Objective To compare TyG index between the patients with CHF and ADHF to eluci-date the metabolic difference between these two stages.Methods A total of 1156 HF patients ad-mitted in Taizhou People's Hospital between January 2020 and December 2022 were enrolled,and according to 2021 ESC Guidelines for Diagnosis and Treatment of Acute and Chronic Heart Fail-ure,they were divided into CHF group(365 cases)and ADHF group(791 cases).The clinical da-ta,results of laboratory tests,and cardiovascular history were collected,and TyG index was calcu-lated.All-cause death outcome was observed in ADHF patients during a follow-up of 1 year.Results The TyG index was significantly lower in the ADHF group than the CHF group[8.27(7.99,8.62)vs 8.35(8.04,8.75),P=0.001].In the ADHF group,the TyG index was positively correlated with SBP,DBP,TC,TG,LDL-C,FPG,HbA1c,BMI,and LVEF,and negatively with age(P＜0.01).In the CHF group,the index was positively correlated with DBP,TC,TG,LDL-C,FPG,BMI,and HbA1c,and negatively with age(P＜0.05,P＜0.01).Both univariate and multiva-riate logistic regression analyses indicated that the TyG index was a protective factor for ADHF(OR=0.647,95％CI:0.503～0.832,P=0.001;OR=0.694,95％CI:0.536～0.898,P=0.005).Multivariate logistic regression analysis showed that the index in ADHF patients was a protective factor for one-year all-cause mortality(OR=0.483,95％CI:0.254-0.916;P=0.026).Conclusion TyG index might be regarded as an important marker for assessing the metabolic status in HF patients and predicting the prognosis in ADHF patients.

Objective To compare TyG index between the patients with CHF and ADHF to eluci-date the metabolic difference between these two stages.Methods A total of 1156 HF patients ad-mitted in Taizhou People's Hospital between January 2020 and December 2022 were enrolled,and according to 2021 ESC Guidelines for Diagnosis and Treatment of Acute and Chronic Heart Fail-ure,they were divided into CHF group(365 cases)and ADHF group(791 cases).The clinical da-ta,results of laboratory tests,and cardiovascular history were collected,and TyG index was calcu-lated.All-cause death outcome was observed in ADHF patients during a follow-up of 1 year.Results The TyG index was significantly lower in the ADHF group than the CHF group[8.27(7.99,8.62)vs 8.35(8.04,8.75),P=0.001].In the ADHF group,the TyG index was positively correlated with SBP,DBP,TC,TG,LDL-C,FPG,HbA1c,BMI,and LVEF,and negatively with age(P＜0.01).In the CHF group,the index was positively correlated with DBP,TC,TG,LDL-C,FPG,BMI,and HbA1c,and negatively with age(P＜0.05,P＜0.01).Both univariate and multiva-riate logistic regression analyses indicated that the TyG index was a protective factor for ADHF(OR=0.647,95％CI:0.503～0.832,P=0.001;OR=0.694,95％CI:0.536～0.898,P=0.005).Multivariate logistic regression analysis showed that the index in ADHF patients was a protective factor for one-year all-cause mortality(OR=0.483,95％CI:0.254-0.916;P=0.026).Conclusion TyG index might be regarded as an important marker for assessing the metabolic status in HF patients and predicting the prognosis in ADHF patients.

