Objective To investigate the value of preoperative clinical data and computed tomography angiography (CTA) data in predicting perioperative mortality risk in patients with acute aortic dissection (AAD), and to construct a Nomogram prediction model. Methods A retrospective study was conducted on AAD patients treated at Affiliated Hospital of Zunyi Medical University from February 2013 to July 2023. Patients who died during the perioperative period were included in the death group, and those who improved during the same period were randomly selected as the non-death group using a random number table method. The first CTA data and preoperative clinical data within the perioperative period of the two groups were collected, and related risk factors were analyzed to screen out independent predictive factors for perioperative death. The Nomogram prediction model for perioperative mortality risk in AAD patients was constructed using the screened independent predictive factors, and the effect of the Nomogram was evaluated by calibration curves and area under the curve (AUC). Results A total of 270 AAD patients were included. There were 60 patients in the death group, including 42 males and 18 females with an average age of (56.89±13.42) years. There were 210 patients in the non-death group, including 163 males and 47 females with an average age of (56.15±13.77) years. Multivariate logistic regression analysis showed that type A AAD [OR=4.589, 95%CI (2.273, 9.267), P<0.001], irregular tear morphology [OR=2.054, 95%CI (1.025, 4.117), P=0.042], decreased hemoglobin [OR=0.983, 95%CI (0.971, 0.995), P=0.007], increased uric acid [OR=1.003, 95%CI (1.001, 1.005), P=0.004], and increased aspartate aminotransferase [OR=1.003, 95%CI (1.000, 1.006), P=0.035] were independent risk factors for perioperative death in AAD patients. The Nomogram prediction model constructed using the above risk factors had an AUC of 0.790 for predicting perioperative death, indicating good predictive performance. Conclusion Type A AAD, irregular tear morphology, decreased hemoglobin, increased uric acid, and increased aspartate aminotransferase are independent predictive factors for perioperative death in AAD patients. The Nomogram prediction model constructed using these factors can help assess the perioperative mortality risk of AAD patients.

Aim To investigate the effects of tran-scription factor FoxO1 on acute kidney injury(AKI)induced by ischemic reperfusion injury(IRI)and to explore the underlying mechanisms.Methods Male C57BL/6 mice were randomly divided into four groups:Sham,IRI,FoxO1 inducible cell-specific knockout(FoxO1 icKO),and IRI+FoxO1 icKO.Tamoxifen(25 mg·kg-1)was intraperitoneally injec-ted to specifically knock out FoxO1 in mouse macro-phages,and a unilateral renal IRI model was estab-lished.The levels of serum creatinine(Scr),blood u-rea nitrogen(BUN),Fe2+,malondialdehyde(MDA),reactive oxygen species(ROS),and reduced glutathi-one(GSH)in renal tissues were detected.Hematoxy-lin-eosin(HE)staining was used to observe the patho-logical changes in renal tissues.Quantitative polymer-ase chain reaction(qPCR)was used to detect the mR-NA levels of inflammatory factors such as IL-1β and MCP1 in renal tissues.Western blot was used to detect the expression levels of apoptosis and ferroptosis-relat-ed proteins.Results Compared with the control group,the levels of Scr and BUN in the IRI group were significantly upregulated,the infiltration of inflammato-ry factors IL-1β,TNF-α and MCP1 increased,the pro-tein expressions of Bax/Bc12,cleaved-caspase-3/caspase-3,cytochrome C,and FTH1 in renal tissues were significantly enhanced,while the expression of GPX4 decreased.In addition,the levels of Fe2+,MDA and ROS in the renal cortex of the IRI group signifi-cantly increased,and the level of GSH markedly de-creased(P＜0.05).Compared with the IRI group,the levels of Scr and BUN in the FoxO1 icKO group were significantly reduced,the infiltration of inflammatory factors was alleviated,the expression of apoptosis-relat-ed proteins in renal tissue decreased,the expression level of ferroptosis protein GPX4 increased,and the ex-pression of FTH1 decreased.The levels of Fe2+,MDA and ROS in the renal cortex decreased,and the level of GSH significantly increased(P＜0.05).Conclusion Inducing the specific knockout of FoxO1 in macro-phages can alleviate AKI induced by IRI,and its mech-anism may be related to the inhibition of ferroptosis caused by IRI by FoxO1.

