Objective To investigate the role of activating transcription factor 4 (ATF4) in benign prostatic hyperplasia (BPH) in order to elucidate the molecular mechanism underlying BPH progression. Methods Firstly, we analyzed the correlation between the expression of ATF4 and the volume of prostate transition zone in BPH tissues using publicly available datasets. Subsequently, we explored the potential association among ATF4, epithelial-mesenchymal transition (EMT) and BPH through single-cell RNA sequencing (scRNA-seq). Finally, we validated the findings by silencing ATF4 and treating BPH cells with ATF4 protein inhibitors, followed by reverse transcription quantitative polymerase chain reaction (RT-qPCR), CCK-8 assay, and Western blot. Results The expression of ATF4 in BPH tissues exhibited a significant positive correlation with the volume of prostate transition zone (r=0.64, P＜0.05). scRNA-seq analysis revealed that ATF4 was significantly upregulated in the prostate epithelial cells of BPH patients (P＜0.05), and its expression demonstrated a significant positive correlation with the Hallmark EMT singscore (r=0.14, P＜0.05). In vitro experiments further indicated that knockdown of ATF4 led to a significant reduction in the proliferative activity of BPH-1 cells (P＜0.05). Similarly, inhibition of ATF4 activity resulted in a marked decrease in the proliferative capacity and EMT of BPH-1 cells (P＜0.05). Conclusion ATF4 may exert a promoting effect on BPH by modulating the EMT signaling pathway;therefore, ATF4 may serve as a novel therapeutic target of BPH.

OBJECTIVE To provide technical support for improving recognition rate of adverse drug events （ADEs） related to traditional Chinese medicine （TCM） formula granules and decoction pieces among inpatient patients. METHODS By referencing the global trigger tool （GTT） whitepaper， literature on adverse reactions to TCM， and expert review opinions， ADE trigger items for TCM formula granules and decoction pieces used in the inpatients were established. GTT was applied to analyze ADEs in inpatients who had used TCM formula granules and decoction pieces in our hospital from August 2013 to August 2023， utilizing the Chinese Hospital Pharmacovigilance System. The effectiveness of GTT and the characteristics of these ADEs were analyzed. RESULTS A total of forty-eight triggers were established， including thirty-two laboratory test indexes， thirteen clinical symptoms， and three antidotes. Among the 1 682 patients included， GTT identified 652 potential ADEs， 284 true positive ADEs，with a trigger rate of 38.76% and a positive predictive value of 43.56%. After review by the auditor， 278 cases of ADEs were finally confirmed， with an incidence rate of 16.53%， significantly higher than the number of spontaneously reported ADEs during the same period （0）. The 278 cases of ADEs were mostly grade 1 （223 cases）， mainly involving hepatobiliary system， gastrointestinal system， blood- lymphatic system， etc；a total of 219 types of TCMs are involved，and the top five suspected TCMs used at a frequency higher than 1% were Poria cocos， Codonopsis pilosula， Atractylodes macrocephala， fried Glycyrrhiza uralensis， and Scutellaria baicalensis. CONCLUSIONS The established GTT can improve the recognition rate of ADEs for hospitalized patients using traditional Chinese medicine formula granules and decoction pieces.

Objective:To analyze the research and development of control system for airbag pressure of intelligent tracheal catheter,and its application effect in clinical practice.Methods:The hospital designed an intelligent self-adaptive control system for cuff pressure of tracheal catheter,which can rationally apply main components such as single chip microcomputer,display screen,control panel,pressure monitoring module,inflation device and solenoid valve,etc..This control system connected the measuring module of pressure through single chip microcomputer,so as to continuously detect the airbag pressure of tracheal catheter.An inflation and deflation algorithm was independently researched and developed to control air pump or solenoid valve to inject or release part of the gas to the airbag,so as to achieve intelligent control for the pressure of airbag.Sixty patients underwent endotracheal intubation who admitted to the department of general surgery of Wuhan Hospital of Traditional Chinese Medicine from January 2022 to January 2023 were selected as the study objects,and they were divided into control group(n=30)and observation group(n=30)according to random number table method.The cuff pressure of endotracheal intubation of patients in control group were managed by conventional method.The intelligent adaptive control system was adopted to manage the cuff pressure of endotracheal intubation for patients in the observation group.The complications,compliance rate of airbag pressure,the instantaneous maximum value of airbag pressure during sputum aspiration,insertion of gastric tube,and turning over of body were compared between the two groups after intubation.Results:The incidence of complication included cough,trachyphonia,dysphagia and bloody sputum after tracheal intubation in the observation group were 6.66%,which was significantly lower than 33.33%in the control group,and the difference was statistically significant(x2=6.667,P<0.05).The compliance rate of the pressure(25-30cmH2O)of airbag in the control group was 92.83%,which was significantly lower than 97.78%in the observation group,and the difference was statistically significant(x2=14.698,P<0.05).The instantaneous maximum values of airbag pressure during sputum aspiration,insertion of gastric tube and turning over were(28.24±3.65)cmH2O,(27.98±4.25)cmH2O and(28.65±4.87)cmH2O in observation group,respectively,which were significantly lower than those in control group,and the differences were significant(t=17.930,19.208,16.485,P<0.05).Conclusion:The application of intelligent adaptive control system for cuff pressure of tracheal catheter can maintain the airbag pressure of tracheal catheter at normal level(20-30 cmH2O),and reduce complications,and improve the compliance rate of airbag pressure.

