Objective To assess the potential role of disulfidptosis-related genes (DRGs) in pan-cancer on prognosis and immunity on the basis of bioinformatics approaches. Methods Pan-cancer RNA-seq data, mutation profiles, clinical information, TMB, MSI, stemness scores, and tumor and immune microenvironment data contained in TCGA and various open-source online databases, and multi-group R-language algorithms were used for comprehensive analysis. The expression levels of DRGs at the cellular level were experimentally validated using qPCR. Results LRPPRC, NCKAP1, NDUFS1, and NUBPL had a better prognosis in renal clear cell carcinoma (P<0.001), whereas SLC7A11, NCKAP1, and SLC3A2 had a worse prognosis in hepatocellular carcinoma (P<0.001). TME analysis showed that LRPPRC was negatively correlated with immune cells, stromal cells, and estimated scores in all tumor types. TMB analysis revealed the potential research value of DRGs for PD-1/PD-L1 therapy in pan-cancer. Drug sensitivity analysis showed that SLC7A11 (r=0.454), SLC3A2 (r=0.366), and NCKAP1 (r=0.455) were significantly associated with Kahalide F (P<0.01). Experimental validation demonstrated the overall higher expression levels of GYS1 and NCKAP1 than normal cells in lung adenocarcinoma, colon adenocarcinoma, esophageal squamous carcinoma, and hepatocellular carcinoma (P<0.05). Conclusion Pan-cancer analysis of DRGs indicates that DRGs may serve as important biomarkers for the diagnosis and prognosis of renal clear-cell carcinoma, lung adenocarcinoma, and hepatocellular carcinoma.

Objectives:This study aims to investigate the relationship between neutrophil to high-density lipoprotein cholesterol ratio(NHR)and incidence of cardiovascular disease(CVD)among individuals with metabolic associated fatty liver disease(MAFLD).Methods:We conducted a prospective cohort study utilizing health check-up data from 2006 to 2007 at Kailuan General Hospital and its 10 affiliated hospitals.The study population consisted of employees and retirees diagnosed with MAFLD,excluding those with incomplete neutrophil and high-density lipoprotein cholesterol data or a history of heart failure,myocardial infarction,cerebral hemorrhage,or cerebral infarction.CVD was defined as the presence of heart failure,myocardial infarction,cerebral hemorrhage,or cerebral infarction.Annual follow-ups were conducted from 2006,new-onset CVD cases identified through discharge records from the 11 Kailuan Group hospitals and records from municipal social insurance agencies,the final follow up date was December 31,2022.NHR was calculated as the ratio of neutrophil to high-density lipoprotein cholesterol,and the MAFLD cohort(n=28 952)was stratified into four groups by NHR quartiles:Q1 group(NHR<1.97,n=7 241),Q2 group(1.97≤NHR<2.57,n=7 235),Q3 group(2.57≤NHR<3.36,n=7 240),and Q4 group(NHR≥3.36,n=7 236).The Kaplan-Meier method was employed to plot survival curves for new-onset CVD,and the cumulative incidences of CVD across different NHR quartiles groups were determined.Intergroup comparisons were made using the log-rank test,and a multifactorial Cox proportional hazards regression model was used to assess the association between NHR quartiles and the risk of new-onset CVD in the MAFLD population.Results:The average follow-up duration was(14.03±3.99)years,during which 4 666 new CVD cases were recorded among the study population.The number of CVD cases across Q1 group to Q4 group were 1 061,1 167,1 186 and 1 252,respectively,with an overall incidence density of 11.5 cases per 1 000 person-years.The incidence densities for Q1 group to Q4 group were 10.4,11.4,11.7 and 12.5 cases per 1 000 person-years,respectively.The multifactorial Cox proportional hazards regression analysis revealed that higher NHR quartiles were associated with an increased relative risk of new-onset CVD(Q2 group:HR=1.13,95%CI:1.04-1.23;Q3 group:HR=1.15,95%CI:1.05-1.25;Q4 group:HR=1.22,95%CI:1.12-1.33).Conclusions:The risk of new-onset cardiovascular disease in individuals with MAFLD escalates with increasing NHR.

