ObjectiveTo investigate the association of SH2B1 rs7359397 （C>T） polymorphism with the progression to hepatic fibrosis in the elderly patients with metabolic dysfunction-associated steatotic liver disease （MASLD） in Beijing， China， and to provide an important genetic basis for the precise subtyping， prognostic evaluation， and individualized treatment of elderly MASLD patients in China. MethodsA total of 505 elderly patients （aged ≥65 years） who participated in regular physical examination in Mentougou Kuangshan Hospital of Beijing Jingmei Group General Hospital from November 2020 to September 2021 and were diagnosed with MASLD by abdominal ultrasound were enrolled as MASLD group， and 381 elderly population who underwent physical examination in the same community hospital during the same period of time and were not found to have MASLD by abdominal ultrasound were enrolled as control group. FibroScan was used to measure liver fat content and determine fibrosis stage. The 96-well microfluidic chip technique was used to identify SH2B1 rs7359397 polymorphism. The independent-samples t test was used for comparison of normally distributed continuous data between the two groups， and the chi-square test or the adjusted chi-square test was used for comparison of categorical data between the two groups. Univariate and multivariate Logistic regression analyses were used to identify the independent predictive factors for MASLD and its comorbidities. ResultsCompared with the control group， the MASLD group had a significantly younger age and significantly higher levels of waist circumference， hip circumference， waist-hip ratio， body mass index （BMI）， alanine aminotransferase， aspartate aminotransferase， triglyceride， platelet count， and fibrosis-4 （FIB-4） index， as well as a significantly lower level of high-density lipoprotein cholesterol （all P<0.05）. Among the 381 patients in the control group， 264 （69.29%） had genotype CC and 117 （30.71%） had genotype CT+TT， while among the 505 patients in the MASLD group， 317 （62.77%） had genotype CC and 188 （37.23%） had genotype CT+TT， suggesting that the MASLD group had a significantly higher proportion of patients with genotype CT+TT compared with the control group （χ²=4.09， P=0.043）. In the MASLD group， compared with the genotype CC group， the genotype CT+TT group had a significantly lower proportion of patients with FIB-4 ≥2 or atherosclerotic cardiovascular diseases （P<0.05）. The multivariate Logistic regression analysis showed that after adjustment for age， sex， and BMI， carrying T allele was a protective factor against progressive hepatic fibrosis （odds ratio ［OR］=0.481， 95% confidence interval ［CI］： 0.249 — 0.929， P=0.029）. In the subgroups of comorbidities with hypertension， metabolic syndrome， and obesity， genotype CT+TT was associated with a significant reduction in the risk of progressive hepatic fibrosis （hypertension： OR=0.27， 95%CI：0.09 — 0.77， P=0.014； metabolic syndrome： OR=0.30， 95%CI： 0.11 — 0.79， P=0.015； obesity： OR=0.11， 95%CI： 0.03 — 0.48， P=0.003）. After adjustment for age， sex， and BMI， in the patients with MASLD， the patients with genotype CT+TT had a significant reduction in the prevalence rate of atherosclerotic cardiovascular diseases compared with those with genotype CC （OR=0.506， 95%CI：0.336 — 0.761， P=0.001）. ConclusionSH2B1 rs7359397 （C>T） polymorphism is associated with the reduction in the risk of hepatic fibrosis and atherosclerotic cardiovascular diseases in MASLD patients.

Metabolic dysfunction-associated fatty liver disease is a chronic liver condition associated with metabolic abnormalities characterized by hepatic steatosis that can progress to metabolic-related steatohepatitis, liver fibrosis, cirrhosis, and even hepatocellular carcinoma. Currently, a liver biopsy is still the gold standard for diagnosis but due to its invasiveness and risk of complications, the development of serological diagnostic indicators to achieve non-invasive diagnosis has been a hot research topic in recent years. Herein, well-researched serological non-invasive diagnostic indicators present now for fatty livers are reviewed.

