ObjectiveTo construct a nomogram prediction model for non-valvular persistent atrial fibrillation （PeAF） patients with left ventricular hypertrophy （LVH） ， followed by prognostic analysis through follow-up. MethodsThis study retrospectively enrolled 949 patients with newly diagnosed and hospitalized non-valvular PeAF. Among them， 403 patients presented with LVH. The cohort was randomly stratified into a training set （n=665） and a validation set （n=284）. Univariate and multivariate Logistic regression analyses were employed to identify independent risk factors for PeAF complicated by LVH. A nomogram prediction model was subsequently constructed and evaluated for discriminative ability， calibration， and clinical utility using receiver operating characteristic （ROC） curve analysis， calibration plots， and decision curve analysis （DCA）. ResultsSeven independent risk factors were ultimately identified and included in the prediction model： female sex， hypertension， diabetes， red blood cell distribution width-SD （RDW-SD）， body mass index （BMI）， left atrial diameter （LAD）， and left ventricular ejection fraction （LVEF）. The area under the ROC curve （AUC） in the training set was 0.862 （95% CI： 0.834-0.890）， and in the validation set， it was 0.870 （95% CI： 0.829-0.911）， demonstrating excellent predictive performance. ConclusionIndependent risk factors for LVH in PeAF patients include female， hypertension， diabetes， RDW-SD， BMI， LAD， and LVEF. The prediction model built based on this can help early identification of PeAF patients with high risk of LVH. At the same time， the incidence of major adverse cardiovascular events （MACE） is higher in PeAF patients with LVH. Patients with atrial fibrillation combined with LVH may benefit from catheter ablation.

Objective: Exploring the effect and mechanism of Xinyang Tablet on reduction of ferroptosis in myocardial cells from mice with chronic heart failure. Methods: Sixty C57BL/6J mice were randomly assigned to the sham, model, Xinyang Tablet low-dose (0.34 g/kg), Xinyang Tablet medium-dose (0.68 g/kg), Xinyang Tablet high-dose (1.36 g/kg), and perindopril (0.607 mg/kg) groups using a random number table method (10 mice in each group). Except for the sham group, all other groups underwent aortic arch constriction surgery to construct a chronic heart failure model. On the third day after completion of the modeling, each treatment group was administered the corresponding medication by gavage, while the sham and model groups were administered equal volumes of water by gavage once a day for eight consecutive weeks. After treatment, cardiac ultrasound was used to detect the structure and function of the mouse heart. Hematoxylin and eosin staining was used to detect pathological changes in mouse heart tissue. Masson staining was used to detect the proportion of fibrotic area of mouse heart tissue. Realtime fluorescence PCR was used to detect the mRNA expression of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), collagen 3α (Col3α), and myosin heavy chain 7 (MYH7) in mouse myocardial tissue. Transmission electron microscope was used to detect the ultrastructure of myocardial cell mitochondria. Reactive oxygen species (ROS) staining was used to detect the mean fluorescence intensity of ROS in myocardial tissue. Micro-determination was used to detect superoxide dismutase (SOD) activity in myocardial tissue. An immunofluorescence assay was used to detect the mean fluorescence intensity of phosphorylated histone deacetylase 2 (p-HDAC2) in myocardial cell. Western blotting was used to detect the protein expression of nuclear factor-erythroid 2-related factor 2 (Nrf2), p-HDAC2, nicotinamide adenine dinucleotide phosphate oxidase 1 (NOX1), glutathione peroxidase 4 (GPX4), and cystine glutamate reverse transporter (xCT) in mouse myocardial tissue. Results: Compared to the sham group, the model group showed a decrease in left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), an increase in left ventricular end-systolic diameter(LVESD) and left ventricular end-diastolic diameter (LVEDD), an increase in the proportion of cardiac fibrosis area, an increase in relative expression levels of ANP, BNP, Col3α, and MYH7 mRNA, an increase in ROS mean fluorescence intensity, a decrease in SOD activity, an increase in mean fluorescence intensity of p-HDAC2, an increase in relative expression levels of p-HDAC2 and NOX1 proteins, and a decrease in relative expression levels of Nrf2, GPX4, and xCT proteins (P<0.05). Myocardial fibrosis lesions are obvious, with disordered mitochondrial arrangement, decreased volume and shrinkage, increased membrane density, and reduced mitochondrial cristae. Compared to the model group, the LVEF and LVFS of mice in each dose group of Xinyang Tablet and the perindopril group increased, LVESD and LVEDD decreased, the proportion of fibrotic area of heart tissue decreased, the relative expression levels of ANP, BNP, Col3α, MYH7 mRNA decreased, ROS mean fluorescence intensity decreased, SOD activity increased, mean fluorescence intensity of p-HDAC2 decreased, relative expression levels of p-HDAC2 and NOX1 proteins decreased, and relative expression levels of Nrf2 and xCT proteins increased (P<0.05). Myocardial fibrosis was reduced, the mitochondrial arrangement was more regular, the mitochondria enlarged, the membrane density was reduced, and mitochondrial cristae increased. Compared to the model group, the relative expression level of the GPX4 protein in myocardial tissue increased in the Xinyang Tablet medium-, high-dose, and the perindopril groups (P<0.05). Conclusion Xinyang Tablet can improve ferroptosis and ventricular remodeling in mice with chronic heart failure by regulating the HDAC2-mediated Nrf2 antioxidant pathway.

