Objective Rapid eye movement sleep behavior disorder（RBD） is a common sleep disorder in the elderly， and this study aims to investigate the activity of cerebral cortex based on the changes in electroencephalography （EEG） power spectrum and the difference in approximate entropy during the ictal period of RBD. Methods A total of 35 patients with idiopathic RBD who received video polysomnography monitoring were enrolled as RBD group， and 25 normal volunteers matched for age were enrolled as control group.REM EEG results with fewer artifacts was selected for both groups， and the RBD group had an increase in mandibular electromyographic activity or dream-enacting behaviors. The leads containing artifacts were excluded， and finally O1 （or O2 alternative） leads with relatively little interference were selected. After pretreatment， Fourier transform was performed for EEG data from both groups to calculate the absolute power and relative power ratio of EEG in five different frequency bands， i.e.， δ （0.5-3 Hz）， θ （4-7 Hz）， α （8-13 Hz）， β （14-30 Hz）， and γ （30-35 Hz）. The normal distribution of power values in each frequency band was tested for both groups， and the t-test was used for comparison. Approximate entropy was calculated for EEG in both two groups， and the t-test was used for comparison. Results The θ band was the dominant frequency band of REM EEG in both the control group and the RBD group. Compared with the control group， the RBD group had a significant increase in the absolute power of fast-wave activity on REM α band and significant reductions in δ/α and θ/α relative power ratios. There was a significant difference in EEG ApEn value between the control group and the RBD group （P<0.05）， and the RBD group had a higher ApEn value during REM sleep than the NC group， with a significant difference in EEG ApEn value during the phase of dream-enacting behaviors. Conclusion In the RBD group， there are significant increases in the absolute power and nonlinear approximate entropy of fast-wave activity on REM α band during the ictal period of REM， which reflects the hyperactive functional changes of cerebral cortex during the ictal period of RBD， and the involvement of cerebral cortex in RBD neural pathway disorders is an important supplement to the current theory. Moderate inhibition of cerebral cortex hyperactivity is of great significance for the treatment of RBD.

Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent inflammation and joint damage, accompanied by the accumulation of plasma cells, which contributes to its pathogenesis. Understanding the genetic alterations occurring during plasma cell differentiation in RA can deepen our comprehension of its pathogenesis and guide the development of targeted therapeutic interventions. Here, our study elucidates the intricate molecular mechanisms underlying plasma cell differentiation by demonstrating that PRDX1 interacts with DOK3 and modulates its degradation by the autophagy-lysosome pathway. This interaction results in the inhibition of plasma cell differentiation, thereby alleviating the progression of collagen-induced arthritis. Additionally, our investigation identifies Salvianolic acid B (SAB) as a potent small molecular glue-like compound that enhances the interaction between PRDX1 and DOK3, consequently impeding the progression of collagen-induced arthritis by inhibiting plasma cell differentiation. Collectively, these findings underscore the therapeutic potential of developing chemical stabilizers for the PRDX1-DOK3 complex in suppressing plasma cell differentiation for RA treatment and establish a theoretical basis for targeting PRDX1-protein interactions as specific therapeutic targets in various diseases.

Objective To explore the changes in cognitive neural networks in AD patients at differ-ent stages of disease progression to provide electrophysiological basis for the pathogenesis and early diagnosis and treatment of AD.Methods A total of 84 patients admitted to Department of Neurology of General Hospital of Tianjin Medical University from September 2018 to June 2022 were prospectively recruited,and divided into AD patients group(42 cases)and MCI group(42 cases)according to their disease severity.Another 42 healthy individuals who taking physical examination during the same period were subjected and served as HC group.Post-resting EEG data were analyzed with Matlab software,and coherence analysis was performed by self-programmed program.Univariate analysis of variance was used to compare the interhemispheric and intra-hemispheric coherence values of six frequency bands in the three groups.Results The cohe-rence values of the related electrode pairs in the anterior head(frontal region+anterior tem-poral region)were significantly lower in the AD group than in the HC group(P＜0.05),with the Alpha and Beta dominant bands and dominant hemispheres dominant,while the values of related electrode pairs in the posterior head(temporal region)were obviously higher in the AD group than the HC group(P＜0.05),with the Gamma band dominant.In all the frequency bands except the Alpha band,the AD group had higher coherence values in most of the electrode pairs than the HC group,and the Gamma band was the most extensive.In the MCI group,only the coherence value of the electrodes in the occipito-posterior temporal region(O2-T6)in the right Alpha band was higher than that in the HC group(P＜O.05).Except Gamma band,the coherence value of the related electrode pairs in the frontal region was notably lower in the AD group than the MCI group(P＜0.05),and the Alpha and Beta bands were dominant.The results of interhemispheric cohe-rence showed that most of the electrode pairs in the AD group had higher coherence values than the MCI group in all the frequency bands and the Gamma band(P＜0.05).Conclusion EEG coherence can provide electrophysiological basis for the pathogenesis and early diagnosis of AD.

