OBJECTIVE To compare the efficacy and safety of evolocumab and probucol in patients with ultra-high-risk atherosclerotic cardiovascular disease （ASCVD） following percutaneous coronary intervention （PCI）. METHODS A retrospective analysis was conducted on 156 ultra-high-risk ASCVD patients who underwent PCI in our institution between January 1， 2023 and December 31， 2024. According to the lipid-lowering regimen， the patients were categorized into evolocumab group （ n ＝86） and probucol group （ n ＝70）. Changes in lipid parameters [total cholesterol （TC）， low-density lipoprot ein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）， triglycerides， lipoprotein （a）， and lipid goal achievement rate ] ， inflammatory markers [interleukin-6 （IL-6） and C-reactive protein （CRP） ] ， and cardiac function indices （left ventricular ejection fraction， left ventricular end-systolic diameter， left ventricular end-diastolic diameter， and N-terminal pro-B-type natriuretic peptide） were compared between two groups at baseline and after 6 months of treatment. The incidence of adverse clinical events during treatment， including acute myocardial infarction， in-stent restenosis， acute heart failure， cerebral hemorrhage， and stroke， was also evaluated. RESULTS No statistically significant differences were observed between the two groups at baseline （ P ＞0.05）. After 6 months of treatment， both groups demonstrated significant improvements in lipid profiles （except HDL-C） and inflammatory markers compared to those at baseline （ P ＜0.05）. The evolocumab group exhibited greater reductions in TC， LDL-C， IL-6， and CRP， along with a higher lipid target achievement rate， compared with the probucol group （ P ＜0.05）. There were no statistically significant differences in the cardiac function-related indicators before and after treatment between the two groups， nor in the incidence of adverse events during the treatment （ P ＞0.05）. CONCLUSIONS For ultra-high-risk ASCVD patients after PCI， both of the above treatment options are associated with improvements in blood lipid and inflammatory response， with good safety during short-term follow-up. Evolocumab shows superior efficacy in TC， LDL-C and inflammatory markers reduction and lipid target achievement， compared to probucol.

Objective To explore the mechanism of Shen Hong capsule in preventing and treating acute mountain sickness based on biological information platform and in vitro experiment. Methods Traditional Chinese Medicine Systems Pharmacology （TCMSP） and Traditional Chinese Medicine Information Database （TCMID） were used to obtain the active components and predicted targets of Shen Hong capsule. Therapeutic Target Database （TTD）, Disease Gene Network （DisGeNET） database and GeneCards database were used to search for the targets of acute mountain sickness related diseases, and the potential therapeutic targets were obtained. The protein-protein interaction （PPI） was analyzed by Search Tool for the Retrieval of Interacting Genes/Proteins （STRING）, the Database for Annotation, Visualization, and Integrated Discovery （DAVID） online platform was used to analyse the Gene Ontology （GO） and the Kyoto Encyclopedia of Genes and Genomes （KEGG） signal pathway enrichment. The network information was visualized by Cytoscape software, the key targets in PPI network were obtained according to the topology data, and the binding ability of main active components and key therapeutic targets were analyzed by molecular docking. The validation of the main active components was performed by liquid chromatography-mass spectrometry （LC-MS）. The hypoxia model was created by H9c2 cells, apoptosis was visualized by Hoechst33342 staining, and key target proteins were verified by Western blot. Results 91 active components, 3 main active components and 150 predicted targets were selected from Shen Hong capsule. 515 targets of altitude sickness-related diseases and 37 targets of Shen Hong capsule regulating altitude sickness-related diseases were screened out. 44 related signal pathways, such as HIF-1 signal pathway, PPAR signal pathway, drug metabolism - cytochrome P450, were enriched and analyzed. TNF, IL1B, VEGFA, NOS3, EGFR, ESR1, PPARG, NR3C1, HMOX1 and IFNG were 10 key targets. The molecular docking results showed that the docking conformations between the main active components and the key targets were stable. The three main active components of quercetin, luteolin and kaempferol were identified by LC-MS, and in vitro experiments proved that Shen Hong capsule could relieve acute hypoxia injury by regulating the expression of HIF-1α, PPARG, NOS3, and TNF. Conclusion Shen Hong capsule could regulate the body’s hypoxia response and metabolism through multi-component, multi-target and multi-channel ways, so as to prevent and treat acute mountain sickness. This study provided a direction for further exploring the mechanism of Shen Hong capsule, and also provided a theoretical basis for further development and clinical application.

