Objective To explore the relationship between the levels of serum death-associated protein kinase 1(DAPK1)and total tau(T-tau)protein and cognitive dysfunction in patients with type 2 diabetes mellitus(T2DM).Methods A total of 178 patients with T2DM who were diagnosed and treated at the Affiliated Hospital of Xuzhou Medical University from May 2024 to January 2025 were selected.According to whether the patients had cognitive dysfunction,they were divided into cognitive dysfunction group(88 cases)and control group(90 cases).Based on Montreal cognitive assessment(MoCA)score,patients with cognitive dysfunction were further divided into severe group(MoCA score＜10 points,24 cases);moderate group(10 points ≤MoCA score ≤17 points,31 cases),and mild group(18 points ≤MoCA score＜26 points,33 cases).The levels of serum DAPK1 and T-tau proteins were detected by enzyme-linked immunosorbent assay,and the risk factors were analyzed by Logistic regression.Spearman correlation analysis was used to evaluate the correlation between T-tau protein,DAPK1 and the severity of cognitive dysfunction.Results The age,duration of diabetes mellitus,proportion of hyperlipidemia,fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,T-tau protein,and DAPK1 of patients in cognitive dysfunction group were significantly higher than those in control group,while the educational level was significantly lower than that in control group(P＜0.05).Logistic regression analysis showed that the duration of diabetes mellitus,T-tau protein,DAPK1,and glycated hemoglobin were all independent risk factors for cognitive dysfunction in patients with T2DM(P＜0.05).The T-tau protein and DAPK1 of patients in severe group were significantly higher than those in mild group and moderate group(P＜0.001).Spearman correlation analysis showed that DAPK1 and T-tau proteins were positively correlated with severity of cognitive dysfunction(P＜0.05).Conclusion The duration of diabetes mellitus,glycated hemoglobin,DAPK1 and T-tau protein are all independent risk factors for cognitive dysfunction in patients with T2DM.The levels of DAPK1 and T-tau protein are related to the severity of cognitive dysfunction and can be used as potential markers for risk assessment.

Objective To construct and validate the efficacy of a risk prediction model for pneumothorax after CT-guided percutaneous pulmonary puncture biopsy(CT-PCNB)based on nomograms.Methods A total of 246 patients who underwent CT-PCNB examination in the hospital from October 2020 to October 2023 were selected and divided into training set(n=144)and validation set(n=102)using a random sampling method.In the training set,univariate and multivariate logistic regression analyses were performed to identify risk factors for pneumothorax after CT-PCNB.A nomogram model was constructed based on the identified risk factors,and its accuracy was validated using the validation set.Results Multifactorial logistic regression analysis showed that age≥60 years,concomitant underlying lung disease,lesion diameter<2 cm,distance from lesion to pleura≥10 mm,puncture through interlobular pleura,and≥2 pleural punctures were the risk factors for pneumothorax after CT-PCNB in the training set(P<0.05).A nomogram model was constructed based on these six factors.The ROC curve results for the training set showed an AUC of 0.852,sensitivity of 84.50%,and specificity of 67.50%.The nomogram model was validated using the validation set,with ROC curve results showing an AUC of 0.845,sensitivity of 83.00%,and specificity of 69.50%.There was no statistically significant difference between the predicted and actual values in both the training and validation sets(χ2=1.803,1.225;P>0.05),indicating clinical validity.Conclusion The nomogram model constructed based on the risk factors for pneumothorax after CT-PCNB has high predictive efficacy and is clinically meaningful.

Objective To construct and validate the efficacy of a risk prediction model for pneumothorax after CT-guided percutaneous pulmonary puncture biopsy(CT-PCNB)based on nomograms.Methods A total of 246 patients who underwent CT-PCNB examination in the hospital from October 2020 to October 2023 were selected and divided into training set(n=144)and validation set(n=102)using a random sampling method.In the training set,univariate and multivariate logistic regression analyses were performed to identify risk factors for pneumothorax after CT-PCNB.A nomogram model was constructed based on the identified risk factors,and its accuracy was validated using the validation set.Results Multifactorial logistic regression analysis showed that age≥60 years,concomitant underlying lung disease,lesion diameter<2 cm,distance from lesion to pleura≥10 mm,puncture through interlobular pleura,and≥2 pleural punctures were the risk factors for pneumothorax after CT-PCNB in the training set(P<0.05).A nomogram model was constructed based on these six factors.The ROC curve results for the training set showed an AUC of 0.852,sensitivity of 84.50%,and specificity of 67.50%.The nomogram model was validated using the validation set,with ROC curve results showing an AUC of 0.845,sensitivity of 83.00%,and specificity of 69.50%.There was no statistically significant difference between the predicted and actual values in both the training and validation sets(χ2=1.803,1.225;P>0.05),indicating clinical validity.Conclusion The nomogram model constructed based on the risk factors for pneumothorax after CT-PCNB has high predictive efficacy and is clinically meaningful.