Objective To study the association between serum soluble growth stimulating expression factor 2(sST2),N-terminal pro-B-type natriuretic peptide(NT-probNP),and echocardiographic parameters with myocardial remodeling in patients with heart failure(HF)after acute myocardial infarction(AMI).Methods A total of 120 patients with HF after AMI admitted to the hospital from January 2023 to January 2024 were enrolled.According to the results of echocardiography during a 6-month follow-up,the enrolled patients were divided into a myocardial remodeling group and a non-myocardial remodeling group.Serum sST2,NT-proBNP and echocardio-graphic parameters were compared between groups,and the predictive value on myocardial remodeling was analyzed.Results According to the Killip heart failure classification,the patients were classified into three groups.The sST2,NT-proBNP,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)and left atrial diameter(LAD)showed progressive increase in the three groups,Killip Ⅱ to Killip Ⅳ(P<0.05).Conversely,left ventricular ejection fraction(LVEF)decreased across the three groups(P<0.05).Multivariate analysis found that high sST2,high NT-proBNP and high LAD were independent risk factors of myocardial remodeling in patients with HF after AMI(P<0.05).ROC curve revealed that the area under the curve(AUC)of the nomogram model was 0.82(95%CI:0.71～0.92).Hosmer-Lemeshow goodness of fit test of the model indicated that the chi-square value was 3.67(χ2=3.67,P=0.801),and it was considered that basic consistency was exhibited between the fitted probability value and actual probability value.After 1 000 times of Bootstrap repeated sampling,the calibration curve was drawn and found that the calibration curve had good consistency with the actual curve,and both were close to the ideal curve.Decision curve displayed that the net benefit of patients was higher than that of the other two extreme curves,and when the threshold probability was between 0.16 and 0.94,the model could produce better clinical benefits.Conclusion The nomogram prediction model based on serum sST2,NT-proBNP and echo-cardiographic parameters has high predictive value on myocardial remodeling in HF patients after AMI.

Objective To explore the clinical efficacy and medical costs of high ligation and stripping of the great saphenous vein,simple foam sclerotherapy,and high ligation of the great saphenous vein combined with foam sclerotherapy for treating varicose of great saphenous vein.Methods The clinical data of patients with varicose of great saphenous vein undergoing high ligation and stripping of the great saphenous vein,simple foam sclerotherapy,or high ligation of the great saphenous vein combined with foam sclerotherapy were analyzed retrospectively.The evaluation included efficacy assessment,quality of life evaluation,hospitalization days and costs,postoperative complications,and recurrence after surgery.Results There were no statistical differences in gender,age,disease course and clinical etiology anatomy pathophysiology(CEAP)grading system among the three groups(P＞0.05).The clinical efficacy assessments in all patients among the three groups showed significant effects at 3 and 6 months postoperatively.One patient in the group treated with high ligation of the great saphenous vein combined with foam sclerotherapy suffered deep vein thrombosis of lower extremity after operation.In terms of quality of life,there was no statistically significant difference in venous clinical severity score(VCSS)among the three groups at 3 months postoperatively(P＞0.05).The group treated with simple foam sclerotherapy showed significantly shorter hospitalization days compared with the other two groups.Additionally,the group treated with simple foam sclerotherapy showed lower hospitalization expenses,which was not statistically significant when compared to the group treated with high ligation and stripping of the great saphenous vein group(P＞0.05),but there was a statistical difference compared to the group treated with high ligation of the great saphenous vein combined with foam sclerotherapy(P＜0.05).Conclusion There are no significant differences in clinical efficacy,postoperative pain,and quality of life evaluation among the three methods.However,simple foam scle-rotherapy may reduce the length of hospitalization stay and direct medical costs.

