Objective To explore the correlation between the expression of serum microRNA(miR)-1298-5p,miR-625-5p,and miR-155 with the degree of Helicobacter pylori(Hp)infection in elderly gastric cancer patients.Methods From January 2021 to November 2023,120 elderly patients with gastric cancer admitted to the hospital from January 2021 to November 2023 were selected as the gastric cancer group,and 130 non-gas-tric cancer patients who underwent gastroscopy were selected as the control group.The expression levels of miR-1298-5p,miR-625-5p and miR-155 in serum were detected by fluorescence quantitative PCR(qPCR).Car-bon 13 urea breath test was used to detect the positive rate of Hp infection in two groups,and the degree of Hp infection in elderly patients with gastric cancer were evaluated.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum miR-1298-5p,miR-625-5p,and miR-155 expression levels for Hp infection in elderly gastric cancer patients.Pearson method was applied to analyze the correlation between serum miR-1298-5p,miR-625-5p,miR-155 expression and positive rate of Hp infection in elderly gas-tric cancer patients.Results Compared with the control group,the expression levels of miR-1298-5p and miR-625-5p in serum of gastric cancer group decreased(P＜0.05),while the positive rate of Hp infection and the expression level of serum miR-155 increased(P＜0.05).The expression levels of serum miR-1298-5p and miR-625-5p in elderly gastric cancer patients with Hp grade Ⅰ,Ⅱ,and Ⅲ infection were lower than those without Hp infection,while the expression level of miR-155 was higher(P＜0.05).Patients with poor differ-entiation,lymph node metastasis,and TNM stage Ⅲ-Ⅳ had lower expressions of serum miR-1298-5p and miR-625-5p(P＜0.05),and higher expression of miR-155(P＜0.05)than those with moderate-high differen-tiation,no lymph node metastasis,and TNM stage Ⅰ-Ⅱ.The expression levels of serum miR-1298-5p and miR-625-5p were negatively correlated with the positive rate of Hp infection in elderly patients with gastric cancer(r=-0.443,-0.386,both P＜0.001),and the expression levels of serum miR-155 were positively correlated with the positive rate of Hp infection(r=0.525,P＜0.001).The area under the curve(AUC)of serum miR-1298-5p,miR-625-5p and miR-155 combined diagnosis of Hp infection in elderly gastric cancer pa-tients was higher than that of single diagnosis(P＜0.05).Conclusion The expression levels of miR-1298-5p and miR-625-5p in serum of elderly gastric cancer patients with Hp infection decrease,while the expression level of miR-155 increases.These three factors are related to the degree of Hp infection and have good diag-nostic value for the occurrence of Hp infection.

To explore the molecular mechanisms underlying acupuncture-induced weight loss,the effects of acupuncture based on the principles of consolidating the foundation and strengthening the spleen and stomach on the Leptin-mediated JAK2/STAT5α/PGE2 signaling pathway in the liver tissue of obese rats were investigated.Methods Obese rat models were established and divided into six groups:Normal control group,normal control+AG490 group,obese model group,obese model+AG490 group,obese model+acupuncture group,and obese model+acupuncture+AG490 group,with 10 rats in each group.Serum Leptin and PGE2 levels were detected using ELISA,the expression of related proteins in liver tissue was assessed by Western blot,and changes in adipocyte morphology were observed through HE staining.Results In the obese model group,serum Leptin and PGE2 levels were significantly elevated,adipocyte area was enlarged,and the expression of JAK1,JAK2,STAT5α,COX1,and COX2 proteins in liver tissue significantly increased.Acupuncture treatment significantly reduced serum Leptin and PGE2 levels,decreased adipocyte area,and inhibited the expression of related proteins in liver tissue.Conclusion Acupuncture achieves weight loss by inhibiting the JAK2/STAT5α/PGE2 signaling pathway,improving Leptin resistance,reducing inflammatory responses,and decreasing fat accumulation.