Objective To explore the relationship between the levels of serum death-associated protein kinase 1(DAPK1)and total tau(T-tau)protein and cognitive dysfunction in patients with type 2 diabetes mellitus(T2DM).Methods A total of 178 patients with T2DM who were diagnosed and treated at the Affiliated Hospital of Xuzhou Medical University from May 2024 to January 2025 were selected.According to whether the patients had cognitive dysfunction,they were divided into cognitive dysfunction group(88 cases)and control group(90 cases).Based on Montreal cognitive assessment(MoCA)score,patients with cognitive dysfunction were further divided into severe group(MoCA score＜10 points,24 cases);moderate group(10 points ≤MoCA score ≤17 points,31 cases),and mild group(18 points ≤MoCA score＜26 points,33 cases).The levels of serum DAPK1 and T-tau proteins were detected by enzyme-linked immunosorbent assay,and the risk factors were analyzed by Logistic regression.Spearman correlation analysis was used to evaluate the correlation between T-tau protein,DAPK1 and the severity of cognitive dysfunction.Results The age,duration of diabetes mellitus,proportion of hyperlipidemia,fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,T-tau protein,and DAPK1 of patients in cognitive dysfunction group were significantly higher than those in control group,while the educational level was significantly lower than that in control group(P＜0.05).Logistic regression analysis showed that the duration of diabetes mellitus,T-tau protein,DAPK1,and glycated hemoglobin were all independent risk factors for cognitive dysfunction in patients with T2DM(P＜0.05).The T-tau protein and DAPK1 of patients in severe group were significantly higher than those in mild group and moderate group(P＜0.001).Spearman correlation analysis showed that DAPK1 and T-tau proteins were positively correlated with severity of cognitive dysfunction(P＜0.05).Conclusion The duration of diabetes mellitus,glycated hemoglobin,DAPK1 and T-tau protein are all independent risk factors for cognitive dysfunction in patients with T2DM.The levels of DAPK1 and T-tau protein are related to the severity of cognitive dysfunction and can be used as potential markers for risk assessment.

The Dietary Ration for Military Personnel(GJB 826C-2022)is a new standard formulated after revision of the national military standard-Dietary Ration for Soldiers(GJB826B-2010).The major changes included that:①The daily standards of the ration for different types of stoveswere merged and integrated,and special requirements for food ration and food quality of personnel in special positions such as pilots,divers and those in direct contact with nuclear materials were specified;② The food structure was optimized.The daily standards of ration for grain,animal food,especially livestock and poultry meat were lowered while those for fruit and milk were increased.The requirements for the supply of whole grains were elevated while the proportions of lean meat,beef and mutton,seafood and other animal foods were detailed;③The new daily standards for nuts were added.The new standard could better meet the practical needsof actual combat,underscored dietary quality,and proved to be more user-friendly and practical.It is of great significance for improving the dietary nutrition of troops,creating a new dietary pattern to improve combat effectiveness,constructing a support system for joint military operations,and enhancing the military supply capabilities in China.

