Objective To explore the occurrence and influencing factors of MODS in elderly pa-tients with SAH.Methods A retrospective analysis was conducted on 187 elderly SAH patients admitted in the Second Affiliated Hospital of Guizhou Medical University from January 2021 to June 2024.According to the presence or absence of MODS,they were divided into MODS group(81 cases)and non-MODS group(106 cases).Their general clinical data were compared between the two groups.Multivariate logistic regression analysis was used to identify the risk factors for MODS in elderly SHA patients.ROC curve analysis was applied to evaluate the predictive value of the major risk factors for MODS in the patients.Results The MODS group had significantly ad-vanced age,larger proportion of modified Fisher grades Ⅲ—Ⅳ,higher APACHE Ⅱ score,and in-creased FPG level than the non-MODS group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that APACHE Ⅱ score(OR=1.108,95％CI:1.070-1.148,P=0.000)and mo-dified Fisher grade(OR=1.143,95％CI:1.095-1.194,P=0.000)were independent risk factors for MODS in elderly SAH patients.ROC curve analysis suggested that the AUC value of APACHE Ⅱ score,modified Fisher grade and their combination in predicting the occurrence of MODS in elderly SAH patients was 0.809,0.737 and 0.880,respectively,with a sensitivity of 59.35％,88.93％and 84.02％,and a specificity of 88.73％,58.52％and 81.15％,respectively.The combined detection showed better predictive performance than the indicator alone(P＜0.01).Con-clusion The incidence of MODS is quite high in elderly patients with SAH.APACHE Ⅱ score and modified Fisher grade are the main risk factors affecting the occurrence of MODS.

Xanthii Fructus contains phenolic acids, terpenoids, thiazines, flavonoids, water-soluble glycosides and other chemical components, and the toxic components are mainly water-soluble glycosides. Xanthii Fructus and its chemical constituents have pharmacological effects such as anti-inflammatory, anti-allergy, immune regulation, anti-oxidation and anti-tumor. They can play an important role in the prevention and treatment of allergic rhinitis by regulating immunity, inhibiting inflammatory response, anti-histamine and other pharmacological effects.

Objective To explore the influencing factors of somatic symptom disorder(SSD)in patients with epilepsy,and to construct a nomogram prediction model.Methods Using structured interviews,according to the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders(Fourth Edition),206 patients with epilepsy included in this study were divided into SSD group and non-SSD(n-SSD)group.The clinical data of the two groups were compared.The quality of life in epilepsy inventory(QOLIE-31),general anxiety disorder-7(GAD-7),neurological disorders depression inventory for epilepsy(NDDI-E)and Pittsburgh sleep quality index(PSQI)were used to evaluate the anxiety,depression and sleep of patients.LASSO regression was used for variable screening,and Logistic regression model was used to explore the risk factors of SSD in patients with epilepsy.Based on these factors,a nomogram was constructed and the area under the ROC curve(AUC)was calculated and verified internally.Calibration curve and decision curve analysis were used to evaluate the calibration and clinical utility of the nomogram,respectively.Results Compared with those in the n-SSD group,there were significant differences in age,age of onset,educational background,place of residence,number of physical diseases and negative life events in the SSD group(all P＜0.05).Compared with those in the n-SSD group,GAD-7 score,NDDI-E score,PSQI score,total score of QOLIE-31 and the scores of seizure worry,drug influence,energy/fatigue,life satisfaction,social function and emotion in the SSD group were significantly lower(all P＜0.05).Multivariate Logistic regression analysis showed that age(OR=1.076,95％CI:1.015-1.141),negative life events(OR=6.624,95％CI:2.130-20.606),seizure worry(OR=0.945,95％CI:0.895-0.999),energy/fatigue(OR=0.923,95％CI:0.872-0.977),GAD-7 score(OR=1.274,95％CI:1.037-1.565),NDDI-E score(OR=1.233,95％CI:1.038-1.442),PSQI score(OR=1.375,95％CI:1.097-1.723)were independent predictors of SSD.According to the variables in the results of multivariate Logistic regression analysis and their corresponding regression coefficients,the nomogram of SSD in patients with epilepsy was established.The AUC of the nomogram was 0.939(95％CI:0.904-0.975),the best cut-off value was 0.200,the sensitivity was 0.847,the specificity was 0.953,and the discrimination was good.The decision curve risk threshold showed that the model provides significant clinical net benefits.Conclusions Age,negative life events,seizure concerns,energy/fatigue,GAD-7 score,NDDI-E score and PSQI score are risk factors for epileptic SSD.The columniogram model constructed based on the above factors can effectively predict the risk of epileptic SSD.