Objective:To verify the validity of the atopic dermatitis control tool (ADCT) in assessing disease control in patients with atopic dermatitis (AD) .Methods:Based on a cross - sectional study, demographic data, comorbidities and information on disease assessment - related scales such as the ADCT, the pruritus numerical rating scale (NRS), the patient-oriented eczema measure (POEM), and the dermatological life quality index (DLQI) were collected from patients with AD at Tianjin Medical University General Hospital from June 2021 to March 2023. The reliability and validity of the ADCT were assessed using these data. The discrimination power of the ADCT total score was evaluated by comparing the differences in the mean ADCT total scores among adjacent POEM/DLQI subgroups based on POEM/DLQI response classifications (POEM: clear or almost absent, mild, moderate, severe, very severe; DLQI: no effect, mild effect, moderate effect, serious effect, very serious effect). According to the ADCT scores, the AD patients were divided into an uncontrolled AD group (ADCT scores ≥ 7 points) and a controlled AD group (ADCT scores < 7 points). Differences between the above two groups were analyzed in terms of ADCT item scores, mean pruritus NRS scores, POEM total scores, DLQI total scores, and DLQI dimension scores to evaluate the validity of the ADCT in assessing AD disease control.Results:A total of 338 patients with AD were included, comprising 170 (50.30%) males and 168 (49.70%) females, and they were aged 17 to 89 (41.36 ± 17.63) years. Reliability analysis showed that the Cronbach′s α coefficient and split-half reliability coefficient of the ADCT were 0.886 and 0.878 respectively (both > 0.70), and the test- retest reliability coefficient was 0.977 (> 0.70, P < 0.001). Content validity analysis showed that the Pearson correlation coefficients between the ADCT item scores and the ADCT total score ranged from 0.753 to 0.852 (all P < 0.001) ; confirmatory factor analysis revealed that the Chi-square to degree of freedom ratio ( χ2/df) was 2.896 (< 5), the Tucker-Lewis index was 0.976 (> 0.9), the comparative fit index was 0.991 (> 0.9), the standardized root mean square residual was 0.026 (< 0.08), and the root-mean-square error of approximation was 0.075 (< 0.08) ; convergent validity analysis showed that the standardized factor loadings of all observed variables ranged from 0.689 to 0.905 (all > 0.500), combined reliability coefficient was 0.896 (> 0.700), and the average extracted variance value was 0.591 (> 0.500) ; criterion validity analysis showed that the correlation coefficients of the ADCT total score with other patient - reported outcome measures (the mean pruritus NRS scores, peak pruritus NRS scores, POEM total scores, and DLQI total scores) and DLQI dimension scores ranged from 0.649 to 0.730 and from 0.303 to 0.647, respectively (all P < 0.001). Analysis of the discrimination power of the ADCT total score showed significant differences in the mean ADCT total scores among adjacent POEM/DLQI subgroups (all P ≤ 0.001). The uncontrolled AD group (287 cases) showed significantly increased ADCT item scores, mean pruritus NRS score, POEM total score, DLQI total score, and DLQI dimension scores compared with the controlled AD group (51 cases, all P<0.001) . Conclusion:The ADCT exhibited good reliability, validity and discriminability based on the cross-sectional study, and can efficiently and reliably assess disease control in AD patients.

