Objective To investigate mitophagy in diabetic foot ulcer(DFU)target genes and analyze the immune correlation.Methods DFU related datasets were obtained from the Gene Expression Omnibus(GEO)and screened for their differential expression genes(DEGs).Mitophagy related genes(MRGs)were obtained from the Genecards database.DEGs and MRGs were intersected and analysed using gene ontology(GO),Kyoto Encyclopedia of Genes and Genomes(KEGG)and protein-protein interaction(PPI).Target genes were mined using four machine learning models:Support vector machine-recursive feature eliminatio,least absolute shrinkage and selection operator,random forest,extreme gradient boosting.DEGs were analysed for immune infiltration and the correlation of target genes with immune infiltration.Results GO enrichment results showed that it was mainly enriched in regulation of autophagy of mitochondrion.KEGG enrichment results showed that hypoxia inducible factor-1 signalling pathway,p53 signalling pathway and AMPK signalling pathway were mainly enriched.Machine learning results showed TP53 and CYCS as target genes.Immune infiltration results showed a clear correlation of TP53 with plasma cells,regulatory T cells,follicular helper T cells,CD8+T cells and monocytes.CYCS showed a clear correlation with B cell memory,T cells CD8+T cells,monocytes,plasma cells and regulatory T cells.Conclusion TP53,CYCS may be the target genes regulating mitophagy in DFU and have a key role in reducing the level of oxidative stress.At the same time,the dysregulation of plasma cells,T cells and other immune cells may also have some effect on mitophagy.

Objective:To learn about both the distribution of resources of radiodiagnostic and radiotherapeutic and the frequencies of radiological examinations to provide a basis for rational allocation of medical resources and standardize medical ionizing radiation.Methods:Based on the data on permanent resident population and the data reported by the Suzhou medical institutions in possesion of radiological equipment to the " Suzhou radiological health information management platform", a summary was made of the number of items of radiological equipment and the frequencies of radiological examinations in Suzhou medical institutions in 2022 and 2023.Results:In 2023, there were 368 medical institutions with radiological equipment in Suzhou, including 28 tertiary hospitals, 58 secondary hospitals, 159 primary hospitals and 123 unrated others. The total number of the items of radiological equipment was 1 688, with 39 items more than in 2022, about 1.30 units per 10 000 population. There were 5 187 medical radiation workers in total, with 339 more than in 2022. The frequencies of radiological procedures were 1 157.961/per thousand population, with 37.70% being from computed tomography in 2023.Conclusions:The number of items of radiodiagnostic and radiotherapeutic equipment and the frequencies of radiological procedures was at a relatively high level in China, but the distribution of medical resources were in a unbanlanced state. Efforts should be focused on optimization of the allocation of medical resources for the sake of reducing the public radiation dose and protecting public health.

Objective:To learn about both the distribution of resources of radiodiagnostic and radiotherapeutic and the frequencies of radiological examinations to provide a basis for rational allocation of medical resources and standardize medical ionizing radiation.Methods:Based on the data on permanent resident population and the data reported by the Suzhou medical institutions in possesion of radiological equipment to the " Suzhou radiological health information management platform", a summary was made of the number of items of radiological equipment and the frequencies of radiological examinations in Suzhou medical institutions in 2022 and 2023.Results:In 2023, there were 368 medical institutions with radiological equipment in Suzhou, including 28 tertiary hospitals, 58 secondary hospitals, 159 primary hospitals and 123 unrated others. The total number of the items of radiological equipment was 1 688, with 39 items more than in 2022, about 1.30 units per 10 000 population. There were 5 187 medical radiation workers in total, with 339 more than in 2022. The frequencies of radiological procedures were 1 157.961/per thousand population, with 37.70% being from computed tomography in 2023.Conclusions:The number of items of radiodiagnostic and radiotherapeutic equipment and the frequencies of radiological procedures was at a relatively high level in China, but the distribution of medical resources were in a unbanlanced state. Efforts should be focused on optimization of the allocation of medical resources for the sake of reducing the public radiation dose and protecting public health.

