Objective:To analyze the application value of ultrasound Thyroid Imaging Reporting and Data System (TI-RADS) classification in the differential diagnosis of thyroid nodules and its correlation with patients' midkine, thymidine kinase 1, and thyroid function indicators.Methods:This study was a prospective study. A total of 108 patients with thyroid nodules (120 nodules) who visited Jinan 2 nd People's Hospital from December 2022 to February 2024 were included. Ultrasound examinations were conducted to complete the TI-RADS classification, and serum levels of midkine (MK) and thymidine kinase 1 (TK1), as well as thyroid function indicators, were measured. Based on the patients' pathological results, the consistency between the TI-RADS diagnostic results and the pathological findings was analyzed. The diagnostic efficacy of TI-RADS classification was calculated. The incidence of malignant nodules across various TI-RADS categories was assessed, and the differences in serum levels of MK, TK1, and thyroid function indicators between patients with benign and malignant nodules were compared. Additionally, a correlation analysis was performed to analyze the correlation between the TI-RADS classification of thyroid nodules and the serum levels of MK, TK1, and thyroid function indicators. Results:Pathological examination results revealed 38 malignant nodules and 82 benign nodules. The consistency between ultrasound TI-RADS classification diagnoses and pathological results was good ( Kappa = 0.90, P < 0.001), with diagnostic sensitivity, specificity, and accuracy of 86.84% (33/38), 97.56% (80/82), and 94.17% (113/120), respectively. Among the ultrasound TI-RADS classifications, the malignant rates for category Ⅳb and category Ⅴ thyroid nodules were the highest, at 92.00% (23/25) and 100.00% (10/10), respectively. Serum levels of MK, TK1, and thyroid-stimulating hormone (TSH) were significantly higher in patients with malignant thyroid nodules than in those with benign thyroid nodules (all P < 0.05). Correlation analysis indicated that TI-RADS classification was positively correlated with serum levels of MK, TK1, and TSH ( r = 0.56, 0.60, 0.52, all P < 0.05). Conclusions:Ultrasound TI-RADS classification can be used to differentiate the nature of thyroid nodules, demonstrating high accuracy with low risks of missed or misdiagnoses. It is also closely related to indicators such as MK, TK1, and TSH, providing a basis for the detection of thyroid cancer.

Objective To explore the characteristics and influencing factors of complicated intra-abdominal infection in ICU patients after abdominal surgery.Methods A retrospective study was performed on ICU patients(n=92,observation group)developing complicated intra-abdominal infection after abdominal surgery versus patients(n=104,control group)without complicated intra-abdominal infection after abdominal surgery in our hospital from January 2020 to December 2023.The characteristics of patients who developed complicated intra-abdominal infections were analyzed and the relevant influencing factors were identified using multivariate Logistic regression analysis.Results A total of 124 strains of pathogenic bacteria were isolated and identified in 92 infected patients,with 64.52％(80/124)of Gram-negative strains comprising mainly 29.03％(36/124)of Escherichia coli,25.81％(32/124)of Gram-positive strains comprising mainly 12.90％(16/124)of Enterococcus faecalis,and 9.68％(12/124)of fungi comprising mainly 6.45％(8/124)of Candida albicans.Multivariate Logistic regression results showed that preoperative underlying disease,surgical methods,duration of surgery,invasive procedures,antibiotic use,and length of ICU stay,enteral nutrition were the influencing factors of complicated intra-abdominal infection in ICU patients after abdominal surgery(P＜0.0 5).Conclusion Patients with complicated intra-abdominal infection are infected with a variety of pathogenic bacteria,predominantly Gram-negative.The patient's preoperative underlying disease,surgical approach,duration of surgery,invasive procedures,use of antibiotics,length of ICU stay,and early enteral nutrition all affect the risk of complicated intra-abdominal infection in ICU patients after abdominal surgery.

