Objective:To investigate the changes in blood betatrophin in overweight and obese children，and analyze the relationship with glucose and lipid metabolism.Methods:A total of 177 children，including overweight-obese children and healthy controls，who visited the pediatric endocrinology clinic of Tianjin First Central Hospital from July 1，2021 to May 31，2023 were selected as study subjects. They were divided into an overweight-obese group（104 cases）and a normal control group（73 cases）. Data from both groups were collected and analyzed to explore the relationship between betatrophin and parameters such as body mass index（BMI）and glycolipid metabolism-related indicators.Results:The age［10.5（8.0，12.0）years vs 8.0（6.0，12.0）years］，fasting insulin［19.99（11.47，31.60）μIU/ml vs 7.27（5.02，10.99）μIU/ml］，triglyceride［0.95（0.74，1.31）mmol/L vs 0.75（0.62，0.92）mmol/L］，total cholesterol［（3.88 ± 0.72）mmol/L vs（3.60 ± 0.66）mmol/L］，low-density lipoprotein cholesterol［（2.37 ± 0.63）mmol/L vs（2.06 ± 0.62）mmol/L］，uric acid［353.20（287.40，434.12）μmol/L vs 278.60（218.00，313.80）μmol/L］，Betatrophin［22.54（17.08，27.53）mIU/L vs 19.30（15.78，23.33）mIU/L］，and fatty liver［31 cases（29.8%）vs 1 case（1.4%）］in overweight-obese group children were all higher than those in the normal control group children，and the differences were statistically significant（all P<0.01）.After adjusting for confounding factors such as age and BMI，partial correlation analysis revealed a positive correlation between betatrophin and triglycerides（ P<0.05）. Receiver operating characteristic（ROC）curve analysis indicated that a betatrophin level of 22 mIU/L had predictive value for hypertriglyceridemia，with an area under the curve（AUC）of 0.705（95% CI：0.566-0.843），showing statistical significance（ P=0.014）. Conclusion:Betatrophin may be associated with weight gain in children，mainly involved in the triglyceride metabolism.

Objective:To investigate the clinical significance of serum galectin-9 (Gal-9) in patients with dermatomyositis (DM) or clinically amyopathic dermatomyositis (CADM) .Methods:This cross-sectional study included 105 newly diagnosed patients with DM or CADM who were admitted to the Department of Dermatology in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from January 2015 to October 2024, among whom 53 had cancer-associated DM/CADM (CRDM). Additionally, an age-matched control group was included, consisting of 30 newly diagnosed cancer patients without autoimmune diseases, 27 systemic lupus erythematosus (SLE) patients, and 31 healthy controls. Serum levels of Gal-9 and transcriptional intermediary factor 1-gamma (TIF1-γ) were measured using enzyme-linked immunosorbent assay. The relationship between Gal-9 levels and laboratory indicators of DM disease activity was analyzed. Comparisons between different groups were performed using the t-test, Mann-Whitney U test, and chi-square test. Spearman correlation analysis was used to assess the association between Gal-9 levels and laboratory indicators. The diagnostic efficacy of Gal-9 and TIF1-γ for CRDM was evaluated using receiver operating characteristic (ROC) curve analysis. Results:Among the 105 DM/CADM patients, 35 were male (33.3%) and 70 were female (66.7%), with a mean age of 53.2 ± 15.1 years. In the 53 CRDM patients, the incidence rates of V-neck sign, dyschromia, and dysphagia were higher than those in non-CRDM patients (all P > 0.05). Serum Gal-9 levels in DM/CADM patients (21.2 [12.2, 32.3] ng/ml) were significantly higher than those in healthy controls (6.8 [5.4, 7.9] ng/ml, P < 0.001), SLE patients (12.3 [8.1, 15.5] ng/ml, P = 0.011), and cancer patients without autoimmune diseases (7.5 [4.9, 8.5] ng/ml, P < 0.001). Gal-9 levels were positively correlated with serum TIF1-γ antibody levels ( rs = 0.21, P = 0.029), serum ferritin ( rs = 0.29, P = 0.003), lactate dehydrogenase ( rs = 0.44, P < 0.001), creatine kinase ( rs = 0.28, P = 0.004), aspartate aminotransferase ( rs = 0.42, P < 0.001), C-reactive protein ( rs = 0.34, P < 0.001), and erythrocyte sedimentation rate ( rs = 0.46, P < 0.001). Among CRDM patients, those who had not received cancer treatment had higher Gal-9 levels (30.1 [23.3, 38.3] ng/ml) than those in stable condition after cancer treatment (13.5 [10.5, 27.9] ng/ml, P = 0.007). The area under the ROC curve (AUC) for serum TIF1-γ in diagnosing CRDM was 0.718, with an optimal cutoff value of 23.02 U/ml. The AUC for serum Gal-9 was 0.719, with an optimal cutoff value of 55.02 ng/ml. When combining both markers, the AUC increased to 0.783, with a sensitivity of 0.85 and specificity of 0.74. Conclusions:Gal-9 was highly expressed in serum of DM/CADM patients, particularly in CRDM patients. Dynamic monitoring of Gal-9 in CRDM patients may be helpful to monitor the therapeutic effect of malignancies.

