Objective To explore the correlation between nutritional status and frailty in elderly patients with cardiovascular disease (CVD), and to provide suggestions for the prevention of frailty occurrence in elderly patients with CVD. Methods A retrospective study was conducted on 357 elderly CVD patients who were admitted to the Third Affiliated Hospital of Chengdu Medical College from May 2024 to July 2024. These patients were divided into a frailty group and a non-frailty group based on the presence or absence of frailty. Data on the patients' nutritional status indicators [body mass index (BMI), weight loss, calf circumference, albumin, and grip strength], general demographic and clinical data, laboratory and physiological indicators, and functional and activity indicators were collected. The influencing factors of frailty and the correlation between nutritional status indicators and frailty were analyzed. Results Among the 357 patients, 69 cases (19.33%) were detected with frailty, while 288 (80.67%) were without frailty. Multivariate logistic regression analysis revealed that age (OR=1.120, 95% CI: 1.023–1.225) and weight loss (OR=2.776, 95% CI: 1.145–6.732) were risk factors influencing the occurrence of frailty in elderly CVD patients (P<0.05), while grip strength (OR=0.902, 95% CI: 0.831–0.980), albumin level (OR=0.892, 95% CI: 0.806–0.988), and calf circumference (OR=0.900, 95% CI: 0.829–0.978) were protective factors of frailty occurrence in elderly CVD patients (P<0.05). Conclusion The incidence rate of frailty is relatively high in elderly patients with CVD. Age and weight loss are independent risk factors for frailty, while high grip strength level, high albumin level, and large calf circumference are independent protective factors of frailty.

Objective: To explore the relative importance of different food attributes and levels in food decision making of school aged children, and to understand their meal preferences, so as to provide the evidence for formulating precise intervention strategies for dietary behaviours of school aged children. Methods: From May to June 2024, a total of 854 children aged 11 to 15 years old were selected from 2 middle schools (each school in urban and rural areas) in both Hubei Province and Anhui Province by stratified cluster random sampling method to conduct a D-optimal discrete choice experiment. The mixed Logit model was used to analyze children s preference for meal attributes and different levels, and to calculate the relative importance (RI) of attributes and willingness to pay (WTP) in meal choices. Results: The included five food attributes had statistical significance on meal choice of school aged children ( P <0.05). The relative importance of food attributes affecting the meal choices of school aged children in descending order were dining mode ( RI =31.26%), food varieties ( RI =30.56%), cooking method( RI =23.84%), taste( RI =8.06%) and price ( RI =6.27%). Among them, school aged children preferred home cooked meals ( β =0.74) (WTP=86.3 yuan),varied foods(grain/tubers+vegetables+fish, meat, eggs and beans) ( β =0.61) (WTP=71.9 yuan), fried/roasted cooking ( β =0.51) and spicy taste ( β =0.33).Price was negatively correlated with meal choices( β =-0.01) ( P <0.05). Based on residential area and body mass index (BMI), the stratified analysis showed that dining mode was highest in the relative importance for rural children with overweight and obese children ( RI =31.28%,34.17%), both of whom preferred home cooked meals ( β =0.76, 0.91), and meals containing fish, meat, eggs and beans with grain/tubers or grain/tubers and vegetables in terms of food choice (area: β =0.53, 0.53 ; BMI: β =0.55, 0.56) ( P <0.05). Conclusions School aged children have different preferences for different attributes of meals. The quality of school meals should be improved,the cost of buying healthy meals should be reduced,targeted family health education should be carried out,and healthy cooking methods should be advocated.