Objective To explore the influencing factors of somatic symptom disorder(SSD)in patients with epilepsy,and to construct a nomogram prediction model.Methods Using structured interviews,according to the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders(Fourth Edition),206 patients with epilepsy included in this study were divided into SSD group and non-SSD(n-SSD)group.The clinical data of the two groups were compared.The quality of life in epilepsy inventory(QOLIE-31),general anxiety disorder-7(GAD-7),neurological disorders depression inventory for epilepsy(NDDI-E)and Pittsburgh sleep quality index(PSQI)were used to evaluate the anxiety,depression and sleep of patients.LASSO regression was used for variable screening,and Logistic regression model was used to explore the risk factors of SSD in patients with epilepsy.Based on these factors,a nomogram was constructed and the area under the ROC curve(AUC)was calculated and verified internally.Calibration curve and decision curve analysis were used to evaluate the calibration and clinical utility of the nomogram,respectively.Results Compared with those in the n-SSD group,there were significant differences in age,age of onset,educational background,place of residence,number of physical diseases and negative life events in the SSD group(all P＜0.05).Compared with those in the n-SSD group,GAD-7 score,NDDI-E score,PSQI score,total score of QOLIE-31 and the scores of seizure worry,drug influence,energy/fatigue,life satisfaction,social function and emotion in the SSD group were significantly lower(all P＜0.05).Multivariate Logistic regression analysis showed that age(OR=1.076,95％CI:1.015-1.141),negative life events(OR=6.624,95％CI:2.130-20.606),seizure worry(OR=0.945,95％CI:0.895-0.999),energy/fatigue(OR=0.923,95％CI:0.872-0.977),GAD-7 score(OR=1.274,95％CI:1.037-1.565),NDDI-E score(OR=1.233,95％CI:1.038-1.442),PSQI score(OR=1.375,95％CI:1.097-1.723)were independent predictors of SSD.According to the variables in the results of multivariate Logistic regression analysis and their corresponding regression coefficients,the nomogram of SSD in patients with epilepsy was established.The AUC of the nomogram was 0.939(95％CI:0.904-0.975),the best cut-off value was 0.200,the sensitivity was 0.847,the specificity was 0.953,and the discrimination was good.The decision curve risk threshold showed that the model provides significant clinical net benefits.Conclusions Age,negative life events,seizure concerns,energy/fatigue,GAD-7 score,NDDI-E score and PSQI score are risk factors for epileptic SSD.The columniogram model constructed based on the above factors can effectively predict the risk of epileptic SSD.

Objective To explore the occurrence and influencing factors of MODS in elderly pa-tients with SAH.Methods A retrospective analysis was conducted on 187 elderly SAH patients admitted in the Second Affiliated Hospital of Guizhou Medical University from January 2021 to June 2024.According to the presence or absence of MODS,they were divided into MODS group(81 cases)and non-MODS group(106 cases).Their general clinical data were compared between the two groups.Multivariate logistic regression analysis was used to identify the risk factors for MODS in elderly SHA patients.ROC curve analysis was applied to evaluate the predictive value of the major risk factors for MODS in the patients.Results The MODS group had significantly ad-vanced age,larger proportion of modified Fisher grades Ⅲ—Ⅳ,higher APACHE Ⅱ score,and in-creased FPG level than the non-MODS group(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that APACHE Ⅱ score(OR=1.108,95％CI:1.070-1.148,P=0.000)and mo-dified Fisher grade(OR=1.143,95％CI:1.095-1.194,P=0.000)were independent risk factors for MODS in elderly SAH patients.ROC curve analysis suggested that the AUC value of APACHE Ⅱ score,modified Fisher grade and their combination in predicting the occurrence of MODS in elderly SAH patients was 0.809,0.737 and 0.880,respectively,with a sensitivity of 59.35％,88.93％and 84.02％,and a specificity of 88.73％,58.52％and 81.15％,respectively.The combined detection showed better predictive performance than the indicator alone(P＜0.01).Con-clusion The incidence of MODS is quite high in elderly patients with SAH.APACHE Ⅱ score and modified Fisher grade are the main risk factors affecting the occurrence of MODS.