Peroxisome proliferator activated receptor-α (PPAR-α) is significantly expressed in various tissues such as the liver, kidney, myocardium, and skeletal muscle, which plays a central role in the development of various diseases by regulating key physiological processes such as energy homeostasis, redox balance, inflammatory response, and ferroptosis. As an important metabolic and excretory organ of the body, renal dysfunction can lead to water and electrolyte imbalance, toxin accumulation, and multiple system complications. The causes of kidney injury are complex and diverse, including acute injury factors (such as ischemia/reperfusion, nephrotoxic drugs, septic shock, and immune glomerulopathy), as well as chronic progressive causes [such as metabolic disease-related nephropathy, hypertensive nephropathy (HN)], and risk factors such as alcohol abuse, obesity, and aging. This review briefly describes the structure, function, and activity regulation mechanism of PPAR-α, systematically elucidates the molecular regulatory network of PPAR-α in the pathological process of kidney injury including acute kidney injury (AKI) such as renal ischemia/reperfusion injury (IRI), drug-induced AKI, sepsis-associated acute kidney injury (SA-AKI), glomerulonephritis, chronic kidney disease (CKD) such as diabetic nephropathy (DN), HN, and other kidney injury, and summarizes the mechanisms related to PPAR-α regulation of kidney injury, including regulation of metabolism, antioxidation, anti-inflammation, anti-fibrosis, and anti-ferroptosis. This review also evaluates PPAR-α's medical value as a novel therapeutic target, and aims to provide theoretical basis for the development of kidney protection strategies based on PPAR-α targeted intervention.
Humans ; PPAR alpha/metabolism* ; Acute Kidney Injury/therapy* ; Animals ; Kidney/metabolism*

Objective To investigate the differences of language abilities between children with developmental delay(DD)and those with autism spectrum disorder(ASD)aged 3-6 years,and to provide references for clinical differential diagnosis and subsequent rehabilitation therapy.Methods In this study,61 cases of DD children and 61 cases of ASD chil-dren were selected.The language ability of children was assessed using the"Children's Language Ability Assessment Stand-ards and Methods",which evaluated grammar,comprehension,expression and communication abilities.Results Children with DD showed better comprehension and social skills but weaker grammar and expressive abilities.Children with ASD generally had lower levels in all language areas.There was no significant difference in the average language ability or expres-sive ability the two groups(P＞0.05),but the language comprehension ability and communication ability of the ASD group were significantly lower than those of the DD group(P＜0.05).The grammar ability of the ASD group was higher than that of the DD group(P＜0.05).Conclusion The levels of different language areas of children with DD and ASD children are significantly different.Language ability tests can assist in the differential diagnosis of DD and ASD children,and provide reference for language rehabilitation training.

