Acute respiratory distress syndrome (ARDS) is a common respiratory emergency, but current clinical treatment remains at the level of symptomatic support and there is a lack of effective targeted treatment measures. Our previous study confirmed that inhalation of hydrogen gas can reduce the acute lung injury of ARDS, but the application of hydrogen has flammable and explosive safety concerns. Drinking hydrogen-rich liquid or inhaling hydrogen gas has been shown to play an important role in scavenging reactive oxygen species and maintaining mitochondrial quality control balance, thus improving ARDS in patients and animal models. Coral calcium hydrogenation (CCH) is a new solid molecular hydrogen carrier prepared from coral calcium (CC). Whether and how CCH affects acute lung injury in ARDS remains unstudied. In this study, we observed the therapeutic effect of CCH on lipopolysaccharide (LPS) induced acute lung injury in ARDS mice. The survival rate of mice treated with CCH and hydrogen inhalation was found to be comparable, demonstrating a significant improvement compared to the untreated ARDS model group. CCH treatment significantly reduced pulmonary hemorrhage and edema, and improved pulmonary function and local microcirculation in ARDS mice. CCH promoted mitochondrial peripheral division in the early course of ARDS by activating mitochondrial thioredoxin 2 (Trx2), improved lung mitochondrial dysfunction induced by LPS, and reduced oxidative stress damage. The results indicate that CCH is a highly efficient hydrogen-rich agent that can attenuate acute lung injury of ARDS by improving the mitochondrial function through Trx2 activation.

Objective To analyze the value of serum neutrophil count (NEUT), homocysteine (Hcy), adiponectin (APN) and blood glucose in predicting the occurrence of acute myocardial infarction (AMI) in patients with coronary heart disease. Methods The clinical data of 98 patients with coronary heart disease who were admitted to the hospital from March 2022 to March 2024 were collected retrospectively. Patients included were divided into AMI group (n=33) and non-AMI group (n=65) according to the presence and absence of AMI. Baseline data, complications, ultrasound examination data and laboratory examination data were collected. Multivariate logistic regression analysis was performed to identify the influencing factors of AMI in patients with coronary heart disease. The receiver operating characteristic curves were used to evaluate the predictive value of NEUT, Hcy, APN and blood glucose for AMI in patients with coronary heart disease. Results The levels of fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2hPG), glycosylated hemoglobin (HbA1c), NEUT, APN, Hcy, N-terminal pro B-type natriuretic peptide (NT-proBNP), C-reactive protein (CRP), red blood cell distribution width (RDW) and white blood cell (WBC) in the AMI group were higher than those in the non-AMI group (P<0.05). Logistic regression analysis found that FPG, 2hPG, HbA1c, NEUT, APN, Hcy, NT-proBNP, CRP, RDW, and WBC were independent influencing factors of AMI in patients with coronary heart disease (P<0.05). ROC curves indicated that the levels of FPG, 2hPG, HbA1c, NEUT, APN and Hcy were abnormally elevated in patients with coronary heart disease. Above indicators were helpful for predicting the occurrence of AMI. The area under the curve (AUC) and sensitivity of FPG for predicting AMI in patients with coronary heart disease were the best (P<0.05). Conclusion Abnormal elevated levels of FPG, 2hPG, HbA1c, NEUT, APN and Hcy are independent risk factors for AMI in patients with coronary heart disease. All of these indicators have predictive value.

ObjectiveFat infiltration has been shown to be closely related to muscle mass loss and a variety of muscle diseases. This study proposes a method based on phase-angle electrical impedance tomography (ΦEIT) to visualize the electrical characteristic response caused by muscle fat infiltration, aiming to provide a new technical means for early non-invasive detection of muscle mass deterioration. MethodsThis study was divided into two parts. First, a laboratory pork model was constructed to simulate different degrees of fat infiltration by injecting1 ml or 2 ml of emulsified fat solution into different muscle compartments, and the phase angle images were reconstructed using ΦEIT. Second, a human experiment was conducted to recruit healthy subjects (n=8) from two age groups (20-25 years old and 26-30 years old). The fat content percentage η_fat of the left and right legs was measured by bioelectrical impedance analysis (BIA), and the phase angle images of the left and right calves were reconstructed using ΦEIT. The relationship between the global average phase angle Φ_M and the spatial average phase angle Φ_Mi of each muscle compartment and fat infiltration was further analyzed. ResultsIn the laboratory pork model, the grayscale value of the image increased with the increase of η_fat and Φ_M showed a downward trend. The results of human experiments showed that at the same fat content percentage, the Φ_M of the 26-30-year-old group was about 20%-35% lower than that of the 20-25-year-old group. The fat content percentage was significantly negatively correlated with Φ_M. In addition, the M₂ (soleus) compartment was most sensitive to fat infiltration, and the spatial average phase angles of the M₂ (soleus), M₃ (tibialis posterior and flexor digitorum longus), and M₄ (tibialis anterior, extensor digitorum longus, and peroneus longus) compartments all showed significant inter-group differences. ConclusionΦEIT imaging can effectively distinguish different degrees of fat infiltration, especially in deep, small or specially located muscles, showing high sensitivity, demonstrating the potential application of this method in local muscle mass monitoring and early non-invasive diagnosis.