Objective:To investigate the effect of nuclear receptor subfamily 2 group F member 2(NR2F2)on the biological behaviors of human ovarian cancer SKOV3 cells,and to clarify its molecular mechauism and provide the new idea for treatment of ovarian cancer.Methods:Gene Expression Profiling Interactive Analysis(GEPIA)Database analyse the expression level of NR2F2 gene in ovarian tissue,and analyse its correlation with clinical prognosis of ovarian cancer patients.The human ovarian cancer SKOV3 cells were divided into control group and NR2F2 over-expression(NR2F2 OE)group,which were transfected with mCherry control virus and NR2F2 OE over-expression virus,respectively,when the cell deusity reached 70％,and the stable transfection SKOV3 cell lines were screened with puromycin(puro)48h lafter.Real-time fluorescence quantitative PCR(RT-qPCR)and Western blotting methods were used to detect the transfection efficiencies of the cells;RT-qPCR method was used to detect the expression levels of NR2F2 and sex-determining region Y-box 2(SOX2)mRNA in the cells in two groups;Western blotting method was used to detect the expression levels of NR2F2,ATP-binding cassette superfamily G member 2(ABCG2),and programmed cell death 1-ligand 1(PD-L1)protcins in the cells in two groups.CCK-8 assay was used to detect the proliferation activities of the cells in two groups;Wound assay was used to detect the migration rates of the cells in two groups;Transwell chamber assay was used to detect the number of transmembrane cells;Spheroidization assay was used to detect the numbers of spheroids in the cells;peripheral blood mononuclear cells(PBMCs)-mediated tumor cell killing assay was used to detect the relative densities of surviving tumor cells;CCK-8 assay was used to detect the half maximal inhibitory concentration(IC50)of paclitaxel(PTX)and carboplatin(CBP).Results:Compared with normal ovarian tissue,the expression level of NR2F2 gene in ovarian tumor tissue was decreased(P＜0.05),and decreased with the improvement of clinical pathological grading of ovarian tumor.The patients with higher expression level of NR2F2 gene had better clincal prognosis.The SKOV3 cells with NR2F2 over-expresson were successfully constructed,and the expression levels of NR2F2 mRNA and protein in the cells in NR2F2 OE group were increased compared with control group(P＜0.001).The CCK-8 assay results showed that compared with control group,the proliferation activities of the cells in NR2F2 OE group were decreased at different time points(1,2,3,and 4 d)(P＜0.05 or P＜0.01).The cell wound assay results showed that compared with control group,the migration rate of the cells in NR2F2 OE group was decreased(P＜0.001).The Transwell assay results showed that compared with control group,the number of transmembrane cells in NR2F2 OE group was decreased(P＜0.01).Compared with control group,the number of the spheroids in NR2F2 OE group was decreased(P＜0.05),and the expression levels of SOX2 mRNA(P＜0.01)and protein(P＜0.001)were increased.Compared with control group,the relative density of surviving tumor cells in NR2F2 OE group was decreased,but the difference was not significant(P＜0.05),and the expression level of PD-L1 protein was decreased(P＜0.05).Compared with control group,the proliferation activities of cells in NR2F2 OE group were decreased(P＜0.05),and the drug sensitivities of the cells to PTX and CBP were enhanced(P＜0.05);the IC50 of PTX was significantly reduced,while the IC50of CBP could not be calculated due to excessively high drug concentration;the expression level of ABCG2 protein was decreased(P＜0.05).Conclusion:The over-expression of NR2F2 may inhibit the proliferation,migration,and invasion of the human ovarian cancer SKOV3 cells,decrease the expression levels of SOX2,PD-L1 and ABCG2 proteins,suppress the stemness and immune evasion ability of the SKOV3 cells,and enhance the sensitivities of the SKOV3 cells to PTX and CBP.

Objective Sleep is an important physiological process for maintaining normal cognitive functions,but with the accelerated pace and increased work pressure in modern society,sleep deprivation has become a common phenomenon.It has been shown that sleep deprivation interferes with higher cognitive functions such as working memory,but the specific mechanism of its effect is still not completely clear.The present study aimed to systematically investigate the effects of 36 hours of sleep deprivation on the stages of the working memory processing chain and its neural mechanisms through behavioral and event-related potential(ERP)techniques.Methods Using a randomized controlled experimental design,48 healthy adult subjects were recruited and randomly assigned to sleep deprivation and control groups.All subjects completed a 2-back phonological working memory task,and behavioral data(response time and correctness)and ERP data(P2,N2,and P3 component wave amplitudes)were collected at 0 and 36 hours,respectively.The effects of sleep deprivation on working memory behavioral performance and neurophysiological indices were assessed by ANOVA.Results Behavioral results showed that the sleep deprivation group had a significantly longer response time after 36 hours,but no significant decrease in correctness,indicating a decrease in response efficiency but stable accuracy.ERP results showed that P2 amplitude did not change significantly before and after sleep deprivation,indicating that the early perception and categorization stages were limitedly affected by sleep deprivation;whereas,N2 and P3 amplitudes decreased significantly after sleep deprivation,reflecting that later cognitive processing such as conflict monitoring and resource allocation and other late cognitive processing were significantly disturbed.Conclusion Through ERP technology,this study uncovers the phased impact of 36-hour sleep deprivation on the working memory processing chain.The study found that early perceptual and categorization stages may be less susceptible to the effects of sleep deprivation,likely due to their relatively automatic processing and lower demand for cognitive resources.In contrast,during later stages of cognitive processing,particularly in higher-order functions such as conflict monitoring and resource allocation,sleep deprivation significantly impaired task performance efficiency by disrupting prefrontal cortex function.This finding deepens the understanding of the mechanisms underlying the effects of sleep deprivation and provides a scientific basis for cognitive intervention and management strategies in high-stress occupational groups.Future studies can further explore the long-term effects of sleep deprivation and its neural mechanisms by combining multimodal techniques.