To explore the molecular mechanisms underlying acupuncture-induced weight loss,the effects of acupuncture based on the principles of consolidating the foundation and strengthening the spleen and stomach on the Leptin-mediated JAK2/STAT5α/PGE2 signaling pathway in the liver tissue of obese rats were investigated.Methods Obese rat models were established and divided into six groups:Normal control group,normal control+AG490 group,obese model group,obese model+AG490 group,obese model+acupuncture group,and obese model+acupuncture+AG490 group,with 10 rats in each group.Serum Leptin and PGE2 levels were detected using ELISA,the expression of related proteins in liver tissue was assessed by Western blot,and changes in adipocyte morphology were observed through HE staining.Results In the obese model group,serum Leptin and PGE2 levels were significantly elevated,adipocyte area was enlarged,and the expression of JAK1,JAK2,STAT5α,COX1,and COX2 proteins in liver tissue significantly increased.Acupuncture treatment significantly reduced serum Leptin and PGE2 levels,decreased adipocyte area,and inhibited the expression of related proteins in liver tissue.Conclusion Acupuncture achieves weight loss by inhibiting the JAK2/STAT5α/PGE2 signaling pathway,improving Leptin resistance,reducing inflammatory responses,and decreasing fat accumulation.

This paper summarized the experience of Professor FANG Dingya in staged treatment of Sjögren's syndrome from the perspective of dryness toxin. It is believed that the cause of Sjögren's syndrome is externally-contracted dryness， consumption of essence and fluid， congenital and acquired essence deficiency， depleted essence and insufficient blood， and the core mechanism is internal accumulation of dryness toxin. The treatment can be divided into three stages， that is dryness toxin transforming into fire-heat， damp-heat and phlegm-stasis， from the perspective of dryness metal qi transformation. It is emphasized to dispel pathogen mainly， to clear and moisten with yin-nourishing medicinals in supplementation， and to treat by stages based on syndrome differentiation. For dryness toxin with fire-heat， it is suggested to moisten dryness， resolve toxins and subdue fire， with self-made Runzao Jiedu Decoction （润燥解毒汤） in modification. For dryness toxin with damp-heat， the method of nourishing yin， clearing heat and draining dampness should be used， and Chunze Decoction （春泽汤） in modification is suggested. For dryness toxin with phlegm-stasis， it is recommended to unblock collaterals， disperse phlegm and dissipate stasis， with self-made Sanyu Xiaotan Decoction （散瘀消痰汤） in modification.

Objective:To identify early predictors of factors influencing the efficacy of infliximab (IFX) treatment in patients with Crohn's disease (CD) .Methods:This study is a nested case-control study, including CD patients treated with IFX at the Second Affiliated Hospital of Soochow University from November 2015 to April 2021 and at the First Affiliated Hospital of Nanjing Medical University from November 2015 to December 2022. All the patients were followed up until June 2023 and categorized into IFX non-response and treatment-effective groups based on changes in clinical symptoms and endoscopic image during the follow-up. Laboratory data of inflammatory markers, post-induction trough IFX concentration and antibody levels in both groups were retrospectively collected and compared. Logistic regression models were employed to identify potential factors associated with the risk of IFX non-responsiveness. Machine learning using random forest analysis was utilized to quantitatively assess the predictive features for IFX treatment efficacy and ROC curves was used to evaluate the model's accuracy.Results:This study included 147 CD patients undergoing IFX treatment, with 58 from the Second Affiliated Hospital of Soochow University and 89 from the First Affiliated Hospital of Nanjing Medical University. Among them, 38 were classified as the IFX non-response group, and 109 as the effective group. Patients in the IFX non-response group had lower trough concentration ( P < 0.001), higher antibody levels ( P < 0.001), and a less pronounced reduction in ESR during the induction therapy ( P < 0.001). Univariate and multi-variate Logistic regression models demonstrated that IFX trough concentration and the ratio of ESR before and after induction therapy was associated with the risk of non-responsiveness. After the induction period, for each unit increase in IFX trough concentration (1 μg/ml), the risk of IFX non-response decreased by 23% ( RR = 0.77, 95% CI = 0.68-0.89), while each doubling of the ESR ratio after induction was associated with a 1.43-fold increase in the risk of non-response ( RR = 2.43, 95% CI = 1.48-4.00). Random forest machine learning analysis revealed that IFX trough concentration below 1.5 μg/ml could predict IFX non-response, with area under the ROC curve was 0.722. Conclusion:Lower post-induction IFX trough concentrations is predictive of IFX non-response, while a lack of significant decrease in ESR during the induction phase is also significantly associated with IFX non-response.

