To evaluate the safety of the novel oral cortisol synthesis inhibitor osilodrostat in the treatment of Cushing syndrome (CS) through data mining of real-world databases.

ObjectiveTo systematically evaluate the efficacy and safety of Qi-reinforcing and blood-activating/stasis-expelling Chinese patent medicines in the treatment of coronary microvascular disease （CMD）. MethodsPubMed， Cochrane Library， CNKI， Wanfang Data， and VIP were searched for the randomized controlled trials （RCTs） on the treatment of CMD with Chinese patent medicines for reinforcing Qi and activating blood/expelling stasis with the time interval from inception to December 31， 2023. The primary outcome indicators included the index of microcirculatory resistance （IMR）， coronary flow reserve （CFR）， and corrected TIMI flow frame count （cTFC）. The secondary outcome indicators included symptomatic efficacy， left ventricular ejection fraction （LVEF）， hypersensitive C-reactive protein （hs-CRP）， nitric oxide （NO）， and adverse events. Cochrane risk-of-bias assessment tool 2.0 （RoB 2.0） and Stata 17.0 were used for literature quality evaluation and meta-analysis of the included RCTs. The Grading of Recommendations， Assessment， Development and Evaluation （GRADE） was used to evaluate the quality of evidence. ResultsA total of 36 RCTs were included in this study， involving 3 029 patients. Compared with conventional Western medicine alone， the combined use of Chinese patent medicines for reinforcing Qi and activating blood/expelling stasis and Western medicine reduced the IMR ［mean difference （MD）=-5.93， 95% confidence interval （95%CI） ［-8.73，-3.14］， n=382， P<0.01］， cTFC （MD=-9.35， 95%CI ［-13.94，-4.76］， n=618， P<0.01）， and hs-CRP ［standard mean difference （SMD）=-1.50， 95%CI ［-1.90，-1.11］， n=1 483， P<0.01］， improved the CFR （SMD=1.14， 95%CI ［0.08，2.19］， n=304， P=0.03）， symptomatic efficacy ［relative risk （RR）=1.36， 95%CI ［1.21，1.53］， n=756， P<0.01］， LVEF （MD=4.39， 95%CI ［2.31，6.47］， n=533， P<0.01）， and NO （SMD=3.16， 95%CI ［2.07，4.25］， n=946， P<0.01） of CMD patients. In terms of safety， the combined therapy reduced the occurrence of adverse events in CMD patients （RR=0.49， 95%CI ［0.29，0.82］， n=591， P=0.01）. GRADE showed moderate quality evidence for adverse events， low quality evidence for cTFC， symptomatic efficacy， LVEF， and NO， and very low quality evidence for IMR， CFR， and hs-CRP. ConclusionBased on microcirculatory function indicators， the combined use of Qi-reinforcing and blood-activating/stasis-expelling Chinese patent medicines and Western medicine may further improve the coronary microvascular function in CMD patients with good safety. The above conclusions remain to be verified with high-quality clinical trials.

Objective To explore the relationship between miR-409-3p and miR-325-3p with the efficacy of inter-ventional therapy in patients with primary liver cancer.Methods Ninety-six patients with primary liver cancer who visited Nanyang Central Hospital from October 2021 to January 2024 were regarded as the liver cancer group.All patients underwent transcatheter arterial chemoembolization(TACE)treatment and were separated into an effective group(complete remission,partial remission)and an ineffective group(disease stability,disease progression)based on the treatment effect.Totally 91 patients with liver cirrhosis who underwent treatment in our hospital during the same period were selected as liver cancer group and 98 healthy individuals who received physical examinations during the same period were selected as the healthy group.Serum miR-409-3p,miR-325-3p levels were detected and analyzed for their correlation.Logistic regression was applied to analyze the relevant factors affecting the effi-cacy of TACE treatment.Receiver operating characteristic(ROC)curve was applied to evaluate their predictive value for TACE treatment efficacy of serum miR-409-3p,miR-325-3p levels.Results Compared with the healthy group,the serum level of miR-409-3p and miR-325-3p in the liver cirrhosis group and liver cancer group were re-duced(P＜0.05).Compared with the liver cirrhosis group,the serum level of miR-409-3p and miR-325-3p in the liver cancer group were also reduced(P＜0.05).Compared with the effective group,the serum level of miR-409-3p and miR-325-3p in the ineffective group significantly decreased(P＜0.05).There was a positive correlation between serum level of miR-409-3p and of miR-325-3p in patients with primary liver cancer(r=0.472,P＜0.001).The elevated level of miR-409-3p and miR-325-3p were protective factors for ineffective TACE treat-ment in primary liver cancer patients(P＜0.05).The combination of serum miR-409-3p and miR-325-3p was su-perior to single prediction in predicting efficacy after TACE treatment in primary liver cancer patients(Zcombination-miR-409-3p=4.556,P＜0.001,Zcombination-miR-325-3p=2.613,P＜0.01).Conclusions The serum level of miR-409-3p as well as miR-325-3p is both reduced in patients with primary liver cancer,and is related to the effi-cacy of interventional therapy.

