ObjectiveTo construct a risk prediction model for frequent acute exacerbations of chronic obstructive pulmonary disease （COPD） under disease-syndrome combination， thus providing decision support for precise clinical intervention. MethodsA total of 2 029 patients with acute exacerbations of COPD admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2020 to August 2024 were retrospectively included. These patients were classified into groups of frequent acute exacerbations （≥2 times/year） and infrequent acute exacerbations （<2 times/year） according to the hospitalization times per year. Risk factors were screened by LASSO regression combined with logistic regression， and a nomogram model was constructed. The model performance was assessed based on the area under the curve （AUC）， calibration curves， and decision curve analysis （DCA）. ResultsThe differences in baseline characteristics between the frequent acute exacerbations group （1 196 cases） and infrequent acute exacerbations group （833 cases） were not statistically significant. LASSO regression combined with multivariate logistic regression screened the following independent risk factors： body mass index （BMI）， hospitalization days， number of smoking years， place of residence， use of noninvasive ventilators， oxygen-demanding therapy， liver cirrhosis， use of systemic glucocorticosteroids， and traditional Chinese medicine syndrome （phlegm and stasis obstructing the lung）. The nomogram model showed good discrimination and calibration in both the training set （AUC=0.748） and validation set （AUC=0.774）. ConclusionThe risk prediction model for frequent acute exacerbations of COPD， integrating traditional Chinese medicine syndrome， constructed in this study has high accuracy. It can provide a scientific basis for early clinical identification of high-risk patients and individualized intervention.

ObjectiveTo investigate whether anti-programmed death-1 （PD-1） monoclonal antibody can enhance the efficacy and safety of argon-helium cryoablation combined with targeted therapy in patients with unresectable hepatocellular carcinoma （uHCC） aged 60 years or older. MethodsA retrospective analysis was performed for the clinical data of 124 patients with advanced uHCC aged 60 years or older who were treated at The Fifth Medical Center of Chinese PLA General Hospital from January 2013 to September 2024. After propensity score matching， 57 patients received cryoablation combined with targeted therapy （double combination group）， while 57 received cryoablation combined with targeted therapy and anti-PD-1 monoclonal antibody （triple combination group）. The indicators for efficacy assessment included objective response rate （ORR）， disease control rate （DCR）， progression-free survival （PFS）， overall survival （OS）， and the incidence rate of adverse events. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves， and the Log-rank test was used for comparison between groups. A Cox proportional-hazards regression model analysis was used to investigate the influencing factors for survival prognosis. ResultsThe triple combination group had a significantly higher ORR than the double combination group （59.6% vs 29.8%， χ²=9.083， P=0.003）， while there was no significant difference in DCR between the two groups （87.7% vs 77.2%， χ²=1.516， P=0.218）， and compared with the double combination group， the triple combination group had significantly longer median PFS （9.1 months vs 4.8 months， χ²=7.813， P=0.005） and median OS （26.1 months vs 13.6 months， χ²=14.199， P<0.001）. The multivariate Cox proportional-hazards regression model analysis showed that triple combination treatment was an independent influencing factor for PFS （hazard ratio ［HR］=0.52， 95% confidence interval ［CI］： 0.35 — 0.78， P=0.001） and OS （HR=0.32， 95%CI： 0.20 — 0.51， P<0.001）. There was no significant difference in the incidence rate of adverse events between the two groups （P>0.05）. ConclusionTriple combination treatment with argon-helium cryoablation， targeted therapy， and anti-PD-1 monoclonal antibody can significantly improve survival benefits in uHCC patients aged 60 years or older， with a controllable safety profile.

