Objective: To evaluate the diagnostic performance of magnetic resonance spectroscopy (MRS) in discriminating fumarate hydratase-deficient (FH-d) uterine leiomyomas (ULs) from FH-preserved ULs. Materials and Methods: This study consisted of three stages, with independent cohorts recruited for each stage: 1) sample-size estimation was retrospectively performed on UL specimens (diameter ≥3 cm; age, 20–40 years) from our database with immunohistochemistry (IHC) for 2-succinocysteine (2-SC) as the reference, without genetic testing, 2) MRS sequence optimization in confirmed FH germline mutation participants with ultrasound-detected ULs (diameter ≥3 cm), without IHC analysis, and 3) prospective diagnostic test accuracy was evaluated in consecutive participants with ultrasound-detected ULs (diameter ≥3 cm;age, 20–40 years), using IHC for 2-SC for determining the FH status and subsequent genetic testing in those with positive 2-SC results to identify whether FH mutations were germline or somatic in origin. The choline and fumarate peaks in MRS were classified as positive, negative, or technical failure (TF). TFs were analyzed separately and excluded from the primary diagnostic accuracy calculations. T1-, T2-, and diffusion-weighted images were interpreted as hyperintense or hypointense. The enhancement rate and apparent diffusion coefficient were also acquired. Diagnostic performance was compared between MRS and various magnetic resonance imaging (MRI) features. Results: The optimal MRS parameters for the fumarate peak were echo time (TE) = 140 ms and an average of 256. Among the 360 prospective participants, 37 were confirmed to have FH-dULs. MRS showed positive fumarate peaks in 35 of 37 FH-dULs.After excluding six TFs, the positive fumarate peak on MRS showed 94.6% (35/37) sensitivity, 99.7% (316/317) specificity, and 99.2% (351/354) accuracy, all of which were significantly superior to those of other MRI features (P ≤ 0.002). Conclusion A positive fumarate peak on MRS may be a useful imaging biomarker for diagnosing FH-dULs.

Objective:To construct and validate a depression risk prediction model for middle-aged and elderly patients with diabetes.Methods:Data were extracted from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 900 diabetic patients were identified, and after excluding those with missing data or invalid questionnaires, 769 patients were included in the analysis. Patients were randomly divided into a training set and a validation set in a 7∶3 ratio. Univariate analysis and logistic regression analysis were performed to screen the optimal predictors of depression in diabetic patients, and a nomogram model was developed. The predictive performance of the model was assessed by the area under the receiver operating characteristic curve ( AUC). Model calibration and accuracy were evaluated using bootstrap resampling, calibration plots, and the Hosmer-Lemeshow test. The clinical utility was further assessed by decision curve analysis (DCA) and clinical impact curves (CIC) . Results:Among the 769 patients, 366 (47.59%) had depression. Logistic regression analysis showed that place of residence, pain, difficulty in toileting, difficulty in bathing, sleep duration, physical exercise, life satisfaction, and children's satisfaction were independent predictors of depression in diabetic patients. A nomogram was constructed based on these variables, yielding an AUC of 0.775. At the optimal cutoff value of 0.557, the model demonstrated a sensitivity of 59.1% and a specificity of 84.8%, indicating good discriminative ability. The Hosmer-Lemeshow test showed (χ 2=15.821, P=0.105), suggesting good agreement between predicted and observed outcomes. In the validation set, the AUC was 0.778, with Hosmer-Lemeshow (χ 2=8.557, P=0.575). DCA and CIC indicated favorable clinical applicability of the model. Conclusions:The depression risk prediction model constructed in this study demonstrated good predictive performance. It can assist clinicians in early identification of high-risk individuals with diabetes and provide a theoretical basis for targeted interventions.

OBJECTIVE To investigate the current status of monitoring indicators related to the"Perioperative In-fection Control"in medical institutions above the secondary level in Guizhou Province,and to delve into the imple-mentation of key measures for infection prevention and control during the perioperative period for patients under-going surgical operations.METHODS Based on the"Implementation Plan for the'Perioperative Infection Control'Initiative in Guizhou Province",a"Case Investigation Form on Key Measures for Infection Prevention and Control During the Perioperative Period for Patients Undergoing Surgical Operation"was developed.A total of 138 medi-cal institutions participated in the case investigation,and a total of 2 128 cases were investigated.RESULTS The overall monitoring indicators for the"Perioperative Infection Control"initiative in the 138 medical institutions a-bove the secondary level in Guizhou Province were at a relatively low level.The skin cleansing compliance rate was 80.32％,the hair removal compliance rate was 16.43％,the prophylactic antibacterial drug administration rate within 0.5-1 hour before surgery was 55.94％and the antibacterial drug discontinuation rate within 24 hours after prophylactic medication for type Ⅰ incision surgeries was 56.48％.The hair removal compliance rate was higher in tertiary medical institutions(19.21％)than in secondary medical institutions(14.34％)(P=0.039).The distri-bution of the four monitoring indicators varied in clinical departments and surgery types,with statistically signifi-cant differences(P＜0.05).The preferred method for surgical site skin cleansing in medical institutions across the province was local wiping,primarily with clean water(57.21％).The primary method for hair removal was razors(68.82％),and hair removal on the day of surgery was most common(61.75％).CONCLUSIONS Conduc-ting a survey on the current status of"Perioperative Infection Control"initiative monitoring indicators in medi-cal institutions in Guizhou Province helps to understand the implementation of key measures for perioperative in-fection prevention and control and set intervention targets,thus providing references for establishing a dynam-ic monitoring indicator change mechanism.

