Objective To explore the correlation between anxiety and depression, treatment compliance and social support level in elderly patients with coronary heart disease. Methods A cross-sectional study was conducted on 325 patients with coronary heart disease who were treated in this hospital from June 2023 to June 2025 Pearson correlation analysis was used to examine the correlations between the level of social support [Social Support Rating Scale (SSRS)] and treatment compliance [12-item Medication Compliance Scale (MAS)], anxiety [Hamilton Anxiety Scale (HAMA)], and depression [Hamilton Depression Scale (HAMD)]. Logistic regression analysis was conducted to analyze the factors related to treatment compliance of coronary heart disease. Results SSRS score was positively associated with MAS score, and negatively correlated with HAMA score and HAMD score in patients with coronary heart disease (P<0.05). Logistic regression analysis suggested that age, education level, living alone, cardiac function grading, mini-mental state examination scale score, SSRS score, HAMA score and HAMD score were independently correlated with treatment compliance in patients with coronary heart disease (P<0.05). Conclusion The level of social support in patients with coronary heart disease is positively correlated with treatment compliance, and negatively correlated with anxiety and depression, and social support level, anxiety and depression are independent related factors affecting treatment compliance.

Introduction: Pheochromocytoma is a catecholamine-secreting adrenal tumor associated with major perioperative hemodynamic instability. When concurrent major pelvic pathology requires surgery, operative planning becomes particularly challenging. We describe the successful single-stage management of pheochromocytoma and a giant uterine fibroid, highlighting the importance of multidisciplinary coordination and perioperative optimization. Case: A 49-year-old female with symptomatic uterine fibroid was found to have proliferative endometrium on a pipelle biopsy. Computed tomography (CT) abdomen incidentally detected a right adrenal mass alongside a large posterior uterine fibroid (11.9 × 17.4 × 14.6 cm). CT adrenal protocol demonstrated a heterogeneously enhancing right adrenal mass (6.9 × 6.9 × 9.6 cm) with high unenhanced attenuation. Biochemical evaluation revealed markedly elevated 24-hour urinary metanephrine (4.7× upper limit) and normetanephrine (2.4× upper limit). Following multidisciplinary discussions, a single-stage surgical approach was planned after careful assessment of feasibility and perioperative risk in view of the uncertain malignant potential of the pelvic mass and to minimize repeated exposure to anesthesia. Preoperative optimization included transitioning from terazosin to phenoxybenzamine, with subsequent addition of bisoprolol for hemodynamic control. The operative strategy prioritized pheochromocytoma resection first, given its potential for significant hemodynamic instability. Progression to hysterectomy was contingent upon achieving adequate intraoperative hemodynamic stability following adrenalectomy, with continuous reassessment by the anesthetic and surgical teams. Right adrenalectomy was performed first, followed by total abdominal hysterectomy with bilateral salpingooophorectomy. Significant hemodynamic lability occurred during tumor manipulation, with hypertensive surges managed using sodium nitroprusside and remifentanil infusions. Following adrenal vein ligation and tumor removal, hypotension was managed with noradrenaline and additional adrenaline support as required. Total operative time was approximately 6 hours. Postoperatively, transient noradrenaline support was required but was rapidly weaned as hemodynamic stability was achieved. Conclusion Single-stage adrenalectomy and major pelvic surgery can be safely performed in selected patients with pheochromocytoma when guided by meticulous preoperative optimization, clear intraoperative sequencing, and close multidisciplinary coordination.
Pheochromocytoma ; Adrenalectomy ; Leiomyoma ; Hysterectomy

Hepatocellular carcinoma(HCC),which is essentially primary liver cancer,is closely related to CD8+T cell immune infiltration and immune suppression.We constructed a CD8+T cells related risk score model to pre-dict the prognosis of HCC patients and provided therapeutic guidance based on the risk score.Using integrated bulk RNA sequencing(RNA-seq)and single-cell RNA sequencing(scRNA-seq)datasets,we identified stable CD8+T cell signatures.Based on these signatures,a 3-gene risk score model,comprised of KLRB1,RGS2,and TN-FRSF1B was constructed.The risk score model was well validated through an independent external validation co-hort.We divided patients into high-risk and low-risk groups according to the risk score and compared the differ-ences in immune microenvironment between these two groups.Compared with low-risk patients,high-risk patients have higher M2-type macrophage content(P＜0.0001)and lower CD8+T cells infiltration(P＜0.0001).High-risk patients predict worse response to immunotherapy treatment than low-risk patients(P＜0.01).Drug sensitivity a-nalysis shows that PI3K-β inhibitor AZD6482 and TGFβRII inhibitor SB505124 may be suitable therapies for high-risk patients,while the IGF-1R inhibitor BMS-754807 or the novel pyrimidine-based anti-tumor metabolic drug Gemcitabine could be potential therapeutic choices for low-risk patients.Moreover,expression of these 3-gene mod-el was verified by immunohistochemistry.In summary,the establishment and validation of a CD8+T cell-derived risk model can more accurately predict the prognosis of HCC patients and guide the construction of personalized treatment plans.