Objective:To explore the effects of vitamin D supplementation combined with suspended lumbar abdominal muscle training on rehabilitation and bone metabolism indexes of patients after OVCF.Methods:A total of 140 patients with osteoporotic vertebral compression fractures (OVCF) treated at Yantaishan Hospital from Jun. 2021 to Jun. 2024 were included in this study. Patients were randomly assigned to a control group and an observation group using a random number table, with 70 patients in each group. The control group received suspension lumbar and abdominal muscle training, while the observation group received vitamin D supplementation combined with suspension lumbar and abdominal muscle training. Outcomes evaluated included VAS scores, Oswestry Disability Index (ODI) , Cobb Angle, lumboabdominal muscle strength, and serum levels of 25-hydroxyvitamin D [25 (OH) D], bone mineral density T value, and bone metabolism markers [serum osteocalcin (OC) , calcitonin (CT) , total type I collagen amino-terminal propeptide (tPINP) , type I collagen carboxy-terminal peptide β special sequence (β-CTX) , intact parathyroid hormone (iPTH) , and bone-specific alkaline phosphatase (BALP) ] measured by chemiluminescence.Results:In comparison with the control group, the VAS and ODI scores in the observation group were lower after treatment ( t=13.66, t=9.87, P < 0.05) . Compared to the control group, the lumbar muscle strength score of the observation group, the 25 (OH) D level and bone mineral density T value was higher after treatment ( t=57.63, t=6.64, t=5.01, P < 0.05) , and the Cobb Angle was smaller ( t=9.21, P < 0.05) .Compared with the control group, the bone metabolism indexes OC, CT, tPINP, and BALP were higher in the observation group after treatment ( t=4.21, t=3.05, t=2.66, t=3.16, P < 0.05) , while the iPTH and β-CTX were lower ( t=7.28, t=3.50, P < 0.05) . Conclusions:Vitamin D supplementation combined with suspended lumbar and abdominal muscle training can promote postoperative rehabilitation of OVCF patients and improve the level of bone metabolism indexes after surgery.

Objective:To explore the effects of vitamin D supplementation combined with suspended lumbar abdominal muscle training on rehabilitation and bone metabolism indexes of patients after OVCF.Methods:A total of 140 patients with osteoporotic vertebral compression fractures (OVCF) treated at Yantaishan Hospital from Jun. 2021 to Jun. 2024 were included in this study. Patients were randomly assigned to a control group and an observation group using a random number table, with 70 patients in each group. The control group received suspension lumbar and abdominal muscle training, while the observation group received vitamin D supplementation combined with suspension lumbar and abdominal muscle training. Outcomes evaluated included VAS scores, Oswestry Disability Index (ODI) , Cobb Angle, lumboabdominal muscle strength, and serum levels of 25-hydroxyvitamin D [25 (OH) D], bone mineral density T value, and bone metabolism markers [serum osteocalcin (OC) , calcitonin (CT) , total type I collagen amino-terminal propeptide (tPINP) , type I collagen carboxy-terminal peptide β special sequence (β-CTX) , intact parathyroid hormone (iPTH) , and bone-specific alkaline phosphatase (BALP) ] measured by chemiluminescence.Results:In comparison with the control group, the VAS and ODI scores in the observation group were lower after treatment ( t=13.66, t=9.87, P < 0.05) . Compared to the control group, the lumbar muscle strength score of the observation group, the 25 (OH) D level and bone mineral density T value was higher after treatment ( t=57.63, t=6.64, t=5.01, P < 0.05) , and the Cobb Angle was smaller ( t=9.21, P < 0.05) .Compared with the control group, the bone metabolism indexes OC, CT, tPINP, and BALP were higher in the observation group after treatment ( t=4.21, t=3.05, t=2.66, t=3.16, P < 0.05) , while the iPTH and β-CTX were lower ( t=7.28, t=3.50, P < 0.05) . Conclusions:Vitamin D supplementation combined with suspended lumbar and abdominal muscle training can promote postoperative rehabilitation of OVCF patients and improve the level of bone metabolism indexes after surgery.