Objective To gain insights into the biological characteristics of different populations of Culex tritaeniorhynchus within and around the Yellow Sea wetland from the perspective of the occurrence of resistance, we investigated the levels of resistance to deltamethrin and kdr gene mutation in the wetland and its peripheral areas. Methods Specimens were collected from Cx. tritaeniorhynchus populations at two monitoring sites in the Rare Bird National Nature Reserve and Tiaozi Ni Wetland Scenic Area, and also from two populations in Yancheng City and the Liuhe District of Nanjing, and the resistance of these mosquitoes to deltamethrin was determined using the CDC biotest bottle method. For each concentration of deltamethrin assessed, a random subset of exposed specimens was selected for amplification of the kdr gene fragment, followed by Sanger sequencing to identify and analyze resistance-associated mutations. Results The LC50 levels of deltamethrin among mosquitoes from the four populations in Luhe, Yancheng, the Rare Bird National Nature Reserve and the Tiaozi Ni Wetland Scenic Area were 2.048 5, 7.798 2, 3.473 3, and 17.695 5 mg/mL, respectively, with corresponding concentrations of deltamethrin ranging from 0.005 to 5.000,0.050 to 50.000,0.050 to 25.000 and 0.050 to 50.000 mg/mL, respectively. Furthermore, the ranges of the KT50 values were 11.76-107.43, 67.05-216.30,29.77-107.43 and 28.40-329.51 min; the 1-h knockdown rates were 34.58%-99.15%, 9.52%-43.80%, 55.09%-73.01%, and 10.09%-68.07%; and the 24-h mortality rates were 12.15%-67.52%,9.52%-79.56%,13.17%-82.21%, and 11.01%-78.99%, respectively. With respect to kdr gene mutation, we assayed a total of 63,70,59, and 57 mosquitoes for the four populations, for which we detected L1014F mutation frequencies of 14.29%, 35.00%, 20.34%, and 31.58%, respectively, with a majority of these mutations being heterozygous for resistance. In addition, five adult mosquitoes were identified has having synonymous mutations at site 1011[i. e. , AAT(asparagine)mutation to AAC(asparagine)]. Conclusions Our findings revealed the clear resistance of Cx. tritaeniorhynchus to deltamethrin in the Yancheng region of the Yellow Sea wetland, and the resistance phenotype and kdr frequency of Cx. tritaeniorhynchus in the wetland environment were comparable to those of Cx. tritaeniorhynchus in the wetland environment, thereby indicating that the resistance of different populations of Cx. tritaeniorhynchus was homogeneous under the pressure of different insecticide selection within and around the wetland. However, the underlying mechanisms need to be further studied.

Objective To explore the effects of esophageal vocalization training based on health empowerment model on self-efficiency,self-management ability and vocal function in patients with laryngeal cancer after total laryngectomy.Methods A total of 86 patients with laryngeal cancer who underwent total laryngectomy in The Second Affiliated Hospital of Naval Medical University from January 2023 to June 2024 were selected as the research subjects.The patients returned to the hospital to receive esophageal vocalization training 2 months after surgery.According to the random number table method,patients were assigned to control group(43 cases,receiving routine care)or observation group(43 cases,receiving routine care and nursing based on health empowerment).The training continued for 3 months.The general self efficacy scale(GSES)score,exercise of self-care agency scale(ESCA),voice handicap index(VHI)score,and training compliance were compared between the two groups before and after nursing care.Results After 3 months of vocal training,the GSES and ESCA scores of both groups increased,while VHI score decreased.The observation group had higher GSES and ESCA scores and lower VHI score than the control group(P<0.05).The overall compliance rate of the observation group was higher than that of the control group(P<0.05).Conclusion The esophageal vocalization training based on health empowerment can improve self-efficacy,self-management ability,training compliance,and vocal function in patients with laryngeal cancer after total laryngectomy.

Objective To report the diagnosis and treatment of a case of acute pulmonary embolism caused by thrombus detachment within a popliteal venous aneurysm and conduct a literature review,aiming to enhance the understanding of the disease.Methods The case data of a patient with pulmonary embolism caused by thrombus detachment within a popliteal venous aneurysm who was admitted to the Second Hospital of Lanzhou University were retrospectively analyzed.The relevant literature published from July 2014 to July 2023 in the CNKI and PubMed databases was retrieved,and the diagnosis and treatment methods of the disease were summarized.Results The patient in this case was a 61-year-old male,who was admitted was admitted to the hospital due to"intermittent chest tightness and shortness of breath for 5 days".Color Doppler ultrasound examination and pulmonary artery CT angiography(CTA)suggested popliteal venous aneurysm combined with intramural thrombus and pulmonary embolism.Therefore,the pulmonary embolism and popliteal venous aneurysm were treated surgically in stages.The patient recovered well after the operation and there were no symptoms of chest tightness or shortness of breath after discharge.A total of 11 literatures were retrieved,involving 11 patients,all of whom underwent surgical treatment;Among them,4 patients were treated with inferior vena cava filter placement,and 2 patients underwent popliteal venous aneurysm surgery after filter placement.Through literature review,it can be known that the etiology of popliteal venous aneurysm remains unclear,and there is no unified standard for diagnosis and treatment.Up to now,surgery is still the preferred option for treatment.Conclusions Patients with popliteal venous aneurysms may be asymptomatic but can lead to deep vein thrombosis of the lower limbs and subsequent pulmonary embolism.Surgical intervention is an effective treatment option.For patients with combined pulmonary embolism,especially those with recurrent pulmonary embolism,it is recommended to perform surgical treatment following placement of an inferior vena cava filter.

