Objective To summarize the clinical efficacy of modified Morrow surgery in the treatment of hypertrophic obstructive cardiomyopathy. Methods A retrospective analysis was conducted on the clinical data of patients with hypertrophic obstructive cardiomyopathy treated with modified Morrow surgery at Zhongshan Hospital Affiliated to Fudan University from 2020 to 2023. Results A total of 318 patients were enrolled, including 156 males and 162 females, with an average age of (55.6±13.1) years. Preoperative echocardiography showed a mean interventricular septal thickness of (18.1±3.8) mm, peak left ventricular outflow tract pressure difference of (86.4±24.9) mm Hg. The surgery time was (162.3±51.0) min, extracorporeal circulation time was (80.9±31.0) min, and aortic occlusion time was (44.8±20.8) min. After the surgery, transesophageal echocardiography showed that the interventricular septal thickness was (11.0±1.8) mm and left ventricular outflow tract peak pressure difference was (9.4±5.1) mm Hg. The incidence rate of postoperative complete left bundle branch block was 45.3%, Ⅲ° atrioventricular block was 3.8%, and postoperative newly developed atrial fibrillation was 3.1%. The postoperative hospital stay was (6.6±4.9) days, and one perioperative death occurred, with a mortality rate of 0.3%. The follow-up time was (10.3±9.4) months, during which the transthoracic echocardiography revealed a ventricular septal thickness of (12.9±2.9) mm and a peak left ventricular outflow tract pressure difference of (13.9±10.0) mm Hg. Conclusion The modified Morrow procedure for the treatment of hypertrophic obstructive cardiomyopathy is safe and effective, with good results in the short and medium term.

Objective To analyze the situation of rapid antiretroviral therapy (ART) and death of HIV/AIDS in Wuhan from 1994 to 2023, and to provide a scientific basis for further rapid initiation of ART and reduction of mortality rate. Methods According to the case follow-up and treatment database of China AIDS Prevention and Control Information System, data were obtained from all the cases reported from January 1, 1994 to December 31, 2023 with the current address in Wuhan City and the review status of the final review card. The data were analyzed using Kaplan-Meier and Cox proportional hazards models. Results The total mortality rate of HIV/AIDS in Wuhan from 1994 to 2023 was 12.76%. The proportion of receiving antiretroviral therapy within 30 days increased year by year, and the mortality rate decreased year by year. After adjusting for sex, age, occupation, ethnicity, education level, mobile population, history of STD, route of infection, source of sample, and first CD4 value, receiving antiretroviral therapy within 30 days (HR=0.08, 95%CI: 0.07-0.10) was a protective factor for HIV/AIDS mortality. Conclusion Rapid antiretroviral therapy can significantly reduce the risk of HIV/AIDS death. A sustainable model of rapid initiation of antiretroviral therapy should be further established to increase the proportion of rapid antiretroviral therapy for HIV/AIDS in Wuhan.