Objective To explore the potential categories and influencing factors of the fear of progression in patients with inflammatory bowel diseases(IBD).Methods IBD patients who received inpatient treatment in a tertiary hospital in Nanjing from July 2022 to July 2023 were selected as the study subjects by convenience sampling method.The General Demographic Information Questionnaire,the Chinese version of the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),the Chinese version of Inflammatory Bowel Disease Self-efficacy Scale(IBD-SES),and Social Support Rating Scale(SSRS)were administered to the participants.We applied one-way ANOVA and Logistic regression analysis to identify the factors associated with the potential categories of the fear of progression.Results A total of 303 retumed questionnaires(out of the 310)were valid,resulting an effective response rate of 97.74％.According to the results of latent profile analysis,we classified the respondents into 3 categories by the fear of progression,namely"low risk fear of disease adaptation group"(n=127,41.91％),"medium risk fear of illness distress group"(n=139,45.88％),"high risk fear of dysfunction group"(n=37,12.21％).3 groups showed statistically significant differences in permanent address,self-rated financial pressure,current disease status and self-efficacy(P＜0.05).Conclusion Patients with IBD had obvious differences in characteristics on the fear of progression.Nursing personnel should formulate personalized intervention strategies based on the classification characteristics of the fear of progression of IBD patients.Moreover,nurses should focus on improving patients'self-efficacy and promoting patients to treat medical care,stress and emotion management correctly.

Objective:To explore the relationship between dietary pattern and sexual function in people of childbearing age.Methods:This study adopted a cross-sectional method and included all women and men who visited Reproduction Center of Maanshan Maternal and Child Health Hospital, Reproductive Medicine Center of the 901th Hospital of the Joint Logistics Support Force of People's Liberation Army and Reproduction Center of Anhui Wanbei Coal Power Group General Hospital from December 2020 to March 2022. The Female Sexual Function Index (FSFI) and International Index of Erectile Function-15 (IIEF-15) were used to assess sexual function. Factor analysis was used to establish dietary patterns, and multivariate logistic regression was used to analyze the association between dietary patterns and sexual function.Results:A total of 1 290 females and 1 331 males were included in the study, including 1 031 females and 899 males with sexual dysfunction. There were 289 women and 272 men with balanced dietary pattern, 473 women and 395 men with traditional dietary pattern, 272 women and 324 men with processed dietary pattern, and 256 women and 340 men with beverage dietary pattern. After adjusting for confounding factors such as residence and age, it was found that balanced dietary pattern was negatively correated with female sexual desire disorder ( OR=0.904, 95% CI: 0.820-0.995, P=0.039), sexual arousal disorder ( OR=0.840, 95% CI: 0.759-0.929, P=0.001), vaginal lubrication disorder ( OR=0.833, 95% CI: 0.710-0.979, P=0.026), orgasmic disorder ( OR=0.764, 95% CI: 0.680-0.858, P<0.001), low sexual satisfaction ( OR=0.887, 95% CI: 0.796-0.987, P=0.028), sexual dysfunction ( OR=0.805, 95% CI: 0.714-0.907, P<0.001), and male orgasmic disorder ( OR=0.859, 95% CI: 0.763-0.967, P=0.012). The traditional dietary pattern was negatively correlated with female sexual desire disorder ( OR=0.879, 95% CI: 0.786-0.983, P=0.024), sexual arousal disorder ( OR=0.884, 95% CI: 0.784-0.995, P=0.042), male erectile disorder ( OR=0.736, 95% CI: 0.634-0.855, P<0.001), sexual desire disorder ( OR=0.753, 95% CI: 0.648-0.876, P<0.001), and sexual dysfunction ( OR=0.769, 95% CI: 0.653-0.907, P=0.020). The processed dietary pattern was positively correlated with erectile disorder ( OR=1.162, 95% CI: 1.049-1.287, P=0.004), orgasmic dysfunction ( OR=1.207, 95% CI: 1.091-1.337, P<0.001), sexual desire disorder ( OR=1.199, 95% CI: 1.081-1.330, P=0.001) and sexual dysfunction ( OR=1.134, 95% CI: 1.020-1.261, P=0.002). Beverage dietary pattern was not associated with sexual dysfunction in men and women (all P>0.05). Conclusion:Balanced, traditional dietary patterns were related to the reduce risk of sexual dysfunction in both women and men of childbearing age, while processed dietary patterns were related to the increased risk of sexual dysfunction in men of childbearing age.

