Objective:To explore the independent risk factors for uremic encephalopathy(UE)in maintenance hemodialysis(MHD)patients and provide evidence for early clinical warning and intervention.Methods:A case-control study was conducted,enrolling 67 MHD patients diagnosed with UE(UE group)at Laibin People's Hospital from January 2010 to December 2024,and 67 non-UE patients during the same period(control group).Demographic characteristics,dialysis parameters,laboratory indicators,and infection events were collected.Univariate and multivariate logistic regression analyses were used to identify independent risk factors for UE.Results:The UE group had significantly higher rates of infection(58.2％vs.29.9％),serum creatinine(789 vs.702 μmol/L),and iPTH levels(568 vs.385 pg/mL)compared to the control group(P＜0.05).Multivariate analysis revealed that concurrent infection(OR=3.022,95％CI:1.312-6.958),elevated serum creatinine(OR=1.004,95％CI:1.000-1.008),and elevated iPTH(OR=1.002,95％CI:1.001-1.003)were independent risk factors for UE(P＜0.05).The combined prediction model achieved an AUC of 0.878(95％CI:0.822-0.934),with 82.1％sensitivity and 80.6％specificity.Conclusion:Infection,elevated serum creatinine,and elevated iPTH significantly increase the risk of UE in MHD patients.Clinical management should emphasize infection prevention,toxin clearance optimization,and parathyroid function regulation to reduce UE incidence.

Objective:To explore the mechanism of long non-coding RNA nuclear-enriched transcript 1(LncRNA NEAT1)on improving myocardial injury in rats with myocardial infarction(MI)mechanism through miR-136/extracellular signal-regulated kinase 1/2(ERK1/2)axis.Methods:Using the random number table method,120 male SD rats were divided into 6 groups(n=20):sham group,myocardial infarction group(MI group),control interference group(sh-NC group),NEAT1 interference group(sh-NEAT1 group),NEAT1 interference+miR-136 control inhibition group(sh-NEAT1+antagomiR-NC group)and NEAT1 interference+miR-136 suppression group(sh-NEAT1+antagomiR-136 group).Seven days before MI operation,100 μl of corresponding adenovirus vector was injected into the myocardium.Rats in each group were ligated the left anterior descending vessel to establish MI model.In sham group,only the left chest was opened and the heart was exposed without ligation.H9C2 cardiomyocyte were divided into:control group,vehicle group,sh-NC group,sh-NEAT1 group,sh-NEAT1+antagomiR-NC group and sh-NEAT1+antagomiR-136 group.Car-diomyocyte were transfected with corresponding NEAT1 interference vector and negative control,miR-136 inhibitor and negative con-trol.StarBase prediction and dual luciferase report experiment verify the targeted regulation of LncRNA NEAT1 on miR-136;myocar-dial infarct size was measured by TTC staining,and myocardial histopathological changes were observed by HE staining;Echocardiog-raphy was used to detect rat cardiac function;detection of apoptosis in rat myocardial tissue and H9C2 cells by flow cytometry.ELISA method was used to detect serum oxidative stress,corresponding indexes of myocardial enzymes and the contents of inflammatory fac-tors in myocardial tissue and H9C2 cells.CCK8 and EdU staining were used to detect the proliferation ability of H9C2 cells.RT-qPCR was used to detect the expressions of miR-136,SIRT1 mRNA in myocardial tissue and H9C2 cells.Western blot was used to detect the expressions of ERK1/2,p-ERK1/2,B-cell lymphoma-2(Bcl-2),Bcl2-related X protein(Bax)protein in rat myocardial tissue and H9C2 cells.Results:The expression of LncRNA NEAT1 was up-regulated in injured myocardial tissues and cells,and the expression of miR-136 was down-regulated(P<0.05).At the same time,NEAT1 targets and regulates the level of miR-136.Inhibition of NEAT1 expression could increase left ventricular ejection fraction(LVEF),left ventricular fraction shortening(LVFS),Bcl-2 level,and de-crease the activities of creatine kinase(CK),lactate dehydrogenase(LDH),and aspartame Acid transaminase(AST),superoxide dismutase(SOD),reduce Bax,troponin Ⅰ(cTnⅠ),malondialdehyde(MDA),TNF-α,IL-1β,IL-6,ERK1/2/p-ERK1/2 levels(P<0.05),promote the proliferation of myocardial cells,inhibit cell apoptosis,reduce the area of myocardial infarction,inhibit oxida-tive stress and inflammation,and improve myocardial damage Inhibiting miR-136 can save the above effects.Conclusion:The expres-sion of LncRNA NEAT1 is up-regulated and the expression of miR-136 is down-regulated in injured myocardial tissue and cells.Inhibi-tion of LncRNA NEAT1 expression inhibits apoptosis,oxidative stress and inflammation through miR-136/ERK1/2 axis,thus improving myocardial injury.