Objective:To summarize the relevant evidence of testicular cancer patients' fertility management which provides a basis for fertility guidance for young testicular cancer patients.Methods:The evidence,guidelines,expert consensus,evidence summary,systematic review and Meta-analysis on fertility-related clinical decision-making were searched from computer decision sup-port systems,relevant guideline websites,evidence-based databases,original research databases,and professional association websites at home and abroad.The search period was set dating from the establishment of the database to July 2024.Two researchers with evi-dence-based nursing research background independently completed the quality evaluation,evidence extraction and summary of the liter-ature.Results:A total of 21 articles were selected,including 4 clinical decisions,8 guidelines,4 expert consensuses,3 systematic reviews and 2 Meta-analyses.Thirty-three pieces of best evidence from six aspects were summarized,including fertility assessment,fertility counseling,fertility preservation timing,fertility preservation regimen,anti-tumor therapy and fertility,and contraceptive tim-ing.Conclusion:The best evidence summarized in this study provides a basis for clinical medical staff to carry out fertility manage-ment in testicular cancer patients.In clinical application,medical staff need to fully consider the patient's wishes in combination with the clinical situation,and promote the maximum benefit of the patient,so as to further improve the life quality of the patients.

Objective To investigate the differences of language abilities between children with developmental delay(DD)and those with autism spectrum disorder(ASD)aged 3-6 years,and to provide references for clinical differential diagnosis and subsequent rehabilitation therapy.Methods In this study,61 cases of DD children and 61 cases of ASD chil-dren were selected.The language ability of children was assessed using the"Children's Language Ability Assessment Stand-ards and Methods",which evaluated grammar,comprehension,expression and communication abilities.Results Children with DD showed better comprehension and social skills but weaker grammar and expressive abilities.Children with ASD generally had lower levels in all language areas.There was no significant difference in the average language ability or expres-sive ability the two groups(P＞0.05),but the language comprehension ability and communication ability of the ASD group were significantly lower than those of the DD group(P＜0.05).The grammar ability of the ASD group was higher than that of the DD group(P＜0.05).Conclusion The levels of different language areas of children with DD and ASD children are significantly different.Language ability tests can assist in the differential diagnosis of DD and ASD children,and provide reference for language rehabilitation training.

BACKGROUND:Currently,artificial corneas used for full-thickness transplantation lack biological activity and mechanical adaptability.Composite artificial corneas face interface issues between the corneal button and surrounding components.OBJECTIVE:To prepare an integrated artificial cornea with peptide enhancement,matched mechanical strength to natural cornea,and excellent transparency via in situ ultraviolet light curing of decellularized porcine cornea.METHODS:Non-ionic decellularization reagent Triton X-100 combined with ultrasonic freeze-thawing and super nucleases was utilized to prepare decellularized porcine cornea.Hydroxyethyl methacrylate monomer and photoinitiator were introduced into the decellularized porcine cornea simultaneously.Ultraviolet light with a filter was used to cover the peripheral region except for the central area,where polymerization was initiated using 275 nm ultraviolet light.After removal of unreacted monomers and initiators,the central optical zone was obtained.Similarly,the posterior lamellar layer was polymerized to form the hydrophobic barrier zone.Finally,REG active polypeptide was introduced to obtain in situ integrated full-layer artificial cornea.The physical properties,mechanical properties,transparency,degradation properties and in vivo and in vitro biocompatibility of artificial cornea were characterized.RESULTS AND CONCLUSION:(1)An optical region with the co-existence of polymer and collagen fibers was constructed in situ using hydroxyethyl methacrylate in the central region of decellularized porcine cornea.Under scanning electron microscopy,the upper surface of the artificial cornea was rough and irregular,with obvious concave and convex structure,and the lower surface was relatively smooth.The artificial cornea had mechanical properties close to those of natural cornea.The transparency of the optical zone reached 80%of that of the natural cornea.After soaking in PBS aseptic solution containing collagenase,it could preserve the solidified optical region and hydrophobic barrier zone,and maintain the basic structure of cornea.The artificial cornea had good cytocompatibility,could provide a suitable adhesion and growth environment for cells,was conducive to the migration and adhesion of corneal epithelial cells,promoted the growth of vascular endothelial cells and the formation of new blood vessels,and promoted the epithelialization process.The artificial cornea had good biocompatibility and safety after 12 weeks of subcutaneous implantation in SD rats,and could reduce the acute inflammatory reaction at the initial stage of implantation.(2)The results show that the integrated full-layer artificial cornea prepared by the experiment has the potential as a full-layer artificial cornea scaffold.