Objective To explore the clinical efficacy of the regimen based on sacubitril/valsartan and empagliflozin in the treatment of elderly hypertension patients with type 2 diabetes(T2DM)and determine the impact on left ventricular remodeling.Methods A prospective randomized trial was conducted on 100 elderly patients with essential hypertension combined with T2DM admitted in our hospital from January 2022 to January 2023.All of them had left ventricular hypertrophy(LVH).They were randomly divided into an observation group(n=50,empagliflozin combined with sacubitril/valsartan)and a control group(n=50,empagliflozin combined with valsartan).Baseline data,and SBP,DBP,left ventricular ejection fraction,left ventricular mass(LVM),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),and LVM index(LVMI)before and at 3 and 6 months after treatment were recorded and compared between the two groups.The incidence of adverse events was also compared between them.Results Repeated measures ANOVA showed that the values of SBP,DBP,IVST,LVPWT,LVM and LVMI were gradually reduced in the two groups with the extension of treatment time,and reached the lowest levels at 6 months of treatment(Ftime=4.829,10.037,121.202,65.784,214.796,162.801,P＜0.05,P＜0.01).With the elapse of treatment time,the observation group obtained more significant declines in terms of SBP,DBP,IVST,LVPWT,LVM and LVMI(Ftreatment×time=5.252,5.685,4.574,6.239,8.292,11.660,P＜0.05,P＜0.01).The inter-group effect was statistically significant.After 6 months of treatment,the values of above indicators were notably lower in the observation group than the control group(Ftreatment=79.151,97.673,4.250,8.080,9.598,20.091,P＜0.05,P＜0.01).SBP(129.80±7.67 mm Hg vs 138.48±12.35 mm Hg.P＜0.01),DBP(79.76±5.96 mm Hg vs 87.46±9.57 mm Hg,P＜0.01),IVST,LVPWT,LVM and LVMI were obviously lower in the observation group than the control group.Both valsartan+empagliflozin and sacubitril/valsartan+empagliflozin showed good safety.Conclusion Sacubitril/valsartan can effectively improve blood pressure,cardiac function,and left ventricular remodeling in elderly hypertensive patients with T2DM and LVH,with good safety.

Objective:To investigate the clinical and pathological characteristics of primary thoracic synovial sarcoma (PTSS).Methods:Forty-two PTSS cases diagnosed at the Department of Pathology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from October 2011 to April 2024 were analyzed. All cases were retrospectively studied using hematoxylin-eosin staining and immunohistochemistry. Their clinicopathological features were also reviewed. SS18 rearrangement was assessed in 28 cases using fluorescence in situ hybridization (FISH). Next generation sequencing (NGS) was performed on 8 cases.Results:Among the 42 cases, there were 23 biopsies and 19 surgically-removed specimens. One case was a specimen resected after neoadjuvant chemotherapy. There were 22 males and 20 females, with an age ranging from 6 to 68 years. Twenty-nine cases occured in the lung, 6 in mediastinum, 4 in pericardium, 1 in visceral pleura, and 1 in right atrium. One case did not show any unequivocal primary site. Computed tomography showed the tumors were manifested as a cystic mass, a solid mass, or thickening of the pleura and pericardium. Thirty-two cases had respiratory symptoms, while 19 had pleural effusion. One case had a history of radiotherapy for papillary thyroid carcinoma. Nineteen patients were treated with surgery, while 19 were treated with chemotherapy without surgery. Four patients were diagnosed and discharged, without specific treatment on the record. Morphologically, 1 case was biphasic type, 39 cases were monophasic type, and 2 cases were poorly differentiated type. In addition to the typical morphology of synovial sarcoma, tumors also showed pulmonary bullous changes, stromal collagen hyalinization, hemangiopericytoma-like vasculature, stromal edematous myxoid changes, and microcystic structure. Immunohistochemically, all cases were diffusely positive for TRPS1 (22/22), TLE1 (21/22), CD99 (26/26), SS18-SSX (25/25) and INI1 (12/12), including 3 cases with decreased expression of INI1. Twenty-one cases were focally positive for EMA (21/30), 4 cases for SMA (4/23), 2 cases for S-100 (2/28), and 2 cases (2/35) for CKpan. Twenty-eight cases (28/28) had SS18 rearrangement displaying a split signal on FISH analysis. Eight cases were found to have mutations in SMC1A, NOTCH2, CDK12, SPRY4, BRCA1, STK11, NF2, and PDGFRα genes using NGS. Eighteen of the 29 patients survived and 16 showed disease progression.Conclusions:PTSS is more commonly found in the lungs than other sites and has non-classical morphological features of various types, which need to be differentiated from other tumors. TRPS1 is highly expressed in PTSS and has certain diagnostic values. The diagnosis of PTSS also requires combination of patient′s medical history with thorough imaging studies.