AIM To explore the clinical effects of Tongfu Jiangzhuo Formula on ICU delirium patients with Internal Accumulation of Turbid Toxins.METHODS Based on Turbid Toxins theory,two hundred and ten patients were randomly assigned into control group(105 cases)for intervention of conventional treatment,and observation group(105 cases)for intervention of both Tongfu Jiangzhuo Formula and conventional treatment.The changes in clinical effects,delirium scores(CAM-ICU,ICDSC),TCM syndrome score,inflammatory factors(IL-1β,IL-6,IL-8),Raf-1,MEK-2,ERK-1 mRNA and incidence of adverse reactions were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P＜0.05).After the treatment,the two groups displayed decreased delirium scores,TCM syndrome score,inflammatory factors and Raf-1,MEK-2,ERK-1 mRNA(P＜0.05),especially for the observation group(P＜0.05).No significant difference in incidence of adverse reactions was found between the two groups(P＞0.05).CONCLUSION For the patients with ICU delirium due to Internal Accumulation of Turbid Toxins,Tongfu Jiangzhuo Formula can safely and effectively improve symptoms,and reduce inflammation levels and Raf-1,MEK-2,ERK-1 mRNA expressions.

Objective To explore the characteristics and influencing factors of complicated intra-abdominal infection in ICU patients after abdominal surgery.Methods A retrospective study was performed on ICU patients(n=92,observation group)developing complicated intra-abdominal infection after abdominal surgery versus patients(n=104,control group)without complicated intra-abdominal infection after abdominal surgery in our hospital from January 2020 to December 2023.The characteristics of patients who developed complicated intra-abdominal infections were analyzed and the relevant influencing factors were identified using multivariate Logistic regression analysis.Results A total of 124 strains of pathogenic bacteria were isolated and identified in 92 infected patients,with 64.52％(80/124)of Gram-negative strains comprising mainly 29.03％(36/124)of Escherichia coli,25.81％(32/124)of Gram-positive strains comprising mainly 12.90％(16/124)of Enterococcus faecalis,and 9.68％(12/124)of fungi comprising mainly 6.45％(8/124)of Candida albicans.Multivariate Logistic regression results showed that preoperative underlying disease,surgical methods,duration of surgery,invasive procedures,antibiotic use,and length of ICU stay,enteral nutrition were the influencing factors of complicated intra-abdominal infection in ICU patients after abdominal surgery(P＜0.0 5).Conclusion Patients with complicated intra-abdominal infection are infected with a variety of pathogenic bacteria,predominantly Gram-negative.The patient's preoperative underlying disease,surgical approach,duration of surgery,invasive procedures,use of antibiotics,length of ICU stay,and early enteral nutrition all affect the risk of complicated intra-abdominal infection in ICU patients after abdominal surgery.

Objective:To investigate the expression of LINC01088 in breast cancer and its effects on cell prolifera-tion,migration,and invasion.Methods:GEPIA and bc-GenExMiner were used to analyze the correlation between LINC01088 expression levels and clinical characteristics as well as prognosis.The expression of LINC01088 in MCF10A and MDA-MB-231,BT-549,MCF7 were detected by Real-time PCR.The effect of LINC01088 on the biological func-tion of breast cancer cells was examined by overexpressing LINC01088 in breast cancer cells.Cell proliferation was as-sessed using the Incucyte assay,while cell migration and invasion were evaluated using Transwell assays.Western blot-ting was employed to detect the expression of proteins associated with cell proliferation and metastasis.Results:LINC01088 expression was significantly lower in breast cancer tissues compared to normal breast tissues(P<0.05).Data from the bc-GenExMiner database revealed higher LINC01088 expression in HER2 positive patients(P<0.0001),corre-lating with longer overall survival(P=0.0006)and disease-free survival(P=0.0002).The mRNA expression level of LINC01088 in normal breast epithelial cell line was higher than that in breast cancer cell lines(P<0.05).Overexpression of LINC01088 significantly reduced proliferation,migration,and invasion in three breast cancer cell lines(P<0.01).Addi-tionally,LINC01088 upregulated p21 and p27(P<0.01),while downregulating Snail,Slug,PI3K,and phosphorylated Akt(P<0.05).Conclusion:LINC01088 expression was significantly reduced in human breast cancer.In vitro,LINC01088 in-hibited the proliferation,migration,and invasion of breast cancer cells.This effect may be attributed to its role in sup-pressing the PI3K-AKT pathway and epithelial-mesenchymal transition.