Objective:To evaluate the left ventricular（LV）function in heart transplant（HTx）patients with post-transplant diabetes（PTDM），and to examine the relevance of PTDM and LV function to the patient's prognosis.Methods:Two hundred and thirteen adult HTx patients who underwent echocardiography at Union Hospital，Tongji Medical College，Huazhong University of Science and Technology between January 2018 and January 2022 were prospectively included. The patients were divided into PTDM group（ n=86）and Non-PTDM group（ n=127）. LV function parameters were acquired using conventional and two-dimensional speckle-tracking echocardiography（2D-STE），and were compared between the two groups. The primary endpoints included all-cause mortality or transplant-related readmission. Results:Compared with Non-PTDM group，the LV mass of PTDM group was higher，the LV ejection fraction，LV global longitudinal strain（GLS），peak systolic global longitudinal strain rate，and early diastolic global longitudinal strain rate（dGLSr）were lower（all P＜0.05）. After a median follow-up period of 37.6（29.3）months，27 patients experienced clinical events. A multivariate analysis revealed that PTDM（ HR=2.198，95% CI=1.018-4.743， P=0.045）and low GLS（ HR=6.456，95% CI=2.889-14.426， P＜0.001）were independent predictors of adverse clinical events after adjustment for dGLSr，body mass index and age. After subdividing the two groups into 4 subgroups by the cutoff value of GLS（16.5%），the prognosis was worst for HTx patients with PTDM and low GLS. Conclusions:HTx patients with PTDM have worse LV systolic and diastolic function than those without PTDM. Management of HTx patients with PTDM may be improved using GLS guidance.