Objective:To explore the independent risk factors for uremic encephalopathy(UE)in maintenance hemodialysis(MHD)patients and provide evidence for early clinical warning and intervention.Methods:A case-control study was conducted,enrolling 67 MHD patients diagnosed with UE(UE group)at Laibin People's Hospital from January 2010 to December 2024,and 67 non-UE patients during the same period(control group).Demographic characteristics,dialysis parameters,laboratory indicators,and infection events were collected.Univariate and multivariate logistic regression analyses were used to identify independent risk factors for UE.Results:The UE group had significantly higher rates of infection(58.2％vs.29.9％),serum creatinine(789 vs.702 μmol/L),and iPTH levels(568 vs.385 pg/mL)compared to the control group(P＜0.05).Multivariate analysis revealed that concurrent infection(OR=3.022,95％CI:1.312-6.958),elevated serum creatinine(OR=1.004,95％CI:1.000-1.008),and elevated iPTH(OR=1.002,95％CI:1.001-1.003)were independent risk factors for UE(P＜0.05).The combined prediction model achieved an AUC of 0.878(95％CI:0.822-0.934),with 82.1％sensitivity and 80.6％specificity.Conclusion:Infection,elevated serum creatinine,and elevated iPTH significantly increase the risk of UE in MHD patients.Clinical management should emphasize infection prevention,toxin clearance optimization,and parathyroid function regulation to reduce UE incidence.

Type 2 diabetes mellitus(T2DM)is a chronic metabolic disorder characterized primarily by pancreatic β-cell dysfunction and insulin resistance.Beyond impaired glucose homeostasis,the glucotox-icity resulting from dysregulated glucose metabolism can lead to complications such as diabetic nephropa-thy,diabetic coronary heart disease,and diabetic cognitive dysfunction,posing severe threats to patients' health.Therefore,enhancing glucose metabolism and improving insulin resistance are critical strategies for T2DM prevention and treatment.Currently,the primary therapeutic approaches for T2DM include oral hypoglycemic agents and exogenous insulin injections.However,these methods face challenges such as unclear diagnostic markers,suboptimal therapeutic efficacy,and drug-related side effects.Consequently,the development of more precise and effective treatment strategies remains a top priority in clinical re-search.MicroRNA(miRNA)is a short non-coding RNA that regulates gene transcription.It has been reported to exhibit significant alterations even before the onset of overt pathological features like hypergly-cemia,suggesting their potential as early diagnostic biomarkers for T2DM to address current issues like delayed diagnosis and disease progression due to missed optimal treatment windows.Moreover,miRNAs can modulate the expression of pathways involved in glucose metabolism,thereby improving insulin resist-ance and maintaining glucose homeostasis while avoiding side effects associated with conventional thera-pies,such as reduced bone density and localized fat accumulation.This positions miRNAs as a promising avenue for precise and efficient T2DM management.This article systematically elucidates the molecular mechanisms by which miRNAs regulate glucose metabolism-related pathways,providing a theoretical foundation and reference for future clinical research.

Type 2 diabetes mellitus(T2DM)is a chronic metabolic disorder characterized primarily by pancreatic β-cell dysfunction and insulin resistance.Beyond impaired glucose homeostasis,the glucotox-icity resulting from dysregulated glucose metabolism can lead to complications such as diabetic nephropa-thy,diabetic coronary heart disease,and diabetic cognitive dysfunction,posing severe threats to patients' health.Therefore,enhancing glucose metabolism and improving insulin resistance are critical strategies for T2DM prevention and treatment.Currently,the primary therapeutic approaches for T2DM include oral hypoglycemic agents and exogenous insulin injections.However,these methods face challenges such as unclear diagnostic markers,suboptimal therapeutic efficacy,and drug-related side effects.Consequently,the development of more precise and effective treatment strategies remains a top priority in clinical re-search.MicroRNA(miRNA)is a short non-coding RNA that regulates gene transcription.It has been reported to exhibit significant alterations even before the onset of overt pathological features like hypergly-cemia,suggesting their potential as early diagnostic biomarkers for T2DM to address current issues like delayed diagnosis and disease progression due to missed optimal treatment windows.Moreover,miRNAs can modulate the expression of pathways involved in glucose metabolism,thereby improving insulin resist-ance and maintaining glucose homeostasis while avoiding side effects associated with conventional thera-pies,such as reduced bone density and localized fat accumulation.This positions miRNAs as a promising avenue for precise and efficient T2DM management.This article systematically elucidates the molecular mechanisms by which miRNAs regulate glucose metabolism-related pathways,providing a theoretical foundation and reference for future clinical research.