Objective:To explore the experience of emotion management and program needs of patients with vasovagal syncope (VVS) from the doctor-nurse-patient perspective.Methods:This study was a phenomenological study in qualitative research. Using purposive sampling method, four medical specialists, four nursing specialists, and 10 patients with VVS from the Syncope Center of Shanghai East Hospital, Tongji University were selected from March to May 2024 for semi-structured interviews. Colaizzi's phenomenological data analysis was used to analyze the data.Results:Theme 1 was the initial perception and experience of emotion management, in which the doctor-nurse perspective included two sub-themes of emotion management met the actual needs of clinical patients and the management program was too specialized and unknown, and the patient perspective included three sub-themes of differences in the ability of individuals to recognize their own emotional state, lack of knowledge related to emotion management, and lack of social support. Theme 2 was the need for emotion management programs, in which the doctor-nurse perspective involved two sub-themes of multidisciplinary cooperation, suitable for clinical operation and follow-up, and the combination of online and offline, and in-hospital and out-of-hospital linkage, and the patient perspective involved two sub-themes of the need for healthcare guidance, easy to operate, and the diversification of forms, personalization, and meeting the needs of different populations.Conclusions:The content of emotion management is relatively unknown to doctors, nurses and patients, and even more so to patients. VVS emotion management work is still in its infancy, and emotion management as a branch of rehabilitation needs to be emphasized for its development, and psychological assessment and intervention work should be incorporated into the routine of syncope rehabilitation.

This study assessed the role and mechanism of the recombinant Bacillus Calmette-Gue?rin vaccine(rBCG)with c-di-AMP adjuvant in regulating metabolism and immunity in epididymal white adipose(eWAT)in mice.Male C57BL/6 mice were intravenously immunized with BCG and rBCG,and their body weights were monitored.eWAT was isolated from the mice,and the stromal vascular fractions(SVFs)cell number was counted with a hemocytometer.Sections of mouse adipose tissue were prepared,and the size,number,and morphology of eWAT adipocytes and crown-like structure(CLS)formation were compared under a microscope after HE staining.The transcription levels of lipid metabolism-associated factors,cytokines and aging-associated genes in each group were determined with qRT-PCR.The body weights of mice gradually increased after immunization with BCG and rBCG.The proportions of eWAT increased,and the SVFs cell number decreased,in rBCG immunized mice.HE staining indicated that BCG immunization promoted hyperplasia,whereas rBCG immunization promoted hypertrophy of eWAT adipocytes;moreover,both BCG and rBCG immunization induced CLS formation in eWAT.The qRT-PCR results indicated that rBCG immunization inhibited the expression of genes associated with lipolysis and energy expenditure in eWAT.BCG immunization had little effect on cytokine transcription,whereas rBCG significantly induced the transcription of IFN-γ and IL-1Ra,and inhibited that of IL-15 and IL-2,but did not induce the expression of aging-associated genes.Thus,rBCG immunization induced eWAT adipocyte hypertrophy,which was associated with the inhibition of eWAT lipolysis and the regulation of cytokine expression.

