Objective To investigate the cross-sectional associations between different fatty liver classifications and cardiac structure and function in people undergo health examination. Methods A total of 6 545 adults who underwent health examinations at the Health Management Center of Zhongshan Hospital, Fudan University between January 1 and December 31, 2017, were retrospectively included. Demographic characteristics and laboratory data were collected. The hepatic steatosis was graded by ultrasonography. And patients with fatty liver were further stratified according to alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels, as well as the degree of liver fibrosis. Cardiac morphology and function were assessed by transthoracic echocardiography, and left ventricular geometric patterns were classified accordingly. Multivariate logistic regression analysis was performed to evaluate the associations between fatty liver classifications and cardiac abnormalities. Results There were 2 795 patients (42.7%) with fatty liver, of whom 832 (29.8%) had significant cardiac structural alterations and 1 500 (53.7%) had diastolic dysfunction. Severe fatty liver was risk factor for concentric remodeling and increased relative wall thickness (RWT), with odds ratios (ORs) of 1.27 (P＝0.012) and 1.27 (P＝0.009), respectively. Fatty liver accompanied by elevated ALT or AST was risk factor for concentric remodeling (OR＝1.45,1.56; P＝0.001, 0.001), increased RWT (OR＝1.48,1.57; P＜0.001, ＜0.001), and diastolic dysfunction (OR＝1.27, 1.32; P＝0.035, 0.040), respectively. Fatty liver with liver fibrosis was risk factor for concentric remodeling (OR＝1.83, P＝0.046) and diastolic dysfunction (OR＝2.64, P＝0.034). Conclusions Advanced fatty liver, including severe hepatic steatosis, accompanied by elevated liver enzymes or liver fibrosis, could increase risks of cardiac remodeling and diastolic dysfunction, while systolic function is preserved. For patients with fatty liver, it is recommended to undergo regular ultrasonography examination.

Objective:To investigate the predictive value of platelet-to-albumin ratio (PAR) for organ failure in patients with acute pancreatitis (AP).Methods:The clinical data of 128 patients with AP from January 2021 to January 2024 in Affiliated Hospital of Jining Medical College were retrospectively analyzed. Among them, 68 patients developed organ failure (failure group), and 60 patients did not develop organ failure (non-failure group). The inflammatory indexes on admission were compared between the two groups. The severity of illness was evaluated by acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA). Pearson method was employed for correlation analysis. The receiver operating characteristic (ROC) curve was utilized to analyze the efficacy of PAR in predicting organ failure in patients with AP.Results:The APACHE Ⅱ, SOFA, white blood cell, platelet, red blood cell distribution width, C-reactive protein, fasting blood glucose, blood urea nitrogen, interleukin 6 (IL-6) and PAR in failure group were significantly higher than those in non-failure group: (25.91 ± 1.46) scores vs. (20.98 ± 1.46) scores, (7.03 ± 0.17) scores vs. (5.51 ± 0.33) scores, (11.22 ± 1.77) × 10 9/L vs. (9.32 ± 1.81) × 10 9/L, (200.12 ± 24.11) × 10 9/L vs. (173.18 ± 17.19) × 10 9/L, 0.134 ± 0.007 vs. 0.112 ± 0.007, (64.12 ± 7.38) mg/L vs. (46.93 ± 9.07) mg/L,(7.23 ± 1.09) mmol/L vs. (6.56 ± 0.87) mmol/L, (6.46 ± 1.17) mmol/L vs. (3.91 ± 0.39) mmol/L, (207.32 ± 74.29) ng/L vs. (109.27 ± 33.55) ng/L and 5.79 ± 0.98 vs. 4.30 ± 0.79, the serum calcium and albumin were significantly lower than those in non-failure group: (1.58 ± 0.09) mmol/L vs. (2.19 ± 0.32) mmol/L and (35.04 ± 4.05) g/L vs. (41.10 ± 5.79) g/L, and there were statistical differences ( P<0.01). Pearson correlation analysis result showed that PAR was positively correlated with APACHE Ⅱ, SOFA, white blood cell, platelet, red blood cell distribution width, C-reactive protein, fasting blood glucose, blood urea nitrogen and IL-6 ( r = 0.559, 0.623, 0.237, 0.782, 0.511, 0.392, 0.287, 0.555 and 0.505; P<0.01), and negatively correlated with serum calcium and albumin ( r = - 0.526 and - 0.820, P<0.01). ROC curve analysis result showed that the area under the curve of PAR for predicting organ failure in patients with AP was 0.875 (95% CI 0.818 to 0.933), with an optimal cutoff value of 4.56, sensitivity of 91.2%, and specificity of 66.7%. Conclusions:PAR can effectively predict the occurrence of organ failure in AP patients with high sensitivity, providing certain guiding significance for clinical treatment.