Objective:To explore the relationship between dietary pattern and sexual function in people of childbearing age.Methods:This study adopted a cross-sectional method and included all women and men who visited Reproduction Center of Maanshan Maternal and Child Health Hospital, Reproductive Medicine Center of the 901th Hospital of the Joint Logistics Support Force of People's Liberation Army and Reproduction Center of Anhui Wanbei Coal Power Group General Hospital from December 2020 to March 2022. The Female Sexual Function Index (FSFI) and International Index of Erectile Function-15 (IIEF-15) were used to assess sexual function. Factor analysis was used to establish dietary patterns, and multivariate logistic regression was used to analyze the association between dietary patterns and sexual function.Results:A total of 1 290 females and 1 331 males were included in the study, including 1 031 females and 899 males with sexual dysfunction. There were 289 women and 272 men with balanced dietary pattern, 473 women and 395 men with traditional dietary pattern, 272 women and 324 men with processed dietary pattern, and 256 women and 340 men with beverage dietary pattern. After adjusting for confounding factors such as residence and age, it was found that balanced dietary pattern was negatively correated with female sexual desire disorder ( OR=0.904, 95% CI: 0.820-0.995, P=0.039), sexual arousal disorder ( OR=0.840, 95% CI: 0.759-0.929, P=0.001), vaginal lubrication disorder ( OR=0.833, 95% CI: 0.710-0.979, P=0.026), orgasmic disorder ( OR=0.764, 95% CI: 0.680-0.858, P<0.001), low sexual satisfaction ( OR=0.887, 95% CI: 0.796-0.987, P=0.028), sexual dysfunction ( OR=0.805, 95% CI: 0.714-0.907, P<0.001), and male orgasmic disorder ( OR=0.859, 95% CI: 0.763-0.967, P=0.012). The traditional dietary pattern was negatively correlated with female sexual desire disorder ( OR=0.879, 95% CI: 0.786-0.983, P=0.024), sexual arousal disorder ( OR=0.884, 95% CI: 0.784-0.995, P=0.042), male erectile disorder ( OR=0.736, 95% CI: 0.634-0.855, P<0.001), sexual desire disorder ( OR=0.753, 95% CI: 0.648-0.876, P<0.001), and sexual dysfunction ( OR=0.769, 95% CI: 0.653-0.907, P=0.020). The processed dietary pattern was positively correlated with erectile disorder ( OR=1.162, 95% CI: 1.049-1.287, P=0.004), orgasmic dysfunction ( OR=1.207, 95% CI: 1.091-1.337, P<0.001), sexual desire disorder ( OR=1.199, 95% CI: 1.081-1.330, P=0.001) and sexual dysfunction ( OR=1.134, 95% CI: 1.020-1.261, P=0.002). Beverage dietary pattern was not associated with sexual dysfunction in men and women (all P>0.05). Conclusion:Balanced, traditional dietary patterns were related to the reduce risk of sexual dysfunction in both women and men of childbearing age, while processed dietary patterns were related to the increased risk of sexual dysfunction in men of childbearing age.

