Heart failure,as a global public health challenge,is experiencing an increasingly severe disease burden.Given the close relationship be-tween the Nitric Oxide-Soluble Guanylate Cyclase-Cyclic Guanosine Monophosphate(NO-sGC-cGMP)signaling pathway and heart failure,this study,through a comprehensive search and review of re-cent literature on the NO-sGC-cGMP pathway and heart failure,aims to outline the mechanism of ac-tion of this signaling pathway and its connection with heart failure,in order to explore new avenues for the treatment of heart failure.

Heart failure,as a global public health challenge,is experiencing an increasingly severe disease burden.Given the close relationship be-tween the Nitric Oxide-Soluble Guanylate Cyclase-Cyclic Guanosine Monophosphate(NO-sGC-cGMP)signaling pathway and heart failure,this study,through a comprehensive search and review of re-cent literature on the NO-sGC-cGMP pathway and heart failure,aims to outline the mechanism of ac-tion of this signaling pathway and its connection with heart failure,in order to explore new avenues for the treatment of heart failure.

Objective:To establish a clinical predictive model for poor clinical outcomes in patients with secondary hemophagocytic lymphohistiocytosis (sHLH) and to evaluate its clinical application value.Methods:Patients diagnosed with sHLH who met the study criteria and were initially admitted to the Emergency Department of Peking University People’s Hospital between September 2017 and December 2024 were enrolled. Clinical data were collected, and patients were categorized into a death group or a survival group based on clinical outcomes as the observational endpoint. Differences in clinical data between the two groups were compared. Univariate and multivariate logistic regression analyses were conducted to screen significant variables, and a predictive model nomogram was developed using the R programming language. The discriminative ability, calibration, and clinical utility of the predictive model were assessed using the receiver operating characteristic curve, net reclassification improvement index, calibration curve, and decision curve analysis. K-fold cross-validation was employed to evaluate the model's performance. The model was compared with the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score and the Sequential Organ Failure Assessment (SOFA) score.Results:A total of 116 cases were enrolled in the study, comprising 36 cases in the mortality group and 80 cases in the survival group. Multivariate logistic analysis identified age, platelet count, prothrombin time, total bilirubin, altered mental status, and cardiac involvement as factors significantly associated with clinical outcomes. Based on these factors, an early warning model for adverse clinical prognosis was established, and a corresponding nomogram was developed. The model demonstrated excellent discriminative ability, calibration, and clinical utility (AUC=0.950; Hosmer-Lemeshow test: χ2=2.5476, P=0.980; calibration curve: R 2=0.649, P=0.906), outperforming both the APACHE Ⅱ and SOFA scores in predicting adverse outcomes (both P<0.01). Conclusions:This study established an early warning model for adverse clinical prognosis in sHLH based on objective clinical data. The model aids in the clinical assessment of sHLH patients, facilitates early warning, and supports clinical decision-making for treatment.

Objective To explore the effect of CT slice thickness on the reproducibility of radiomic features in urinary stones.Methods A retrospective analysis was performed on 30 cases of stones diagnosed by urinary CT.Thin-slice(1 mm)images were reconstructed into two groups of images with thicknesses of 2 mm and 5 mm.Two radiologists conducted manual segmentation independently and then extracted features.The reproducibility of the radiomic features was calculated using the concordance correlation coefficient(CCC).Results Under different slice thickness conditions by the same radiologist,the average CCC of all groups was less than 0.85(P＜0.05).For radiologist A,the proportion of stone features with CCC＜0.85 were 50.13％,79.91％,and 82.38％in the 1 mm vs 2 mm group,2 mm vs 5 mm group,and 1 mm vs 5 mm group,respectively.Corresponding values for radiologist B were 44.55％,79.47％and 82.32％,respectively.Among the seven categories of radiomic features,the morphological features with CCC＜0.85 was 100％in the 1 mm vs 5 mm group.Conclusion CT slice thickness significantly affected the reproducibility of radiomic features in urinary stones,with the greatest effect observed in morphological features.Thin-slice imaging demonstrated more stable reproducibility of stone characteristics.

