ObjectiveTo investigate the impact of hepatocellular carcinoma （HCC） on the prognosis of patients with liver cirrhosis undergoing emergency endoscopic therapy for esophagogastric variceal bleeding， as well as independent influencing factors for the prognosis of liver cirrhosis patients without HCC after emergency endoscopic therapy for esophagogastric variceal bleeding. MethodsA total of 117 liver cirrhosis patients without HCC and 119 liver cirrhosis patients with HCC who underwent emergency endoscopic therapy for esophagogastric variceal bleeding in Renmin Hospital of Wuhan University from January 2017 to July 2023 were enrolled. Basic information including age and sex was collected from all patients， as well as the presence or absence of chronic diseases such as hypertension， diabetes， and coronary heart disease， the time of emergency endoscopy after admission， and liver function parameters including international normalized ratio， albumin， creatinine， sodium， total bilirubin， alanine aminotransferase， and aspartate aminotransferase （AST）. The independent-samples t test was used for comparison of normally distributed continuous variables between two groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous variables between two groups； the chi-square test was used for comparison of categorical variables between groups. The covariance analysis and the multivariate logistic regression analysis were used for comparison of outcome variables after control of baseline variables， and the Kaplan-Meier survival curve was plotted for each group. The univariate and multivariate Cox regression analyses were performed for survival time in the non-HCC group to investigate the independent influencing factors for survival time， and then the Kaplan-Meier curve analysis and the log-rank test were performed to validate such independent influencing factors and analyze the independent influencing factors for secondary outcomes. ResultsCompared with the non-HCC group， the HCC group had significantly higher red blood cell transfusion units （6.00［2.00～9.00］ vs 4.00［1.75～7.00］， Z=-2.050， P=0.040， F=4.869， adjusted P=0.028）， a significantly shorter survival time （29.77±16.01 days vs 38.07±11.43 days， t=4.574， P<0.001， F=17.294， adjusted P<0.001）， and a significantly higher 5-day rebleeding rate （22.69% vs 6.84%， χ²=11.736， P<0.001， adjusted P=0.021）. The Kaplan-Meier curve analysis showed that the risk of 42-day mortality in the HCC group was 3.897 （95% confidence interval ［CI］： 2.338 ‍— 6.495， P<0.001） times that in the non-HCC group. The multivariate Cox regression analysis of the non-HCC group showed that the total length of hospital stay （hazard ratio ［HR］=0.793， 95%CI： 0.644 ‍— ‍0.976， P=0.029） was an independent protective factor for 42-day survival. The Kaplan-Meier curve analysis showed that a length of hospital stay of >9 days was beneficial for the prognosis of patients （HR=4.302， 95%CI： 1.439 — 12.870， P=0.037）. Blood sodium level （odds ratio ［OR］=0.523， 95%CI： 0.289 ‍— ‍0.945， P=0.032） and MELD-Na score （OR=0.495， 95%CI： 0.257 ‍— ‍0.954， P=0.036） were independent protective factors against 5-day rebleeding， while AST level was an independent risk factor for 5-day rebleeding （OR=1.023， 95%CI： 1.002 ‍— ‍1.043， P=0.028） and in-hospital death （OR=1.036， 95%CI： 1.001‍— ‍1.073， P=0.045）. ConclusionLiver cirrhosis patients with variceal bleeding and HCC tend to have a worse prognosis， and for the non-HCC group， in-hospital mortality rate increases with the increase in AST level. The total length of hospital stay is an independent protective factor for survival time in the non-HCC group， and it is recommended to appropriately prolong the length of hospital stay for such patients.

