ObjectiveTo investigate the mRNA expression profile and clinical significance of the RAB24 gene in hepatocellular carcinoma （HCC） based on multi-source database including The Cancer Genome Atlas （TCGA） and clinical cohort validation. MethodsData from TCGA （n=424） were utilized to evaluate the prognostic value of RAB24 expression via Kaplan-Meier analysis and Cox regression models. An independent clinical cohort comprising 90 HCC and 30 paracancerous tissues was established to validate protein expression and histopathological features through immunohistochemistry （IHC） and routine histological staining. The TIMER database was employed to analyze the association between RAB24 and the tumor microenvironment （TME）. Furthermore， integrated with LinkedOmics， GSEA and GSVA algorithms were used to quantitatively characterize the core molecular pathways regulated by RAB24. ResultsThe mRNA expression level of RAB24 in HCC was significantly higher than that in non-tumor liver tissues （P<0.05）. Kaplan-Meier analysis revealed that the overall survival （OS） of patients in the RAB24 low-expression group was significantly longer compared to the high-expression group （HR=1.570， Log-rank P=0.01）. Cox proportional hazards regression analysis demonstrated that RAB24 expression （HR=1.480， P=0.028）， T stage （HR=2.949， P<0.001）， M stage （HR=4.077， P=0.017）， and tumor residual status （HR=2.317， P<0.001） were independent prognostic factors for HCC. RAB24 expression was highly correlated with alpha-fetoprotein （AFP） levels and immune infiltration levels （P<0.01）， and showed a significant， low-level positive correlation with the TP53 gene （Rho=0.31， P<0.01）. Quantitative analysis of the RAB24 protein in clinical samples validated that RAB24 expression in HCC tissues was significantly elevated compared to non-tumor liver tissues （P<0.05）. TIMER analysis confirmed that RAB24 expression was highly associated with the infiltration of multiple immune cells （such as B cells and NK cells）， as well as stromal and tumor purity scores in tumor tissues （P<0.01）. GSEA/GSVA enrichment revealed that the P53， MYC， and mTORC1 signaling pathways were activated in the RAB24 high-expression group； correlation analysis confirmed that the RAB24 expression level exhibited a significant， low-level positive correlation with the ribosome pathway activity score （r=0.23， P<0.01）. ConclusionsThe RAB24 gene， as a poor prognostic factor for HCC patients， is a potential biomarker for HCC diagnosis， treatment and prognosis. The study is expected to lay a theoretical foundation for the precise diagnosis and treatment of clinical HCC.

Objective To investigate the effect of miR-132-3p on epithelial-mesenchymal transition(EMT)of trophoblast cells through targeted regulation of the SIRT1/NF-κB pathway.Methods Placental tissues from 37 pre-eclampsia(PE)patients who underwent cesarean section in Zhengzhou Women&Infants Hospital and 37 normal pregnant women who underwent cesarean section were collected as the research group and control group,respectively.RT-qPCR was performed to detect the expression of miR-132-3p and SIRT1 in tissues.During the logarithmic pro-liferation phase,HTR-8/SVneo cells were grouped into inhibitor negative group,miR-132-3p inhibitor group,mimic negative group,miR-132-3p overexpression group,miR-132-3p inhibitor+interference negative group,and miR-132-3p inhibitor+interference SIRT1 group,with untransfected HTR-8/SVneo cells as the blank group.CCK-8,Transwell assay,scratch assay,and RT-qPCR were used to detect the proliferation,invasion,migration,and changes in miR-132-3p and SIRT1 mRNA expression of HTR-8/SVneo cells.Western blot was used to detect the expression levels of EMT related proteins and SIRT1,NF-κB proteins.Dual luciferase was used to validate the targeting relationship between miR-132-3p and SIRT1.Results The level of miR-132-3p in the research group was significantly higher than that in the control group,while the SIRT1 mRNA was lower(P＜0.05).The level of miR-132-3p,E-cadherin,p-NF-κBp65/NF-κBp65 in the miR-132-3p inhibitor group was lower than those in the inhib-itor negative group and blank group.The proliferation rate,invasion cell number,migration rate,level of vimentin,N-cadherin,and SIRT1 were all higher(P＜0.05).The miR-132-3p,E-cadherin,p-NF-κBp65/NF-κBp65 in the miR-132-3p overexpression group were higher than those in the mimic negative group,the proliferation rate,inva-sion number,migration rate,vimentin,N-cadherin,and SIRT1 were lower(P＜0.05).The level of E-cadherin and p-NF-κBp65/NF-κBp65 in the miR-132-3p inhibitor+interference SIRT1 group was higher than those in the miR-132-3p inhibitor+interference negative group(P＜0.05),the proliferation rate,invasion number,migration rate,vimentin,N-cadherin,and SIRT1 expression were lower(P＜0.05).MiR-132-3p targeted regulation of SIRT1 expression(P＜0.05).Conclusions Inhibition of miR-132-3p promotes the EMT,proliferation,invasion,and migration of trophoblast cells by targeting and activating the SIRT1/NF-κB pathway.