Objective To investigate the correlation between sleep duration and chest pain in the Chinese population.Methods A cross-sectional analysis was conducted using data on chest pain and sleep duration from 7942 participants in the 2018 China Health and Retirement Longitudinal Study(CHARLS).Among them,1239 had chest pain and 6703 did not;2645 were aged>65 years and 5297 were aged≤65 years.All participants were categorized into three groups based on sleep duration:≤6 h(n=3123),6-8 h(n=2959),and>8 h(n=1860).Differences in characteristics such as gender,age,marital status,education level,diabetes,and hypertension were compared across these groups.Multivariate logistic regression analysis,curve fitting,and threshold effect analysis were further employed to explore the correlation between sleep duration and chest pain.Results A total of 7942 participants were finally included in the study.Among the three groups with sleep duration>8 h,6-8 h and≤6 h,the incidences of chest pain were 12.6%,13.0%,and 19.8%,respectively.Multivariate logistic regression analysis demonstrated that with the increase in sleep duration,the incidence of chest pain showed a decreasing trend[odds ratio(OR)=0.88,95%confidence interval(CI)0.86-0.91,P<0.001].Curve fitting and threshold effect analysis indicated a U-shaped relationship between sleep duration and the risk of chest pain.In the population aged≤65 years,the inflection point for sleep duration was 8.5 h,beyond which the risk of chest pain did not decrease;in the population aged>65 years,the inflection point was 7.7 h,beyond which the risk of chest pain significantly increased(P<0.05).Conclusions There is a U-shape relationship between sleep duration and the risk of chest pain.In the age group≤65 years old,8.5 h is the turning point;in the population>65 years old,7.7 h is the turning point.When the sleep duration is below the turning point,prolonging the sleep time can help reduce the risk of chest pain.It is recommended to maintain an appropriate sleep duration of 6-8 h to reduce the risk of chest pain.

Objective To analyze the effect of sodium cantharidinate and vitamin B6 injection(SCV)on four human hepatocellular carcinoma(HCC)cell lines(SMMC-7721,Bel-7402,Huh7,and HepG2)and explore its mechanism.Methods Normal hepatic cell line L02 was treated with SCV at concentrations of 0 μmol/L(control),0.5,1,2,4,8,16,and 32 μmol/L,and the cytotoxicity of SCV on L02 cells was detected using CCK-8 assay.Human HCC cell lines(SMMC-7721,Bel-7402,Huh7,and HepG2)were cultured.SCV-untreated control group(0 μmol/L)and 2,4,and 8 μmol/L SCV-treated groups were set up.CCK-8 assay,plate cloning formation assay,Transwell assay,wound healing assay,and flow cytometry were used to detect the effects of SCV on the growth and proliferation capacity,colony formation ability,invasion and migration capabilities,cell cycle,and apoptosis of the four hepatocellular carcinoma cell lines,respectively.Western blotting was performed to detect the expression levels of apoptosis-related proteins,including nuclear factor kappa-B subunit p65(p65),B-cell lymphoma 2(Bcl-2),and Caspase-3,and to preliminarily explore the underlying mechanism.Results The CCK-8 assay showed that SCV at 0.5,1,2,4,and 8 μmol/L had no significant cytotoxic effect on L02 cells compared with untreated control group,so 2,4,and 8 μmol/L SCV were selected for subsequent experiments.Compared with the untreated control group(0 μmol/L),SCV at different concentrations(2,4,and 8 μmol/L)significantly inhibited the proliferation of the four HCC cell lines(P<0.001).The plate cloning formation assay showed that SCV at different concentrations(2,4,and 8 μmol/L)significantly reduced the colony formation ability of the four HCC cell lines(P<0.05 or P<0.01 or P<0.001).In addition,Transwell and wound healing assays revealed that SCV at different concentrations(2,4,and 8 μmol/L)significantly inhibited the invasion and migration of HCC cells(P<0.05 or P<0.01 or P<0.001).In the above results,the inhibitory effect of SCV was concentration-dependent.Flow cytometry analysis indicated that SCV arrested cells in the G2/M phase(P<0.05 or P<0.01 or P<0.001)and significantly promoted cell apoptosis(P<0.05 or P<0.01 or P<0.001).Western blotting showed that SCV significantly down-regulated the expression of p65(P<0.05 or P<0.01)and Bcl-2(P<0.05),and up-regulated the expression of Caspase-3(P<0.05 or P<0.01).Conclusions SCV can significantly inhibit the proliferation,colony formation,invasion,and migration of multiple human HCC cell lines and arrest the cell cycle.SCV may inhibit the expression of p65 and Bcl-2,thereby lifting their inhibitory effect on the apoptotic pathway and activating Caspase-3 to promote apoptosis.