Objective To develop and evaluate a nucleic acid amplification test for spectinomycin-resistant Neisseria gonorrhoeae(N.gonorrhoeae).Methods N.gonorrhoeae-specific primers NG1/NG2 and primers specific to the N.gonorrhoeae rpsE gene mutation(80_82 delTTA)were designed.Genomic nucleic acids of spectinomycin-sensitive and resistant N.gonorrhoeae,Escherichia coli,Pseudomonas aeruginosa,and Salmonella typhi were used as templates to be amplified by PCR and quantitative real-time PCR(qPCR).The sensitivity and specificity of the method were evaluated accordingly.Results The NG1/NG2 primers could effectively amplify specific fragments of N.gonorrhoeae,yielding negative results for the nucleic acid amplification test of the other types of bacteria tested.E64/E175R and E-87/E95R could effectively differentiate the wild type and mutant(80_82 delTTA)rpsE genes.In PCR reactions,the minimum limits of NG1/NG2,E64/E175R,and E87/E95R for the target genes were 414.8 copies,414.8 copies,and 4.1 copies/μL,respectively,while those for qPCR reactions were 41.5,41.5,and 4.1×10-2 copies/μL,respectively.Conclusion A nucleic acid amplification test for spectinomycin-resistant N.gonorrhoeae with high specificity and sensitivity was successfully established in this study,which is expected to provide support for the rapid diagnosis of N.gonorrhoeae infection and treatment decision-making in clinical settings.

Objective To investigate the role of a novel rpsE gene mutation in mediating high-level spectinomycin resistance in Neisseria gonorrhoeae and to evaluate its effect on the biological fitness of the bacteria.Methods Spectinomycin-containing medium was used to screen for Neisseria gonorrhoeae strains with spontaneous mutations that conferred spectinomycin resistance.Minimum inhibitory concentrations(MIC)were determined,and the rpsE gene was sequenced.Changes in the growth rates of spectinomycin-resistant strain were assessed using the drop plate method and growth curves.Additionally,in vitro competition experiments were conducted with spectinomycin at different concentrations to assess changes in the biological fitness of the spectinomycin-resistant strain.Results A Neisseria gonorrhoeae strain with high-level spectinomycin resistance mediated by a novel rpsE gene mutation(88_90delGTT)was successfully identified and designated NG-SPTR.Compare with the wild-type strain,the NG-SPTR exhibited reduced growth rate(optical density[OD]comparison,P<0.05).In addition,in vitro competition experiments showed a competitive index(CI)<1 in gonococcal base liquid(GCBL)without or with low-concentration spectinomycin(≤16 μg/mL).In the GCBL with 32 μg/mL spectinomycin,the CI value gradually increased from<1 before 18 h to>1 after 18 h.The mutant strain showed CI>1 in GCBL with spectinomycin concentrations≥64 μg/mL.Conclusion The rpsE gene mutation(88_90delGTT)mediates high-level spectinomycin resistance in Neisseria gonorrhoeae,and imposes a fitness cost on the bacteria.The biological fitness of the mutant strain is influenced by the concentration of spectinomycin.