Objective:To investigate the effects of chronic persistent hypoxia on hepatic function, histological morphology, and ultrastructure in aged mice, and to evaluate the protective role of pyrroloquinoline quinone(PQQ).Methods:Thirty-two 2-month-old (young group)and thirty-two 18-month-old(aged group)male C57BL6/J mice were each randomly divided into four groups (n=8 per group): normoxia+ normal saline (NS)group, normoxia+ PQQ group, hypoxia+ NS group, and hypoxia+ PQQ group.The normoxia+ NS and normoxia+ PQQ groups were housed under normoxic conditions[fraction of inspired oxygen(FiO 2)=21%], while the hypoxia+ NS and hypoxia+ PQQ groups were continuously exposed to a hypoxic environment[FiO 2=(10±0.5)%]simulated by a custom-made hypoxic chamber, maintaining a constant oxygen concentration for 24 hours per day.The normoxia+ NS and hypoxia+ NS groups received daily intragastric administration of NS, whereas the normoxia+ PQQ and hypoxia+ PQQ groups received daily intragastric administration of PQQ disodium salt(8 mg·kg -1·d -1).After 8 weeks of continuous intervention, blood samples were collected to measure red blood cell count, hemoglobin levels, and liver function-related biochemical indicators.Lung tissues were processed for HE staining, and liver tissues were processed for both HE staining and electron microscopy.The histological and ultrastructural features of each group were observed under light and electron microscopy, respectively, and the differences between the groups were compared and analyzed. Results:Compared with the normoxia+ NS groups, both young and aged hypoxia+ NS groups exhibited significant pulmonary arteriole narrowing( P<0.001), with markedly elevated red blood cell count and hemoglobin levels (all P<0.001), which were not alleviated by PQQ.Compared with the young normoxia+ NS group, the young hypoxia+ NS group showed significantly higher alanine aminotransferase (ALT)and lactate dehydrogenase (LDH)levels( Z=2.72, 2.53, P=0.007, 0.011), whereas the young hypoxia+ PQQ group exhibited LDH levels similar to those of the young normoxia+ NS group.The aged hypoxia+ NS group exhibited significant ALT elevation( t=2.66, P=0.013)compared with the aged normoxia+ NS group.Light microscopy revealed hepatocyte ballooning degeneration, mild fatty accumulation, and focal necrosis around central veins in the young hypoxia+ NS group, while the young hypoxia+ PQQ group exhibited no significant pathological damage but displayed numerous deeply stained binucleated hepatocytes.The aged normoxia+ NS group demonstrated hepatocyte ballooning degeneration and inflammatory cell infiltration around central veins, whereas the aged normoxia+ PQQ group exhibited no obvious pathological damage with scattered deeply stained binucleated hepatocytes.The aged hypoxia+ NS group exhibited significant necrosis following physiological oxygen concentration gradient distribution, while the aged hypoxia+ PQQ group displayed no obvious pathological damage with scattered deeply stained binucleated hepatocytes.Electron microscopy revealed that the aged normoxia+ NS group had reduced mitochondrial electron density ( P<0.001)and less developed rough endoplasmic reticulum compared with the young normoxia+ NS group.The young hypoxia+ NS group exhibited a smaller mitochondrial area( P<0.001), decreased mitochondrial matrix electron density( P<0.001), blurred or absent mitochondrial cristae, inactive rough endoplasmic reticulum, and increased accumulation of glycogen and lipid droplets compared with the young normoxia+ NS group, while the young hypoxia+ PQQ group maintained mitochondrial matrix electron density comparable to the young normoxia+ NS group.The aged hypoxia+ NS group exhibited larger mitochondrial area( P=0.001), decreased mitochondrial matrix electron density( P<0.001), blurred or absent mitochondrial cristae, mitochondrial edema, increased lysosomes, and elevated cytoplasmic electron density compared with the aged normoxia+ NS group.The aged hypoxia+ PQQ group exhibited reduced mitochondrial area( P<0.001)and restored mitochondrial matrix electron density to levels comparable with the aged normoxia+ NS group.The aged normoxia+ PQQ group demonstrated increased mitochondrial matrix electron density compared with the aged normoxia+ NS group( P<0.001). Conclusions:Chronic persistent hypoxia induces hepatic functional, histological and ultrastructural damage in mice, with more pronounced effects in aged animals.PQQ provides a certain degree of protection against these injuries.

