Objective To investigate risk factors for residual lesions after initial transurethral resection of bladder tumors(TURBT)and risk factors for tumor recurrence after second TURBT in patients with non-muscle-invasive bladder cancer(NMIBC)in order to provide reference for clinical management.Methods A case-control study design was adopted to include 120 NMIBC patients who underwent initial TURBT and then second surgery within 2～8 weeks in our department from January 2017 to January 2025.Based on the presence of residual lesions after the initial TURBT or not,the patients were divided into a residual lesion group(n=34)and a non-residual lesion group(n=86).Chi-square test and multivariate logistic regression analysis were performed to identify potential risk factors for residual lesions following the initial TURBT.Univariate and multivariate Cox regression models were used to analyze potential risk factors for tumor recurrence after the second TURBT.Results The residual lesion rate after initial TURBT was 28.33％.Chi-square test analysis revealed that tumor stage T1(Chi-square=5.756,P=0.016)and broad tumor base(Chi-square=4.331,P=0.037)were factors influencing residual lesions after initial TURBT.Multivariate logistic regression analysis identified tumor stage T1(OR=3.047,95％CI:1.128～8.226,P=0.028)as an independent risk factor for residual lesions after initial TURBT.The tumor recurrence rate after second TURBT was 17.5％.Multivariate Cox regression analysis identified tumor stage T1(OR=4.258,95％CI:1.248～14.532,P=0.021),intravesical chemotherapy instillation after second TURBT(OR=3.539,95％CI:1.284～9.752,P=0.015),history of urinary system tumors(OR=3.002,95％CI:1.145～7.873,P=0.025)and high platelet-to-lymphocyte(PLR)ratio(OR=2.798,95％CI:1.115～7.023,P=0.028)as independent risk factors for tumor recurrence after second TURBT.Conclusion Tumor stage T1 and broad tumor base are risk factors for residual lesions after initial TURBT,while tumor stage T1,intravesical chemotherapy instillation after second TURBT,history of urinary system tumors and high PLR ratio are risk factors for tumor recurrence after second TURBT.Comprehensive analysis on above 4 indicators can effectively assess the risk of tumor recurrence in NMIBC patients following second TURBT,and timely early medical intervention is beneficial for improving patient outcomes.

OBJECTIVE: To identify the risk factors for acute respiratory distress syndrome (ARDS) in geriatric patients following gastrointestinal perforation surgery, and constructed a model to validate its predictive value. METHODS: A retrospective analysis was conducted. The clinical data of geriatric patients (aged ≥ 60 years) after gastrointestinal perforation surgery admitted to the intensive care unit (ICU) of Hebei General Hospital from October 2017 to October 2024 were enrolled. Two groups were divided according to whether ARDS occurred postoperatively, and the differences in each index between the groups were compared. Lasso regression and multifactorial Logistic regression analyses were used to identify independent risk factors for the development of ARDS, and a prediction model was constructed based on these, which was presented using a nomogram. The receiver operator characteristic curve (ROC curve), calibration curve, and decision curve analysis (DCA) were plotted to evaluate the discrimination, accuracy, and clinical practicability of the model. RESULTS: A total of 155 geriatric patients following gastrointestinal perforation surgery were ultimately included in the analysis, among whom 43 developed ARDS, with an incidence rate of 27.7%. There were significantly differences in age, body mass index (BMI), acute kidney injury comorbidity, heart rate, onset time, the duration of surgery, the site of perforation, seroperitoneum, amount of bleeding, shock comorbidity, central venous pressure (CVP), C-reactive protein, and albumin between ARDS and non-ARDS groups. Lasso regression identified nine significant predictors: age, BMI, acute kidney injury comorbidity, onset time, seroperitoneum, shock comorbidity, CVP, hemoglobin, and albumin. Multivariate Logistic regression analysis identified BMI [odds ratio (OR) = 1.310, P < 0.001], hemoglobin (OR = 1.019, P = 0.045), seroperitoneum (OR = 1.001, P = 0.017), and albumin (OR = 0.871, P < 0.001) as independent risk factors for the occurrence of ARDS. A prediction model was constructed based on the above four independent risk factors, and the ROC curve showed that the area under the curve (AUC) of the model for predicting the occurrence of ARDS was 0.885 [95% confidence interval (95%CI) was 0.824-0.946], and internal validation was performed using bootstrap resampling (Bootstrap 500 times), which showed that the AUC value of the model was 0.886 (95%CI was 0.883-0.889). Calibration curves revealed excellent concordance between observed outcomes and model predictions. DCA indicated a high net benefit value for the model, which has good clinical utility. CONCLUSIONS BMI, hemoglobin, seroperitoneum, and albumin were identified as independent risk factors for ARDS in geriatric patients following gastrointestinal perforation surgery. The prediction model constructed using these four indicators facilitates early identification of high-risk individuals by clinicians.
Humans ; Respiratory Distress Syndrome/etiology* ; Retrospective Studies ; Aged ; Risk Factors ; Logistic Models ; Postoperative Complications ; Intestinal Perforation/surgery* ; Male ; ROC Curve ; Female ; Middle Aged ; Intensive Care Units ; Nomograms