Objective To investigate mitophagy in diabetic foot ulcer(DFU)target genes and analyze the immune correlation.Methods DFU related datasets were obtained from the Gene Expression Omnibus(GEO)and screened for their differential expression genes(DEGs).Mitophagy related genes(MRGs)were obtained from the Genecards database.DEGs and MRGs were intersected and analysed using gene ontology(GO),Kyoto Encyclopedia of Genes and Genomes(KEGG)and protein-protein interaction(PPI).Target genes were mined using four machine learning models:Support vector machine-recursive feature eliminatio,least absolute shrinkage and selection operator,random forest,extreme gradient boosting.DEGs were analysed for immune infiltration and the correlation of target genes with immune infiltration.Results GO enrichment results showed that it was mainly enriched in regulation of autophagy of mitochondrion.KEGG enrichment results showed that hypoxia inducible factor-1 signalling pathway,p53 signalling pathway and AMPK signalling pathway were mainly enriched.Machine learning results showed TP53 and CYCS as target genes.Immune infiltration results showed a clear correlation of TP53 with plasma cells,regulatory T cells,follicular helper T cells,CD8+T cells and monocytes.CYCS showed a clear correlation with B cell memory,T cells CD8+T cells,monocytes,plasma cells and regulatory T cells.Conclusion TP53,CYCS may be the target genes regulating mitophagy in DFU and have a key role in reducing the level of oxidative stress.At the same time,the dysregulation of plasma cells,T cells and other immune cells may also have some effect on mitophagy.

Objective To investigate the effects of long-term exposure to three new types of light emitting diode (LED) sources on the behavior, learning, and memory of rats. Methods A total of 160 specific pathogen-free SD rats were divided into eight groups as followed, trichromatic fluorescent lamps color temperature control group, violet-chip full-spectrum white LED group, blue-chip white LED group, and blue-chip full-spectrum white LED group based on the light sources types, with color temperature of 4 000 K and 6 500 K groups in each group using the 4×2 factorial design. There were 20 rats in each group, with half of the rats were males and half females. Rats were exposed to artificial lighting, and the illumination was set at 750 lx. The rats in each group were exposed to different lighting environments for 12 hours per day for 24 weeks. The open-field and step-down tests were conducted in rats after 24 weeks exposure, followed by sacrifice of rats and measurement of organ coefficients. Differences in body weight, organ coefficients, and neurobehavioral indexes of rats in different groups were compared. Results The spleen coefficient of female rats decreased in blue-chip white LED of 6 500 K color temperature group, and the liver coefficient of male rats decreased in the violet-chip full-spectrum white LED of 4 000 K color temperature, blue-chip full-spectrum white LED of 4 000 K color temperature, and blue-chip full-spectrum white LED of 6 500 K color temperature groups, compared with the same-sex rats in trichromatic fluorescent lamps with same-color temperature control group (all P<0.05). The result of different types of light sources compared in the open-field test showed that the index of total distance and movement speed of female rats in the blue-chip full-spectrum white LED group were lower than those in the other three groups, and the time cost to the central area was longer than that in the blue-chip white LED group and the violet-chip full-spectrum white LED group (all P<0.05). The total distance and movement speed of male rats in the blue-chip full-spectrum white LED group were longer or higher than those in the violet-chip full-spectrum white LED group (all P<0.05). Based on the comparison of color temperature, the time and total distance of male rats in 6 500 K color temperature group were lower than that in the 4 000 K color temperature group (both P<0.05). In the step-down test, both male and female rats in the blue-chip full-spectrum white LED group made more errors compared with other three groups with the same gender (all P<0.05). Conclusion Based on the experimental conditions of this study, the blue-chip full-spectrum white light LED affects behavior, learning and memory of the rats, and trichromatic fluorescent lamp has the lowest effect on neurobehavior. The color temperature also affects behavior of the rats, and high color temperature has higher risk.