Objective:To analyze clinical data from patients with chronic spontaneous urticaria (CSU) , and to explore their disease burden.Methods:Clinical data were retrospectively collected from CSU outpatients who visited the Tianjin Medical University General Hospital from November 2021 to October 2023. The primary evaluation indicators included the 7-day urticaria activity score (UAS7) , chronic urticaria quality of life questionnaire (CU-Q2oL) , urticaria control test (UCT) , medication use in the past 6 months, number of outpatient visits and medical expenses, CSU disease duration, and the presence of comorbid atopic diseases and autoimmune diseases. For quantitative data, results were expressed as mean ± standard deviation when normally distributed, or as median (lower quartile, upper quartile) when not normally distributed. Correlation analysis was performed using Pearson correlation coefficients, false discovery rate (FDR) correction, multivariate linear regression, and collinearity diagnostics.Results:A total of 489 CSU patients were included, comprising 303 females (62.0%) and 186 males (38.0%) , with the ages being 39.3 ± 15.0 years and disease duration being 0.75 (0.17, 3) years. The number of outpatient visits was 5.1 ± 1.9, and the medical costs were 396.4 ± 116.0 yuan. Baseline UAS7, UCT, and CU-Q2oL scores were 16.9 ± 11.0 points, 7.0 ± 3.8 points, and 51.9 ± 16.3 points, respectively. Seventy-two patients (14.7%) had a family history of atopic diseases, and 144 patients (29.4%) had comorbid atopic conditions, including atopic dermatitis ( n = 29) , allergic rhinitis ( n = 89) , allergic conjunctivitis ( n = 13) , allergic asthma ( n = 7) , and allergic sinusitis ( n = 6) . Forty-one patients (8.4%) had comorbid autoimmune diseases, including connective tissue diseases ( n = 2) and autoimmune thyroid diseases ( n = 39) . In the past 6 months, 419 patients (85.7%) received first-line or second-line therapies (antihistamines alone or in combination) , while 70 patients (14.3%) received third-line therapies, including omalizumab ( n = 35, 7.1%) , glucocorticoids ( n = 22, 4.5%) , cyclosporine ( n = 7, 1.4%) , and Tripterygium wilfordii preparations ( n = 7, 1.4%) . According to the UAS7 scores, 98 patients (20.0%) were in good control, 153 (31.3%) exhibited mild disease activity, 138 (28.2%) showed moderate activity, and 100 (20.5%) exhibited severe activity; outpatient visits and medical costs increased with disease activity (both P < 0.05) . The CU-Q2oL scores were positively correlated with the UAS7 scores ( r = 0.520, P < 0.001, FDR < 0.001) , and negatively correlated with the UCT scores ( r = -0.597, P < 0.001, FDR < 0.001) . Disease duration was positively associated with the UAS7 scores ( β = 0.223, P = 0.023) . The patients with autoimmune diseases had significantly longer disease duration ( P = 0.049) , but there was no significant difference in the UAS7 score between the patients with and without autoimmune diseases ( P = 0.340) ; there were no significant differences in disease duration or UAS7 scores between patients with and without atopic diseases (both P > 0.05) . Conclusion:Higher disease activity in CSU patients was significantly correlated with worse quality of life, increased outpatient visits, and greater economic burden.

Objective:To investigate the efficacy and safety of omalizumab in the treatment of chronic spontaneous urticaria (CSU) during pregnancy and lactation.Methods:A single-center retrospective study was conducted. From February 2022 to December 2024, 8 pregnant or lactating patients with CSU who received omalizumab treatment were collected from the Departments of Dermatovenereology and Allergy, Tianjin Medical University General Hospital, including 3 pregnant and 5 lactating patients. Clinical data were analyzed, including the patients' ages, disease duration of CSU, timing of omalizumab initiation, dosage and treatment intervals of omalizumab. During the treatment and follow-up, the 7-day urticaria activity score (UAS7) was used to evaluate disease activity of CSU patients, and adverse events were recorded.Results:The ages of the 8 patients ranged from 29 to 40 (33.25 ± 3.81) years, and the disease duration of CSU ( M[ Q1, Q3]) was 2.8 (1.6, 5.2) years. Three patients began omalizumab treatment before conception, with a dose of 300 mg every 3 - 4 weeks; after 3 - 8 sessions of treatment, pregnancy was confirmed, followed finally by successful deliveries. Five patients started omalizumab treatment at doses of 150 - 300 mg/4 weeks during lactation. All the 8 patients received omalizumab injections for 3 - 24 sessions, with an average of 10.38 sessions. Before omalizumab treatment, the UAS7 scores were 6.0 (2.8, 23.5) points; during the treatment, UAS7 scores decreased to 0 - 6 points, and CSU symptoms were completely controlled or well controlled. None of the 3 pregnant patients reported maternal adverse events, small-for-gestational-age or low-birth-weight infant outcomes, premature delivery (< 37 weeks) , spontaneous abortion (< 28 weeks) , congenital malformations in infants, or infant adverse events. One lactating patient developed a mild fever and fatigue 6 hours after the first omalizumab injection, which resolved spontaneously within 48 hours; the other 4 lactating patients did not experience any maternal or infant adverse events. Conclusion:Omalizumab may be an effective and safe treatment option for CSU patients during pregnancy and lactation.

