Objective To construct a predictive model for cerebral small vessel disease (CSVD) MRI burden based on β2-microglobulin (β2-MG) and lipoprotein(a) [Lp(a)], analyze its predictive value, and validate the model. Methods A total of 138 CSVD patients admitted to Anhui No.2 Provincial People’s Hospital from February 2023 to August 2024 were enrolled. Patients were divided into a low-burden group (n=63) and a moderate/severe burden group (n=75) according to the CSVD MRI burden scoring criteria. The related clinical data were compared between the two groups. Binary logistic regression analysis was used to identify independent factors for CSVD moderate/severe MRI burden. A nomogram predictive model was constructed based on these factors and its performance was evaluated. Results The proportions of male patients, as well as those with a history of diabetes or hypertension, were significantly higher in the moderate/severe burden group than those in the low burden group. Additionally, the age of patients in the moderate/severe burden group was significantly older, and the levels of β2-MG, Lp(a), and homocysteine (Hcy) were higher than those in the low burden group (P＜0.01). Binary logistic regression analysis revealed that hypertension, diabetes, β2-MG, and Lp(a) were independent factors for CSVD moderate/severe MRI burden (P＜0.05). The nomogram predictive model based on these four factors had a cut-off value of 0.467 0, with an area under curve (AUC) of 0.838 7 (95%CI 0.760 8-0.916 6) in the training set (n＝97) and 0.854 1 (95%CI 0.742 1-0.966 1) in the internal validation set (n＝41) . The calibration curve demonstrated good agreement between predicted and observed values. Decision curve analysis (DCA) indicated that the nomogram model had good clinical utility. Conclusions The nomogram model based on β2-MG and Lp(a) has high predictive performance in assessing the risk of CSVD moderate/severe MRI burden, with good discrimination and calibration.

Objective: To analyze the serological characteristics of anti-Mur antibodies and investigate the distribution frequency of the Mur antigen among voluntary blood donors in Shiyan, thereby providing a basis for guiding clinical transfusion and establishing a Mur blood type database. Methods: ABO blood grouping of donors and patients was performed using an automated blood typing analyzer and the gel card method, respectively. Unexpected antibody screening and identification were performed using the saline, tube anti-human globulin, and polybrene methods. The specificity of anti-Mur antibodies was confirmed using Fisher's exact probability test. Plasma treated with 2-mercaptoethanol was used to distinguish IgM and IgG antibodies. IgM and IgG anti-Mur titers were determined by the saline tube method and the anti-human globulin tube method, respectively, at 4℃, room temperature, and 37℃. A total of 1 659 donor red blood cell samples were initially screened for the Mur antigen phenotype using three samples of human-derived anti-Mur plasma by the micro-tube method. Donors who tested positive for Mur antigen were further tested by the direct antiglobulin test (DAT); those with negative results were confirmed for Mur antigen by the gel card and polybrene methods. Results: Three blood samples were identified to contain mixed IgG and IgM anti-Mur antibodies. The titers of both IgM and IgG anti-Mur antibodies were highest at 4℃, intermediate at room temperature, and lowest at 37℃. The positive frequency of the Mur antigen among voluntary blood donors in Shiyan was 1.99% (33/1 659). Conclusion: anti-Mur antibodies were detected in both blood donors and patients in our region. The Mur antigen shows a certain distribution frequency among voluntary blood donors in Shiyan. Screening for the Mur blood type and establishing a corresponding database could enhance transfusion safety.

