The aim of this study is to investigate the protective effect of idebenone (IDE) combined with borneol (BO) against Parkinson's disease (PD). In this study, wild-type AB zebrafish and transgenic Tg ( vmat2: GFP) zebrafish with green fluorescence labeled dopamine neurons were used to establish the PD model with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine hydrochloride (MPTP). Following drug treatment, the behavioral performance and dopamine neuron morphology of zebrafish were evaluated, and regulation of dopamine signaling pathway-related genes was determined using RT-qPCR. The results showed that IDE combined with BO improved the behavioral disorders of zebrafish such as bradykinesia and shortening movement distance, also effectively reversed the damage of MPTP-induced dopaminergic neurons. At the same time, the expression of dopamine synthesis and transportation-related genes was up-regulated, and the normal function of the signal transduction pathway was restored. The combination showed a better therapeutic effect compared to the IDE monotherapy group. This study reveals the protective mechanism of IDE combined with BO on the central nervous system for the first time, which provides an important experimental basis and theoretical reference for clinical combination strategy in PD treatment.
Animals ; Zebrafish ; Signal Transduction/drug effects* ; Animals, Genetically Modified ; Dopamine/metabolism* ; Neuroprotective Agents/pharmacology* ; Disease Models, Animal ; Camphanes/pharmacology* ; Ubiquinone/pharmacology* ; Parkinson Disease/drug therapy* ; Dopaminergic Neurons/metabolism*

Objective:To explore the predictive value of serum fibroblast growth factor-21 (FGF-21), insulin-like growth factor-1 (IGF-1), and serum ferritin (SF) for maternal and infant outcomes in patients with pregnancy complicated by hypothyroidism.Methods:A total of 246 patients with pregnancy complicated by hypothyroidism who underwent prenatal examination at the Ankang Central Hospital from January 2021 to September 2024 were retrospectively selected as the observation group. Meanwhile, 100 healthy pregnant women who received prenatal examination in the hospital during the same period were enrolled as the control group. According to the maternal and infant outcomes, the observation group was divided into the adverse maternal and infant outcome group ( n=55) and the favorable maternal and infant outcome group ( n=191). Baseline data were compared among groups. Pearson correlation analysis was used to evaluate the correlations between FGF-21, IGF-1, SF and thyroid hormone levels. Univariate and multivariate analyses were applied to screen the influencing factors of maternal and infant outcomes in patients with pregnancy complicated by hypothyroidism. Receiver operating characteristic (ROC) curve was drawn to assess the predictive value of FGF-21, IGF-1, and SF for adverse maternal and infant outcomes in these patients. Results:The serum levels of FGF-21 and thyroid-stimulating hormone (TSH) in the observation group were higher than those in the control group (all P<0.05), while the levels of IGF-1, SF, free thyroxine (FT4), and free triiodothyronine (FT3) were lower (all P<0.05). Pearson correlation analysis showed that in patients with pregnancy complicated by hypothyroidism, FGF-21 was positively correlated with TSH and negatively correlated with FT4 and FT3 (all P<0.05); IGF-1 and SF were negatively correlated with TSH and positively correlated with FT4 and FT3 (all P<0.05). Univariate analysis indicated that FGF-21, IGF-1, SF, TSH, and FT4 were related to maternal and infant outcomes in patients with pregnancy complicated by hypothyroidism (all P<0.05). Multivariate logistic regression analysis revealed that FGF-21 was an independent risk factor for adverse maternal and infant outcomes, while IGF-1 and SF were protective factors (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum FGF-21, IGF-1, and SF alone for predicting adverse maternal and infant outcomes were 0.811, 0.738, and 0.837, with sensitivities of 84.1%, 81.3%, and 76.6%, respectively—all lower than the AUC (0.876) and sensitivity (93.5%) of combined prediction, with statistically significant differences (all P<0.05). Conclusions:FGF-21, IGF-1, and SF are independent influencing factors for maternal and infant outcomes in patients with pregnancy complicated by hypothyroidism, and have good predictive value for adverse maternal and infant outcomes.

Inflammatory bowel disease(IBD)is a non-specific chronic inflammatory bowel condition.Crohn's disease(CD)and ulcerative colitis(UC)are the 2 main types of IBD.IBD is prone to recurrent attacks,which is associated with many factors,such as immune dysfunction,intestinal microenvironment homeostasis imbalance,and environmental and genetic factors;however,its specific pathogenesis is still unclear.Zebrafish has recently emerged as an emerging animal model and have been used extensively for mechanistic research into IBD,model construction,activity evaluation,and screening of anti-IBD agents,due to their unique biological advantages.Based on the latest research progress using zebrafish in the field of IBD,this review systematically introduces the intestinal development characteristics,tissue structure,intestinal immunity,IBD model,and the application of drug screening in zebrafish,to demonstrate the value of zebrafish in the study of IBD.