OBJECTIVE: To assess the feasibility of first polar body transfer (PB1T) combined with preimplantation mitochondrial genetic testing for blocking the transmission of a pathogenic mitochondrial DNA 8993T>G mutation. METHODS: A Chinese family affected with Leigh syndrome which had attended the Reproductive Medicine Centre of the First Affiliated Hospital of Anhui Medical University in September 2021 was selected as the study subject. Controlled ovarian hyperstimulation was carried out for the proband after completing the detection of the mitochondrial DNA 8993T>G mutation load among the pedigree members. Mature MII oocytes were inseminated by intracytoplasmic sperm injection (ICSI), cultured in vitro for 5 to 6 days to the blastocyst stage, and trophoblastocytes were obtained by microbiopsy. Mitochondrial DNA testing (PGT-MT) and chromosomal aneuploidy (PGT-A) analyses were carried out after whole-genome amplification, and the embryos with zero mutation load were selected for transfer. Amniotic fluid and umbilical cord blood samples were collected during middle pregnancy and after birth respectively for mitochondrial DNA testing to verify the reliability of embryo screening. As an attempt, PB1 with good morphology of MII oocytes was selected for transfer into the enucleated oocytoplasm from healthy donors, followed by ICSI fertilization, blastocyst culture and PGT of embryos using the same procedure. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University (No. 2021zhyx-B12). RESULTS: An antagonist protocol was used for ovarian stimulation, and a total of 19 oocytes were obtained, of which 14 MII were fertilized by ICSI, and 2 had developed into blastocysts. PGT-MT was carried out on biopsied trophoblastocytes, in which the mitochondrial DNA 8993T>G mutation load was not detected in one embryo, the other was 100% mutated, and the mutation loads of the remaining unfertilized eggs and developmentally arrested embryos ranged from 0% ~ 100%, presenting a clear biased distribution. With fully informed consent, one PGT-MT zero mutation load blastocyst was transferred and clinical pregnancy was achieved. Mitochondrial DNA and chromosomal testing of amniotic fluid cells during middle pregnancy had revealed no abnormalities. The proband had delivered a healthy boy through Caesarean section at 39⁺⁵ weeks of gestation, and no mutation was detected in the cord blood sample. Five well-formed PBs from 14 eggs were selected for PB1 transfer, followed by ICSI and culture, and two of the reconstituted embryos had formed blastocysts, with none of the above mutations detected in the biopsied samples. CONCLUSION The PGT-MT technology can help families affected with mitochondrial diseases to have healthy offspring. PB1 transfer in combination with ICSI and PGT-MT holds the promise of turning waste into treasure and providing an alternative means of fertility for such families.