Objective To explore the efficacy of goal management training(GMT)on core symptoms and mental status in college students with attention deficit hyperactivity disorder(ADHD)inattentive type.Methods Delphi method was used to construct a GMT program for college students with inattentive ADHD.Then,totally 68 college students with inattentive ADHD were recruited through advertisements published by hospitals and universities(Second Affiliated Hospital of Army Medical University,and 3 universities in Chongqing from March to June 2024.The subjects were randomly divided into an intervention group(n=34)and a control group(n=34).The intervention group received GMT for 2 h,once a week,for 7 weeks,and the control group did not receive training for the time being.The 2 groups were evaluated within 1 week before and in 7 weeks after intervention by using Adult ADHD Self-Report Scale(ASRS),Dysregulation of Emotions Rating Scale(DERS),Generalized Anxiety Disorde-7(GAD-7),Patient Health Questionnaire-9(PHQ-9),Self-Compassion Scale(SCS),and Satisfaction with Life Scale(SWLS).Results ① The expert authority coefficient(Cr)of 2 rounds of expert consultation was 0.83,with a questionnaire recovery rate of 100%and 95%,respectively,the Kendall's coordination coefficient was 0.081(P<0.01)and 0.226(P<0.01),and the coefficient of variation was<0.3,indicating the results of the expert consultation were reliable.The constructed GMT program includes 1 first-level indicator,7 second-level indicators,and 20 third-level indicators.② After 7 weeks of GMT intervention,the interaction between the 2 groups and time showed that the experimental group obtained significant improvements than the control group in terms of inattention symptoms(Wald Chi-square=28.35,P<0.001),dysregulation of emotions(Wald Chi-square=23.81,P<0.001),anxiety(Wald Chi-square=22.79,P<0.001),depression(Wald Chi-square=20.52,P<0.001),self-compassion(Wald Chi-square=9.36,P<0.01),and life satisfaction(Wald Chi-square=3.97,P<0.05).Conclusion GMT intervention can significantly improve the core symptoms of college students with inattentive ADHD,reduce anxiety and depression levels,enhance their emotion regulation and self-compassion abilities,and improve their life satisfaction.

Objective:To investigate the effects of chronic persistent hypoxia on hepatic function, histological morphology, and ultrastructure in aged mice, and to evaluate the protective role of pyrroloquinoline quinone(PQQ).Methods:Thirty-two 2-month-old (young group)and thirty-two 18-month-old(aged group)male C57BL6/J mice were each randomly divided into four groups (n=8 per group): normoxia+ normal saline (NS)group, normoxia+ PQQ group, hypoxia+ NS group, and hypoxia+ PQQ group.The normoxia+ NS and normoxia+ PQQ groups were housed under normoxic conditions[fraction of inspired oxygen(FiO 2)=21%], while the hypoxia+ NS and hypoxia+ PQQ groups were continuously exposed to a hypoxic environment[FiO 2=(10±0.5)%]simulated by a custom-made hypoxic chamber, maintaining a constant oxygen concentration for 24 hours per day.The normoxia+ NS and hypoxia+ NS groups received daily intragastric administration of NS, whereas the normoxia+ PQQ and hypoxia+ PQQ groups received daily intragastric administration of PQQ disodium salt(8 mg·kg -1·d -1).After 8 weeks of continuous intervention, blood samples were collected to measure red blood cell count, hemoglobin levels, and liver function-related biochemical indicators.Lung tissues were processed for HE staining, and liver tissues were processed for both HE staining and electron microscopy.The histological and ultrastructural features of each group were observed under light and electron microscopy, respectively, and the differences between the groups were compared and analyzed. Results:Compared with the normoxia+ NS groups, both young and aged hypoxia+ NS groups exhibited significant pulmonary arteriole narrowing( P<0.001), with markedly elevated red blood cell count and hemoglobin levels (all P<0.001), which were not alleviated by PQQ.Compared with the young normoxia+ NS group, the young hypoxia+ NS group showed significantly higher alanine aminotransferase (ALT)and lactate dehydrogenase (LDH)levels( Z=2.72, 2.53, P=0.007, 0.011), whereas the young hypoxia+ PQQ group exhibited LDH levels similar to those of the young normoxia+ NS group.The aged hypoxia+ NS group exhibited significant ALT