Objective To explore the risk factors for futile recanalization after mechanical throm-bectomy for acute large vessel occlusion(LVO)in elderly patients with atrial fibrillation(AF),and construct a prediction model.Methods A total of 146 elderly AF patients who undergoing mechanical thrombectomy due to LVO and achieved successful recanalization(modified thromb-olysis in cerebral infarction,mTICI≥2b)in our hospital from January 2018 to July 2023 were consecutively recruited in this retrospective analysis.According to the 90-day clinical outcome,they were divided into a futile recanalization group(79 cases)and an effective recanalization group(67 cases).The general clinical data were compared between the two groups.Multivariate logistic regression analysis was performed to identify the risk factors for futile recanalization,and based the factors,a nomogram for the prediction was drawn.ROC curve and calibration curve analyses were applied to evaluate the reliability of the prediction model,and decision curve analysis was conducted to assess the clinical application value.Results Multivariate logistic regression analysis identified that baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombec-tomy≥3 attempts were independent risk factors for futile recanalization(OR=1.395,95％CI:1.174-1.658,P=0.000;OR=1.001,95％CI:1.000-1.001,P=0.003;OR=8.024,95％CI:2.554-25.204,P=0.000;OR=5.056,95％CI:1.778-14.375,P=0.002).The AUC value of the prediction model was 0.868(95％CI:0.808-0.929).Calibration curve analysis showed that the model obtained consistent predicted probability with actual probability,and decision curve analy-sis indicated that the model had good clinical benefit.Conclusion Baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombectomy≥3 attempts are independent risk factors for futile recanalization after mechanical thrombectomy in elderly AF patients.Our prediction model has good predictive performance and prediction accuracy,but its application still needs prospective research and external verification.

Inflammatory bowel disease(IBD)is a non-specific chronic inflammatory bowel condition.Crohn's disease(CD)and ulcerative colitis(UC)are the 2 main types of IBD.IBD is prone to recurrent attacks,which is associated with many factors,such as immune dysfunction,intestinal microenvironment homeostasis imbalance,and environmental and genetic factors;however,its specific pathogenesis is still unclear.Zebrafish has recently emerged as an emerging animal model and have been used extensively for mechanistic research into IBD,model construction,activity evaluation,and screening of anti-IBD agents,due to their unique biological advantages.Based on the latest research progress using zebrafish in the field of IBD,this review systematically introduces the intestinal development characteristics,tissue structure,intestinal immunity,IBD model,and the application of drug screening in zebrafish,to demonstrate the value of zebrafish in the study of IBD.

Objective To explore the risk factors for futile recanalization after mechanical throm-bectomy for acute large vessel occlusion(LVO)in elderly patients with atrial fibrillation(AF),and construct a prediction model.Methods A total of 146 elderly AF patients who undergoing mechanical thrombectomy due to LVO and achieved successful recanalization(modified thromb-olysis in cerebral infarction,mTICI≥2b)in our hospital from January 2018 to July 2023 were consecutively recruited in this retrospective analysis.According to the 90-day clinical outcome,they were divided into a futile recanalization group(79 cases)and an effective recanalization group(67 cases).The general clinical data were compared between the two groups.Multivariate logistic regression analysis was performed to identify the risk factors for futile recanalization,and based the factors,a nomogram for the prediction was drawn.ROC curve and calibration curve analyses were applied to evaluate the reliability of the prediction model,and decision curve analysis was conducted to assess the clinical application value.Results Multivariate logistic regression analysis identified that baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombec-tomy≥3 attempts were independent risk factors for futile recanalization(OR=1.395,95％CI:1.174-1.658,P=0.000;OR=1.001,95％CI:1.000-1.001,P=0.003;OR=8.024,95％CI:2.554-25.204,P=0.000;OR=5.056,95％CI:1.778-14.375,P=0.002).The AUC value of the prediction model was 0.868(95％CI:0.808-0.929).Calibration curve analysis showed that the model obtained consistent predicted probability with actual probability,and decision curve analy-sis indicated that the model had good clinical benefit.Conclusion Baseline blood glucose,NT-proBNP,internal carotid artery occlusion,and thrombectomy≥3 attempts are independent risk factors for futile recanalization after mechanical thrombectomy in elderly AF patients.Our prediction model has good predictive performance and prediction accuracy,but its application still needs prospective research and external verification.