Objective:To investigate the expression and clinical value of integrin-associated protein 47 (CD47) and soluble programmed death receptor-ligand 1 (sPD-L1) in patients with primary immune thrombocytopenia (ITP).Methods:The method of retrospective study was adopted, 76 patients with ITP admitted to the Affiliated Hospital of Jining Medical University from July 2016 to July 2022 were regarded as the study group, and another 76 cases of physical examination were regarded as the control group. The levels of serum CD47, sPD-L1, interleukin-33(IL-33) and transforming growth factor beta (TGF-β) were determined by the enzyme-linked immunosorbent assay, the diagnostic value of CD47 and sPD-L1 for ITP was analyzed by the receiver operating characteristic (ROC) curve, Pearson test was applied to analyze the correlation between serum CD47 and sPD-L1 in ITP patients, multivariate Logistic regression analysis was applied to analyze the risk factors affecting ITP.Results:The levels of serum CD47, sPD-L1 and IL-33 in the study group were higher than those in the control group: (40.31 ± 6.59) μg/L vs. (32.16 ± 6.33) μg/L, (78.42 ± 10.22) ng/L vs. (64.49 ± 10.36) ng/L, (73.29 ± 14.26) ng/L vs. (26.54 ± 5.16) ng/L; the level of serum TGF-β in the study group was lower than that in the control group: (1 752.66 ± 310.73) ng/L vs. (2 625.88 ± 389.58) ng/L, there were statistical differences ( P<0.05). The result of the Pearson test showed that there was a positive correlation between serum CD47 and sPD-L1 in ITP patients ( r = 0.572, P<0.05). The result of the ROC curve showed that the area under the curve predicted by the combination of serum CD47 and sPD-L1 was 0.948 (95% CI 0.916 - 0.979), which was better than that predicted by CD47 and sPD-L1 alone ( P<0.05). The result of multivariate Logistic regression analysis showed that CD47, sPD-L1, and IL-33 were the risk factors affecting ITP ( P<0.05), and TGF-β was the protective factor affecting ITP ( P<0.05). Conclusions:The serum levels of CD47 and sPD-L1 in patients with ITP are elevated, and the combined detection of the two indicators has a good diagnostic value for ITP.

Objective To analyze the changes in serum miR-205,miR-23b and miR-25 levels and their correlation with the prognosis of patients with different severities of sepsis.Methods A retrospective study was conducted in 86 patients with sepsis admitted to our hospital between September 2021 and September 2023.Based on the severity of illness,patients were divided into mild(52 cases)and severe(34 cases)groups.Eighty healthy individuals undergoing medical check-ups during the same period were selected as controls.The patients were follo wed-up for 28 days and were then categorized into a survival group(68 patients)and a death group(18 patients).Real-time polymerase chain reaction was used to detect the serum miR-205,miR-23b,and miR-25 levels in patients and analyze their corre-lation with prognosis.Multivariate Cox regression analysis was used to analyze the risk factors affecting patient prognosis.The diagnostic value of serum miR-205,miR-23b,and miR-25 levels in assessing sepsis and their predictive value for prognosis were analyzed using receiver operating characteristic curves.Results Serum miR-205,miR-23b,and miR-25 levels were significantly lower in the two groups of patients with sepsis than in the control group(P＜0.05),and were significantly higher in the survival group than in the death group(P＜0.05).Their levels negatively correlated with prognosis.Heart rate and APACHE Ⅱ score were risk factors for a poor prognosis of patients with sepsis,whereas high serum miR-205,miR-23b,and miR-25 levels were protective factors(P＜0.05).The areas under the curve(AUC)for individual serum miR-205,miR-23b,and miR-25 levels and their combination to assess sepsis were 0.794,0.786,0.768,and 0.926,respectively.The AUC for predicting poor prognosis for patients were 0.776,0.762,0.797,and 0.918,respectively.Conclusion Serum miR-205,miR-23b,and miR-25 levels were reduced in patients with sepsis,and were closely correlated with patient prognosis.Thus,they may serve as serological biomarkers for assessing disease and predicting prognosis.