As the population is aging rapidly,the incidence of Alzheimer's disease(AD)is increasing year by year.The World Health Organization stresses that early prevention plays a key role in reducing the incidence of AD.Subjective cognitive decline(SCD)is an early window of AD development,and timely intervention can effectively slow down the progression of the disease or prevent it from developing into dementia,thus reducing the burden on the society.White matter hyperintensity(WMH)can effectively reflect white matter changes and provide strong evidence to identify SCD.In this paper,we review the recent research progress in WMH and SCD,reveal the problems in the current research on WMH,explain the correlation between WMH and SCD in terms of physiopathology and cognitive function,and put forward several suggestions for the future research.
Humans ; White Matter/pathology* ; Cognitive Dysfunction/pathology* ; Alzheimer Disease/pathology* ; Magnetic Resonance Imaging

Objective To investigate the improvement effects of homogeneous fecal microbiota transplantation(FMT)on chemotherapy-induced diarrhea(CID)in mice.Methods Fifteen C57BL/6N mice were divided into control group,CID model group and CID+FMT group according to the random number distribution and remainder grouping method,with 5 mice per group.Control group received no intervention,and their feces were used to prepare fecal bacteria suspension.CID model group was injected intraperitoneally with fluorouracil(65 mg/kg)for 5 consecutive days to construct the CID mouse model,followed by gavage with 0.1 ml of saline on alternate days.CID+FMT group was given 0.1 ml fecal bacteria suspension gavage on alternate days for one week,followed by intraperitoneal injection of fluorouracil(65 mg/kg)for 5 consecutive days to construct the CID mouse model,with the experiment ending on the 14th day.During the experiment,the mice's food intake and body weight were recorded.At the end of the experiment,the mice were euthanized with deep carbon dioxide anesthesia,and the mice colonic specimens from cecum to anus were collected for hematoxylin and eosin(HE)staining and histopathological examination.Fecal samples were collected for 16S rRNA gene sequencing.Shannon index,Simpson index and Chao1 algorithm were used to analyze the α-diversity species of the intestinal flora in each group of mice.Similarity analysis(Anosim)was used to perform non-parametric on the inter-group differences of intestinal flora among the mice.Linear discriminate analysis size effect(LEfSe)and nonmetric multidimensional scaling(NMDS)were employed to analyze the intestinal dominant flora and the similarity classification relationships in each group of mice.Results The colonic specimen's length from cecum to anus in CID model group was significantly shorter than that in control group(P<0.05),while there was no significant difference between CID+FMT group and CID model group(P>0.05).The weight of mice in CID model group decreased by 42.04%,while control group mice gained 10.24%,with a significant difference between the two groups(P<0.05).The weight of mice in CID+FMT group decreased by 8.12%,which was significantly improved compared to CID model group(P<0.05).HE staining results revealed the intestinal mucosal structure in CID model group was severely damaged,with atrophy and deformation,accompanied by inflammatory cell infiltration,and the pathological score was higher than that of control group(P<0.05).Compared with CID model group,the intestinal mucosal integrity and crypt cells in the CID+FMT group were improved,with less damage,and the pathological score was lower than that of CID model group,but the difference was not statistically significant(P>0.05).The α-diversity analysis showed that there were significant differences in the Shannon,Simpson and Chao1 indices among the three groups(P<0.05).ANOSIM and NMDS analysis revealed that the intestinal flora in CID+FMT group was closer to the normal intestinal flora compared to CID model group.LEfSe analysis showed that the intestinal flora in CID model group was enriched in famliy_Bacteroidaceae,and the intestinal flora in CID+FMT group was similar to that of control group,with an enrichenment of familiy_Enterobacteriaceae.Conclusion Homogeneous FMT can improve the abundance of intestinal flora in CID mice,making it more similar to normal intestinal flora,thereby protecting intestinal mucosa,reducing damage and alleviating the severity of CID.