Alzheimer's disease (AD) is the most prevalent neurodegenerative disorder worldwide, causing dementia and affecting millions of individuals. One prominent characteristic in the brains of AD patients is glucose hypometabolism. In the context of galactose metabolism, intracellular glucose levels are heightened. Galactose mutarotase (GALM) plays a crucial role in maintaining normal galactose metabolism by catalyzing the conversion of β-D-galactose into α-D-galactose (α-D-G). The latter is then converted into glucose-6-phosphate, improving glucose metabolism levels. However, the involvement of GALM in AD progression is still unclear. In the present study, we found that the expression of GALM was significantly increased in AD patients and model mice. Genetic knockdown of GALM using adeno-associated virus did not change the expression of amyloid precursor protein (APP) and APP-cleaving enzymes including a disintegrin and metalloprotease 10 (ADAM10), β-site APP-cleaving enzyme 1 (BACE1), and presenilin-1 (PS1). Interestingly, genetic overexpression of GALM reduced APP and Aβ deposition by increasing the maturation of ADAM10, although it did not alter the expression of BACE1 and PS1. Further electrophysiological and behavioral experiments showed that GALM overexpression significantly ameliorated the deficits in hippocampal CA1 long-term potentiation (LTP) and spatial learning and memory in AD model mice. Importantly, direct α-D-G (20 mg/kg, i.p.) also inhibited Aβ deposition by increasing the maturation of ADAM10, thereby improving hippocampal CA1 LTP and spatial learning and memory in AD model mice. Taken together, our results indicate that GALM shifts APP processing towards α-cleavage, preventing Aβ generation by increasing the level of mature ADAM10. These findings indicate that GALM may be a potential therapeutic target for AD, and α-D-G has the potential to be used as a dietary supplement for the prevention and treatment of AD.
Animals ; ADAM10 Protein/metabolism* ; Alzheimer Disease/pathology* ; Amyloid Precursor Protein Secretases/metabolism* ; Disease Models, Animal ; Humans ; Mice ; Amyloid beta-Peptides/metabolism* ; Male ; Mice, Transgenic ; Membrane Proteins/metabolism* ; Cognitive Dysfunction/pathology* ; Mice, Inbred C57BL ; Amyloid beta-Protein Precursor/metabolism* ; Female ; Hippocampus/metabolism* ; Long-Term Potentiation/physiology*

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This study aims to systematically characterize the targeted effects of Quanduzhong Capsules on cartilage lesions in knee osteoarthritis by integrating spatial transcriptomics data mining and animal experiments validation, thereby elucidating the related molecular mechanisms. A knee osteoarthritis model was established using Sprague-Dawley(SD) rats, via a modified Hulth method. Hematoxylin and eosin(HE) staining was employed to detect knee osteoarthritis-associated pathological changes in knee cartilage. Candidate targets of Quanduzhong Capsules were collected from the HIT 2.0 database, followed by bioinformatics analysis of spatial transcriptomics datasets(GSE254844) from cartilage tissues in clinical knee osteoarthritis patients to identify spatially specific disease genes. Furthermore, a "formula candidate targets-spatially specific genes in cartilage lesions" interaction network was constructed to explore the effects and major mechanisms of Quanduzhong Capsules in distinct cartilage regions. Experimental validation was conducted through immunohistochemistry using animal-derived biospecimens. The results indicated that Quanduzhong Capsules effectively inhibited the degenerative changes in the cartilage of affected joints in rats, which was associated with the regulation of Quanduzhong Capsules on the thioredoxin-interacting protein(TXNIP)-NOD-like receptor family pyrin domain containing 3(NLRP3)-bone morphogenetic protein receptor type 2(BMPR2)-fibronectin 1(FN1)-matrix metallopeptidase 2(MMP2) signal axis in the articular cartilage surface and superficial zones, subsequently inhibiting cartilage matrix degradation leading to oxidative stress and inflammatory diffusion. In summary, this study clarifies the spatially specific targeted effects and protective mechanisms of Quanduzhong Capsules within pathological cartilage regions in knee osteoarthritis, providing theoretical and experimental support for the clinical application of this drug in the targeted therapy on the inflamed cartilage.
Animals ; Osteoarthritis, Knee/metabolism* ; Drugs, Chinese Herbal/administration & dosage* ; Rats, Sprague-Dawley ; Rats ; Male ; Humans ; Capsules ; Female ; Disease Models, Animal