AIM:This study aims to investigate the mechanisms by which Gegen(Puerariae lobatae Radix)and Danshen(Salviae miltiorrhizae Radix et Rhizoma)intervene in diabetes mellitus(DM)-related atherosclerosis(AS)through the regulation of adipokine homeostasis.METHODS:A mouse model of DM-related AS was established in male apolipoprotein E gene knockout(ApoE-/-)mice by high-fat diet feeding and intraperitoneal injection of streptozotocin.The mice were randomly divided into model group,low-dose Gegen-Danshen group,high-dose Gegen-Danshen group and posi-tive control drug metformin group,while male C57BL/J mice served as blank control group,with 6 mice in each group.Se-rum lipid levels of the mice were assessed.Oil red O staining was employed to observe pathological changes in the abdomi-nal aorta,while HE staining was used to examine the morphological changes of adipose tissues surrounding abdominal or-gans.The protein expression levels of adipokines,including adiponectin,apelin,chemerin and resistin,in adipose tis-sues were measured using RT-qPCR and Western blot.RESULTS:The administration of Gegen and Danshen resulted in a significant increase in the protein expression levels of adiponectin and apelin in adipose tissues(P＜0.01).Conversely,the levels of chemerin and resistin were significantly decreased(P＜0.01),and there was a notable reduction in low-densi-ty lipoprotein cholesterol(P＜0.01).Results of oil red O staining revealed that the aortic AS plaques of the mice in model group were numerous,large and scattered,whereas those in high-dose Gegen-Danshen group were fewer and smaller.CONCLUSION:Gegen and Danshen play a protective role in preventing DM-related AS in mice by enhancing the expres-sion of adiponectin and apelin but inhibiting the expression of chemerin and resistin.

AIM:This study aims to investigate the mechanisms by which Gegen(Puerariae lobatae Radix)and Danshen(Salviae miltiorrhizae Radix et Rhizoma)intervene in diabetes mellitus(DM)-related atherosclerosis(AS)through the regulation of adipokine homeostasis.METHODS:A mouse model of DM-related AS was established in male apolipoprotein E gene knockout(ApoE-/-)mice by high-fat diet feeding and intraperitoneal injection of streptozotocin.The mice were randomly divided into model group,low-dose Gegen-Danshen group,high-dose Gegen-Danshen group and posi-tive control drug metformin group,while male C57BL/J mice served as blank control group,with 6 mice in each group.Se-rum lipid levels of the mice were assessed.Oil red O staining was employed to observe pathological changes in the abdomi-nal aorta,while HE staining was used to examine the morphological changes of adipose tissues surrounding abdominal or-gans.The protein expression levels of adipokines,including adiponectin,apelin,chemerin and resistin,in adipose tis-sues were measured using RT-qPCR and Western blot.RESULTS:The administration of Gegen and Danshen resulted in a significant increase in the protein expression levels of adiponectin and apelin in adipose tissues(P＜0.01).Conversely,the levels of chemerin and resistin were significantly decreased(P＜0.01),and there was a notable reduction in low-densi-ty lipoprotein cholesterol(P＜0.01).Results of oil red O staining revealed that the aortic AS plaques of the mice in model group were numerous,large and scattered,whereas those in high-dose Gegen-Danshen group were fewer and smaller.CONCLUSION:Gegen and Danshen play a protective role in preventing DM-related AS in mice by enhancing the expres-sion of adiponectin and apelin but inhibiting the expression of chemerin and resistin.

In unicompartmental replacement surgery, there are a wide variety of commercially available unicompartmental prostheses, and the consistency of the contact surface between the common liner and the femoral prosthesis could impact the stress distribution in the knee after replacement in different ways. Medial tibial plateau fracture and liner dislocation are two common forms of failure after unicompartmental replacement. One of the reasons is the mismatch in the mounting position of the unicompartmental prosthesis in the knee joint, which may lead to failure. Therefore, this paper focuses on the influence of the shape of the contact surface between the liner and the femoral prosthesis and the mounting position of the unicompartmental prosthesis on the stress distribution in the knee joint after replacement. Firstly, a finite element model of the normal human knee joint was established, and the validity of the model was verified by both stress and displacement. Secondly, two different shapes of padded knee prosthesis models (type A and type B) were developed to simulate and analyze the stress distribution in the knee joint under single-leg stance with five internal or external rotation mounting positions of the two pads. The results showed that under a 1 kN axial load, the peak contact pressure of the liner, the peak ACL equivalent force, and the peak contact pressure of the lateral meniscus were smaller for type A than for type B. The liner displacement, peak contact pressure of the liner, peak tibial equivalent force, and peak ACL equivalent force were the smallest for type A at 3° of internal rotation in all five internal or external rotation mounting positions. For unicompartmental replacement, it is recommended that the choice of type A or type B liner for prosthetic internal rotation up to 6° should be combined with other factors of the patient for comprehensive analysis. In conclusion, the results of this paper may reduce the risk of liner dislocation and medial tibial plateau fracture after unicompartmental replacement, providing a biomechanical reference for unicompartmental prosthesis design.
Arthroplasty, Replacement, Knee/methods* ; Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Knee Joint/surgery* ; Knee Prosthesis ; Tibia/surgery*