Objective To analyze the feasibility and efficacy of a deep convolutional neural network(DCNN)model based on chest CT images to evaluate bone mineral density(BMD).Methods A total of 1 048 health check subjects'2 096 central level images of lumbar 1 and 2 vertebral bodies were used for experiments and analysis in this retrospective study.According to the results of quanti-tative computed tomography(QCT)BMD measurement,the subjects were divided into three categories:normal,osteopenia,osteopo-rosis(OP).Herein,a DCNN segmentation model was constructed based on chest CT images[training set(n=1 096),tuning set(n=200),and test set(n=800)],the segmentation performance was evaluated using the Dice similarity coefficient(DSC)to com-pare the consistency with the manually sketched region of vertebral body.Then,the DCNN classification models 1(fusion feature construction of lumbar 1 and 2 vertebral bodies)and model 2(image feature construction of lumbar 1 alone)was developed based on the training set(n=530).Model performance was compared in a test set(n=418)by the receiver operating characteristic(ROC)curve analysis.Results When the number of images in the training set(n=300)was adopted,the DSC value was 0.950 in the test set.The results showed that the sensitivity,specificity and area under the curve(AUC)of model 1 and model 2 in diagno-sing osteopenia and OP were 0.716,0.960,0.952;0.941,0.948,0.980;0.638,0.954,0.940;0.843,0.959,0.978,respectively.The AUC value of normal model 1 was higher than that of model 2(0.990 vs 0.983,P=0.033),while there was no significant difference in AUC values between osteopenia and OP(P=0.210,0.546).Conclusion A DCNN may have the potential to evaluate bone mass based on chest CT images,which is expected to become an effective tool for OP screening.

During the progression of heart failure(HF),abnormal transduction of the transforming growth factor-β(TGF-β)/Smads signaling pathway is important mechanism of myocardial fibrosis(MF)in HF.TGF-β,a key factor in MF,is in an overexpression state in the process of MF in HF,and Smads is a major effector downstream of TGF-β.The TGF-β/Smads pathway induces abnormal proliferation of myofibroblasts,aggravates myocardial extracellular matrix deposition,and reduces the ability of the cardiac tissues to resist fibrosis,which plays a complex role in the pathogenesis of MF in HF.Traditional Chinese medicine(TCM)has the efficacy of unequivocal inhibiting myocardial collagen deposition,anti-MF,protecting the myocardium and improving cardiac function in the prevention and treatment of MF in HF and so on,and the TGF-β/Smads pathway is one of the key pathways through which TCM monomers,TCM combinations,and proprietary medicines can exert their cardioprotective effects on the HF.This paper reviews the existing experimental research results of TCM intervening in the TGF-β/Smads pathway for the treatment of MF in HF over the past 10 years,with a view to providing theoretical basis for the prevention and treatment of HF MF well as the development and of new drugs.

Objective To investigate the ameliorative effect of ginsenoside Rf on endometriosis(EMS)and its mechanism.Methods In animal experiments,Wistar female rats were randomly divided into sham group(laparotomy without other treatment),model group(EMS construction),low dose group(1.0 mg·kg-1 ginsenoside Rf),middle dose group(2.0 mg·kg-1 ginsenoside Rf),high dose group(3.0 mg·kg-1 ginsenoside Rf),positive group(0.25 mg·kg-1 pregnrienone capsule).The volume of ectopic lesions and the number of painful twisting were detected;the apoptosis rate in tissues was detected by TdT mediated dUDP nick end labeling(Tunel)assay;the expression of related proteins in each group was detected by Western blot assay.Cell experiment:The isolated primary rat endometrial cells were randomly divided into control group(normal tissue isolation),EMS group(EMS cells),Rf group(20 μmol·L-1 ginsenoside Rf treated EMS cells),combined group(20 μmol·L-1 ginsenoside Rf and 50 μmol·L-1 autophagy inhibitor 3-MA treated EMS cells).Western blot assay was used to detect the expression of related proteins;flow cytometry was used to detect apoptosis.Results Animal experiment:The times of body twisting in sham group,model group,high dose group and positive group were 0,37.10±4.64,14.70±1.90 and 20.20±1.78,respectively;the ectopic lesion volumes were 0,(118.91±19.51),(50.11±9.69)and(37.64±3.56)mm,respectively;the apoptosis rates were(3.43±0.33)％,(3.22±0.27)％,(20.42±1.82)％and(22.92±2.67)％,respectively;Beclin 1 protein expression were 0.32±0.03,0.36±0.04,0.79±0.12,0.35±0.07,respectively;glutathione peroxidase 4(GPX4)protein expression were 1.10±0.07,0.94±0.11,0.53±0.03,0.96±0.16,respectively.The above indexes of the model group were compared with those of the sham group,and the above indexes of the high dose group were compared with those of the model group,and the differences were significant(all P＜0.05).Cell experiment:Beclin1 protein expression in control group,EMS group,Rf group and combined group were 0.22±0.05,0.31±0.03,0.52±0.07 and 0.19±0.03,respectively;GPX4 protein expression were 0.97±0.07,0.81±0.09,0.63±0.05 and 1.05±0.09,respectively;the apoptosis rates were(3.48±0.04)％,(3.42±0.23)％,(21.66±2.95)％and(12.51±1.15)％,respectively;the above indexes in Rf group were compared with those in EMS group,and the above indexes in combined group were compared with those in Rf group,and the differences were significant(all P＜0.05).Conclusion Ginsenoside Rf can improve endometrial lesion,pain sensitivity and apoptosis in EMS rats,which may be related to the regulation of autophagy dependent ferroptosis.

