Objective To investigate the value of integrin subunit αM(ITGAM)and integrin subunit β2(ITGB2)levels in peripheral blood mononuclear cells(PBMC)in the diagnosis and prognosis evaluation for patients with severe acute pancreatitis(SAP)complicated with acute lung injury(ALI).Methods A total of 205 patients with SAP admitted from November 2022 to February 2024 in the hospital were selected,and they were divided into ALI group(103 cases)and non-ALI group(102 cases)according to whether they were com-plicated with ALI.Meanwhile,110 healthy people who underwent the physical examination were selected as the control group.The differences of the levels of ITGAM and ITGB2 in PBMC in different groups were com-pared.Logistic regression was used to analyze the influencing factors for ALI in patients with SAP.The re-ceiver operating characteristic(ROC)curve was used to analyze the diagnostic value of levels of ITGAM and ITGB2 in PBMC for SAP patients complicated with ALI and the predictive value for poor prognosis.Results The levels of ITGAM,ITGB2 in PBMC,and serum amylase and urine amylase levels in ALI group were higher than those in non-ALI group and control group(P＜0.05).Multivariate Logistic regression anal-ysis showed that the increase of ITGAM,ITGB2 and serum amylase levels were risk factors for ALI in pa-tients with SAP(P＜0.05).ROC curve results showed that the area under the curve(AUC)of ITGAM com-bined with ITGB2 in diagnosing ALI in patients with SAP was significantly higher than those of ITGAM and ITGB2 alone(P＜0.05).The levels of ITGAM and ITGB2 in PBMC in the poor prognosis group were higher than those in the good prognosis group(P＜0.05).ROC curve results showed that the AUC of ITGAM com-bined with ITGB2 in predicting poor prognosis in patients with SAP complicated with ALI was significantly higher than those of ITGAM and ITGB2 alone(P＜0.05).Conclusion Increased levels of ITGAM and IT-GB2 in PBMC are risk factors for ALI in patients with SAP.ITGAM combined with ITGB2 has a good predic-tive efficacy for the poor prognosis in patients with SAP complicated with ALI,which has important value in clinical practice and is expected to become potential biomarkers.

Schizophrenia is a common chronic mental disorder.Cognitive dysfunction is one of its core symptoms,which severely affects the social functioning of patients.Currently,antipsychotic medication treatments have poor efficacy in improving cognitive functions.Recent studies have found that metformin can improve cognitive dysfunction in patients with schizophrenia.However,the mechanism of action remains unclear.This review summarizes the therapeutic effects of metformin on cognitive dysfunction in schizophrenia patients such as improving insulin resistance,repairing neuronal damage,regulating neuroimmunity,and combating oxidative stress,thereby providing new insights for the treatment of cognitive dysfunction in schizophrenia.

Late-onset cobalamin C (cblC) deficiency is an inherited organic acid metabolic disorder characterized by clinical heterogeneity, which often presents challenges in accurate diagnosis. This article presents a case study of a young female patient who initially experienced epileptic-like seizures. Over a span of 9 years, she subsequently developed psychotic symptoms. Her condition has been steadily deteriorating over a period of 16 years, leading to mutism, loss of ambulation, dysphagia, and urinary and fecal incontinence. Although electroencephalography and cranial computed tomography did not show significant findings during the course of the illness, cranial magnetic resonance imaging showed evidence of cerebral atrophy. Biochemical analysis revealed elevated levels of blood homocysteine and urinary methylmalonic acid-2. Genetic testing identified two pathogenic mutations in the MMACHC gene, confirming the diagnosis of late-onset cobalamin C (cblC) deficiency. Despite receiving interventions such as antiepileptic and antipsychotic medications during the diagnostic and therapeutic phases, the patient′s clinical progress remained limited.Following the definitive diagnosis, targeted metabolic therapy was initiated, leading to significant clinical improvement. This article provides a comprehensive review of the patient′s clinical data, along with a synthesis of relevant literature, in order to enhance the awareness of psychiatric practitioners regarding this rare disorder. The primary objective is to promote early identification, prompt diagnosis, and timely intervention.