The paper introduces Professor JI Laixi's academic thought and clinical experience in treatment of primary open angle glaucoma with "nape-eight-needle" acupotomy. Professor JI Laixi believes that the key pathogenesis lies in "occlusion of xuanfu (subtle orifices) within the eyes and obstruction of meridian pathways". Using the unblocking principle of treatment, taking meridian theory of traditional acupuncture as the core and based on the anatomical principles of structural acupuncture, Professor JI has proposed his academic thought, "treating eye diseases from the nape". In treatment, "nape-eight-needle" acupotomy is adopted, combined with filiform needle acupuncture. It is the advantageous compound therapeutic method, aiming to open xuanfu, restore brain-eye meridian connectivity, harmonize body, qi and mind through systemic regulation, address both the causative factors and symptoms and prevent from blindness. This therapeutic approach provides a new idea for clinical treatment of primary open angle glaucoma.
Humans ; Acupuncture Therapy/history* ; Glaucoma, Open-Angle/therapy* ; Male ; Meridians ; Female ; Acupuncture Points ; Middle Aged ; Aged

Obesity is a worldwide health problem. An imbalance in energy metabolism is an important cause of obesity and related metabolic diseases. Our previous studies showed that inhibition of miR-429 increased the protein level of uncoupling protein 1 (UCP1) in beige adipocytes; however, whether local inhibition of miR-429 in subcutaneous adipose tissue affects diet-induced obesity and related metabolic disorders remains unclear. The aim of this study was to investigate the effect of local overexpression of miR-429 sponge in subcutaneous adipose tissue on obesity and related metabolic disorders. The control adeno-associated virus (AAV) or AAV expressing the miR-429 sponge was injected into mouse inguinal white adipose tissue. Seven days later, the mice were fed a high-fat diet for 10 weeks to induce obesity. The effects of the miR-429 sponge on body weight, adipose tissue weight, plasma glucose and lipid levels, and hepatic lipid content were explored. The results showed that the overexpression of miR-429 sponge in subcutaneous white adipose tissue reduced body weight and fat mass, decreased fasting blood glucose and plasma cholesterol levels, improved glucose tolerance, and alleviated hepatic lipid deposition in mice. Mechanistic investigation showed that the inhibition of miR-429 significantly upregulated the expression of UCP1 in adipocytes and adipose tissue. These results suggest that local inhibition of miR-429 in subcutaneous white adipose tissue ameliorates obesity and related metabolic disorders potentially by upregulating UCP1, and miR-429 is a potential therapeutic target for the treatment of obesity and related metabolic disorders.
Animals ; MicroRNAs/physiology* ; Obesity/metabolism* ; Mice ; Adipose Tissue, White/metabolism* ; Metabolic Diseases ; Subcutaneous Fat/metabolism* ; Male ; Uncoupling Protein 1/metabolism* ; Diet, High-Fat ; Mice, Inbred C57BL