Objective:To investigate the clinical significance of serum galectin-9 (Gal-9) in patients with dermatomyositis (DM) or clinically amyopathic dermatomyositis (CADM) .Methods:This cross-sectional study included 105 newly diagnosed patients with DM or CADM who were admitted to the Department of Dermatology in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from January 2015 to October 2024, among whom 53 had cancer-associated DM/CADM (CRDM). Additionally, an age-matched control group was included, consisting of 30 newly diagnosed cancer patients without autoimmune diseases, 27 systemic lupus erythematosus (SLE) patients, and 31 healthy controls. Serum levels of Gal-9 and transcriptional intermediary factor 1-gamma (TIF1-γ) were measured using enzyme-linked immunosorbent assay. The relationship between Gal-9 levels and laboratory indicators of DM disease activity was analyzed. Comparisons between different groups were performed using the t-test, Mann-Whitney U test, and chi-square test. Spearman correlation analysis was used to assess the association between Gal-9 levels and laboratory indicators. The diagnostic efficacy of Gal-9 and TIF1-γ for CRDM was evaluated using receiver operating characteristic (ROC) curve analysis. Results:Among the 105 DM/CADM patients, 35 were male (33.3%) and 70 were female (66.7%), with a mean age of 53.2 ± 15.1 years. In the 53 CRDM patients, the incidence rates of V-neck sign, dyschromia, and dysphagia were higher than those in non-CRDM patients (all P > 0.05). Serum Gal-9 levels in DM/CADM patients (21.2 [12.2, 32.3] ng/ml) were significantly higher than those in healthy controls (6.8 [5.4, 7.9] ng/ml, P < 0.001), SLE patients (12.3 [8.1, 15.5] ng/ml, P = 0.011), and cancer patients without autoimmune diseases (7.5 [4.9, 8.5] ng/ml, P < 0.001). Gal-9 levels were positively correlated with serum TIF1-γ antibody levels ( rs = 0.21, P = 0.029), serum ferritin ( rs = 0.29, P = 0.003), lactate dehydrogenase ( rs = 0.44, P < 0.001), creatine kinase ( rs = 0.28, P = 0.004), aspartate aminotransferase ( rs = 0.42, P < 0.001), C-reactive protein ( rs = 0.34, P < 0.001), and erythrocyte sedimentation rate ( rs = 0.46, P < 0.001). Among CRDM patients, those who had not received cancer treatment had higher Gal-9 levels (30.1 [23.3, 38.3] ng/ml) than those in stable condition after cancer treatment (13.5 [10.5, 27.9] ng/ml, P = 0.007). The area under the ROC curve (AUC) for serum TIF1-γ in diagnosing CRDM was 0.718, with an optimal cutoff value of 23.02 U/ml. The AUC for serum Gal-9 was 0.719, with an optimal cutoff value of 55.02 ng/ml. When combining both markers, the AUC increased to 0.783, with a sensitivity of 0.85 and specificity of 0.74. Conclusions:Gal-9 was highly expressed in serum of DM/CADM patients, particularly in CRDM patients. Dynamic monitoring of Gal-9 in CRDM patients may be helpful to monitor the therapeutic effect of malignancies.

Objective:To evaluate the left ventricular（LV）function in heart transplant（HTx）patients with post-transplant diabetes（PTDM），and to examine the relevance of PTDM and LV function to the patient's prognosis.Methods:Two hundred and thirteen adult HTx patients who underwent echocardiography at Union Hospital，Tongji Medical College，Huazhong University of Science and Technology between January 2018 and January 2022 were prospectively included. The patients were divided into PTDM group（ n=86）and Non-PTDM group（ n=127）. LV function parameters were acquired using conventional and two-dimensional speckle-tracking echocardiography（2D-STE），and were compared between the two groups. The primary endpoints included all-cause mortality or transplant-related readmission. Results:Compared with Non-PTDM group，the LV mass of PTDM group was higher，the LV ejection fraction，LV global longitudinal strain（GLS），peak systolic global longitudinal strain rate，and early diastolic global longitudinal strain rate（dGLSr）were lower（all P＜0.05）. After a median follow-up period of 37.6（29.3）months，27 patients experienced clinical events. A multivariate analysis revealed that PTDM（ HR=2.198，95% CI=1.018-4.743， P=0.045）and low GLS（ HR=6.456，95% CI=2.889-14.426， P＜0.001）were independent predictors of adverse clinical events after adjustment for dGLSr，body mass index and age. After subdividing the two groups into 4 subgroups by the cutoff value of GLS（16.5%），the prognosis was worst for HTx patients with PTDM and low GLS. Conclusions:HTx patients with PTDM have worse LV systolic and diastolic function than those without PTDM. Management of HTx patients with PTDM may be improved using GLS guidance.