Objective To observe the value of preoperative CT radiomics models for predicting composition of in vivo urinary calculi.Methods Totally 543 urolithiasis patients were retrospectively enrolled and divided into calcium oxalate monohydrate stone group(group A,n=373),anhydrous uric acid stone group(group B,n=86),carbonate apatite group(group C,n=30),ammonium urate stone group(group D,n=28)and ammonium magnesium phosphate hexahydrate stone group(group E,n=26)according to the composition of calculi,also divided into training set and test set at the ratio of 7:3.Radiomics features were extracted and screened based on plain CT images of urinary system.Five binary task models(model A-E corresponding to group A-E)and a quinary task model were constructed using least absolute shrinkage and selection operator algorithm for predicting the composition of calculi in vivo.Then receiver operating characteristic curves were drawn,and the area under the curves(AUC)were calculated to evaluate the predictive efficacy of binary task models,while the accuracy,precision,recall and F1 score were used to evaluate the predictive efficacy of the quinary task model.Results All binary task models had good efficacy for predicting the composition of urinary calculi in vivo,with AUC of 0.860-0.948 in training set and of 0.856-0.933 in test set.The accuracy,precision,recall and F1 score of the quinary task model for predicting the composition of in vivo urinary calculi was 82.25％,83.79％,46.23％and 0.596 in training set,respectively,while was 80.63％,75.26％,43.48％and 0.551 in test set,respectively.Conclusion Binary task radiomics models based on preoperative plain CT had good efficacy for predicting the composition of in vivo urinary calculi,while the quinary task radiomics model had high accuracy but relatively poor stability.

OBJECTIVES: This study aimed to use modified articular disc anchorage in treating old irreducible temporomandibular joint (TMJ) disc displacement with perforation and rupture, as well as to explore its efficacy. METHODS: A total of 31 patients (34 sides) with 47 TMJ disc perforations who underwent surgical treatment in the Affiliated Stomatolo-gical Hospital of Nanchang University from January 2018 to December 2021 were selected. According to the location of disc perforation, it has five types: posterior disc perforation (typeⅠ), anterior disc perforation (typeⅡ), lateral disc perforation (type Ⅲ), composite disc perforation, and destruction disc perforation. The modified methods of disc anchoring were divided into two types according to the location of the perforation. TypesⅠandⅢ disc perforation were trea-ted by posterior anchoring method. For posterior ancho-ring, a screw was implanted into the posterolateral side of the condylar neck, and the disc was fixed on the screw by horizontal mattress suture. TypeⅡdisc perforation and compo-site disc perforation combined typeⅡperforation were treated by anterior and posterior double-anchoring method. For anterior anchoring, anchor screws or holes were placed at the anterior edge of the condylar neck, and horizontal mattress suture was performed at the posterior edge of the anterior perforation with an anchor wire. The articular disc was then fixed on the anchor screws or holes. For the posterior anchoring method, it was the same as the previous one. Paired t test was used to analyze the visual analog scale (VAS), maximum interincisal opening (MIO), and TMJ disorder index (CMI) of the patient before surgery and 1, 3, and 6 months after surgery. Disk-condyle position relationship by magnetic resonance imaging and postoperative quality of life in postoperative were analyzed. RESULTS: The incidence of perforation was 41.2% (14/34) in typeⅠ, 11.8% (4/34) in typeⅡ, 8.8% (3/34) in typeⅢ, 29.4% (10/34) in composite type, and 8.8% (3/34) in destruction type. The VAS, MIO, and CMI at 3, 6 months after operation significantly improved compared with those before operation (P<0.05). The effective reduction rate of disc was 96.77% (30/31). The quality of life at 6 months after surgery was 47.22±2.13, and the rate of excellent evaluation was 96.4% (27/28). CONCLUSIONS Modified articular disc anchorage achieves a good curative effect for treating temporomandibular joint disc perforation and rupture. Nevertheless, its long-term effect requires further observation.
Humans ; Temporomandibular Joint Disc/surgery* ; Quality of Life ; Joint Dislocations/surgery* ; Temporomandibular Joint Disorders/surgery* ; Magnetic Resonance Imaging/methods* ; Temporomandibular Joint/pathology* ; Mandibular Condyle