Objective To investigate the relationship between intraoperative central venous pressure(CVP)and postoperative acute kidney injury(AKI)in off-pump coronary artery bypass grafting(OPCABG).Methods A retrospective analysis was conducted,collecting clinical data from patients who underwent OPCABG at the General Hospital of Northern Theater Command of the Chinese People's Liberation Army between 2018 and 2021,and at the Second Affiliated Hospital of Dalian Nedical University between 2019 and 2022.Preoperative,intraoperative,and postoperative data were gathered using electronic medical record and anesthesia systems.The patients were divided into two groups according to whether AKI occurred within 7 days after surgery:AKI group and non-AKI group.The receiver operating characteristic(ROC)curve of intraoperative average CVP and postoperative AKI was plotted to determine the optimal cut-off value of intraoperative average CVP.Multivariate logistic regression analysis was used to assess the corre-lation between intraoperative average CVP and postoperative AKI.Results AKI occurred in 400 patients(34.9％).Compared with the non-AKI group,the age was older(P＜0.05),the BMI and serum creati-nine levels,the proportion of insulin therapy among patients with preoperative hypertension and diabetes,the average CVP,and the incidence of acute hypotensive episodeswas higher(P＜0.05),the intraoperative urine output was significantly reduced(P＜0.05),and the duration of hypotension was lon-ger(P＜0.05)in the AKI group.After fully adjusting for demographics,preoperative comorbidities,and intraoperative variables such as medication use and other covariates,each 1 mmHg increase in intraoperative average CVP was associated with a 1.47-fold increase in the odds of developing AKI(OR=1.47,95％CI 1.36-1.59,P＜0.001).The ROC curve identified 10.11 mmHg as the optimal cutoff value for intraopera-tive average CVP.Patients with an intraoperative average CVP≥10.11 mmHg had a 4.14-fold higher risk of developing postoperative AKI compared to those with CVP＜10.11 mmHg.Conclusion Elevated intrao-perative average CVP(≥10.1 mmHg)is independently associated with a higher risk of postoperative AKI in OPCABG.

Primary aldosteronism(PA) is a common cause of secondary hypertension, with adrenal vein sampling(AVS)being the gold standard for etiological typing diagnosis. This retrospective study analyzed data from patients diagnosed with PA who underwent AVS or unilateral adrenalectomy at Nanjing Drum Tower Hospital′s Endocrinology Department from July 2018 to August 2021. Using multivariate logistic regression analysis, factors associated with unilateral aldosterone hypersecretion were identified. Based on these factors, a predictive model for diagnosing unilateral primary aldosteronism(UPA)was established: age <40 years, plasma aldosterone concentration(PAC)>15 ng/dL, adrenal CT indicating an unilateral typical adenoma, and spontaneous hypokalemia. This predictive model could help 14% of PA patients avoid unnecessary AVS procedures.