Objective: To explore the risk factors of allogeneic blood transfusion during lung transplant surgery and prognostic effects of transfusion by analyzing the basic data, surgical details, laboratory tests results, and intraoperative blood transfusion details during the perioperative period of lung transplant, so as to guide clinical blood use. Methods: A retrospective analysis was conducted on the data of 319 patients who underwent lung transplantation surgery in our hospital from January 2022 to December 2023. The patients were divided into a non-transfusion group (n=70) and a transfusion group (n=249) based on their intraoperative blood transfusion status. The clinical data, surgical details, perioperative laboratory results and other relevant preoperative and postoperative parameters were compared between the two groups, and the postoperative prognosis (improvement, non-recovery, and death) was analyzed. Results: After comparison between the two groups of patients, it was found that the non-transfusion group had higher levels of preoperative Hb (g/L)(144.41±17.66 vs 129.78±20.44), preoperative Hct [43.25(40.23, 47.5) vs 40.7(37, 43.55)], preoperative TBIL (μmol/L)[11.45(9.15, 15.3)vs 9.9(6.88, 13.33)], and postoperative PLT (×10 /L)(167.74±64.43 vs 132.37±54.84) than the transfusion group (all P<0.05). The non-transfusion group had lower levels of preoperative pCO (mmHg)[41.4(37.4, 45.8)vs 45.3(40, 52.48)], postoperative TBIL (μmol/L)[25.45(17.68, 33.95)vs 30.8(21.55, 43.05)], postoperative pH (7.41±0.09 vs 7.45±0.10), bilateral lung transplantation [27(38.6%) vs 157(63.1%)], surgical duration (h) [5(4, 7)vs 6.5(5, 8)], use of ECMO [52(74.3%) vs 232(93.2%)], and intraoperative blood loss (mL)[600(500, 800)vs 1 000(800, 1 500)] compared to the transfusion group (all P<0.05). The items with P<0.1 in the compared indicators were included in the binary logistic regression analysis, and the results showed that bilateral lung transplantation, intraoperative blood loss, preoperative TBIL, postoperative PLT, postoperative TBIL, preoperative pCO2, and postoperative pH were significantly correlated with whether blood transfusion was performed (P<0.05). The P values of the Chi-square test for postoperative improvement and mortality in the non transfusion group and transfusion group were both greater than 0.05, indicating no statistically significant difference in the prognosis rate between the two groups of patients. Conclusion: Bilateral lung transplantation, intraoperative blood loss, preoperative TBIL, and preoperative pCO are risk factors for blood transfusion during lung transplantation. Intraoperative blood transfusion has a significant impact on postoperative PLT, postoperative TBIL, and postoperative pH indicators, but has no significant effect on prognosis. A comprehensive evaluation of laboratory indicators and surgical details can help developing blood transfusion strategies more effectively.

To establish a double fluorescent RT-LAMP that can distinguish between chicken astro-virus(CAstV)and avian nephritis virus(ANV),two sets of specific primers and probes labeled with fluorescent groups were designed by comparing the conserved sequences of CAstV ORF1b gene and ANV ORF1b gene downloaded from GenBank.The CAstV probe was labeled with CY3 fluorophore at the 3'end and the quencher BHQ2 at the 5'end.The ANV probe was labeled with CY3 fluorophore at the 3'end and the quencher BHQ2 at the 5'end.The reaction system of the method was optimized,and specificity,repeatability,interference,sensitivity,and clinical sample detection were performed.The results were compared with RT-qPCR and RT-PCR to verify the ef-fectiveness of the method.The experimental results showed that the established double fluorescence RT-LAMP method could complete the reaction within 60 min,and the optimal reac-tion temperature was 65 ℃.This method only detects ANV and CAstV,with no cross-reactivity to other common avian pathogens.The minimum detection limit of CAstV was 1.4 ×10 2 copies/μL,and the minimum detection limit of ANV was 1.5×10 2 copies/μL.The interference and reproduc-ibility tests were good.Compared with RT-qPCR,the coincidence rates of CAstV and ANV were 97.97％and 98.85％,respectively.In conclusion,the double fluorescence RT-LAMP method estab-lished in this study has the characteristics of rapidity,accuracy,good specificity,high sensitivity and good reproducibility,which is suitable for clinical diagnosis and provides technical support for the epidemiological investigation of CAstV and ANV.