Objective To study the effectiveness of pro-abdominal exercise in improving the quality of gastroscopy,and provide patients with a better preoperative preparation for gastroscopy.Methods 307 patients who underwent painless gastroscopy from March to July 2023 were selected and divided into three groups according to the random number table method.There were 106 cases in the abdominal massage group,103 cases in the bed turning group and 98 cases in the control group.On the basis of routine medication,different preoperative activity guidance was used to compare and analyze the preoperative preparation time,examination time and gastric mucosal visual field clarity score in each group.Results The gastroscopy time in the abdominal massage group and the bed-turning group was significantly shorter than that in the control group,and the clarity score of the gastric mucosal visual field was significantly lower than that of the control group,with statistically significant differences(P<0.05).However,there were no statistically significant differences in the gastroscopy time or visual field clarity score for gastric body,gastric fundus,and gastric antrum between the abdominal massage group and the bed-turning group(P>0.05).The satisfaction rate of endoscopists in the abdominal massage group and the bed turning group was higher than that in the control group,and the differences were statistically significant.Conclusion Abdominal massage and turning over in bed as preoperative preparation methods for gastroscopy can improve the quality of gastroscopy,while abdominal massage can shorten the preparation time before gastroscopy,which is helpful for the efficient operation of digestive endoscopy center and is worthy of clinical application.

Objective:To explore the feasibility, accuracy and reproducibility of a novel, fully automated three-dimensional echocardiography right ventricular(RV) quantification software(3D Anto RV) to evaluate the RV volume and RV ejection fraction (RVEF) using artificial intelligence in patients after heart transplantation (HT) comparing with the gold reference-cardiac magnetic resonance (CMR).Methods:Forty-six patients after HT who were scheduled for echocardiogram at their routine follow-up examinations and also agreed to undergo CMR examination within the following 24 hours in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from October 2018 to June 2019 were prospectively included. The right ventricular end-diastolic volume (RVEDV), right ventricular end-systolic volume (RVESV), right ventricular stroke volume (RVSV) and RVEF of HT patients were measured by CMR 3D Auto RV and conventional semi-automated three-dimensional echocardiography RV quantification software (Tomtec 4D RV function 2.0). The results of the 3D Auto RV and conventional semi-automated Tomtec were respectively compared with CMR using paired two-tailed student′s t-tests, Pearson correlation coefficients and Bland-Altman analyses. Results:The feasibility of the 3D Auto RV was 87%.The fully automated analysis realized in 27 (59%) patients by 3D Auto RV and the analysis time required only (12±1)s. The results of the remaining 19 (41%) patients needed manual adjustment and the mean analysis time in manual adjustment was also <2 min that was shorter than the conventional semi-automated three-dimensional echocardiography RV quantification software[(108±15)s vs (160±34)s, P<0.001]. For the results of RV volumes: There were good correlations between the 3D Auto RV and CMR, conventional semi-automated Tomtec and CMR for the measurements of RVEDV, RVESV and RVSV ( r=0.77-0.84, all P<0.001). In addition, compared with CMR, although there were significantly underestimated RV volumes by the 3D Auto RV and conventional semi-automated Tomtec, the negative bias was smaller in the 3D Auto RV than the conventional semi-automated Tomtec. For the results of RVEF: the corresponding RVEF derived from 3D Auto RV and CMR showed an excellent correlation and consistency ( r=0.84, P<0.001; bias=-1.1%, Limit of agreement=-8.1%-6.0%). In addition, the correlations between the manual adjustment by 3D Auto RV and the CMR ( r=0.63-0.72, all P<0.001) was lower than the correlations between the 3D Auto RV and the CMR ( r=0.76-0.82, all P<0.001) for RV volumes and RVEF.Finally, 3D Auto RV had a good reproducibility. Conclusions:The new fully 3D Auto RV quantification software underestimate RV volumes that less than the conventional semi-automated Tomtec. And the 3D Auto RV quantification software can accurately evaluate the RVEF in patients after HT with rapid analysis and higher reproducibility, which may also support the routine adoption of this method during follow-ups of HT patients in the daily clinical workflow.

