Background: s/Aims: Anti-mitochondrial M2 antibody (AMA-M2) is a specific marker for primary biliary cholangitis (PBC) and it could be also present in non-PBC individuals. Methods: A total of 72,173 Chinese health check-up individuals tested AMA-M2, of which non-PBC AMA-M2 positive individuals were performed follow-up. Baseline data of both clinical characteristics and laboratory examinations were collected in all AMA-M2-positive individuals. Least absolute shrinkage and selection operator (LASSO) regression was performed to investigate the potential variables for developing PBC. Results: A total of 2,333 individuals were positive with AMA-M2. Eighty-two individuals had a medical history of PBC or fulfilled the diagnostic criteria of PBC at baseline, and 2,076 individuals were non-PBC. After a median follow-up of 6.6 years, 0.6% developed PBC, with an accumulative 5-year incidence rate of 0.5%. LASSO regression showed that levels of alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), immunoglobulin M (IgM), eosinophilia proportion (EOS%), gamma globulin percentage, and hemoglobin (HGB) were potential variables for developing PBC. Multivariate Cox regression is used to construct a predictive model based on 7 selected variables, and time-dependent receiver operating characteristic analysis showed that the area under the curve of the prediction model at 3, 5, and 10 years were, respectively, 1.000, 0.875, and 0.917. Conclusions This study offers insights into the onset of PBC among individuals who tested positive for AMA-M2 during routine health check-ups. The prediction model based on ALP, GGT, IgM, EOS%, gamma globulin percentage, HGB, and sex has a certain predictive ability for the occurrence of PBC in this population.

Background: s/Aims: Anti-mitochondrial M2 antibody (AMA-M2) is a specific marker for primary biliary cholangitis (PBC) and it could be also present in non-PBC individuals. Methods: A total of 72,173 Chinese health check-up individuals tested AMA-M2, of which non-PBC AMA-M2 positive individuals were performed follow-up. Baseline data of both clinical characteristics and laboratory examinations were collected in all AMA-M2-positive individuals. Least absolute shrinkage and selection operator (LASSO) regression was performed to investigate the potential variables for developing PBC. Results: A total of 2,333 individuals were positive with AMA-M2. Eighty-two individuals had a medical history of PBC or fulfilled the diagnostic criteria of PBC at baseline, and 2,076 individuals were non-PBC. After a median follow-up of 6.6 years, 0.6% developed PBC, with an accumulative 5-year incidence rate of 0.5%. LASSO regression showed that levels of alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), immunoglobulin M (IgM), eosinophilia proportion (EOS%), gamma globulin percentage, and hemoglobin (HGB) were potential variables for developing PBC. Multivariate Cox regression is used to construct a predictive model based on 7 selected variables, and time-dependent receiver operating characteristic analysis showed that the area under the curve of the prediction model at 3, 5, and 10 years were, respectively, 1.000, 0.875, and 0.917. Conclusions This study offers insights into the onset of PBC among individuals who tested positive for AMA-M2 during routine health check-ups. The prediction model based on ALP, GGT, IgM, EOS%, gamma globulin percentage, HGB, and sex has a certain predictive ability for the occurrence of PBC in this population.

Background: s/Aims: Anti-mitochondrial M2 antibody (AMA-M2) is a specific marker for primary biliary cholangitis (PBC) and it could be also present in non-PBC individuals. Methods: A total of 72,173 Chinese health check-up individuals tested AMA-M2, of which non-PBC AMA-M2 positive individuals were performed follow-up. Baseline data of both clinical characteristics and laboratory examinations were collected in all AMA-M2-positive individuals. Least absolute shrinkage and selection operator (LASSO) regression was performed to investigate the potential variables for developing PBC. Results: A total of 2,333 individuals were positive with AMA-M2. Eighty-two individuals had a medical history of PBC or fulfilled the diagnostic criteria of PBC at baseline, and 2,076 individuals were non-PBC. After a median follow-up of 6.6 years, 0.6% developed PBC, with an accumulative 5-year incidence rate of 0.5%. LASSO regression showed that levels of alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), immunoglobulin M (IgM), eosinophilia proportion (EOS%), gamma globulin percentage, and hemoglobin (HGB) were potential variables for developing PBC. Multivariate Cox regression is used to construct a predictive model based on 7 selected variables, and time-dependent receiver operating characteristic analysis showed that the area under the curve of the prediction model at 3, 5, and 10 years were, respectively, 1.000, 0.875, and 0.917. Conclusions This study offers insights into the onset of PBC among individuals who tested positive for AMA-M2 during routine health check-ups. The prediction model based on ALP, GGT, IgM, EOS%, gamma globulin percentage, HGB, and sex has a certain predictive ability for the occurrence of PBC in this population.