Objective To analyze the PLCβ4 gene mRNA expression and its clinical significance in hepatocellular carcinoma (HCC) based on TCGA database. Methods Based on the data on 424 clinical samples (including 374 cases of HCC tissues and 50 cases of nontumor liver tissues) in the TCGA database, Kaplan–Meier method, Cox regression analysis, and immune infiltration analysis were performed to evaluate the relationship between PLCβ4 gene and the clinical characteristics and survival prognosis of HCC patients. Correlation analysis between PLCβ4 gene and 24 types of immune cells was applied to investigate the relationship between PLCβ4 gene and immune cell infiltration and mRNA expression level of TP53 gene, a high-frequency mutation gene in HCC. In addition, paraffin sections of highly, moderately, and poorly differentiated tumor tissues and normal liver tissues from HCC patients were collected. The histopathological observation was carried out via HE staining method, and the expression levels of PLCβ4 and Ki-67 proteins in each clinical sample were verified through the immunohistochemical method. Results The expression level of PLCβ4 gene in HCC was significantly higher than that in normal tissues (P<0.01), and all patients in the PLCβ4 high-expression group had a significantly longer overall survival than those in the low-expression group (P<0.05), which suggested that PLCβ4 substantially affected the prognosis of HCC patients. Correlation analysis showed that the expression level of PLCβ4 gene was highly correlated with immune cell infiltration and the expression level of TP53 gene. As verified by clinical sample experiments, HE staining experiments and immunohistochemical results revealed that PLCβ4 gene expression in HCC tissue samples was significantly higher than that in normal tissues (P<0.001), and it was negatively correlated with the degree of differentiation. Conclusion PLCβ4 may serve as an independent prognostic factor in HCC and is expected to be a novel molecular target for HCC treatment.