There is a large gap between production and demand of plant oil in China, which leads to the heavy reliance on imports. Diacylglycerol acyltransferase (DGAT) and phospholipid: diacylglycerol acyltransferase (PDAT) are two key enzymes responsible for the synthesis of triacylglycerol, thereby affecting the yield and quality of plant oil. This paper comprehensively reviews the research progress in DGAT and PDAT in terms of their biological functions in plant oil synthesis, the molecular mechanisms of regulating plant lipid metabolism, growth, and development under stress, and their roles in driving oil synthesis under the background of synthetic biology. Furthermore, future research and application of DGAT and PDAT are prospected. This review aims to provide a basis for deeply understanding the molecular mechanism of plant oil synthesis and improving the quality and productivity of oil crops by the utilization of DGAT and PDAT genes.
Diacylglycerol O-Acyltransferase/physiology* ; Plant Oils/metabolism* ; Acyltransferases/metabolism* ; Lipid Metabolism/genetics* ; Gene Expression Regulation, Plant ; Triglycerides/biosynthesis*

Acromegaly is a rare disease characterized by the overproduction of growth hormone(GH)and insulin-like growth factor-1(IGF-1), which affects multiple organ systems and increases mortality risk.As the population ages, the number of elderly patients with acromegaly is rising annually, leading to more pronounced systemic complications and significantly impacting quality of life(QoL). However, there is limited data in the literature regarding the assessment of acromegaly complications in the elderly.Therefore, to enhance our understanding of acromegaly in this demographic, the present review focuses on the epidemiology, diagnosis, complication assessment, and therapeutic prognosis of acromegaly in elderly patients.