AIM:To investigate the effect of cryptotanshinone(CPT)on myocardial hypertrophy induced by isoprenaline(ISO)in rats and explore its potential mechanism.METHODS:The experimental design consisted of two parts.The first aimed to investigate the effects of CPT on cardiac function,pathological manifestations,and the Janus ki-nase 2(JAK2)/signal transducer and activator of transcription 3(STAT3)signaling pathway in rats with myocardial hyper-trophy.The rats were divided into six groups,namely the control,CPT control,and model groups and low-(15 mg·kg-1·d-1),medium-(30 mg·kg-1·d-1),and high-dose(60 mg·kg-1·d-1)CPT treatment groups,with six rats per group.The sec-ond part aimed to validate the role of the JAK2/STAT3 signaling pathway in the CPT-mediated myocardial hypertrophy treatment.Rats were divided into four groups,namely the control,model,high-dose CPT treatment,and coumermycin A1(CA1,a JAK2/STAT3 agonist)intervention(rats received ISO injection followed by 60 mg·kg-1·d-1 of high-dose CPT and 1 mg·kg-1·d-1 of CA1 for 15 d)groups,with five rats per group.Myocardial hypertrophy was induced in rats via intra-peritoneal injection of ISO(5 mg/kg),and CPT intervention lasted for 15 days.Cardiac function-related parameters were assessed using echocardiography,and pathological changes were evaluated through hematoxylin-eosin,Masson,and wheat germ agglutinin staining.Protein expression levels of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),β-myosin heavy chain(β-MHC),and JAK2/STAT3 signaling pathway-related proteins were detected by Western blot analysis.RESULTS:Compared with the model group,CPT administration improved cardiac dysfunction-related ul-trasound markers and significantly reduced ISO-induced cardiomyocyte hypertrophy and myocardial fibrosis in rats with hy-pertrophy in a dose-dependent manner(P<0.05).Additionally,CPT decreased the levels of ANP,BNP,and β-MHC in-duced by ISO modeling(P<0.05),and inhibiting the phosphorylation of JAK2 and STAT3(P<0.05).Furthermore,a partial reversal of the therapeutic effect on myocardial hypertrophy induced by ISO modeling was observed when CA1 was administered(P<0.05).CONCLUSION:The CPT exhibits potential as a therapeutic agent for cardiac hypertrophy by effectively attenuating ISO-induced cardiac hypertrophy in rats through JAK2/STAT3 signaling inhibition.

Objectives:To observe the effect of teriparatide and elcatonin on the efficacy of endoscopic lum-bar interbody fusion(Endo-LIF)in patients with osteoporosis.Methods:A total of 60 patients diagnosed with lumbar spinal stenosis combined with osteoporosis undergone Endo-LIE via posterior transforaminal approach(Endo-P/TLIF)in Foshan Jianxiang Orthopedics Hospital between July 2021 and February 2023 were collect-ed.Among the patients,30 treated with vitamin D+calcium+elcatonin for 3 months after operation were included in the control group(6 males,24 females,aged 67.0±6.6 years;12 involved single segments,18 involved double segments);30 treated with teriparatide+elcatonin+vitamin 1)+calcium for 3 months after operation were included in the observation group(7 males,23 females,aged 66.0±5.9 years;10 involved single segments,20 involved double segments).There were no statistical differences in age,sex ratio,bone mineral density(BMD)before treatment and surgical segments between the two groups(P＞0.05).The visual analogue scale(VAS)score,Oswestry disability index(ODI),and systemic bone metabolism indexes[P 1NP,β-CTX,BGP,2,5(OH)VitD]were counted before and at 1 month and 3 months after treatment.The intervertebral body fusion at 3 months after treatment,and the T values of BMD before and at 6 months after treatment were also collected and evaluated.A t-test or chi-square test was applied to compare the differences between the two groups.Results:There were no statistical differences in VAS scores,ODIs,bone metabolism indexes,and T values of BMD between the two groups before treatment(P＞0.05).At 1 and 3 months after treatment,the VAS scores and ODIs were significantly reduced in both groups,with the decrease in the observation group more significantly than that in the control group at the same time point(P＜0.05).P1NP,β-CTX,BGP and 2,5(OH)VitD in the observation group were significantly higher at 1 and 3 months after treatment compared with before treatment(P＜0.05).BGP and 2,5(OH)VitD in the control group increased significantly at 3 months after treatment compared with before treatment(P＜0.05).P1NP,β-CTX and BGP were higher in the observation group than in the control group at 3 months after treatment(P＜0.05).There was no statistical difference in 2,5(OH)VitD at the same time point between the two groups(P＞0.05).The intervertebral fusion rate in the observation group was significantly higher than that of the control group at 3 months after treatment(96.66％vs 80.00％,P＜0.05).The T value of BMD in the observation group was significantly higher than in the control group at 6 months after treatment(-2.76±0.37 vs 3.06±0.42,P＜0.05).Conclusions:Teriparatide combined with elcatonin can improve the clinical symptoms,bone mineral density,and systemic bone metabolism index changes,and enhance early interbody fusion rate after Endo-P/TLIF in osteoporosis patients.