Humans ; Preimplantation Diagnosis/methods* ; Female ; DNA, Mitochondrial/genetics* ; Genetic Testing/methods* ; Pregnancy ; Mitochondrial Diseases/genetics* ; Polar Bodies ; Adult ; Feasibility Studies ; Sperm Injections, Intracytoplasmic/methods* ; Embryo Transfer/methods* ; Mutation ; Male ; Blastocyst/metabolism* ; Pedigree

Objective:To assess the feasibility of first polar body transfer (PB1T) combined with preimplantation mitochondrial genetic testing for blocking the transmission of a pathogenic mitochondrial DNA 8993T>G mutation.Methods:A Chinese family affected with Leigh syndrome which had attended the Reproductive Medicine Centre of the First Affiliated Hospital of Anhui Medical University in September 2021 was selected as the study subject. Controlled ovarian hyperstimulation was carried out for the proband after completing the detection of the mitochondrial DNA 8993T>G mutation load among the pedigree members. Mature MII oocytes were inseminated by intracytoplasmic sperm injection (ICSI), cultured in vitro for 5 to 6 days to the blastocyst stage, and trophoblastocytes were obtained by microbiopsy. Mitochondrial DNA testing (PGT-MT) and chromosomal aneuploidy (PGT-A) analyses were carried out after whole-genome amplification, and the embryos with zero mutation load were selected for transfer. Amniotic fluid and umbilical cord blood samples were collected during middle pregnancy and after birth respectively for mitochondrial DNA testing to verify the reliability of embryo screening. As an attempt, PB1 with good morphology of MⅡ oocytes was selected for transfer into the enucleated oocytoplasm from healthy donors, followed by ICSI fertilization, blastocyst culture and PGT of embryos using the same procedure. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Anhui Medical University (No. 2021zhyx-B12). Results:An antagonist protocol was used for ovarian stimulation, and a total of 19 oocytes were obtained, of which 14 MⅡ were fertilized by ICSI, and 2 had developed into blastocysts. PGT-MT was carried out on biopsied trophoblastocytes, in which the mitochondrial DNA 8993T>G mutation load was not detected in one embryo, the other was 100% mutated, and the mutation loads of the remaining unfertilized eggs and developmentally arrested embryos ranged from 0% ~ 100%, presenting a clear biased distribution. With fully informed consent, one PGT-MT zero mutation load blastocyst was transferred and clinical pregnancy was achieved. Mitochondrial DNA and chromosomal testing of amniotic fluid cells during middle pregnancy had revealed no abnormalities. The proband had delivered a healthy boy through Caesarean section at 39+ 5 weeks of gestation, and no mutation was detected in the cord blood sample. Five well-formed PBs from 14 eggs were selected for PB1 transfer, followed by ICSI and culture, and two of the reconstituted embryos had formed blastocysts, with none of the above mutations detected in the biopsied samples.Conclusion:The PGT-MT technology can help families affected with mitochondrial diseases to have healthy offspring. PB1 transfer in combination with ICSI and PGT-MT holds the promise of turning waste into treasure and providing an alternative means of fertility for such families.

Objective:To explore the effects of happy PERMA intervention on resilience, stigma and quality of life in colostomy patients with colorectal cancer.Methods:According to convenience sampling method, 120 patients with colorectal cancer who underwent permanent colostomy in the hospital were enrolled from September 2021 to August 2023. According to admission order, they were divided into control group (60 cases, September 2021-August 2022) and study group (60 cases, September 2022-August 2023). The control group was given routine nursing, while the study group was additionally given happy PERMA mode nursing intervention for 8 weeks. The scores of Connor-Davidson resilience scale (CD-RISC), social impact scale (SIS), ostomy adjustment inventory-20 (OAI-20), quality of life questionnaire core 30(QLQ-C30), general well-being schedule(GWB) and self-care ability before and after 8 weeks of intervention were compared between the two groups using SPSS 22.0 software.Results:After the intervention, the scores of resilience (45.28±2.59), strength (26.34±2.47), optimism (11.05±0.78), and the total CD-RISC score (80.95±3.47) in the study group were significantly higher than those in the control group (37.46±2.08, 18.55±1.96, 8.96±0.63, 65.11±2.32) ( t=18.235, 19.137, 16.146, 29.394, all P<0.05). The scores of internalized stigma (13.09±1.97), economic discrimination (6.85±0.78), social isolation (14.15±1.98), social exclusion (16.93±2.54), and the total SIS score (50.17±2.35) in the study group were significantly lower than those in the control group (13.97±2.44, 7.36±0.95, 16.94±2.37, 19.55±3.42, 58.69±2.83)( t=2.174, 3.214, 6.998, 4.764, 13.756, all P<0.05). The score of persistent worry (11.95±2.16) in the study group was significantly lower than that in the control group (16.57±1.92) ( t=12.383, P<0.05), while the score of acceptance (15.28±1.16), positive life attitude (17.38±2.31), and the total OAI-20 score (58.64±2.08) in the study group were significantly higher than those in the control group (12.19±0.97, 14.55±1.94, 46.30±1.57) ( t=15.829, 7.267, 36.679, all P<0.05). The scores of role function (86.27±3.15), emotional function (81.25±4.33), social function (79.63±3.16), cognitive function (83.55±3.97), general health (83.15±3.16), and the total QLQ-C30 score (407.13±15.92) in the study group were significantly higher than those in the control group (77.62±4.38, 73.85±4.96, 71.80±3.98, 79.42±4.31, 75.34±3.62, 372.65±11.58)( t=12.419, 8.706, 11.935, 5.459, 12.590, 13.567, all P<0.05). The GWB score (86.95±3.57) and self-care ability score (91.13±3.45) in the study group were significantly higher than those in the control group (73.82±4.06, 87.55±4.68)( t=18.812, 4.769, both P<0.05). Conclusion:Happy PERMA mode intervention can effectively improve resilience, reduce stigma and improve quality of life in colostomy patients with colorectal cancer.