Objective:To investigate the influence of prealbumin on cerebral infarction severity, hemorrhage transformation and 1-year prognosis.Methods:A retrospective study was conducted to select 752 patients with cerebral infarction who were treated in Beijing Tiantan Hospital,Capital Medical University from December 2018 to December 2019 as the study objects. Personal information and laboratory indicators of the patients were collected including prealbumin, hemoglobin, white blood cell count, etc.Patients were divided into group B1 (<238 mg/L) and group B2 (≥238 mg/L) based on median prealbumin. By inquiry patient's case, NIHSS score (<16 was classified as mild, ≥16 as moderate and severe)and cerebral infarction volume (<20 cm 3 as small infarct, >20 cm 3 as large infarct) were recorded to evaluate the severity of the disease, and whether hemorrhage transformation occurred during hospitalization was recorded. Patients were followed up 1 year after discharge, and prognostic information of patients was recorded, including neurological function recovery (mRS score <3 was classified as good recovery, ≥3 as poor recovery),all-cause case fatality rate, and recurrence of cardio-cerebrovascular events. Normally distributed measurement data were expressed as xˉ±s, non-normally distributed measurement data were expressed as median and quartiles[ M( Q1, Q3)], categorical variable were expressed as ratio and percent(%). Comparison between groups of measurement data were performed by independent sample t test and Mann-Whitney U test. Chi-square test were used on comparison between groups of categorical variable. Single-factor comparison, Spearman correlation analysis and multiple Logistic regression were used to analyze the correlation between prealbumin and other laboratory indicators, cerebral infarction severity, hemorrhage transformation and 1-year prognosis, respectively. Results:The NIHSS score and infarct volume of patients in group B1 were 5(2,10) and 3.18(0.72,18.00) cm 3, and those in group B2 were 3(2,7) and 2.0(0.5,10.0) cm 3, respectively, which were higher in group B1 than in group B2, the differences were statistically significant ( Z=3.85, P<0.001, Z=2.81, P=0.005). The proportion of mRS Score ≥3 in group B1 was 28.8%(107/371), and the all-cause case fatality rate was 7.5%(28/371), both higher than 20.5%(78/381) and 3.1%(12/381) in group B2, with statistical significance ( χ2=7.10, P=0.008, χ2=7.22, P=0.007). Hemorrhage transformation and recurrence of cardio-cerebrovascular events were 13.5%(50/371) and 11.6%(43/371) in group B1 and 9.2% (35/381) and 8.7%(33/381) in group B2, respectively, with no significant difference between the two groups ( χ2=3.45, P=0.063, χ2=1.78, P=0.183). Multivariate logistic regression analysis showed that, after adjusted for potential confounding factors, prealbumin was protective factor of NIHSS ( OR and 95% CI: 0.990(0.984-0.997), P=0.035), poor neurological recovery(mRS≥3) ( OR and 95% CI:0.992(0.988-0.997), P<0.001) and all-cause case fatality rate ( OR and 95% CI:0.991(0.983-0.999), while prealbumin had no significant influence on cardiocerebrovascular recurrence events ( OR and 95% CI: 0.999(0.993-1.005), P=0.729). Conclusion:Prealbumin is significantly associated with the severity of cerebral infarction and poor prognosis 1 year after discharge, and low prealbumin was an independent risk factor for NIHSS score(≥16), poor neurological recovery (mRS≥3) and all-cause case fatality rate.

Objectives:To explore the effects of infarct volume, infarct type, inflammation, and coagulation indicators on hemorrhagic transformation in patients with acute cerebral infarction.Methods:711 patients with cerebral infarction admitted to Beijing Tiantan Hospital were retrospectively included as the study objects from December 2018 to December 2019 [535 males and 176 females, age 22-95 years, mean age (59.6±12.1) years]. Clinical data, laboratory indicators such as inflammation and coagulation function of patients were collected, and information such as location, volume and type of infarction were recorded. The patients were divided into hemorrhage transformation group and non-hemorrhage transformation group according to whether hemorrhage transformation occurred during hospitalization. Normally distributed measurement data were expressed as xˉ± s, non-normally distributed measurement data were expressed as median and quartiles [ M( Q1, Q3)], categorical variable were expressed as ratio and percent (%). Comparison between groups of measurement data were performed by independent sample t test and Mann-Whitney U test. χ2 test were used on comparison between groups of categorical variable. Univariate comparison and multivariate Logistic regression were used to analyze the correlation between hemorrhage transformation and infarct volume, infarction type and laboratory indicators, respectively, to explore the risk factors of hemorrhage transformation. ROC curve analysis was used to evaluate the diagnostic value of indicators. Results:The rates of coronary heart disease and atrial fibrillation history in the hemorrhage transformation group were 23.5% (20/85) and 22.4% (19/85), respectively, which were significantly higher than those in the non-hemorrhage transformation group (13.9% (87/626) and 5.8% (36/626), respectively), and the difference between the two groups was statistically significant ( χ2=5.43, χ2=28.90, P=0.020, P<0.001, respectively). The NIHSS score [10(4,17) points] and infarct volume [46.50 (14.21,118.42) mL] in the hemorrhage transformation group were significantly higher than those in the non-hemorrhage transformation group [4(2,7) points, 2.00(0.51,8.94) mL]. The difference between the two groups was statistically significant ( Z values were 6.69 and 10.69, respectively, P<0.001). The results of multivariate Logistic regression analysis showed that atrial fibrillation (OR=2.604, 95% CI: 1.186-5.716, P=0.107), infarct volume (OR=1.009, 95% CI: 1.004-1.015, P=0.001), infarct type of Chinese ischemic stroke subclassfication (OR=1.371, 95% CI: 1.085-1.731, P=0.008) and neutrophil/lymphocyte ratio (OR=1.047, 95% CI: 1.006-1.090, P=0.023) were independent risk factors for hemorrhage transformation. ROC curve analysis showed that the area under curve (AUC) of infarct volume and neutrophil/lymphocyte ratio were 0.861 (0.821-0.901) and 0.684 (0.626-0.741), respectively, which were effective in predicting hemorrhage transformation after cerebral infarction. The prediction of infarct volume was more efficient. Conclusion:History of atrial fibrillation, classification of cardioembolic stroke, infarct volume, and neutrophil/lymphocyte ratio are all risk factors for hemorrhagic transformation after acute cerebral infarction.