The pathogenesis of osteoarthritis (OA) is related to a variety of factors such as mechanical overload, metabolic dysfunction, aging, etc., and is a group of total joint diseases characterized by intra-articular chondrocyte apoptosis, cartilage fibrillations, synovial inflammation, and osteophyte formation. At present, the treatment methods for osteoarthritis include glucosamine, non-steroidal anti-inflammatory drugs, intra-articular injection of sodium hyaluronate, etc., which are difficult to take effect in a short period of time and require long-term treatment, so the patients struggle to adhere to doctor’s advice. Some methods can only provide temporary relief without chondrocyte protection, and some even increase the risk of cardiovascular disease and gastrointestinal disease. In the advanced stages of OA, patients often have to undergo joint replacement surgery due to pain and joint dysfunction. Mitochondrial dysfunction plays an important role in the development of OA. It is possible to improve mitochondrial biogenesis, quality control, autophagy balance, and oxidative stress levels, thereby exerting a protective effect on chondrocytes in OA. Therefore, compared to traditional treatments, improving mitochondrial function may be a potential treatment for OA. Here, we collected relevant literature on mitochondrial research in OA in recent years, summarized the potential pathogenic factors that affect the development of OA through mitochondrial pathways, and elaborated on relevant treatment methods, in order to provide new diagnostic and therapeutic ideas for the research field of osteoarthritis.

Objectives: Lack of physical activity has a critical effect on the physical and mental health of adolescents. This study examined the influence of family adversities on the longitudinal changes in physical inactivity among adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: The study used multi-wave data from the Korean Children and Youth Panel Survey, including 2590 Korean adolescents aged 12-14 years. The longitudinal trajectory of physical inactivity among adolescents and the effects of related factors were estimated using a latent growth modeling method. Results: Our results revealed a significant increase in physical inactivity among adolescents over time. At the onset of the pandemic, approximately one-seventh of Korean middle schoolers reported a lack of physical activity. However, 3 years later, during the quarantine, nearly one-fifth of these adolescents reported a significant increase in their physical inactivity. Initially, low level parental education was predictive of adolescents’ physical inactivity, but this effect diminished over time, becoming statistically insignificant by the end of the 3-year period. Moreover, the increase in physical inactivity over the 3 years was significantly influenced by parental rejection. Conclusions These findings suggest that adolescents who experience parental rejection are more likely to report an increase in sedentary behaviors in contexts such as the COVID-19 pandemic.

Conversion of 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC) by ten-eleven translocation (TET) family proteins leads to the accumulation of 5hmC in the central nervous system; however, the role of 5hmC in the postnatal brain and how its levels and target genes are regulated by TETs remain elusive. We have generated mice that lack all three Tet genes specifically in postnatal excitatory neurons. These mice exhibit significantly reduced 5hmC levels, altered dendritic spine morphology within brain regions crucial for cognition, and substantially impaired spatial and associative memories. Transcriptome profiling combined with epigenetic mapping reveals that a subset of genes, which display changes in both 5hmC/5mC levels and expression patterns, are involved in synapse-related functions. Our findings provide insight into the role of postnatally accumulated 5hmC in the mouse brain and underscore the impact of 5hmC modification on the expression of genes essential for synapse development and function.
Animals ; Brain/growth & development* ; 5-Methylcytosine/metabolism* ; Mice ; Synapses/genetics* ; Proto-Oncogene Proteins/metabolism* ; DNA-Binding Proteins/metabolism* ; Dioxygenases/metabolism* ; Cognition/physiology* ; Gene Expression ; Mixed Function Oxygenases/metabolism* ; Epigenesis, Genetic ; Mice, Knockout ; Mice, Inbred C57BL