Objective:To explore the relationship between autistic trait and pain empathy among college students, as well as the mediating role of personal pain perception.Methods:From October to December 2023, a cross-sectional survey was conducted among 1 195 college students using the autism spectrum quotient, pain sensitivity questionnaire, fear of pain questionnaire, pain catastrophizing scale and empathy for pain scale.SPSS 27.0 software was used for descriptive statistics and correlation analysis.A structural equation model was constructed using Mplus 8.3 to examine the mediating effect of personal pain perception, which was composed of pain sensitivity, fear and catastrophizing cognition.Results:Autistic trait(22.00(18.00, 26.00))was significantly positively correlated with pain sensitivity (55.00(43.00, 70.00)), fair of pain (69.00(60.00, 78.00)), and pain catastrophizing cognition (16.00(8.00, 23.00)) ( r=0.112, 0.154, 0.204, all P<0.001).Autistic trait was also significantly positively correlated with affective distress(62.00(46.00, 80.00), r=0.162, P<0.001) and vicarious pain (14.00(8.00, 20.00), r=0.096, P<0.001) of pain empathy.Pain sensitivity, fear of pain and pain catastrophizing cognition were significantly positively correlated with affective distress( r=0.244, 0.332, 0.375, all P<0.001) and vicarious pain ( r=0.210, 0.232, 0.285, all P<0.001) of pain empathy.The effects of autistic trait on affective distress and vicarious pain dimensions of pain empathy were fully mediated by personal pain perception, with the mediating effects of 0.115( P<0.001, 95% CI=0.073-0.165) and 0.085( P<0.001, 95% CI=0.053-0.124). Conclusions:The autistic trait of college students can predict the affective distress and vicarious pain of pain empathy indirectly through personal pain perception.

Objective:To summarize the clinical and genetic characteristics of 23 children with pathogenic ACAN gene variants, enhance the understanding of this disorder, and explore possible regulatory mechanisms. Methods:A retrospective case series summary.The clinical characteristics and genetic analysis results of 23 children with ACAN gene variants treated in the Department of Endocrinology, Genetics and Metabolism, Children′s Hospital of Soochow University from January 2016 and September 2024 were analyzed retrospectively.Transcriptome sequencing was performed on peripheral blood samples from 3 of affected children and 3 age-matched healthy children as controls.Differentially expressed genes (DEGs) in the peripheral blood transcriptome profiles were identified.Gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analyses were conducted to explore the potential signaling pathways involved. Results:Among the 23 cases, there were 13 males and 10 females, aged from 2 years and 8 months to 12 years old, with 11 cases presenting advanced bone age.Thirteen cases were treated with growth hormone (GH), including 6 cases who received concomitant gonadotropin-releasing hormone analogue therapy.The treatment duration ranged from 3 to 70 months, resulting in varying degrees of height improvement in all treated patients.Transcriptomic analysis identified 811 DEGs, with 516 up-regulated and 295 down-regulated.GO and KEGG enrichment analyses revealed that the heterozygous ACAN variants were significantly associated with FcγR-mediated phagocytosis, nuclear factor-κB signaling pathway, the intestinal immune network for IgA production, rheumatoid arthritis, and systemic lupus erythematosus signaling pathways. Conclusions:The predominant clinical manifestations of patients with ACAN gene variants are short stature and advanced bone age.Although GH provocation tests may indicate normal GH levels, GH therapy can be effective in improving height.Immune-related factors may play a role in the pathogenesis of this disorder.