Objective·To explore the efficacy of the XP-Endo Shaper(XPS)and Reciproc(RC)engine-driven nickel-titanium file systems in removing root canal fillings,and to provide evidence for clinical application.Methods·The maxillary first permanent molars were obtained from patients who visited the Department of General Dentistry,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,between March and September 2022,which required tooth extraction due to periodontal disease.A total of 30 mesiobuccal or distobuccal root canals with moderate curvature were selected and randomly divided into the RC file group(control group,n=15)and the XPS file group(experimental group,n=15).All root canals were first negotiated and shaped using M3-PRO nickel-titanium files,followed by root canal obturation with bioceramic paste using the single-cone technique.Then,RC files(R25)were used in the control group,while XPS files were used in the experimental group to remove the root canal obturation.Cone Beam Computed Tomography(CBCT)scans were performed before and after the removal procedures.The time required for obturation removal,the percentage of residual obturation volume,the amount of apical debris extrusion,and the degree of instrument deformation were recorded.Independent-sample t-tests and chi-square test were used to compare the differences between the two groups.Results·The XPS group required slightly more time(118.87±18.58)s than the RC group(107.93±14.79)s,but the difference between two groups was not statistically significant.The XPS group had a lower percentage of residual obturation volume(7.51±8.06)%compared to the RC group(15.02±14.63)%,but the difference was not statistically significant.The XPS group had significantly less apical debris extrusion(6.15±1.42)mg than the RC group(8.29±2.01)mg,with a statistically significant difference(P=0.002).Both groups exhibited varying degrees of instrument deformation,but yet no instrument separation occurred in either group.Conclusion·The RC engine-driven nickel-titanium files were slightly more time-efficient in removing root canal fillings,whereas the XPS files achieved a higher canal cleanliness and produced less apical debris extrusion.As there was no significant difference in removal time,and considering the superior cleaning performance and reduced risk of postoperative complications,the XPS file system appears more suitable for removing root canal fillings in moderately curved root canals.

Objective To investigate the value of contrast-enhanced ultrasound(CEUS)liver imaging reporting and data system version 2017(LI-RADS v2017)in the differential diagnosis between hepatocellular carcinoma(HCC)and other hepatic malignancies(OM)less than or equal to 3 cm.Methods The clinical and imaging data of 163 liver lesions less than or equal to 3 cm in 126 patients with pathologically-confirmed liver malignancy were retrospectively analyzed.The patient underwent CEUS from Jan.2018 to Jun.2022 in our hospital,including 133 with HCC and 30 with OM.Nodules were classified based on the CEUS features according to the CEUS LI-RADS v2017.The evaluation of CEUS characteristics and CEUS LI-RADS v2017 in differential diagnosis of HCC and OM were calculated based on pathological findings.Results There were significant differences in the characteristics of arterial phase enhancement,timing of washout onset and washout degree between the HCC group and the OM group(all P＜0.001).The HCC group was mainly LR-3(20 lesions,15.04%),LR-4(25 lesions,18.80%)and LR-5(82 lesions,61.65%),and the OM group was mainly LR-M(28 lesions,93.33%).The specificity and positive predictive value of late washout for HCC were 93.33%(28/30)and 98.06%(101/103),respectively;and the sensitivity of early washout for OM was 93.33%(28/30).With LR-5 as the criterion to diagnose HCC,the sensitivity was 61.65%(82/133),the specificity was 93.33%(28/30),and the positive predictive value was 97.62%(82/84);with LR-4/5 as the criterion to diagnose HCC,the sensitivity was 80.45%(107/133),the specificity was 93.33%(28/30),and the positive predictive value was 98.17%(107/109),with the sensitivity of LR-4/5 being significantly higher than those of LR-5(P=0.001).With LR-M as the criterion to diagnose OM,the sensitivity was 93.33%(28/30)and the specificity was 95.49%(127/133).Conclusion The CEUS LI-RADS v2017 can effectively distinguish HCC from OM less than or equal to 3 cm.LR-5 has a low sensitivity for HCC,while LR-4/5 can improve the sensitivity for HCC.