Acute respiratory distress syndrome(ARDS)is a common respiratory emergency,but current clinical treatment remains at the level of symptomatic support and there is a lack of effective targeted treatment measures.Our previous study confirmed that inhalation of hydrogen gas can reduce the acute lung injury of ARDS,but the application of hydrogen has flammable and explosive safety concerns.Drinking hydrogen-rich liquid or inhaling hydrogen gas has been shown to play an important role in scavenging reactive oxygen species and maintaining mitochondrial quality control balance,thus improving ARDS in patients and animal models.Coral calcium hydrogenation(CCH)is a new solid molecular hydrogen carrier prepared from coral calcium(CC).Whether and how CCH affects acute lung injury in ARDS re-mains unstudied.In this study,we observed the therapeutic effect of CCH on lipopolysaccharide(LPS)induced acute lung injury in ARDS mice.The survival rate of mice treated with CCH and hydrogen inhalation was found to be comparable,demonstrating a significant improvement compared to the untreated ARDS model group.CCH treatment significantly reduced pulmonary hemorrhage and edema,and improved pulmonary function and local microcirculation in ARDS mice.CCH promoted mitochon-drial peripheral division in the early course of ARDS by activating mitochondrial thioredoxin 2(Trx2),improved lung mitochondrial dysfunction induced by LPS,and reduced oxidative stress damage.The results indicate that CCH is a highly efficient hydrogen-rich agent that can attenuate acute lung injury of ARDS by improving the mitochondrial function through Trx2 activation.

Objective: In the background of endometrial hyperplasia triggered by obesity and estrogen, could the perilipin 2 (PLIN2) serve as a possible prognostic marker for early atypical endometrial hyperplasia (AEH)? Methods: A retrospective study examined blood lipid levels in endometrial cancer (EC) or AEH patients. An AEH mice model was established administrating with estradiol and/or high-fat (HF) diet. Hematoxylin and eosin staining were employed to assess pathological changes in the endometrium. Immunohistochemical staining were employed to evaluate the expression of adipose metabolism and endometrial hyperplasia proteins. The Cell Counting Kit-8 assay, cell colony-forming assays, and western blotting were utilized to verify the impact of oleic acid (OA) on HEC-1A cells. Results: The retrospective study revealed elevated blood lipid levels among patients with EC or AEH. Prolonged HF diet stimulated the endometrium to exhibit features of complex atypical hyperplasia. In the early stage, PLIN2 (p=0.006) expression significantly increased with endometrial glandular hyperplasia. Both PLIN2 (p=0.008) and progesterone receptor (PR; p=0.019) exhibited elevated expression concurrent with simple endometrial hyperplasia.When AEH occurred, there were notable rise in the expression of PLIN2 (p<0.001), PR (p=0.044), and estrogen receptor (p=0.045). The atypical hyperplasia glands demonstrated notably elevated PLIN2 expression in comparison to surrounding normal glands in AEH lesions. OA was found to enhance the proliferation and clonal formation of HEC-1A cells.HEC-1A cells induced by OA demonstrated elevated autophagy levels accompanied by enhanced expression of PLIN2. Conclusion PLIN2 may potentially serve as a biomarker for early development of AEH and EC, facilitating diagnosis and intervention and contributing to the determination of prognosis.