Objective To investigate the characteristics of lens diameter in different axial positions and their rela-tionship with ocular biometric parameters using swept-source optical coherence tomography.Methods A total of 180 pa-tients(180 eyes)with age-related cataract who were scheduled for phacoemulsification combined with intraocular lens im-plantation from July to December 2023 were included,and the operated eyes were used as the observation eyes.The lens diameter data of patients were obtained by scanning at 16 axial positions using the swept-source optical coherence tomo-graphy device CASIA2.The patients were divided into three groups according to the scanning axial positions of the maxi-mum and minimum lens diameters:horizontal group,oblique group,and vertical group.The distribution differences of the maximum and minimum lens diameters among the three groups were compared.Ocular biometric parameters,including ax-ial length(AL),white-to-white distance,anterior chamber depth(ACD),and lens thickness(LT),were measured using the IOL Master 700.Correlation analysis was used to assess the relationship between lens diameter and age,ocular biomet-ric parameters.Multiple linear regression analysis was used to evaluate the impact of age and ocular biometric parameters on lens diameter.Results The maximum lens diameter[10.13(9.20,10.80)mm]was significantly larger than the min-imum lens diameter[9.26(8.21,9.91)mm],with a statistically significant difference(Z=-7.387,P＜0.001).There were no statistically significant differences in the maximum and minimum lens diameters among the three groups(H=1.575,P=0.455;H=0.927,P=0.629).The distribution difference of the maximum lens diameters between the oblique group and the horizontal group was statistically significant(x2=6.035,P=0.014);differences in other group comparisons were not statistically significant(all P＞0.022).The proportion of the maximum lens diameter occurring in the oblique group(55.2％)was significantly higher than that in the horizontal group(38.0％).The maximum lens diameter was more commonly found in the oblique group.The lens diameter was positively correlated with age and LT(rs=0.217,P＜0.05;rs=0.538,P＜0.001),and negatively correlated with ACD(rs=-0.379,P＜0.001).Comparison of standardized regres-sion coefficients(β')showed that LT had the greatest impact on lens diameter,followed by AL;both LT and AL had a sig-nificant positive impact on lens diameter(β'=0.483,P＜0.001;β'=0.314,P＜0.001).Conclusion The distribution frequency of the maximum lens diameter in the oblique group(30°-60° and 120°-150°)was significantly higher than that in the horizontal group.There was a positive correlation between lens diameter and age and LT,and a negative correlation between lens diameter and ACD.Among all the factors affecting lens diameter,LT and AL are the most critical factors,with LT having a more significant impact on lens diameter than AL.

Objective:To analyze the surveillance results of brucellosis in Shanxi Province, to gain a understanding of the epidemic characteristics and changing trend of brucellosis in Shanxi Province, and to provide scientific basis for formulating prevention and control strategies and measures for brucellosis.Methods:The surveillance data of brucellosis in Shanxi Province from Infectious Disease Reporting Information Management System of China Disease Prevention and Control Information System, and the active surveillance results of 5 national brucellosis surveillance sites from 2018 to 2023 were collected for descriptive analysis.Results:From 2018 to 2023, a total of 24 041 cases of human brucellosis were reported in Shanxi Province, with the number of cases increased from 2 800 in 2018 to 5 131 in 2023. The annual reported incidence was 11.22/100 000, ranging from 7.56/100 000 to 14.74/100 000, showing an overall upward trend (χ 2trend = 1 377.43, P < 0.001). The epidemic had affected all counties (cities and districts) in the province, mainly concentrated in Linfen City, Jinzhong City, Datong City, and Shuozhou City, with a total of 13 489 cases of human brucellosis reported, accounting for 56.11%. The population distribution was mainly composed of individuals aged 40 - 69 (17 682 cases), males (18 513 cases), farmers (20 295 cases), and household and unemployed individuals (1 017 cases). The onset of the disease showed obvious seasonality, with the peak time from March to August, accounting for 66.39% (15 961/24 041). A total of 14 130 occupational individuals were investigated at the surveillance sites, and 11 141 underwent serological tests, with a positive rate of 5.25% (585/11 141), including 299 new cases. The positive rate of serological tests was relatively high in Qinyuan County, at 8.51% (241/2 832). Etiological culture was conducted on 338 human blood samples, and 43 strains of Brucella were isolated, with a detection rate of 12.72%. All strains were Brucella melitensis, including 42 strains of Brucella melitensis biovar 3. Conclusions:The overall trend of human brucellosis epidemic in Shanxi Province from 2018 to 2023 is on the rise, and it is still at a high level. It is suggested to continue strengthening monitoring, study the epidemic situation in a timely manner, take comprehensive prevention and control measures, and effectively control the spread of brucellosis.