The female reproductive system is essential for sustaining reproductive endocrine homeostasis,however,its vulnerability to various endogenous and exogenous insults,including pathological conditions,pharmacological agents,genetic predispositions,and environmental factors,often results in compromised fertility.The existing protective approaches(including surgical interventions,hormonal replacement therapies,and assisted reproductive techniques)are constrained by several limitations,such as adverse therapeutic effects,technical complexities,and their incapacity to reverse ovarian senescence.Artemisinin and its derivatives(ARTs),characterized by their unique endoperoxide bridge configuration,have exhibited outstanding therapeutic performance across multiple domains including malaria treatment,anticancer therapy,inflammation modulation,and parasitic infection control.Emerging research has identified their novel protective capabilities against various reproductive system pathologies.This comprehensive review systematically elucidates the molecular mechanisms underlying artemisinin-based interventions in reproductive pathologies and evaluates their clinical translation prospects,thereby proposing innovative strategies for the development of next-generation fertility-protective agents with enhanced safety and efficacy profiles.

The female reproductive system is essential for sustaining reproductive endocrine homeostasis,however,its vulnerability to various endogenous and exogenous insults,including pathological conditions,pharmacological agents,genetic predispositions,and environmental factors,often results in compromised fertility.The existing protective approaches(including surgical interventions,hormonal replacement therapies,and assisted reproductive techniques)are constrained by several limitations,such as adverse therapeutic effects,technical complexities,and their incapacity to reverse ovarian senescence.Artemisinin and its derivatives(ARTs),characterized by their unique endoperoxide bridge configuration,have exhibited outstanding therapeutic performance across multiple domains including malaria treatment,anticancer therapy,inflammation modulation,and parasitic infection control.Emerging research has identified their novel protective capabilities against various reproductive system pathologies.This comprehensive review systematically elucidates the molecular mechanisms underlying artemisinin-based interventions in reproductive pathologies and evaluates their clinical translation prospects,thereby proposing innovative strategies for the development of next-generation fertility-protective agents with enhanced safety and efficacy profiles.

