs 11 (19.6%), p=0.032). Conclusions: The present study suggests that age-related rotator cuff tendinopathy is more prevalent among patients with diabetes. Therefore, MRI is an investigation of choice for early detection i.e., at pre-symptomatic stages of rotator cuff tendinopathy, as the patients may develop symptoms later. Keywords: asymptomatic

Introduction: With surgical advancements and improved implants and instrumentation, nailing is the procedure of choice in subtrochanteric fractures. However, failure in achieving reduction of the multidirectional displacement of the fragments prior to passing the nail, contributes to delayed/non-unions at the fracture site leading to implant failures. In this study, we aim to analyse the factors affecting union of closed subtrochanteric fractures treated by nailing. Materials and methods: In this retrospective study, closed subtrochanteric fractures treated with cephalomedullary nailing between 2015 and 2019 were included. Demographic, surgical and radiological data were retrieved and analysed. A total of 60 cases were eligible to be included in the study. Results: Majority of patients were male (50), with a mean age of 46.07±16.40 years. Twenty-two fractures were multifragmentary having a separate butterfly fragment. In 27 patients mini-open technique was used to get the anatomical alignment and to hold reduction until fixation. Overall, the mean time for union was 7.63±5.85 months. We had nine delayed unions and eight non-unions. Varus alignment in the coronal plane of more than 8.5° was the only significant factor associated with delayed or non-union apart from loss of medial continuity. Conclusion: We recommend achieving fracture reduction with less than 8.5° of varus malalignment in the coronal plane. Varus malalignment is poorly tolerated in fractures at this region. To achieve this, we suggest having a very low threshold to minimally open the fracture site for reduction of these fractures, which does not have any negative effect on the fracture union.

Patellar tendon rupture is an uncommon but serious complication that results in loss of knee extension during and after total knee arthroplasty (TKA), significantly impacting the patient’s quality of life. Various surgical treatments, ranging from initial repair to reconstruction, are available and accessible. In recent years, the peroneus longus tendon autograft has been utilised to restore the knee extensor system. The purpose of this case report was to present the case of a patient who had a traumatic patellar tendon rupture following TKA and requiring surgery along with peroneus tendon augmentation. A 71-year-old woman underwent bilateral robotic-assisted cruciate retaining TKA for a Grade IV arthritic knee. Post surgery, on day five patient had a history of a fall at home, following which she was unable to extend her knees. On evaluation through ultrasonography and radiographs, she was found to have a ruptured patellar tendon and sprain of the medial collateral ligament. Primary repair of the tendon along with augmentation with the peroneus tendon was performed, and the patient was followed for 12 months, at the end of which, the patient was able to achieve a good functional outcome. In conclusion, early results from patellar tendon reconstruction using an ipsilateral peroneus longus tendon autograft following TKA suggest that this technique is effective for managing acute post-traumatic patellar tendon rupture. It facilitates early recovery, yields favourable outcomes, and may reduce the risk of infection.