Objectives:To investigate the clinical value of cardiac magnetic resonance imaging(CMR)feature-tracking strain analysis in risk stratification of diabetic heart failure with preserved ejection fraction(HFpEF).Methods:In this retrospective study,a total of 215 patients with diabetic HFpEF who underwent CMR at Chinese Academy of Medical Sciences Fuwai Hospital from January 2012 to December 2018 were included.Myocardial strain parameters were calculated using CMR feature-tracking technology.Patients were followed up by medical records or telephone calls.Composite endpoint event,all-cause death or heart failure hospitalization during follow-up were recorded.Patients were divided into event group and event-free group.Univariable and multivariable Cox proportional hazard regression analyses were performed to determine the risk factors for the outcomes in diabetic HFpEF.The effects of hypertension and obesity on the prognosis of diabetic HFpEF patients and whether they affect the prognostic value of CMR feature-tracking strain analysis were also analyzed.Results:During a follow-up of(7.1±1.8)years,93(43.3%)patients had endpoint events(event group),including 28 all-cause deaths and 65 heart failure hospitalization.Compared with the event-free group(n=122),patients in the event group had significantly lower left ventricular ejection fraction,higher prevalence and extent of late gadolinium enhancement,and significantly reduced global longitudinal strain(GLS),global circumferential strain,global radial strain,and global systolic longitudinal strain rate(all P<0.05).The absolute GLS value was significantly lower in event group than in event-free group,regardless of the presence of hypertension and obesity.Multivariate Cox regression analysis showed that estimated glomerular filtration rate(HR=0.983,95%CI:0.972-0.993,P=0.001),left atrial volume index(HR=1.015,95%CI:1.005-1.026,P=0.004),and GLS(HR=1.142,95%CI:1.060-1.231,P<0.001)were independent risk factors for adverse cardiovascular events in diabetic HFpEF patients.However,adjusted N-terminal pro-brain natriuretic peptide was not an independent prognostic factor.The cut-offvalue of GLS to predict outcome was-14.09%from ROC curve analysis.The Kaplan-Meier curve showed that in patients with and without hypertension and obesity,patients with the GLS>-14.09%had lower event-free survival compared to patients with GLS≤-14.09%(all P<0.05),and the ability of GLS to predict adverse outcomes was not affected by hypertension and obesity.Conclusions:GLS obtained by CMR feature-tracking strain analysis is an independent predictor of adverse outcomes in diabetic HFpEF,and its ability to predict adverse outcomes is independent of hypertension and obesity.

Objective To investigate the regulatory effects and molecular mechanisms of PUS3 on GBM cell malignant behaviors(proliferation,apoptosis,invasion)in vitro,providing potential therapeutic targets for GBM.Methods The expression of PUS3 in GBM was analyzed using the GEPIA2 database.Kaplan-Meier survival analysis evaluated the survival difference between PUS3 high-and low-expression patients.qRT-PCR and Western blot were performed to detect PUS3 expression in normal glial cells(HEB)and GBM cell lines(U87,LN229,U251,T98G).PUS3-stably overexpressing GBM cell lines were constructed.Colony formation,CCK-8 assay,and flow cytometry were used to assess proliferation and apoptosis.Transwell assay evaluated cell invasion.Immunohis-tochemistry(IHC)detected PUS3 expression in GBM patient tissues.Western blot analyzed tumor-related pathway proteins after PUS3 overexpression.Results The expression level of PUS3 is elevated in GBM patient tissues,and the mRNA and protein expression levels in GBM cells are significantly higher than those in HEB cells(P<0.01).After overexpression of PUS3,the proliferation ability of GBM cells was enhanced(P<0.05),the apoptosis rate decreased(P<0.01),and the number of invasive cells increased(P<0.001).Mechanistically,overexpression of PUS3 significantly activates the AKT pathway,and the use of AKT inhibitors in PUS3 overexpressing cells can reverse the pro cancer effect.Conclusion PUS3 is highly expressed in glioblastoma(GBM)and promotes tumor cell proliferation,invasion,and apoptosis inhibition by activating the AKT pathway,suggesting its potential as a therapeutic target for GBM treatment.