Objective To investigate the status of hearing impaired children's hearing device independence skills,and to explore the ways to improve their self-use of hearing equipment.Methods This study surveyed 64 re-habilitation teachers and 411 parents of children with hearing impairment aged 0-12 years.Through face-to-face or remote telephone interview,3 good habits(A asking parents for advice before removing the HA,B putting the de-vice into a moisture-proof box after removing it,C bringing batteries to school and knowing where are them)and 3 key abilities[D wearing the device independently,E replacing the battery independently,and F independently handle foreign bodies in the ear mold(Fa)and water vapor(Fb)]was investigated.The age when mastering skills or de-veloping habits difference of hearing impaired children in different groups were compared.Results ① The ratio of ability D in the bilateral CI group and the bilateral HA group of preschool children was 30.97％and 18.57％respec-tively.Among elementary school children,85.29％and 90.70％had this ability respectively.② The ratio of ability E in the bilateral CI group,the bilateral HA group and the bimodel group were 11.50％,15.71％and 16.49％,re-spectively.Among elementary school children,64.71％,53.49％and 68.52％had this ability,respectively.③Among preschool children,there was no statistical difference in age when different equipment groups developed the three good habits and acquired ability D and E(P＞0.05).④ Among primary school children,there was a statisti-cal difference in the age when different equipment groups formed habit A(P＜0.05),and the age when double CI group had this ability was slightly earlier than the double HA group.There was no significant difference in other abilities among age groups(P＞0.05).Conclusion The age at which hearing impaired children develop the three good habits precedes the age at which they master the key skills,which accords with the law of skill acquisition and development of ordinary children.Corresponding teaching process should be based on the age and ability of hearing-impaired children without considering the type of equipment.

Objectives: Vertebral fractures are associated with disability and mortality, but most vertebral fractures are asymptomatic. The present study aimed to determine the incidence of and develop a predictive nomogram for asymptomatic vertebral fractures in Vietnamese adults. Methods: This cohort study as a part of the Vietnam Osteoporosis Study involved 168 men and 287 women aged 50 years and older without a clinically diagnosed vertebral fracture. Their spine x-rays were taken at the recruitment and subsequent 2-year visit. Vertebral fractures were ascertained using the Genant’s semiquantitative method. We employed the Bayesian Model Averaging method to search for the optimal model for predicting asymptomatic vertebral fractures. A predictive nomogram was also developed to facilitate risk prediction. Results: During a median of 2.38 years of follow-up, 13 men and 16 women developed an asymptomatic vertebral fracture, yielding the overall incidence rate of 28 fractures per 1000 person-years, or 33 fractures/1000 personyears in men and 24 fractures/1000 person-years in women, respectively. Most asymptomatic vertebral fractures were moderate, almost 1.5 times more common than mild fractures. The optimal model for predicting incident asymptomatic vertebral fractures included age, male sex and lower femoral neck T-score. The area under the receiver’s operating characteristic curve was 0.91, with 95% CI ranging from 0.86 to 0.96. Conclusions Asymptomatic vertebral fractures were relatively common among adults in Vietnam. A simple model with sex, age and femoral neck T-score is helpful for selective screening of asymptomatic vertebral fractures in Vietnamese individuals.