AIM:This study aims to explore the role of asprosin(ASP)in regulating hepatic lipid anabolic metabolism,as well as the effects of ASP and its downstream pathways on hepatic lipid anabolic metabolism under obesity and exercise intervention.METHODS:To explore the effect of ASP on liver lipid synthesis under physiological condi-tion,5-week-old male C57BL/6J were randomly divided into 4 groups:wild-type(WT)group,WT+ASP group,knockout(KO)group,and KO+ASP group.The mice in KO and KO+ASP groups were ASP gene heterozygous KO mice,and the re-combinant ASP protein was intraperitoneally injected into the mice in WT+ASP and KO+ASP groups for one month before sampling.To explore the role of ASP on liver lipid synthesis under obesity and exercise intervention,5-week-old male C57BL/6J mice were randomly divided into 3 groups:normal control(NC)group,high-fat diet(HFD)group,and HFD+exercise group.After 10 weeks of HFD feeding,the mice in HFD group received no intervention,while those in HFD+ex-ercise group underwent 8 weeks of treadmill exercise intervention.The mice in both groups were fed with HFD during the intervention period.After the interventions,liver tissues were collected from the mice.Western blot and RT-qPCR meth-ods were used to detect the expression levels of ASP,fibroblast growth factor 21(FGF21),nuclear factor E2-related factor 2(NRF2),stearoyl-coenzyme A desaturase 1(SCD1)and fatty acid synthase(FASN)in the mouse liver.ELISA was used to detect the triglycerol(TG)and cyclic adenosine monophosphate(cAMP)levels in the mouse liver,and HE stain-ing and oil red O staining were performed to observe the morphological changes of mouse liver tissues.RESULTS:(1)Compared with WT mice,KO mice exhibited significantly reduced body weight and liver weight,while liver index and he-patic TG levels were significantly increased.The mRNA and protein levels of cAMP,ASP,FGF21 and NRF2 in the liver were significantly decreased,whereas the mRNA and protein levels of SCD1 and FASN were significantly increased.In the WT+ASP group,liver index and hepatic TG levels were significantly reduced,but there were no statistical differences in body weight and liver weight.The mRNA and protein levels of SCD1 and FASN in the liver were significantly de-creased,while the cAMP level and the mRNA and protein levels of NRF2 were significantly increased.The FGF21 mRNA level decreased,but the protein level increased.(2)Compared with KO mice,KO+ASP mice had significantly reduced hepatic TG level,with a certain degree of reduction in liver weight and liver index,but without statistical significance.The cAMP level and the mRNA and protein levels of ASP,FGF21 and NRF2 in the liver were significantly increased,while the mRNA and protein levels of SCD1 and FASN were significantly decreased.(3)Compared with NC mice,HFD mice showed increased body weight,liver weight,and hepatic TG level.The cAMP level and the mRNA and protein levels of NRF2 in the liver were significantly decreased,while the mRNA and protein levels of SCD1 and FASN were significant-ly increased.The FGF21 mRNA level increased,but its protein level decreased.The ASP mRNA level decreased,but its protein level increased.(4)Compared with HFD mice,HFD+exercise mice had significantly reduced body weight,liver weight,and hepatic TG level.The mRNA and protein levels of SCD1 and FASN in the liver were significantly decreased,while the cAMP level and the mRNA and protein levels of NRF2 were significantly increased.The FGF21 mRNA level de-creased,but its protein level increased.The ASP mRNA level increased,but its protein level decreased.CONCLU-SION:(1)The ASP exerts an inhibitory effect on hepatic lipogenesis through the cAMP/FGF21/NRF2 pathway.(2)Un-der HFD feeding condition,the protein expression of FGF21 decreases,leading to our speculation that ASP may develop resistance.Aerobic exercise intervention can attenuate ASP resistance under high-fat condition and alleviate hepatic lipid accumulation caused by HFD.