Objective:To evaluate the association between erectile dysfunction(ED)and myocardial infarction(MI)using two sample Mendelian randomization.Methods:A Mendelian randomization study was conducted using comprehensive data on ED and MI from extensive genome-wide association data.Using inverse variance weighted analysis for causal relationships,and correct for confounding factors using multivariate Mendelian randomization,the potential mediating effects were evaluated as well.Based on Gene-card data,the genes related to ED and MI were identified.Molecular docking was used to reveal spontaneously bound drug molecules.Results.Our study found that exposure to ED was a risk factor for MI(OR:1.001 0,95％CI:1.000 2-1.001 8,P=0.017 7),which also held true in the validation dataset(OR:1.028 5,95％CI:1.005 0-1.052 6,P=0.017 2).No statistically significant heterogeneity or horizontal pleiotropy was found.The results of reverse Mendelian randomization analysis showed any reverse causal re-lationship between ED and MI.In multivariate Mendelian randomization analysis,after excluding confounding factors(excluding tri-glycerides and high-density lipoprotein),the P-value remained less than 0.05,and the OR ranged from 1.000 1 to 1.000 7,indica-ting that ED was still a risk factor for MI.In the mediation analysis,it was found that the current mediation ratio of smoking to MI was 13.06％.In summary-data-based mendelian randomization analysis,it was found that the gene PTPN11 was a common target gene for MI and ED(OR=0.990,P＜0.001).Subsequent molecular docking with sildenafil,clopidogrel,and dapoxetine could spontaneous-ly bind to the PTPN11 gene receptor.Conclusion:There is a causal relationship between ED and MI,with smoking as a potential mediating factor,and the gene PTPN11 being a co-target gene.

BACKGROUND:Hormonal osteonecrosis of the femoral head is strongly associated with aging,but the regulatory targets and mechanisms are still unclear.Through bioinformatics combined with machine learning analysis and experimental verification,the key genes of hormonal osteonecrosis of the femoral head mediated by cell senescence will be identified,which will provide new ideas for the prevention and treatment of hormonal osteonecrosis of the femoral head.OBJECTIVE:To screen and validate the senescence core genes of hormonal osteonecrosis of the femoral head using bioinformatics analysis to explore its mechanism of action.METHODS:The GSE123568 dataset was obtained from the GPL15207 platform of the GEO database,which contained the gene expression profiles of peripheral serum samples of 30 hormonal osteonecrosis of the femoral head patients and 10 healthy controls.Data on 279 cellular senescence-related genes were obtained from the CellAge database.Differential analysis and weighted correlation network analysis(WGCNA)were performed on hormonal osteonecrosis of the femoral head gene profiles,and both were intersected with senescence-related genes and then concatenated to obtain hormonal osteonecrosis of the femoral head senescence potential genes,and GO and KEGG analyses were performed.The machine learning method screened out the pivotal genes,constructed nomogram model,and performed consensus clustering and immune infiltration analysis.Finally,clinical femoral samples were collected for validation by qPCR and western blot assay.RESULTS AND CONCLUSION:(1)41 potential genes were obtained,which were mainly enriched in biological processes such as aging and oxidative stress response,as well as FoxO and tumor necrosis factor signaling pathways.(2)The pivotal genes catalase,connective tissue growth factor,forkhead box protein O3,insulin receptor substrate 2,and mitogen-activated protein kinase kinase 11 were obtained after machine learning identification,and the predictive ability of nomogram model was good.(3)The patients were classified into three groups,namely a,b and c,by the consensus clustering analysis.Catalase,forkhead box protein O3,insulin receptor substrate 2,and mitogen-activated protein kinase kinase 11 were differentially expressed among the three molecular subtypes(P＜0.05).Results of immune infiltration showed that the abundance of immune cells,such as activated CD4+T cells,activated CD8+T cells,and eosinophils,differed among the three molecular subclasses(P＜0.05).(4)The results of qPCR and western blot assay showed that the expression of catalase,connective tissue growth factor,forkhead box protein O3,and mitogen-activated protein kinase kinase 11 was lower in hormonal osteonecrosis of the femoral head group compared to the control group(P＜0.05),and the expression of insulin receptor substrate 2 was elevated(P＜0.05).(5)It is concluded that through in-depth analysis combined with bioinformatics and machine learning,and further experimental verification,five hormonal osteonecrosis of the femoral head age-related hub genes were finally identified.These genes are catalase,connective tissue growth factor,forkhead box o3,insulin receptor substrate 2,and serine/threonine kinase 11.These genes may provide potential molecular targets for the prevention and treatment of hormonal osteonecrosis of the femoral head in the future by regulating the cellular aging process.