Objective To investigate the expression level of centromere protein(CENP)Ⅰin lung adenocarcinoma cells,to study the effects of CENPⅠon the proliferation,invasion,migration,apoptosis,and epithelial-mesenchymal transition(EMT)of lung adenocarci-noma cells,and to explore the possible mechanisms related to its occurrence.Methods The expression of CENPⅠmRNA and protein in four types of lung adenocarcinoma cells and normal alveolar epithelial cells were detected by quantitative real-time polymerase chain reaction(RT-qPCR)and Western blotting.The expression of CENPⅠin H1650 cells was knocked down by the siRNA technique,The transfection efficiency was detected by RT-qPCR and Western blotting.The effects of knock-down CENPⅠon proliferation,cell cycle,apoptosis,invasion and migration of H1650 cells were detected by the cell counting kit-8 assay,the transwell assay,and flow cytometry.Western blotting was used to detect the expression of E-cadherin,N-cadherin,vimentin,Ki-67,cyclin D1,Bcl-2,PI3K,AKT,mTOR,p-PI3K,p-AKT,and p-mTOR.Results After the knock-down of CENPⅠ,the proliferative ability of the H1650 cells significantly decreased,the number of apoptotic cells significantly decreased,and the cell invasion and migration abilities significantly decreased(P<0.01).E-cadherin expression was upregulated and N-cadherin,vimentin,Ki-67,cyclin D1,Bcl-2,p-PI3K,p-AKT,and p-mTOR expres-sion were down-regulated in the CENTI group compared with the control group(P<0.05).The expression of p-PI3K,p-AKT,and p-mTOR in the si-CENPⅠ+IGF-1 group was upregulated compared to that in the si-CENPⅠgroup(P<0.05).Conclusion High expression of CENPⅠin lung adenocarcinoma cells promotes the proliferation,invasion,and migration of lung adenocarcinoma H1650 cells and EMT inhibits apoptosis,which may be related to the activation of the PI3K/AKT/mTOR signaling pathway.

Objective:To explore the relationship between autistic trait and pain empathy among college students, as well as the mediating role of personal pain perception.Methods:From October to December 2023, a cross-sectional survey was conducted among 1 195 college students using the autism spectrum quotient, pain sensitivity questionnaire, fear of pain questionnaire, pain catastrophizing scale and empathy for pain scale.SPSS 27.0 software was used for descriptive statistics and correlation analysis.A structural equation model was constructed using Mplus 8.3 to examine the mediating effect of personal pain perception, which was composed of pain sensitivity, fear and catastrophizing cognition.Results:Autistic trait(22.00(18.00, 26.00))was significantly positively correlated with pain sensitivity (55.00(43.00, 70.00)), fair of pain (69.00(60.00, 78.00)), and pain catastrophizing cognition (16.00(8.00, 23.00)) ( r=0.112, 0.154, 0.204, all P<0.001).Autistic trait was also significantly positively correlated with affective distress(62.00(46.00, 80.00), r=0.162, P<0.001) and vicarious pain (14.00(8.00, 20.00), r=0.096, P<0.001) of pain empathy.Pain sensitivity, fear of pain and pain catastrophizing cognition were significantly positively correlated with affective distress( r=0.244, 0.332, 0.375, all P<0.001) and vicarious pain ( r=0.210, 0.232, 0.285, all P<0.001) of pain empathy.The effects of autistic trait on affective distress and vicarious pain dimensions of pain empathy were fully mediated by personal pain perception, with the mediating effects of 0.115( P<0.001, 95% CI=0.073-0.165) and 0.085( P<0.001, 95% CI=0.053-0.124). Conclusions:The autistic trait of college students can predict the affective distress and vicarious pain of pain empathy indirectly through personal pain perception.