Objective:To assess the implications of hormone therapy on confirmation of clinical diagnosis and prognosis of adult hemophagocytic syndrome (HPS) in the emergency department setting.Methods:The eligible 34 patients admitted with suspected HPS in the Emergency Department of Peking University People's Hospital from September 2019 to August 2021 were respectively collected. The patients were divided into the death group and survival group according to the prognosis and divided into early hormone therapy group and standard hormone therapy group according to the timing of hormone application. Patients in the early hormone therapy group were divided into the routine 4 criteria group and non-routine 4 criteria group according to the conditions of meeting the four HLH-2004 diagnostic criteria. Medical records of the following were collected and statistically analyzed: complete blood count, blood biochemical index, coagulation function, serum ferritin, NK cell activity, sCD25 level, peripheral blood smear, bone marrow biopsy, abdominal ultrasound scan, and abdominal CT on admission, and recheck the clinical indicators such as blood count, blood biochemical index and blood coagulation dunction 5-7 days later.Results:①Patients from the death group were older, with higher APACHEⅡ scores and SOFA scores, higher total bilirubin, and lower serum albumin. ② Univariate Logistic analysis showed age ( OR=1.098, CI: 1.019-1.183, P=0.014), APACHE Ⅱ score ( OR=1.144, CI: 1.017-1.285, P=0.024), SOFA score ( OR=1.441, CI: 1.079-1.925, P=0.013) were associated with the risk of death. Multivariate Logistic analysis showed that age ( OR=1.099, CI: 1.014-1.190, P=0.021) was associated with the risk of death. There was no significant correlation between early hormone therapy and clinical prognosis. Kaplan-Meier survival curves showed that there was no difference in the 60-day survival rate between the early hormone therapy group and the standard hormone therapy group. ③ The level of triglyceride still increased after early hormone therapy, and the number of indexes meeting the diagnostic criteria of HLH-2004 increased significantly. All patients met the criteria of Hscore>169, and 3 patients did not meet at least 5 diagnostic criteria of HLH-2004, accounting for 16.7% of the total cases of early hormone therapy. ④ Starting hormone therapy when the four HLH-2004 diagnostic criteria were met could reduce the length of hospital stay. Prothrombin time and activited partial thomboplastin time were closer to normal levels in patients 5-7 days after treatment. Early hormone therapy had no significant effect on treatment response and in-hospital death risk. There were no significant differences in APACHE Ⅱ score, SOFA score, confirmation of diagnosis, treatment response, clinical prognosis, and related clinical indicators after hormone therapy between the routine 4 criteria and non-routine 4 criteria groups. Conclusions:Initiation of early hormone therapy has no significant effect on the confirmation of clinical diagnosis, treatment response, in-hospital mortality, and 60-day survival rate of patients with HPS, and can quickly correct coagulation dysfunction and effectively reduce the length of hospital stay. An earlier start of hormonal therapy (meeting the four HLH-2004 diagnostic criteria) may be considered by the emergency physician when a patient is highly suspected of HPS diagnosis

Objective: To illuminate the temporal expression of the triggering receptor expressed on myeloid cells-1 (TREM-1) in the experimental periodontitis in rat and to investigate the function of TREM-1 in the pathogenesis of experimental periodontitis in rat. Methods: The experimental periodontitis model was established in the maxillary first molar by means of 'wire ligation + vaccination periodontal pathogen Porphyromanus gingivalis (Pg) + high-sugar diet' in Sprague-Dawley (SD) rats. The experimental animals were divided into six groups: the control group and each of the time points of establishing the models for one week and two to five weeks. There were six rats for each of the six groups. The bone loss of the palatal site was calculated to estimate whether the periodontitis model was successfully established. The expression of TREM-1, proinflammatory cytokines: tumor necrosis factor-α (TNF-α), interleukin (IL)-1β and IL-6, anti-inflammatory cytokines: IL-4, IL-10 and transforming growth factor-β (TGF-β) were examined by using quantitative real-time PCR. The expression level of TREM-1 protein was analyzed by the method of immunohistochemistry. Results: The average bone loss area of the palatal site was (0.17±0.04) mm² in the group of three weeks and was statistically significant (P<0.05) compared to the control group [(0.10±0.01) mm²]. The experimental periodontitis model was successfully established in the group of three weeks. The expression of TREM-1 increased significantly in the inflamed periodontal tissues and reached to its maximum expression in the three weeks group accounting for 159.50±38.26 in protein expression and 4.35±0.60 in mRNA expression, respectively. TREM-1 expression difference between the three weeks group and control group was statistically significant (P<0.01). The expression of IL-6 by gingival tissues was correlated with the mRNA level of TREM-1 (r=0.813 P=0.049). Conclusions TREM-1, as a proinflammatory receptor, could facilitate the periodontal inflammatory response. The possible way of TREM-1 to promote inflammation may be through controling the expression of IL-6.