Objective:To evaluate the value of quantitative analysis of the relative signal intensity (SI) of liver gadolinium disodium enhanced MRI in the grading of liver fibrosis.Methods:From January 2018 to October 2020, the relevant data of 131 patients who underwent gadoxetate disodium enhanced MRI examination were retrospectively analyzed in Henan Provincial People′s Hospital. All patients had histopathological results. According to the Laennec grading system of liver fibrosis, the patients were classified in F0-F1 (27 cases), F2 (19 cases), F3 (17 cases) and F4 (68 cases). The signal intensity of the liver, erector spinae and spleen were measured before and after the enhancement; and 5 post-contrast relative SI parameters were calculated, including the relative enhancement (RE), liver-to-muscle contrast ratio (LMC), liver-to-spleen contrast ratio (LSC), LMC increase rate, LSC increase rate. The differences of 5 post-contrast relative SI parameters among the different fibrosis grades were compared using one-way analysis of variance. The receiver operating characteristic (ROC) curves were drawn to evaluate the diagnostic efficacy of 5 post-contrast relative SI parameters in the diagnosis of clinically significant liver fibrosis (F2-F4), advanced liver fibrosis (F3-F4) and liver cirrhosis (F4).Results:The differences of RE, LMC, LSC, LMC increase rate, LSC increase rate among different liver fibrosis grades were statistically significant (all P<0.001). With the increasing of the degree of liver fibrosis, the RE, LMC increase rate and LSC increase rate showed decreased. ROC results showed that the area under the curve (AUC) of RE, LMC increase rate, LSC increase rate in diagnosing liver fibrosis in all levels were greater than those of LMC and LSC. The AUC values of RE, LMC increase rate, LSC increase rate in the diagnosis of significant fibrosis (F2-F4) were 0.89, 0.86, 0.83, with the sensitivity as 81.7%, 71.2%, 81.7%, and the specificity as 96.3%, 85.2%, and 74.1%, respectively. The AUC values of RE, LMC increase rate, LSC increase rate in the diagnosis of advanced liver fibrosis (F3-F4) were 0.93, 0.88, 0.86, with the sensitivity as 84.7%, 72.9%, 91.8%, and the specificity as 91.3%, 87.0 %, 71.7%; and the AUC values for diagnosing liver cirrhosis (F4) were 0.92, 0.86, 0.85, with the sensitivity as 82.4%, 76.5%, 92.7%, and the specificity as 88.9%, 81.0%, 65.1%, respectively. Conclusion:Gadoxetate disodium enhanced MRI relative SI parameters including RE, LMC increase rate and LSC increase rate might be used as a useful imaging marker in liver fibrosis grading.

Objective:To investigate the clinical outcomes of patients with intrahepatic cholangiocarcinoma (ICC) undergoing surgical resection.Methods:Patients who undergoing radical surgical resection for ICC from Jan 2015 to Apr 2021 at the Department of General Surgery, the First Affiliated Hospital of Anhui Medical University were included in this retrospective cohort study.Results:There were 67 patients in the final analysis, The median follow-up duration was 14 months (range: 1-60 months). Firty three patients (79.1%) had tumor recurrence, 52 patients (77.6%) died, Among them, 49 patients (73.1%) died from tumor recurrence. The 1-、2-、and 3-year accumulated disease-free and overall survival rate were 35.6%, 19.6%, 16.8% and 53.7%, 32.4%, 20.8%. respectively. The overall survival rate of the group without microvascular invasion was significantly better than those of the group with microvascular invasion ( χ2=5.916, P=0.015). CA19-9≥1 000 U/ml was the only independent risk factor for the disease-free survival. CA19-9≥1 000 U/ml、blood loss≥600 ml、microvascular invasion and tumor recurrence were the independent risk factors for the overall survival. Conclusion:For ICC patients with single tumor, when the tumor diameter is less than 5 cm and has no microvascular invasion, surgical resection is recommended, and a satisfactory prognosis could be achieved.