ObjectiveTo evaluate the comprehensive intervention effects of Huangqin Qingre Chubi Capsule （黄芩清热除痹胶囊， HQC） on self-perception of patients （SPP） and immune inflammation in patients with rheumatoid arthritis （RA）， and to explore its potential mechanisms. MethodsClinical data of 452 RA patients were retrospectively collected. Patients were divided into a control group （274 cases）， treated with conventional western medicine， and an observation group （178 cases）， treated with HQC for at least 2 weeks in addition to conventional western medicine. The treatment duration was 2 weeks for both groups. Propensity score matching （PSM） was performed at a ratio of 1∶1 to match patients between groups. SPP including the Chinese version of the short form-36 health survey （SF-36）， self-rating anxiety scale （SAS）， self-rating depression scale （SDS）， visual analog scale （VAS）， and Chinese patient-reported index for rheumatoid arthritis （CPRI-RA）， as well as immune inflammatory indicators， including erythrocyte sedimentation rate （ESR）， high-sensitivity C-reactive protein （hs-CRP）， rheumatoid factor （RF）， anti-cyclic citrullinated peptide antibody （anti-CCP）， interleukin-6 （IL-6）， immunoglobulin A （IgA）， immunoglobulin G （IgG）， immunoglobulin M （IgM）， complement C3， and complement C4， were collected before and after treatment. Spearman correlation analysis was used to assess the relationships between SPP and immune inflammatory indicators. Logistic regression， association rule analysis， and mediation analysis were performed to evaluate the effects and potential pathways of HQC on SPP and immune inflammatory indicators. Network pharmacology was applied to identify the active components and core targets of HQC in the treatment of RA， followed by molecular docking verification. In cell experiments， cells were divided into normal group， model group， 20% medicated serum group， and 80 nmol/L control group. Human synovial fibroblasts （FLS） were cultured with complete medium in the normal group， while human rheumatoid arthritis fibroblast-like synoviocytes （RA-FLS） were cultured in the model group. In the 20% medicated serum group， RA-FLS were cultured with medium containing 20% HQC-medicated serum， and in the 80 nmol/L control group， RA-FLS were cultured with complete medium containing 80 nmol/L methotrexate suspension. After 48 h of culture， cell viability was detected by cell counting kit-8 （CCK-8） assay. Levels of interleukin-1β （IL-1β）， interleukin-6 （IL-6）， interleukin-8 （IL-8）， and interleukin-10 （IL-10） in the cell supernatant were measured by enzyme-linked immunosorbent assay （ELISA）. Protein levels of matrix metalloproteinase 9 （MMP9）， transcription factor AP-1 subunit （JUN）， vascular endothelial growth factor A （VEGFA）， and C-X-C motif chemokine ligand 8 （CXCL8） were detected by Western Blot， and cell migration ability was evaluated using Transwell assay. ResultsAfter PSM， 178 cases were included in each group. After treatment， SF-36 scores increased， while scores of SAS， SDS， VAS and CPRI-RA， levels of ESR， hs-CRP， IL-6， complement C3， and complement C4 levels decreased in both groups； IgG and IgM levels were also reduced in the observation group （P＜0.05）. Physical functioning （correlation coefficient -0.19， P＜0.05） and social functioning （correlation coefficient -0.18， P＜0.05） of SF-36 were negatively correlated with hs-CRP， while VAS score was positively correlated with hs-CRP （correlation coefficient 0.19， P＜0.05）. HQC showed high associations with improvements in multiple indicators of SPP and immune inflammatory， and acted as a protective factor for the improvement of several SPP； hs-CRP and ESR played partial mediating roles in the improvement of SPP induced by HQC （P＜0.05）. Network pharmacology analysis identified baicalein， quercetin， α1-sitosterol， β-sitosterol， stigmasterol， baicalin， and crocetin as the core active components， and JUN， IL-6， VEGFA， MMP9， IL-1β， and CXCL8 as the core targets. Molecular docking results showed strong binding affinities of quercetin with VEGFA， JUN， MMP9， IL-6， and IL-1β， of baicalin with VEGFA and MMP9， and of wogonin with CXCL8. Cell experiments demonstrated that HQC and methotrexate inhibited RA-FLS viability and migration， reduced levels of IL-1β， IL-6， and IL-8， decreased protein levels of MMP9， JUN， VEGFA， and CXCL8， and increased IL-10 levels （P＜0.05）. ConclusionHQC can improve SPP in RA by regulating immune inflammatory responses. Its mechanism may be related to multi-pathway and multi-target inhibition of synovial cell inflammation and migration.