BACKGROUND: Ventricular remodeling after acute anterior wall ST-segment elevation myocardial infarction (AAMI) is an important factor in occurrence of heart failure which additionally results in poor prognosis. Therefore, the treatment of ventricular remodeling needs to be further optimized. Compound Danshen Dripping Pills (CDDP), a traditional Chinese medicine, exerts a protective effect on microcirculatory disturbance caused by ischemia-reperfusion injury and attenuates ventricular remodeling after myocardial infarction. OBJECTIVE: This study is designed to evaluate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function after AAMI on a larger scale. METHODS: This study is a multi-center, randomized, double-blind, placebo-controlled, parallel-group clinical trial. The total of 268 patients with AAMI after primary percutaneous coronary intervention (pPCI) will be randomly assigned 1:1 to the CDDP group (n=134) and control group (n=134) with a follow-up of 48 weeks. Both groups will be treated with standard therapy of ST-segment elevation myocardial infarction (STEMI), with the CDDP group administrating 20 tablets of CDDP before pPCI and 10 tablets 3 times daily after pPCI, and the control group treated with a placebo simultaneously. The primary endpoint is 48-week echocardiographic outcomes including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), and left ventricular end-systolic volume index (LVESVI). The secondary endpoint includes the change in N terminal pro-B-type natriuretic peptide (NT-proBNP) level, arrhythmias, and cardiovascular events (death, cardiac arrest, or cardiopulmonary resuscitation, rehospitalization due to heart failure or angina pectoris, deterioration of cardiac function, and stroke). Investigators and patients are both blinded to the allocated treatment. DISCUSSION This prospective study will investigate the efficacy and safety of CDDP in improving ventricular remodeling and cardiac function in patients undergoing pPCI for a first AAMI. Patients in the CDDP group will be compared with those in the control group. If certified to be effective, CDDP treatment in AAMI will probably be advised on a larger scale. (Trial registration No. NCT05000411).
Humans ; ST Elevation Myocardial Infarction/therapy* ; Stroke Volume ; Ventricular Remodeling ; Prospective Studies ; Microcirculation ; Ventricular Function, Left ; Myocardial Infarction/etiology* ; Treatment Outcome ; Percutaneous Coronary Intervention/adverse effects* ; Heart Failure/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic

SARS-CoV-2 infection causes complicated clinical manifestations with variable multi-organ injuries, however, the underlying mechanism, in particular immune responses in different organs, remains elusive. In this study, comprehensive transcriptomic alterations of 14 tissues from rhesus macaque infected with SARS-CoV-2 were analyzed. Compared to normal controls, SARS-CoV-2 infection resulted in dysregulation of genes involving diverse functions in various examined tissues/organs, with drastic transcriptomic changes in cerebral cortex and right ventricle. Intriguingly, cerebral cortex exhibited a hyperinflammatory state evidenced by significant upregulation of inflammation response-related genes. Meanwhile, expressions of coagulation, angiogenesis and fibrosis factors were also up-regulated in cerebral cortex. Based on our findings, neuropilin 1 (NRP1), a receptor of SARS-CoV-2, was significantly elevated in cerebral cortex post infection, accompanied by active immune response releasing inflammatory factors and signal transmission among tissues, which enhanced infection of the central nervous system (CNS) in a positive feedback way, leading to viral encephalitis. Overall, our study depicts a multi-tissue/organ transcriptomic landscapes of rhesus macaque with early infection of SARS-CoV-2, and provides important insights into the mechanistic basis for COVID-19-associated clinical complications.
Animals ; COVID-19/genetics* ; Macaca mulatta ; SARS-CoV-2/genetics* ; Transcriptome

Objective:To investigate the value of ADC derived from DWI combined with texture analysis derived from T 2WI fat suppressed images in distinguishing benign and malignant soft tissue tumors. Methods:The MRI and DWI images of 94 patients with soft tissue tumors (44 cases with malignant and 50 cases with benign) confirmed by pathology were analyzed retrospectively in the First Affiliated Hospital of USTC West District. ADC values of solid components were measured at GE ADW4.6 workstation. The texture features were extracted by manually drawing the ROI on the maximum level of the T 2WI fat suppressed images; the ADC values and texture parameters between the two groups were statistically analyzed by SPSS17.0, and the multivariate logistic regression model were conducted to analyze and calculate the diagnostic performance. Results:ADC value of benign and malignant soft tissue tumors was (1.6±0.3)×10 -3 mm 2/s, (1.2±0.5)×10 -3 mm 2/s, respectively, and the difference was statistically significant( t=-5.382, P<0.05). Taking 1.28×10 -3 mm 2/s as the critical value, the area under curve (AUC) for the diagnosis of benign and malignant soft tissue tumors was 0.783, the sensitivity was 92.00%, and the specificity was 65.91%. Among the texture features, the AUC of frequency size, skewness, Inertia All Direction_offset7, Inverse Difference Moment angle0_offset1, Inverse Difference Moment angle0_offset7 and Haralick Correlation All Direction_offset4_SD distinguishing benign and malignant soft tissue tumors were 0.825, 0.739, 0.826, 0.816, 0.820 and 0.783, respectively. The AUC, sensitivity and specificity of the best predictive model distinguishing benign and malignant soft tissue tumors were 0.930, 88.00% and 86.36% respectively using multivariate logistic regression analysis. Conclusion:ADC combined with texture analysis is of great value in preoperative differentiation of benign and malignant soft tissue tumors.