Objective:To identify early predictors of factors influencing the efficacy of infliximab (IFX) treatment in patients with Crohn's disease (CD) .Methods:This study is a nested case-control study, including CD patients treated with IFX at the Second Affiliated Hospital of Soochow University from November 2015 to April 2021 and at the First Affiliated Hospital of Nanjing Medical University from November 2015 to December 2022. All the patients were followed up until June 2023 and categorized into IFX non-response and treatment-effective groups based on changes in clinical symptoms and endoscopic image during the follow-up. Laboratory data of inflammatory markers, post-induction trough IFX concentration and antibody levels in both groups were retrospectively collected and compared. Logistic regression models were employed to identify potential factors associated with the risk of IFX non-responsiveness. Machine learning using random forest analysis was utilized to quantitatively assess the predictive features for IFX treatment efficacy and ROC curves was used to evaluate the model's accuracy.Results:This study included 147 CD patients undergoing IFX treatment, with 58 from the Second Affiliated Hospital of Soochow University and 89 from the First Affiliated Hospital of Nanjing Medical University. Among them, 38 were classified as the IFX non-response group, and 109 as the effective group. Patients in the IFX non-response group had lower trough concentration ( P < 0.001), higher antibody levels ( P < 0.001), and a less pronounced reduction in ESR during the induction therapy ( P < 0.001). Univariate and multi-variate Logistic regression models demonstrated that IFX trough concentration and the ratio of ESR before and after induction therapy was associated with the risk of non-responsiveness. After the induction period, for each unit increase in IFX trough concentration (1 μg/ml), the risk of IFX non-response decreased by 23% ( RR = 0.77, 95% CI = 0.68-0.89), while each doubling of the ESR ratio after induction was associated with a 1.43-fold increase in the risk of non-response ( RR = 2.43, 95% CI = 1.48-4.00). Random forest machine learning analysis revealed that IFX trough concentration below 1.5 μg/ml could predict IFX non-response, with area under the ROC curve was 0.722. Conclusion:Lower post-induction IFX trough concentrations is predictive of IFX non-response, while a lack of significant decrease in ESR during the induction phase is also significantly associated with IFX non-response.

Objective:Rural widowed elderly women living alone may face higher risks of depression and loneliness than general elderly people,which will have an impact on their quality of life.This study aims to explore the correlation of depression and loneliness with quality of life among rural widowed elderly women living alone. Methods:A two-stage cluster sampling method was used to select 234 rural widowed older women living alone in Longshan county,Xiangxi autonomous prefecture,Hunan Province,and a questionnaire survey was conducted with the General Situation Questionnaire,the Geriatric Depression Scale-15(GDS-15),the University of California,Los Angeles(UCLA)Loneliness Scale-8(ULS-8),and the 36 Items Short Form Health Survey(SF-36). Results:The ages of 234 rural widowed older women living alone were(73.29±7.36)years.Among them,103(44.0%)women were detected as depressed,114(48.7%)were not lonely or mildly lonely,111(47.4%)were moderately lonely,and 9(3.9%)were severely lonely.The total quality of life scores were 63.39±19.70.Depression and loneliness were negatively correlated with quality of life(all P<0.001).After adjusting for confounding factors,multiple linear regression analysis showed that age,number of acute and chronic diseases,personal monthly income,depression,and loneliness independently impacted the quality of life among rural widowed older women(all P<0.05). Conclusion:Depression and loneliness can affect the quality of life of rural widowed older women living alone.In healthy aging efforts,the quality of life of these rural widowed older women can be improved by strengthening the management of underlying illnesses,increasing income,and alleviating depression and loneliness.