ObjectiveTo investigate the effect and mechanism of long intergenic non-coding RNA02086 （LINC02086） overexpression mediated macrophage polarization on the proliferation， migration and invasion of gastric cancer cells. MethodsThe expression levels of LINC02086 in the human gastric epithelial cell line GES-1 and human gastric cancer cell lines HCG-27， NCI-N87， and AGS were determined by qRT-PCR. Human acute monocytic leukemia cells （THP-1） were induced to differentiate into M0 macrophages using phorbol 12-myristate 13-acetate （PMA）. HGC-27 cells were infected with either LINC02086 overexpression lentivirus （OE-LINC02086） or its negative control lentivirus （Vector）， and the culture supernatants were collected as conditioned medium （CM1）. M0 macrophages were co-cultured with the infected HGC-27 cells， and the resulting supernatants were designated as conditioned medium 2 （CM2）. M0 macrophages were treated with CM1 alone or in combination with Wnt/β-catenin pathway inhibitor IWR-1， forming the Vector+CM1， OE-LINC02086+CM1， and OE-LINC02086+CM1+IWR-1 groups， respectively. Flow cytometry was used to detect mannose receptor C-type 1 （CD206） expression， and qRT-PCR was employed to measure mRNA levels of interleukin-10 （IL⁃10）， transforming growth factor-β （TGF⁃β）， vascular endothelial growth factor （VEGF）， and chemokine ligand 22 （CCL22）. Western blot was performed to evaluate protein expression of CD206， VEGF， and key components of the Wnt/β-catenin pathway—Wnt family member 3a （Wnt3a）， glycogen synthase kinase-3β （GSK-3β）， and β-catenin. HGC-27 cells were treated with CM2 alone or combined with IWR-1， establishing the Vector+CM2， OE-LINC02086+CM2， and OE-LINC02086+CM2+IWR-1 groups. CCK-8 assay was used to evaluate cell proliferation， and Transwell assays were conducted to assess migration and invasion capabilities. ResultsCompared with GES-1 cells， the expression levels of LINC02086 were upregulated in HCG-27， NCI-N87， and AGS cells （P < 0.05）， with the smallest increase observed in HCG-27 cells. Compared with Vector+CM1 group， the level of CD206 and the expression levels of IL⁃10， TGF⁃β， VEGF and CCL22 mRNA in macrophages stimulated by OE-LINC02086+CM1 increased （P<0.05）. Meanwhile， the expression levels of Wnt3a and β-catenin proteins in cells increased （P<0.05）， and the expression level of GSK-3β protein decreased （P<0.05）. However， co-treatment with IWR-1 markedly reversed the promoting effects of LINC02086 overexpression on the expression of M2 polarization markers， including CD206， IL⁃10， and TGF⁃β mRNA， in macrophages （P<0.05）， as well as its activation of the Wnt/β-catenin signaling pathway （P<0.05）. Compared with Vector+CM2 group， HGC-27 cells infected with OE-LINC02086+CM2 had increased proliferation activity and increased number of migration and invasion cells （P<0.05）. However， the combined intervention of IWR-1 significantly reversed the promotion of LINC02086 overexpression on the proliferation， migration and invasion of HGC-27 cells （P<0.05）. ConclusionLINC02086 overexpression promotes the proliferation， migration and invasion of gastric cancer cells by activating Wnt/β-catenin pathway to mediate M2 polarization of macrophages.

ObjectiveZheng’s San Qi San (ZSQS) power, a classic traditional Chinese medicine (TCM) formula, is used for treating soft tissue injuries involving muscles, tendons, and ligaments. However, its underlying therapeutic mechanisms remain unclear. This study aimed to screen and identify pharmaceutically active ingredients and their candidate biomolecule targets, and further elucidate the molecular mechanism of ZSQS in the treatment of skeletal muscle injury. MethodsNetwork pharmacology was employed to construct “ZSQS-component-target”, “protein-protein interaction (PPI)” and “active ingredient-core protein-pathway” networks to predict the key active ingredients and potential core targets of ZSQS for skeletal muscle injury. The predicted results were then validated via microarray data from the GEO database. Molecular docking was then performed to assess the binding ability between the screened active ingredients of ZSQS and the candidate core targets. Moreover, liquid chromatography-mass spectrometry (LC-MS) was used for qualitative and quantitative analysis to verify the active components of the drug and ZSQS serum. Finally, an animal model of eccentric exercise-induced skeletal muscle injury and a myotube cell model of oxidative stress-induced injury were established to validate the effects of ZSQS and its interventional effects on the biological functions of critical targets, thereby demonstrating the potential therapeutic mechanism of ZSQS. ResultsAmong the 111 active components identified in ZSQS and their corresponding 204 targets related to the skeletal muscle injury repair process, 14 core targets (including AKT1) and 4 core active components (quercetin, luteolin, kaempferol, and β‑sitosterol) were screened out, while the corresponding metabolites of quercetin, luteolin and kaempferol were detected in the ZSQS serum. Among these targets, 5 candidate genes (IL-6, CASP3, HIF1A, STAT3, and JUN) overlapped with the differential expression screening results with GEO data, and IL-6 was confirmed to be enriched in the PI3K/AKT pathway. Combined with the prediction results of the AKT expression levels, these findings suggest that the phosphorylation level of AKT1 plays a core role in the therapeutic mechanism of ZSQS. Molecular docking analysis further revealed that the PH domain of AKT1 had high binding energy with all 4 core active components, as verified by LC-MS. Finally, animal model studies have shown the promoting effect of ZSQS administration on skeletal muscle injury repair and its possible antioxidant damage mechanism. Cell model studies further demonstrated that ZSQS-containing serum, core active ingredient combination therapy, and quercetin monomer could increase the phosphorylation level of AKT, promote the nuclear translocation of Nrf2, upregulate the expression of downstream antioxidant enzymes (SOD, GPx, and GR), and inhibit the expression of inflammatory factors (IL-6 and TNF-α), thereby alleviating oxidative stress and the inflammatory response. ConclusionZSQS alleviates skeletal muscle injury mainly by activating the AKT/Nrf2 signaling pathway, enhancing cellular antioxidant and anti-inflammatory capabilities. The results of this study provide a scientific basis for the clinical application and modernized development of ZSQS.