elevation( t=2.66, P=0.013)compared with the aged normoxia+ NS group.Light microscopy revealed hepatocyte ballooning degeneration, mild fatty accumulation, and focal necrosis around central veins in the young hypoxia+ NS group, while the young hypoxia+ PQQ group exhibited no significant pathological damage but displayed numerous deeply stained binucleated hepatocytes.The aged normoxia+ NS group demonstrated hepatocyte ballooning degeneration and inflammatory cell infiltration around central veins, whereas the aged normoxia+ PQQ group exhibited no obvious pathological damage with scattered deeply stained binucleated hepatocytes.The aged hypoxia+ NS group exhibited significant necrosis following physiological oxygen concentration gradient distribution, while the aged hypoxia+ PQQ group displayed no obvious pathological damage with scattered deeply stained binucleated hepatocytes.Electron microscopy revealed that the aged normoxia+ NS group had reduced mitochondrial electron density ( P<0.001)and less developed rough endoplasmic reticulum compared with the young normoxia+ NS group.The young hypoxia+ NS group exhibited a smaller mitochondrial area( P<0.001), decreased mitochondrial matrix electron density( P<0.001), blurred or absent mitochondrial cristae, inactive rough endoplasmic reticulum, and increased accumulation of glycogen and lipid droplets compared with the young normoxia+ NS group, while the young hypoxia+ PQQ group maintained mitochondrial matrix electron density comparable to the young normoxia+ NS group.The aged hypoxia+ NS group exhibited larger mitochondrial area( P=0.001), decreased mitochondrial matrix electron density( P<0.001), blurred or absent mitochondrial cristae, mitochondrial edema, increased lysosomes, and elevated cytoplasmic electron density compared with the aged normoxia+ NS group.The aged hypoxia+ PQQ group exhibited reduced mitochondrial area( P<0.001)and restored mitochondrial matrix electron density to levels comparable with the aged normoxia+ NS group.The aged normoxia+ PQQ group demonstrated increased mitochondrial matrix electron density compared with the aged normoxia+ NS group( P<0.001). Conclusions:Chronic persistent hypoxia induces hepatic functional, histological and ultrastructural damage in mice, with more pronounced effects in aged animals.PQQ provides a certain degree of protection against these injuries.

Objective:To investigate the outcome of epicanthoplasty combined with double eyelidplasty in different aesthetic forms of double eyelids (inner type and outer type) using Z-epicanthoplasty and inverted L method.Methods:The clinical data of patients with single eyelids and epicanthus were retrospectively analyzed from November 2021 to October 2022 in Gaoxin Hospital of the First Affiliated Hospital of Nanchang University. Patients were divided into inner type group and outer type group based on their aesthetic requirements for inner double eyelids. Both groups underwent Z-epicanthoplasty or inverted L method for epicanthus correction. Postoperative follow-up was conducted to observe the incision healing, complications, and postoperative effects of the two groups. The correction effects [ineffective, effective, and markedly effective, with the effective rate calculated as (the number of markedly effective cases + the number of effective cases)/total number of cases × 100%], scar scores, and patient satisfaction scores were collected for more than 12 months after surgery. Independent sample t-test was used for the scar scores and patient satisfaction scores, and chi-square test was used for the epicanthus correction effects. P<0.05 indicated a statistically significant difference. Results:A total of 76 patients were included. Among them, 41 patients in the inner type group (4 males and 37 females, with an average age of 22.3 years, ranging from 18 to 28 years) underwent 19 cases of Z-epicanthoplasty and 22 cases of inverted L method; 35 patients in the outer type group (3 males and 32 females, with an average age of 24.2 years, ranging from 19 to 30 years) underwent 20 cases of Z-epicanthoplasty and 15 cases of inverted L method. After 12 to 16 months of follow-up, with an average of 14 months, all incisions in both groups healed in the first stage, with no significant scar hyperplasia or other complications. Most of the double eyelid shapes are natural after the surgery, and the correction of epicanthus