Objective:To explore the pathological characteristics of adrenal masses based on various tumor diameter and unenhanced computed tomography(CT) attenuation value, and evaluate the value of the two parameters in the assessment of the benign and malignant nature of adrenal masses.Methods:The data of 1 367 patients who underwent adrenalectomy in Nanjing Drum Tower Hospital from January 2017 to October 2022 were retrospectively collected. The adrenal masses were divided into four groups according to tumor diameter and unenhanced CT attenuation value, and the clinical and histopathological characteristics of the four groups were compared respectively. Logistic regression was used to analyze the correlation between tumor diameter, non-contrast CT attenuation value and malignant adrenal masses, and receiver operating characteristic(ROC) curve was used to assess the diagnostic value of both in benign and malignant adrenal masses.Results:The proportion of adrenocortical carcinoma and other malignant tumors increased with the rise of tumor diameter or unenhanced CT attenuation value. After adjusting for age and gender, tumor diameter( OR=1.624, 95% CI 1.464-1.803, P<0.001) and unenhanced CT attenuation value( OR=1.108, 95% CI 1.079-1.138, P<0.001) were predictors of malignant adrenal masses. The tumor diameter and unenhanced CT attenuation value in diagnosing malignant adrenal masses had area under the ROC curve(AUC) of 0.838 and 0.892, respectively. With the optimal cut-off values of >3.4 cm and >30 HU, the sensitivity was 75.5% and 83.7%, and the specificity was 80.5% and 84.4%, respectively. The combination of tumor diameter >3.4 cm and unenhanced CT attenuation value >20 HU had an AUC of 0.927, with a sensitivity of 71.4% and a specificity of 90.1% in diagnosing malignant adrenal masses. Conclusions:Tumor diameter and unenhanced CT attenuation value has important significance in the differential diagnosis of benign and malignant adrenal masses. A combination of tumor diameter (>3.4 cm) and unenhanced CT attenuation value (>20 HU) demonstrates best diagnostic efficiency. Clinical application of this combined index can effectively diagnose malignant adrenal masses while avoiding unnecessary investigations or surgery.

Objective:To explore the value of adrenocorticotrophic hormone (ACTH) stimulation in adrenal vein sampling (AVS) with its effect on the sampling success rate and lateralization determination.Methods:The clinical data of 54 patients with primary aldosteronism (PA) who underwent AVS in Nanjing Drum Tower Hospital from July 2018 to June 2020 were collected retrospectively. Blood samples from bilateral adrenal veins were collected simultaneously at baseline and after ACTH stimulation. The selectivity index (SI), lateralization index (LI), and relative aldosterone secretion index (RASI) were examined.Results:The concentration of serum cortisol level in left and right adrenal vein and peripheral vein increased significantly after ACTH stimulation ( P<0.001). SI of left adrenal vein increased from 18.00 (2.29, 20.29) to 34.76 (12.10, 46.86) , and the SI of right adrenal vein increased from 26.61(5.24, 31.85) to 28.40 (27.65, 56.05, P<0.001). The bilateral vein sampling success rate increased from 80%(43/54) to 93%(50/54). LI decreased from 2.85(1.78, 6.20) at baseline to 2.45(1.40, 6.10) after ACTH stimulation without significant difference( P>0.05). Eleven patients who identified unilateral secretion at baseline demonstrated bilateral after ACTH stimulation, and the RASI of these patients decreased from 0.50 (0.38, 1.25 ) to 0.37 (0.22, 0.84, P=0.019). Conclusion:ACTH stimulation significantly increased SI and the AVS success rate in patients with PA: ACTH stimulation decreased the relative aldosterone secretion in the dominant side of some patients with aldosterone producing adenoma, thus reduced the proportion of identified unilateral PA.

Next generation sequencing (NGS) has developed very rapidly in the last decade. Compared with Sanger sequencing, NGS has the advantages of high sensitivity and high throughput. Movement disorders are a common type of neurological disease. Although traditional linkage analysis has become a standard method to identify the pathogenic genes in diseases, it is getting difficult to find new pathogenic genes in rare Mendelian disorders, such as movement disorders, due to a lack of appropriate families with high penetrance or enough affected individuals. Thus, NGS is an ideal approach to identify the causal alleles for inherited disorders. NGS is used to identify genes in several diseases and new mutant sites in Mendelian movement disorders. This article reviewed the recent progress in NGS and the use of NGS in Mendelian movement disorders from genome sequencing and transcriptome sequencing. A perspective on how NGS could be employed in rare Mendelian disorders is also provided.
Alleles ; Genetic Linkage ; High-Throughput Nucleotide Sequencing ; methods ; Humans ; Movement Disorders ; diagnosis ; genetics ; Sequence Analysis, DNA ; Transcriptome