Porcine reproductive and respiratory syndrome virus(PRRSV)mainly causes sow abor-tion,stillbirth,mummified fetus and respiratory symptoms in piglets.Since first reported in China in 1996,the virus complexity has increased significantly in more than 20 years of genetic evolution,bringing huge economic losses to the pig industry.In recent years,with the emergence of various PRRSV recombinant virus strains,preventing and controlling this epidemic became increasingly difficult.The purpose of this article is to comprehensively review the genome structure and func-tion of PRRSV,RNA virus recombination mechanism,main types of recombination,and the epi-demic status and recombination for the dominant epidemic PRRSV strains,in order to provide clues for in-depth research on gene recombination of PRRSV,thus providing the theoretical sup-port for formulating scientific prevention and control strategies.

Hepatocellular carcinoma(HCC),which is essentially primary liver cancer,is closely related to CD8+T cell immune infiltration and immune suppression.We constructed a CD8+T cells related risk score model to pre-dict the prognosis of HCC patients and provided therapeutic guidance based on the risk score.Using integrated bulk RNA sequencing(RNA-seq)and single-cell RNA sequencing(scRNA-seq)datasets,we identified stable CD8+T cell signatures.Based on these signatures,a 3-gene risk score model,comprised of KLRB1,RGS2,and TN-FRSF1B was constructed.The risk score model was well validated through an independent external validation co-hort.We divided patients into high-risk and low-risk groups according to the risk score and compared the differ-ences in immune microenvironment between these two groups.Compared with low-risk patients,high-risk patients have higher M2-type macrophage content(P＜0.0001)and lower CD8+T cells infiltration(P＜0.0001).High-risk patients predict worse response to immunotherapy treatment than low-risk patients(P＜0.01).Drug sensitivity a-nalysis shows that PI3K-β inhibitor AZD6482 and TGFβRII inhibitor SB505124 may be suitable therapies for high-risk patients,while the IGF-1R inhibitor BMS-754807 or the novel pyrimidine-based anti-tumor metabolic drug Gemcitabine could be potential therapeutic choices for low-risk patients.Moreover,expression of these 3-gene mod-el was verified by immunohistochemistry.In summary,the establishment and validation of a CD8+T cell-derived risk model can more accurately predict the prognosis of HCC patients and guide the construction of personalized treatment plans.

This study was aimed at providing basic data for the control and prevention of Yersinia enterocolitica(Ye)infections.Ye isolates from stool samples collected from patients with diarrhea in a Beijing district between January 2019 and June 2024 were studied.Basic patient information and stool samples were collected,and quantitative polymerase chain reaction(qPCR)was applied to enriched cultures.Further analyses included virulence gene detection,whole-genome sequencing,and drug resistance detection.The detection rate of Ye was 0.76%(11/1 439),according to culture methods,thus yielding 12 Ye strains from distinct patients:11 isolated during the study period and 1 from 2017.The 12 Ye positive patients were 6-41 years of age,and their clinical presentations predominantly featured watery stools(66.67%,8/12)and loose stools(33.33%,4/12).The frequencies of nausea,vomiting,and fever were 41.67%(5/12),41.67%(5/12),and 8.33%(1/12),respectively.The drug resistance rates of Ye to TET,AMP,and NAL were 50.00%(6/12),33.33%(4/12),and 25.00%(3/12),respectively.One Ye strain exhibited multidrug resistance to ETP,MEM,TET,CIP,NAL,and AMP.According to qPCR detection of five common virulence genes,two Ye strains were identified as ystA+/ystB-type(ystA+/ystB-/ail+/yadA+/virF+),whereas ten strains were identified as ystA-/ystB+type(ystA-/ystB+/ail-/yadA-/virF-).VFDB database analysis based on genome sequences indicated that 12 Ye strains carried an average of 11 key virulence genes associated with adhesion,invasion,protease activity,and flagellar movement,and predicted 106 virulence genes and 12 virulence gene profiles.Only the two ystA+/ystB-Ye strains contained elements related to the TTSS and ABC transporter function.Detection of ystA-/ystB+Ye in stool isolation and culture of diarrhea cases might potentially have been missed in some cases,thus highlighting the importance of fluorescence PCR screening of fecal growth solutions to enhance isolation efficiency.Moreover,our findings revealed the genetic diversity of Ye isolated from diarrhea cases,thereby indicating the presence of multiple types of virulence genes within this pathogen.