AIM:To investigate the effect of cryptotanshinone(CPT)on myocardial hypertrophy induced by isoprenaline(ISO)in rats and explore its potential mechanism.METHODS:The experimental design consisted of two parts.The first aimed to investigate the effects of CPT on cardiac function,pathological manifestations,and the Janus ki-nase 2(JAK2)/signal transducer and activator of transcription 3(STAT3)signaling pathway in rats with myocardial hyper-trophy.The rats were divided into six groups,namely the control,CPT control,and model groups and low-(15 mg·kg-1·d-1),medium-(30 mg·kg-1·d-1),and high-dose(60 mg·kg-1·d-1)CPT treatment groups,with six rats per group.The sec-ond part aimed to validate the role of the JAK2/STAT3 signaling pathway in the CPT-mediated myocardial hypertrophy treatment.Rats were divided into four groups,namely the control,model,high-dose CPT treatment,and coumermycin A1(CA1,a JAK2/STAT3 agonist)intervention(rats received ISO injection followed by 60 mg·kg-1·d-1 of high-dose CPT and 1 mg·kg-1·d-1 of CA1 for 15 d)groups,with five rats per group.Myocardial hypertrophy was induced in rats via intra-peritoneal injection of ISO(5 mg/kg),and CPT intervention lasted for 15 days.Cardiac function-related parameters were assessed using echocardiography,and pathological changes were evaluated through hematoxylin-eosin,Masson,and wheat germ agglutinin staining.Protein expression levels of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),β-myosin heavy chain(β-MHC),and JAK2/STAT3 signaling pathway-related proteins were detected by Western blot analysis.RESULTS:Compared with the model group,CPT administration improved cardiac dysfunction-related ul-trasound markers and significantly reduced ISO-induced cardiomyocyte hypertrophy and myocardial fibrosis in rats with hy-pertrophy in a dose-dependent manner(P<0.05).Additionally,CPT decreased the levels of ANP,BNP,and β-MHC in-duced by ISO modeling(P<0.05),and inhibiting the phosphorylation of JAK2 and STAT3(P<0.05).Furthermore,a partial reversal of the therapeutic effect on myocardial hypertrophy induced by ISO modeling was observed when CA1 was administered(P<0.05).CONCLUSION:The CPT exhibits potential as a therapeutic agent for cardiac hypertrophy by effectively attenuating ISO-induced cardiac hypertrophy in rats through JAK2/STAT3 signaling inhibition.