Objective:To investigate the predictive value of platelet-to-albumin ratio (PAR) for organ failure in patients with acute pancreatitis (AP).Methods:The clinical data of 128 patients with AP from January 2021 to January 2024 in Affiliated Hospital of Jining Medical College were retrospectively analyzed. Among them, 68 patients developed organ failure (failure group), and 60 patients did not develop organ failure (non-failure group). The inflammatory indexes on admission were compared between the two groups. The severity of illness was evaluated by acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA). Pearson method was employed for correlation analysis. The receiver operating characteristic (ROC) curve was utilized to analyze the efficacy of PAR in predicting organ failure in patients with AP.Results:The APACHE Ⅱ, SOFA, white blood cell, platelet, red blood cell distribution width, C-reactive protein, fasting blood glucose, blood urea nitrogen, interleukin 6 (IL-6) and PAR in failure group were significantly higher than those in non-failure group: (25.91 ± 1.46) scores vs. (20.98 ± 1.46) scores, (7.03 ± 0.17) scores vs. (5.51 ± 0.33) scores, (11.22 ± 1.77) × 10 9/L vs. (9.32 ± 1.81) × 10 9/L, (200.12 ± 24.11) × 10 9/L vs. (173.18 ± 17.19) × 10 9/L, 0.134 ± 0.007 vs. 0.112 ± 0.007, (64.12 ± 7.38) mg/L vs. (46.93 ± 9.07) mg/L,(7.23 ± 1.09) mmol/L vs. (6.56 ± 0.87) mmol/L, (6.46 ± 1.17) mmol/L vs. (3.91 ± 0.39) mmol/L, (207.32 ± 74.29) ng/L vs. (109.27 ± 33.55) ng/L and 5.79 ± 0.98 vs. 4.30 ± 0.79, the serum calcium and albumin were significantly lower than those in non-failure group: (1.58 ± 0.09) mmol/L vs. (2.19 ± 0.32) mmol/L and (35.04 ± 4.05) g/L vs. (41.10 ± 5.79) g/L, and there were statistical differences ( P<0.01). Pearson correlation analysis result showed that PAR was positively correlated with APACHE Ⅱ, SOFA, white blood cell, platelet, red blood cell distribution width, C-reactive protein, fasting blood glucose, blood urea nitrogen and IL-6 ( r = 0.559, 0.623, 0.237, 0.782, 0.511, 0.392, 0.287, 0.555 and 0.505; P<0.01), and negatively correlated with serum calcium and albumin ( r = - 0.526 and - 0.820, P<0.01). ROC curve analysis result showed that the area under the curve of PAR for predicting organ failure in patients with AP was 0.875 (95% CI 0.818 to 0.933), with an optimal cutoff value of 4.56, sensitivity of 91.2%, and specificity of 66.7%. Conclusions:PAR can effectively predict the occurrence of organ failure in AP patients with high sensitivity, providing certain guiding significance for clinical treatment.

Chronic obstructive pulmonary disease(COPD)is a common disease with a high global incidence and mortality rate.It is charac-terized by chronic inflammation and structural airway obstruction that is not fully reversible,leading to shortness of breath caused by air trapping and increased physical exertion.Over the past few decades,the incidence of COPD has continued to rise.Although commonly used therapeutic agents,such as glucocorticoids and bronchodilators,have demonstrated significant symptomatic relief,they primarily target symptoms rather than halting disease progression.Therefore,further research is needed to better understand the underlying mechanisms of COPD and to develop novel therapeutic strategies for its prevention and management.Early studies on the pathogenesis of COPD primarily focused on airway epithelial cell injury,while relatively less attention was given to pulmonary vascular endothelial cells(PVECs).However,recent evidence indicates that COPD is not only an airway and systemic inflammatory disorder but also a vascular disease,with PVECs playing a critical role in its pathogenesis.PVECs are among the main cellular targets damaged in COPD and are involved in mediating its initiation and progression.In this review,we summarize emerging evidence that highlights the close association between PVEC injury and COPD pathogenesis.We also explore the roles and mechanisms of various therapeutic interventions targeting PVECs,including chemical agents and traditional Chinese medicine,in the treatment of COPD.

As an important indicator to assess the revenue structure of hospitals,healthcare service revenue can truly reflect the labor value of medical personnel.A unified financial classification is the premise of accurate calculation of revenue structure.Meeting the needs of financial management of medical institutions through mapping with current healthcare service items in various regions,Financial Classification of Medical Service Items has unified the financial classification from the aspects of bill classification,accounting subject and expense classification in medical record.

The assignment of the"item code"element in National Technical Specification of Medical Service Items(Version 2023)continues the classification framework and coding rules of National Specification of Medical Service Price Items(Version 2012).The project team experts are members of the WHO-Family of International Classifications(WHO-FIC)China Classification,Terminology and Standards Collaborating Center.The design concept of project coding is the same as that of the International Classification of Health Interventions(ICHI).Both adopt an alphanumeric characters hybrid coding classification method based on multi-axis classification,clarified the definition and scope of these four key classification axis which including anatomy system,anatomical site,surgical procedure and surgical approach,and optimize and update item property,sub-classifications and coding.Unified medical service item code can make contribution to the comparability of statistics related to health care items across regions,promote cross-regional healthcare and healthcare insurance settlement at the national level;improve its refined management level in hospital,and play an important role in performance management and data statistical analysis.