BACKGROUND:Hormonal osteonecrosis of the femoral head is strongly associated with aging,but the regulatory targets and mechanisms are still unclear.Through bioinformatics combined with machine learning analysis and experimental verification,the key genes of hormonal osteonecrosis of the femoral head mediated by cell senescence will be identified,which will provide new ideas for the prevention and treatment of hormonal osteonecrosis of the femoral head.OBJECTIVE:To screen and validate the senescence core genes of hormonal osteonecrosis of the femoral head using bioinformatics analysis to explore its mechanism of action.METHODS:The GSE123568 dataset was obtained from the GPL15207 platform of the GEO database,which contained the gene expression profiles of peripheral serum samples of 30 hormonal osteonecrosis of the femoral head patients and 10 healthy controls.Data on 279 cellular senescence-related genes were obtained from the CellAge database.Differential analysis and weighted correlation network analysis(WGCNA)were performed on hormonal osteonecrosis of the femoral head gene profiles,and both were intersected with senescence-related genes and then concatenated to obtain hormonal osteonecrosis of the femoral head senescence potential genes,and GO and KEGG analyses were performed.The machine learning method screened out the pivotal genes,constructed nomogram model,and performed consensus clustering and immune infiltration analysis.Finally,clinical femoral samples were collected for validation by qPCR and western blot assay.RESULTS AND CONCLUSION:(1)41 potential genes were obtained,which were mainly enriched in biological processes such as aging and oxidative stress response,as well as FoxO and tumor necrosis factor signaling pathways.(2)The pivotal genes catalase,connective tissue growth factor,forkhead box protein O3,insulin receptor substrate 2,and mitogen-activated protein kinase kinase 11 were obtained after machine learning identification,and the predictive ability of nomogram model was good.(3)The patients were classified into three groups,namely a,b and c,by the consensus clustering analysis.Catalase,forkhead box protein O3,insulin receptor substrate 2,and mitogen-activated protein kinase kinase 11 were differentially expressed among the three molecular subtypes(P＜0.05).Results of immune infiltration showed that the abundance of immune cells,such as activated CD4+T cells,activated CD8+T cells,and eosinophils,differed among the three molecular subclasses(P＜0.05).(4)The results of qPCR and western blot assay showed that the expression of catalase,connective tissue growth factor,forkhead box protein O3,and mitogen-activated protein kinase kinase 11 was lower in hormonal osteonecrosis of the femoral head group compared to the control group(P＜0.05),and the expression of insulin receptor substrate 2 was elevated(P＜0.05).(5)It is concluded that through in-depth analysis combined with bioinformatics and machine learning,and further experimental verification,five hormonal osteonecrosis of the femoral head age-related hub genes were finally identified.These genes are catalase,connective tissue growth factor,forkhead box o3,insulin receptor substrate 2,and serine/threonine kinase 11.These genes may provide potential molecular targets for the prevention and treatment of hormonal osteonecrosis of the femoral head in the future by regulating the cellular aging process.

Porcine reproductive and respiratory syndrome virus(PRRSV)mainly causes sow abor-tion,stillbirth,mummified fetus and respiratory symptoms in piglets.Since first reported in China in 1996,the virus complexity has increased significantly in more than 20 years of genetic evolution,bringing huge economic losses to the pig industry.In recent years,with the emergence of various PRRSV recombinant virus strains,preventing and controlling this epidemic became increasingly difficult.The purpose of this article is to comprehensively review the genome structure and func-tion of PRRSV,RNA virus recombination mechanism,main types of recombination,and the epi-demic status and recombination for the dominant epidemic PRRSV strains,in order to provide clues for in-depth research on gene recombination of PRRSV,thus providing the theoretical sup-port for formulating scientific prevention and control strategies.