Objectives:To observe the effect of teriparatide and elcatonin on the efficacy of endoscopic lum-bar interbody fusion(Endo-LIF)in patients with osteoporosis.Methods:A total of 60 patients diagnosed with lumbar spinal stenosis combined with osteoporosis undergone Endo-LIE via posterior transforaminal approach(Endo-P/TLIF)in Foshan Jianxiang Orthopedics Hospital between July 2021 and February 2023 were collect-ed.Among the patients,30 treated with vitamin D+calcium+elcatonin for 3 months after operation were included in the control group(6 males,24 females,aged 67.0±6.6 years;12 involved single segments,18 involved double segments);30 treated with teriparatide+elcatonin+vitamin 1)+calcium for 3 months after operation were included in the observation group(7 males,23 females,aged 66.0±5.9 years;10 involved single segments,20 involved double segments).There were no statistical differences in age,sex ratio,bone mineral density(BMD)before treatment and surgical segments between the two groups(P＞0.05).The visual analogue scale(VAS)score,Oswestry disability index(ODI),and systemic bone metabolism indexes[P 1NP,β-CTX,BGP,2,5(OH)VitD]were counted before and at 1 month and 3 months after treatment.The intervertebral body fusion at 3 months after treatment,and the T values of BMD before and at 6 months after treatment were also collected and evaluated.A t-test or chi-square test was applied to compare the differences between the two groups.Results:There were no statistical differences in VAS scores,ODIs,bone metabolism indexes,and T values of BMD between the two groups before treatment(P＞0.05).At 1 and 3 months after treatment,the VAS scores and ODIs were significantly reduced in both groups,with the decrease in the observation group more significantly than that in the control group at the same time point(P＜0.05).P1NP,β-CTX,BGP and 2,5(OH)VitD in the observation group were significantly higher at 1 and 3 months after treatment compared with before treatment(P＜0.05).BGP and 2,5(OH)VitD in the control group increased significantly at 3 months after treatment compared with before treatment(P＜0.05).P1NP,β-CTX and BGP were higher in the observation group than in the control group at 3 months after treatment(P＜0.05).There was no statistical difference in 2,5(OH)VitD at the same time point between the two groups(P＞0.05).The intervertebral fusion rate in the observation group was significantly higher than that of the control group at 3 months after treatment(96.66％vs 80.00％,P＜0.05).The T value of BMD in the observation group was significantly higher than in the control group at 6 months after treatment(-2.76±0.37 vs 3.06±0.42,P＜0.05).Conclusions:Teriparatide combined with elcatonin can improve the clinical symptoms,bone mineral density,and systemic bone metabolism index changes,and enhance early interbody fusion rate after Endo-P/TLIF in osteoporosis patients.

Objective:To further investigate the safety and efficacy of Belimumab in the treatment of patients with systemic lupus erythematosus (SLE).Methods:All SLE patients treated with Belimumab from May 1, 2020 to February 1, 2022 in Peking Union Medical College Hospital were retrospectively collected and analyzed. The clinical manifestations, the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2000) score, and laboratory test such as levels of anti-dsDNA antibody, the medication before and after Belimumab treatment, adverse events were collected. Normally distributed data were tested using the t-test, otherwise the Wilcoxon paired signed rank test was used. Results:A total of 81 patients were enrolled in this study. The use of belimumab could significantly decrease the SLEDAI-2000 score [10.00(7.75, 12.00) vs. 4.00(3.75, 6.00), Z=-5.38, P<0.001], ESR of SLE patients [19.50(12.75, 32.25) mm/1 h vs. 14.00(7.75, 20.25) mm/1 h, Z=-3.71, P=0.003], anti-dsDNA titer detected by CLIFT [300.00 (117.00, 864.00) vs. 183.00(100.00, 471.00), Z=-4.15, P=0.001], meanwhile, increase the complement C3 [0.78 (0.62, 0.97)g/L vs. 0.69 (0.55, 0.84)g/L, Z=-4.68, P<0.001], and the complement C4 [0.12 (0.08, 0.19)g/L vs. 0.10 (0.05, 0.14)g/L, Z=-4.78, P<0.001]. We also observed that with the use of Belimumab, the dosage of Glucocorticoids decreased significantly, which were [10.00(7.50, 22.50) mg vs. 7.50(5.00, 10.00) mg, Z=-4.90, P<0.001]. In addition, the antibody of IgG, IgA and IgM decreased significantly. Only one patient stopped the administration of Belimumab due to the low level of immunoglobulin. Conclusion:Belimumab can alleviate disease activity of patients with SLE and help in safely tapering the daily dose of glucocorticoid with good safety.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Schizophrenia(SZ)is a serious mental illness,and traditional diagnostic methods are prone to missed and misdiagnosis.Using machine learning(ML)algorithms can extract SZ relative features from functional MRI(fMRI)data,hence being helpful for diagnosing and predicting treatment response of SZ.The research progresses of ML based on fMRI for diagnosis and treatment of SZ were reviewed in this article.