ObjectiveTo screen for the patients with metabolic dysfunction-associated fatty liver disease （MAFLD） among the physical examination population， to observe the characteristics of MAFLD patients， and to compare the differences in lifestyle between the MAFLD population and the non-MAFLD population. MethodsA cross-sectional study was conducted among 6 206 individuals who underwent physical examination in a physical examination institution in Beijing from December 2015 to December 2019， and according to the new diagnostic criteria for MAFLD， the examination population was divided into MAFLD group and non-MAFLD group. Based on body mass index （BMI）， the MAFLD group was further divided into lean MAFLD group （BMI<24 kg/m²） and non-lean MAFLD group （BMI ≥24 kg/m²）. Related data were compared between groups， including demographic indicators， education level， work pressure， physical measurement indicators， and lifestyles such as sleep， diet， and exercise. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the chi-square test was used for comparison of categorical data between groups. ResultsOf all individuals in this study， 1 926 （31.1%） had MAFLD and 4 280 （68.9%） did not have MAFLD. Compared with the non-MAFLD group， the MAFLD group had significantly higher age （Z=-14.459， P<0.001）， proportion of male patients （χ²=72.004， P<0.001）， work pressure （χ²=7.744， P=0.005）， body weight （Z=-43.508， P<0.001）， BMI （Z=-47.621， P<0.001）， waist circumference （Z=-48.515， P<0.001）， hip circumference （Z=-42.121， P<0.001）， and waist-hip ratio （Z=-43.535， P<0.001）， as well as a significantly lower education level （χ²=33.583， P<0.001）. In terms of behavior， the MAFLD group had a significantly shorter sleep time （χ²=5.820， P=0.016） and a significantly faster eating speed （χ²=74.476， P<0.001）. In terms of diet， the patients in the MAFLD group consumed more high-sodium， high-sugar， and high-calorie diets （χ²=42.667， P<0.001） and low-fiber diet （χ²=4.367， P=0.008）. In terms of exercise， the MAFLD group had a significantly higher proportion of patients without exercise habits （χ²=10.278， P=0.001）. Further analysis showed that there were 202 individuals （10.5%） in the lean MAFLD group and 1 724 （89.5%） in the non-lean MAFLD group. Compared with the non-lean MAFLD group， the lean MAFLD group had significantly higher age （Z=3.368， P=0.001） and education level （χ²=9.647， P=0.002） and significantly lower proportion of male patients （χ²=27.664， P<0.001）， body weight （Z=-18.483， P<0.001）， BMI （Z=-23.286， P<0.001）， waist circumference （Z=-18.565， P<0.001）， and hip circumference （Z=-18.097， P<0.001）， and in terms of behavior， the non-lean MAFLD group had a significantly faster eating speed （χ²=4.549， P=0.033）. ConclusionThere is a relatively high prevalence rate of MAFLD among the physical examination population in Beijing， with a higher number of people with unhealthy lifestyles compared with the non-MAFLD population.

Objective:To construct and validate a nomogram prediction model for the recurrence of common bile duct stones after endoscopic retrograde cholangiopancreatography (ERCP) in patients with common bile duct stones.Methods:The clinical data of 515 patients with common bile duct stones treated in Yancheng First People's Hospital from January 2018 to December 2022 were retrospectively analyzed, including 273 males and 242 females, aged (65.5±12.1) years. According to the ratio of 8∶2, all cases were randomly divided into a training set ( n=412) and a validation set ( n=103). According to whether common bile duct stones recurred after ERCP, 412 patients in the training set were divided into two groups: the recurrence group ( n=72) and the non-recurrence group ( n=340). The patients' gender, age, length and diameter of stones, number of stones, diameter of common bile duct and other clinical data were recorded. The logistic regression model was used to analyze the risk factors of recurrence, and a nomogram was constructed based on the analysis results. The concordanceindex, area under the receiver operating characteristic (ROC) curve and calibration chart were used to evaluate the model. Bootstrap self sampling method was used to internally verify the prediction model. Results:The recurrence rate of common bile duct stones in the training set was 17.5% (72/412). Multivariate logistic regression analysis showed that stone length, stone number, mixed stones, periampullary diverticulum, postoperative cholecystectomy, nipple incision were risk factors for recurrence of common bile duct stones after ERCP (all P<0.05). Small incision of nipple assisted with large balloon dilatation, incision of nipple titanium splint synthesis, and postoperative ursodeoxycholic acid were protective factors for recurrence of common bile duct stones after ERCP (all P<0.05). The concordance index of the nomogram model based on the above influencing factors was 0.791(95% CI: 0.633-0.892), and the area under the ROC curve for predicting postoperative recurrence of common bile duct stones in the training set and the validation set were 0.905(95% CI: 0.819-0.987) and 0.873(95% CI: 0.809-0.935), respectively. The calibration curve was basically consistent with the ideal curve, and the concordanceindex of internal validation was 0.781(95% CI: 0.628-0.874). Conclusion:The nomogram model based on the influencing factors of common bile duct stone recurrence can predict the risk of common bile duct stone recurrence after ERCP.