ObjectiveTo investigate the effect of Dingzhi Xiaowan （DZXW） in post-stroke cognitive impairment （PSCI） model mice. MethodsThe cerebral ischemia-reperfusion injury model of mice was established by using the middle cerebral artery occlusion method. Forty C57BL/6 male mice were randomly divided into the sham operation group， model group， low-dose DZXW group （1.43 g·kg^-1）， and high-dose DZXW group （2.56 g·kg^-1）， with 10 mice in each group. Both the sham operation group and the model group were treated with equal amounts of normal saline by gavage， and the above four groups of mice were gavaged once a day for 30 consecutive days. Morris water maze test was used to evaluate the learning memory ability of mice. Serum levels of amyloid precursor protein （APP）， amyloid 42 （Aβ₄₂）， acetylcholinesterase （AChE）， and superoxide dismutase （SOD） were measured by enzyme-linked immunosorbent assay （ELISA）. Deoxyribonucleotide end transferase-mediated nick end labelling （TUNEL） assay was applied to detect the degree of apoptosis in the mouse's hippocampal neurons. Western blot was used to detect the protein expression of phosphoinositol-3 kinase （PI3K）， protein kinase B （Akt）， mammalian target of rapamycin （mTOR）， hypoxia-inducible factor 1-alpha （HIF-1α）， B-cell lymphoma 2 （Bcl-2） homologous structural domain protein （Beclin1）， sequestosome 1 （p62）， microtubule-associated protein light chain 3 （LC3）， Bcl-2， and Bcl-2-associated X protein （Bax） in hippocampal tissue. Prussian blue staining was used to detect iron deposition in hippocampal tissue. Transmission electron microscopy was taken to observe the ultrastructure of the mouse's hippocampal neurons. ResultsCompared with the sham operation group， the latency， APP， Aβ₄₂， AChE， TUNEL positivity， ferric ion deposition， HIF-1α， Beclin1， Bax， and LC3Ⅱ/Ⅰ were significantly increased in the model group （P<0.01）， while the number of crossing platforms， SOD， p-PI3K， p-Akt， p-mTOR， p62， and Bcl-2 were significantly decreased （P<0.01）. Compared with the model group， the latency， APP， Aβ₄₂， AChE， TUNEL positivity rate， ferric ion deposition， HIF-1α， Beclin1， Bax， and LC3Ⅱ/Ⅰ were significantly reduced in the DZXW groups （P<0.05）， while the number of crossing platforms， SOD， p-PI3K， p-Akt， p-mTOR， p62， and Bcl-2 were significantly higher （P<0.05）. ConclusionDZXW can alleviate cognitive impairment induced by oxidative stress-aggravated hippocampal neuronal damage in PSCI model mice by modulating the PI3K/Akt/mTOR/HIF-1α autophagy signalling pathway.

OBJECTIVES: This study aims to explore the current status and risk factors of oral health-related quality of life OHRQoL in patients with mental disorders and provide evidence for effective intervention measures. METHODS: A total of 397 patients diagnosed with mental illness were selected by convenience sampling, and investigation was carried out using general data questionnaire, health literacy in dentistry-14 (HeLD-14), oral health impact profile-14 (OHIP-14), and oral health status checklist. RESULTS: The total score of OHIP-14 in patients with mental disorders was 8(2, 14). The score of HeLD-14 was negatively correlated with the score of OHIP-14 (r=-0.142, P<0.01). The results of multiple linear regression showed that six variables including annual family income, schizophrenia, sweets, frequency of visits to the dentist, dental caries, and missing teeth affected OHRQoL of patients with mental disorders (P<0.05). CONCLUSIONS The poor OHRQoL of psychiatric patients is associated with many factors. Medical personnel should pay attention to their oral health problems and develop targeted oral care programs throughout the course of disease to improve oral health and related quality of life of patients.
Humans ; Quality of Life ; Oral Health ; Mental Disorders ; Risk Factors ; Surveys and Questionnaires ; Male ; Female ; Dental Caries ; Adult ; Middle Aged ; Schizophrenia

Objective: To retrospectively compare the impact of different intraoperative transfusion strategies for platelets and cryoprecipitate on perioperative blood usage and clinical outcomes in patients undergoing orthotopic heart transplant (OHT), thereby providing a reference for perioperative patient blood management. Methods: The clinical data of 65 patients who had undergone OHT at our hospital between 2020 and 2025 were retrospective collected. Patient demographics, underlying chronic conditions, and perioperative (preoperative, intraoperative, and postoperative) laboratory blood test results were analyzed. The transfusion volumes of intraoperative red blood cells, plasma, platelets, and cryoprecipitate were examined. Univariate and multivariate logistic regression models were employed to identify factors associated with perioperative outcomes. Results: A total of 65 patients received allogeneic blood transfusion during the perioperative period. The ultilization of intraoperative platelets and cryoprecipitate was as follows: simultaneous transfusion of both platelets and cryoprecipitate (at a 1∶1 ratio) was administered in 42 patients (64.62%), platelets alone in 12 patients (18.46%), and cryoprecipitate alone in 11 patients (16.92%). Patients who received simultaneous transfusion of platelets and cryoprecipitate (1∶1) (n=42) had a shorter ICU length of stay (32.45±10.18 d), while those who received either platelets or cryoprecipitate alone (n=23) had a significantly longer ICU length of stay (68±15.97 d). Patients receiving simultaneous intraoperative transfusion of platelets and cryoprecipitate also required fewer units of allogeneic red blood cells intraoperatively (median=4 units) and had a lower mortality rate (16.7%) than those receiving either product alone (26.1%), with a statistically significant difference (P=0.023). Multivariate logistic regression analysis indicated that the volume of cryoprecipitate transfused was an independent protective factor against postoperative allogeneic red blood cell transfusion (OR=0.344, 95% CI [0.177, 0.829], P=0.0159). Multivariate logistic regression also identified cryoprecipitate transfusion volume as an independent protective factor for ICU length of stay (OR=0.877, 95% CI [0.719, 0.986], P=0.0008), which was in line with the multivariate Cox regression results. Conclusion: In patients undergoing OHT, the intraoperative transfusion strategy for platelets and cryoprecipitate influences the volume of perioperative allogeneic red blood cell transfusion and patient mortality. Intraoperative cryoprecipitate transfusion volume is an independent protective factor against both postoperative allogeneic red blood cell transfusion and prolonged ICU length of stay. The establishment of a multidisciplinary collaborative blood management model, combined with the modification of perioperative blood utilization practices and the implementation of a comprehensive patient blood management strategy, can holistically ensure perioperative patient safety.