Objective:To identify the characteristics of research on scalp acupuncture in the treatment of post-stroke cognitive impairment (PSCI).Methods:This was a bibliometric analysis. We selected relevant studies from both Chinese databases (China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and WanFang Data Knowledge Service Platform) and English databases (Web of Science, PubMed, and Scopus) from their inception to December 2023. The CiteSpace software was used to perform visual-based analyses of publication trends, collaborative networks among countries and institutions, author collaboration networks, and research hotspots.Results:We included 730 Chinese studies and 112 English-language studies. From 2004 to 2023, the number of publications on scalp acupuncture for PSCI showed an increasing trend. All Chinese studies were published in China, mainly by universities, and the institutional collaboration density was low (0.002 9). For English-language studies, China had the most publications (103), followed by the USA (7) and Germany (3). Chinese universities were the main publishing institutions, and the density of inter-institutional collaboration (0.183 3) was higher than that for Chinese literature. The density of the author collaboration network was 0.005 0 for Chinese studies and 0.023 8 for English-language studies. In Chinese studies, the most frequent keywords with a centrality greater than 0.1 were cognitive impairment (248 times), stroke (240 times), needling (162 times), cerebral infarction (82 times), and electroacupuncture (80 times). In English-language studies, these were stroke (40 times), cognitive impairment (32 times), acupuncture (15 times), dementia (15 times), ischemic stroke (10 times), and mechanism (7 times). For Chinese studies, the top 3 clusters focused on clinical studies of the effects of scalp acupuncture on PSCI. In English-language studies, the top 4 clusters mainly involved research on the effects and assessment methods of scalp acupuncture for PSCI. The timeline map of keywords in Chinese studies showed that before 2015, the high-frequency keywords were stroke, cognitive impairment, needling, electroacupuncture, scalp acupuncture, body acupuncture, rehabilitation, moxibustion, and clinical research. From 2015 onwards, keywords such as rat, apoptosis, inflammatory factors, mechanism research, signaling pathways, mice, and animal experiments appeared. The timeline map of keywords in English-language studies showed that before 2013, there were few accumulated keywords. After 2013, high-frequency keywords included "multi-infarction rat""computer-based cognitive training""apoptosis""electroacupuncture""mild cognitive impairment""randomized controlled trial""scalp acupuncture""post-stroke cognitive impairment""stroke rehabilitation""systematic review" and "hippocampal CA1 region". In Chinese studies, keywords with high burst intensity included cerebral infarction, acupuncture therapy, vascular, baihui (GV-20), review, learning and memory, and scalp acupuncture. In English-language studies, these included "multi-infarction rat""mild cognitive impairment""electroacupuncture""post-stroke cognitive impairment"and"systematic review".Conclusions:Research in this field has grown rapidly in recent years. Chinese studies focus mainly on the clinical effects of scalp acupuncture for PSCI, while English-language studies focus more on related mechanisms. Furthermore, both Chinese and English-language studies show good consistency in the focus of experimental research, which mainly focuses on the mechanisms of electroacupuncture in the treatment of PSCI.