Objective To investigate the effects of obesity-related indexes on cardiovascular autonomic nervous function in type 2 diabetes mellitus(T2DM)patients.Methods A total of 421 T2DM patients treated in the Department of Endocrinology of Gansu Provincial People's Hospital were enrolled in this study from October 2020 to October 2023.All the patients were divided into simple T2DM group with VFA<100 cm2(n=193)and obese group with VFA≥100 cm2(OB,n=228)according to visceral fat area(VFA).BMI,waist-to-height ratio(WHtR),waist-to-hip ratio(WHR),lipid accumulation index(LAP),visceral fat index(VAI),Chinese visceral fat index(CVAI),tapeness index(CI),body shape index(ABSI),and body roundness index(BRI)were calculated.Time domain parameters of heart rate variability(HRV)in 24 h holter electrocardiogram were recorded,including the global standard deviation(SDNN)of normal sinus RR interval,standard deviation of mean value of sinus RR interval(SDANN),root mean square difference(RMSSD)of normal continuous sinus RR interval.The percentage of adjacent RR interval difference>50 ms in total interval(PNN50),the HRV triangle index,the standard deviation of the difference of the entire adjacent NN interval length(SDSD).Results Compared with T2DM group,the OB group showed an increase in age,weight,BMI,WC,hip circumference(HC),neck circumference(NC),SBP,HbA1c,TG,SUA,CI,WHtR,WHR,VFA,SFA,VAI,LAP,CVAI,and BRI(P<0.05 or P<0.01),while a decrease in HDL-C(P<0.05).The SDNN,SDANN,SDSD,RMSSD,HRV trigonometric index,and PNN50 were lower in OB group than in T2DM group(P<0.05 or P<0.01).Spearman correlation analysis showed that SDNN and HRV trigonometric index was negatively correlated with age,DM duration,HR,SBP,PWV,WHtR,TG,SUA,VAI,LAP,BRI,VFA,LAP,and CVAI(P<0.05 or P<0.01).Logistic regression analysis shows that age,VFA,and LAP are influencing factors for cardiac autonomic dysfunction.The analysis of the working characteristic curve of the subjects showed that the area under the curve of VFA,age,and LAP in predicting cardiovascular autonomic dysfunction was 0.680,0.614,and 0.577,with sensitivity of 87.5%,41.7%,and 61.8%,and specificity of 47.3%,73.6%,and 55.6%respectively.Conclusions BMI,HC,NC,WC,TG,SFA,CI,WHtR,WHR,LAP,BRI,VAI,CVAI and VFA are closely related to cardiovascular autonomic nervous function in T2DM patients.As VFA,Ageand LAP increase,the risk of cardiovascular autonomic dysfunction increases.

The comorbidity of online game disorder and depression has become a universal problem in the world,which seriously affects the physical and mental health of teenagers.Online game disorder closely relate to depression or depressive mood.There is a certain correlation and interaction between the two in the symptom dimension,leading to the decline of academic performance,and even non-suicidal self-injury,suicidal ideation and other problems.In terms of the neurobiological mechanism of the two comorbidity,there were abnormal functional connection of amygdaloid-dorsolateral prefrontal cortex network,abnormal activity pattern of default mode network and abnormal function of dopamine system in comorbidities.In terms of social psychological mechanism,comorbidities are characterized by loneliness,cognitive bias and poor coping strategies.Exploring the comorbidity mechanism of online game disorder and depression can help to formulate individualized comprehensive intervention measures to reduce the occurrence and development of online game disorder and depression in adolescents.

