Objective:To analyze the current situation and potential profile of self-disgust in peritoneal dialysis patients and explore the influencing factors of different categories of hemodialysis patients.Methods:Using convenient sampling method, 466 patients with peritoneal dialysis from 3 tertiary hospitals of Cangzhou People′s Hospital, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou Central Hospital were selected as the survey object from April to June 2023. A cross-sectional survey was conducted using the general data questionnaire, Questionnaire for the Assessment of Self-Disgust, Social Avoidance and Distress Scale and Perceived Social Support Scale. The potential profile of self-disgust in peritoneal dialysis patients was analyzed, and the influencing factors of different potential categories were analyzed by multiple Logistic regression.Results:Finally, 458 patients were included, with 283 males and 175 females, aged (48.68 ± 13.85) years old. The Questionnaire for the Assessment of Self-Disgust was scored (38.24 ± 5.25) points, the Social Avoidance and Distress Scale was scored (22.32 ± 3.78) points, the Perceived Social Support Scale was scored (53.59 ± 8.64) points in peritoneal dialysis patients. The level of self-disgust in peritoneal dialysis patients could be divided into 3 sections: self-pity (28.38%, 130/458), self-reflection (52.18%, 239/458) and self-acceptance (19.44%, 89/458). The results of multiple Logistic regression analysis showed that age, number of comorbidities, dialysis age, Social Avoidance and Distress Scale and Perceived Social Support Scale scores were the influencing factors of self-disgust in peritoneal dialysis patients ( OR values were 0.804-2.019, all P<0.05). Conclusions:The self-disgust in peritoneal dialysis patients was at a high level and somewhat heterogeneous. Clinical workers should focus on self-pity and self-reflective peritoneal dialysis patients, and provide targeted interventions to reduce the level of patient self-disgust according to the influencing factors of different potential categories of patients.

Objective To investigate the prevalence of metabolic associated fatty liver disease(MAFLD)and its correlation with metabolic components among personnel on tropical islands.Methods The data of personnel who received health examination on islands in 2024 were analyzed,and they were grouped with the age limit of 30 years old to compare the detection rates of MAFLD and metabolic components in different age groups.In people aged≥ 30 years old,the age,gender,body mass index(BMI),waist circumference(WC),fasting blood glucose,blood lipids,liver function,kidney function and other indexes were compared between MAFLD and non-MAFLD groups.Univariate and multivariate logistic regression models were conducted to analyze the factors affecting the occurrence of MAFLD.The effects of various metabolic components on the risk of MAFLD in different age groups were analyzed by subgroup analyses.Results Among 1213 personnel,175(14.4％)cases had MAFLD,of which 141(80.6％)cases were mild,32(18.3％)were moderate,and 2(1.1％)were severe.The detection rates of MAFLD(25.6％[74/289]vs 10.9％[101/924])and overweight/obesity(55.7％[161/289]vs 37.7％[348/924])in age ≥ 30 years old were significantly higher than those in age＜30 years old(both P＜0.001).In people aged≥ 30 years old,compared with the non-MAFLD group,the BMI,WC,systolic blood pressure,diastolic blood pressure,triglyceride(TG),low density lipoprotein-cholesterol,alanine transaminase,aspartate transaminase,gamma glutamyltransferase and uric acid(UA)in the MAFLD group were significantly higher(all P＜0.05),and the high density lipoprotein-cholesterol(HDL-C)was significantly lower(P＜0.05).There were no significant differences in age,gender,fast blood glucose,total cholesterol,alkaline phosphatase,total bilirubin,serum creatinine,or blood urea nitrogen(all P＞0.05).Logistic regression analysis showed that WC was an independent risk factor for MAFLD(odds ratio[OR]=1.101,95％confidence interval[95％CI]1.030-1.176,P=0.004);HDL-C was an independent protective factor for MAFLD(OR=0.071,95％CI0.016-0.323,P=0.001);and BMI ≥24.0 kg/m2 and WC≥90 cm were positively correlated with MAFLD(both P＜0.01).In people aged≥30 years old,the risk of MAFLD was increased in those with overweight/obesity,arterial blood pressure≥ 130/85 mmHg(1 mmHg=0.133 kPa),TG≥1.7 mmol/L,HDL-C≤1.0 mmol/L and UA＞420 μmol/L(all P＜0.05),and the risk of MAFLD was most significantly increased in overweight/obesity people(hazard ratio[HR]=5.088,95％CI 2.724-9.504,P＜0.001).Among people aged＜30 years old,the risk of MAFLD was increased in those with overweight/obesity and UA＞420 μmol/L(both P＜0.01),and the risk of MAFLD was most significantly increased in overweight/obesity individuals(HR=6.305,95％CI3.973-10.006,P＜0.001).Conclusion The detection rates of MAFLD and various metabolic components are higher in the personnel on tropical islands,and the risk of MAFLD is higher in those with overweight/obesity,TG≥1.7 mmol/L and hyperuricemia.