Objective To investigate the expression level of centromere protein(CENP)Ⅰin lung adenocarcinoma cells,to study the effects of CENPⅠon the proliferation,invasion,migration,apoptosis,and epithelial-mesenchymal transition(EMT)of lung adenocarci-noma cells,and to explore the possible mechanisms related to its occurrence.Methods The expression of CENPⅠmRNA and protein in four types of lung adenocarcinoma cells and normal alveolar epithelial cells were detected by quantitative real-time polymerase chain reaction(RT-qPCR)and Western blotting.The expression of CENPⅠin H1650 cells was knocked down by the siRNA technique,The transfection efficiency was detected by RT-qPCR and Western blotting.The effects of knock-down CENPⅠon proliferation,cell cycle,apoptosis,invasion and migration of H1650 cells were detected by the cell counting kit-8 assay,the transwell assay,and flow cytometry.Western blotting was used to detect the expression of E-cadherin,N-cadherin,vimentin,Ki-67,cyclin D1,Bcl-2,PI3K,AKT,mTOR,p-PI3K,p-AKT,and p-mTOR.Results After the knock-down of CENPⅠ,the proliferative ability of the H1650 cells significantly decreased,the number of apoptotic cells significantly decreased,and the cell invasion and migration abilities significantly decreased(P<0.01).E-cadherin expression was upregulated and N-cadherin,vimentin,Ki-67,cyclin D1,Bcl-2,p-PI3K,p-AKT,and p-mTOR expres-sion were down-regulated in the CENTI group compared with the control group(P<0.05).The expression of p-PI3K,p-AKT,and p-mTOR in the si-CENPⅠ+IGF-1 group was upregulated compared to that in the si-CENPⅠgroup(P<0.05).Conclusion High expression of CENPⅠin lung adenocarcinoma cells promotes the proliferation,invasion,and migration of lung adenocarcinoma H1650 cells and EMT inhibits apoptosis,which may be related to the activation of the PI3K/AKT/mTOR signaling pathway.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

This study summarizes the preoperative and intraoperative nursing experience in 5 cases of bridge-to-transplant heart transplantation with left ventricular assist device(LVAD)explant.Key points of nursing include:preoperative care and assessment of LVAD patients,preoperative discussion of the multidisciplinary team,safe transfer of patients to surgical rooms and other preoperative preparation,cardiomyocardial protection and multidisciplinary team cooperation during bridging transplantation,and intra-operative patient safety management.All 5 patients in this group successfully completed the surgery and were discharged.Pressure sores,wound infections,and other postoperative complications have not occurred.Postoperative cardiac function of 5 patients in this group were classified as New York Heart Association class Ⅰ～Ⅱ.The follow-up period for the 5 patients in this group ranged from 6 months to 6 years.The results of the most recent echocardiography follow-up showed that the left ventricular ejection fraction of all patients was all above 65％,with well prognosis.

Background Kurtosis reflecting noise's temporal structure is an effective metric for evaluating noise-induced hearing loss (NIHL), and its threshold is still unclear. Objective To explore the energy range of kurtosis and the threshold of NIHL induced by kurtosis in this energy rangeMethods Using cross-sectional design, 4631 noise-exposed workers in manufacturing industry were selected. The hearing loss and noise exposure data of each worker were collected. Logistic regression model was used to establish the dose-response relationship between noise exposure and hearing loss and estimate the range of energy effects. Restricted cubic spline model was utilized to analyze the dose-response relationship curves of kurtosis to noise-induced hearing loss (NIHI) and high-frequency noise-induced hearing loss (HFNIHL) under different 8 h equivalent sound levels (L_{EX,8 h}), as well as to estimate the kurtosis effect threshold. Results The logistic regression model analysis showed that the prevalence of NIHI and HFNIHL increased significantly with increase of L_{EX,8 h} for steady noise; when L_{EX,8 h} of non-steady noise was 80-100 dB(A), the risk of hearing loss increased with an increase in kurtosis (P<0.05). The restricted cubic spline model showed that when L_{EX,8 h} of non-steady noise was 0-80 dB(A) or >100 dB(A), there was no significant relationship between kurtosis and NIHI or HFNIHL. When L_{EX,8 h} was 80-100 dB(A), there was a significant nonlinear dose-response relationship between kurtosis and NIHL or HFNIHL (P <0.001), and kurtosis > 28.08 exerted effect in elevating NIHI or HFNIHL. Conclusion The effect threshold of kurtosis on NIHL is 28.08 when non-steady noise levels are in the range of 80-100 dB(A). The effect threshold of kurtosis needs further verification.