Objective To analyze the influencing factors of death in the elderly with coronavirus disease 2019(COVID-19).Methods The case data of death caused by COVID-19 in West China Fourth Hospital from January 1 to July 8,2023 were collected,and surviving cases from the West China Elderly Health Cohort infected with COVID-19 during the same period were selected as the control.LASSO-Logistic regression was adopted to analyze the data after propensity score matching and the validity of the model was verified by drawing the receiver operating characteristic curve.Results A total of 3 239 COVID-19 survivors and 142 deaths with COVID-19 were included.The results of LASSO-Logistic regression showed that smoking(OR=3.33,95%CI=1.46-7.59,P=0.004),stroke(OR=3.55,95%CI=1.15-10.30,P=0.022),malignant tumors(OR=19.93, 95%CI=8.52-49.23, P<0.001),coronary heart disease(OR=7.68, 95%CI=3.52-17.07, P<0.001),fever(OR=0.51, 95%CI=0.26-0.96, P=0.042),difficulty breathing or asthma symptoms(OR=21.48, 95%CI=9.44-51.95, P<0.001),and vomiting(OR=8.19,95%CI=2.87-23.58, P<0.001)increased the risk of death with COVID-19.The prediction model constructed based on the influencing factors achieved an area under the curve of 0.889 in the test set.Conclusions Smoking,stroke,malignant tumors,coronary heart disease,fever,breathing difficulty or asthma symptoms,and vomiting were identified as key factors influencing the death risk in COVID-19.
Humans ; COVID-19/mortality* ; Aged ; Propensity Score ; China/epidemiology* ; Risk Factors ; Logistic Models ; Smoking ; SARS-CoV-2 ; Male ; Female ; Stroke ; Neoplasms

BACKGROUND:Scholars at home and abroad consider New Zealand rabbits to be an ideal model animal because of the similar anatomical morphology of the lumbar spine to that of the human lumbar spine.There is a lack of systematic comparison of different ways to establish rabbit intervertebral disc degeneration models under X-ray guidance. OBJECTIVE:To establish a rabbit model of lumbar disc degeneration using X-ray guided acupuncture,end-plate injection and combined method,and to compare the modeling effects of these three methods. METHODS:Eighteen 6-month-old New Zealand white rabbits were randomly selected and divided into four groups:acupuncture group,endplate injection group,combined group and blank control group.In the acupuncture group,three consecutive segments of the intervertebral discs(L2/3,L3/4,L4/5)were needled and modeled;in the endplate injection group,50 μL of anhydrous ethanol was injected at a single point on the endplates of the three consecutive segmental discs;in the combined group,three consecutive segmental intervertebral discs were needled and injected with 50 μL of anhydrous ethanol at four azimuthal points on the endplates of the corresponding segmental discs;and the blank control group received no interventions.X-ray examination was performed to measure the disc height index at 2,4,and 8 weeks after surgery.The intervertebral disc tissues were then taken for anatomical observation and pathological examination. RESULTS AND CONCLUSION:(1)Anatomical examination showed that fibrous annulus rupture,nucleus pulposus degeneration,and total disc structure disorder were the main manifestation in the acupuncture group,endplate injection group,and combined group,respectively.(2)X-ray examination showed that the disc height index showed the most obvious reduction in the acupuncture group at 2 weeks after operation,significant reductions in the endplate injection group at 2 and 4 weeks after operation,and significant reductions in the combined group at 2,4,and 8 weeks after operation.(3)Pathological examination showed that the fibrous ring structure was damaged and the inner annulus fibrosus protruded inward in the acupuncture group;endplate fissure,disordered arrangement and nucleus loss were observed in the endplate injection group;total disc structure disorder with the nucleus pulposus losing water and shrinking and no obvious border with the broken annulus fibrosus was found in the combined group.To conclude,acupuncture,endplate injection and the modified endplate injection method can establish the rabbit intervertebral disc degeneration model.Compared with the single method,the modified endplate injection method can greatly accelerate and aggravate the degeneration of the intervertebral disc,and can effectively shorten the experiment period.