BACKGROUND:Cervical spondylosis is a chronic degenerative disease that has become one of the most common and frequent diseases threatening human health.At present,the initial diagnosis of the cervical spine and its surrounding structures mainly relies on the interpretation of medical images by radiologists,which not only requires a high level of technical requirements for operators,but also has the disadvantages of strong subjectivity,high labor intensity,and low efficiency.With the rapid development of artificial intelligence technology,its powerful data processing and image recognition capabilities have shown broad application prospects in the medical field.Deep learning has also made certain progress in the research of spinal diseases.OBJECTIVE:To summarize the current status and research progress in the application of artificial intelligence technology in cervical spine imaging images in recent years,evaluating the performance of artificial intelligence models as well as future trends and challenges to be overcome.METHODS:The first author searched the relevant articles in WanFang,CNKI,and PubMed in June 2024.The Chinese search terms were"artificial intelligence,deep learning,cervical spine."English serach terms were"artificial intelligence,Al,cervical vertebrae,cervical."Finally,101 articles were included and analyzed.RESULTS AND CONCLUSION:(1)Artificial intelligence technology can realize automatic segmentation of cervical vertebrae and measurement of curvature change by segmentation,classification,landmarks recognition of medical image parts,detect cervical vertebral fracture,nerve root,and spinal cord type cervical spondylosis,identify cervical spine ossification of posterior longitudinal ligament,and predict post-surgery related risk factors and cervical vertebra maturation classification.(2)Although artificial intelligence technology has shown great potential in the field of cervical spine research,it is still in the early stages of exploration and rapid development,with unlimited room for development and innovation.

Objective:To analyze the current situation and potential profile of self-disgust in peritoneal dialysis patients and explore the influencing factors of different categories of hemodialysis patients.Methods:Using convenient sampling method, 466 patients with peritoneal dialysis from 3 tertiary hospitals of Cangzhou People′s Hospital, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou Central Hospital were selected as the survey object from April to June 2023. A cross-sectional survey was conducted using the general data questionnaire, Questionnaire for the Assessment of Self-Disgust, Social Avoidance and Distress Scale and Perceived Social Support Scale. The potential profile of self-disgust in peritoneal dialysis patients was analyzed, and the influencing factors of different potential categories were analyzed by multiple Logistic regression.Results:Finally, 458 patients were included, with 283 males and 175 females, aged (48.68 ± 13.85) years old. The Questionnaire for the Assessment of Self-Disgust was scored (38.24 ± 5.25) points, the Social Avoidance and Distress Scale was scored (22.32 ± 3.78) points, the Perceived Social Support Scale was scored (53.59 ± 8.64) points in peritoneal dialysis patients. The level of self-disgust in peritoneal dialysis patients could be divided into 3 sections: self-pity (28.38%, 130/458), self-reflection (52.18%, 239/458) and self-acceptance (19.44%, 89/458). The results of multiple Logistic regression analysis showed that age, number of comorbidities, dialysis age, Social Avoidance and Distress Scale and Perceived Social Support Scale scores were the influencing factors of self-disgust in peritoneal dialysis patients ( OR values were 0.804-2.019, all P<0.05). Conclusions:The self-disgust in peritoneal dialysis patients was at a high level and somewhat heterogeneous. Clinical workers should focus on self-pity and self-reflective peritoneal dialysis patients, and provide targeted interventions to reduce the level of patient self-disgust according to the influencing factors of different potential categories of patients.