is obvious. Comparison of the treatment efficacy between Z-epicanthoplasty and inverted L method showed no significant difference [94.87% (37/39) vs. 94.59% (35/37), P>0.05]. In the inner type group, the postoperative scar score of the inverted L method was lower than that of the Z-epicanthoplasty [(6.81±0.66) vs. (7.31±0.88)], and the satisfaction score was better than that of the Z-epicanthoplasty [(0.86±0.63) vs. (1.73±0.65)], with statistically significant differences (both P<0.05). In the outer type group, the scar score of the inverted L method was higher than that of the Z-epicanthoplasty [(7.66±0.89) vs. (7.00±0.64)], and the satisfaction score was worse than that of the Z-epicanthoplasty [(1.80±0.86) vs. (1.00±0.56)], with statistically significant differences (both P<0.05). Conclusion:For patients requiring inner type aesthetic form of medial double eyelids, inverted L method can achieve less postoperative scars and higher postoperative satisfaction compared with Z-epicanthoplasty. For patients requiring "outer type" aesthetic form, Z-epicanthoplasty can achieve less postoperative scars and higher postoperative satisfaction compared with inverted L method.

Objective:To investigate the outcome of epicanthoplasty combined with double eyelidplasty in different aesthetic forms of double eyelids (inner type and outer type) using Z-epicanthoplasty and inverted L method.Methods:The clinical data of patients with single eyelids and epicanthus were retrospectively analyzed from November 2021 to October 2022 in Gaoxin Hospital of the First Affiliated Hospital of Nanchang University. Patients were divided into inner type group and outer type group based on their aesthetic requirements for inner double eyelids. Both groups underwent Z-epicanthoplasty or inverted L method for epicanthus correction. Postoperative follow-up was conducted to observe the incision healing, complications, and postoperative effects of the two groups. The correction effects [ineffective, effective, and markedly effective, with the effective rate calculated as (the number of markedly effective cases + the number of effective cases)/total number of cases × 100%], scar scores, and patient satisfaction scores were collected for more than 12 months after surgery. Independent sample t-test was used for the scar scores and patient satisfaction scores, and chi-square test was used for the epicanthus correction effects. P<0.05 indicated a statistically significant difference. Results:A total of 76 patients were included. Among them, 41 patients in the inner type group (4 males and 37 females, with an average age of 22.3 years, ranging from 18 to 28 years) underwent 19 cases of Z-epicanthoplasty and 22 cases of inverted L method; 35 patients in the outer type group (3 males and 32 females, with an average age of 24.2 years, ranging from 19 to 30 years) underwent 20 cases of Z-epicanthoplasty and 15 cases of inverted L method. After 12 to 16 months of follow-up, with an average of 14 months, all incisions in both groups healed in the first stage, with no significant scar hyperplasia or other complications. Most of the double eyelid shapes are natural after the surgery, and the correction of epicanthus is obvious. Comparison of the treatment efficacy between Z-epicanthoplasty and inverted L method showed no significant difference [94.87% (37/39) vs. 94.59% (35/37), P>0.05]. In the inner type group, the postoperative scar score of the inverted L method was lower than that of the Z-epicanthoplasty [(6.81±0.66) vs. (7.31±0.88)], and the satisfaction score was better than that of the Z-epicanthoplasty [(0.86±0.63) vs. (1.73±0.65)], with statistically significant differences (both P<0.05). In the outer type group, the scar score of the inverted L method was higher than that of the Z-epicanthoplasty [(7.66±0.89) vs. (7.00±0.64)], and the satisfaction score was worse than that of the Z-epicanthoplasty [(1.80±0.86) vs. (1.00±0.56)], with statistically significant differences (both P<0.05). Conclusion:For patients requiring inner type aesthetic form of medial double eyelids, inverted L method can achieve less postoperative scars and higher postoperative satisfaction compared with Z-epicanthoplasty. For patients requiring "outer type" aesthetic form, Z-epicanthoplasty can achieve less postoperative scars and higher postoperative satisfaction compared with inverted L method.