Objective To investigate the feasibility of constructing a preeclampsia(PE)risk model based on multiple exosomal micrornas(miRNA)expression levels and to verify its efficacy in predicting PE.Methods A total of 1037 pregnant women who were archived in our hospital from June 2019 to December 2021 and whose gestational weeks were less than or equal to 20 weeks were selected as the research subjects.The expression of exosomal miRNA(including miR-155-5p,miR-215-5p,miR-203a-3p,miR-199a-5p and miR-125a-3p)in all samples was detected by qRT-PCR.Then,all patients were followed up to the end of pregnancy.The occurrence of PE during the follow-up period was counted,and all samples were divided into the PE group and the control group according to results.Cox regression was used to analyze the influencing factors of PE.The multi-miRNA risk model was constructed with ggrisk package,and the predictive effect of the model on PE was evaluated by receiver operating characteristic(ROC)curve.Results By the end of follow-up on October 31,2022,974 cases were finally followed up,and the follow-up completion rate was 93.92%.Among all the 974 patients who completed the follow-up,65 patients developed PE,so they were finally divided into the PE group,and 909 cases were used as the control group.The age,pre-pregnancy BMI and waist circumference at 12 weeks of gestation were higher in the PE group than those in the control group(P＜0.05).The proportions of smoking history and drinking history were higher in the PE group than those of the control group(P＜0.05).The contents of triglyceride(TG),low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),alanyl aminotransferase(ALT),aspartate aminotransferase(AST),platelet distribution width(PDW),mean platelet volume(MPV),miR-155-5p,miR-199a-5p and miR-215-5p were higher in the PE group than those in the control group,while contents of thyroid stimulating hormone(TSH),miR-125a-3p and miR-203a-3p were lower in the PE group than those in the control group(P＜0.05).The expression levels of miR-125a-3p,miR-155-5p,miR-199a-5p and miR-215-5p were independent predictors of PE(P＜0.05).The predictive risk model constructed from the above miRNAs had good predictive value in the occurrence of PE(AUC=0.998),with a sensitivity of 98.46%(63/65)and a specificity of 93.94%(854/909).Conclusion miR-125a-3p,miR-155-5p,miR-199a-5p,miR-203a-3p and miR-215-5p are significantly related to the occurrence of PE,and the PE prediction model constructed with the above five miRNAs has better effect.