Objective:To access the relation of aortic arch calcification (AoAC) volume based on parathyroid SPECT/CT imaging with hungry bone syndrome (HBS) in patients with renal secondary hyperparathyroidism (SHPT) after parathyroidectomy (PTX).Methods:From June 2015 to May 2024, the imaging and clinical data of 89 renal SHPT patients (52 males, 37 females, age: (51.5±10.3) years) who underwent parathyroid 99Tc m-methoxyisobutylisonitrile (MIBI) SPECT/CT in Affiliated Jiangyin Hospital of Nantong University were retrospectively analyzed. The AoAC volume was measured by Volume software of SPECT/CT system. The patients were divided into HBS group and non-HBS group, and the independent-sample t test, Mann-Whitney U test were used to compare differences of various indicators between the two groups. Logistic regression was used to analyze the influencing factors of HBS. Results:All 89 patients underwent PTX successfully, 50 patients (56.2%) were with HBS and 39 patients (43.8%) were not. The differences of age ((47.9±9.9) vs (56.1±9.0) years, t=-3.98, P<0.001), AoAC volume (0.36(0.02, 1.30) vs 1.57(0.37, 3.77)cm 3, Z=-3.17, P=0.002), preoperative alkaline phosphatase (ALP) (345.75(218.50, 632.50) vs (203.13±114.57)U/L, Z=-4.69, P<0.001), preoperative parathyroid hormone (147.85(109.83, 227.40) vs (135.58±51.14)pmol/L, Z=-2.34, P=0.019) and preoperative serum corrected calcium ((2.38±0.21) vs 2.54(2.39, 2.62)mmol/L, Z=-3.09, P=0.002) between HBS group and non-HBS group were significant. Logistic regression analysis showed that the AoAC volume ((odds ratio, OR)=0.628, 95% CI: 0.427-0.924, P=0.018), preoperative ALP ( OR=1.007, 95% CI: 1.002-1.012, P=0.010) and preoperative serum corrected calcium ( OR=0.041, 95% CI: 0.003-0.545, P=0.016) were independent risk factors for HBS. Conclusion:The AoAC volume measured by preoperative SPECT/CT can be used for an effective criteria of evaluating HBS in patients with renal SHPT after PTX, and AoAC volume may be one of independent risk factors for HBS.

Objective:To investigate the relationship of the number and morphological of parathyroid glands on 99Tc m-methoxyisobutylisonitrile (MIBI) SPECT/CT with hungry bone syndrome (HBS) in patients with renal secondary hyperparathyroidism (SHPT) after parathyroidectomy (PTX). Methods:Eighty renal SHPT patients (46 males, 34 females; age (50.3±11.0) years) who underwent PTX between January 2018 and June 2024 were retrospectively analyzed in Affiliated Jiangyin Hospital of Nantong University. The number of parathyroid glands detected on SPECT/CT, diameter of parathyroid gland and its volume were recorded and measured. Patients were divided into HBS group and non-HBS group. Independent-sample t test, Mann-Whitney U test and χ2 test were used to compare differences of various indicators between those 2 groups. Multivariate logistic regression was used to analyze influencing factors of HBS. Results:HBS group included 45 patients and the rest 35 patients belonged to non-HBS group. Age ( t=-3.61, P=0.001), preoperative alkaline phosphatase (ALP) ( Z=-4.65, P<0.001), preoperative parathyroid hormone ( Z=-2.34, P=0.019) and preoperative serum corrected calcium ( t=-2.71, P=0.008) were all significantly different between HBS group and non-HBS group. Patients with the number of parathyroid glands≥4 detected by SPECT/CT were more in HBS group than those in non-HBS group (82.2%(37/45) vs 51.4%(18/35); χ2=8.87, P=0.003), and the total volume of parathyroid glands (2.56(1.93, 4.44) vs 2.00(1.18, 2.94)cm 3;Z=-2.25, P=0.024) and the maximum diameter of parathyroid glands ((17.71±3.78) vs (15.87±3.91) mm; t=2.14, P=0.036) were significantly different between those 2 groups. Logistic regression analysis showed that preoperative ALP (odds ratio ( OR)=1.008, 95% CI: 1.002-1.014, P=0.015), preoperative serum corrected calcium ( OR=0.017, 95% CI: 0.000-0.869, P=0.042) and the number of parathyroid gland≥4 detected by SPECT/CT ( OR=4.156, 95% CI: 1.038-16.642, P=0.044) were independent influencing factors for HBS. The sensitivity of the number of parathyroid glands≥4 detected by SPECT/CT for diagnosing HBS was 82.2%(37/45). Conclusion:The number of parathyroid glands≥4 detected by SPECT/CT is an independent influencing factor for HBS, with high diagnostic sensitivity for HBS, thus having good clinical value.