Late-onset cobalamin C (cblC) deficiency is an inherited organic acid metabolic disorder characterized by clinical heterogeneity, which often presents challenges in accurate diagnosis. This article presents a case study of a young female patient who initially experienced epileptic-like seizures. Over a span of 9 years, she subsequently developed psychotic symptoms. Her condition has been steadily deteriorating over a period of 16 years, leading to mutism, loss of ambulation, dysphagia, and urinary and fecal incontinence. Although electroencephalography and cranial computed tomography did not show significant findings during the course of the illness, cranial magnetic resonance imaging showed evidence of cerebral atrophy. Biochemical analysis revealed elevated levels of blood homocysteine and urinary methylmalonic acid-2. Genetic testing identified two pathogenic mutations in the MMACHC gene, confirming the diagnosis of late-onset cobalamin C (cblC) deficiency. Despite receiving interventions such as antiepileptic and antipsychotic medications during the diagnostic and therapeutic phases, the patient′s clinical progress remained limited.Following the definitive diagnosis, targeted metabolic therapy was initiated, leading to significant clinical improvement. This article provides a comprehensive review of the patient′s clinical data, along with a synthesis of relevant literature, in order to enhance the awareness of psychiatric practitioners regarding this rare disorder. The primary objective is to promote early identification, prompt diagnosis, and timely intervention.

Antipsychotic medications are commonly used to treat schizophrenia,but they can have negative effects on lipid metabolism,leading to an increased risk of cardiovascular diseases,reduced life expectancy,and difficulties with treatment adherence.The specific mechanisms by which antipsychotics disrupt lipid metabolism are not well understood.Sterol regulatory element-binding proteins(SREBPs)are important transcriptional factors that regulate lipid metabolism.Proprotein convertase subtilisin/kexin type 9(PCSK9),a gene regulated by SREBPs,plays a critical role in controlling levels of low-density lipoprotein cholesterol(LDL-C)and has become a focus of research on lipid-lowering drugs.Recent studies have shown that antipsychotic drugs can affect lipid metabolism through the SREBP/PCSK9 pathway.A deep understanding of the mechanism for this pathway in antipsychotic drug-related metabolic abnormalities will promote the prevention of lipid metabolism disorders in patients with schizophrenia and the development and application of new drugs.

With the increasing variety and quantity of energy consuming equipment in hospitals, the phenomenon of high energy consumption in hospitals is becoming increasingly prominent. In June 2021, this study established an energy consumption control strategy for hospitals based on the energy consumption characteristics of medical service units, targeting the current situation and shortcomings of hospital energy consumption management, and then conducted exploration of strategy application. The strategy was designed to deepen the analysis of the energy consumption hierarchy and energy consumption characteristics of medical service units in the hospital′s energy consumption system, extract personalized energy consumption control indexes, and optimize or build energy consumption control systems with the help of self-control and information technology, through collaboration among multiple departments. These measures above aimed to reduce ineffective energy consumption in the energy consumption terminal of medical service units, promote the deep integration of energy consumption system operation status and energy consumption demand characteristics of medical service units, and realize precise energy consumption control.In June 2021 and March 2022, two tertiary hospitals carried out energy consumption control practices based on the energy consumption characteristics of operating rooms and wards respectively. After practices, the energy-saving rates of operating rooms and wards were both>10.0%, achieving good application results. This strategy can provide references for hospitals in China to promote energy conservation and emission reduction.

Purpose To identify the role of tyrosine kinase receptor Axl for anti-apoptosis which was induced by cisplatin (DDP) and methotrexate (MTX) chemotherapy and to analyze the relationship between P-Axl and apoptosis-related proteins in osteosarcoma.Methods Osteosarcoma cell lines MG63,143B and U2OS were used in apoptosis assays,Axl siRNA transfection,cytotoxicity assays,cell cycle analysis,etc.A total of 41 cases of osteosarcom patients were included for immunohistochemistry of EnVision two-step staining and clinico-pathological relative analysis.TUNEL assay was performed in ten cases for apoptosis detection.Results Among the osteosarcoma cell lines,Gas6/Axl could obviously protect tumor cells from apoptosis induced by DDP and MTX (P ＜ 0.05).Axl siRNA transfection enhanced cell apoptosis,whereas Gas6 prone to function upon previous knockdown by Axl siRNA.Among the 41 cases,the positive rate of P-Axl,BCL-2,and Bax was 85.4％,70.7％,and 36.6％,respectively.In contrast,the positive rate of them was 22.2％,11.1％,and 11.1％ in osteofibrous dysplasia,respectively.The expression levels of these apoptosisrelated factors were significantly higher in osteosarcoma than in osteofibrous dysplasia (P ＜ 0.05).Through clinico-pathological analysis,there were significant relationships between the survival status and BCL-2 or Bax expression (P ＜ 0.05).Pearson correlation analysis demonstrated that BCL-2 was positively correlated to P-Axl with statistical significance (r =0.842,P ＜ 0.0001).By Cox univariate analysis,BCL-2 or Bax was correlated with the patients' prognosis.TUNEL assay also demonstrated that P-Axl high expression inhibited apoptosis in osteosarcoma tissues.Conclusion Gas6/Axl protects osteosarcoma cells from the apoptosis induced by DDP and MTX chemotherapy and inhibits apoptosis in osteosarcoma tissue,possibly through the regulation of apoptosis-related protein BCL-2.