The comorbidity of online game disorder and depression has become a universal problem in the world,which seriously affects the physical and mental health of teenagers.Online game disorder closely relate to depression or depressive mood.There is a certain correlation and interaction between the two in the symptom dimension,leading to the decline of academic performance,and even non-suicidal self-injury,suicidal ideation and other problems.In terms of the neurobiological mechanism of the two comorbidity,there were abnormal functional connection of amygdaloid-dorsolateral prefrontal cortex network,abnormal activity pattern of default mode network and abnormal function of dopamine system in comorbidities.In terms of social psychological mechanism,comorbidities are characterized by loneliness,cognitive bias and poor coping strategies.Exploring the comorbidity mechanism of online game disorder and depression can help to formulate individualized comprehensive intervention measures to reduce the occurrence and development of online game disorder and depression in adolescents.

Objective To investigate the relationship between interventricular septal dimensions(IVSd)and urinary albumin/creatinine ratio(UACR)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 757 patients with T2DM hospitalized in the Department of Endocrinology of Gansu Provincial People's Hospital from March 2021 to April 2024 were enrolled in this study.All the patients were divided into T2DM patients without proteinuria(n=388),microproteinuria group(Mic,n=260)and macroproteinuria group(Mac,n=109)according to the UACR levels.General clinical data and biochemical indexes were collected from all the patients.Color Doppler echocardiography was used to record left ventricular ejection fraction(LVEF),left ventricular fraction shortening(LVFS),IVSd,left ventricular posterior wall dimensions(LVPWd),and left atrial diameter(LAD).Pearson correlation analysis was conducted to analyze the correlation between IVSd,LVPWd and related indicators of renal function.Logistic regression analysis was conducted to analyze the influencing factors for T2DM patients with proteinuria.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of the DM duration and IVSd in patients with T2DM and proteinuria.Results The DM duration,SBP,FIns,HbA1c,Scr,24 hUTP,UACR,UAER,IVSd,LVPWd were increased successively(P<0.05),while LVEF and eGFR were decreased successively(P<0.05)in T2DM,Mic,Mac group.Age was higher in Mic group than in T2DM group(P<0.05).DBP and FPG were higher in Mac group than in T2DM and Mic group(P<0.05).Pearson correlation analysis showed that IVSd and LVPWd were positively correlated with 24 hUTP,UACR,UAER and Scr(P<0.05),and negatively correlated with eGFR(P<0.05).Logistic regression analysis indicated that the DM duration and IVSd were significant influencing factors for proteinuria in patients with T2DM.ROC curve showed that the area under ROC curve of IVSd was 0.620,with sensitivity 43.3%and specificity 76.8%,respeictively.Conclusions The DM duration and IVSd are influencing factors for UACR in patients with T2DM.The risk of proteinuria in T2DM patients increases with rising IVSd.