Aim To investigate the effect of curcumol(Cur)on apoptosis in senescent Hep3B cells induced by XL413.Methods XL413 induced a senescence model in Hep3B cells.Cur intervention was adminis-tered.CCK-8 and Incucyte? assays were used to eval-uate cell proliferation.Senescence-associated beta-gal-actosidase(SA-β-gal)staining was performed to assess cellular senescence.Flow cytometry was employed to detect apoptosis.RT-qPCR was conducted to measure the mRNA expression levels of senescence-associated secretory phenotype(SASP)factors IL-6,IL-8,and CXCL10.Western blot was performed to assess the ex-pression levels of p16,PI3K,p-PI3K,Akt,p-AKT,Bax,and Bcl-2.The ratios of p-PI3K/PI3K,p-Akt/Akt,and Bcl-2/Bax were calculated.Results Fol-lowing XL413 intervention,the proportion of SA-β-gal-positive cells and the expression of p16 protein signifi-cantly increased compared to the control group(P＜0.05),suggesting the successful establishment of the cell senescence model.CCK-8 assay showed that the IC50 values of Cur intervention in Hep3B cells at 24 h,48 h,and 72 h were 106.40 μmol·L-1,54.67 μmol·L-1,and 31.87 μmol·L-1,respectively.Incucy-te? cell proliferation assay demonstrated that the cell proliferation rate was significantly lower in the XL413 group compared to that in the control group(P＜0.05),and further decreased after Cur intervention(P＜0.05)in a concentration-dependent manner.The proportion of apoptotic cells in the Cur group was sig-nificantly higher than that in the XL413 group(P＜0.05),also exhibiting concentration dependence.Cur intervention led to a significant reduction in IL-6,IL-8,CXCL10 mRNA expression levels,as well as p-PI3K/PI3K and p-AKT/AKT ratios compared to the XL413 group(P＜0.05),with a concentration-de-pendent effect.The expression of Bax protein increased(P＜0.05),while Bcl-2 protein expression decreased and the Bcl-2/Bax ratio decreased(P＜0.05)in the Cur group,showing a dose-dependent effect.Conclu-sions Cur has been shown to clear XL413-induced senescent Hep3B cells,reduce their SASP expression and promote apoptosis.The underlying mechanism may be related to the inhibition of the PI3K/AKT signaling pathway.