Objectives:This study aims to investigate the relationship between neutrophil to high-density lipoprotein cholesterol ratio(NHR)and incidence of cardiovascular disease(CVD)among individuals with metabolic associated fatty liver disease(MAFLD).Methods:We conducted a prospective cohort study utilizing health check-up data from 2006 to 2007 at Kailuan General Hospital and its 10 affiliated hospitals.The study population consisted of employees and retirees diagnosed with MAFLD,excluding those with incomplete neutrophil and high-density lipoprotein cholesterol data or a history of heart failure,myocardial infarction,cerebral hemorrhage,or cerebral infarction.CVD was defined as the presence of heart failure,myocardial infarction,cerebral hemorrhage,or cerebral infarction.Annual follow-ups were conducted from 2006,new-onset CVD cases identified through discharge records from the 11 Kailuan Group hospitals and records from municipal social insurance agencies,the final follow up date was December 31,2022.NHR was calculated as the ratio of neutrophil to high-density lipoprotein cholesterol,and the MAFLD cohort(n=28 952)was stratified into four groups by NHR quartiles:Q1 group(NHR<1.97,n=7 241),Q2 group(1.97≤NHR<2.57,n=7 235),Q3 group(2.57≤NHR<3.36,n=7 240),and Q4 group(NHR≥3.36,n=7 236).The Kaplan-Meier method was employed to plot survival curves for new-onset CVD,and the cumulative incidences of CVD across different NHR quartiles groups were determined.Intergroup comparisons were made using the log-rank test,and a multifactorial Cox proportional hazards regression model was used to assess the association between NHR quartiles and the risk of new-onset CVD in the MAFLD population.Results:The average follow-up duration was(14.03±3.99)years,during which 4 666 new CVD cases were recorded among the study population.The number of CVD cases across Q1 group to Q4 group were 1 061,1 167,1 186 and 1 252,respectively,with an overall incidence density of 11.5 cases per 1 000 person-years.The incidence densities for Q1 group to Q4 group were 10.4,11.4,11.7 and 12.5 cases per 1 000 person-years,respectively.The multifactorial Cox proportional hazards regression analysis revealed that higher NHR quartiles were associated with an increased relative risk of new-onset CVD(Q2 group:HR=1.13,95%CI:1.04-1.23;Q3 group:HR=1.15,95%CI:1.05-1.25;Q4 group:HR=1.22,95%CI:1.12-1.33).Conclusions:The risk of new-onset cardiovascular disease in individuals with MAFLD escalates with increasing NHR.

ObjectiveTo investigate the association between cumulative triglyceride （cumTG） exposure and the risk of acute pancreatitis （AP）. MethodsA prospective study was conducted for a cohort of 56 883 workers from Kailuan Group who participated in annual physical examination for three consecutive times in 2006-2010 （2006， 2008， and 2010） and had complete TG data without the medical history of AP. According to the quartiles of cumTG calculated， the subjects were divided into four groups （Q1， Q2， Q3， and Q4 groups）， and general information was compared between the two groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups， and the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups； the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot the survival curve and calculate the cumulative incidence rate of AP， and the Log-rank test was used for comparison between groups； the Cox regression model was used to analyze the effect of different cumTG levels on new-onset AP events. ResultsAfter follow-up for 10.51±1.76 years， there were 158 AP events in total， with a total incidence density of 2.64 per 10 000 person-years， and the number of cases and incidence density in the Q1， Q2， Q3， and Q4 groups were 29 cases （1.93 per 10 000 person-years）， 34 cases （2.27 per 10 000 person-years）， 30 cases （2.01 per 10 000 person-years）， and 65 cases （4.37 per 10 000 person-years）. The Log-rank test showed that there was a significant difference in cumulative incidence rate between groups （χ²=22.41， P<0.001）. The multivariate Cox regression analysis showed that compared with the Q1 group， the Q4 group had a significantly higher risk of AP （hazard ratio ［HR］=1.94， 95% confidence interval ［CI］： 1.20‍ ‍—‍ 3.13， P=0.01）. Compared with cumulative triglyceride exposure for 0 year， cumulative triglyceride exposure for 4 and 6 years significantly increased the risk of AP， with an HR value of 2.04 （95%CI： 1.26‍ ‍—‍ 3.30， P<0.01） and 3.20 （95%CI： 1.98‍ ‍—‍ 5.17， P<0.01）， respectively. After exclusion of the AP cases that occurred during the 2-year follow-up， the repeated multivariate Cox regression analysis showed that the Q4 group had an HR value of 1.96 （95%CI： 1.23‍ ‍—‍ 3.12， P<0.01） for the onset of AP， and after exclusion of the death cases during follow-up， the repeated multivariate Cox regression analysis showed that the Q4 group had an HR value of 1.85 （95%CI： 1.10‍ ‍—‍ 3.14， P<0.05） for the onset of AP. ConclusionThe incidence rate and risk of AP tend to increase with the increase in cumTG exposure.