Objectives:We evaluated the clinical significance of unipolar electrogram and bipolar electrogram in guiding radiofrequency ablation for outflow tract ventricular premature contractions(PVC).Methods:Data were collected from 78 patients who underwent successful radiofrequency ablation of PVC.Pre-procedure electrocardiogram showed a LBBB morphology on inferior leads.In the included patients,the right-side ablation was performed at first,and if the ablation failed,the left-side ablation was then performed.According to the location of the successful ablation target,they were divided into unilateral ablation successful group and bilateral ablation successful group.The differences in the earliest bipolar local activation to QRS(LATBi),unipolar-dV/dTmax to QRS(LATUni),and local activation time were compared between the two groups.Furthermore,the electrogram characteristics predicting bilateral ablation were explored.Results:Patients were divided into unilateral ablation group(n=57)and bilateral ablation group(n=21)according to the ablation site.There were statistically significant differences in LATBi(25[21,30]ms vs.14[10,24]ms),LATUni(7[0,17]ms vs.-23[-41,-11]ms),and ΔLATBi-Uni(15[11,25]ms vs.44[25,56]ms)between the unilateral ablation group and the bilateral ablation group(all P<0.05).Multivariate regression analysis suggested that LATBi,LATUni,and ΔLATBi-Uni were independent predictors of the need for bilateral ablation.There was no significant difference between left and right LATBi,LATUni and ΔLATBi-Uni in the bilateral ablation group.LATUni≤-1 was the most accurate parameter for predicting the need for bilateral ablation(AUC=0.941;specificity 80.7%;sensitivity 100%).Conclusions:LATUni≤-1ms is a useful indicator for predicting the need for bilateral PVC ablation in this patient cohort.

OBJECTIVE To investigate the effects of Chuangling Ye(CLY)on diabetic foot ulcer(DFU)model mice based on the nuclear factor erythroid 2-related factor 2(Nrf2)/solute carrier family 7 member 11(SLC7A11)/glutathione peroxidase 4(GPX4)pathway and explore its potential mechanism.METHODS In animal experiments,streptozotocin(STZ)-induced diabetic mice with full-thickness skin defects were divided into control,model,positive control(recombinant human epidermal growth factor,rhEGF),and CLY low-and high-dose groups(n=10).After 14 days of intervention,wound healing rate was measured.Serum inflammatory factors(IL-6,TNF-α,IL-1β)were detected by ELISA,while oxidative stress markers(SOD,MDA,GSH)and tissue ferrous iron(Fe2+)levels were measured by colorimetric assays.Mitochondrial ultrastructure was observed via transmission electron microscopy(TEM).Nrf2,SLC7A11,and GPX4 expression in wound tissues were analyzed by qPCR and Western blot.In cell experiments,a high glucose(HG)-induced ferroptosis model in human umbilical vein endothelial cells(HUVECs)was established and divided into control,HG,CLY,and CLY combined with pathway inhibitors(ML385,Erastin,RSL3)groups.CCK-8 was used to detect cell via-bility,FerroOrange was used to detect Fe2+content,DCFH-DA and C11-BODIPY 581/591 probes were used to detect intracellular ROS and lipid ROS content,and Western blot was used to detect the expression of proteins such as Nrf2/SLC7A11/GPX4.RESULTS Animal experiments showed that compared with the model group,the wound healing rate in the low-and high-dose CLY groups was significantly improved(P<0.01);the serum IL-6,IL-1β,and TNF-α levels were significantly decreased(P<0.01);the MDA con-tent was significantly reduced(P<0.01),and the SOD activity and GSH content were significantly restored(P<0.05).Colorimetric a-nalysis showed that the low-and high-dose CLY significantly reduced the abnormally elevated Fe2+levels in DFU wounds(P<0.05,P<0.001).Electron microscopy showed that the mitochondrial cristae structure was improved in the low-and high-dose groups.qPCR showed that high-dose CLY upregulated the expression levels of Rno-Nfe2l2(Nrf2),Rno-Slc7a11,Rno-Gpx4,and Rno-Acsl4 mR-NA,and inhibited the expression level of Rno-Acsl4 mRNA(P<0.001).Western blot results showed that CLY upregulated the expres-sion of Nrf2,SLC7A11,GPX4,and FTH1 in DFU wound tissues(P<0.01),while downregulated the level of ACSL4(P<0.01).Cell experiments showed that treatment with CLY increased the survival rate of high glucose-stimulated HUVECs(P<0.001).However,the protective effect of CLY was significantly inhibited after the addition of ML385,Erastin,or RSL3(P<0.01).Treatment with CLY significantly decreased the Fe2+content(P<0.001),which was reversed by ML385,Erastin,or RSL3.The levels of ROS and lipid ROS were also significantly reduced(P<0.001),while the addition of ML385,Erastin,or RSL3 partially weakened the antioxidant effect of CLY.Western blot results showed that CLY significantly upregulated the expression of Nrf2、SLC7A11 and GPX4(P<0.001)and downregulated the expression of 4-HNE and COX2(P<0.01),and ML385,Erastin,or RSL3 could reverse this protective effect.CONCLUSION CLY promotes DFU healing by activating the Nrf2/SLC7A11/GPX4 pathway to inhibit ferroptosis,mitigate oxidative stress,and suppress inflammation,providing a novel therapeutic target for DFU.