Objective:To construct a device-related pressure injury prevention program for orthopedic patients based on evidence-based and SSKINS (S: skin, S: surface, K: keep moving, I: incontinence, N: nutrition, S: self-care) clinical management model, and to provide reference for clinical nursing practice.Methods:In June 2023, a research team was set up to retrieve the literature related to device-related pressure injury in orthopedic patients, and the evidence was extracted and screened with reference to the SSKINS clinical management model, and the first draft of the protocol was formulated based on clinical practice. The final plan was determined through two rounds of expert consultations from October to December 2023.Results:The response rate of the two rounds of expert correspondence was 100%(20/20). The expert authority coefficients were 0.897 and 0.907, the overall Kendall coordination coefficients of the two rounds were 0.116 and 0.136 respectively, and the Kendall coordination coefficients of all levels were 0.104-0.213 (all P<0.001). The final protocol contains 6 first-level items (assessment and examination, the use and adjustment of device, prophylactic dressings, skin protection, nutritional support, health education) and 31 second-level items. Conclusions:The proposed orthopedic device-related pressure injury prevention program is scientific and practical, and can provide a reference for the prevention and management of clinical medical staff.

AIM:To analyze the characteristics and correlation of phacoemulsification parameters and anterior segment parameters in cataract patients with different blood glucose levels.METHODS:A total of 45 type 2 diabetic cataract patients(45 eyes)treated in our hospital from March 2023 to April 2024 were stratified into two groups based on glycosylated hemoglobin(HbA1c)levels: group A: HbA1c <7%(n=18)and group B: 7%≤HbA1c<8.5%(n=27); a total of 94 age-matched age-related cataract patients(94 eyes)were enrolled as the control group(group C). All underwent phacoemulsification with intraocular lens implantation. Anterior segment parameters, including corneal, lens and anterior chamber measurements, were recorded. Correlations between phacoemulsification parameters and anterior segment parameters were analyzed, and differences among groups were compared.RESULTS: In groups A and B, effective phacoemulsification time(EPT)negatively correlated with corneal endothelial cell density(CECD)(r=-0.315, P=0.035). Average phacoemulsification time(APT)positively correlated with the anterior corneal surface radius of curvature(Rm; r=0.402, P=0.006)and negatively correlated with the flat axis meridian curvature(K1), steep axis meridian curvature(K2), mean curvature(Km)of the anterior corneal surface, and lens density at 6 mm zones(PDZ3; all P<0.05). Average phacoemulsification energy(AVE)positively correlated with mean lens density(LD-mean), lens density at 2 mm zones(PDZ1), lens density at 4 mm zones(PDZ2), and PDZ3(all P<0.05), and negatively with pupil diameter(r=-0.385, P=0.009). In the group C, EPT showed a positive correlation with Pentacam nucleus staging(PNS)density grade, PDZ1, PDZ2, and PDZ3(all P<0.05). A positive correlation was observed between AVE and PNS classification(r=0.246, P=0.018). Conversely, AVE exhibited a negative correlation with CECD(r=-0.245, P=0.018). EPT in groups A and B was higher than that in the group C(P<0.05). Both EPT and APT in the group B were higher than those in the group A(P<0.05). In diabetic cataract patients, CECD, corneal density(CD), and posterior corneal surface height positively correlated with diabetes duration(P<0.05). Posterior corneal surface K1 and Rm positively correlated with 7%≤HbA1c<8.5%(P<0.05). Total corneal astigmatism negatively correlated with HbA1c, 2-hour post-breakfast blood glucose(2hPBG), and fasting insulin(FINS; P<0.05). CD and lens thickness(LT)positively correlated with FINS(P<0.05).CONCLUSION: Phacoemulsification parameters and blood glucose-related indices exhibited varying degrees of correlation with anterior segment parameters in cataract patients with different blood glucose levels. EPT in diabetic cataract patients was higher than that in age-related cataract patients, while EPT and APT in diabetic cataract patients with poor glycemic control were higher than those with good glycemic control.