Objective To investigate the relationship between interventricular septal dimensions(IVSd)and urinary albumin/creatinine ratio(UACR)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 757 patients with T2DM hospitalized in the Department of Endocrinology of Gansu Provincial People's Hospital from March 2021 to April 2024 were enrolled in this study.All the patients were divided into T2DM patients without proteinuria(n=388),microproteinuria group(Mic,n=260)and macroproteinuria group(Mac,n=109)according to the UACR levels.General clinical data and biochemical indexes were collected from all the patients.Color Doppler echocardiography was used to record left ventricular ejection fraction(LVEF),left ventricular fraction shortening(LVFS),IVSd,left ventricular posterior wall dimensions(LVPWd),and left atrial diameter(LAD).Pearson correlation analysis was conducted to analyze the correlation between IVSd,LVPWd and related indicators of renal function.Logistic regression analysis was conducted to analyze the influencing factors for T2DM patients with proteinuria.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of the DM duration and IVSd in patients with T2DM and proteinuria.Results The DM duration,SBP,FIns,HbA1c,Scr,24 hUTP,UACR,UAER,IVSd,LVPWd were increased successively(P<0.05),while LVEF and eGFR were decreased successively(P<0.05)in T2DM,Mic,Mac group.Age was higher in Mic group than in T2DM group(P<0.05).DBP and FPG were higher in Mac group than in T2DM and Mic group(P<0.05).Pearson correlation analysis showed that IVSd and LVPWd were positively correlated with 24 hUTP,UACR,UAER and Scr(P<0.05),and negatively correlated with eGFR(P<0.05).Logistic regression analysis indicated that the DM duration and IVSd were significant influencing factors for proteinuria in patients with T2DM.ROC curve showed that the area under ROC curve of IVSd was 0.620,with sensitivity 43.3%and specificity 76.8%,respeictively.Conclusions The DM duration and IVSd are influencing factors for UACR in patients with T2DM.The risk of proteinuria in T2DM patients increases with rising IVSd.

Objective To investigate the association between body roundness index(BRI)and hyperuricemia(HUA)in patients with type 2 diabetes mellitus(T2DM).Methods 555 T2DM inpatients were selected from July 2022 to October 2023 in Gansu Province People's Hospital Endocrinology.According to BRI,the T2DM patients were divided into four group:low BRI(L-BRI,BRI≤3.579,n=140)group,moderate BRI(M-BRI,3.579

Objective To analyze the risk factors of delayed bleeding after colonic polyp resection.Methods 700 patients with colonic polyps admitted to General medical treatment Hanzhong 3201 hospital from January 2022 to May 2023 were included as the research object,and all patients were treated with colonoscopy polypectomy.According to whether Post-procedural bleeding(PPB)occurred after operation,they were divided into two groups:the group with PPB occurrence(n=85 cases)and the group without PPB occurrence(n=615 cases).The general data,clinical data and operation-related data of the two groups were analyzed by univariate analysis.Multivariate Logistic regression was used to analyze the risk factors of postoperative PPB,and receiver operating characteristic curve was drawn to analyze the predictive value of risk factors.Results 700 patients in this study were all treated by colon polypectomy,and 85 patients(12.14％)developed PPB within 30 days after operation,that is,the incidence of PPB in this study was 12.14％.There was significant difference in sex,age,hypertension and treatment history of thrombosis between the two groups(P＜0.05).There was significant difference in the morphology,diameter and surgical methods between the two groups(P＜0.05).Multivariate Logistic regression analysis showed that polyp morphology(stalk),polyp diameter(＞1 cm),Endoscopic mucosal resection(EMR)and Endoscopic submucosal dissection(ESD)were the risk factors for postoperative PPB(P＜0.05).The ROC curve showed that the area under curve of polypoid-shaped is 0.653,95％CI is 0.616-0.688,the AUC of polyp-diameter is 0.741,95％CI is 0.707-0.773;and in the way of operation,the AUC of argon plasma coagulation/ESD is 0.730,95％CI is 0.713-0.802,the AUC of EMR/ESD is 0.541,95％CI is 0.498-0.584,the AUC of APC/EMR is 0.604 and 95％CI is 0.565-0.641.Conclusion Polyp pedicled,diameter＞1 cm,EMR and ESD are the risk factors for postoperative PPB.