Objective:To analyze the mediating effects of psychological resilience on the relationship between perceived social support and health behavior capacity in patients with ischemic stroke.Methods:In this cross-sectional study, 500 patients with ischemic stroke were consecutively recruited using purposive sampling in the First People′s Hospital of Lianyungang between July and September in 2023. The sociodemographic characteristics, perceived social support scale, psychological resilience questionnaire and self-rated abilities for health practices scale in the patients were collected. A total of 500 questionnaires were distributed and 493 questionnaires were collected, of which 473 (95.9%) were valid. The structural equation model was constructed to explore the mediating effects of psychological resilience on the relationship between perceived social support and health behavior capacity in patients with ischemic stroke.Results:Among the 473 patients included in the analysis, there were 254 males and 219 females, with an average age of (66.8±11.4) years. The duration of stroke was less than 3 months for 329 patients (69.6%); the scores for perceived social support, psychological resilience and health behavior capacity was (59.68±11.15), (23.68±6.52), and (60.54±23.52), respectively. Perceived social support exerted significant direct effect ( β=0.334, bias-corrected 95% CI: 0.232-0.438) on health behavior capacity in patients with ischemic stroke, accounting for 63.62% of the total effect. Psychological resilience played a mediating role in the relationship between perceived social support and health behavior capacity ( β=0.191, bias-corrected 95% CI: 0.142-0.248), accounting for 36.38% of the total effect (all P<0.05). Conclusion:The health behavior capacity of patients with ischemic stroke is at a moderately low level, perceived social support may positively affect health behavior capacity through the positive mediating effect of psychological resilience.

Objective:To describe the prevalence of non-alcoholic fatty liver disease (NAFLD) in people living with HIV in Taizhou, Zhejiang Province, and identify the factors associated with NAFLD in this population.Methods:A cross-sectional survey was conducted from 2021 to 2023. Based on the routine follow-up management of people living with HIV, liver ultrasound examination, physical examination and laboratory test were conducted to collect the information about the diagnosis of NAFLD and biochemical indicators in this population. Logistic regression model was used to identify the factors associated with the prevalence of NAFLD.Results:In the 2 550 study participants, the prevalence of NAFLD was 21.5% (548/2 550), abnormal liver function was found in 23.7% (604/2 550) of the study participants, and liver fibrosis was found in 45.2% (1 152/2 550) of the study participants. Multivariable logistic regression analyses showed that being women (a OR=0.55, 95% CI: 0.42-0.73), being overweight or obese (a OR=3.22, 95% CI: 2.59-4.01), having diabetes (a OR=3.37, 95% CI: 2.15-5.29), having dyslipidemia (a OR=2.96, 95% CI: 2.25-3.89), CD4 + T lymphocyte (CD4) counts <200 cells/μl (a OR=0.61, 95% CI: 0.42-0.88), and receiving Efavirenz (EFV) + Lamivudine (3TC) + Zidovudine (AZT) for antiretroviral therapy (ART)(a OR=1.52, 95% CI: 1.17-1.98) were associated with NAFLD. NAFLD was positively associated with abnormal liver function (a OR=2.01, 95% CI: 1.60-2.52) and inversely associated with liver fibrosis (a OR=0.76, 95% CI: 0.59-0.98). The 45-59 age group (a OR=7.05, 95% CI: 5.65-8.80), CD4 counts <200 cells/μl (a OR=1.45, 95% CI: 1.06-1.97) and receiving Nevirapine (NVP)+3TC+AZT of ART (a OR=1.87,95% CI: 1.44-2.43) were the main factors associated with liver fibrosis. Conclusions:The prevalence of NAFLD in people living with HIV Taizhou was more than 20.0%, with a significant proportion of them having abnormal liver function and liver fibrosis. Being overweight or obese, suffering from diabetes, having dyslipidemia, low CD4 counts, and receiving specific ART were associated with NAFLD. NAFLD, CD4 counts and specific ART were the main factors associated with abnormal liver function and liver fibrosis.