Objective:To explore the effect of problem-based learning (PBL) combined with case teaching method in the three-year probationary teaching of clinical urology in three-year higher vocational colleges.Methods:A total of 45 students from Class 1, Grade 2015, and 37 students from Class 2, Grade 2016 of Ningxia Medical University were selected as study subjects. They were divided into experimental group and control group. Forty-two students in experimental group were taught with PBL combined with case teaching method. 40 students in control group were taught with traditional clinical probation teaching method. Besides, a questionnaire survey was conducted among two groups of students in the Department of urology.Results:There was no significant difference in the scores of theoretical examination between the experimental group and the control group ( P>0.05). The scores of medical history collection, physical examination, practical skills and total scores were much higher in the experimental group than in the control group. The results of the questionnaire survey showed that the teaching of the experimental group could significantly motivate students' enthusiasm and participation, as well as enhance ability of self-study, information acquisition, innovation, analysis and problem-solving and team consciousness ( P<0.05). Conclusion:The new model of PBL combined with case teaching is helpful in improving students' academic performance, probation effect and comprehensive practical ability in urology internship teaching, which is worth being popularized in clinical teaching.

Objective: To investigate the clinical value of blood coagulation and fibrinolysis index detection in lymphoma patients. Methods: A total of 115 lymphoma patients hospitalized at Zhongshan Hospital of Xiamen University from January 2013 to September 2017 were retrospectively analyzed. According to the diagnostic and therapeutic criteria of lymphoma from World Health Organization (2008), these patients were divided into chemotherapy remission group (76 cases) and chemotherapy non-remission group (39 cases). A total of 138 healthy examination subjects at the same period were selected as the control group. Coagulation factor Ⅶ (FⅦ), D-dimer (D-D), von Willebrand factor antigen (vWF: Ag) and serum lactate dehydrogenase (LDH) levels were measured in all subjects. Kruskal-Wallis test was used to compare the differences of blood coagulation and fibrinolysis indicators in patients with different lymphoma staging and stratified treatment outcomes. Correlation test of D-D and LDH and disease staging was performed by using Spearman correlation analysis. The receiver operating characteristics (ROC) curve was used to analyze the efficacy of D-D in the assisted diagnosis of lymphoma with thrombosis. Results: The plasma D-D, vWF: Ag levels and FⅦ activity [the median (interquartile range)] in lymphoma patients were higher than those in healthy controls [1 240 ng/ml (1 610 ng/ml) vs. 250 ng/ml (43 ng/ml), Z = -10.728, P < 0.01; 170 ng/ml (113 ng/ml) vs. 105 ng/ml (28 ng/ml), Z = -6.425, P < 0.01; 120% (26%) vs. 96% (26%), Z = -4.602, P < 0.01]. With the increase of Ann Arbor stage, plasma D-D, vWF: Ag levels and FⅦ activity were also increased gradually (all P < 0.05); plasma D-D, vWF: Ag levels and FⅦ activity in lymphoma with thrombosis group were higher than those in the group without thrombosis (all P < 0.01), D-D and vWF: Ag levels in the chemotherapy remission group were lower than those in the chemotherapy non-remission group (all P < 0.01). Plasma D-D levels were positively correlated with LDH level and Ann Arbor stage (r values were 0.414 and 0.530, respectively, all P < 0.01). When the plasma D-D level was 1 735 ng/ml, the sensitivity of diagnosis of thrombosis in patients with lymphoma was 81.8%, the specificity was 85.7%, the area under the ROC curve was 0.894, and the Youden index was the highest (0.675). Conclusions Clinically, blood coagulation and fibrinolysis in patients with lymphoma can be evaluated by detecting blood coagulation and fibrinolysis indexes such as plasma D-D. Real-time monitoring of plasma D-D level can determine the thrombosis trend of lymphoma patients, and it may play an important role in evaluating the efficacy and prognosis.