Objective To investigate the brain activation at the Stroop task in a group of adolescents diagnosed as the internet gaming disorder (IGD).Methods 10 IGD adolescents and 10 adolescent recreational internet game users (RGU) completed a functional magnetic resonance imaging (fMRI) Stroop task.The response time and accuracy of the two groups and the whole brain activation were measured.The differences between the two groups in response time and accuracy were assessed by t test,and the fMRI data was analyzed by SPM8.Results (1) Compared with the RGU group,the response time in congruent (CC) stimulus was longer ((707.7± 56.1) ms vs.(632.1 ± 83.5) ms;t=2.38,P=0.031) and the accuracy to incongruent (IC) stimulus was less((60.2± 17.5)％ vs.(79.0± 19.5)％;t=-2.27,P=0.034) in IGD group;(2) During IC stimulus,compared to RGU group,the neural activation in IGD group significantly decreased in the bilateral cerebellum posterior lobe,left superior temporal gyrus,left prefrontal lobe,left thalamus,left precentral gyrus,left middle frontal gyrus and the right cingulate gyrus (Peak value=-4.11--5.13,P＜0.05,AlphaSim corrected).And the IGD group showed less activation during the CC stimulus in right cerebellum anterior lobe,right superior temporal gyrus,right prefrontal lobe and left insula (Peak value=-3.84--4.72,P＜0.05,AlphaSim corrected).During the Stroop effect (IC-CC),IGD group showed significantly less activation in left precentral gyrus,left precuneus lobe,and left paracentral lobule (Peak value=-3.94,-5.49,P＜0.05,AlphaSim corrected).Conclusion IGD adolescents have poor Stroop performance in response time and accurate rate,which might be correlated to the abnormal activation of their dysfunctional brain regions,such as the frontal lobe,cingulate cortex,temporal lobe,thalamus,precuneus,and the cerebellum.

Objective To investigate the brain activation at the Stroop task in a group of adolescents diagnosed as the internet gaming disorder (IGD).Methods 10 IGD adolescents and 10 adolescent recreational internet game users (RGU) completed a functional magnetic resonance imaging (fMRI) Stroop task.The response time and accuracy of the two groups and the whole brain activation were measured.The differences between the two groups in response time and accuracy were assessed by t test,and the fMRI data was analyzed by SPM8.Results (1) Compared with the RGU group,the response time in congruent (CC) stimulus was longer ((707.7± 56.1) ms vs.(632.1 ± 83.5) ms;t=2.38,P=0.031) and the accuracy to incongruent (IC) stimulus was less((60.2± 17.5)％ vs.(79.0± 19.5)％;t=-2.27,P=0.034) in IGD group;(2) During IC stimulus,compared to RGU group,the neural activation in IGD group significantly decreased in the bilateral cerebellum posterior lobe,left superior temporal gyrus,left prefrontal lobe,left thalamus,left precentral gyrus,left middle frontal gyrus and the right cingulate gyrus (Peak value=-4.11--5.13,P＜0.05,AlphaSim corrected).And the IGD group showed less activation during the CC stimulus in right cerebellum anterior lobe,right superior temporal gyrus,right prefrontal lobe and left insula (Peak value=-3.84--4.72,P＜0.05,AlphaSim corrected).During the Stroop effect (IC-CC),IGD group showed significantly less activation in left precentral gyrus,left precuneus lobe,and left paracentral lobule (Peak value=-3.94,-5.49,P＜0.05,AlphaSim corrected).Conclusion IGD adolescents have poor Stroop performance in response time and accurate rate,which might be correlated to the abnormal activation of their dysfunctional brain regions,such as the frontal lobe,cingulate cortex,temporal lobe,thalamus,precuneus,and the cerebellum.