Objective:To investigate the effects and molecular mechanisms of Wilms tumor 1-associated proteins(WTAP)on the cell biological properties of esophageal squamous cell carcinoma(ESCC)cells.Methods:31 pairs of ESCC tissues and their paired paracancerous tissues that were surgically resected at the Second Clinical Medical College of Chuanbei Medical College between September 2019 and April 2021 were collected.The esophageal cancer cells KYSE30,KYSE410,KYSE150,KYSE510,TE-1,and normal human esophageal epithelial cells HET-1A were routinely cultured.Transfection reagents were used to transfect si-NC,si-WTAP#1 and si-WTAP#2 nucleic acids into KYSE150 and KYSE510 cells.The cells were divided into si-NC,si-WTAP#1 and si-WTAP#2 groups.The expressions of WTAP and MAP3K9 mRNA were detected in the cells of each group by qPCR assay.CCK-8 assay,clone formation assay,and scratch healing assay,Transwell assay were employed to detect the effects of knockdown of WTAP expression on ESCC cell proliferation,migration,invasion and apoptosis.WB assay was used to detect the expressions of WTAP,MAP3K9,EMT and MAPK pathway-related proteins in ESCC cells of each group knocked down of WTAP;immunohistochemistry to detect the expression of WTAP proteins in ESCC tissues,immunoprecipitation of methylated RNA(MeRIP)-qPCR assay to detect the level of MAP3K9 m6A in ESCC cells,actinomycin D assay to detect the stability of mRNA of MAP3K9,and database data to analyze the expression,target genes,functional enrichment,and interacting RNA of WTAP.Results:WTAP was highly expressed in ESCC tissues and cells(P<0.05 or P<0.01 or P<0.001)and correlated with the degree of differentiation(P<0.01);the expression of WTAP mRNA and its protein were successfully knocked down in KYSE150 and KYSE510 cells(P<0.01 or P<0.001);the knockdown of WTAP significantly inhibited the proliferation,migration and invasion of KYSE150 and KYSE510 cells(P<0.05 or P<0.01 or P<0.001),and promoted the apoptosis of KYSE150 and KYSE510 cells(P<0.05 or P<0.01).Knockdown of WTAP resulted in a significant decrease in the m6A level of MAP3K9(P<0.05),and its mRNA expression level and mRNA stability were both significantly reduced(P<0.05).Database data analysis showed that WTAP target genes clustered in the MAPK signaling pathway;the expression levels of MAP3K9,p-ERK,N-cadherin,and MMP9 were significantly reduced(P<0.05 or P<0.01),and the expression level of E-cadherin was significantly elevated(P<0.05 or P<0.01)in the KYSE150 and KYSE510 cells after knockdown of WTAP.Conclusions:WTAP is highly expressed in ESCC tissues and cells and correlates with their differentiation.It promotes the stability of MAP3K9 mRNA through m6A modification,activates the MAPK pathway and thus promotes the malignant biological behaviors of ESCC cells.

Objective:To explore the expression of nectin-4 and vanin-1 in esophageal squamous cell carcinoma(ESCC)and its influence on the malignant biological behaviors of ESCC cells,as well as the underlying mechanisms.Methods:Transcriptome sequencing combined with GO and KEGG enrichment analysis was used to identify the downstream target gene(vanin-1)regulated by nectin-4.The mRNA expression of vanin-1 in ESCC tissues was studied using the Timer2.0 database,and the mRNA and protein expression of vanin-1 in normal esophageal epithelial HET-1 and ESCC cells was detected by qPCR and Western blot,identifying ESCC KYSE-410 and KYSE-510 cells with the most significant differential expression.The expression of vanin-1 in KYSE-410 and KYSE-510 cells was knocked down using siRNA.The effects of vanin-1 knockdown on cell proliferation,migration,and invasion were measured using CCK-8 assay,wound healing assay,and Transwell chamber assay.Furthermore,KEGG and GO enrichment analyses were conducted for vanin-1-related signaling pathways.Immunohistochemistry was performed to compare the expression of vanin-1 between ESCC tissues and adjacent non-tumor tissues.Results:Timer2.0 database analysis and qPCR results showed that vanin-1 was highly expressed in both ESCC tissues and cell lines(both P<0.01).WB assay also confirmed high expression of vanin-1 protein in ESCC cells(P<0.01).siRNA successfully knocked down vanin-1 expression in KYSE-410 and KYSE-510 cells.Knockdown of vanin-1 significantly inhibited the proliferation,migration,and invasion capabilities of KYSE-410 and KYSE-510 cells(P<0.05 or P<0.01 or P<0.001 or P<0.000 1).KEGG and GO enrichment analysis suggested that vanin-1 might function through pathways related to pantothenic acid and coenzyme A synthesis metabolism.Immunohistochemistry results indicated that vanin-1 was highly expressed in ESCC tissues(P<0.000 1).Conclusion:Vanin-1 is highly expressed in ESCC tissues and promotes the proliferation,migration,and invasion of KYSE-410 and KYSE-510 cells through the nectin-4/vanin-1 axis.Targeting vanin-1 might offer a new therapeutic strategy for ESCC.