Thyroid cancer is the most prevalent malignant tumor of the endocrine system,and its incidence has shown a significant upward trend in recent years.Acetylation,an important post-translational protein modification,is involved in regulating gene transcription,cell cycle progression,and invasion ability in various types of thyroid cancers.Additionally,histone deacetylase(HDAC)inhibitors have shown potential in the treatment of thyroid cancer.This article systematically reviews the biological functions and regulatory mechanisms of acetylation in the development and progression of thyroid cancer based on recent literature.Furthermore,it discusses the clinical application prospects of HDAC inhibitors,providing a solid theoretical basis and feasible therapeutic strategies for targeted therapy of thyroid cancer.

Follicular variant of papillary thyroid carcinoma(FVPTC)is commonly found in young and middle-aged women,and cases in children and adolescents are relatively rare.The main driving genes of FVPTC are the RAS oncogene family or B-Raf proto-oncogene serine/threonine protein kinase(BRAF),and DICER1 gene mutation is rarely reported in this subtype.This article reports a case of recurrent FVPTC with positive DICER1 mutation in an adolescent,aiming to provide reference for the clinical diagnosis and treatment of FVPTC.The patient,a 19-year-old female,underwent total thyroidectomy and central lymph node dissection due to thyroid nodules 5 years ago,and was pathologically diagnosed with follicular tumor of uncertain malignant potential(FT-UMP);after surgery,the patients did not regularly undergo thyroid-stimulating hormone(TSH)suppression therapy and follow-up as instructed.Two months ago,the patient visited the hospital due to enlarged cervical lymph nodes,imaging suggested tumor recurrence with metastases to both lungs and vertebrae,and multigene testing indicated a DICER1 gene mutation.After comprehensive multidisciplinary consultation,bilateral cervical lymph node dissection was performed,and postoperative pathology confirmed the diagnosis of metastatic FVPTC.Te clinicans should focus on rare gene mutations such as DICER1 in the FVPTC patients,and for adolescent patients,follow-up and formulation of individualized treatment plans should be emphasized to achieve early tumor identification and precise intervention,and improve the long-term prognosis of patients.

Local anesthetics (LAs), such as articaine (AT), exhibit limited efficacy in inflammatory environments, which constitutes a significant limitation in their clinical application within oral medicine. In our prior research, we developed AT-17, which demonstrated effective properties in chronic inflammatory conditions and appears to function as a novel oral LA that could address this challenge. In the present study, we further elucidated the beneficial effects of AT-17 in acute inflammation, particularly in oral acute inflammation, where mitochondrial-related apoptosis played a crucial role. Our findings indicated that AT-17 effectively inhibited lipopolysaccharide (LPS)-induced nerve cell apoptosis by ameliorating mitochondrial dysfunction in vitro. This process involved the inhibition of mitochondrial reactive oxygen species (mtROS) production and the subsequent activation of the NRF2 pathway. Most notably, improvements in mitochondria-related apoptosis were key contributors to AT-17's inhibition of voltage-gated sodium channels. Additionally, AT-17 was shown to reduce mtROS production in nerve cells through the Na⁺/NCLX/ETC signaling axis. In conclusion, we have developed a novel local anesthetic that exhibits pronounced anesthetic functionality under inflammatory conditions by enhancing mitochondria-related apoptosis. This advancement holds considerable promise for future drug development and deepening our understanding of the underlying mechanisms of action.