Objective:To analyze the genetic characteristics of the prevalent strains of Varicella-Zoster virus (VZV) in the population of Dali, Yunnan, and to understand its evolutionary status in the population of Dali.Methods:Herpes fluid and 163 sera were collected from 249 patients clinically suspected to have varicella or herpes zoster in the Department of Dermatology of the Second People′s Hospital of Dali city, Yunnan province, China, from 2023 to 2024. The levels of VZV-specific IgG and IgM antibodies in serum were detected using enzyme-linked immunoassay. Viral DNA was extracted from the herpes fluid, and the cycle threshold ( Ct) of the samples was detected using quantitative real-time polymerase chain reaction (qPCR), and some samples with Ct ≦ 22 were selected for sequencing by next-generation sequencing technology (next-generation sequencing). Next-generation sequencing (NGS) was used to obtain 90 whole genome sequences of VZV, and the sequencing result were compared with the sequences of reference strains for multiple sequence comparison and evolutionary analysis. Snapgene was used to translate the nucleotides into amino acids, and the result were compared with the amino acid sequences of the reference strain. Results:Of the 90 VZV whole-genome sequences, one whole-genome sequence was from an adult varicella patient, and the remaining 89 whole-genome sequences were from herpes zoster patients. The serum-specific IgG antibody positivity rate was 99.4%, and the IgM antibody positivity rate was 52.8%. The result of both single nucleotide polymorphism (SNPs) site typing and genome-wide phylogenetic tree analysis showed that 83 of the 90 VZV whole-genome sequences in this study were on the same branch as Clade 2, and 7 VZV whole-genome sequences were on the branch of Clade 9.Conclusions:The main endemic branch in Dali region in 2023-2024 was Clade 2, with the emergence of Clade 9 branch; there were amino acid mutations in the proteins encoded by ORF22 and ORF68 in 83 VZV whole genome sequences of Clade 2 branch, and the mutations did not cause significant changes to the protein structure.

Objective:To investigate the impact of immunosuppressive therapy on the severity of SARS-CoV-2 infection and cytokine levels in pediatric patients with kidney diseases.Methods:A retrospective analysis was conducted on the clinical data of 40 hospitalized pediatric patients who were diagnosed with SARS-CoV-2 infection at the 900th Hospital of PLA Joint Logistic Support Force from December 2022 to February 2023. Based on their immunosuppressive status prior to SARS-CoV-2 infection, these patients were categorized into immunosuppressive group and non-immunosuppressive group. Independent sample t-tests, Mann-Whitney U tests, and χ2 test were employed to compare the clinical baseline characteristics and laboratory data, the severity of SARS-CoV-2 infection, and the levels of cytokines between the 2 groups. Results:Among the 40 patients, 11 were in the immunosuppressive group (aged 13 (8, 14) years, 9 males and 2 females) and 29 in the non-immunosuppressive group (aged 2 (1, 4) years, 15 males and 14 females). In the immunosuppressive group, 2 were asymptomatic cases, 8 were mild cases, and 1 was moderate case, and there was no severe or critical cases. In the non-immunosuppressive group, 8 were mild cases, 5 were moderate, 15 were severe cases, 1 was critical case, and no asymptomatic cases. The underlying diseases in the immunosuppressive group included nephrotic syndrome (6 cases), IgA vasculitis nephritis (2 cases), lupus nephritis (1 case), post-renal transplantation (1 case), and renal failure (1 case), with a mean total immunosuppression score (TIS) of (3.6±1.4) points. In the non-immunosuppressive group, 2 patients had a history of epilepsy, and the remaining 27 cases had no underlying conditions, all with TIS scores of 0. Compared to the children in the non-immunosuppressive group, those in the immunosuppressive group were more likely to exhibit asymptomatic or mild infection, with lower risks of severe disease, cytokine storm, fever, and cough, but a higher risk of fatigue ( OR=1.22, 2.66, 0.48, 0.12, 0.12, 0.13, 1.22; 95% CI 0.93-1.62, 0.99-7.15, 0.33-0.70, 0.03-0.57, 0.03-0.57, 0.03-0.65, 0.93-1.62; all P<0.05). The levels of cytokine IL-6, interferon-α and interferon-γ in the immunosuppressive group were all lower than those in the non-immunosuppressive group ( Z=2.23, 2.51, 2.92, respectively; all P<0.05). Conclusion:Pediatric patients with kidney diseases receiving appropriate immunosuppressive therapy may mitigate the severity of SARS-CoV-2 infection by suppressing the expression of cytokines.