Objective To investigate the impact and predictive value of high mobility group protein B1(HMGB1)and angiopoietin like protein 2(Angptl-2)on coronary artery damage in children with Kawasaki disease.Methods A total of 114 children with Kawasaki disease were selected and divided into the normal coronary artery group(85 cases)and the coronary artery lesion group(29 cases)according to the presence or absence of coronary artery lesions.The general clinical data of the two groups were compared.Enzyme linked immunosorbent assay was applied to detect serum levels of HMGB1 and Angptl-2 in children and compared between the two groups.Logistic regression was applied to analyze the influencing factors of coronary artery damage in children with Kawasaki disease.Receiver operating curve(ROC)was applied to analyze the predictive value of serum levels of HMGB1 and Angptl-2 for coronary artery damage in children with Kawasaki disease.Results The serum levels of HMGB1 and Angptl-2 were significantly higher in acute stage than those in remission stage(P＜0.05).Before treatment,the duration of fever,white blood cell count,erythrocyte sedimentation rate,procalcitonin and serum HMGB1 and Angptl-2 levels were significantly higher in the coronary artery lesion group than those in the normal coronary artery group(P＜0.05).Logistic regression analysis showed that the duration of fever,white blood cell count,erythrocyte sedimentation rate,procalcitonin,HMGB1 and Angptl-2 levels before treatment were all independent risk factors for coronary artery damage in children with Kawasaki disease(P＜0.05).The area under the curve(AUC)of serum HMGB1 and Angptl-2 for diagnosing coronary artery damage in children with Kawasaki disease was 0.907(95%CI:0.838-0.953)and 0.857(95%CI:0.780-0.916),respectively,with cut-off value of 59.62 μg/L and 10.35 μg/L,respectively.The AUC,sensitivity and specificity of the combined diagnosis of coronary artery damage in children with Kawasaki disease were 0.958(95%CI:0.903-0.987),93.10%and 90.59%,respectively,which were better than their individual diagnose.Conclusion The serum levels of HMGB1 and Angptl-2 are obviously elevated in children with Kawasaki disease complicated by coronary artery damage,and the combined detection of HMGB1 and Angptl-2 levels in serum can provide a good prediction for coronary artery damage in children with Kawasaki disease.