Objective:To construct and validate a depression risk prediction model for middle-aged and elderly patients with diabetes.Methods:Data were extracted from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 900 diabetic patients were identified, and after excluding those with missing data or invalid questionnaires, 769 patients were included in the analysis. Patients were randomly divided into a training set and a validation set in a 7∶3 ratio. Univariate analysis and logistic regression analysis were performed to screen the optimal predictors of depression in diabetic patients, and a nomogram model was developed. The predictive performance of the model was assessed by the area under the receiver operating characteristic curve ( AUC). Model calibration and accuracy were evaluated using bootstrap resampling, calibration plots, and the Hosmer-Lemeshow test. The clinical utility was further assessed by decision curve analysis (DCA) and clinical impact curves (CIC) . Results:Among the 769 patients, 366 (47.59%) had depression. Logistic regression analysis showed that place of residence, pain, difficulty in toileting, difficulty in bathing, sleep duration, physical exercise, life satisfaction, and children's satisfaction were independent predictors of depression in diabetic patients. A nomogram was constructed based on these variables, yielding an AUC of 0.775. At the optimal cutoff value of 0.557, the model demonstrated a sensitivity of 59.1% and a specificity of 84.8%, indicating good discriminative ability. The Hosmer-Lemeshow test showed (χ 2=15.821, P=0.105), suggesting good agreement between predicted and observed outcomes. In the validation set, the AUC was 0.778, with Hosmer-Lemeshow (χ 2=8.557, P=0.575). DCA and CIC indicated favorable clinical applicability of the model. Conclusions:The depression risk prediction model constructed in this study demonstrated good predictive performance. It can assist clinicians in early identification of high-risk individuals with diabetes and provide a theoretical basis for targeted interventions.

Objective:To explore the effect of self-compassion-based writing on prosocial behavior in college students with different self-construals.Methods:A total of 182 college students were recruited,and the Self-Con-structional Scales were used to determine the self-construal types(independent or interdependent).Participants were then assigned to either a self-compassion-based writing group(n=91)or a non-self-compassion daily writing group(n=91)and completed writing tasks according to the respective instructions.Prosocial behavior was evaluated with the Prosocial Tendencies Measure(PTM),situational judgment tests,and donation amounts.Results:The evaluation results from the PTM showed that prosocial behavior was significantly higher in individuals with interdependent self-construal compared to those with independent self-construal(P＜0.001),the main effect of the group type was not statistically significant(P＞0.05).The evaluation results from situational judgment tests showed that prosocial behavior was significantly higher in individuals with interdependent self-construal compared to those with independ-ent self-construal(P＜0.001),the self-compassion-based writing group demonstrated significantly more prosocial behavior than the non-self-compassion daily writing group(P＜0.05).The evaluation results from donation a-mounts showed that the main effect of self-construal type was not statistically significant(P＞0.05),the self-com-passion-based writing group demonstrated significantly more prosocial behavior than the non-self-compassion daily writing group(P＜0.05).Conclusion:Compared to daily writing,self-compassion-based writing could effectively increase prosocial behavior in college students,regardless of their self-construal type.

Objective:To explore potential categories of disease progression fear and self-management ability in patients with maintenance hemodialysis (MHD) and their influencing factors.Methods:Convenience sampling was used to select MHD patients in the Blood Purification Center of the Affiliated Nantong Hospital of Nanjing University of Chinese Medicine, the Affiliated Suzhou Hospital of Nanjing University Medical School, and the Affiliated Huaian First People's Hospital of Nanjing Medical University from November 2022 to May 2023 as study subjects. General Information Questionnaire, Fear of Progression Questionnaire-short form (FoP-Q-SF), Hemodialysis Self-management Instrument (HDSMI), and Perceived Social Support Scale (PSSS) were used to conduct the survey. Mplus 8.7 software was applied to conduct latent profile analysis, and multiple Logistic regression was used to explore the factors influencing the disease progression fear and self-management ability of different MHD patients.Results:A total of 380 questionnaires were distributed, and 364 valid questionnaires were recovered, with an effective recovery rate of 95.79%. The mean scores of FoP-Q-SF and HDSMI in 364 MHD patients were (2.53±0.84) and (2.81±0.54), respectively. MHD patients' fear of disease progression and self-management ability were manifested in three different potential categories, named high fear-general self-management (59.34%, 216/364), moderate fear-low self-management (24.45%, 89/364), and low fear-good self-management (16.21%, 59/364). Multiple Logistic regression showed that age, education level, marital status, comorbidities, duration on dialysis, and social support were influencing factors in the potential categories of fear of disease progression and self-management ability in MHD patients, and the difference was statistically significant ( P<0.05) . Conclusions:Healthcare professionals should give appropriate interventions to MHD patients with different types of fear of progression and self-management ability in order to reduce patients' fear of disease progression and improve their self-management ability.