OBJECTIVE To retrospectively analyze the clinical efficacy of Qingchi San in the treatment of mild-to-moderate ul-cerative colitis.METHODS A retrospective analysis was conducted on 221 ulcerative colitis patients treated at the Gastroenterology Department of First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from December 2014 to February 2024.Participants were divided into an observation group(n=121)and a control group(n=100).The control group received oral me-salazine,while the observation group received Qingchi San enema in addition to the control group's treatment.Both groups received a 4-week course of treatment.The two groups were compared in terms of clinical efficacy,clinical remission rate,TCM syndrome score,time to intestinal bleeding remission,and changes in inflammatory markers(C-reactive protein,erythrocyte sedimentation rate,and white blood cells)and coagulation markers(platelets and D-dimer).RESULTS After treatment,the total effective rate and clinical remission rate in the observation group were significantly higher than those in the control group(P<0.05,P<0.01).The TCM syn-drome scores for each item(diarrhea,abdominal pain,bloody stools with mucus,and tenesmus)in the observation group were signifi-cantly improved compared with those in the control group(P<0.01).The time to intestinal bleeding remission in the observation group was significantly shorter than that in the control group(P<0.01).C-reactive protein,erythrocyte sedimentation rate,and white blood cell count in the observation group were significantly decreased compared with those in the control group(P<0.05,P<0.01).There was no statistically significant difference in coagulation markers(platelets and D-dimer)between the two groups(P>0.05).No signif-icant treatment-related adverse reactions,such as liver and kidney damage,were observed during treatment.CONCLUSION Qing-chi San enema can improve the clinical efficacy of patients with mild-to-moderate ulcerative colitis,improve clinical symptoms,short-en bleeding time,and reduce inflammatory markers.

Objective To investigate the effects of STIP1 homology and U-box containing protein 1(STUB1)on the ubiquitination of glutathione peroxidase 4(GPX4)and ferroptosis in colon cancer cells HCT116,as well as the impact on CD8+T cell-mediated killing of HCT116 cells.Methods HCT116 cells were divided into control group,empty plasmid transfection(pcDNA3.1-vector)group,STUB1 overexpression plasmid transfection(pcDNA3.1-STUB1)group,and co-transfection(pcDNA3.1-STUB1+pcDNA3.1-GPX4)group.Cell proliferation ability was assessed by CCK-8 assay.Clonogenic ability was determined by clone formation assay.Malondialdehyde(MDA)levels in cells were measured using an MDA kit.Intracellular ferrous ion(Fe2+)levels were detected with an Fe2+probe.Changes in mitochondrial membrane potential were detected using JC-1 dye.Protein expression levels of STUB1,solute carrier family 7 member 11(SLC7A11),and GPX4 were determined by western blot.The binding between STUB1 and GPX4 was assessed by co-immunoprecipitation.The effect of STUB1 on GPX4 protein ubiquitination was detected using a ubiquitin antibody.HCT116 cells transfected with different plasmids were co-cultured with human peripheral blood CD8+T cells,and the killing ability of CD8+T cells against HCT116 cells was measured using a lactate dehydrogenase(LDH)kit.Perforin,granzyme,and interferon-γ levels in the co-culture supernatant were determined by ELISA.Results Compared with the control group,the pcDNA3.1-STUB1 group showed decreased cell proliferation ability,mitochondrial membrane potential,and protein expression levels of SLC7A11 and GPX4,along with increased STUB1 protein expression,MDA,Fe2+levels,and GPX4 ubiquitination in HCT116 cells.Compared with the pcDNA3.1-STUB1 group,the pcDNA3.1-STUB1+pcDNA3.1-GPX4 group exhibited increased cell proliferation ability,mitochondrial membrane potential,and expression levels of SLC7A11 and GPX4,along with decreased MDA and Fe2+levels in HCT116 cells.After co-culture of HCT116 cells with CD8+T cells,the pcDNA3.1-STUB1 group showed significantly increased killing rate of CD8+T cells against HCT116 cells,as well as elevated levels of perforin,granzyme,and interferon-γ in the co-culture supernatant compared with the control group.Compared with the pcDNA3.1-STUB1 group,the pcDNA3.1-STUB1+pcDNA3.1-GPX4 group exhibited decreased killing rate of CD8+T cells against HCT116 cells and reduced levels of perforin,granzyme,and interferon-γ in the co-culture supernatant.Conclusion Overexpression of STUB1 promotes GPX4 ubiquitination in colon cancer cells HCT116,induces ferroptosis,and enhances the killing effect of CD8+T cells on HCT116 cells.