BACKGROUND: Arsenic trioxide (ATO) is indicated as a broad-spectrum medicine for a variety of diseases, including cancer and cardiac disease. While the role of ATO in hepatic ischemia/reperfusion injury (HIRI) has not been reported. Thus, the purpose of this study was to identify the effects of ATO on HIRI. METHODS: In the present study, we established a 70% hepatic warm I/R injury and partial hepatectomy (30% resection) animal models in vivo and hepatocytes anoxia/reoxygenation (A/R) models in vitro with ATO pretreatment and further assessed liver function by histopathologic changes, enzyme-linked immunosorbent assay, cell counting kit-8, and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay. Small interfering RNA (siRNA) for extracellular signal-regulated kinase (ERK) 1/2 was transfected to evaluate the role of ERK1/2 pathway during HIRI, followed by ATO pretreatment. The dynamic process of autophagic flux and numbers of autophagosomes were detected by green fluorescent protein-monomeric red fluorescent protein-LC3 (GFP-mRFP-LC3) staining and transmission electron microscopy. RESULTS: A low dose of ATO (0.75 μmol/L in vitro and 1 mg/kg in vivo ) significantly reduced tissue necrosis, inflammatory infiltration, and hepatocyte apoptosis during the process of hepatic I/R. Meanwhile, ATO obviously promoted the ability of cell proliferation and liver regeneration. Mechanistically, in vitro  studies have shown that nontoxic concentrations of ATO can activate both ERK and phosphoinositide 3-kinase-serine/threonine kinase (PI3K-AKT) pathways and further induce autophagy. The hepatoprotective mechanism of ATO, at least in part, relies on the effects of ATO on the activation of autophagy, which is ERK-dependent. CONCLUSION Low, non-toxic doses of ATO can activate ERK/PI3K-AKT pathways and induce ERK-dependent autophagy in hepatocytes, protecting liver against I/R injury and accelerating hepatocyte regeneration after partial hepatectomy.
Animals ; Arsenic Trioxide ; Autophagy/physiology* ; Reperfusion Injury/prevention & control* ; Mice ; Male ; Proto-Oncogene Proteins c-akt/physiology* ; Arsenicals/therapeutic use* ; Oxides/therapeutic use* ; Liver/metabolism* ; Extracellular Signal-Regulated MAP Kinases/metabolism* ; Mice, Inbred C57BL

Toxoplasma gondii is a single-celled parasite that infects nearly all warm-blooded animals, including humans (Montoya and Liesenfeld, 2004). It occurs worldwide and can persist for a lifetime in mammals. Humans get infected by eating undercooked meat of animals containing the tissue cysts of this parasite. In immune-competent individuals, T. gondii infection usually does not cause significant clinical symptoms, whereas in pregnant or immunocompromised individuals, T. gondii infection (toxoplasmosis) can cause more serious problems like abortion and even death (Dunn et al., 1999; Wang et al., 2017). A combination of pyrimethamine and sulfadiazine is usually used to treat toxoplasmosis, although it is generally inefficient and causes side effects (Alday and Doggett, 2017). Worse still, there is a lack of vaccines to prevent T. gondii infection in humans or animals.
Toxoplasma/enzymology* ; Animals ; Humans ; Toxoplasmosis ; Mitochondria/enzymology* ; Protozoan Proteins/metabolism*