To explore the effect and mechanism of sodium propionate and mixed short-chain fatty acids on colitis induced by Citrobacter rodentium (C.r.) in mice. Mice were induced by oral gavage of C.r. The C.r. growth monitoring, histopathological analysis, qPCR analysis, intestinal permeability test and flow cytometry was used to study the effects of sodium propionate and mixed short-chain fatty acids on intestinal infection. The results showed that sodium propionate could inhibit the growth of C.r. more effectively than mixed short-chain fatty acids. Results of animal experiments showed that sodium propionate significantly reduced the weight loss and intestinal bacterial output in mice. Meanwhile, compared with mixed short chain fatty acids, sodium propionate effectively alleviated the pathological manifestations of colonic inflammatory infiltration, destruction of epithelial cell structure and decrease of goblet cell caused by C.r. infection, also increased the levels of antimicrobial peptides like interleukin-17 (IL-17) and regenerated islet derived protein 3γ (Reg3γ). In addition, sodium propionate decreased intestinal permeability better than mixed short-chain fatty acids, and sodium propionate significantly induced T helper cells 17 (Th17) and regulatory T cells (Treg) differentiation. The results showed that sodium propionate significantly alleviated colitis induced by C.r. infection compared with mixed short-chain fatty acids, which may be related to its inhibition of C.r. growth and enhancement of intestinal anti-infective function. The expected results can provide a safer and effective treatment strategy and scientific basis for colitis.

Objective:To investigate the mechanism through which ginsenoside Re enhances lipid metabolism and mitochondrial function in H9C2 cardiomyocytes induced by high glucose and high fat, specifically by modulating AMP-activated protein kinase(AMPK)and specificity protein 1(Sp1).Methods:The H9C2 cardiomyocyte model was cultured in a high-glucose and high-lipid(HGHL)environment.Six groups were established: a control group(CON group), a model group(HGHL group), a ginsenoside Re 60 μmol/L group(Re 60 μmol/L), a model+ ginsenoside Re 20 μmol/L group(HGHL+ Re 20 μmol/L), a model+ ginsenoside Re 40 μmol/L group(HGHL+ Re 40 μmol/L), and a model+ ginsenoside Re 60 μmol/L group(HGHL+ Re 60 μmol/L).Cell morphology was assessed using hematoxylin and eosin(HE)staining, while intracellular oil and triglyceride content were evaluated using oil red O staining.Reactive oxygen species(ROS)levels were measured with a fluorescence kit, apoptosis was assessed using TUNEL staining, and the expressions of phosphorylated AMPK, Sp1, nuclear respiratory factor 1(Nrf1), and peroxisome proliferator-activated receptor gamma coactivator 1 alpha(PGC1α)were analyzed via Western blotting.Results:Compared to the control group, the model group exhibited significant increases in cell hypertrophy, ROS levels, apoptosis, and intracellular TG.Conversely, the expressions of pAMPK, Nrf1, and PGC1α were significantly decreased, while the expression of Sp1 was significantly increased( P<0.05).Compared to the model group, treatment with Ginsenoside Re at concentrations of 20 μmol/L, 40 μmol/L, and 60 μmol/L significantly improved cell hypertrophy, reduced ROS levels, alleviated apoptosis, and decreased intracellular TG levels.Additionally, the expressions of pAMPK, Nrf1, and PGC1α were significantly increased, while Sp1 expression was significantly decreased in a dose-dependent manner( P<0.05). Conclusions:Ginsenoside Re enhances lipid metabolism, mitigates mitochondrial oxidative stress, and reduces apoptosis in H9C2 cardiomyocytes induced by high glucose and high lipid conditions.This effect is associated with the regulation of AMPK and Sp1 proteins, leading to increased expressions of pAMPK, Nrf1, and PGC-1α, and decreased expression of Sp1.