Objective:To explore the predictive value of serum fibroblast growth factor-21 (FGF-21), insulin-like growth factor-1 (IGF-1), and serum ferritin (SF) for maternal and infant outcomes in patients with pregnancy complicated by hypothyroidism.Methods:A total of 246 patients with pregnancy complicated by hypothyroidism who underwent prenatal examination at the Ankang Central Hospital from January 2021 to September 2024 were retrospectively selected as the observation group. Meanwhile, 100 healthy pregnant women who received prenatal examination in the hospital during the same period were enrolled as the control group. According to the maternal and infant outcomes, the observation group was divided into the adverse maternal and infant outcome group ( n=55) and the favorable maternal and infant outcome group ( n=191). Baseline data were compared among groups. Pearson correlation analysis was used to evaluate the correlations between FGF-21, IGF-1, SF and thyroid hormone levels. Univariate and multivariate analyses were applied to screen the influencing factors of maternal and infant outcomes in patients with pregnancy complicated by hypothyroidism. Receiver operating characteristic (ROC) curve was drawn to assess the predictive value of FGF-21, IGF-1, and SF for adverse maternal and infant outcomes in these patients. Results:The serum levels of FGF-21 and thyroid-stimulating hormone (TSH) in the observation group were higher than those in the control group (all P<0.05), while the levels of IGF-1, SF, free thyroxine (FT4), and free triiodothyronine (FT3) were lower (all P<0.05). Pearson correlation analysis showed that in patients with pregnancy complicated by hypothyroidism, FGF-21 was positively correlated with TSH and negatively correlated with FT4 and FT3 (all P<0.05); IGF-1 and SF were negatively correlated with TSH and positively correlated with FT4 and FT3 (all P<0.05). Univariate analysis indicated that FGF-21, IGF-1, SF, TSH, and FT4 were related to maternal and infant outcomes in patients with pregnancy complicated by hypothyroidism (all P<0.05). Multivariate logistic regression analysis revealed that FGF-21 was an independent risk factor for adverse maternal and infant outcomes, while IGF-1 and SF were protective factors (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum FGF-21, IGF-1, and SF alone for predicting adverse maternal and infant outcomes were 0.811, 0.738, and 0.837, with sensitivities of 84.1%, 81.3%, and 76.6%, respectively—all lower than the AUC (0.876) and sensitivity (93.5%) of combined prediction, with statistically significant differences (all P<0.05). Conclusions:FGF-21, IGF-1, and SF are independent influencing factors for maternal and infant outcomes in patients with pregnancy complicated by hypothyroidism, and have good predictive value for adverse maternal and infant outcomes.

Objective:To search, evaluate and summarize the best research evidence of perioperative intestinal management in patients with cervical spinal cord injury, so as to provide evidence-based basis for clinical nursing practice.Methods:Literature on perioperative intestinal management of cervical spinal cord injury were systematically searched in databases, domestic and foreign relevant guidlines network and professional associations, such as UpToDate, Cochrane Library, PubMed, China National Knowledge Infrastructure, Wanfang Database, etc. The search period was from the establishment of the databases to October 1, 2023. The quality of the included literature was evaluated and the evidence was extracted and summarized.Results:Finally, 9 articles were included, including 2 guidelines, 2 expert consensuses, 1 randomized controlled trials, and 4 observational studies. Twenty-five pieces of evidence were summarized across six aspects: assessment, diet management, physical activity, physical therapy, drug therapy, prevention and management of intestinal complications.Conclusions:The best evidence of perioperative intestinal management in patients with cervical spinal cord injury summarized in this study can provide reference for clinical nursing practice.

Objective:To investigate the risk factors and predictive value of early neurological deterioration (END) in patients with minor stroke caused by middle cerebral artery occlusion.Methods:Consecutive patients with minor stroke caused by middle cerebral artery occlusion admitted to Zhangjiagang Hospital Affiliated to Soochow University from October 2021 to May 2023 were retrospectively included. Minor stroke was defined as the National Institutes of Health Stroke Scale (NIHSS) score ≤5 at admission, and END was defined as an increase of ≥4 from baseline in the NIHSS score within 24 h of admission (excluding intracranial hemorrhage). Multivariate logistic regression analysis was used to determine independent risk factors for END. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of various risk factors on END. Results:A total of 130 patients with minor stroke caused by middle cerebral artery occlusion were included, of which 33 (25.4%) had END and 97 (74.6%) did not. Univariate analysis showed that there were statistically significant differences in NIHSS scores, volume with cerebral blood flow <30%, CT perfusion mismatch volume, baseline blood glucose, and baseline white blood cell count between the END and non-END groups (all P<0.05). Multivariate logistic regression analysis showed that CT perfusion mismatch volume (odds ratio [ OR] 1.010, 95% confidence interval [ CI] 1.003-1.017; P=0.007) and baseline white blood cell count ( OR 1.582, 95% CI 1.200-2.085; P=0.001) were the independent risk factors for END. ROC curve analysis showed that the area under the curves of CT perfusion mismatch volume and baseline white blood cell count for predicting END were 0.748 (95% CI 0.660-0.835; P<0.001) and 0.757 (95% CI 0.659-0.854; P<0.001), respectively. The area under the curve of combined predicting END was 0.821 (95% CI 0.738-0.905; P<0.001). Conclusions:CT perfusion mismatch volume and baseline white blood cell count are independent risk factors for the occurrence of END patients with minor stroke caused by middle cerebral artery occlusion, and the combination of the two has good predictive value for END.

Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.