Objective To investigate the relationship between gene mutation characteristics and immunological markers in patients with small cell lung cancer.Methods From January 2019 to 2020,155 patients with small cell lung cancer were admitted.Gene mutations were detected in these patients using target gene capture and sequencing method.Moreover,the tumor mutational burden(TMB)and expression of PD-L1 in some patients were detected.Results A total of 326 gene mutations were detected in the patients,the most significant of which were TP53 and RB1.Among the 8 genes with mutation frequency higher than 15％,patients with KMT2D,KMT2C,FAT1 and NOTCH1 mutations had higher TMB than those without mutation,and the difference was statistically significant(P＜0.05).Conclusion The most common mutated genes in patients with small cell lung cancer are TP53 and RB1.KMT2D,KMT2C,FAT1 and NOTCH1 may be potential markers for the efficacy of immunotherapy in small cell lung cancer.

Objective:To summarize the characteristics of oral contrast ultrasound in patients with esophageal hiatal hernia (EHH), to screen the diagnostic criteria for EHH diagnosis by oral contrast ultrasound and to evaluate their diagnostic values.Methods:Sixty-one patients who visited the Hernia and Abdominal Wall Surgery Department of the Sixth Affiliated Hospital of Sun Yat-sen University from June 2023 to December 2023 for symptoms of acid reflux, heartburn, belching, recurrent epigastric pain, chest pain, and cough, and who were clinically suspected of EHH and underwent oral contrast ultrasound were retrospectively collected. The internal diameter of the esophageal hiatus, the length of the intraabdominal esophagus (IAEL), the angle of His, the supradiaphragmatic hernia sac, the sign of gastric wall sliding, and the sign of esophageal-gastric ring uplift were recorded by oral contrast ultrasound. All ultrasonographic data were retrospectively analyzed, and the diagnosis of EHH by surgery or with the simultaneous diagnosis of EHH by barium meal examination and gastroscopy were used as the gold standard. The diagnostic criteria of oral contrast ultrasound for EHH were obtained and their diagnostic values were evaluated by ROC curve analysis.Results:The indicators of EHH diagnosed by oral contrast ultrasound were analyzed according to ROC curves as follows: internal diameter of esophageal hiatus >15 mm (AUC=0.913), IAEL≤33 mm (AUC=0.776), angle of His > 90° (AUC=0.735), supradiaphragmatic hernia sac (AUC=0.913), gastric wall sliding sign (AUC=0.827), upward displacement of the esophagogastric ring (AUC=0.721). The diagnostic sensitivity, specificity, accuracy, positive predictive value, negative predictive value, AUC, and 95% CI of the diagnosis of EHH using the internal diameter of the esophageal hiatus >15 mm or the presence of a supradiaphragmatic hernia sac as the diagnostic criterion for the diagnosis of EHH by oral contrast ultrasound were 86.5%, 100%, 88.5%, 100%, 56.3%, 0.933, and 0.838-0.981, respectively. Conclusions:The optimal diagnostic criterion for EHH diagnosis by oral contrast ultrasound is esophageal hiatal internal diameter >15 mm or the presence of supradiaphragmatic hernia sac, which has 100% specificity and positive predictive value. It is recommended to be widely used as a screening test for EHH in the clinic.