Objective To investigate the corr-elation between MRI burden and inflammatory factors and depression in elderly patients with cerebral small vessel disease(CSVD).Methods The clinical data of 150 patients with CSVD confirmed by brain MRI(CSVD group)and 40 patients with normal brain MRI(control group)were collected.The Hamilton depression rating scale 17-item(HAMD-17)was used to evaluate the degree of depression of the patients.The differences in CSVD burden,inflammatory markers and risk factors between the depressed group and the non-depressed group were compared,and the predictive value of the three and their combined predictions on depression were analyzed.The difference and correlation of HAMD-17 item scale scores between control group and CSVD group were compared.Results There were statistically significant differences in women,stress level,and high-sensitivity C-reactive protein(hs-CRP)level between the depressed group and the non-depressed group(all P＜0.05).Logistic regression analysis showed that CSVD burden degree,female,and hs-CRP were independent risk factors for depression(all P＜0.05).The ROC curve showed that the cut-off value of CSVD burden for depression was moderate,the sensitivity was 73％,the specificity was 47％,and the area under the curve(AUC)was 0.648(95％CI:0.558-0.738,P=0.002);the cut-off value of hs-CRP for depression was 3.73 mg/L,the sensitivity was 60％,the specificity was 73％,and the AUC area was 0.657(95％CI:0.566-0.748,P=0.001);the sensitivity of gender to depression was 68％,the specificity was 52％,and the AUC area was 0.597(95％CI:0.505-0.690,P=0.045).The combined sensitivity and specificity of the three were 70％and 73％,and the AUC area was 0.738(95％CI:0.656-0.820,P＜0.001).Compared with that in the control group,the HAMD-17 score of patients in the mild,moderate and severe burden groups were significantly increased(H=21.854,P＜0.001).Spearman correlation analysis showed that CSVD burden was positively correlated with HAMD-17 score(r=0.330,P＜0.001).Conclusions CSVD burden,female and elevated hs-CRP are independent risk factors for depression in elderly patients with CSVD.The degree of CSVD burden is positively correlated with depression score,and the accuracy of the combined prediction model is high,which has certain predictive value for senile depression.

Evolocumab is a lipid-lowering agent used to reduce low-density lipoprotein cholesterol levels and decrease the all-cause mortality rate of cardiovascular diseases.There are few ocular adverse reactions when the drug is used clinically.This article reports a case of primary angle-closure glaucoma.After three sessions of lipid-lowering treatment with the proprotein convertase subtilisin type 9(PCSK9)inhibitor Evolocumab,the patient developed swelling and pain in the left eye and blurred vision.Ophthalmic examination revealed a significant increase in intraocular pressure in the left eye,suggesting an acute attack of angle-closure glaucoma.After treatment,the intraocular pressure dropped to the normal level.This article discusses this case and reviews relevant literature,suggesting that when using PCSK9 inhibitors in clinical practice,the ocular conditions of patients should be closely monitored,especially for those with risk factors for glaucoma.

Background: Maturity-onset diabetes of the young (MODY) due to variants of hepatocyte nuclear factor 1-beta (HNF1β) (MODY5) has not been well studied in the Chinese population. This study aimed to estimate its prevalence and evaluate the application of a clinical screening method (Faguer score) in Chinese early-onset diabetes (EOD) patients. Methods: Among 679 EOD patients clinically diagnosed with type 2 diabetes mellitus (age at diagnosis ≤40 years), the exons of HNF1β were sequenced. Functional impact of rare variants was evaluated using a dual-luciferase reporter system. Faguer scores ≥8 prompted multiplex ligation-dependent probe amplification (MLPA) for large deletions. Pathogenicity of HNF1β variants was assessed following the American College of Medical Genetics and Genomics (ACMG) guidelines. Results: Two rare HNF1β missense mutations (E105K and G454R) were identified by sequencing in five patients, showing functional impact in vitro. Another patient was found to have a whole-gene deletion by MLPA in 22 patients with the Faguer score above 8. Following ACMG guidelines, six patients carrying pathogenic or likely pathogenic variant were diagnosed with MODY5. The estimated prevalence of MODY5 in Chinese EOD patients was approximately 0.9% or higher. Conclusion MODY5 is not uncommon in China. The Faguer score is helpful in deciding whether to perform MLPA analysis on patients with negative sequencing results.