Aged ; Aged, 80 and over ; Cytarabine ; administration & dosage ; therapeutic use ; Female ; Harringtonines ; administration & dosage ; therapeutic use ; Humans ; Induction Chemotherapy ; methods ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged

Objective To analyze the clinical features of,concurrence of allergic diseases in,as well as serum levels of total immunoglobulin E (IgE) and specific IgEs in,232 patients with alopecia areata (AA),and to estimate their relationship.Methods Serum samples were obtained from 232 patients with AA and 110 healthy controls from a health check-up center.Turbidimetric immunoassay and fluorescence-based enzyme-linked immunosorbent assay were performed to measure total IgE and specific IgEs to common antigens in these serum samples,respectively.Statistical analysis was carried out by t test,rank sum test,and chi-square test.Results The patients showed a male/female ratio of 127 ∶ 105 with an average age of (26.4 ± 13.8) years and clinical course of (25.3 ± 42.3) months.Among these patients,89 (38.4％) suffered from severe AA,and 67 (28.9％) reported at least one allergic disease.No significant difference was found in the positive rates of serum total IgE (30.2％ vs.21.8％,P ＞ 0.05),anti-Dermatophagoides pteronyssinus and-Cockroach specific IgEs or the serum levels of antiDermatophagoides pteronyssinus or-Cockroach IgE between the patients and healthy controls.The three most common specific IgEs were anti-Dermatophagoides pteronyssinus IgE (34.1％),anti-Dermatophagoides farinae IgE (31.9％) and anti-Cockroach IgE (22.5％) in patients with AA,whose serum levels were positively correlated with the level of serum total IgE separately.A significant increase was observed in the positive rates and serum levels of anti-Dermatophagoides pteronyssinus and-Cockroach specific IgEs in patients with severe and diffuse AA compared with the healthy controls and patients with mild AA,as well as in those of anti-Dermatophagoides pteronyssinus specific IgE in child patients with AA compared with the healthy controls and adult patients with AA (P ＜ 0.05 or 0.01).Conclusions Dust mite allergy may be not only a pathogenic factor for severe,diffuse and childhood AA,but also a risk factor for early onset and severe type of AA.

AIM:To investigate the influential factors of the blood-brain barrier (BBB) permeability and to observe the effects of zileuton,a selective 5-lipoxygenase inhibitor (5-LO),on focal cerebral ischemia-reperfusion injury (CIRI).METHODS:The right middle cerebral artery of the rat was occluded by inserting a thread through internal carotid artery for 2 h,and then reperfused for 24 h. Zileuton (10,50 mg?kg-1,po) was orally administered 2 h before ischemia and at 0,5,10 h after reperfusion. The permeability of blood brain barrier (BBB) was detected by using Evans blue (EB) as a labelling compound. The degree of cerebral edema was estimated by AutoCAD image analysis software. The mRNA of cysteiny leukotrienes receptor1 (CysLTR1) was detected by RT-PCR. The content of LTB4 in serum was measured by enzyme linked immunosorbent assay (ELISA). The expressions of AQP4 and MMP-9 proteins were measured by immunohistochemical staining method. RESULTS:After middle cerebral artery occlussion 2 h/reperfusion 24 h,the permeability of BBB in the brain tissue of injured side and the brain edema degree were increased. The content of LTB4 in serum was elevated. The expression of CysLTR1 mRNA from the brain tissue of occluded side was enhanced. The expressions of MMP-9 and AQP4 proteins of the ischemia realm and ischemia penumbra (IP) of the infarct focus perimeter were increased. Both 10 and 50 mg?kg-1 doses of zileuton dramatically relieved the BBB permeability destruction and the degree of the brain edema,inhibited the expression of CysLTR1 mRNA in the brain tissue and also reduced the content of LTB4 in serum. The expressions of AQP4 and MMP-9 proteins in the brain tissue were also decreased.CONCLUSION:The permeability of BBB is destroyed after the focal CIRI. The mechanisms of protective effect of zileuton might be attributed to its effects by inhibiting the activation of 5-LO pathways on the brain tissue and circulatory blood,reducing the expressions of AQP4 and MMP-9 proteins of the ischemia and IP realm in the brain tissue.