Objective To investigate the correlation between exposure of uric acid accumulation and the risks of acute pancreatitis(AP)in the population in Kailuan Group.Methods A prospective study was performed based on thesubjects receiving annual physical examination during 2006 to 2010 in Kailuan Group.All of them had no AP history but had complete data on UA.The starting point of follow-up was when the subjects completed the health examination in 2010,and the end point was new AP events,deaths or the end of follow-up(2021-12-31).Exposure of uric acid accumulation(cumUA)was calculated according to the average values of uric acid measured in each two consecutive physical examinations and the intervalbetween these two consecutive physical examinations.The cumulative incidences of AP indifferent subgroups(determined by the quartile of cumUA)were described using Kaplan-Meier product limit-method and compared by log-rank test.Multivariate Cox proportional hazards regression model was used to analyze the impacts of different cumUA subgroups on new occurrence of AP events.Results A total of 55,799 subjects were included in this study.The subjects were divided into four groups according to the quartile of cumUA.Sex ratio,average age,BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),FPG,TC,TG,LDL-C,HDL-C,smoking,alcohol consumption,education≥9 years,physical exercise,history of hypertension,and history of cholelithiasis differed significantly among the groups(P<0.05),there was no difference in diabetes history among the 4 groups(P=0.30).153 patients developed AP during an average follow-up of(10.52±1.75)years,the incidence rates were 1.65,2.76,2.13 and 3.96 per 10 000 person-year in the Q1,Q2,Q3and Q4,respectively(P<0.01).After adjusting sex,age,TC,TG,eGFR,smoking,alcohol consumption,education,physical activity,and history of hypertension,diabetes,or cholelithiasis,Multivariate analysis showed a significantly increased risk in Q4(HR=1.77,95%CI:1.07～2.92)as comparing with Q1.After excluding deaths during the follow-up period,Multivariate Cox regression analysis was performed again in Q4 HR=1.75(95%CI:1.04～2.95).Conclusions With the increase of cumUA exposure,both morbidity and risk of AP occur-rence have the tendency of rising.

Objective:To investigate the diagnostic value of microRNA-19(miR-19)and microRNA-21(miR-21)in elderly patients with differentiated thyroid carcinoma(DTC), and to analyze the relationship of miR-19 and miR-21 expression with pathological characteristics in elderly patients with DTC.Methods:A total of ninety-six elderly DTC patients visiting our hospital from January 2015 to January 2018 were included in this retrospective study.They underwent cervical lymph node puncture biopsy and radical surgery for thyroid cancer.The expression levels of miR-21 and miR-19 were detected in lymph node tissues, thyroid cancer tissues and normal para-cancerous tissue.The differences in miR-21 and miR-19 expression levels between three different pathological tissues in elderly patients were analyzed.The correlation of miR-21 and miR-19 expression levels with different clinico-pathological features in elderly patients was observed.Results:The expression levels of miR-21 from low to high were(0.92±0.33)in para-cancerous tissue, (3.41±0.64)in lymph node tissue and(4.28±1.56)in DTC tissue respectively( F=296.683, P<0.01), the difference was statistically significant( F=296.683, P=0.01). While, there was no significant difference in the expression levels of miR-19 among different tissues( P>0.05). Spearman correlation test showed that the expression level miR-21 in DTC tissue was positively correlated with that in lymph node tissue and para-cancerous tissue( r values were 0.724, 0.801, all P<0.01), while the expression level of miR-19 showed no correlation of DTC tissues with lymph node and para-cancerous tissues( r=0.127 and 0.165, P>0.05). The expression level of miR-21 in lymph node tissue was positively correlated with that in para-cancerous tissues( r=0.705, P<0.01), but the expression level of microRNA-19 had no correlation between the two kinds of tissues( r=0.191, P>0.05). There was no significant difference in the expression of miR-21 in cervical lymph nodes among patients with different gender and tumor diameter( P>0.05). The expression level of miR-21 in cervical lymph nodes was significantly higher in stage Ⅲ patients than in stage Ⅰ-Ⅱ patients( P<0.05). The expression level of microRNA-21 in cervical lymph nodes was higher in patients with extra-glandular infiltration than without extra-glandular infiltration( P<0.05). The expression of microRNA-19 in cervical lymph nodes showed no significant difference regardless of sex, tumor diameter, tumor stage, extra-thyroid invasion. Conclusions:MiR-19 may not be involved in the development of DTC in elderly patients, and microRNA-21 may play an important role in the development of DTC in elderly patients, especially in the process of tumor invasion and metastasis.Early cervical lymph node puncture for miR-21 detection helps early diagnose and evaluate DTC, to provide a basis for the choice of treatment options.