Objectives:To investigate the clinical efficacies of endoscopic cross-overtop decompression(Cross-overtop)and endoscopic unilateral laminotomy bilateral decompression(Endo-ULBD)in the treatment of severe lumbar spinal stenosis.Methods:A retrospective study was conducted on the patients with single-level severe lumbar spinal stenosis admitted and treated with Cross-overtop decompression(30 cases)and En-do-ULBD(30 cases)in our hospital between July 2021 and December 2022.There were 37 male cases and 23 female cases.The average age of the Cross-overtop group was 66.2±8.8 years,and the average age of the Endo-ULBD group was 71.4±8.7 years.The patients were followed up at 1 week,3 months,6 months,and≥ 12 months(final)after operation.Clinical outcomes were assessed using the visual analog scale(VAS)score,Oswestry disability index(ODI),and Japanese Orthopaedic Association(JOA)scores.The sagittal diameter of the affected spinal canal was measured to evaluate central canal expansion.Postoperative excellent and good rate of efficacy were determined using the MacNab criteria at 12 months'or the final follow-up.Results:All 60 patients completed follow-up with a duration ranging from 12 to 25 months.Both groups showed significant improvements in VAS scores for low back and leg pain and ODI at each follow-up interval compared to the previous assessment.The Cross-overtop group demonstrated a greater expansion rate(5.08％)of the sagittal di-ameter of the central canal at the affected level compared to the Endo-ULBD group(1.59％),with statistically significant differences(P＜0.05).At postoperative 12-month or final follow-up,MacNab evaluation revealed an excellent and good rate of 90.0％in the Cross-overtop group and 83％in the Endo-ULBD group.Conclusions:Cross-overtop decompression is one of the minimally invasive endoscopic surgical techniques for treating severe lumbar spinal stenosis,which is safe and effective with distinct advantages.

In recent years,the global consumption of ultra-processed foods(UPFs)has increased.UPFs are classified as the fourth group of food in the NOVA classification system:industrially formulated foods made entirely or mostly from substances extracted from foods(oils,fats,sugar,starch,proteins,etc),derivatives of food constituents(hydrogenated fats,modified starches,etc),or multiple food additives.Common manufacturing techniques include extrusion,moulding,and pre-frying.As high-energy-density foods,UPFs are typically characterized by high levels of sugar,fat,and salt,and low levels of dietary fiber,protein,vitamins,and minerals,resulting in low nutrient density.Studies have shown that a high intake of UPFs increases the risk of various chronic diseases.Nutrition during pregnancy is a crucial factor influencing pregnancy outcomes,and balanced and adequate nutrient intake is essential for the health of both the mother and child.Given that UPFs have limited nutritional density,high intake during pregnancy may be detrimental to maternal and infant health.However,the impact of consuming UPFs during pregnancy on maternal and infant health is not extensively studied.This article reviews the literature on the effects of UPFs on pregnancy outcomes,aiming to provide a foundation for further research and personalized dietary guidance.

Objective To evaluate the sensitivity of swept-source optical coherence tomography(SS-OCT)in detecting early deminer-alization at the resin-enamel bonding interface,and the differences in enamel demineralization around restorations among different resins(Filtek Z350 XT,Filtek Bulk Fill,TetricN-Ceram Bulk Fill).Methods Twenty-seven extracted third molars were selected and prepared into 5-mm-thick specimens,and Class Ⅰ cavities measuring 3 mm × 3 mm × 4 mm were created on the occlusal surfaces.The specimens were randomly divided into three groups,with nine teeth in each group,and were respectively filled with Filtek Z350 XT(layered filling of 4 mm),Filtek Bulk Fill(bulk filling of 4 mm in one step),and Tetric N-Ceram Bulk Fill(bulk filling of 4 mm in one step).After applying acid-resistant nail varnish to non-experimental areas,the specimens were placed in a demineralizing solution for 4 weeks.SS-OCT and Micro-CT scans of the resin-enamel bonding interface were performed before demineralization and weekly thereafter to monitor the progression of demineralization and changes in demineralization depth were quantitatively analyzed.Results Both SS-OCT and Micro-CT were capable of non-destructive dynamic monitoring of demineralization at the resin-enamel bonding inter-face.After demineralization,four types of patterns were observed at the resin-enamel bonding interface.At different stages of demineral-ization,no significant differences in demineralization depth were detected among the three resins using either SS-OCT or Micro-CT.There was a high level of agreement between the demineralization depth measurements obtained from SS-OCT and Micro-CT at each demineralization stage(ICC:0.760-0.897).Conclusion The early demineralization of resin-enamelbonding interface can be noninva-sively detected by SS-OCT,and there was no significant differenceamong three resins in their ability to resist enamel demineralization around the restoration.