Objective To explore the mediating effect of facial emotion recognition on prosocial behavior of medical students in mask-obscured scenes.Methods Fifty-three medical students from a medical university in Chongqing were enrolled from July to September 2023 to complete the facial emotion recognition task,the dictator gaming task and the state empathy test.Spearman correlation analysis was used to examine the correlation between mask wearing and state empathy,trait empathy and prosocial behaviours,and the PROCESS procedure was used to test the mediation of state empathy and the moderating effect of mask wearing or not.Results ①mask wearing,state empathy and prosocial behaviour were significantly correlated(P＜0.01);② State empathy exerted mediated effect between facial emotion recognition and prosocial behavior,with the largest effect size(47％)for the relative mediating effect of sadness;③The interaction terms of facial emotion recognition and mask wearing had a significant effect on state empathy(P＜0.05).Conclusion Facial emotion recognition can influence prosocial behavior directly and also exert indirect effect on prosocial behavior through state empathy.Compared to the condition without mask wearing,mask wearing can significantly facilitate the effect of happy,sad and neutral emotions on state empathy.

Objective To investigate the effects of group identification on death anxiety among military medical students and the chain mediating effects of self-esteem and collective self-esteem.Methods Cluster sampling was conducted to survey the students in a military medical university in July,2021,and finally survey data from 360 participants were collected through WeChat Mini Program,Questionnaire Star.The Questionnaires included Templer Death Anxiety Scale(T-DAS),Organizational Identification Questionnaire,Rosenberg Self-Esteem Scale-Revised(RSES-R),Collective Self-Esteem Scale and a self-designed general information questionnaire.Results ①The score of death anxiety in the participants ranged from 1.00 to 4.33(M=2.60).②The scores of group identification,self-esteem and collective self-esteem were negatively correlated with death anxiety(r=-0.56～-0.21,P＜0.01).Significantly positive correlations were observed in any 2 scores among the above 3 scores(r=0.42～0.68,P＜0.01).③ Group identification significantly negatively predicted death anxiety(b=-0.21,SE=0.02,P＜0.001).④ There were 3 mediation effects between group identification and death anxiety:group identification→self-esteem→death anxiety,group identification→ collective self-esteem→ death anxiety,group identification→ self-esteem→collective self-esteem→death anxiety,with a total indirect effect of-017.Conclusion Group identification can negatively predict death anxiety among military medical students,and self-esteem and collective self-esteem play a chain mediating role between them.

Background/Aims: Ulcerative colitis (UC) is an incurable, relapsing-remitting inflammatory disease that increases steadily. Mucosal healing has become the primary therapeutic objective for UC. Nevertheless, endoscopic assessments are invasive, expensive, time-consuming, and inconvenient. Therefore, it is crucial to develop a noninvasive predictive model to monitor endoscopic activity in patients with UC. Methods: Clinical data of 198 adult patients with UC were collected from January 2016 to August 2022 at Huadong Hospital, China. Results: Patients with UC were randomly divided into the training cohort (70%, n=138) and the validation cohort (30%, n=60). The receiver operating characteristic curve value for the training group was 0.858 (95% confidence interval [CI], 0.781 to 0.936), whereas it was 0.845 (95% CI, 0.731 to 0.960) for the validation group. The calibration curve employed the Hosmer-Lemeshow test (p>0.05) to demonstrate the consistency between the predicted and the actual probabilities in the nomogram of these two groups. The decision curve analysis validated that the nomogram had clinical usefulness. Conclusions The nomogram, which incorporated activated partial thromboplastin time, fecal occult blood test, β2-globulin level, and fibrinogen degradation products, served as a prospective tool for evaluating UC activity in clinical practices.