Objective:To analyze the clinical features and genetic characteristics of a patient with Shwachman-Diamond syndrome (SDS) due to compound heterozygous variants of SBDS gene.Methods:A female child with SDS who was admitted to the Children's Hospital Affiliated to Zhengzhou University in February 2022 was selected as the study subject. Clinical data of the child was collected. Peripheral blood samples of the child and her elder sister and parents were collected and subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing.Results:The child, a 1-year-and-1-month-old girl, had mainly manifested with diarrhea, hematochezia, growth retardation and malnutrition, along with increased transaminases and decreased neutrophils and hemoglobin. The anteroposterior X-ray of her left wrist indicated significantly delayed bone age. Colonoscopy revealed that her colorectal mucosa was erosive with oily food residues attached to the intestinal lumen. Genetic testing revealed that she has harbored c. 258+ 2T>C and c. 100A>G compound heterozygous variants of the SBDS gene. The c. 258+ 2T>C variant has derived from her father and known to be pathogenic, whilst the other has derived from her mother. Based on the guidelines from the American College of Medical Genetics and Genomics, the c. 100A>G variant was classified as likely pathogenic (PM1+ PM2_Supporting+ PM3+ PM5+ PP3). Conclusion:The compound heterozygous variants of c. 258+ 2T>C and c. 100A>G probably underlay the SDS in this child. For children with refractory diarrhea, liver damage and growth retardation, SDS should be suspected, and genetic testing can facilitate the diagnosis and treatment.

Objective To apply cone beam CT measurements(CBCT)to analyze the effect of skeletal Class Ⅲ high angle with devia-tion on upper airway morphology and hyoid position.Methods A total of 120 patients with skeletal Class Ⅲ high angle malocclusion who visited our hospital from September 2019 to December 2022 were selected.CBCT was taken in all subjects.According to the degree of mandibular deviation(MD)of the point under the chin from the median sagittal plane,the 120 patients were divided into three groups:non-migratory,mildly migratory,and severely migratory groups,and the volume of the upper airway as well as the position of the hyoid bone of three groups were measured and analyzed respectively.Results There was no significant difference in the volume and minimum cross-sectional area of the nasopharyngeal segment,palatopharyngeal segment,and minimum cross-sectional area of the laryngopharyngeal segment.No siginificant difference was found between the position of the hyoid bone(HB)on the Y-axis(Y-HB)and the position of the hyoid bone on the Z-axis(Z-HB)among the three groups(P＞0.05).Compared with the other two groups,the vol-ume and total volume of the nasopharyngeal segment,the laryngopharyngeal segment,and minimum cross-sectional area of the laryngo-pharyngeal segment in the group of severe deviation were significantly reduced(P＜0.05)and X-HB was significantly larger(P＜0.05).Conclusion In patients with skeletal ClassⅢhyperkeratosis with severe deviation,the total volume of the glossopharyngeal segment,laryngopharyngeal segment,and upper airway,as well as the minimum cross-sectional area of the glossopharyngeal segment were smal-ler than those of the othertwo groups.In patients with severe deviation,the position of the hyoid bone(HB)in the X-axis(X-HB)was larger than that of the non-migratory group,indicating that migratory jaws mainly affect the morphology of the lingual-pharyngeal seg-ment as well as the laryngopharyngeal segment of the upper airway;the effect of migratory jaws on the hyoid bone is reflected in the X-HB,indicating that migratory jaws can lead to the deviation of the hyoid bone from the median sagittal plane.