Objective To investigate the association between the polymorphism of the microsomal triglyceride transport protein (MTTP) gene at rs1800591 locus and the risk of nonalcoholic fatty liver disease (NAFLD) in the elderly population. Methods The clinical cohort of this study was established in Menkuang Hospital, Beijing Jingmei Group General Hospital. A total of 1098 healthy elderly volunteers were recruited for physical examination in communities in Mentougou District of Beijing, China, from January 11, 2020 to September 30, 2021, among whom there were 614 patients with NAFLD and 484 individuals without NAFLD. Gene microarray was used to determine the genotypes of MTTP rs1800591; demographic data were collected, and blood biochemical parameters were measured. The independent samples t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. The chi-square test was used to investigate whether the distribution of genotype frequency was in accordance with Hardy-Weinberg equilibrium. The unconditional logistic regression model was used to calculate odds ratio ( OR ) and its 95% confidence interval ( CI ) to investigate the association of gene polymorphism with the risk of NAFLD and other comorbidities. Results There were significant differences in sex and age between the two groups ( P < 0.05). Compared with the non-NAFLD group, the NAFLD group had significantly higher levels of body mass index (BMI), waist-hip ratio, triglyceride, alanine aminotransferase, aspartate aminotransferase, controlled attenuation parameter (CAP), and liver stiffness measurement and a significantly lower level of high-density lipoprotein (HDL) (all P < 0.05). Compared with the non-NAFLD group, the NAFLD group had a significantly higher proportion of patients with hypertension, diabetes, obesity, and metabolic syndrome (all P < 0.05). The distribution of genotype frequency at MTTP rs1800591 locus was in accordance with Hardy-Weinberg equilibrium in the control group ( χ 2 =1.097, P =0.29). There were a significant differences in the genotype and the distribution of alleles at MTTP rs1800591 locus between the patients with NAFLD and the control group (all P < 0.001). In the total population, there was a significantly lower carrying rate of T allele (GT+TT, n =351) in male individuals, and the individuals carrying T allele had significantly higher BMI and CAP than those carrying GG allele ( n =747) ( P < 0.001). Compared with the individuals who did not carry T allele, the individuals carrying T allele (GT+TT, n =232) had a significantly higher proportion of patients with obesity and a significantly lower NFS score ( P < 0.05). As for the individuals with NAFLD, the individuals carrying T allele had a significantly lower proportion of male individuals, a significantly lower waist-hip ratio, and a significantly higher level of HDL compared with those who did not carry T allele (GG, n =382), and the GT+TT group had a significantly lower NFS score than the GG group (all P < 0.05). The non-conditional logistic regression analysis showed that after adjustment for the confounding factors of sex, age, and BMI, the GT+TT genotype at MTTP rs1800591 locus significantly increased the risk of NAFLD ( OR =1.643, 95% CI : 1.226-2.203, P =0.001), and carrying T allele also increased the risk of obesity in the total population ( OR =1.371, 95% CI : 1.051-1.788, P =0.02). Conclusion MTTP rs1800591 polymorphism is associated with the development of NAFLD in the elderly population, and carrying T allele may promote hepatic steatosis and increase the risk of obesity in NAFLD, while it may inhibit the progression of liver fibrosis.