[Objective]To comprehensively compare the feasibility of three different treatment strategies consisting of low-dose chemotherapy(LDC),surgery and surgery with adjuvant low-dose chemotherapy(SLDC)for children with solitary bone lesions of eosinophilic granuloma(SBL-EG).[Methods]We retrospectively reviewed the records of 149 pediatric patients with SBL-EG at our institutions from 2002 to 2014. Our study included 86 patients who received LDC ,33 patients who received surgery and 30 patients who received SLDC. The duration of hospital stay ,time to symptom relief,recovery time,cost,complications and relapse-free sur-vival(RFS)of each strategy were analyzed.[Results]Hospital stay,time to symptom relief,recovery time and cost in the LDC group were significantly shorter or less than those in the surgery or SLDC group (P < 0.05). No statistically significant differences were observed in the above-mentioned factors between the surgery and SLDC groups (P > 0.05). Chemotherapy-related adverse events in the LDC and SLDC groups included nausea(8.62%),aminotransferase elevation(7.76%),slight hair loss(4.31%), immunity decline (21.55%),growth retardation (10.34%) and moon face (7.76%). LDC and SLDC treatment resulted in a significantly longer RFS (147 months and 126 months ,respectively) than surgery alone (114 months)(P = 0.005 and 0.019 , respectively). However ,there was no statistically significant difference in RFS between the LDC and SLDC groups (P = 0.732).[Conclusions]Compared with surgery or SLDC,LDC appears to promote more rapid recovery,less invasion,increase safety and eco-nomic treatment strategy for pediatric patients with SBL-EG.

A technique of diffusive gradients in thin films (DGT) was developed for the in situ measurement of reactive phosphorus species in natural waters, sediments and potentially soils. Polyacrylamide / basic magnesium carbonate was used as the novel binding phase of DGT. Various factors, such as initial concentration, deployment time, pH and ionic strength, which may affect the adsorption of phosphate to the DGT were investigated. H2 SO4(0. 25 mol/ L, 10 mL) was used for elution of phosphate from the binding gel, and an elution efficiency of 85±5% was obtained. The DGT measurement was independent of ionic strength (0. 001-0. 05 mol/ L) and pH (4. 10-9. 15). The results indicated that the maximum adsorption capacities of DGT were limited to 20. 4 μg per disc ( T = 25℃, pH = 7. 00, [ P] = 2 mg / L). Good agreement was obtained between the measurement results of DGT method and molybdenum blue method in the P concentration from 0. 001 to 20 mg / L. The method detection limit (MDL) was 102. 4 ng / L. Field performances of DGT in synthetic seawater, the coastal seawater of Xiamen, Lake Yihai, Lake Chaohu and Nanfei River indicated that the basic magnesium carbonate-DGT method was more reliable than the commonly used ferrihydrite-DGT method.

Objective To investigate the expression level and clinical significance of melanoma antigen gene A (MAGEA) in osteosarcoma patients. Methods Compare gene expression profiles in osteosarcoma cell lines and osteoblasts with gene microarrays. Validation of differentially expressed genes was carried out by real-time polymerase chain reaction analysis. Corresponding protein levels were measures by Western blot analysis in osteosarcoma cell lines and by immunohistochemistry in osteosarcoma tissues. The staining intensity of immuno-histochemistry was correlated with clinical outcome , and its prognostic significance was analyzed. Results Sev-eral genes belonging to MAGEA increased significantly in all osteosarcoma cell lines and tumor tissue , but not in normal osteoblast cell. Patients with MAGEA expression has higher risk of lung metastasis (relative risk 2.79, 95% confidence interval, 1.12-6.93; P = 0.028) and lower five-year survival rates (39.6% ± 8.4% vs. 80% ± 8.9%, P = 0.01) compared with patients without MAGEA expression. Conclusions The expression of MAGEA increased in osteosarcoma , which inversely correlating with outcome of osteosarcoma patients.