BACKGROUND:Olfactory dysfunction is an early biological marker of various diseases.However,the neuroimaging mechanism by which olfactory dysfunction occurs following cerebral small vessel disease is unclear. OBJECTIVE:To explore the different neuroimaging mechanisms of olfactory function regulation in patients with cerebral small vessel disease and Parkinson's disease,and explore the potential application value of olfactory function assessment in patients with cerebral small vessel disease. METHODS:Neuropsychological and olfactory tests,high-resolution structural magnetic resonance and resting-state functional magnetic resonance data were collected in 80 patients with cerebral small vessel disease,44 healthy controls and 29 patients with Parkinson's disease.DPABI,SPM12 and SPSS were used to analyze and compare the amplitude of low frequency fluctuation,regional homogeneity and functional connectivity values between the cerebral small vessel disease,control and Parkinson's disease groups.Correlations between the significantly altered resting-state functional magnetic resonance imaging measures and olfactory and cognitive scores were evaluated. RESULTS AND CONCLUSION:Compared with the control group,low-frequency fluctuation amplitude of the right dorsolateral superior frontal gyrus and the regional homogeneity of the left wedge leaf were significantly reduced in the cerebral small vessel disease and Parkinson's disease groups.The right dorsolateral superior frontal gyrus and the left cuneiform lobe are the seed points.Compared with the Parkinson's disease group,the functional connectivity values of the right anterior cunei,inferior temporal gyrus,anterior central gyrus and dorsolateral superior frontal gyrus,left posterior central gyrus and inferior temporal gyrus were significantly enhanced in the control and cerebral small vessel disease groups.The left cuneiform lobe was the seed point.Compared with the control group,the functional connectivity of the left lingual gyrus was significantly weakened in the cerebral small vessel disease and Parkinson's disease groups.The functional connectivity values of the left middle temporal gyrus and the right posterior central gyrus were enhanced in the control group compared with the cerebral small vessel disease and Parkinson's disease group,and that was enhanced in the cerebral small vessel disease group compared with the Parkinson's disease group.Correlation analysis showed that the olfactory score and cognitive score were positively correlated in the cerebral small vessel disease group,and the regional homogeneity of the left wedge lobe was negatively correlated with the Montreal Cognitive Assessment Scale score,while the functional connectivity of left wedge lobe-left middle temporal gyrus in the Parkinson's disease group was positively correlated with the olfactory recognition score,and the functional connectivity values of the left wedge lobe-left posterior central gyrus and left wedge lobe-left lingual gyrus were positively correlated with the olfactory identification score and the total olfactory score,respectively.The regulation of olfactory function in patients with cerebral small vessel disease has a different neuroimaging mechanism from that of olfactory dysfunction in patients with Parkinson's disease.The olfactory function of patients with cerebral small vessel disease is related to cognitive function.It is speculated that the olfactory function following cerebral small vessel disease is a secondary change of brain dysfunction,while olfactory dysfunction following Parkinson's disease is directly caused by abnormal function of olfactory-related brain areas.Olfactory function assessment in patients with cerebral small vessel disease has potential application in predicting cognitive function.

Objective:To explore the efficacy and safety of sodium stibogluconate (SSG) and liposomal amphotericin (L-AmB) as well as their combination regimen in the treatment of Kala-azar (also known as visceral leishmaniasis) in China.Methods:Clinical data of patients with Kala-azar hospitalized in the First Hospital of Lanzhou University from January 2012 to December 2021 were collected, including patient demographic information, clinical characteristics of Kala-azar, previous treatment history, therapeutic drugs, clinical efficacy and adverse drug reactions (ADRs) in the treatment. The clinical characteristics, efficacy and occurrence of ADRs related to SSG and L-AmB in patients treated with SSG (SSG group) and L-AmB or SSG+L-AmB (L-AmB or SSG+L-AmB group) were analyzed by descriptive statistics.Results:A total of 44 patients were included in the analysis, including 25 males and 19 females; 25 were children (56.8%) and 19 were adults (43.2%). Thirty-seven patients (84.1%) were treated with SSG (SSG group), which was used as an initial treatment in 32 patients and was used also in previous treatment in 5 patients. Seven patients (15.9%) were treated with L-AmB, including 2 with L-AmB monotherapy and 5 with SSG+L-AmB, and all of them have been treated with SSG before. Among the 32 patients used SSG as initial treatments in the SSG group, 29 (90.6%) were clinically cured. All the 5 patients, who had been treated before, were also clinically cured after prolonged treatments. Seven patients in the L-AmB or SSG+L-AmB group were treated with a low-dose and long-term L-AmB regimen, and all of them were cured without Kala-azar recurrence. The common ADRs of SSG were abnormal liver function and elevated pancreatic enzymes; the common ADRs of L-AmB were hypokalemia and mild elevation of serum creatinine.Conclusions:The efficacy of SSG in initial treatment of patients with Kala-azar is more than 90%, and it can still be used as the preferred drug to treat Kala-azar. The monitoring of liver function and pancreatic enzymes should be paid attention to during the treatment. For patients that have been treated before, especially those with multiple Kala-azar recurrences, L-AmB or SSG+L-AmB should be advised. Low dose and long-term administration of L-AmB can obtain better efficacy and reduce the risk of ADR, and electrolytes and renal function should be monitored during the treatment.