Purpose To evaluate the effectiveness of deep learning image reconstruction(DLIR)algorithms in reconstructing lumbar vertebrae images from abdominal CT scans,aiming to reduce radiation dose and eliminate the need for repeat lumbar CT examinations.Materials and Methods A retrospective collection was conducted from March to May 2024 in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.Thirty-two patients who underwent both abdominal and lumbar CT scans in a supine head-first position were enrolled.The abdominal CT(DLIR group)utilized a tube voltage of 120 kVp and a current of 200 mA with high-intensity DLIR for lumbar reconstruction.The standard lumbar CT(lumbar group)used the same voltage with a tube current of 260 mA and was reconstructed using 60%weighted adaptive statistical iterative reconstruction.Objective assessments was used to measure the CT values,noise(standard deviation,SD value),signal-to-noise ratio and contrast-to-noise ratio(excluding adipose tissue)at the third lumbar vertebral pedicle level and the L2/L3 intervertebral disc level for muscle,adipose tissue,cancellous bone,intervertebral discs,dura mater and cortical bone.Subjective assessments employed a five-point scale to evaluate image contrast,noise and sharpness.Results The volume CT dose index in lumbar group and DLIR group were 15.25 mGy and 11.74 mGy,respectively.There was no statistical difference in CT values between the structures of both groups(all P>0.05).Compared with the lumbar group,the DLIR group showed significant reductions in SD values across the measured tissues by 31.09%,35.66%,13.48%,27.82%,24.93%and 15.09%(t=5.09-7.21,all P<0.05).The signal-to-noise ratio improved by 36.40%,52.31%,16.56%,34.13%,38.39%and 18.81%,and the contrast-to-noise ratio improved by 51.70%,51.32%,36.24%,34.47%and 53.56%(t=-9.58--4.23,all P<0.001).The DLIR group significantly outperformed the lumbar group in image contrast[4.45(4.00,5.00)points vs.4.75(4.00,5.00)points],image noise[4.06(4.00,4.00)points vs.4.39(4.00,5.00)points],and spatial resolution of fine structures[4.00(4.00,4.00)points vs.4.27(4.00,5.00)points](Z=-3.80,-4.38,-3.55,all P<0.001).Conclusion Using high-intensity DLIR for abdominal examinations can achieve high-quality lumbar CT images with a 25%reduction in radiation dose,enabling simultaneous abdominal and lumbar scanning in a single session.

Objective:To analyze the current status, influencing factors and action pathways of quality of life in patients with cardiovascular disease.Methods:From July 2023 to June 2024, a convenience sampling method was used to obtain 2 702 patients with cardiovascular disease from 9 hospitals in Guangxi Zhuang Autonomous Region.The general information questionnaires, item short form health survey, self-rating depression scale, self-rating anxiety scale, type D personality scale-14, and type A behavior pattern scale were used for investigation.SPSS 26.0 and AMOS 24.0 softwares were used for data statistical analysis.The current status of quality of life were analyzed through descriptive statistics, the influencing factors of quality of life were analyzed using multiple linear regression analysis models, and the relationship between statistical variables was analyzed through paths.Results:The overall quality of life score of patients with cardiovascular disease was (59.29±17.59).Compared with the domestic normal population norm, the 8 factors had statistically significant differences ( t=16.50-44.16, all P<0.001).The results of multiple regression analysis showed that age, marital status, low per capita monthly income, lack of exercise, irregular daily life, poor appetite, unhealthy diet, poor sleep quality, hypertension, coronary heart disease, chronic heart failure, heart valve disease, multiple types of medication taken daily, anxiety level, depression level, type D personality, and type A personality all had negative predictive effects on quality of life ( B=-0.862--0.205, all P<0.05).Demographic and life factors affected the quality of life through 4 paths, and their direct effect and indirect effect were -0.183, 0.224 respectively (there was a masking effect).Disease-related factors affected life through 2 paths, and its direct effect and indirect effect were -0.341, 0.255 respectively (there was a masking effect).Psychological factors directly and negatively affected the quality of life through one path, and its effect value was -0.651. Conclusion:The quality of life of patients with cardiovascular disease is generally at a moderate to low level.The factors that affect the quality of life of patients with cardiovascular disease produce effects through multiple pathways in a multi-combined state.