Purpose: This study aimed to develop a nomogram for predicting pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (CRT) in patients with esophageal squamous cell carcinoma (ESCC) by integrating hematological biomarkers and clinicopathological characteristics. Materials and Methods: Between 2003 and 2017, 306 ESCC patients who underwent neoadjuvant CRT followed by esophagectomy were analyzed. Besides clinicopathological factors, hematological parameters before, during, and after CRT were collected. Univariate and multivariate logistic regression analyses were performed to identify predictive factors for pCR. A nomogram model was built and internally validated. Results: Absolute lymphocyte count (ALC), lymphocyte to monocyte ratio, albumin, hemoglobin, white blood cell, neutrophil, and platelet count generally declined, whereas neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) increased significantly following neoadjuvant CRT. After surgery, 124 patients (40.5%) achieved a pCR. The pCR group demonstrated significantly more favorable survival than the non-pCR group. On multivariate analysis, significant factors associated with pCR included sex, chemotherapy regimen, post-CRT endoscopic finding, pre-CRT NLR, ALC nadir during CRT, and post-CRT PLR, which were incorporated into the prediction model. The nomogram indicated good accuracy in predicting pCR, with a C-index of 0.75 (95% confidence interval, 0.71 to 0.78). Conclusion Female, chemotherapy regimen of cisplatin/vinorelbine, negative post-CRT endoscopic finding, pre-CRT NLR (≤ 2.1), ALC nadir during CRT (> 0.35 ×109/L), and post-CRT PLR (≤ 83.0) were significantly associated with pCR in ESCC patients treated with neoadjuvant CRT. A nomogram incorporating hematological biomarkers to predict pCR was developed and internally validated, showing good predictive performance.

At present, nonalcoholic fatty liver disease (NAFLD) has become one of the most common chronic liver diseases in the world. With the development of the bio-psycho-social medical model, the mental health problems of patients with NAFLD are gradually attracting more and more attention. In recent years, more and more studies have been conducted on the association between NAFLD and psychiatric diseases, especially depression. Studies have shown that there is a significant correlation between NAFLD and depression; however, the common pathophysiological mechanism of such correlation is still unclear and further studies are needed to determine their causal relationship and treatment. This article reviews the research advances in the association between NAFLD and depression, common pathophysiological mechanism, and treatment, so as to lay a foundation for further research on these two disease and help with their prevention and treatment in future clinical practice.

Objective:To investigate the influencing factors of hospitalization expenses in high-rate cases, and provide scientific basis for targeted cost control.Methods:The first page data of 79 929 discharged medical records of a tertiary hospital in Ningxia Hui Autonomous Region in 2018 were selected for DRG analysis and evaluation. The average total hospitalization expenses of the same DRG group in the same level and similar hospitals in Ningxia were taken as the benchmark cost to calculate the benchmarking ratio of each DRG group. GM grey correlation method was applied to analyze the correlation between each sub-item cost and the total hospitalization cost of each DRG group, and the logistic regression was used to analyze the influencing factors of high-rate cases.Results:There were 1 292 high-rate cases, accounting for 1.64% of 78 789 DRG-incorporated cases. The results of grey correlation analysis showed that among the 10 high-rate DRG groups, the correlation order of drug cost in 6 DRG groups was the first, and that of consumables cost was the first in 2 DRG groups; logistic regression results showed that age group( P=0.010), actual hospital stay( P<0.001), and mode of leaving hospital( P<0.001) were the influencing factors of high-rate cases. Conclusions:Drug costs, consumables costs, and length of stay have great influence on the hospitalization costs for high-rate cases, which should be paid particular attention to.

With the rapid change in lifestyle in recent years, the prevalence rate of nonalcoholic fatty liver disease (NAFLD) is increasing year by year and it has gradually become one of the major causes of chronic liver diseases. With the development of the bio-psycho-social medical model, the influence of psychological diseases on physical diseases has attracted the attention of scholars. At present, evidence has shown that anxiety, as one of the most common type of mental disorders, may be associated with the development of NAFLD. This article introduces the current status of research on anxiety and NAFLD and their common influencing factors and predicts the possible pathophysiological mechanism of NAFLD caused by anxiety, so as to lay a foundation for further research on the association between anxiety and NAFLD and provide new directions for the treatment of NAFLD.

Radiation-induced cognitive impairment is hypothesized to occur because of dynamic interactions be -tween multiple cell types, including astrocytes, endothelial cells, microglia, neurons, and oligodendrocytes.Cur-rent researche indicates that radiation-induced changes include the decrease in hippocampus neurogenesis , altera-tions of neuronal functions , particularly synaptic plasticity , as well as the elevation of neuroinflammatory cytokines .