Objective:To explore the efficacy and safety of sodium stibogluconate (SSG) and liposomal amphotericin (L-AmB) as well as their combination regimen in the treatment of Kala-azar (also known as visceral leishmaniasis) in China.Methods:Clinical data of patients with Kala-azar hospitalized in the First Hospital of Lanzhou University from January 2012 to December 2021 were collected, including patient demographic information, clinical characteristics of Kala-azar, previous treatment history, therapeutic drugs, clinical efficacy and adverse drug reactions (ADRs) in the treatment. The clinical characteristics, efficacy and occurrence of ADRs related to SSG and L-AmB in patients treated with SSG (SSG group) and L-AmB or SSG+L-AmB (L-AmB or SSG+L-AmB group) were analyzed by descriptive statistics.Results:A total of 44 patients were included in the analysis, including 25 males and 19 females; 25 were children (56.8%) and 19 were adults (43.2%). Thirty-seven patients (84.1%) were treated with SSG (SSG group), which was used as an initial treatment in 32 patients and was used also in previous treatment in 5 patients. Seven patients (15.9%) were treated with L-AmB, including 2 with L-AmB monotherapy and 5 with SSG+L-AmB, and all of them have been treated with SSG before. Among the 32 patients used SSG as initial treatments in the SSG group, 29 (90.6%) were clinically cured. All the 5 patients, who had been treated before, were also clinically cured after prolonged treatments. Seven patients in the L-AmB or SSG+L-AmB group were treated with a low-dose and long-term L-AmB regimen, and all of them were cured without Kala-azar recurrence. The common ADRs of SSG were abnormal liver function and elevated pancreatic enzymes; the common ADRs of L-AmB were hypokalemia and mild elevation of serum creatinine.Conclusions:The efficacy of SSG in initial treatment of patients with Kala-azar is more than 90%, and it can still be used as the preferred drug to treat Kala-azar. The monitoring of liver function and pancreatic enzymes should be paid attention to during the treatment. For patients that have been treated before, especially those with multiple Kala-azar recurrences, L-AmB or SSG+L-AmB should be advised. Low dose and long-term administration of L-AmB can obtain better efficacy and reduce the risk of ADR, and electrolytes and renal function should be monitored during the treatment.

Sialyllactose is one of the most abundant sialylated oligosaccharides in human milk oligosaccharides (HMOs), which plays an important role in the healthy development of infants and young children. However, its efficient and cheap production technology is still lacking presently. This study developed a two-step process employing multiple-strains for the production of sialyllactose. In the first step, two engineered strains, E. coli JM109(DE3)/ pET28a-BT0453 and JM109(DE3)/pET28a-nanA, were constructed to synthesize the intermediate N-acetylneuraminic acid. When the ratio of the biomass of the two engineered strains was 1:1 and the reaction time was 32 hours, the maximum yield of N-acetylneuraminic acid was 20.4 g/L. In the second step, E. coli JM109(DE3)/ pET28a-neuA, JM109(DE3)/ pET28a-nst and Baker's yeast were added to the above fermentation broth to synthesize 3'-sialyllactose (3'-SL). Using optimal conditions including 200 mmol/L N-acetyl-glucosamine and lactose, 150 g/L Baker's yeast, 20 mmol/L Mg²⁺, the maximum yield of 3'-SL in the fermentation broth reached 55.04 g/L after 24 hours of fermentation and the conversion rate of the substrate N-acetyl-glucosamine was 43.47%. This research provides an alternative technical route for economical production of 3'-SL.
Child ; Humans ; Child, Preschool ; N-Acetylneuraminic Acid ; Escherichia coli/genetics* ; Lactose ; Fermentation ; Saccharomyces cerevisiae ; Oligosaccharides ; Glucosamine