Background: Maturity-onset diabetes of the young (MODY) due to variants of hepatocyte nuclear factor 1-beta (HNF1β) (MODY5) has not been well studied in the Chinese population. This study aimed to estimate its prevalence and evaluate the application of a clinical screening method (Faguer score) in Chinese early-onset diabetes (EOD) patients. Methods: Among 679 EOD patients clinically diagnosed with type 2 diabetes mellitus (age at diagnosis ≤40 years), the exons of HNF1β were sequenced. Functional impact of rare variants was evaluated using a dual-luciferase reporter system. Faguer scores ≥8 prompted multiplex ligation-dependent probe amplification (MLPA) for large deletions. Pathogenicity of HNF1β variants was assessed following the American College of Medical Genetics and Genomics (ACMG) guidelines. Results: Two rare HNF1β missense mutations (E105K and G454R) were identified by sequencing in five patients, showing functional impact in vitro. Another patient was found to have a whole-gene deletion by MLPA in 22 patients with the Faguer score above 8. Following ACMG guidelines, six patients carrying pathogenic or likely pathogenic variant were diagnosed with MODY5. The estimated prevalence of MODY5 in Chinese EOD patients was approximately 0.9% or higher. Conclusion MODY5 is not uncommon in China. The Faguer score is helpful in deciding whether to perform MLPA analysis on patients with negative sequencing results.

Background: Maturity-onset diabetes of the young (MODY) due to variants of hepatocyte nuclear factor 1-beta (HNF1β) (MODY5) has not been well studied in the Chinese population. This study aimed to estimate its prevalence and evaluate the application of a clinical screening method (Faguer score) in Chinese early-onset diabetes (EOD) patients. Methods: Among 679 EOD patients clinically diagnosed with type 2 diabetes mellitus (age at diagnosis ≤40 years), the exons of HNF1β were sequenced. Functional impact of rare variants was evaluated using a dual-luciferase reporter system. Faguer scores ≥8 prompted multiplex ligation-dependent probe amplification (MLPA) for large deletions. Pathogenicity of HNF1β variants was assessed following the American College of Medical Genetics and Genomics (ACMG) guidelines. Results: Two rare HNF1β missense mutations (E105K and G454R) were identified by sequencing in five patients, showing functional impact in vitro. Another patient was found to have a whole-gene deletion by MLPA in 22 patients with the Faguer score above 8. Following ACMG guidelines, six patients carrying pathogenic or likely pathogenic variant were diagnosed with MODY5. The estimated prevalence of MODY5 in Chinese EOD patients was approximately 0.9% or higher. Conclusion MODY5 is not uncommon in China. The Faguer score is helpful in deciding whether to perform MLPA analysis on patients with negative sequencing results.

Background: Maturity-onset diabetes of the young (MODY) due to variants of hepatocyte nuclear factor 1-beta (HNF1β) (MODY5) has not been well studied in the Chinese population. This study aimed to estimate its prevalence and evaluate the application of a clinical screening method (Faguer score) in Chinese early-onset diabetes (EOD) patients. Methods: Among 679 EOD patients clinically diagnosed with type 2 diabetes mellitus (age at diagnosis ≤40 years), the exons of HNF1β were sequenced. Functional impact of rare variants was evaluated using a dual-luciferase reporter system. Faguer scores ≥8 prompted multiplex ligation-dependent probe amplification (MLPA) for large deletions. Pathogenicity of HNF1β variants was assessed following the American College of Medical Genetics and Genomics (ACMG) guidelines. Results: Two rare HNF1β missense mutations (E105K and G454R) were identified by sequencing in five patients, showing functional impact in vitro. Another patient was found to have a whole-gene deletion by MLPA in 22 patients with the Faguer score above 8. Following ACMG guidelines, six patients carrying pathogenic or likely pathogenic variant were diagnosed with MODY5. The estimated prevalence of MODY5 in Chinese EOD patients was approximately 0.9% or higher. Conclusion MODY5 is not uncommon in China. The Faguer score is helpful in deciding whether to perform MLPA analysis on patients with negative sequencing results.