Objective:To evaluate the consistency between architectural distortion（AD）observed on coronal images in three-dimensional ultrasonography（3D-US）and full-field digital mammography（FFDM），and to analyze the influencing factors of the presence of AD on 3D-US coronal images.Methods:A retrospective study was conducted on 96 female patients（97 lesions）with AD identified via FFDM that examined at Affiliated Hangzhou First People's Hospital，School of Medicine，Westlake University from January 2019 to December 2021，all of which with corresponding 3D-US results. Kappa analysis was used to assess the consistency between AD on 3D-US and FFDM.The differences of the lesion characteristics on FFDM（glandular density，presence of calcifications，and degree of distortion），3D-US features（number of lesions，presence of mass or non-mass lesions，and skipping sign in coronal images），clinical pathological characteristics（age，location，and pathology）between groups with AD and without AD in 3D-US were compared. Multivariate Logistic regression was used to identify the influencing factors.Results:Among the FFDM-identified AD lesions，62（63.92%，62/97）lesions showed AD on 3D-US coronal images，including 30 malignant lesions（48.39%，30/62）；35（36.08%，35/97）lesions without AD on 3D-US，in which 4（11.43%，4/35）were malignant. The consistency of distortion degree between FFDM and 3D-US was moderate（Kappa=0.455， P<0.001），with no statistically significant difference（ χ2=2.882， P=0.143）. The probability of malignancy was higher in typical AD compared to atypical AD. The comparisons of age，location，number of lesions，presence of skipping sign in 3D-US，breast density，and presence of calcification in the lesion showed no statistically significant differences between the groups with and without AD（all P >0.05）.The pathological results of malignancy，presence of lesions in 3D-US（mass and non-mass lesions），and the degree of distortion in FFDM showed statistically significant differences（all P < 0.05）. The multivariate Logistic regression analysis indicated that there were no independent risk factors for the appearance of AD in 3D-US（all P > 0.05）. Conclusions:In breast FFDM AD lesions，the incidence of 3D-US coronal plane AD was 63.92%，and the consistency between the degree of distortion in FFDM and 3D-US was moderate. The probability of malignancy is higher with typical AD. Pathological malignancy，presence of lesions in 3D-US（both mass and non-mass lesions），and typical AD in FFDM are more likely to correspond with AD in the coronal.

Objectives: Vertebral fractures are associated with disability and mortality, but most vertebral fractures are asymptomatic. The present study aimed to determine the incidence of and develop a predictive nomogram for asymptomatic vertebral fractures in Vietnamese adults. Methods: This cohort study as a part of the Vietnam Osteoporosis Study involved 168 men and 287 women aged 50 years and older without a clinically diagnosed vertebral fracture. Their spine x-rays were taken at the recruitment and subsequent 2-year visit. Vertebral fractures were ascertained using the Genant’s semiquantitative method. We employed the Bayesian Model Averaging method to search for the optimal model for predicting asymptomatic vertebral fractures. A predictive nomogram was also developed to facilitate risk prediction. Results: During a median of 2.38 years of follow-up, 13 men and 16 women developed an asymptomatic vertebral fracture, yielding the overall incidence rate of 28 fractures per 1000 person-years, or 33 fractures/1000 personyears in men and 24 fractures/1000 person-years in women, respectively. Most asymptomatic vertebral fractures were moderate, almost 1.5 times more common than mild fractures. The optimal model for predicting incident asymptomatic vertebral fractures included age, male sex and lower femoral neck T-score. The area under the receiver’s operating characteristic curve was 0.91, with 95% CI ranging from 0.86 to 0.96. Conclusions Asymptomatic vertebral fractures were relatively common among adults in Vietnam. A simple model with sex, age and femoral neck T-score is helpful for selective screening of asymptomatic vertebral fractures in Vietnamese individuals.

Objectives: Vertebral fractures are associated with disability and mortality, but most vertebral fractures are asymptomatic. The present study aimed to determine the incidence of and develop a predictive nomogram for asymptomatic vertebral fractures in Vietnamese adults. Methods: This cohort study as a part of the Vietnam Osteoporosis Study involved 168 men and 287 women aged 50 years and older without a clinically diagnosed vertebral fracture. Their spine x-rays were taken at the recruitment and subsequent 2-year visit. Vertebral fractures were ascertained using the Genant’s semiquantitative method. We employed the Bayesian Model Averaging method to search for the optimal model for predicting asymptomatic vertebral fractures. A predictive nomogram was also developed to facilitate risk prediction. Results: During a median of 2.38 years of follow-up, 13 men and 16 women developed an asymptomatic vertebral fracture, yielding the overall incidence rate of 28 fractures per 1000 person-years, or 33 fractures/1000 personyears in men and 24 fractures/1000 person-years in women, respectively. Most asymptomatic vertebral fractures were moderate, almost 1.5 times more common than mild fractures. The optimal model for predicting incident asymptomatic vertebral fractures included age, male sex and lower femoral neck T-score. The area under the receiver’s operating characteristic curve was 0.91, with 95% CI ranging from 0.86 to 0.96. Conclusions Asymptomatic vertebral fractures were relatively common among adults in Vietnam. A simple model with sex, age and femoral neck T-score is helpful for selective screening of asymptomatic vertebral fractures in Vietnamese individuals.