Background::Gastric cancer (GC), a malignant tumor with poor prognosis, is one of the leading causes of cancer-related deaths worldwide; consequently, identifying novel therapeutic targets is crucial for its corresponding treatment. NUF2, a component of the NDC80 kinetochore complex, promotes cancer progression in multiple malignancies. Therefore, this study aimed to explore the potential of NUF2 as a therapeutic target to inhibit GC progression. Methods::Clinical samples were obtained from patients who underwent radical resection of GC at Lanzhou University Second Hospital from 2016 to 2021. Cell count assays, colony formation assays, and cell-derived xenotransplantation (CDX) models were used to determine the effects of NUF2 on GC progression. Flow cytometry was used to detect the effect of NUF2 or quercetin on cell cycle progression and apoptosis. A live-cell time-lapse imaging assay was performed to determine the effect of NUF2 on the regulation of mitotic progression. Transcriptomics was used to investigate the NUF2-associated molecular mechanisms. Virtual docking and microscale thermophoresis were used to identify NUF2 inhibitors. Finally, CDX, organoid, and patient-derived xenograft (PDX) models were used to examine the efficacy of the NUF2 inhibitor in GC. Results::NUF2 expression was significantly increased in GC and was negatively correlated with prognosis. The deletion of NUF2 suppressed GC progression both in vivo and in vitro. NUF2 significantly regulated the mitogen-activated protein kinase (MAPK) pathway, promoted G2/M phase transition, and inhibited apoptosis in GC cells. Additionally, quercetin was identified as a selective NUF2 inhibitor with low toxicity that significantly suppressed tumor growth in GC cells, organoids, CDX, and PDX models. Conclusions::Collectively, NUF2-mediated G2/M phase transition and apoptosis inhibition promoted GC progression; additionally, NUF2 inhibitors exhibited potent anti-GC activity. This study provides a new strategy for targeting NUF2 to suppress GC progression in clinical settings.

Disturbances of gut microbiota may affect the balance of the host immune system.The metabolism of gut microbiota produces many bioactive molecules interacting with host,typically secondary bile acids(SBAs).SBAs are involved in regulating the energy metabolism and the expression of inflammatory response-related genes by bind-ing to membrane receptors and nuclear receptors,such as takeda G protein-coupled receptor(TGR5)and farnesol X receptor(FXR),which are essential for maintaining host immune homeostasis.

Objective To explore effects of a derivative of imperatorin(IMP-1)on the activity and resistance proteins of alveolar type Ⅱ(ATⅡ)cells in chronic obstructive pulmonary disease(COPD).Methods AT Ⅱ cells were divided into the blank group(well growing AT Ⅱ cells cultured in conventional medium),the cigarette smoke extract(CSE)group(induced culture with 2%CSE added)and the IMP-1 group(intervention with 10 μ mol/L of IMP-1 on CSE induced AT Ⅱcells).Proliferation rates of AT Ⅱ cells at 24,48 and 72 hours were measured using MTT method.Apoptosis of ATⅡ cells was detected by Hoechst 33342 staining.The proportion of cells in each cycle was analyzed by flow cytometry.The number of ATⅡ cell clones was detected by soft AGAR clone formation assay.Multidrug resistance gene 1(MDR1)and multidrug resistance associated protein 1(MRP1)were detected by Western blot assay.Results Compared with the blank group,the apoptosis rate and the proportion of G0/G1 phase of ATⅡ cell cycle were increased in the CSE group,and the proliferation rate and the proportion of S,G2/M phase were decreased at 24 h,48 h and 72 h(P＜0.05).Compared with the CSE group,the cell proliferation rate,the proportion of S and G2/M phases and the number of cell clones were increased in the IMP-1 group,and the proportion of G0/G1 phase in ATⅡ cell cycle and the protein levels of MDR1 and MRP1 were decreased in the IMP-1 group(P＜0.05).Conclusion IMP-1 may downregulate the expression of MDR1 and MRP1 proteins induced by CSE in AT Ⅱ cells,inhibiting the progression of AT Ⅱ cells from S phase to G2 phase and from G2 phase to M phase,thereby inhibiting abnormal cell activation and increasing apoptosis.

Objective To explore the feasibility of automatic segmentation of clinical target volume(CTV)and organs at risk(OARs)for cervical cancer using AccuLearning(AL)based on geometric and dosimetric indices.Methods Seventy-five CT localization images with manual contouring data of postoperative cervical cancer were enrolled in this study.Sixty cases were randomly selected to trained to generate automatic segmentation model by AL,and the CTV and OARs of the remaining 15 cases were automatically contoured.Radiotherapy plans on the automatic segmentation contours were imported on the CT images of manual contours.The efficiency,Dice similarity coefficient(DSC),Hausdorff distance(HD)and dosimetric parameters were compared between the two methods.Results The time of automatic segmentation was significantly shorter than that of the manual contour(P<0.05).The DSC of all structures were≥0.87.The HD of bowel bag and rectum were about 10 mm,and that of the rest of OARs were less than 5 mm.CTV(D98,V90% ,V95% ,Dmean,HI),bowel bag(V50)and bladder(V50)had significant differences in dosimetric comparison(P<0.05).Conclusion The automatic segmentation model based on AL can improve the efficiency of radiotherapy.Automatic segmentation of OARs has the potential of clinical application,while that of CTV still needs to be further modified.