Objective To investigate the characteristics of lens diameter in different axial positions and their rela-tionship with ocular biometric parameters using swept-source optical coherence tomography.Methods A total of 180 pa-tients(180 eyes)with age-related cataract who were scheduled for phacoemulsification combined with intraocular lens im-plantation from July to December 2023 were included,and the operated eyes were used as the observation eyes.The lens diameter data of patients were obtained by scanning at 16 axial positions using the swept-source optical coherence tomo-graphy device CASIA2.The patients were divided into three groups according to the scanning axial positions of the maxi-mum and minimum lens diameters:horizontal group,oblique group,and vertical group.The distribution differences of the maximum and minimum lens diameters among the three groups were compared.Ocular biometric parameters,including ax-ial length(AL),white-to-white distance,anterior chamber depth(ACD),and lens thickness(LT),were measured using the IOL Master 700.Correlation analysis was used to assess the relationship between lens diameter and age,ocular biomet-ric parameters.Multiple linear regression analysis was used to evaluate the impact of age and ocular biometric parameters on lens diameter.Results The maximum lens diameter[10.13(9.20,10.80)mm]was significantly larger than the min-imum lens diameter[9.26(8.21,9.91)mm],with a statistically significant difference(Z=-7.387,P＜0.001).There were no statistically significant differences in the maximum and minimum lens diameters among the three groups(H=1.575,P=0.455;H=0.927,P=0.629).The distribution difference of the maximum lens diameters between the oblique group and the horizontal group was statistically significant(x2=6.035,P=0.014);differences in other group comparisons were not statistically significant(all P＞0.022).The proportion of the maximum lens diameter occurring in the oblique group(55.2％)was significantly higher than that in the horizontal group(38.0％).The maximum lens diameter was more commonly found in the oblique group.The lens diameter was positively correlated with age and LT(rs=0.217,P＜0.05;rs=0.538,P＜0.001),and negatively correlated with ACD(rs=-0.379,P＜0.001).Comparison of standardized regres-sion coefficients(β')showed that LT had the greatest impact on lens diameter,followed by AL;both LT and AL had a sig-nificant positive impact on lens diameter(β'=0.483,P＜0.001;β'=0.314,P＜0.001).Conclusion The distribution frequency of the maximum lens diameter in the oblique group(30°-60° and 120°-150°)was significantly higher than that in the horizontal group.There was a positive correlation between lens diameter and age and LT,and a negative correlation between lens diameter and ACD.Among all the factors affecting lens diameter,LT and AL are the most critical factors,with LT having a more significant impact on lens diameter than AL.

Aim To investigate the effects of tran-scription factor FoxO1 on acute kidney injury(AKI)induced by ischemic reperfusion injury(IRI)and to explore the underlying mechanisms.Methods Male C57BL/6 mice were randomly divided into four groups:Sham,IRI,FoxO1 inducible cell-specific knockout(FoxO1 icKO),and IRI+FoxO1 icKO.Tamoxifen(25 mg·kg-1)was intraperitoneally injec-ted to specifically knock out FoxO1 in mouse macro-phages,and a unilateral renal IRI model was estab-lished.The levels of serum creatinine(Scr),blood u-rea nitrogen(BUN),Fe2+,malondialdehyde(MDA),reactive oxygen species(ROS),and reduced glutathi-one(GSH)in renal tissues were detected.Hematoxy-lin-eosin(HE)staining was used to observe the patho-logical changes in renal tissues.Quantitative polymer-ase chain reaction(qPCR)was used to detect the mR-NA levels of inflammatory factors such as IL-1β and MCP1 in renal tissues.Western blot was used to detect the expression levels of apoptosis and ferroptosis-relat-ed proteins.Results Compared with the control group,the levels of Scr and BUN in the IRI group were significantly upregulated,the infiltration of inflammato-ry factors IL-1β,TNF-α and MCP1 increased,the pro-tein expressions of Bax/Bc12,cleaved-caspase-3/caspase-3,cytochrome C,and FTH1 in renal tissues were significantly enhanced,while the expression of GPX4 decreased.In addition,the levels of Fe2+,MDA and ROS in the renal cortex of the IRI group signifi-cantly increased,and the level of GSH markedly de-creased(P＜0.05).Compared with the IRI group,the levels of Scr and BUN in the FoxO1 icKO group were significantly reduced,the infiltration of inflammatory factors was alleviated,the expression of apoptosis-relat-ed proteins in renal tissue decreased,the expression level of ferroptosis protein GPX4 increased,and the ex-pression of FTH1 decreased.The levels of Fe2+,MDA and ROS in the renal cortex decreased,and the level of GSH significantly increased(P＜0.05).Conclusion Inducing the specific knockout of FoxO1 in macro-phages can alleviate AKI induced by IRI,and its mech-anism may be related to the inhibition of ferroptosis caused by IRI by FoxO1.