Objective:To explore the effectiveness of generative artificial intelligence (GAI) -empowered interprofessional collaborative learning model in nursing psychology practical teaching for undergraduate nursing students.Methods:From November to December 2024, 109 second-year nursing students from the Xiangya School of Nursing, Central South University were selected as research subjects using convenience sampling. Two classes were randomly divided into an experimental group (55 students) and a control group (54 students) using a random draw method. Control group received a traditional teaching model based primarily on case discussion and scenario simulation teaching, while experimental group used the GAI-empowered interprofessional collaborative learning model on the basis of control group. The teaching effectiveness was evaluated using the Psychological Nursing Practice Competency Assessment Scale, Caring Ability Inventory (CAI), Readiness for Interprofessional Learning Scale (RIPLS), and Satisfaction Survey Questionnaire.Results:After teaching, experimental group's practical course assessment scores, CAI total scores, and scores in each dimension were all higher than those of control group, with statistically significant differences ( P<0.01). The RIPLS score of nursing students in experimental group after teaching was higher than that before teaching, and the difference was statistically significant ( P<0.01). 90.9% of nursing students supported the introduction of GAI into the classroom, and 90.9% of nursing students recognized the auxiliary role of GAI in achieving learning objectives, and the teaching satisfaction was 96.4%. Conclusions:This study validates the effectiveness of GAI-empowered interprofessional collaborative learning model in nursing psychology practical teaching for undergraduate nursing students, providing new ideas for nursing education reform.

Background: The genus Atractylodes, native to East Asia, encompasses several species that serve as sources for the widely used traditional Chinese medicines Atractylodis Macrocephalae Rhizoma and Atractylodis Rhizoma. However, the international trade arouses concern regarding potential confusion and misidentification of Atractylodes species. Objective: A comprehensive understanding of the chemical diversity is crucial for ensuring the quality and exploring the potential variations in medicinal efficacy of Atractylodes. Methods: The GC-MS/MS-based metabolomics and multivariate statistical analysis identified 589 differentially accumulated metabolites across 5 Atractylodes species. Results: A total of 150 metabolites were predicted as potential chemical markers for species differentiation and quality assessment of Atractylodes. According to the metabolic profiles, the species of Atractylodes can be roughly classified into three categories: A. lancea and A. coreana with the volatile oil components being mainly atractylodin and β-eudesmol; A. macrocephala with the biomarker being atractylon; and A. japonica and A. carlinoides lying between the two categories above. Conclusions: Metabolomic results indicated that the metabolic profiles of A. carlinoides and A. macrocephala were similar and distinct from those of the other three species. Sesquiterpenoids were the main chemical components in the rhizome of A. carlinoides, which indicated the potential medicinal value of this plant.

Background: The genus Atractylodes, native to East Asia, encompasses several species that serve as sources for the widely used traditional Chinese medicines Atractylodis Macrocephalae Rhizoma and Atractylodis Rhizoma. However, the international trade arouses concern regarding potential confusion and misidentification of Atractylodes species. Objective: A comprehensive understanding of the chemical diversity is crucial for ensuring the quality and exploring the potential variations in medicinal efficacy of Atractylodes. Methods: The GC-MS/MS-based metabolomics and multivariate statistical analysis identified 589 differentially accumulated metabolites across 5 Atractylodes species. Results: A total of 150 metabolites were predicted as potential chemical markers for species differentiation and quality assessment of Atractylodes. According to the metabolic profiles, the species of Atractylodes can be roughly classified into three categories: A. lancea and A. coreana with the volatile oil components being mainly atractylodin and β-eudesmol; A. macrocephala with the biomarker being atractylon; and A. japonica and A. carlinoides lying between the two categories above. Conclusions: Metabolomic results indicated that the metabolic profiles of A. carlinoides and A. macrocephala were similar and distinct from those of the other three species. Sesquiterpenoids were the main chemical components in the rhizome of A. carlinoides, which indicated the potential medicinal value of this plant.